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Enrollment Countdown For Obamacare

One week to the March 31st sign-up deadline for Obamacare. We’ll look at where the big health plan stands.

Health and Human Services Secretary Kathleen Sebelius defends President Barack Obama’s healthcare law, the Affordable Care Act, as she answers questions from Republican members of the House Ways and Means Committee during its review of President Obama’s budget requests, Wednesday, March 12, 2014, on Capitol Hill in Washington. (AP)

Health and Human Services Secretary Kathleen Sebelius defends President Barack Obama’s healthcare law, the Affordable Care Act, as she answers questions from Republican members of the House Ways and Means Committee during its review of President Obama’s budget requests, Wednesday, March 12, 2014, on Capitol Hill in Washington. (AP)

One week from today, March 31st, is the deadline for signing up this year for Obamacare.  Health care coverage under the Affordable Care Act.  Miss March 31, and the doors are closed for a year.  It’s been a tumultuous rollout for the controversial health care program.  But America has had a big problem with millions of uncovered citizens.  And now, millions are signing up.  Is it the right millions to make the new system work?  Is it enough?  Is the whole thing holding together?  Working?  This hour On Point:  We’ll ask.  We’re looking at Obamacare, with one week to go for sign-up.

– Tom Ashbrook

Guests

Jenny Gold, health care reporter for Kaiser Health News. (@jennyagold)

Noam Levey, national healthcare reporter for the Los Angeles Times. (@NoamLevey)

From Tom’s Reading List

The New Republic: The Latest Obamacare Doom Prediction—and What to Think About It — “Insurance companies may have expected a better mix of beneficiaries—in other words, more healthy people and fewer sicker ones. If so, the companies could discover that the premiums they set for this year are too low to cover the medical bills they must pay to doctors, hospitals, pharmacies, and the like. If that happens, the insurers could respond by raising premiums next year, perhaps substantially. Serious, honest people are worried about this scenario unfolding, based in part on rumblings they are picking up from within the insurance industry. ”

Los Angeles Times: In healthcare, what makes Maine different? — “Northern Maine ranks high on national measures of health, according to a yearlong review of healthcare data from communities around the country that The Times conducted with help from public health researchers. Residents of the region receive recommended screenings and medical care more often than other Americans. They suffer fewer complications in nursing homes and are less frequently prescribed risky medications. And they are nearly half as likely to die from preventable diseases as residents of other low-income areas, according to data from the Commonwealth Fund, a nonpartisan research foundation that studies healthcare systems.”

Reuters: In U.S. contraception case, a question of corporate rights — “The U.S. Supreme Court could dodge the contentious question of whether corporations have religious rights when it weighs objections to an Obamacare requirement that employers provide insurance coverage for contraception. The court, which hears oral argument in two consolidated cases on March 25, could rule that individuals who own closely held companies, rather than the corporations themselves, can argue their religious rights have been violated. Such a ruling would allow the court to avoid criticism that it favors corporate rights too much.”

The Supreme Court Hears A Contraceptive Health Care Case

Dahlia Lithwick, senior editor at Slate, where she writes about law and the courts.  (@DahliaLithwick)

Washington Post: Here’s what you need to know about the Hobby Lobby case — “The Supreme Court will hear oral arguments on Sebelius v. Hobby Lobby Stores, Inc. and Conestoga Wood Specialties Corp. v. Sebelius, two highly anticipated cases that deal with the Affordable Care Act, religious freedom and women’s access to contraception. The case won’t be decided Tuesday, but we could get a clear indication of which way the justices are leaning.”

 

 

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  • lobstahbisque

    Is Sebelius giving some witch hunt committee the finger? I certainly hope so.

    • OnPointComments

      She’s saying “I don’t know,” her ‘go to’ answer for any question about the ACA.

    • harverdphd

      well, at least her mouth is closed so she’s not lying yet…

  • Shag_Wevera

    As long as the conservative solution consists of tort reform and selling insurance across state lines, the affordable care act is the best we’ve got.

  • Shag_Wevera

    The real solution is good ole socialist single payer universal health care. We’ll have it eventually (inevitable, I’d say), but Obamacare is the half ass measure between where we were and where we need to be.

    • Bluejay2fly

      You are correct but because we have subsidized the system for so long we have no cost control. Universities, pharmaceutical companies, hospital supply companies, bankers, and insurance companies make Billions in profit from the status quo. A single payer system would not be economically feasible without all those middlemen still making a killing ,and they have enough lobbying $$$$ to protect their interests. We are in one hell of a mess.

  • Bluejay2fly

    Whoever decided that healthcare can be capitalist run was a fool. Unlike any other commodity in the free market healthcare cannot be denied to the customer for inability to pay. Worse yet, if I stiff the hospital for 20K dollars there isn’t even a debtors prison I can be thrown into. Ultimately, the government or private health insurance is the backstop for all this debt. Thus we must provide services to people who cannot pay and it costs the state
    government hundreds of Billions each year. NYS spends 3 Billion incarcerating 50K inmates but 20-30 Billion in medical expenses every year. I bet most seniors quickly withdraw more money from Medicare within a short period of time than they ever paid in. I am a NYS employee and when I turn 65 my private health insurance, that I have paid into since my 30′s, turn secondary to Medicare. So gets who gets stuck paying for my healthcare when I am the most expensive?

  • Ed75

    The best description of O-care I’ve heard is Medicare plus, poor coverage. Many people can’t afford it in spite of the subsidies. Tuesday the Supreme Court will hear the Hobby Lobby and Conestoga (sp?) Wagon cases, later this month they will hear the Priests for Life case.
    With an aging society and very expensive medical care, many unborn being killed so not enough young people, it seems to me premiums have to go way up. The problem is cost. But the structure of the plan is not the main problem for me, it’s its immorality of promoting abortion, etc. That’s why Planned P. is out there campaigning for it, they stand to make millions. Killers.
    e.g. 60% of MS medicines are not available on O-care.

