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An Obamacare Report Card

After a rough rollout, we’ll look at who is and who is not signing up for the Affordable Care Act.

House Minority Leader Nancy Pelosi of Calif. meets with reporters on Capitol Hill in Washington, Thursday, Jan. 9, 2014. The top Democrat in the Republican-controlled House focused on the Affordable Care Act and the fight to pass immigration reform. (AP)

House Minority Leader Nancy Pelosi of Calif. meets with reporters on Capitol Hill in Washington, Thursday, Jan. 9, 2014. The top Democrat in the Republican-controlled House focused on the Affordable Care Act and the fight to pass immigration reform. (AP)

After a botched rollout, the Obamacare marketplace is open for business. Celebrities and NBA All-Stars are doing a full-court press to encourage young people to sign up.  So far, those numbers are worrying. Also worrying, is what’s happening in states that didn’t expand Medicaid. Plenty of folks—mostly the poor–are still without any coverage.  Add to the mix, political pushback, and it’s still an uncertain road ahead for the Affordable Care Act.  Two healthcare reporters  are with us to unpack the latest news and answer your questions.   This hour, On Point: a report card on Obamacare.

Guests

Jenny Gold, healthcare reporter for Kaiser Health News. (@JennyAGold).

Dan Mangan, CNBC health care reporter. (@_DanMangan)

Carl Gibson, journalist and activist. Founder of U.S. Uncut. Wrote a piece in December called ‘Why I’m Choosing to Pay $300 to Stay Uninsured.” (@uncutcg)

From The Reading List

CNBC: Employers face tax hit in states with no Medicaid expansion — “The decision by 25 states not to expand Medicaid coverage under Obamacare could cost some employers more than $1.5 billion in new taxes starting next year, a new analysis reveals. That tax hit might come as a shock to many of those businesses unaware of their exposure to the penalty—which will kick in if their employer-offered health plan is deemed too expensive and workers then buy private, subsidized Obamacare insurance.”

Wall Street Journal: Target Cuts Health Coverage for Part-Time Workers — “Target will stop covering part-time employees on April 1, the company said in a corporate blog post quoting human resources chief Jodee Kozlak. Less than 10% of Target’s roughly 360,000 employees take part in the plan being discontinued. Those employees will be given $500 due to the coverage being ended.”

MarketWatch: California’s Obamacare program is close to meeting enrollment goal — “California has, by far, exceeded any other state in the union for Obamacare signups. Figures released last week from the Department of Health and Human Services showed California accounted for roughly one-fourth of all enrollment in the nation during the last three months of the year. The state also got 584,000 applicants into Medi-Cal programs, bringing its total enlistment figure to more than 1 million for the October-December period.”

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  • Fiscally_Responsible

    Honest assessments of not only the number enrolling, but the demographics (invincibles vs. those with higher medical needs), the security concerns of entering personal information into the system through the website, the verification of taxable income that drives the federal subsidy, the true cost including not just premiums but much higher out of pocket maximums for the average person, etc. would be appreciated. Finally, a frank discussion of the politics being played when implementation of Obamacare for certain groups such as large employers, unions, etc. until after the next election would be welcome.

    • northeaster17

      Lets just say that all that you have noted above is true. What exactly has the conservative party offered to fix the problems with our healthcare system that the ACA has been attempting to fix. The party of no needs to put up or shut up.

      • pete18

        That is of course a false choice. No matter what ideas conservatives may or may not have offered in contrast, Obamacare, measured on its own terms, is a complete failure and far worse than the flawed system that preceded it. One must be honest in evaluating the current law and it’s problems before anything can be fixed.

        However, in actuality, the right has been offering alternatives for years and the left has ignored or
        dismissed those plans.

        The only place that I can find any agreement with you is that in moving forward, Republicans will have to present and talk about what replaces Obamacare. Getting rid of it is a good first step but it is not enough.

        • TyroneJ

          “…and far worse than the flawed system that preceded it”

          The system that proceeded it was nothing except uncovered people going to the ER, not paying for care, and me paying for their care via higher premiums.

          The real problem is Obamacare was modeled on Massachusetts system and contains the same structural flaw.

          In both systems, the penalty for not getting health insurance is a fine set to be 50% of the cost of the cheapest qualifying premium. So people just pay the fine. Since you can sign up for healthcare online instantly, and previous conditions must be covered, when people paying the fine need surgery or whatever, they sign up & pay the few hundred dollars for the first months premium costs, have the work done (costing the systems many thousands of dollars), then cancel the insurance once the surgery has been done and go back to paying the fine. If you, as a small business owner, talk to any Massachusetts health care provider, they will tell you that people doing what I described above is a major cost driver in the State, and soon will be Nationwide.

          The State of Massachusetts claims that 97% of people in Massachusetts have health insurance, but they get that number by counting someone with 1 month coverage per year the same as someone with 12 months coverage. If they were to do the counting honestly on a prorated basis, so a person with only 1 month coverage per year counted 1/12th as much as someone with 12 months coverage, this scam would be much more visible.

          • HonestDebate1

            And now premiums are even higher and the ER’s are just as crowded as ever.

          • hennorama

            TyroneJ – you wrote:

            “…you can sign up for healthcare online instantly, and previous conditions must be covered, when people paying the fine need surgery or whatever, they sign up & pay the few hundred dollars for the first months premium costs, have the work done (costing the systems many thousands of dollars), then cancel the insurance once the surgery has been done and go back to paying the fine.”

            This is not accurate.

            People can only sign up for policies inside the health insurance exchanges during open enrollment periods. When the initial open enrollment period for individuals ends on March 31, 2014, future open enrollment periods will be the same as those for Medicare, running from October 15 to December 7 each year. If you miss signing up for coverage before March 31, 2014, you’ll have to wait until the fall to buy a health plan. There are some exceptions, but most people will be out of luck until next year.

            You also fail to mention that:

            -private health insurance plans, both inside and outside of the exchanges, still have waiting periods before coverage begins.

            -insurers account for human behavior. The example of someone waiting until they “need surgery or whatever” is analogous to someone who has driven only used cars for decades, then purchases a new car, pays for full coverage, then gets into an accident the same day. Insurers account for these events. Waiting periods and restricted enrollment periods help discourage this behavior.

        • margbi

          Forgive me but I thought the ACA was based on the Massachusetts Health Care Act passed under Gov. Romney, who, the last I heard was a Republican. At least, many of the features are the same. Just what, if anything, does the opposition to Obamacare plan to propose as a substitute?

          • pete18

            He did, and he was but that plan wasn’t supported by most conservatives. See my post above for George Bush’s plan, which was one of many, more market driven proposals, presented by Republicans over the last 7-years.

        • northeaster17

          Actually in those states that have taken the federal medicade funding it is not seen as a failure. As far as getting rid of the ACA, again, what does the conservative party propose? This has been years in the making. With opportunities galore to have serious input. Consistantly missing from the table has been the right. We are not going back to the days of yore. Solutions are necessary, not rhetoric. I think eventually we will see a single payer system. It’s been proven to be more cost effective than what we are doing now.

          • pete18

            Are you kidding? None of the input by Republicans was ever considered by democrats during the debates leading up to the law, this was a one-party ram through. You can opine all you want about not liking Republican ideas but you cannot pretend they didn’t propose health plan alternatives. It just isn’t true. Even George Bush had proposed one in his second term that would have been far more effective than Obamacare. His plan was declared “dead on arrival” by the democrats in congress in 2007. Party of “no” anyone?

            http://www.forbes.com/sites/theapothecary/2012/04/30/how-george-w-bush-would-have-replaced-obamacare/

          • Ray in VT

            Considering that the plan was going to in part pay for tax credits for people on the individual market by taxing some people’s employer based health care benefits how much support do you think that such a plan would have gotten, and how would such a plan have dealt with people with preexisting conditions? It isn’t correct to say that the GOP has offered nothing, although the current House took quite a long time in rolling out something, but it is largely the same sort of tort reform and stuff that they’ve pushed for years that doesn’t really do anything to address issues such as preexisting conditions or insurance companies charging vastly different rates for people that end up pricing people out of the market as they age or after they get sick.

          • pete18

            Actually, there have been many ideas about addressing preexisting conditions and affordability, but even if there weren’t Obama care has not solved these problems. It has made costs more expensive and they will continue to go up, there is no “cost curve bending” or $2,500 savings for the average family. It also seems very unlikely that the group of uninsured americans that the whole law was aimed at will be any more covered when everything shakes out. It’s a bad law, the previous system, as bad as it was, was better.

          • northeaster17

            The Repubs had the congress from 2000 to 2006. I remember during that time President Bush refering to the availability of the emergency room for those uninsured. Great idea,right? As far as input not being considered, how about those many many many votes by the current house to abolish the ACA. Who is kidding who?

          • pete18

            I see you are trying hard to avoid my point and the facts.

      • John Cedar

        Under republican governor Pataki, NYS devised and implemented Child Health Plus and Family Health Plus insurance, to make coverage affordable for lower income families and individuals. He also made insurance companies cover preexisting conditions, but kept a short grace period in place as a flood gate. The Great RR gave us socialized ERs by forbidding them from turning away patients. And GWB gave us part “D” to cover prescriptions.

        So I guess the two things missing is that the republicans didn’t put all the control in Washington’s/Obama’s hands to unilaterally decide if/ when/how to implement the law. And they did not give free no copay birth control to ivy league perpetual college students. And they did fine people for not buying insurance.

        • northeaster17

          I currently use child health plus. Like VT’s old Dr Dinosuar Program, it works. But if one looks around the country it is obvious that way to many are not helped. Especially adults who are not employed by the right people.

      • John Cedar

        The republicans also suggested tort reform for medical malpractice awards, which uber librul California had no problem implementing, but extremist democrats in Washington, lead by an extremist left wing president, would not even consider.

        They also suggested allowing insurance companies to sell across state lines. I do know that back when I had 20 insurance companies to choose from, the prices were astronomically smaller than they were once I was limited to four choices. Oligopolies are not efficient..

        • northeaster17

          Tort reform is puny in the face of healthcare expenses. Even in the face of todays legal expenses, many who could sue do not. That’s common knowledge in insurance circles. Selling insurance over state lines would require more federal involvement to keep insurers honest by having to insure they have the cash on hand to cover claims. See Baldwin Piano and their issues. A problem from the days of little regulation. Single payer, not oligopolies, has proven more efficent in many industrialized countries. We need to get over the ideological problems.

          • John Cedar

            It doesn’t matter that you are wrong, I still answered your question.
            The 50 billion that the CBO says we would save with tort reform is certainly not puny compared the the trillion EXTRA that Obamacare costs us by “attempting to solve” the problems. So added together, the republicans save one trillion, fifty billion, by enacting tort reform while blocking Obamacare

            Every state in the republic already regulates insurance. You could always choose not to buy from a red state like Texas if you think they are too backwards to regulate theirs.

      • HonestDebate1

        Any of the numerous proposals by Republicans and even Democrats would have been better than Obamacare. But now it’s here and it’s totally unworkable on many levels. There is no fix and all Obama has done is unlawfully delay several aspects until after the midterms. Why didn’t he fix them instead?

  • JGC

    The WSJ had reported that the number of doctors opting out of Medicare was 3,700 in 2009 increasing to 9,500 in 2012. However offsetting that, according to a HHS report, was an increase in the the number of doctors billing for services from 925,000 in 2007 to 1.25-million doctors in 2011. There are more doctors coming into the government healthcare system than leaving it.

  • Ed75

    The people signing up are exactly the people who lost their insurance coverage thanks to the ACA.

    • keltcrusader

      isn’t lying against the tenets of your religion?

      • Ed75

        Well, I really don’t know, but it sounded good. In any case, I think they will lost in the Supreme Court this spring on their attack on religious freedom and requiring religious institutions to provide things against their conscience.

        • 1Brett1

          Translation: “I said one thing to begin with, but I was talking out of my ass. What I really wanted was for someone to reply so I could throw in what I really wanted to say.”

        • keltcrusader

          sooo… you made up something entirely out of whole cloth and presented it as a fact and we are supposed to trust your other posts because…….why exactly?? Your conscience is supposed to keep you from lying to others too.

          • Ed75

            Well, I was really being truthful: people who lost their insurance have no place else to go, so they are applying for O-care. There are others, but so far they say only 11% of applicants were people who didn’t have insurance before.

      • Ed75

        But the ACA is the largest expansion of abortion since Roe, using tax payer money, etc., so I hope (and trust) it will be a disaster.

        • http://neilblanchard.blogspot.com/ Neil Blanchard

          There were abortions before Roe v Wade – that ruling made them legal. Abortion is legal, and it is sometimes required, and it should remain a personal and/r a medical choice.

          • Ed75

            There are robberies – should we make robbery legal? Before Roe, as Bernard Nathansan said, they took the figures of numbers of abortions out of thin air, expanded them greatly.

          • http://neilblanchard.blogspot.com/ Neil Blanchard

            Strawman alert …

          • Ray in VT

            It’s hard to measure what’s being done in back alley clinics and at home with coat hangers. Outlawing abortion again will only drive desperate women back to those places, and more women will die.

            What is your evidence that the ACA is expanding abortion? Long term the number of abortions and the rate has been in decline for quite some time.

          • Ed75

            The abortion rate has decreased a little but it’s leveled off. During the march they counted the abortion done (on average) during the march, it was around 1000.
            From the studies I’ve heard (sorry, can’t cite source), when laws restrict abortion is some way (waiting period, etc.), the number of abortions decreases. On the other hand, when access is made easier, the number of abortions increases. The ACA makes it so everyone’s insurance plan has to cover abortion. (One wonders if the purpose of the AVA was to get healthcare to the uninsured or to promote abortion and to be a windfall for Planned P.)
            Planned P. will be given tax money, (they already get money 1 million dollars a day from the government) to build clinics. And the ACA makes abortion part of healthcare, so it is more difficult to protest it, etc.

          • anamaria23

            Contraception can prevent abortion. Are you against that as is your church?
            Do you ever consider the role of the male in the abortion rate? Has the Catholic Church EVER once called for male responsibility? Just that the female bear the child and deal with it while the male is invisible often long gone?

          • Ed75

            Contraception is a misleading thing. Statistics show that where contraception is used, there are more abortions, which is surprising. The reason seems to be that contraception already separates sex from giving life. So, when an undesired pregnancy wasn’t stopped by contraception, couples turn to abortion. The natural family planning attitude is open-ness to ilfe, even if the couple is using NFP to avoid pregnancy. Pope Paul described this years ago in Humanae Vitae, and it has happened.
            The Church does indeed call for male responsibiilty: morally speaking, a man who gets a woman pregnant is responsible to support that women and that child until the child is 18. Men’s guilt is not as visible (as in Jesus with the woman caught in adultery, the man wasn’t present), but it’s real. The pro-life movement is trying to minister to these men, many of whom are suffering from having done this.
            You’re right, there has to be a change to the whole situation, to everyone involved. The Church calls us all to wholesale conversion from the culture of death.