    • Shag_Wevera

      I don’t think it “promotes” abortion. Not all Americans are Christians, and not all share your or my morality.

      • Bluejay2fly

        I would have said “illusion of morality” but you are a better man than I am Shag.

      • notafeminista

        I would hope not…

        “The second item in the liberal creed, after self-righteousness, is unaccountability. Liberals have invented whole college majors–psychology, sociology, women’s studies–to prove that nothing is anybody’s fault. No one is fond of taking responsibility for his actions, but consider how much you’d have to hate free will to come up with a political platform that advocates killing unborn babies but not convicted murderers. A callous pragmatist might favor abortion and capital punishment. A devout Christian would sanction neither. But it takes years of therapy to arrive at the liberal view.””
        ~ PJ O’Rourke

        • Ray in VT

          Whereas, it seems to me, the American conservative mind will seek to explain away or deny any facts or data that do not conveniently fit into the overly simplistic or preconceived notions upon which its worldview is based, often displaying inexplicable confidence and certainty in positions which are easily shown to be false or majorly lacking evidence.

          • notafeminista

            Oh heavens no. I have no trouble accepting the Left’s pathology that permits abortion and finds capital punishment unacceptable. No trouble believing that at all.

          • Ray in VT

            Don’t like abortion? Then don’t have one. Just keep your ideology out of my wife’s hoo-ha.

          • notafeminista

            By the by there Ray in VT it was Susan B. Anthony’s ideology too.

          • Ray in VT

            Oh, then that changes everything. I’ll totally change the positions that I have arrived at in life because I was not previously aware of that nugget.

          • notafeminista

            Just food for thought – when you are considering overly simplistic or pre-conceived world views.

          • Ray in VT

            George Washington hated dogs. I had probably get rid of mine, then. I’ll just line up whatever is going on in my life with the views of someone who died years ago. That’s far easier than thinking for myself.

          • notafeminista

            Hum. Susan B Anthony’s views and efforts (in part) led to a Constutitional Amendment that,in turn, led to federal laws still being passed even today (Lilly Ledbetter anyone?). I’m so glad we don’t line up with those who died years ago.

          • Ray in VT

            Some very prominent people once believed that we should be able to own and sell other people. Do you want to support that one? Martin Luther said something to the effect that Jews who wouldn’t convert should be killed. How about that one? Should I just take his word for it and give it my support?

          • notafeminista

            (edit added) You tell me. Go with your line of thinking (and 150 years (give or take) of Western women’s suffrage goes down the drain.

            Some very prominent people once also believed Earth was the center of the universe. Another prominent person also dead I might point out) took a telescope that didn’t even belong to him and pointed it towards the heavens – and ultimately proved the first bunch of prominent people wrong. Who ya gonna go with Ray?

            You need to open your mind a little.

          • Ray in VT

            Yes, I need to open up my mind and just take the ideology and positions of those who may have died long before I was born. Very open minded and independent thinking that is. You seem to be stating that I am suggesting that one jettison all that previous generations have said. If so, then please tell me where I said that, as I do not recall saying that. It is possible to agree with people on one issue and not another. Perhaps you are unaware of that.
            Now, with Anthony, perhaps you are suggesting that one cannot appreciate the role that she played in the women’s suffrage movement, one opposed by social and religious conservatives, unless one also opposes abortion, which some claim that she either did or would have, despite what seems to be some disagreement and debate as to the validity of those claims. Ironically, Anthony’s push for women’s voting rights may have led to women seeking the right to have control over their reproductive lives as well.

          • jefe68

            She has a habit of being obtuse.

          • notafeminista

            You didn’t read the source material did you.

          • Ray in VT

            Or it is the other one.
            As to your other point, though, people often have contradictory or conflicting positions. It does seem, though, that the pro-life community’s evidence for putting Anthony in their camp is scant or questionable at best.

          • notafeminista

            1)It was more towards whether or not we think in line with those who have come before, in response to your comment about George Washington and his dogs.

            2)http://cdn.billmoyers.com/wp-content/uploads/2012/09/Revolution-Editorial-by-A.pdf

          • Ray in VT

            I made up the thing about Washington hating dogs, although whether or not he did has no bearing upon what I think of him as a general or a president, just as anything that Anthony may have believed about abortion do not in any way alter how I view her contributions towards women’s suffrage, and vice versa.
            Also, that has never actually been successfully identified as having been written by Susan B. Anthony.

          • Don_B1

            As pointed out in last night’s Cosmos, Isaac Newton derived the Laws of Motion that explained the Earth’s rotation around the Sun and the whole solar system, plus provided the basis for construction of bridges, buildings and much of technology.

            But Newton also spent decades trying to develop rules of alchemy to transform one element to another by chemistry (no one had found the nuclear forces that rule the inner nucleus of the atom or what would be necessary to split or combine those nuclei).

            So an individual who demonstrates genius in one discipline may totally strike out in another.

          • Bluejay2fly

            Your begging the question. Many, including liberals, do not see abortion as murder or the fetus as life.

          • notafeminista

            Good point. Speaking of begging the question, if they don’t see it as a life, then what pray tell do they see it as and why all the fuss about “viability”?

          • Bluejay2fly

            I cannot argue their side as I am actually a person who believes it is a life.

          • Don_B1

            Most psychopaths think the rest of the world are the psychopaths.

            Maybe if you got some real help in understanding what is really happening in this country and were able to see the cognitive dissonance that prevents you from that understanding, you might be able to deal with getting away from your fantasy world and deal with the real world.

          • notafeminista

            Ah and there it is. Clearly I need some guidance from those so enlightened as yourself. And I’m not alone in that – we know there are others like myself who need – education and enlightenment. Perhaps there could be a centralized location we could attend to learn the error of our ways. Because we know this would be a good thing, let’s mandate attendance to these centralized locations just to make sure every poor, misguided soul such as myself is properly educated. Maybe tie attendance to our tax returns or vehicle tag renewals – you know – if some sorry sot such as myself is unable to provide an attendance certificate from the local life enlightenment center, he or she would be prevented from renewing his or her license tags or maybe would be assessed some sort of cognitive tuition penalty on his or her tax return.

        • TFRX

          Please, more quotes from that oldies act PJ about what a woman and her doctor should do.

          • notafeminista

            say hey there TRFX remind us again the list of sources you would find suitable? Mine seems to have gone missing…oh not wait…you never provided one.

          • TFRX

            Hahaha.

            A white straight man jamminng his God into an exam room between a woman and her doctor.

            Really, quit while you’re behind.

          • lobstahbisque

            You mean, God is a really trans vaginal device? I never thought of that!

          • notafeminista

            Speaking of, the woman didn’t get in that place without a man to begin with. Don’t behave as though the male of the species has no interest in the ability of women to get abortion on demand – if for no other reason it completely absolves him of any responsibility what.so.ever.

          • Ray in VT

            An interest perhaps, but a veto is not something that the man should have, although I am not saying that you said that. “Completely absolves him of any responsibility what.so.ever.” You have heard of child support, right?

          • notafeminista

            Yes. And if the woman he’s impregnated has an abortion he has no responsibility for child support, because well. There is no child, right? What man in his right mind wouldn’t completely and entirely embrace abortion on demand? He’s completely absolved of any responsibility at all. Pro-choicers missed the boat on this one by trying to make it solely a women’s issue.

          • Ray in VT

            Why don’t you go out and survey all of the men as to why they do or don’t think as you suggest that they should, and go ahead and let me know when your research is complete. Perhaps you should also ask them if such men get some sort of legally binding guarantee from their female partners that would ensure that a potential pregnancy would be terminated, but women having the choice just probably will if they can, right?

          • notafeminista

            C’mon Ray, this is a no-brainer. Either men are equally responsible or they’re not. What if the man wants a legally binding guarantee that she won’t terminate the pregnancy? He wants the child, she doesn’t. Now what?
            Again, what man in his right mind wouldn’t support abortion on demand? Pro-choicers missed the boat on this one.

          • Ray in VT

            If two people work out a legally binding contract, then that is a matter between them. You seem, or think that you have, the answers on this. You tell me. Why aren’t all guys out there just clamoring for abortions round the clock to get them off of the hook. That would seem to be in their economic best interests, and I am told that such self-interests ultimately guide people. Do you mean to tell me that people might do what is against their economic interests, sort of like poor people voting Republican.

          • notafeminista

            The Left men are – and I suspect solely because they are toe-ing the party line. However any man who disagrees for whatever reason (and you know they are out there) are shouted down and told this is a women’s issue. You said it as much yourself. “Men shouldn’t have a veto.” Well of course they should. They are equally responsible for that whatever it is the Left tries so hard not to call a life, are they not?

          • Ray in VT

            Oh, the “Left men” are? Are what? Out clamoring for abortions 24/7? Please provide some crack research on this, as the “Left men” whom I know aren’t out pushing for ladies to get abortions when they get impregnated. TOPer Desjarlais they are not.
            They do their part to contribute the genetic material, but as far as I know they are not actually growing anything or facing the various risks that pregnancy entails, unless you know of some medical wonders who are.

          • notafeminista

            If they didn’t contribute the genetic material there wouldn’t be anything to grow. Basic biology. The risks go far beyond the pregnancy – you mentioned child support.
            So 2 people enjoy one night together and never see each other again. Unbeknownst to him 1)she’s pregnant 2)she’s going to keep it. She shows up on his doorstep 2 years later, Junior in tow, demanding retroactive child support and child support for the next 16-19 years depending on the state. She cares not what his status may currently be – is he married, has children and so on.

          • Ray in VT

            Thanks for the basic biology lesson. I had never managed to figure it out until you enlightened me. Thanks.
            In your scenario the guy then has to step up and pay for what he helped to create. What is your point? If one is willing to hop into the sack, then one ought to be ready to pay for the consequences that may arise.

          • notafeminista

            Exactly. Women should be held to the same standard. That is equality.

          • Ray in VT

            Fine. Just show me how many bills are being passed to give the government a say in men’s reproductive bits. So, undergoing an abortion isn’t a potential consequence? I think that it is for some.

          • Don_B1

            So pass a law providing for penectomies for those males who do not “do the right thing” and support their offspring, legitimate or illegitimate!

          • hennorama

            notafeminista — the punctuation of your final three words brings [Dana Carvey's] Church Lady to mind.

            Thanks for the.comic.relief.

        • Bluejay2fly

          If your going to quote a comedian please choose a funny one.

          • notafeminista

            Ha! Funny is in the eye of the beholder.

      • Ed75

        Well, that’s two different points. Obamacare does offer, even require to be offered, contraception that is understood to be abortifacient. And it seems to me that if Sibelius et al. had their way abortion would be required to be covered by all healhcare plans. Planned P. is making a killing.

    • John Cedar

      Obamacare IS an abortion.

      • lobstahbisque

        it would have been cleverer if you had said,
        “Obamacare is an Obama-nation”.

    • TFRX

      Planned P are killers. (If I read you right?)

      Submitted without comment.

      • Ed75

        Yup.

  • Shag_Wevera

    What is the downside to delivering healthcare to ALL citizens?