          • keltcrusader

            Doctors were at the forefront of the push to get this medical procedure legalized because they were sick to death of seeing dead and maimed women from botched abortions. I guess the medical privacy and well-being of women means nothing to you. How come I am not surprised.

          • Ed75

            I don’t know that doctors were at the forefront, I’ll have to look into that. Of course Dr. Bernard Nathanson was, but he repented and worked against it the rest of his life. In the late 1800s the AMA said that there was no other point at which to mark the beginning of human life other than conception (obvious) so it seems they would be against it.
            The pro-life people care for women, we feel women deserve better than abortion, and that abortion harms women. We feel that maternity is an important part of a woman’s being, even if not acted on physically, and to destroy a child is a physical, emotional and spiritual disaster for her.

          • keltcrusader

            and that is your personal opinion and religious belief which has absolutely no bearing on our secular country’s laws. You have no right to force your religious beliefs on everyone else and, most definitely, on women who disagree and don’t follow your religion. personal medical matter = none of your business

          • Ed75

            I guess the claim is that the argument against abortion is not a religious law but is based on science and reason. So we bring it to the public square and argue for it. Also, if the unborn child is a human being, it is my concern because he or she is my sister or brother, whom I have to defend if in danger. But our society has turned again and again toward abortion, and now we’re putting it on other countries around the world. It will end somewhere.

          • keltcrusader

            You just can’t keep from lying, even to yourself, can you? Your point of view is based solely on your religious views and you know it. Mind your own business and women will take care of their medical decisions by themselves.

        • keltcrusader

          well there you go lying again, just can’t help yourself?

    • HonestDebate1

      You are absolutely right. What’s else can the millions who have lost their plans do?

      Off topic: were you at the march? It looks like there was quite turnout despite the weather.

      • Ed75

        I couldn’t get free to go, but I watched most of it on EWTN, they vigil Mass, the Mass the next day, very beautiful, the March. They said they had about the same number of people as last year, in spite of the cold, but I haven’t heard numbers yet. No regular media covered it except CSPAN.

      • keltcrusader

        And the other pathological liar chimes in – did you perchance see his response that he made this “fact” up because it sounded good?

        • HonestDebate1

          I don’t think Ed cares much what people think about him. He is never ever uncivil yet takes as much vitriol as anyone including me and that’s a lot. He is correct and my guess is he feels no need to defend himself and is playing you like a fiddle.

          OPC has written a few comments on this with the numbers. Ed is right.

          • keltcrusader

            except it isn’t true

          • HonestDebate1

            So no one signing up for Obamacare lost their plan first?

          • keltcrusader

            can you read?

          • HonestDebate1

            Yes but I don’t understand.

          • keltcrusader

            lol, as usual, I see

    • TFRX

      Another Galt’s Gulcher who lives in a world where insurance policies were never cancelled.

      Why, God, why, are all the people with this crazy ability to believe this crap seemingly on this board?

      • Ed75

        It’s true, the previous insurance situation wasn’t ideal, had serious problems. Costs were going up too fast, we needed to restrain medical costs somehow. But O-Care is, to me, not so much about bringing down costs as it is about a government running of health care, which I am against, and I think it’s a bad solution to a real problem.

        • http://www.findingourdream.blogspot.com Hal Horvath

          I take it then you’d prefer to end all those state laws requiring medical licensing in order to practice medicine from a doctor-run licensing board (such boards are anti-free market of course). I think that would be quite interesting.

          • Ed75

            No, definitely not, regulation but not government run. Still, my main problem with O-care is its support of abortion.

  • Markus6

    Well, if the measure is just more people getting health care, I don’t see how Obamacare can fail in the long run. The government is paying the health care bill for tens of millions of people. I remember hearing on NPR that if a family of 4 made less than $75K, they were candidates for a government subsidy.

    If you’re giving away money, no matter how badly you screw up the technology, add gazillions to the national debt, build up bureaucracy that would make the Department of Motor Vehicles proud, people will move to it.

    Whether it’s a program or a politician, hard to see them failing in the long run when you’re giving away money.

  • Shag_Wevera

    It’s a C-. You cut the insurance companies in on the deal, and that was a fatal flaw. Model ANY of the modern nations that have universal healthcare (Which just happens to be ALL of them).

  • William

    Too big of a power grab when all that was necessary was to open Medicaid up to more people.

    • OnPointComments

      The members of Congress who voted for the Affordable Care Act without reading it should be penalized at least as much as banks were penalized for not reading and robo-signing mortgage documents.

      • William

        Most members of Congress like the idea of another big massive government program and all the hundreds of billions of dollars and tens of thousands of government workers that will come with it.

      • northeaster17

        Lets include the Republicans who never read the Patriot Act

    • TFRX

      Yeah, all the righties woulda been on board with that.

  • OnPointComments

    The photo at the top of this page should include the caption “WHAT’S WRONG WITH THIS PICTURE?”

    • the number of enrollees includes those who lost their insurance because of Obamacare
    • the number of people with insurance under Obamacare who didn’t have insurance before Obamacare may be as low as 11%
    • the number of enrollees includes those who have picked a plan even if they haven’t paid their premiums
    • the number of enrollees includes those who were previously eligible for Medicaid but had never signed up
    • the number of enrollees includes those previously enrolled in Medicaid who renewed their coverage
    • Harry Reid prevented amendments in the discussion of extending unemployment benefits
    • Nancy Pelosi

    • northeaster17

      West Virginia is reporting that since it’s inception the number of uninsured in that state has dropped by about 30%. Not bad for a coule of months.

  • AC

    i don’t think the fine should only be $300. it should be a lot more; and serious penalties if and when they do need healthcare (& a history of how long they chose to go uninsured should be tracked and penalties applied then as well)

    • JGC

      Arre you referring to the mandate? I think it is ramping up significantly over the next few years.

      • BHA_in_Vermont

        I believe you are correct.

    • OnPointComments

      Liberals don’t care what you do, as long as it’s mandatory.

      • Ray in VT

        Whereas conservatives will fight to the last for people to have the “right” and “liberty” to be denied health insurance for having not taken the personal responsibility to be born without a physical defect?

        • James Brian Canary

          Ah..but Obama care is not only for those born with a physical defect. It also covers children with colds that are incureable, but want help paying for a ‘non-cure’ script.

          • Ray in VT

            True, but it also covers child ear infections, broken bones, pneumonia and many other things that are either curable or treatable. If people want to go to the doctor for the common cold, then that probably isn’t a good strategy, especially if one has a co-pay or a deductible.

      • AC

        ? some things are just societal norms, no? like ‘thou shalt not kill’ or ‘molest your child’. stuff like that. i think that’s taboo in just about all cultures. healthcare is one of those things, i think. the very definition of ‘civilization’ – we’re all in it together.
        or you can always go live with apes. actuall, they have group mentalities too…honey badger! you can go live with the honey badger!

    • HonestDebate1

      The fine is scheduled to go up and up leaving people with no choice.

  • creaker

    You have to ask – is it ACA failing to meet its goals – or the success of those who have been trying to derail ACA?

    • OnPointComments

      It’s the ACA failing to meet its goals.

      • iccheap

        I’d say it’s more human nature than ACA failure. Penny wise, pound foolish.

  • creaker

    We can’t lose sight of what the system was like prior to ACA – even the Republicans wouldn’t suggest going back to the way it was.

    • Jeff

      Oh you mean affordable for younger people? Yes that was horrible.

      • iccheap

        You might want to review the proportion that had insurance. Affordable, or not, there was a large proportion that went without. We all end up paying for them when a catastrophic medical situation occurs.

      • Ray in VT

        Considering the cost of health care, the rather lower wages that many younger workers may be earning and the income sensitive insurance subsidies, many younger people are looking at premiums that are far lower than what was previously available.

      • OnPointComments

        Younger people are paying the cost of insuring older people. It’s the greatest transfer of wealth in the history of the country.

        • creaker

          Only until they are older – then they get the same benefit at the expense of the younger – that’s how Medicare and SS work today.

        • BHA_in_Vermont

          “It’s the greatest transfer of wealth in the history of the country.”

          Not hardly.

        • keltcrusader

          and older pay people for the education of this country’s youth so we can have an educated population – a wash really

    • Kathy

      Last I heard, the Republicans want to make it worse. No insurance for anyone and you can bargain with the doctor at the ER over the price while you bleed out in order to enable the power of the free market to lower prices.

  • RolloMartins

    So they wanted 7 million covered…we need about 90 million more covered with *good* coverage. How is this plan ever going to be considered a success if the bar is set so low?

    • RolloMartins

      Single-payer is the only rational solution.

      • creaker

        The right choice would have been making Medicare the floor for everyone – and let people and employers choose to buy add-ons.

        • BHA_in_Vermont

          Yep. For those with the financial means, Medicare supplemental. Those supplemental policies still need to be through a huge pool, or the “extra coverage” will be overpriced for those subsidizing the others.

        • RolloMartins

          The right choice for moral reasons AND fiscal reason. There simply is no rational reason for opposing Medicare For All.

  • northeaster17

    College students ussually stay on their parents policies as long as possible. Now to age 26. That’s in the ACA. How does that figure in your numbers

  • Mina

    Bash it Trash it before it even has a chance to suceed. Why is it you are even having this conversation if every answer coming from your guest is, “thats an unknown,” “we don’t really know.” “Thats a huge unknown.”… sounds like a lot of assumptions without facts.

  • James

    As a young person Dan Mangan hit it on the head,

    I calculated that the penalty is significantly less then the cost of insurance. Depending on how much I get in tax rebates,the cost of insurance is 3 to 12 times as much as the penalty.

    • BHA_in_Vermont

      Until you get in a car, ski/snowboard, other accident.
      Until you slip on ice and break your arm.

      etc

      • RolloMartins

        Or you come down with diabetes, heart disease, stroke, etc.

        • James

          I don’t know very many 27 year olds who have those problems. I do know a couple of 27 year olds who are buried under a mountain of debt.

          • RolloMartins

            Well, my daughter is one (actually 24 yo) and I also knew a girl out of high school who had a stroke. It happens.

      • warryer

        scare tactics

      • James

        fortunately, I have auto insurance, don’t ski or snowboard, rarely ever ice skate, and have never broken a bone in my life.

        • BHA_in_Vermont

          WAY more people slip on ice outdoors than on a rink. Perhaps you live somewhere that never gets that cold. And you can break your arm simply by breaking a fall, the natural tendency is to protect your head (no surprise) and your arms are the instinctive choice.

          My daughter never broke a bone in her life either, until an old platform in a tree collapsed under her. She dropped maybe 5′. The fall shoved her arm into the shoulder socket and broke the bone just below it. Hello ER, hello immediate rise to the TOP of the pile at the ER, hello emergency surgery, weeks of PT after it healed.

          The point is – accidents happen, you don’t plan to have one next year and sign up for insurance beforehand.

          And WHY do you have auto insurance? Probably because it is required. Do you know what the medical coverage per person is? I bet it is $5K. Try paying the hospital bills of an even somewhat serious car crash with $5K.

        • northeaster17

          Don’t worry something will happen. Time always wins

      • TFRX

        Well, BHA, it appears that some of our right wing commenters have seen that documentary of Olive Oyl sleepwalking through a construction site.

    • iccheap

      Free rider defined.

      • James

        Hey, I’ll pay 5000 for a broken arm (more likely take a loan out from my parents) if I need it But I don’t think I will.

        • iccheap

          You’re likely right, but I know some who haven’t payed. I can use my brother as an example. A series of poor choices landed him in the emergency room and with the subsequent hospitalization an 11K bill. He blew it off. This was in his early 20′s. He is well employed now and has insurance, but he didn’t own his responsibility at that time in his life.

      • James Brian Canary

        How do you know he is not self insured? He could take that saving and get a high deductible plan with a HSA and still be in the black.

        • iccheap

          I don’t know he is uninsured, but his argument appears to be a purely economic one and forgoing any insurance will yield the best net return – barring any medical problems, and there lies the rub.

    • hennorama

      James — have you actually checked out your options since you last posted on this topic, back in late December?

      I ask because the results I found, based on the info you provided, ranged from $323 – $568 annually for a Bronze plan, after the credit, depending on zip code.

      Since your penalty would be $200, you might be able to get coverage for another $10 or so per month.

      • James

        well I called into a Saturday afternoon talk show run by a local tax agency, They have been talking about Obamacare. (and advertising Obamacare sign up assistance) All they could tell me is that my tax rebate will depend on how much I make. I’ve been meaning to speak with them directly, but I haven’t found the time yet

        • hennorama

          James — here’s the website, and the toll-free number:

          http://www.healthbenefitexchange.ny.gov/

          1-855-355-5777

          The website also allows you to chat with someone online, and can give you locations for “In-Person Assistors (IPAs)/Navigators,” brokers, etc.

          You could get off here, and check it out.

          • James

            Thank you, I’ll look into that and report back next time on point does a show.

          • hennorama

            James — you absolutely should make whatever choice makes sense for you; just be sure it’s an informed choice.

          • James

            According to the link you gave me…

            At 24,000 taxable income my tax credit is 127.00 (rounded) a month, which with the cheapest health insurance available makes my health insurance cost at effectively $90.00.

            However depending on my OT, I will probably make closer to 26,000. At that amount, my tax credit drops to 103.00 dollars a month, effectively raising my monthly health insurance rates to $120.00 a month.

            120.00 a month doesn’t exactly make me giddy, but its’ not too much that I will dismiss it outright.

            I will have to think about it. Philosophically I’ m opposed to the idea at large, but I don’t want that effect my decision for financial and personal.

          • hennorama

            James — congrats on checking it out, and that your income will be significantly higher than the $20K initially discussed.

            You may still want to get more detailed info rather than just the estimates you discovered.

            Good luck.

            [PS] did you check out catastrophic coverage?

          • James

            I did look into that, catastrophic coverage does not come with the tax rebate.

          • hennorama

            James — correct. Just making sure you checked all options. Good on ya!

          • HonestDebate1

            Pop quiz, gold star, schoolmarm.

          • James

            seriously, man, I appreciate the (partial) ideological agreement, but Hennorama and I were having a nice conversation, so take it easy.

          • HonestDebate1

            I know, apologies. Sometimes it’s bigger than me. It’s an inside joke but most commenters around here know what I meant from experience with her. She even caught some of the same from TFRX. She does have various gold star jpg’s she issues when her homework assignments are met. She will keep you grammatically in line, scold you and enforce her rules too. I get the added benefit of her not replying.

            However, she is smart and I’m sure her advise here is good. It may even be better than mine which is to pay the fine. Sorry again, but I can’t make promises about the future.

    • http://www.findingourdream.blogspot.com Hal Horvath

      It’s easy when you are young to think that insurance isn’t a good bargain. I think when I was like 18 and paying my own way in *all* ways, that auto insurance seemed a waste. I’d just drive carefully….. See the fault in that thinking?

      • James

        true, but car insurance is also dramatically cheaper. I believe I pay about $335 every six months for my auto insurance. (Which is believe is high due to my previous accidents)

        Where according to my research I’ll be paying 120 a month for health insurance.

        • http://www.findingourdream.blogspot.com Hal Horvath

          $120/month. Yeah, that’s a lot for a starving artist, or even just a young person with a modest job. But to get a real contrast: — we were using my wife’s excellent employer-provided insurance in 2007, and she decided to leave that job. COBRA is the law were you can keep that old insurance and pay for it yourself. Cost? $1500/month for family of 3. Not kidding.

  • iccheap

    Humans are horrible “free riders”. A large majority of people won’t enroll until the economics CLEARLY force them. Few imagine they’ll get a “return” on their investment. Time had a decent article in the last few weeks on a family who abhorred “Obamacare”, until they needed better coverage and it benefited them……a real surprise.

    • warryer

      what’s wrong with individual choice?

      are those sickly who subsidize their cost of healthcare across the backs of the healthy considered free-riders?

      • iccheap

        Nothing wrong with individual choice, but almost no one will forgo medical care when a crisis occurs because they don’t have insurance. That means that the risk gamble they made as “individual choice” now becomes a societal obligation.

        • warryer

          And choosing to go the way that most benefits oneself is wrong how?

          The one’s who are already signed up, are they not doing so because it benefits them more to be apart of aca than not?

          • iccheap

            This comes down to a purely philosophical decision. Some may be enrolling purely for selfish reasons, but some are weighing their risk. Not every action we take is motivated by self promotion. Otherwise why provide charity to anything that doesn’t affect you directly?

          • warryer

            Because giving to that charity feels good?

            My point is that; people make decisions for themselves based on what they think is best for themselves. Could you be better informed? Perhaps. But that doesn’t mean they have to choose to listen to you.

            You can’t choose for somebody because at that point in becomes a coercive society and not a free one.

          • iccheap

            It’s really impossible to argue with your base premise that people make decisions to benefit themselves. Unless you’re actively harming yourself, or doing something neutral for your personal situation, it’s all beneficial. You’d likely be able to find a beneficial linkage in nearly any example of human behavior, so, in that measure, I’ll concede to your logic.

            Personally, I am a bit of a socialist so I don’t have a major problem with coercive policies – even in our “free” society we have lots of examples of coercive behavior. One can argue it’s in our nature as a species to promote coercive (compliant) behavior. It keeps anarchy to a minimum.

      • James Brian Canary

        It is if those “sickly” people feel they have the right to take money from others to get there medical paid for. Some of us realize that if you have a “sickly” type of health, you should save the money to pay for it. No satalite,no cable, no internet on the cell phone. If i can, so can another.

        • northeaster17

          Lame.

      • iccheap

        No, they are at least paying something. Beyond luck/fate there goes you, or me.

    • http://www.findingourdream.blogspot.com Hal Horvath

      You may figure this out, or not — but ultimately, we are *all* free riders. Who do we ride on? “Earth” and “civilization” (a thing composed of other humans).

      • iccheap

        You might be getting a bit hyperbolic there. Your point delves into the philosophical realm, best conducted over a table with a nice stout….

        • http://www.findingourdream.blogspot.com Hal Horvath

          True, but also, if you think about it, you will discover all sorts of ways that each citizen has gotten a crucial “free” ride many times in life. A few obvious ones are schooling, roads, protection, but there are more subtle ones also.

          • iccheap

            I wouldn’t call those examples “free rides”. It’s quite difficult to completely avoid gas taxes, property taxes (it’s in your rent, even if you don’t own property), sales taxes, licensing taxes, etc. Those taxes in some way subsidize the examples you give. Someone can go to the emergency room and directly receive services having paid $0 into the system. They may pay their bill, or not, but leveraged payments (insurance) obligates them to be part of the pool.

          • http://www.findingourdream.blogspot.com Hal Horvath

            It appears we agree about all you’ve written here.

  • TFRX

    Please, let’s delve into the assumed viewpoint easy to find on mainstream and right-wing panel shows, that people who don’t have health insurance are just treating this as a mere cost-benefit analysis.

    No health insurance? Every unknown visit to the doctor’s can be a disaster waiting to happen.

    • northeaster17

      Mental health specialists have noted a decrease in anxiety among those now insured through the ACA. A positive side affect

      • hennorama

        northeaster — unfortunately, those collective sighs of relief can’t be channeled to help out with the cold temperatures up yonder.

        • northeaster17

          Maybe a pipeline could help.

  • BHA_in_Vermont

    The fact that there is a need for “younger, more healthy” people to sign up proves that Single Payer is the ONLY real answer. ONE big pool, spread the risk over 316 million people.

    No more haggling to get the best price from providers and pharmaceutical companies for YOUR pool; people in a smaller (or no) pool subsidize the big pool insured by paying MORE than the actual cost of a procedure.

    • RolloMartins

      Plus it would finally give the USA a fair healthcare system.

    • jefe68

      Yep. The ACA is not addressing the costs. Nor does it keep anyone from going bankrupt from health care bills which is one of the major factors in bankruptcies in the US. The US is also the only industrial nation in which people go bankrupt from the outcomes of a health care.

  • OnPointComments

    Here is unsurprising information: the vast majority of the enrollees under Obamacare are people whose plans were cancelled by Obamacare.

    COVERAGE EXPANSION FAIL: LESS THAN ONE-THIRD OF OBAMACARE EXCHANGE ENROLLEES WERE PREVIOUSLY UNINSURED
    http://www.forbes.com/sites/theapothecary/2014/01/18/coverage-expansion-fail-less-than-one-third-of-obamacare-exchange-enrollees-were-previously-uninsured/

    McKinsey & Co., indicates that “only 11 percent of consumers who bought new coverage under the law were previously uninsured.”

    HealthMarkets, a insurance holding company based in Texas, conducted its own survey based on the 7,500-or-so people that the company enrolled in exchange-based plans. Based on their survey, obtained by Wilde and Mathews, only 35 percent of enrollees were previously uninsured.

    Priority Health, a non-profit health insurer in Michigan, surveyed 1,000 “enrollees…in plans that comply with the law,” and found that only a quarter were previously uninsured.

    If we assume that around one-third of exchange enrollees were previously uninsured, and that 90 percent of those who have “selected a marketplace plan” will eventually enroll in coverage, the Obamacare exchanges have thus far only expanded coverage to 660,000 people, far less than the 7 million projected by the Congressional Budget Office.

    …the Obama administration is wildly exaggerating the number of people who have signed up for the law’s expansion of the Medicaid program for low-income Americans. The administration claims that more than 4 million Americans have signed up for Medicaid coverage under the law. But Sean Trende of RealClearPolitics figures that only 5 to 7.5 percent of those enrollees were due to Obamacare.

  • TFRX

    Jane, did you write th opening paragraph in mid-November and then just put it in a time capsule?

  • TFRX

    For those of you wondering <a href="http://www.cjr.org/the_second_opinion/insurance_companies_withhold_info_on_obamacare_exchanges.php"if insurance cos are telling you the truth about the ACA.

  • NewtonWhale

    Gallup: Uninsured rate declines

    “The uninsured rate had been expected to come down as the Affordable Care Act was implemented,” said Frank Newport, Gallup’s editor in chief. “That would be the most reasonable hypothesis.”

    Based on interviews with more than 9,000 people, the Gallup numbers could be the first evidence that core provisions of Obama’s much-debated law have started delivering on the promise of access for nearly all Americans.

    http://www.huffingtonpost.com/2014/01/23/uninsured-rate-drops_n_4650736.html

  • OnPointComments

    Warning: Ignore claims that 3.9 million people signed up for Medicaid because of Obamacare
    http://www.washingtonpost.com/blogs/fact-checker/wp/2014/01/16/warning-ignore-claims-that-3-9-million-people-signed-up-for-medicaid-because-of-obamacare/

    “Essentially, then, it is ridiculous to suggest, as the @BarackObama tweet does, that the people who have selected a health plan in the exchanges are in anyway equivalent to the 3.9 to 4.2 million who were deemed eligible for Medicaid.”

    Rating for the administration claim: Three Pinocchios

  • adks12020

    I don’t think this kid understands how health insurance and a deductible works. I have a relatively high deductible on my plan but so many things are covered with co-pays that I’ve never had to pay substantial out of pocket costs for anything.

  • TFRX

    Given the number of individuals who’ve come onto TV and radio and displayed their ignorance or laziness about what the ACA would cost to them, I’d like Jane to press Gibson about his numbers.

    • Amy L.

      Absolutely correct: see my explanation above.

  • Allen Horner

    Obamacare will prove to be a failure. People are not stupid. One of your speakers made the real point with low turnout: Pay a penalty and normal out-of-pocket costs and you’re ahead of the game economically. Should you have a serious issue, enroll and let all the other suckers and the insurers pay for it despite you’re being allowed in with a pre-existing condition.

    Obamacare fails because it doesn’t attack the big issue with medical care: The high cost of medical care, not just needless tests but for excessive charges per unit of care given. Attack the cost of the medical community on the consumer, make it affordable outside indemnity coverage, and you will have people get medical care when needed AND probably minimize the need for people to insure for it — just like the good ol’ days before group medical insurance.

  • NewtonWhale

    The guest Carl Gibson was on Lawrence O’Donnell’s show last night. Read about the interview here:

    This is what Ezra Klein said to him:

    “It is a mistake to think about yourself of having a singular relationship with the healthcare system. To say I am young and that’s my relationship to healthcare is wrong. One day you are going to be old. You sound healthy but one day you are going to be sick. And if every young person, every healthy person starts to game the system, then when they are old, when they are sick, there will be no system there that is affordable to take care of them.”

    It is really that simple. Ezra Klein called this one right. Klein also made an important point that generally goes unnoticed. In a single payer system, premiums are not age-based and as such the young likely subsidized the old much more than under Obamacare. Under Obamacare premiums for the old can be up to 300 percent of those of the young.

    http://www.dailykos.com/story/2013/12/29/1265563/-Opting-out-of-ACA-because-it-s-not-single-payer-is-dangerous

  • James Brian Canary

    Most health insurance is not ‘insurance’ anymore. It’s a healthcare payment plan. Making a payment plan mandatory is excessive. High deductible plans, ie. $2,500-5,000 deductibles, with a HSA is what health insurance is supposed to be about. Insurance is about “just in case”.Coverage on everything is a big part of the problem.

    • hennorama

      James Brian Canary — as of 2013, High Deductible Health Plans (HDHPs) have a minimum deductible of $1,250 per year for individual coverage and $2,500 for family coverage.

      HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums) are exactly the same as the maximum out-of-pocket costs for any PPACA Marketplace plan for 2014 — $6,350 for an individual plan, and $12,700 for a family plan.

      There are some concerns, because many consumers who used the health insurance marketplaces have been selecting plans with lower premiums and higher deductibles. This may leave them with overall costs that are greater than expected. This results in some added cost risk for health care providers for unpaid bills due to high deductibles and cost-sharing.

      On the other hand, high deductibles may also lead to better informed healthcare decision making, due to cost considerations and comparisons between providers.

  • Citizen James

    I’m curious as to why the website is the only venue for signing up for insurance through ACA. I know there is a phone number as well, but why, for example, can’t I enter a local mall and find a booth in the middle where I can sit down and sign up? I don’t find signing up and navigating through a website a comfortable experience. Why aren’t there other practical options?

  • John Roberts

    Until we go to a single-payor system (like most of the civilized western world), we’re just putting band-aids on top of band-aids. Just look at the profits of third-party HCO/MCO’s & PBMs: as long as they have their hands in the government & our pockets, affordable healthcare for all Americans will elude the wealthiest country on the planet.

  • TFRX

    Hoping that our host has seen this primer on how not to cover the ACA.

  • Kelly

    This selfish Gibson kid ought to remember he’s going to need people just like him someday. The reason it’s expensive is that he’s got a jackass for a Governor.

    Perhaps the medical bills of people who opt out of being insured should be required to assume full cost of any medical treatment and have those bills ineligible for forgiveness, reduction, or clearanceby bankruptcy?

    • BHA_in_Vermont

      I agree. Choose to be uninsured, on the hook forever.

  • WorriedfortheCountry

    Elephant in the room:
    Carl and his uninsured ilk can simply sign up once the get sick. Pre-existing conditions do not prevent signing up. Surprised no one brought that up.

    • BHA_in_Vermont

      But you can’t sign up “just any old time”. Other than “life change” events, you are limited to signing up at the end of each year. I was screwed by that for both of my kids’ wisdom teeth extraction. Didn’t know in November that they would need the procedure the next year, so got basic dental as usual, full freight on the costs.

      • creaker

        If it was that easy people would do the same with their employer provided insurance – but like ACA, you can’t just sign up “just any old time”.

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      It won’t pay retroactively for anything, though.

    • hennorama

      WftC — Absolutely false.

      When the initial open enrollment period for individuals ends on March 31, 2014, future open enrollment periods will be the same as those for Medicare, running from October 15 to December 7 each year. If you miss signing up for coverage before March 31, 2014, you’ll have to wait until the fall to buy a health plan. There are some exceptions, but most people will be out of luck until next year.

      • HonestDebate1

        Do you mean all the talk about pre-existing conditions was yet another lie? Or do you mean millions won’t be covered?

  • mairelena

    The state I live in requires medical insurance as part of automobile insurance. If one is in a car accident, this is the insurance that pays–not you regular medical insurance.

  • That Guy

    Your debate today is very biased when assuming blame to Republicans who are not supporting medicare expansion. Sure there’s politics at play, but the majority of pushback is for two reasons:
    1. They don’t trust that the Feds are going to hold up their end of the bargain
    2. It’s not moral to force people who are tax payers and largely have health insurance to pay for health insurance for others.

    • http://neilblanchard.blogspot.com/ Neil Blanchard

      We already pay for others – the ACA is meant to lower that cost by getting as many people paying into the pool as possible.

      • That Guy

        The government can try to do a lot of things (eliminate poverty, war on drugs, war on terrorism) and usually fails.