    • Fiscally_Responsible

      Delivering health care to all citizens is certainly a good thing. However, the program was promoted based on certain cost and enrollment assumptions. If those assumptions prove too optimistic in terms of lower costs or higher enrollment of invincibles who pay more in premiums than they receive in health care and thus help subsidize the cost to older/more health care needy people, then the cost incurred for the product delivered will be much higher than initially presented. The national debt, which our children and grandchildren will be saddled with, will be even higher than it is now. I personally don’t believe that it is fair to straddle future generations with this debt, particularly if wildly optimistic assumptions were made just to get the program passed. But I am willing to wait and see how it turns out, as it is in my personal financial interest for the program to work. But if the cost/enrollment assumptions prove untrue, then people should be held accountable and not trusted in the future. There are costs and benefits to everything. You have to look at both sides.

      • Shag_Wevera

        Don’t mistake me for a fan of the Affordable Care Act. The moment the President gave the insurance industry a seat at the table, the legislation was doomed. It does get credit for being an attempt at improvement. We sure can’t go back to how things were.

        • Fiscally_Responsible

          It is ridiculous that the U.S.A. spends more money per capita and gets less for it than just about every industrialized nation. Time Magazine had an article last year that points out the myriad of problems with our system. There is enough blame to go around, that’s for sure. We can put a man on the moon, but we can’t create a reasonably affordable system (copying what others are successfully doing?) for health care.

          • Bluejay2fly

            We never copy Europe even though our educational system is terrible, we have no national energy policy, and our tax system is ridiculous.

          • Fiscally_Responsible

            There are numerous aspects of Europe that I would not copy. However, a workable affordable approach to health insurance would be one worth examining and duplicating.

          • Bluejay2fly

            Sadly, I disagree and ironically I cannot move over to Europe because their immigration policy is incredibly strict, unlike ours.

          • jefe68

            Switzerland has a system that could be a good model for us.

          • Bluejay2fly

            They are not in thrall with having 12 aircraft carriers either.

          • Ray in VT

            I don’t know. I saw someone from one of the conservative publications promoting it as a private alternative, but while they pay less than we do per capita, they still pay much more than many other European nations that have gone with a public national healthcare system.

          • Bluejay2fly

            Maybe if we had been bankers to the Nazi’s (screw U Godwin) and allowed offshore banking we may have been wealthy enough to afford a Swiss system.

          • Ray in VT

            It’s a bit Godwin, but it is something that they actually did do, so I’m not going to criticize you for bringing it up.

          • jefe68

            Well the only thing I like about it is that the insurance companies cannot make a profit on health care. It’s not perfect, but as a nation we will never have a single payer system. At least not anytime in the next decade or two. So the only alternative is chipping away at the dysfunctional system we have.

          • notafeminista

            So really, for you, its about putting insurance companies (and however many they employ) out of business.

          • Ray in VT

            So there are no insurance companies in Switzerland?

          • notafeminista

            Beats me. Jefe68 wants insurance companies not to make a profit. Sort of misses the point of going into business in the first place, no?

          • Ray in VT

            Yet Switzerland has insurance companies that do just that. Tell me, how much is the right amount of money to make off of sick or dying people? As much as you can squeeze out of them?

          • jefe68

            Are you not very smart or are you just being obtuse?

            The insurance companies do fine in Switzerland, in fact there is more competition since they change over from a for profit system. Look it up.

          • Ray in VT

            I’ve been trying to figure out your first question.

          • notafeminista

            Thanks for the tip. I did look it up…and will first stipulate that Wikipedia is as good as it is or not on any given day.

            But according to this Swiss healthcare providers only do not make a profit on the basic program mandated by the state. Anything after that (or supplemental to) they absolutely can (and probably do) make a profit from.

            The basic program pays for accident, illness or pregnancy. No mention of a good-health maintenance program (mammograms,prostate exams etc) or chronic use drugs such as birth control or insulin.

            http://en.wikipedia.org/wiki/Health_care_in_Switzerland

          • John Cedar

            Don’t be fooled by the simpleton. He never said out of business…he talks about profit. In my area, the two insurance companies available to me are NON PROFITS. Of course under that system we paid higher rates than most of the rest of the country where they have profitable insurance companies to choose from.

          • jefe68

            It’s the fee for service and the 30 plus percent that is added to the every medical bill by the health insurance companies.
            Look at the cost for a colonoscopy in any city and you will find huge disparities for the same procedure.

            Interesting to note that we are both on the same page on this, which points to my belief that this is beyond ones political dogma.

    • John Cedar

      What does your question have to do with the topic of Obamacare? Obamacare does not deliver healthcare to all citizens. It did manage to take healthcare away from a bunch of citizens and redistribute it to a fewer number of citizens. It did manage to make everyone’s insurance costs go up and redistribute healthcare dollar$ from old people to young able bodied people. It did manage to help Sandra Fluke be able to have more spending money for Starbucks.

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

        Those who oppose the ACA would seem to be fine with the status quo – we have many millions of people who have no insurance and many millions more who are way under insured.

        Even with excellent coverage, there is a lot that is not covered – which is just wrong. We have many many people who are bankrupted by medical expenses, and many people who die young, and/or who lose a large part of their productive lives to ill health.

        In countries with single payer – THERE ARE NO MEDICAL BANKRUPTCIES.

        • Bluejay2fly

          Or any super carriers.

        • John Cedar

          You line of thinking did not work out well for Rosemary Kennedy. No one ever proposed doing nothing about healthcare, but doing anything is not necessarily better than doing nothing.

          • Don_B1

            Note that since the PPACA passed in March 2010, the rate of increases in healthcare spending has been going down, for a mixture of reasons, but one that has put pressure on cost increases is the PPACA.