        • http://neilblanchard.blogspot.com/ Neil Blanchard

          Strawman alert …

          • That Guy

            Past experience predicts future failure

    • BHA_in_Vermont

      Who do you think pays for the uninsured who show up at the ER NOW?? Everyone who pays their bills, bills that are higher because the hospital calculates “unrecoverable” charges and spreads them over those who pay.

      Is it better for people to have insurance and see a GP before they get really sick or take an ambulance (taxis are too expensive) to the ER. Yeah, I know an EMT who had a “regular” “customer” that fit this description.

    • John Roberts

      And what will Republicans do to address affordable healthcare for all Americans if they win the next administration? The same thing they have done to date: Nothing.

      • northeaster17

        At least we have not heard anything yet. Not holding my breath

      • http://neilblanchard.blogspot.com/ Neil Blanchard

        That is a big if …

      • HonestDebate1

        You are the reason for this debacle. You should be impeached.

    • http://www.findingourdream.blogspot.com Hal Horvath

      This idea that you should have to pay for benefits others get applies to *every* and *all* governmental functions, you name it — roads driven on by large trucks for profit that you pay for, free schools for families with kids, Defense budget that protects other people in addition to you….

      You name it, others are benefitting.

      • That Guy

        The average citizen doesn’t have the means to make their own roads, staff their own schools or raise their own army. Those are public goods or services that can be accomplished much more efficiently via pooled resources. On the other hand, millions of Americans are paying for their own health insurance either directly or through their employers.

        • Ray in VT

          And we are paying rates far above those that are being paid for similar services in other industrial nations. Perhaps our approach isn’t all that it is cracked up to be.

        • http://www.findingourdream.blogspot.com Hal Horvath

          You got the exactly correct distinction about what government should do (and thus should not do also) — what people can do for themselves on their own versus what they cannot. 2nd I add to this what government does well versus what it does poorly (see my blog)….
          So, health care….I would do the laws a little differently, and it is complex, so again see my blog.
          One point though, subtle: most people don’t realize how most (not just some) other people contribute indirectly and in ways not understood to their own standard of living…..

        • BHA_in_Vermont

          You are missing a couple of points:
          1) Having everyone as healthy as they personally can be is a public good.
          2) The scads of pools that exist now are individually wresting the best price they can from providers and pharmaceutical companies. Those not in a pool, or not in a “BIGGER than the other guy’s” pool pay MORE for the SAME services.

  • Mina

    Unforseen things happen every day. Carl’s generation of invincibles don’t think they need coverage. Strokes, hit and run accidents happen and who picks up the cost? Those of us who are being responsible pay for those who think they can skate by until something happens. This attitude of those who can afford it but choose not to speaks of values.
    I understand those who can’t afford it. But he sounds educated and just wants to get by on the free ride until something happens.

    • warryer

      You know the risks and you still chose to follow through with paying “your share.” People being able to sign up before going to the hospital is part of how the system works.

      What is wrong with gaming the system to have maximum benefit to oneself? Why aren’t you doing the same thing instead of complaining about it?

      • Mina

        Thats just it, his generation is used to the mentality of gaming the system. We have had plenty of examples over the last decade of doing it because we can no matter if it’s right.
        I do it because I am an American. And I am sick of the slacker individuals and corporations with full greed on display without realizing what the consequences are to our country.

        • warryer

          Indeed. The “American Way” was/is always about individual freedom of choice.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Does that mean you actually support actual, real freedom of choice? The end of medical licensing laws?

        • hennorama

          Mina — your first sentence prompted an AHA! moment.

          The “digital generation” has been conditioned to expect to get things for free: music, video, software, online access, etc., whether or not it is legal or right to do so. This may lead to significant resistance among this cohort to taking responsibility for obtaining health insurance coverage, or for paying for any health care they consume.

  • http://www.findingourdream.blogspot.com Hal Horvath

    Carl Gibson says (paraphrase) “we need to find out why health care is so expensive, and need to reform”

    OK. Here’s the answer:

    Medical networks/associations — doctors and hospitals being bought out by huge networks, so that insurers don’t have any bargaining power, because most all the doctors are in that network which negotiates as a block.

    The old name for this: “monopoly”

    • jefe68

      Yep that’s one reason. THe other is health insurance corporations, which account for about 30% of the cost factor, and pharmaceuticals. Then there is the medical device corporations.

      In Boston Partners is buying up everything. Right now they own two of the largest hospitals MGH and Brigham and Women’s as well as Neighborhood Health insurance.

      • http://www.findingourdream.blogspot.com Hal Horvath

        Wow, all those hospitals? Ouch. Guess which way your premiums will be going next few years…..

        About the old reality of insurers taking as much as 1/3rd…..not any more: by the new law they are limited to 20%.

        • jefe68

          You don’t get it do you. Do have any idea how huge MGH and Brigham and Women’s are? Between them they employ over 80 thousand people in the Boston area. Which makes them the largest employer in the city and it’s suburbs. Why did you post what you did in the first place if you don’t see Partners as a prime example of what you seem to be on about?

          The system is broken. The ACA does a few good things but does nothing to repair our dysfunctional health care system. Nothing. By the way that new 20% cap has some huge loopholes. Also the for profit nature of health insurance will always work against health care as a basic public good.

          • http://www.findingourdream.blogspot.com Hal Horvath

            For answers see my original comment, or my blog also.

  • mumtothree

    Definitely paying the tax penalty would be more affordable for us, but I’m not willing to take the risk. So, as a self-employed (both) family, we pay 20% of our income for insurance premiums. Choosing a plan is a complicated analysis. Over the past couple of years we have come out ahead, factoring in usage, premiums, deductibles and co-pays. You need to track all of your medical expenses and then decide. For some people, the lowest-premium bronze plan will work for them, but it still costs money, and if their only protection is the cap, many will take the risk that they will not need major care and simply pay the penalty.

    • hennorama

      mumtothree — what is your after-tax cost, given the tax advantages available to the self-employed?

      • TFRX

        Part of me wonders if you spent much of your youth helping everyone in your class with their homework.

        • hennorama

          TFRX — Ha! (it wasn’t always by choice.)

      • mumtothree

        Yes, we get to take the deduction for the cost of the premium, which affects our AGI, which reduces our income tax, but not as much as you’d think. We pay about $1500 less income tax because we get the self-employed health insurance deduction. But there’s another kicker: the income with which we pay the health insurance premiums is subject to self-employment tax, so it costs us 7.6% more than the face value to buy it. They pretty much offset each other. So to answer your question, the actual cost of the insurance is the actual cost.

        • HonestDebate1

          And you don’t have an employer matching funds.

        • hennorama

          mumofthree — that’s an odd argument, as everyone who pays out of pocket for individual health insurance (as opposed to paying via employer-sponsored plans) pays with after-tax dollars.

          That you are self-employed is your choice, and you no doubt made the choice in a free and informed manner.

          I’d correct the technical errors of your post, but that would unlikely be worth the effort.

          • mumtothree

            Used to be “after-all-tax” dollars, now it’s only after income tax. FICA is not income tax, it’s SS, Medicare, Medicaid, although it is based on income. The law changed in the Obama administration. I also get a deduction for my so-called “employer” share of FICA. I won’t get into tech arguments with you, suffice it to say I have researched this thoroughly. Bottom line is it’s very expensive, particularly if you are self-employed and have fallen off the Obamacare cliff.

    • Valerie

      It’s not only for you. It’s for the common good. Universal healthcare would have been a better choice. But because we opt for a for-profit system, we all need to be required to sign up for the system to work. Unfortunately.

  • phk46

    Listening to Carl explain why he doesn’t sign up for insurance.

    I guess that is his right under the law. In that case, the penalty he pays serves to buy an “option” to get insurance in the future without concern for preexisting conditions. We had better ensure that the penalty is priced right to cover the cost of that.

    I wonder about the extent of the “no preexisting condition limit”. Suppose he just waits until something bad happens to him. E.g., he gets hit by a car and has $100,000 in medical expenses. Can he sign up for insurance after the fact and get it to pay for his treatment? If so, then the penalty for not having insurance will need to be quite high to cover such abuse.

    • BHA_in_Vermont

      Nope, can’t sign up “late”. WE will all cover his ass because he won’t have the $100K and will renege on his obligation.

  • WorriedfortheCountry

    With half the states opting out of medicaid expansion Obamacare should be showing huge surpluses since the revenues were designed to cover ALL states. Further, if the CNBC dude is right the surpluses should expand next year once businesses start paying additional taxes.

    Is Obama care showing huge surpluses? If not, wouldn’t the program be further in the red if more states expanded medicaid?

    Central planning almost never works.

    • http://www.findingourdream.blogspot.com Hal Horvath

      Imagine a free market in health insurance only regulated so that insurers could not deceive clients with tricks about what is covered and what is not: transparency and honesty required by law.

      With me so far? Now add subsidies for lower income households to buy insurance in the private free market, as envisioned by various Republicans through the 1970s and 1980s and even in the 1990s…..

      How about that system?

      It’s currently called “Obamacare” by many.

      • WorriedfortheCountry

        Big picture:
        $2.6T+ spent over 10 years to leave at least 30 million uncovered with numerous additional unintended consequences to the health delivery system.

        Again, central planning almost never works.

        • http://www.findingourdream.blogspot.com Hal Horvath

          Exactly. Why? See my other comment in this thread about why health care costs so much more in the US than anywhere else in the world.

        • Ray in VT

          So why is it that nations with national health care spend far less per capita and as a share of GDP than we do? Shouldn’t such “central planning” cost more than our system, which relies far more on the free market?

          • BHA_in_Vermont

            Geez Ray, don’t you know that won’t work HERE? We are special you know. ;)

          • Ray in VT

            That seems to be the argument.

          • HonestDebate1

            One reason is in America we can spend as much of our own money as we want compared with central planning spending other people’s money. That a significant difference to me but there is more. This is a good breakdown:

            http://www.forbes.com/sites/toddhixon/2012/03/01/why-are-u-s-health-care-costs-so-high/

            But really your point is moot, the question is will Obamacare make it better or worse?

          • Ray in VT

            Nothing stops people from buying their own private insurance or spending more in places that have national health care. Here we have the “liberty” to pay more for drugs, medical parts and to private insurance company profits.

            Well, my premium hasn’t gone down and the ACA has been rolled out for 23 days, so I guess that we should scrap it and go back to how it was. I guess that I can send that insurance company rebate check back to them too, because I really want to pay more for overhead.

          • HonestDebate1

            Don’t worry your cost will go up. The delays upon delays are just keeping you placated until after the mid terms. They will not go down.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Just a note: don’t take a good mind (yours for instance) and harm it by trusting a source like Forbes, which is often contrary to facts in order to service ideology (in other words, stupid).

          • Ray in VT

            They had a great column about a year and a half ago predicting that GM was headed back into bankruptcy. That one still has me chuckling.

          • HonestDebate1

            Thanks… I guess. But the article made sense to me and was well sourced, it’s not really a matter of trust.

            But again, it’s all moot unless Obamacare is an improvement and I don’t think it is.

  • TFRX

    “We’re hearing things like this one anecdote shows that the rocky rollout of the ACA website continues to hound Obama” per Gold

    One might suggest that a healthcare reporter with ability to go no deeper than “we’re hearing things” and “this one caller’s story” is what’s continuing to hound Obama.

    You’re a healthcare reporter, right? Quote some of your own reportage, Gold. And not so many of those debunked fearmongering stories that got so much traction in mainstream papers and broadcasts, and then vanished when shown to be false.

    • OnPointComments

      It’s amusing to see liberals deride anecdotal stories about the perils of Obamacare when every time the President talks about Obamacare he trots out some anecdotal instance of someone who has benefited.

      • TFRX

        The press has gone out of their way to find idiots and fools, didn’t ask them question one about whether they knew what the hell they were doing, or if they were outright lying. And you come up with that?

        Hahahahaha.

        (Fluck, CNN was caught on the air showing “the ACA website troubles” by having one of their morons refresh the webpage, in the middle of getting a quote. Right where it says “don’t hit refresh or close your browser”. Right where anyone who’s every ordered online knows to not touch the keyboard.)

        So, learn what “anecdotal” anti-ACA story means–it’s not one person’s unconfirmed crap put into the echo chamber until every says “oh, there are so many stories about ACA failure out there”.

        • OnPointComments

          My prediction: at the State of the Union address next week, the POTUS will point to someone sitting next to the FLOTUS and tell us their health care story. And the person may be just like the woman last November who President Obama gave as an Obamacare example, and who subsequently wrote “Wow. You guys really screwed me over. Now I have been priced out and will not be able to afford the plans you offer. But, I get to pay $95 and up for not having health insurance. I am so incredibly disappointed and saddened. You majorly screwed up.”

  • Coastghost

    Truth in advertising, then: the Unaffordable Care Tax Act. (Fans of brevity can rely on “ObamaFraud”.)

  • Valerie

    Premiums and out-of-pocket deductions are going up because we stupidly chose to go for a for-profit health insurance system instead of universal health care! Blame the insurance companies. They increase premiums and deduction however they want before ACA anyways. People should wake up and stop blaming on the Bill itself. My premiums and deductions went up too but I am doing the right thing. People who refuse to sign up will end up costing us even more when they go to emergency room. Some like to say: “why should my tax dollar go and pay for your insurance premium?” Well, my question is “why should my tax dollar pay for your emergency visit because you refuse to sign up for insurance?” who is the real selfish one?

  • creaker

    The “penalty” is smoke and mirrors – if you set up your withholding so you have no tax refund, they can’t collect their penalty.

  • Coastghost

    Why is this caller with two unenrolled 20-somethings not permitting her darlings to find coverage on her own plan until they reach the new ObamaFraud age of majority of 26?

  • creaker

    One big difference under ACA is that all the insurance horror stories we’ve heard all along are now ACA horror stories.

  • Markus6

    I shouldn’t repeat myself but almost every person who I’ve heard say positive things about ACA (other than politicians or newspeople) is someone who got money from the government in some form for their care. ACA can’t fail over the long term because it’s buying support and few think about how it increases our debt.

    • http://www.findingourdream.blogspot.com Hal Horvath

      The taxes built in to it will REDUCE the budget deficits according to the Congressional Budget Office (CBO), widely cited by both parties about all things budget, since they are far away the best experts on accounting.

      • Markus6

        Devil’s in the details. CBO was given several assumptions around medicaid and how ACA was to be paid for that are unrealistic or fiscally, just odd. For one example, ACA was paid for prior to any costs being incurred. What that means is that it’s actually making money now cause it just started. It also means that there’s a break even point after which it increases the deficit. I forget when that occurs, but think it’s next year, could be sooner.

        The details aside, do you really believe that you can subsidize tens of millions of people for health care, while increasing the benefits (e.g. no pre-existing conditions) and not lose money?

        • http://www.findingourdream.blogspot.com Hal Horvath

          The projections I refer to were for 10 years on net, and also for after 10 years.
          Repealing Obamacare would increase deficits over this 10 year period, and after also.

          2nd, to understand more about costs, you have to learn more — when you do *certain* kinds of preventive care (now mandated by law to have a $0 co-pay)….it *reduces* health costs over time.

          See? There are many details for the realistic calculations, many factors.

  • Pia Vastatrix

    I was uninsured for almost a year after being laid off — I could have continued on COBRA, but the premiums were enormous. So, after many hours of aggravation, I finally found a very good, affordable plan. Which brings up another issue: I tried to make an appointment for a physical with my longtime doctor, and the earliest available was in April!

    • http://www.findingourdream.blogspot.com Hal Horvath

      Sounds right.
      What’s going on with health care in the US? Doctors and hospitals being bought out and working for huge associations that negotiate prices with insurers without much competition left. Prices of course go up rapidly.

      • Pia Vastatrix

        The lack of doctors will be felt more acutely with so many more people now able to see doctors. Pent-up demand.

        • http://www.findingourdream.blogspot.com Hal Horvath

          That’s right. Why aren’t there more doctors? Why won’t there be a rapid increase in supply of doctors? See my comment just above.

    • hennorama

      Pia Vastatrix — congratulations on your success in finding “a very good, affordable plan.”

      As to scheduling, there may be an influx of newly insured patients flooding the system, and/or increased patient traffic due to increased awareness of health care issues due to all the media coverage of the changes to the system.

      • Pia Vastatrix

        Thank you. Yes, the increased demand is exactly the point I was making, one I predict will be exploited by nay-sayers once they realize they may have to wait longer.

        • TFRX

          I think that the bulk of “the naysayers”, at least in the media classes (rather than the hoi polloi like me and possibly you) are folks who really haven’t had to do without health insurance.*

          Geographically, I think the increase in demand will be in the rural and urban working-class areas the most .

          Story-wise, it reminds me of men reporting for the draft for WWII or so who had never seen a dentist in their lives or had other massive health issues which were never tended to.

          (*I got this hunch by watching them describe how much fun it was to be poor , and how carefree it was to choose to not have health insurance while keeping, say, three kids in schoold.)

          • Pia Vastatrix

            Actually, I’m in the media class, and the naysayers I was thinking of are in the craven, exploiting politico ranks. I think the right has expended tremendous resources to convince the hoi polloi to embrace policies that work against their welfare by linking them with conservative social policies.

    • BHA_in_Vermont

      ” Which brings up another issue: I tried to make an appointment for a
      physical with my longtime doctor, and the earliest available was in
      April!”

      A couple of months out has always been pretty common here for non “emergency” visits to a GP, or the dentist.

      And yeah, insurance outside that subsidized by an employer and NOW the ACA exchanges are back breakers. Once my subsidized COBRA ends in July, the minimum cost, high deductible plan will be $18K/year, the high end, $28K/year; there is no income sensitivity. Fortunately, losing COBRA coverage is a “life event” and we can sign up through the exchange in Vermont.

      • Pia Vastatrix

        It’s not exactly a controlled comparison — I don’t know, for instance, if staffing has been cut in the past year or two, but when I made my last appointment, the waiting time was six weeks rather than the 12 weeks this time.

  • Amy L.

    Carl Gibson’s cost benefit is not $3800-6800 premium plus deductible vs. $300 fine. It is that $300 vs. the actual $1800 premium. He is on the hook for the deductible amount whether or not he buys insurance. Thus his contention that “he saves close to $7000″ is incorrect.

    • TFRX

      Thanks for doing the math.

      I have the feeling that Gibson will be making the rounds, and some very big name folks won’t make him own his claim.

      • BHA_in_Vermont

        Sadly

    • adks12020

      Exactly. It was killing me to hear him say how much he was saving with no reply from the host or guests about how incorrect his calculations were. He didn’t seem to understand how insurance really works.

      • BenEastwood

        I think you are nitpicking what is is, instead of looking at the bigfer picture, which is that Romneycare will cost Carl more than single payer would, and that Romneycare is an insurance mandate to buy private insurance from a private, for profit, corporation who manages business for their shareholders, as opposed to a public option , which would be run for public good, and not bleed our money away to line the pockets of wall street. ACA is fundamentally flawed, it is not healthcare reform, it is not medicaid or social security, it is the republican insurance mandate and will bleed billions from healthcare in corporate profits. Carl is not advocating against the social contract, the social safety net, he is pointing out that ACA is neither one.

    • Bruce94

      Thanks for pointing this out. I kept hoping that the other guests would call him on this (or even possibly the host), and was surprised they let it go unchallenged.

  • TFRX

    The other, other part about signups: I hope our two HC reporters will talk about the Creepy Uncle Sam ads and how much the anti-ACA right are trying to destroy the ACA.

    This stands in stark contrast to GWB’s Medicare rollout–it was also “rocky” and Dems said “let’s make this work”.

    Also can’t get it out of my head how many corporations and right-wing PACs would try to make Uncle Sam a scare image after 9/11. Wonder what changed?

    • HonestDebate1

      You are comparing apples and giraffes. There is a huge gargantuan in your face difference between Obamacare and Medicare D. Think about it, it will come to you.

      • northeaster17

        As more people sign up for The ACA the more your position will be marginalized. Think about it.There is no turning back the clock. Any changes made, except a single payer system, will be build on the ACA foundation.

        • HonestDebate1

          Obviously, that was the plan all along. Single payer is coming but we can’t get there honestly so we have this sham.

          But that is not the huge gargantuan in your face difference between the two.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Americans seem to value (by a large margin) Medicare (the US single payer).

          • HonestDebate1

            Leaving aside the efficacy and sustainability of Medicare, it was debated, read and passed on a bipartisan basis unlike Obamacare. Changes were treated the same way. And that is the huge gargantuan in your face difference between the two.

            If informed Americans end up with a single payer system it should be bipartisan and through the legislative process. Any program as sweeping and transformative as Obamacare that is railroaded through on a 100% partisan basis ultimately cannot survive.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Trivial to me, but fact is that ACA was advanced in the Senate by virtue of the votes from the moderate Republican Senator from Maine…..
            As I see it, due to the medical monopoly laws (licensing) put in place by doctors, we need to respond by regulating their pay (thus Single Payer due to fact they also limit competition via networking)….OR…get an actual free market by ending the monopoly of licensing…..
            Either or. Not that there isn’t yet a 3rd way, but these 2 ways could help dramatically with cost.

          • HonestDebate1

            I don’t think so, not a single Republican in the House or the Senate voted for Obamacare. That includes Snowe and Collins although they did vote for the “stimulus” along with Arlen Spector. Obama then bribed Mary Landrieu and gave a kickback to Ben Nelson. There was also a meaningless signing statement for Stupek and his crew. If not for those then there would not have even been Democrat support. The final hurdle was using reconciliation which is designed for budgets not for sweeping entitlement reform.

            I disagree with your proposal but I would happily comply if it came to be through honest transparent bipartisan legislation driven by the will of the people.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Ok, then you support repealing medical licensing (monopoly) laws?

          • HonestDebate1

            I know there is a movement to let nurses with a decade or so of experience become doctors. I don’t support that. Beyond that I don’t know enough about it but it smells bad from here.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Each state has laws, but in a generalized nutshell they say you can only practice medicine (be a provider) if you get a license by passing the board exam controlled by…..the existing medical profession. Now, in spite of this, there is still a black market often anyway…… You can indeed get “traditional Chinese medicine” etc. even in states where that is against the law. But…because it is against the law to provide it without a license, it cannot scale up and really compete and drive prices….. See?

          • HonestDebate1

            I get the gist. I guess I’ll expound a bit but again I don’t claim to have the answer and I have not studied it.

            I think the medical profession are best qualified to make the standards. Certainly better than government. So I don’t have as big of a problem with that aspect as you.

            My mother was an RN then certified Midwife. She also is well versed in homeopathy and even got certified for aroma therapy. I am fine with backward compatibility for lack of a better phrase. My mother is a big believer in alternative medicine but she is also professional and knowledgeable with credentials. When they discovered a cancerous lump in her breast she opted for a double mastectomy. She’s doing well.

            A drummer I used to work with got cancer. He decided to forgo modern medicine and get alternative treatment and was soon dead at age 43. He was full of false hope.

            Another friend, ironically another drummer, just got a license to practice Acupuncture and is doing well and helping people, but he should not have the credentials to give false hope.

            We have the best doctors in the world in America. I think the standards should be very high to maintain that status.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Of course, some people are cured with *any* kind of medicine, because their bodies are fighting the illness also, and some die with *any* kind of medicine. If you refer to deaths as showing “false hope” then the mainstream, conventional medicine is chock full of “false hope” of course. And I am *not* against mainstream medicine (!). I’m in favor of free competition, without monopoly laws.

            If you think the medicine is great, why do you need a monopoly protection for it? Doesn’t that imply you think we need government to make decisions for people?

            Should government ever have been deciding if I can have acupuncture? It was illegal once, you know.

            Should government decide I can have back treatment A and not B?

            Really?

          • HonestDebate1

            “Should government decide I can have back treatment A and not B?”

            No not really. But there should be laws against your barber doing disk surgery so that after he paralyzes you (or worse) there will be legal grounds to compensate you or your family. I am not advocating the government deciding what treatment you can have but who is qualified to give it.

          • BenEastwood

            Medicare is a nonprofit, public program run for the public good, wheras ACA privatizes the social safety net so it can be run for corporate and shareholder profit.

          • northeaster17

            The fact that getting to single payer is so difficult is frustrating for sure. I think however that the logjam on this issue was so persistant that something had to happen. If that something is the ACA so be it. Though I think that since the ACA does allow coverage to many more people is reason enough not to kill it. That’s what this whole debate is about for me. Coverage.

  • Coastghost

    At what point do the cumulative ad hoc “adjustments” to all the moving pieces of ObamaFraud REQUIRE repeal so that the legislation is self-consistent? All we hear from Obama as “implementation” proceeds is granting exemptions here, curtailing benefits there, postponing deadlines indefinitely or to some expedient date following an election, et cetera.

    • BHA_in_Vermont

      No repeal, conversion to the Single Payer system it should have been all along.

    • lobstahbisque

      Your cheerleading for the failure of the ACA is un-American. Try to cheer UP and ‘put on a happy face’, then your entries wont be so dreaded by reasonable people.

      • HonestDebate1

        Obamacare is un-American.

        • lobstahbisque

          No. Presidents since Teddy Roosevelt have tried to pass universal healthcare. It’s American as apple pie.

          • BenEastwood

            Romneycare, err obamacare, aka the ACA is not universal healthcare, and is unamerican. It is a private insurance madate which privatizes the social safety net so it can be run for shareholder profit, not public good. It is a sham on the American people.

          • lobstahbisque

            There you go, falling into the nihilism. I believe in the audacity of hope.

          • BenEastwood

            Funny, from your post I figured you had the hopelessness of resignation that the majority of obaaaamapoligists show. The nihilism comes from people like you, who say it is hopeless or meaningless to stand up and demand real healthcare coverage reform rather than settling for Romneycare… I have the audacity to not only hope, but to act to bring about real reform. Single payer is coming to Vermont, and it will be the Progressive Party of Vermont, not the democrapublican syndicate which will bring change. Change can only come from the grass roots, not from those waiting and hoping. Cheers, heres hoping enough people think like Carl Gibson and Michael Moore, to break the stalemate. I am working towards that future.

          • jefe68

            Sure is.

  • coyotejazz

    Let’s hope that Carl has relatives with deep pockets as he will be in a world of hurt should he fall ill without insurance. Either his kindly relatives can step up or he can rely on all of the rest of us as a freerider.

  • Richard Jablonski

    People in the 18 o 26 year bracket need facts about the risks of major illness or injury and the costs of treatment of those conditions. It’s my belief that young people cannot afford not to purchase healthcare insurance which at minimum provides catastrophic illness or injuries; I plan to ask my U.S. senators to have the facts published so better informed decisions can be made.

    • warryer

      Did you have insurance at these rates when you were a young person?

    • TFRX

      I plan to ask my U.S. senators to have the facts published so better informed decisions can be made.

      In a normal world that would be an unalloyed good idea. It has been part and parcel of what we call “governance”, making the public aware of what government services the people can use. At the very least, it’s “you should be able to get what you paid for” becuase one’s tax dollars are setting up any given program.

      But here’s the twist: Who are your Senators? Are they the kind who we should trust when it comes to communicating facts about healthcare?

    • https://www.facebook.com/kyle.rose Kyle Rose

      Insurers are no longer able to discriminate on the basis of pre-existing conditions. Wait until you get sick, then get insurance: problem solved!

      • BHA_in_Vermont

        Sick like your blood pressure is going up so you sign up during the enrollment period at the end of the year or sick like “need immediate care”?

        If the former, yep you can do that. If the latter, sorry, you can only sign up during the enrollment period.

      • hennorama

        Kyle Rose — you should check your sources, as you are misinformed.

        When the initial open enrollment period for individuals ends on March 31, 2014, future open enrollment periods will be the same as those for Medicare, running from October 15 to December 7 each year. If you miss signing up for coverage before March 31, 2014, you’ll have to wait until the fall to buy a health plan. There are some exceptions, but most people will be out of luck until next year.

      • http://www.findingourdream.blogspot.com Hal Horvath

        Fault in idea: you are in car wreck, your fault, you get hauled to ER, you are treated while unconscious. It costs $80,000. They don’t forgive more than about 1/2. You have a lasting $40,000 debt….. That’s yours and you can’t shake it without bankruptcy, which requires forfeit of assets….

        • Ray in VT

          and then the other $40,000 gets picked up by everybody else.

        • BenEastwood

          You get behind the wheel and cause an accident, why should I pay your medical bills? Of course it would be better to have insurance, but being forced to buy it from a corporation is just wrong, and does nothing to really change the system, it just privatizes a social safety net so it can be run for greater shareholder profits instead of better coverage. The ACA, aka Romneycare, is a sham. It is not health coverage, it is a corporate mandate.

          • http://www.findingourdream.blogspot.com Hal Horvath

            “…why should I pay your medical bills?” of uninsured person?
            Answer: You already do. But, you could pay *less* by insuring those individuals. Actually less.
            About the ugly corporate mandate. The real lynchpin of that is medical licensing — where doctor lobbies bought and purchased legislation in every state to prevent free market competition.