            Therefore, with more people getting healthcare coverage in a way that will help them get preventive care which will further lower the rise in healthcare costs.

            Anyone without your ideological blinders would see that the PPACA, for all its faults, is much better than doing nothing.

      • jefe68

        Troll alert^^^

    • jefe68

      Ummm, more people will be able to see a doctor…

  • Bluejay2fly

    Many people complaining about the costs of the plan are correct it is expensive. However, if they were uninsured or underinsured and had cancer they would expect the million dollar expenditure from the hospital to fix them. And they would do so without ever paying it back which leaves the government or my health insurance as the next in line to pay for your chemo and radiation.

    • Jill122

      People go into bankruptcy. They cannot just walk away from those bills. They have to discharge them in a bankruptcy court. “High healthcare costs bankrupt one in four americans.” Google it.

      • Bluejay2fly

        That is true but in the end many do not pay all their bills which forces the government to step in and uptake them into Medicare, Medicaid, or they do not pay it at all. Who pays for a 15 yrs old girl who has a child? Probably nobody or Medicaid.

  • John Cedar

    Will we ever hear the truth about how many fewer people enrolled than had their insurance canceled?

    Will the democrats publicly embrace Obamacare to help them win elections over the next few cycles? Will Obama ever quit waiving his signature law?

    • Bluejay2fly

      Those very few that had to drop their former policy were in no doubt under insured. Shame on these lying neocons who champion America is the greatest nation on earth while we have this disgrace hanging over our heads, The fact that a nation as wealthy as the USA has to have Doctors Without Borders come in and provide healthcare is unbelievable. Where is FOX NEWS on that issue???

      • notafeminista

        So, you believe the US is the greatest nation on Earth or not? Let’s start there. Because if you don’t, then the rest of your argument is moot.

        • Ray in VT

          Because if we’re the greatest, then we must have the greatest health care system, right?

          • notafeminista

            No – because if we’re not, then Doctors Without Borders would not only be no surprise, it would be generally accepted.

        • Bluejay2fly

          Since our inception the USA has always had great problems and some of the time these were social evils worse than what was occurring elsewhere. It is not unpatriotic to find fault with your country when it is doing wrong. Those who are the purveyors of American Exceptionalism are very simpleminded in their thinking. To call us better than countries you know nothing about, have never lived in, or even visited is very unscientific, arrogant and illogical. To answer you question I loved America enough to serve 22 years in the USNR and fight in two wars I did not believe in.

          • notafeminista

            You believe in American Exceptionalism then. (despite thinking it is simple-minded, unscientific, arrogant and illogical)

          • Bluejay2fly

            Rather then go around blowing hot air like most patriots our nation would have been better served if the government and it’s citizens were looking out for American interests. We should have closed our borders years ago and been absolutely militant protecting our industries. Globalist corporation which moved jobs overseas and sold foreign products here have done more harm to this nation than any recent foreign enemy. Our elites and politicians have made a fortune with NAFTA (a Reagan era brainchild) and other forms of globalism. Our defense policy has cost us trillions over the years while our citizenry go without decent healthcare and education. Most “I love America” patriots are too stupid to see how the world has passed us by. Finland is more modern than we are as are most European nations. To the Japanese we look 3rd world. What do they see when touring America? Cities that look like bombed out ruins, people so poorly dressed they look like they were just evicted from section eight housing, cars so rusty and falling apart that they would be in a scrap yard in Japan, people so poorly educated that 7 out of ten probably could not point to Japan on a map, and a society obsessed with the idea it is superior to very one else.

    • OnPointComments

      At least 3.5 million had their policies cancelled. Only 1.14 million of those who have signed up for Obamacare were uninsured before they signed up. No one is saying how many of those 1.14 million have paid their first premium.

    • notafeminista

      Shucks we can’t even hear how many previously uninsured are now insured. Rest assured it’s nowhere near 47 million.

      • jefe68

        How silly of the federal government for not hiring tinker bell so she could have waved her magic wand.

        • Ray in VT

          The gub’ment should have just let the market insure the old, the sick and the poor, like it would if gub’ment wasn’t in the way.

        • notafeminista

          It was the point of the entire bill and subsequent law was it not? Seems….shortsighted at the very least not to count those people.
          On the other hand, the law counts on people being uninsured, so maybe they really don’t care.

          • jefe68

            When SS was enacted it had a host of problems at first. So did Medicare.

          • notafeminista

            So it did. Again however, the entire point. The WHOLE point of the PPACA was to get those 47 million uninsured Americans insured. That was the point in its entirety and we were not allowed to forget for one minute, because we’d be otherwise breathlessly reminded there were 47! Million! Uninsured! Americans!
            And now…now…we don’t even know how many of the 47 million now have insurance? Really?
            But again as I said, the law counts on people not getting insurance (and paying the penalty instead) – so maybe they don’t really care.

          • Bluejay2fly

            They had it running pretty smoothly towards the end.

  • Coastghost

    If Obamacare were a medical pathology, what would it be? Would it be “gangrene”, a localized necrosis killing off tissue requiring amputation? or would it be more like “plague”, highly infectious, not very pretty, and commonly fatal? Would it be some generic “cancer”, in which the body’s own defenses are arrayed against its own organs and tissues? or would it function more like an aneurysm or a blood clot, misdirecting or inhibiting the flow of blood?
    Gallstones? Corns? Gout? Hemorrhoids? Incontinence? Erectile dysfunction? Tuberculosis? Caries? (Obviously, Obamafraud has done nothing to enhance the quality of diagnostics, but once putrefaction of the entire organism sets in, arguably, the time for diagnostics has passed.)
    Then the question remains what to do with the smelly cadaver: embalm it, cremate it, or plastinate it (as an exact model of all that can go wrong)?

    • Bluejay2fly

      I hear this all the time from people at work. Some who have children who are in their twenties and are covered because of the ACA. One individual’s daughter had a stroke ,and curiously, he no longer rants about the ACA.

      • OnPointComments

        Liberals love anecdotal accounts, unless it’s anecdotal accounts of those who have been harmed by Obamacare:

        “…Larry Basich fought his way into the bug storm on ObamaCare launch day, kept plugging away at the garbage ObamaCare computer systems until November, finally managed to buy a plan and pay his first premium, then suffered a heart attack, requiring triple bypass surgery… at which point he discovered the “confused” state ObamaCare exchange never actually assigned him to an insurance provider. Four months later, Basich is sitting on $407,000 in unpaid hospital bills. He “blames his back-and-forth with the exchange in December at least in part for the stress that caused his heart attack…”
        http://www.humanevents.com/2014/03/19/obamacare-sticker-shock-get-ready-for-your-jacked-up-premiums-to-double-or-even-triple/

        • lobstahbisque

          You forgot to say, “ALL liberals…” in your pointless screed.

          • Bluejay2fly

            I know this guy and see him everyday at work, your right, it was a pointless screed!

          • jefe68

            Well, he’s slipping. Maybe his blood pressure meds went up in cost and he’s doing without.

  • TFRX

    Tom, where’s the pull-story about debunking the faked Obamacare horror stories which the right’s been fabricating?

    Didja think that maybe by this point an NPR audience is disappointed with NPR’s parroting of the fake horror stories and want NPR to not be suckered in, so easily, time and again by them?

    • twenty_niner

      Not sure about fake stories. I know several small-bus owners who’s rates have at least doubled and the co pay has quintupled. I know of no one who’s rates have gone down or even stayed the same. Anecdotal yes, but enough anecdotes starts to become a statistic.

      • TFRX

        “Not sure about fake stories”?

        Then do the slightest bit of homework before asking us to conflate your anecs with stats.

        • twenty_niner

          The point is there are a lot of valid stories.

          And if you supported this abomination, thanks for increasing my rates.

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

            All the stories on Fox were just that – stories.

          • TFRX

            There are more, larger spread fake stories which have been been shatstormed all over the right wing advocacy media and out mainstream press corps wimped their way into privilegeing these lies.

            And that includes NPR.

          • Jill122

            Silly. Just silly. The real numbers don’t support you. Of the 6 – 8% increase this year, only 1% or less is attributable to Obamacare. The rest is exactly what you would have experienced anyway. Surely if you have insurance you have noticed that the premiums go up every year or your healthcare options go down. It’s been that way for years and blaming it on this new option is just Silly. Low Information.

          • twenty_niner

            I’m pretty good at math. The latest increase is many times that of previous years. Also, now I’m getting charged for a bunch of coverage that I don’t need such as gastric-bypass surgery.

          • jefe68

            You do understand the idea behind insurance?

          • twenty_niner

            “You do understand the idea behind insurance?”

            Yes. For example, I don’t have to pay collision for my car. If a liberal jumps out in front of me flailing his arms, my insurance covers the liability. The dented bumper is on me.

            “How do you know you wont need gastric-bypass surgery 6 months from now?”

            I’ll pick up the tab in that case. And if somehow, I get pregnant, I’ll cover that as well.

          • Don_B1

            Did you visit an exchange and look at all the other policies that you could choose from? If there was not a policy there priced near what you had been paying, it seems almost certain that your prior policies were of the “catastrophic” type with low premiums and huge deductibles and caps, such that unless you came down with H.I.V. or multiple cancers, you would not get much insurance money.

            As for your statement that “[you'll] pick up the tab in that case [of gastric bypass surgery].” Well most people in this country do not have the savings or income to do that. They are not in a position to do it and most will never be there.

      • DeJay79

        ” I know of no one who’s rates have gone down or even stayed the same.”

        My wife’s rate was cut in half by signing up on Kynect, the Commonwealth of Kentucky’s answer to the ACA.

        Now you know of one person.

        • twenty_niner

          Questions:

          Did she get a subsidy?
          Is she self employed?
          Has the deductible/copay changed?

          • DeJay79

            she is currently self employed. we looked at adding her to my employer sponsored plan and compared that to what Kynect offered. the deductible/copay’s are different but comparable, higher for somethings lower for others. The big difference was the monthly payment is half what it would have been if i added her to my plan.

  • TFRX

    Matt Drudge soils himself. (Again.)

    http://talkingpointsmemo.com/livewire/drudge-individual-mandate-liberty-tax

    Just one more right-winger whose Obama Derangement makes him flip his lid.

    • notafeminista

      The headline says, “probably”. Maybe you ought to hold off on the gloating until someone actually knows.

      • TFRX

        Read it yourself, troll.

        Matt Drudge is crowing about paying a tax penalty now for an expense he thinks he’s going to incur next April.

        How stupid does Matt Drudge and his CPA have to be to do that? I’m not paying my 2014 taxes until 2015, thanks.

        And if it’s a choice between Josh Marshall’s folks and Matt Drudge, well, that’s too easy.

        • notafeminista

          I did read it. Why didn’t you mention “probably” in your post? It would,at the very least, have been intellectually honest.
          Do you plan on not paying taxes next year? I have no idea about Mr. Drudge’s income, but he might well be in a tax bracket that requires him to estimate taxes quarterly. Really at this point, all we have to rely on is that President Obama might waive next year’s uninsured penalty. Of course at this rate, it’s entirely possible. So again, maybe you ought to hold off on the gloating until someone actually knows.

          • TFRX

            Matt Drudge was asked to respond when called out, and couldn’t come up with anything.

            He’s crowing about paying a tax penalty now for an expense he thinks he’s going to incur next April.