          • BenEastwood

            No, any person whose neglegence causes their own pain and suffering SHOULD be responsible for the entirety of their expenses and should be liable to cover the expenses of any other damage they caused as well. We shouldn’t socialize personal or corporate risk. This dangerous line of thinking is what led to bailouts for the banks without any protections, leads to the public funding and insurance of nuclear power plants, with zero public benefit and no local oversight,… socialized risk for private profit is the agenda of ALEC, and the other neoconservative thinktanks that dreamed up this ACA Romneycare scam.

          • http://www.findingourdream.blogspot.com Hal Horvath

            Exactly, good examples with nuclear power liability (on the public), and of course coal burning is another example (mercury emissions, arsenic emissions, particulates; asthma, heart attacks, nerve damage, etc.)…..
            But with life or death in the ER, our society has chosen to say that we will not refuse to treat someone because they have no insurance. By law, they will get treatment.
            So, you’ll help pay, in your own costs, which subsidies those uninsured.

    • hennorama

      Richard Jablonski — the CDC has data on health risks of various age groups, such as

      “Youth Risk Behavior”

      See:
      http://www.cdc.gov/healthyyouth/yrbs/index.htm
      http://www.cdc.gov/healthyyouth/yrbs/pdf/us_overview_yrbs.pdf

      Of course, getting “People in the 18 [to] 26 year bracket” to first pay attention, and to then change behavior, is a tall order.

      • BenEastwood

        Lol, I though Carl was risking financial ruin, now he’s a freeloader… lol, which is it? You romneycare fans can’t seem to make up your minds.

  • OnPointComments

    1/22/2014 Quinnipiac Poll
    http://www.quinnipiac.edu/institutes-and-centers/polling-institute/national/release-detail?ReleaseID=1999

    Do you approve or disapprove of the way Barack Obama is handling – health care?
    36% – Approve
    59% – Disapprove

    Do you support or oppose the health care law passed by Barack Obama and Congress in 2010?
    38% – Support
    56% – Oppose

    • http://www.findingourdream.blogspot.com Hal Horvath

      heh heh….what’s the approval rating of Congress?
      Sometimes people attribute to a President powers that in reality are Congress’s.
      Would just about anyone do health care reform differently?
      Yes. Most people would do it differently, and in different ways from each other too! :-)

    • BHA_in_Vermont

      How many opposed to the ACA are in favor of the vast majority of the individual parts of the bill IF asked about them individually??

      Up or down is not a helpful poll. I could answer either way:
      1) I am for it because it is MUCH better than the system we have been suffering under for generations.
      2) I am against it because it is not Single Payer, health care for all.

      • OnPointComments

        If someone opposes the ACA because they wish it was single payer, how does that change the ACA, the bill they don’t support?

    • Human2013

      ….but we don’t know why they disapprove. Many are opposed because we didn’t get a single payer system and see Obamacare as more of the same.

      • jefe68

        This is an example of why I think trying to engage with the right on health care is futile. As one can see by some of the commenters here they are not interested in solving the health care problem. They just seem to want this to fail.

        Here’s the thing though, we all need health care.

        We all need to go to the doctor the bottom line is our system is failing. So instead of posting things in bold caps and acting like partisan Fox news pundits, how about dealing with this like adults.

        • BenEastwood

          First of all, “the right” makes up half of the 99 percent. If we do not find ways to discuss this accross so called lines, we will never find a solution the majority will support, the 1 percent will always have controlling Interest as long as left and right working people are divided.
          Secondly, by referring to “the right” “the left” etc, you are feeding into the false right, left paradigm… look at what happens whe the right and left unite… Bernie Sanders and Ron Paul worked together and got the fed audited… something the moderate D and R corporatists wanted to avoid.
          The problem is complex, and will take a clever solution, because the corporate money is stacked against the people. Lets not make it harder by dividing folks. The truth is, ACA IS terrible, and needs to be replaced with universal coverage… we just need to find a way to engage people across the political spectrum. This is not an issue the left can fix on its own. None of the big ones are.
          But then again, what do I know? I am just a Vermont Progressive, part of the party that brought single payer to the only state to be working on it. Fulfilling the ACA mandates is slowing real health care coverage reform in our state.

          • jefe68

            Except the GOP will never let that happen. Neither will a lot o the Democrats for that matter. Noam Chomsky once said there really is only one party in the US, it’s the business party.

            Part of me wants believe in your sentiments and wish there was a way of coming a consensus. However, read the comments on by the right wing leaning commenters on this forum. Do see any one of these folks agreeing to a single payer not for profit health care system?

            By the way good luck with the Vermont plan. I really hope it works and shows he rest of the nation that single payer is the only way to go.

      • OnPointComments

        There has never been a single poll that shows a majority of Americans support the Affordable Health Care bill passed by Congress in 2010. Not one. Whether people like this part but not that, or wish it had included this, is irrelevant: the bill that was passed and that we’re all subject to is not supported by a majority of the public.

        • Human2013

          It’s very relevant because most Americans were in dire need of some or all of the ACA provisions and a relevant poll would explore the proponents of the provisions.

    • Guest

      You’ll still lose the election in 2016. Carry on.

    • jimino

      What do your polls say their main complaint is? Is it not being able to be totally denied coverage at the outset due to a pre-exisitng condition? Or maybe it’s not being able to have coverage denied by the insurer to whom they have paid tens of thousands of dollars, AFTER they got the treatment, that really upsets them.

      What exactly do such polls show besides the obvious high level of ignorance of the respondents regarding our health care payment system and the provisions of the ACA?

      • OnPointComments

        The typical and expected liberal response: if you don’t agree with the decisions we’re imposing on you, it’s because you aren’t as smart and perceptive as we are. While liberals may have a paucity of intelligence, they offset the shortage with an abundance of arrogance.

        • jimino

          So you don’t know and can’t even hypothesize what aspects of the law the respondents oppose. Why don’t you just say so?

          And my statement regarding the obvious high level of ignorance of the respondents regarding our health care payment system and the provisions of the ACA is undeniably and demonstrably true. If you take it personally, that’s your problem.

          • OnPointComments

            If someone opposes the ACA because they wish it was single payer, how does that change the ACA, the bill they don’t support? If someone opposes the requirement to have maternity and pediatric coverage, how does their opposition change the ACA, the bill they don’t support?

  • Duras

    I live in Florida, and I have met a lot of people who would receive free health care if Gov. Scott expanded Medicaid. Those very people think they are being forced an arm and a leg to pay for health care. They tell me number that are higher than my costs even though I make more money. Then I tell them that they are actually qualified for free health care under the Medicaid expansion. They say, “really?” Then I tell them that Gov. Scott is blocking the expansion. They then proceed to blame Obama for their lack of free health care.

    If a democrat was governor, they would have free health care, yet they still hate democrats.

    On a wider note: what the is affordable for today’s middle class? Nothing. The middle class is barely getting by. This is the age of Reaganism, not the FDR republic: nothing is affordable anymore. Democrats need to stop trying to find the middle ground because it is hurting them politically.

    Why can’t they see this? The Roosevelts were extremely popular. The current Pope has following beyond Catholicism.
    If democrats would have said, “Forget you, we are expanding medicare for everyone, and the rich are going to pay through the nose for it.” 99% of this country would have been happy. No big bills … nice and simple and short and sweet, how conservatives like it.

    • Human2013

      The conformity across America goes well beyond healthcare. Where are our critical thinking skills? I hate to make generalizations, but many republicans have difficulties thinking “outside the box.” Many think that Medicare is some benevolen for profit organization that comes to their aide in later years. This tax season many will be eligible for the EITC credit (poor subsidy) and then march against government subsidies and spending. I just don’t get it.

      • Duras

        My theory is that their ideology is destroying literacy. I won’t get into it because it is off point.

        There is some extreme cognitive dissonance out there.

  • http://www.findingourdream.blogspot.com Hal Horvath

    How many people know you can’t practice medicine without a license.
    Guess who controls the licensing board. Next, guess what kinds of money they make by limiting competition…..
    Yeah.

    • JGC

      I think that is why Rand Paul made his own privately owned Ophthalmology seal of approval, only filled by his own family members. He was resentful of going through the nationwide licensing board.

      • http://www.findingourdream.blogspot.com Hal Horvath

        The classic ruse used to help establish the semi-monopoly via licensing laws is to scare people with unusual (and often real) examples of the extremes of quack medicine, and suggest (or outright claim) that people will be victimized left and right, all the time, without this control, as if people are entirely helpless to choose for themselves.

  • Bruce94

    Thank you for pointing out the obvious. I was waiting for the other guests to call him on it and was surprised that they let it go unchallenged.

  • Bruce94

    What Carl Gibson failed to mention is that he never pays the deductible if he doesn’t need to see a doctor. Did he say that under the ACA he would pay a modest monthly premium of $150-200 (the cost of a basic cable package or cell phone bill) in order to insure himself against a catastrophic illness or accident? Ummh…great priorities. BTW I respect Reader Supported News (except for their obsession with the NSA story, but that’s for another conversation). However, I don’t agree with the libertarian nonsense from the Left or the Right–a myopic view that says I’ll avoid my personal responsibility (as well as any social obligation I might have to help pay for older, sicker folks) AND if I wind up in the emergency room having crashed my motorcycle and crushed my skull because I was not wearing a helmet, I expect those who did take out insurance and pay their taxes most of their adult lives to cover my medical bills and living expenses after I’ve declared bankruptcy.

    Incidentally, someone needs to point out to the Carls of the world that the cost of an uncomplicated, same-day, elective surgery would likely cost 2-3 times more than his annual deductible would, to say nothing of all the preventive and early detection services that he and other young invincibles need and would be able to get at no or minimal cost.

    • BenEastwood

      A key point missed by folks who parrot the ridiculous idea that the people opting out of the ACA are reneging on their obligation to a multigenerational contract, is that the ACA IS NOT A MULTIGENERATIONAL SOCIAL CONTRACT. It is a privatization of a social contract, where, instead of funds going in to benefit future generations, like social security and medicaid, the ACA funnels funds to for profit corporations who manage that money to benefit shareholders, not the people served. If the ACA were not modeled on Romneycare, you might have a point, but the facts simply do not bear the claims of the Obamapologists. We need single payer, and ACA is neither single payer, nor the road to single payer, but a cul du sac in the corporate insurance industrial park.

      • Bruce94

        While the ACA is not structured like SS (and no one including me is arguing that point), it’s a fact when young people opt out, they help drive costs up for not only older, sicker people, but also younger folks with families or pre-existing conditions. The success of the ACA depends on an expansion of the risk pool in the individual market as well as Medicaid expansion. When the young invincibles (who upon closer examination may not be so invincible), opt out they jeopardize insurance coverage and healthcare access for those of us who are more vulnerable whether by age or infirmity.

        I take your point that we need single payer. Get back to me when you have the votes to pass Medicare for All or some other version. In the meantime, we have to live in the real world. There are some who would make the perfect the enemy of the good. The ACA is IMHO is a good start in the process of moving toward recognition of healthcare as a human right. It’s too early to say if it will lead us to a better place or live up to its billing. Maybe the Mass. experience could shed some light on that question.

        BTW, as I understand it and correct me if I’m wrong, in many states the majority of health insurers on the exchange are non-profits OR there is a menu of non-profit and for-profit entities that you can choose from. Of course, they’re still corporate players, so that may be irrelevant to you.

        • BenEastwood

          The ACA is to affordable healthcare for all what Neanderthal man was to the human genome, a dead end that will not evolve into something better. We will never have the votes as long as people like yourself, who understand that there is a better, more affordable option that provides more services to more people, refuse to stand up for change, and continue to drink the Romneycare Koolaid. Obamapolgy will not bring change we can believe in. The president can’t do it, congress can’t do it, because folks keep voting coke and pepsi corporatists into place.
          Until we stand together and demand real change, demand an end to the corporate takeover of our government… until we stand firm and refuse to support financially or vote for candidates that take corporate graft, until we refuse to support political parties which take corporate graft… until we stand together as a people and raise our voices above the tsunami of corporate cash, we will not effect change, so, unless you are content with the status quo, or should I say stasis quo… this “call me when you have the votes” attitude is exactly the attitude this bill was built to inspire… why bother, we live in the real world… lol, how can you see the world with your head burried in the sands of defeatism? If you aren’t satisfied with the program, stand up and be heard.

          • Bruce94

            Talk about burying your head in the “sands of defeatism.” According to your rant, the ACA is DOA. In my view, it’s still an experiment in progress with Mass. providing the only laboratory for possibly predicting its eventual outcome. If it fails, it will probably be because healthcare costs and insurance premiums couldn’t be constrained. To the extent that opting out pushes premiums higher for the rest of us who are policyholders, those who can afford health insurance but choose to opt out, will be hastening the ACA’s demise, and the corporatists will have won a victory which may or may not be lasting.

            If the demise of the ACA that you are advocating does not usher in a wave of popular support and legislative mandate for single payer, we can all look forward to a restoration of the pre-ACA reality and corporate prerogatives including discriminatory rates and exclusions based on pre-existing conditions, caps on annual/lifetime benefits, rescissions due to sudden illness or accident, and obscene medical loss ratios.

    • http://www.findingourdream.blogspot.com Hal Horvath

      If once doesn’t really want health insurance, but only catastrophic insurance, one can get a bronze plan, pay $0 usually (unless you have a nicely high income), and get both catastrophic coverage, and a very nice thing few young people know — discounted rates for all medical care negotiated by the insurer!! Those discounts are often 60% or more! Not trivial.

      • hennorama

        Hal Horvath — indeed, the very fact that someone has health insurance means that they benefit from the lower in-network healthcare provider prices negotiated by their insurer.

        This means that their out-of-pocket costs that go toward their deductible would be lower compared to an uninsured person, meaning that the uninsured person would reach the same deductible level of out-of-pocket spending much more quickly, assuming the same care was provided.

        This economic benefit is not factored into the simplistic and misleading arguments Mr. Gibson was making, either.

  • pete18

    For anyone interested in an informed and serious debate on the subject check out this from the Intelligence 2 Debate series:

    http://intelligencesquaredus.org/debates/upcoming-debates/item/1016-obamacare-is-now-beyond-rescue

    Dr. Scott Gottlieb and Megan McArdle argue for the proposal that Obamacare is beyond rescue and

    Jonathan Chaitand Dr. Douglas Kamerow argue against. Both sides are actually well represented in the debate and both teams make good points.

    Gottlieb and McArdle won the debate based on the before and after poll with the audience (rather surprising because it was Upper West Side crowd).