            How stupid does Matt Drudge and his CPA have to be to do that? I’m not paying my 2014 taxes until 2015, thanks.

          • Jill122

            There’s no question in my mind. Articles I’ve read say he brings in $800,000 per annum and is a sole proprietorship. So he would be required to pay quarterly income taxes. So instead of paying for insurance at $300 – $500 a month, he’d rather pay $8000. Sounds like he would prefer to give the government about $3,000 AND that he’s willing to take his chances when it comes to his healthcare. An accident could cost him a million easily.

          • notafeminista

            That’s his problem, no? Doesn’t affect you (or me for that matter) in the slightest.

          • TFRX

            Keep digging that hole, idjit.

            Uh, it’s Drudge’s problem, and any jagoff who believes him.

            I expect some Politico tools to pick Drudge’s crap up and for it to therefore be a top-of-hour news item on NPR before Thursday.

          • notafeminista

            That’s what I said. It’s Drudge’s problem. Not yours. Not mine.
            You can always hope for a top of the news hour item. I suspect vindication is always high on your list of priorities.

          • TFRX

            Go away troll. Your reading comprehension fail is embarrassing you.

          • notafeminista

            Oh come now. Let’s have that list of acceptable sources.

          • notafeminista

            You do make a fair point. President Obama could very well waive next year’s penalty.

          • StilllHere

            You’re asking the wrong guy about intellectual honesty.

  • Markus6

    I’d love for the speaker to provide the numbers, but ACA can’t fail to get lots of subscribers over the long term because you’re giving stuff away. Pre-existing conditions don’t matter, no price controls, no legal controls and, most important, the price for a high percentage of people is subsidized by the government. I heard that someone making $75K per year can get a subsidy.

    No matter how badly the government screws up the implementation, if you give away money, people will come around eventually. And the primary cost is buried in the overall national debt which, not surprisingly, Congress doesn’t care much about.

    I understand that the costs of this thing are complicated and don’t make good radio like the simple tracking of people signing up. But some day I’d love a show on what the real costs of this are.

  • ThirdWayForward

    The health care reforms, a.k.a. “Obamacare” is working for vast numbers of Americans beyond those who have newly signed up for health insurance.

    Our children, up to age 26, are now covered under our family health insurance policies.

    We no longer fear the loss of our jobs will mean that we who have “preexisting conditions” will be denied health insurance.

    The media has concentrated on the new insured, but there is enormous systemic benefit from the health insurance reforms that benefits ALL of us.

    Do not fail to mention these other, wider benefits for America when you discuss whether the reforms have been a success.

    • TFRX

      Wait a minute, you’re not trapped in your current job because you (or a family member) have a pre-ex condition?

      I hear the sound of employers scared that labor is not so scared of changing jobs any more.

  • MOFYC

    Obamacare is
    not a “health plan.” It’s a broker for private health insurance plans.

    • ThirdWayForward

      Yes, but it changes the eligibility rules for all health insurance plans (eliminates pre-existing conditions as a barrier to coverage, prevents insurers from dropping sick subscribers, insures children up to age 26 on their parents’ family plans) FOR THE BETTER.

      • Bluejay2fly

        YES, it has helped many and is gold to them. Those who complain they were harmed by it is dubious.

    • ThirdWayForward

      It would have been better to have a public option or to have allowed those under 65 to buy into the Medicare system (at the marginal system cost of adding them), but these kinds of reforms were rabidly opposed by the Republicans and a handful of conservative Democrats.

      But even as mildly reformist as these health insurance reforms are, they are substantial improvements in a private system of health insurance that was fundamentally broken and sucking up ever greater amounts of money each year.

      Next, we need medical cost transparency and cost control measures. The real price of every medical device and service should be known to all parties (patients, doctors, insurers). That alone would create such patient outrage that it would put a brake on health care costs.

      • Bluejay2fly

        How would you square that with a doctor coming out of med school 100-300K in debt? Or Phizer charging $20.00 for a pill that costs 23 cents to make? Or a doctor paying a medical malpractice premium of 20-30K a year, that is what my brother in law pays.

        • ThirdWayForward

          I’m not sure that I get the point. Our system needs to become more efficient in terms of health outcomes per dollar spent.

          The US system gets substantially less bang for its buck than nearly every other medical delivery system in the world. It’s extremely wasteful of resources. The recent health reforms were not meant to address this problem.

          Although I don’t think that doctor salaries are the main problem, US doctors do earn more, in relative and absolute terms, than their counterparts elsewhere in the industrialized world. Medical education here is also the most expensive by far. It doesn’t need to be this way, and other countries have found ways to avoid saddling their medical students with huge amounts of personal debt (individualized risk, debt, and reward are the American way of doing things, but not necessarily the best way when it comes to medicine).

          Simply allowing patients to import their meds would dramatically lower the costs of many pharmaceuticals. Market competition.

          Giving patients incentives to use cheaper meds or to try less expensive types of treatment (first) would help rein in costs. My understanding is that in Massachusetts there is a law that actually prohibits rewarding patients for choosing less expensive hospitals.

          We could use far more mid-level practitioners, and we should provide for a career path in which competent nurses can become doctors. That would increase the supply of doctors and also spread the work around better (fewer overworked doctors).

          Most of us would be happy to trade positions with doctors, even with the early debt and ongoing insurance costs –yes, some of them work very hard, but most are compensated richly for what they do (and face it, some of them don’t do much). They have better jobs than 95% of Americans in terms of pay, job security, and job satisfaction. It’s hard to think of a better profession.

      • MOFYC

        I disagree with your glowing assessment of Obamacare and spineless Democrats but that’s not the point.

        The point is that it’s not, as the headline claims, a “health plan.” It’s the government as insurance broker. My comment was merely about correct an inaccurate statement.