    I think the case they made against Obamacare is pretty hard to refute but Chait and Kamerow effectively outlined the reasons why the old system needed major changes.

    • hennorama

      pete18 — thanks for sharing.

      Details as to the before and after:

      AUDIENCE RESULTS (Motion: Obamacare is now beyond rescue.)

      Before the debate:

      16% FOR
      53% AGAINST
      31% UNDECIDED

      After the debate:

      32% FOR
      59% AGAINST
      9% UNDECIDED

      Meaning an even larger majority of the audience rejected the proposition after the debate, with most of the fence-sitters moving to agreeing with the proposition.

      • pete18

        But as you know, how you measure the effectiveness of a debate is by how many people you sway in your direction not by what a compounded total for any side is. The “for” side added 16% percent more to their side, the “against” only 6%. Even more impressive given that it was in front of what was more likely than not an audience more inclined to support the “against” position.

        • hennorama

          pete18 — indeed, but for those unfamiliar with the way Intelligence Squared works, a different impression would be left if they read only that those arguing FOR the proposition “won the debate.”

          Thanks again for sharing the link.

          • pete18

            A quick look at the link I provided would clear up any misunderstandings about how “winning” was measured. Even better, if people listened to the debate they could decide on the merits of the arguments presented themselves.

          • hennorama

            pete18 — that’s true, but it assumes that everyone will take the time and make the effort to open and read what’s in the linked information.

            There’s nothing at all wrong with your original post. I simply thought that having the before and after info was helpful in presenting the whole story, whether or not one opens the link.

            Thanks again for sharing this debate, as it was quite well done (as is usual with Intelligence Squared).

    • Frank TheUnderemployedProfessi

      “Obamacare” is destined to “fail”, not because requiring people to purchase health insurance is, in and of itself, a problem, but rather because the entire underlying and preexisting quasi-free-market structure of our health care system is the problem.

      What’s sad is that the general populace or at least the brain dead conservatives seem to think that our health care system was roses pre-ACA. In reality it was a train wreck. Coincidentally, it should be noted that the ACA itself is NOT a health care system, but rather just a small aspect of the health care system. Obamacare is a small band aid being placed over a gaping wound.

      Our health care system with the ACA band-aid will, of course, fail, not because of Obamacare, but because the system of private insurance companies and private hospitals itself is very inefficient compared to socialized medicine.

  • andic_epipedon

    I’m reading age discrimination in employment in the tea leaves for those states that did not expand Medicaid.

  • OnPointComments

    If someone opposes the ACA because they wish it was single payer, how does that change the ACA, the bill they don’t support?

  • 1Brett1

    I got a BCBS plan a couple of months ago, a little over $300 a month with a $7,500 annual deductible. Prior to that, I had what was known as a catastrophic plan. The premium was $1,800 a year, cheaper than what I have now, sure, but now I have a lot more coverage (my medications alone were costing me around $300 a month but now are covered). So, yes, my premiums went up with the ACA in place but I now have much better insurance, and my premiums are costing me about what my medications used to cost.

    I have two life-long pre-existing conditions (Type one diabetes and asthma); both have been well-managed for most of the time I have had them (since being a child), but I also had been rejected by most insurance companies prior to the ACA’s implementation. My old insurance didn’t cover things like medication, regular office visits or preventive treatments. Now, I pay a low copay on those.

    I currently have two rotator cuff tears and a bone spur in my left shoulder; and, healing treatments have not proven fruitful for the tears. I will be having orthoscopic surgery soon. While I will have to pay out-of-pocket for most of the surgery (have already paid for the MRIs), some of the visits and tests–which would not have been covered at all under my previous plan–have been covered. I also have a HSA which should be enough to cover things until I reach my deductible this year.

    I am fairly happy with my new plan and my personal approach. I make too much money to be eligible for any financial assistance or subsidies (and live in a Red state), but I also can weather my current medical problems without any real worries. It has also been a relief to have my insulin (diabetes) and daily corticosteroids (asthma) covered.

    There are some bad stories stemming from the ACA’s implementation, I know, but my experience has been good. (BTW, I didn’t go to the Federal exchange website, I went directly to BCBS.) And, like I said, the ability to get decent insurance without worry of being dropped/even getting covered, based on the fact that I am a 59 year old male with two pre-existing conditions, has been a huge benefit.

    There is a lot of confusing/misinformation and disinformation out there about this law, and it comes from both the left and the right. In some Red states, governors have set up prohibitions for even sharing information about ACA requirements. It’s a shame; if more information was more forthcoming and more states set up their own exchanges, the law would work much better. Governors of Red states who refuse to set up state exchanges and prevent information- sharing are playing politics; they want the ACA to fail. If your state has taken measures to prevent your access to services and information, blame your governor.

  • OnPointComments

    Who uses the emergency room more, the insured or the uninsured? In Oregon, enrolling an uninsured person in Medicaid increased ER usage by 40%.

    “In 2008, Oregon initiated a limited expansion of a Medicaid program for uninsured, low-income adults, drawing names from a waiting list by lottery. This lottery created a rare opportunity to study the effects of Medicaid coverage by using a randomized controlled design. By using the randomization provided by the lottery and emergency-department records from Portland-area hospitals, we studied the emergency department use of about 25,000 lottery participants over about 18 months after the lottery. We found that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40% relative to an average of 1.02 visits per person in the control group. We found increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings.”
    http://www.sciencemag.org/content/343/6168/263.abstract

    For years, Americans were told ad nauseum that converting uninsured patients who overuse the ER into insured patients whose doctors could catch problems earlier would help contain exploding healthcare costs. But the very latest data from the ongoing Oregon study demolished this fiction. The researchers found that Medicaid enrollees landed in the ER 40% more than the uninsured control group, “including increases in visits for conditions that may be most readily treatable in primary care settings.” A central justification for the Affordable Care Act lies in tatters.
    http://thefederalist.com/2014/01/21/more-people-on-medicaid-does-not-mean-obamacare-is-a-success/

  • hennorama

    stev619m — you can always drop your employer-sponsored health insurance and carry on a principled battle, “all the way to the Supreme Court!” Of course, given that the SCOTUS has already ruled, you would be carrying on a rather quixotic battle.

    Let us know when you drop your existing coverage, OK?

    • HonestDebate1

      STEPHANOPOULOS: That may be, but it’s still a tax increase.

      OBAMA: No. That’s not true, George. The — for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase. What it’s saying is, is that we’re not going to have other people carrying your burdens for you anymore than the fact that right now everybody in America, just about, has to get auto insurance. Nobody considers that a tax increase. People say to themselves, that is a fair way to make sure that if you hit my car, that I’m not covering all the costs.

      STEPHANOPOULOS: But it may be fair, it may be good public policy…

      OBAMA: No, but — but, George, you — you can’t just make up that language and decide that that’s called a tax increase.

      http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/

  • Cacimo

    Kaiser Health is a Democrat organization. To have them say this issue has become politicized is absurd. Obamacare has been has been political from day one.

    • Coastghost

      You mean the NPR subsidiary? (or has NPR become the Kaiser Health subsidiary? so hard to tell these days: in either event, as you suggest both behave like loyal subsidiaries of the Democratic Party)

    • FrankensteinDragon

      i would say since day two when tea-fascists obnoxiously rejected human care for all americans and obama was forced to submit to the billionaires and the powerful death-mongering for-profit insurance industry–thats when it became political–when the right made it political. health care is a basic human right. we live in a civilized society–not feudal Romania.

      • Chris Carlin

        Funny. “Human care for all americans” is a policy with strong historically fascist qualities.

        • FrankensteinDragon

          absurd. how so wonder boy?

          • Chris Carlin

            Collectivist, nationalist, and top down. Those are qualities historically associated with fascism.

  • Cacimo

    There is no such thing as “free money” the states refusing this poison apple are smart.

    • northeaster17

      States refusing the Medicade expansion are finding that many of their citizens can not afford medical insurance. Something to be proud of I’m sure….

      • Chris Carlin

        Yes. Insisting on running a government that’s responsible, that doesn’t write checks it can’t cash, that has a plan for budgeting its money… those are certainly things to be proud of.

  • jimino

    If it were up to me you could have your way. I think you should have the right to be allowed to bleed to death on the side of the road if you got seriously injured in a car wreck if that is your choice. But what do we do with your body if you don’t have funeral insurance?

    • FrankensteinDragon

      throw it away –but only if they voted against national health care. those who vote for it should have be buried under nice tee with a stone that says–thank you.

    • Frank TheUnderemployedProfessi

      “But what do we do with your body if you don’t have funeral insurance?”

      Soylent Green is made of people!

  • brettearle

    Many people were against Medicare, at first.

    And, since it was implemented, it has SAVED HUNDREDS OF THOUSANDS of lives.

    • HonestDebate1

      Medicare was passed without gimmicks after a vigorous and transparent debate on a bipartisan basis. The public got what was advertised.

      Obamacare, not so much.

      • brettearle

        Medicare confronted noticeable adjustment problems, as well.

        What’s more, at the time, Medicare was opposed strongly by some prominent Republicans–including Dole and Reagan; not to mention the Republican candidate for the Presidency, in 1964….a notorious conservative, who lost, with a monstrous defeat.

        What’s more AMA, basically supported ACA. And yet, at the time, it did not support Medicare.

        Ronald Reagan was spokesman for AMA, when opposing Medicare.

        Your summary above, therefore, leaves out important opposing aspects–and is, therefore slanted.

        • HonestDebate1

          The fact remains.

          • FrankensteinDragon

            yes you’re right, the facts that brettearle pointed out

          • HonestDebate1

            I don’t dispute his facts but the legislative process is not always pretty. Obamacare disregarded it completely, misrepresented the act and railroaded it through with one party. People didn’t have a clue what they were supporting. We still don’t, Obamacare changes every day.

            Medicare was not passed in such a fashion at all. It’s irrelevant who opposed it, they were the minority and the majority knew what they were supporting.

  • Stacy21629

    I had insurance…a high deductable, no maternity Anthem policy. Canceled because it didn’t meet the ACA guidelines. New plans are prohibitively expensive…so I’m left with no insurance and I make too much for Medicaid or other help. Yay ACA.

    • brettearle

      Because you, as health plan consumer, are not alone, in your general category–regarding new, more expensive plans, now that ACA has been implemented–I would be very surprised if there is not an Advocacy Division or Ombudsman(s) for you to contact, about this matter.

      I would also be very surprised if ACA policy does not provide adjustments–either now or in the future.

      I am not saying that your predicament isn’t difficult. I am simply saying that ACA will likely find a way to meet this problem head on, if there are growing numbers in your category.

      And ACA may even be able to meet your needs, eventually, even if there aren’t growing numbers in your category.

      • pete18

        When the false promises come to roost and the failed policies make themselves apparent there’s always wishful thinking to help one avoid looking back at the carnage.

        • brettearle

          Your point is, of course, that new, flawed, complex policy cannot ever be amended or modified.

          Especially by men and women, in the Administration, who believe in what they are doing?

          Of course, if it were a Republican administration, with men and women who believed in what they were doing, it would be different?

          Is that what you are claiming?

          That perhaps Republicans would surely NOT face flaws in policy–and would therefore not give up, for all the policies that would never have failed in the first place; and therefore would never, ever have to implement wishful thinking, or go into denial, as well?

          Your cynicism doesn’t cut it.

          You’re suggesting that the Administration is not taking steps to improve the flaws.

          Not only that but you’re also suggesting that the Administration can’t fix things because it’s wishful thinking and because they’re in denial?

          I would argue that your claims are unfounded, sweeping statements–about ACA’s future, because of its past.

          I would also argue that–although it will take a great deal of time–ACA will survive and will become stronger.

          • pete18

            When a skyscraper is built using flawed architecture by company “D,” and all the engineers from company “R” predict that the framework being used won’t support the structure and then the structure starts tilting over as predicted, the suggestion by company “R” to demolish the building before it destroys the surrounding city is not cynicism, it’s informed realism.

            When the eager and arrogant architects from company “D,” who have been wrong about every prediction they have made about the stability of the building, start promising that new windows and a paint job on the outside of the building will save it, they are in deep denial.

          • brettearle

            The Hancock Building, in Copley Square hasn’t had glass shatter in years.

            What’s more Policies are malleable; Buildings are not.

          • pete18

            You are missing the point of the analogy.
            The windows aren’t falling out of the ACA the whole building is falling over. That’s because it’s basic design is structurally unsound. The inability to deliver on its promises is built into its blueprint. No amount of tinkering around the edges will fix it.

          • Frank TheUnderemployedProfessi

            To hear you tell it, our health care system pre-ACA was a model of efficiency. The problem with your analogy is that the building in question was a disaster long before the D Company ever touched it.

            To hear fans of R Company tell it, we had the best health care system in the world before the ACA. Apparently they missed the tens of millions of unemployed and underemployed Americans, the hundreds of thousands of medical cost-induced bankruptcies, and the private health insurance company death panels among numerous other problems for a lower percentage of GDP spent on health care and also in absolute dollars.

            Oh, it should be noted that other nations that have evil evil (FEAR!) socialized medicine have 100% coverage, zero medical bankruptcies, and a business environment and economy that is not burdened by health insurance concerns. In contrast, the United States with its quasi-market health care system is spending over 17% of its GDP while those other nations are spending far less.

            For those who are wondering how those evil socialist people’s states are doing it, in the U.S. we are spending tons of money to pay insurance company employees and execs, private hospital execs, insurance brokers, and advertising agencies whose work does not provide any actual health care.

          • brettearle

            It is simply regrettable that the President couldn’t have brought in Scandinavian specialists.

            But sooner, or later, it would have come out.

            [More leaks on his Watch than many other Administrations.]

          • Bruce94

            The undeniable fact is that the GOP has been obfuscating and obstructing any serious effort at healthcare reform for decades. They’ve offered no credible alternative to the ACA. From Republicans we hear the familiar, pathetic refrain: “Tort reform, health savings accounts, insurance sales across state lines,” in other words, nothing that would begin to make a substantial difference and as with Paul Ryan’s proposed Medicare reform, proposals that would in many instances make matters much worse for those in the individual insurance market.

          • pete18

            “Tort reform, health savings accounts, insurance sales across state lines,”

            All of which would have had a more significant effect on controlling costs and giving consumers more choices than Obamacare, which has made things more expensive and has limited
            choices for the consumer.

            Even doing nothing would have been far better than this convoluted monstrosity
            called the ACA, which hasn’t delivered on any of it’s promises.

          • Bruce94

            Thanks for the reply. Now that I’ve been hammered from both the Left
            and the Right on this subject, I feel vindicated. As Hen and others on this forum have pointed out, tens of millions of Americans have already benefited from the initial stages of ACA implementation including millions with preexisting conditions who can now get affordable insurance and would otherwise be unable to pay for necessary care, millions who now receive preventive/wellness services free of charge, millions of seniors who now save on their prescriptions, millions of young people who are now covered under their parents’ policies, and millions of small businesses who can now claim tax deductions for providing insurance to their employees.

            Here’s a list from Politifact of the some of the promises kept:

            -Closed the “doughnut hole” in Medicare prescription drug plan
            -Provided easy-to-understand comparisons of the Medicare prescription drug plans
            -Required insurance companies to cover pre-existing conditions
            -Gave tax credits to those who need help to pay health premiums
            -Required children to have health insurance coverage
            -Expanded eligibility for Medicaid
            -Expanded eligibility for State Children’s Health Insurance Fund (SCHIP)
            -Required health plans to disclose how much of the premium goes to patient care
            -Established an independent health institute to provide accurate and objective information
            -Implemented and funded proven health intervention programs
            -Expanded funding to train primary care providers and public health
            practitioners
            -Increased funding to expand community based prevention programs
            -Improved recruitment of public health workers

            Now, what were you saying?

          • brettearle

            Your observations are grossly–but grossly–exaggerated, because of your political bias.

            No question ACA has real problems. But falling apart, it is not.

            The next thing we know, you are planning to say that the White House is covering-up ACA’s full self-destruction.

            Why?

            Because ACA’s impending death isn’t plastered all over the front pages of the WSJ and NYT:

            to wit::

            “Just Like Pete 18, Contributor to OnPoint Forum, Said: ACA, Completely Disintegrating”

            Extra! Extra! Read All About It!

          • pete18

            “Your observations are grossly–but grossly–exaggerated, because of your political bias.”

            Given who has had a better track record of predicting the outcomes of the ACA up to this point, the other possibility you have to consider is that you are unwilling to see or admit to this program’s utter failure to live up to any of its promises and the destruction it is bringing the economy, the availability of doctors, lost coverage, increased costs, increased taxes and the deficit because of your political bias. This may also prevent you from seeing the rash of problems that lie ahead.

          • HonestDebate1

            Name one entitlement that has ever gotten smaller. Policy digs in.

          • Bruce94

            Lessons can be learned from the rollout of Medicare Part D in 2005. Yes, complicated programs with flaws that encounter problems in the early stages of their implementation can be fixed as the history of Medicare Part D demonstrates. It helps if there is bipartisan support for the remedies–something sorely lacking in the Washington today largely due to Tea Party/GOP anti-govt. paranoia and ongoing attempts to undermine the President at any cost even it means sacrificing the health and well-being of their constituents (see Medicaid expansion in Red States).

            http://www.politifact.com/truth-o-meter/statements/2013/nov/13/steve-israel/medicare-part-d-and-obamacare-health-care-gov/

    • http://www.findingourdream.blogspot.com Hal Horvath

      What is Obamacare? About 98% of it is the *subsidies* to make insurance *affordable* for lower income people.

      Help yourself by realizing you don’t know how much it will actually cost until after you get your final cost calculation which depends on your income.

      It will be “affordable” It will not cost 15% of your income (I once paid 25% of my income!), like it has for many people until now. It will cost much less than that.

  • Jackson Hartfeld

    Is there some sort of clearinghouse for ACA bashers? You can
    go to any discussion, blog or board on the topic of the ACA and you will find
    the same strident RW style of posts. Tons of them and far more than the often
    cited numbers of those in polls who oppose the measure would justify.

    • OnPointComments

      In the latest poll, 59% disapprove of the way Barack Obama is handling health care, and 56% oppose the health care law passed by Barack Obama and Congress in 2010. It looks to me like in this forum the pro-ACAs outnumber the anti-ACAs.

      • jimino

        Why?

      • FrankensteinDragon

        the concern is–most people wanted single-payer universalhealthcare–national health care–a basic human right–and obama tried to get that, but was blocked aggressively and obnoxiously by the right, so he had to compromises–something we do in a quasi-democracy. The hope is that getting people health care (they would normally have because private-for-profit greedy vampire insurance companies who made money denying claims–are forced to insure everyone–seems very human to me–seeing we all live under the same GD flag)–will lead to single-payer in the future. Considering the ridiculous inhumane fascist koch financed tea opposition Obama faces, he did what he could he did well. Tho, many people think he should have been tougher and held out for a better deal–some of us dont want to give money to greedy vampire death-mongering insurance agencies (death panels)

        • northeaster17

          Obama did not try to push single payer.

          • HonestDebate1

            Because he knew it was not obtainable through the front door, so he went around back. Single-payer is coming.

          • FrankensteinDragon

            im glad you’re such an optimist–tho I know it was you fear. I hope you are right. One day you will see the benefit, tho you will probably never admit it when you do.

    • HonestDebate1

      Could it be possible there are real concerns that should be addressed?

      • FrankensteinDragon

        not your concerns or red state concerns.

        • HonestDebate1

          Wow. I happen to think writing off half the country is downright evil.

    • Chris Carlin

      Yes: it’s called reality.

      When we look at the data, we see how awful the law is performing. We also see that the bad performance is entirely in line with expectations: its math didn’t SEEM to add up, and now we confirm that it doesn’t.

      Funny how “lots of people have come to this conclusion” is somehow presented as evidence against the conclusion…

  • georgepotts

    So, Obamacare has resulted in less people with insurance, higher costs, and more people with free care.

    Does anyone realize what the Democrats are doing?

    • FrankensteinDragon

      no. what are they doing?

    • northeaster17

      You need to do better than that. Who, how much, where…..

  • HonestDebate1

    Your employer may drop your coverage next year when the employer mandate kicks in. Have you asked your employer what he or she plans to do?

  • FrankensteinDragon

    people your complaints about rising costs are your own fault–if you rejected single-payer–the faults are not obama but the for-profit death-mongering death panels called private insurance agencies. They want profit. PROFIT. If you want good health care where doctors prescribe medicine only when you absolutley ned it or dentists do oral surgery with your best interests at heart–because they ge tpaid no matter what–you NEED universal single-payer national health care. IN such a system there concern is your health–they dont worry about insurance and profit. And doctors will still get paid–180000 -300000 dollars with benefits and perks. Cuba has the best health care in the world, arguably. Britain has outstanding health care–i am experienced with it. Dont believe billionaire lies–they want PROFIT–at your expense–your life.

    I am ashamed of people who fly a flag and reject universal health care. hypocrites.

    look at the state of the union–every aspect–capitalism has failed. it doesnt work. Capitalism is designed to stel from the poor and funnel money to the top. it has no borders, no flag, no identity or nationality BY its nature capitalism is AGAINST jobs–destroys jobs. labor is a cost. You are nothing. fodder. Capitalism does not work. Thats why american health care DOES NOT WORK!

    I will pay 300 dollars to stay uninsured and hopefully that money will help some destitute family or child who really needs it.

    • FrankensteinDragon

      cowards mark down and dont comment. you have nothing say because i am right and you feel less of a person for your lack of concern for other human beings

      • HonestDebate1

        I want to up vote your comment because I agree with your first sentence but just because someone sees things differently doesn’t mean there is a lack of concern for their fellow man. That notion has stifled too much honesty. The sum total of the left’s position is that the right is evil and uncaring. The right doesn’t view the left that way.

        Wear the down votes as a badge of honor, I do.

  • jefe68

    Actually it was first the pursuit of property before it was changed to happiness as the founders thought it sounded better.

  • Mattyster

    I get soooooo tired of hearing this framed as ‘young and healthy’ people must sign up for insurance to pay for the ‘older sicker’ people, as though it’s all about them sacrificing for the ‘old sick’ people with no mention of the benefits to them of having insurance. I also rarely hear mention of the
    aggressive campaign Republicans have waged to discourage ‘young healthy’
    people from signing up.

    • Cutler Hamilton

      The only mention I’ve heard of “sacrificing” was from your comment.

    • Chris Carlin

      As pointed out in Gibson’s piece, a great many will not experience net benefit.

      Meanwhile, young people I know who lost plans that they considered worthwhile are finding their new options not worth the costs they’d have to pay.

      So yes. Voluntary sacrifice for redistribution of wealth is a key part of this plan. The younger are expected to sacrifice to pay for plans for older people.

      If Republicans encourage young people to make financially responsible decisions about whether to voluntarily take on that sacrifice… good for them!

      • Mattyster

        Your argument only works if you think having insurance when you are sick or injured is not a benefit. Insurance is not a lottery in which you win or lose. Insurance prevents financial ruin when you have the bad luck to be sick or injured. Being uninsured is not financially responsible.

        • Chris Carlin

          You have it backwards: insurance IS a lottery. You pay fixed costs into it, and if your number comes up, the insurance may pay back to you more than the amount you put it. Just like buying a weekly lotto ticket.

          Whether or not playing that lottery is responsible or not is a matter of personal taste and individual situation.

          • Mattyster

            I beg to differ. In the lottery you never lose more than you pay in. Insurance protects you from unexpected expenses that you HAVE to pay. You clearly don’t understand the concept of insurance.

          • Chris Carlin

            Nope, the accounting is exactly the same: within a policy you never lose more than you pay in.

            At worst case you pay tens of thousands for a policy over time and you never use it. You’re thus out tens of thousands of dollars, and your financial gamble of buying the policy proved wrong, just the same as buying lottery tickets but never winning.

          • Mattyster

            You’re ignoring the medical bills that can bankrupt you or your family if you are sick or injured.

          • Chris Carlin

            Of course I’m ignoring them. They’re entirely irrelevant to the math, so I’d point out that you’re wrongly getting distracted by them.

            We can easily prove this: if you can’t pay medical bills because you either didn’t buy the right lottery tickets or didn’t buy the right health insurance, you get the same outcome.

            Therefore, insurance and lottery are the same even when you start bringing up medical bills.

          • Mattyster

            I don’t believe you actually believe what you’re saying. Either you can’t or don’t want to understand what insurance is. In any case, I’m done. You can have the last word if you want.

          • Chris Carlin

            I’m happy to keep discussing with you.

            I’ve described here how insurance works, and you’ve replied with an unhelpful “nu-uh!” having neither shown an error in my description nor shown that an alternative description is better.

            Perhaps if you stuck with discussions a bit longer you’d have a better grasp of what insurance is instead of just disbelieving that other people have figured out something you haven’t?

  • Mattyster

    Just for the record I have two friends who make good money in their own businesses – one a doctor the other a real estate investor – and both went on the health care exchange and with little effort reduced their insurance with no subsidies because they are no longer penalized for pre-existing conditions.

  • gudmk

    In this whole segment I heard no problem with Obamacare except the fact that people are falling into the Medicaid gap. In fact Mr. Gibson mentioned in passing something like “I might have qualified for Medicaid but my Governor in Wisconsin didn’t decide to expand it”. But everyone kind of ignored this somehow during the discussion about Mr. Gibson’s. Same applied to the mother of two who called in and can’t afford coverage. So it seems that the problems with Obamacare are not problems with the law, but with the republican Governors who stand in its way.

    • Chris Carlin

      …and they stood in the way due to problems with the law. It’s too expensive even if it uses funky accounting to push costs off to out-years.

      You kind of ignored that somehow.

    • bruder

      It’s unclear why he would say that. His estimated income is $30,000. We would not be eligible for Medicaid. He isn’t even eligible for an Obamacare subsidy.

  • northeaster17

    The Supreme Court thought other wise. But Congress can still pass a law.

  • Frank TheUnderemployedProfessi

    The real irony of Obamacare is that the Republicans have won and gotten what they wanted — salvation of the private health insurance/hospital quasi-free market system and the death of the notion that socialized medicine might be a legitimate option.

    — Obamacare is actually the Republicans’ plan for health care. —

    The idea of an individual mandate was introduced by the conservative Heritage Foundation years ago and numerous Republican legislators advocated it and introduced legislation for it in the early ’90′s as a means of combating the Clintons’ attempts to move us in the direction of establishing real socialized medicine. For years the Republicans advocated plans that required individual mandates and those plans looked very similar to Obamacare. (“The Republicans had a plan for health care. It looked like Obamacare.”)

    • 1Brett1

      Hey, Frank, good to hear from you; it’s been a while!

  • Chris Carlin

    You’re misinterpreting his statement. I’d agree that he could have expressed it better, but he didn’t say what you think he said.

    What he said was entirely accurate: he spent $5000 to save the $1000. Had he not spent that $5000 he wouldn’t have saved the $1000. Yes, he would pay the $5000 either way, but that’s neither here nor there. His point was the large investment one has to make before seeing the first bit of benefit from insurance.

    So yes, one has to spend deductible plus premiums before seeing the first bit of savings from insurance. It is an entirely correct way of stating things that answers a certain question.

    Because after all, he didn’t make the choice to get injured.

  • Caroline

    As someone in the Health Insurance Industry, I appreciate what the President is trying to do, How many people did I have to grill about their health conditions only to let them know that health carriers will not cover their risk? We have had a two-tiered system; those who have the ability to finance their healthcare with help (employer-based coverage) and those who don’t. This leveling is a good thing.

  • bruder

    Great discussion as usual. Mr Gibson appears to be making a rational decision. What he fails to mention is that he is taking a big risk. He talks about his health care costs over the last few years, a broken arm, and uses that expense as a reason to continue going uninsured. In his case the purpose of buying insurance is to protect himself financially from health costs that far exceed what he’s paid in the past. He also presents himself as a typical young person, when he’s actually a borderline case: healthy, without access to group insurance, and just over the income level where he’d get a subsidy. He isn’t typical at all.

  • ExcellentNews

    Target should also give a free burrito to the discontinued workers… The “free market” at its best!

ONPOINT
TODAY
Apr 24, 2014
Senate President Pro Tem Darrell Steinberg, D-Sacramento, left, talks with Sen. Ed Hernandez, D-Covina at the Capitol in Sacramento, Calif., Monday, April 21, 2014. Hernandez proposed a constitutional amendment that would ask voters to again allow public colleges to use race and ethnicity when considering college applicants. The proposal stalled this year after backlash from Asian Americans. (AP)

California as Exhibit A for what happens when a state bans affirmative action in college admissions. We’ll look at race, college and California.

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A Buddhist monk lights the funeral pyre of Nepalese mountaineer Ang Kaji Sherpa, killed in an avalanche on Mount Everest, during his funeral ceremony in Katmandu, Nepal, Monday, April 21, 2014.  (AP)

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The Supreme Court looks at Aereo, the little startup that could cut your cable cord and up-end TV as we’ve known it. We look at the battle. Plus: a state ban on affirmative action in college admissions is upheld. We’ll examine the implications.

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