  • http://hlb-engineering.us/ HLB

    I don’t know if the ACA will work for most Americans are not. But it’s not likely one can effect a societal change by rolling out a guy on TV doing nothing more than stupid president tricks. It’s not just not presidential: it’s just not effective. After all, who gets their life-changing aha moments from a 50 year old Washington guy in a suit?

  • Coastghost

    But–but . . . but the Democratic Party ASSURED US ALL that this was THE way to go, that Obamafraud would cure ALL that heretofore has ailed the availability of health insurance coverage in this country. The Democratic Party was assured of this success at the outset, which explains why they passed it unilaterally in Congress. (NPR itself has gone no short distance ASSURING us that Obamacare is trustworthy, efficient, and sensible, but then you hear catcalls every day that NPR is little more than a Federally-subsidized agitprop broadcaster for the Democratic Party.)

  • http://hlb-engineering.us/ HLB

    Under the law can the president pocket parts of the law he doesn’t like? Under the law.

    • lobstahbisque

      i seem to remember something about signing statements during the time of the Bush Junta. But as Gore Vidal famously said, “We live in the United States of Amnesia”

    • Don_B1

      No, but there is a huge effort by Tea/Republicans and other radical conservatives to cast the Executive Branch’s ability to write the rules of implementation for most laws as not valid for this president.

      There is nothing in the PPACA that even said the law had to be implemented on 1 October 2013, or that it had to be implemented across the whole country simultaneously.

      Many in the software industry feel that a program of this size should have been implemented regionally over a mid-length period of time, so that problems could have been worked out on smaller population groups.

      None of the changes in the implementation that President Obama that Tea/Republicans are complaining about have been shown to be outside the way the law was written. But making unsubstantiated charges is the way the right gets its (false) “message” to the low-information voter.

      • notafeminista

        If there’s nothing in the PPACA stating when implementation would begin, why did it begin as it did then?

        • Don_B1

          Because that date was selected by the administration.

          • notafeminista

            That’s interesting.

  • jefe68

    The argument about the ACA is skewed in this quagmire of left and right .dogma. The bottom line: our entire fee for service, for profit health care system is dysfunctional.

    The ACA does fix some things but it’s not helping with cost. The reason, well it’s obvious. For those who are against the ACA or even any kind of health care reform, well here’s a little fact. You are going to need health care. You might need a lot of it. Unless you’re very wealthy if you have a major hospital stay or a serious illness you have a very good chance of going bankrupt from medical bills. Insurance does not pay for everything and the largest number of bankruptcies are from people with health insurance. In my opinion I doubt this country will ever get a decent single payer system. It’s to late for that, to many high stakes corporate players in the time has long past for us developing anything resembling a decent NH system.

    Our nation spends almost twice per capita on health care than any other industrial nation and we do not even come close to treating even 80% let alone 100% of the population.

    The right will no doubt go on about we have the best health care in the world, which is true if you can afford it. It will point to ills of other NH system such as Canada’s or Great Britain’s and yet when polls are taken in those countries an overwhelming majority are satisfied with their health care systems.

    I’m sure the comments on today’s show will no doubt be a lot of mud slinging back and forth between the right wingers and anyone who disagrees with them, liberals, progressives and so on. The bottom line is we have health care crisis in this country that’s not going away.

    Doing nothing will only make things worse and is not an option in my opinion.

    I wonder if people are aware of the situation with a generic antibiotic that is used to treat pneumonia. What use cost about $6 dollars for months supply is now skyrocketed to $133.

    http://articles.latimes.com/2013/mar/18/business/la-fi-lazarus-20130319

    http://www.americares.org/who-we-are/newsroom/press/2011/free-clinics-survey-united-states-patient-assessment.html

    • John Cedar

      Even Canada is smart enough not to have a single payer system. They break it down by province. If we copied them it would translate to California having six sperate systems within that state alone.

      As Obama said, healthcare needs to be rationed. This latest versioin of using Healthcare dollars to buy Sandra Fluke voters is the epitome of the worst of human nature and the worst of government.

      Lines need to be drawn as to what healthcare means and where resources are allocated. Home health aids, cleaning and cooking in the home, cutting toenails, they all take big dollars to pay for. I currently have three health crises going on in my family/relatives. Family and friends are rising to the occasion to help out. If the government had to pay for what our family and friends are doing, it would bankrupt the country.

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

        What are you talking about? Canada and every other “developed” country in the world has a single payer system. Their systems vary, but ALL of them pay no more than HALF of what we pay – and they pay for everything. They have better outcomes in most cases.

        • Bluejay2fly

          My sister is Canadian and in Ontario they do not have prescription drug, optical, or dental. Those plans in the USA because of our greedy pharmaceutical industry are very expensive. That is why people go to Canada to buy prescription drugs.

        • notafeminista

          Fantastic! Source please.

      • jefe68

        It’s done by province and I’m not sure where you get the idea that California would have six systems. I must say, You’re win the Rodney Dangerfield award for comments that garner no respect.

  • toc1234

    gotta love Tom’s surprise that Obamacare isn’t on solid ground.. but I guess that’s what happens when you get all your ACA status info from krugman’s blog…

  • Charles

    Tom, please ask your guests what will happen to the ACA when the GOP regains full control of congress later this year (as looks likely).
    Obviously, they won’t be able to repeal, but one has to think they will have some options.

    • Don_B1

      They will be making deep cuts in the budgets of the parts of the executive branch that oversee the implementation of the law, just as they have cut the budget for the Social Security Administration, which is why the annual letter showing each taxpayer’s SS account status is no longer mailed out to taxpayers. [It is still available online, but most people do not know that and many do not have easy access to the Internet to get it.]

      The effect of such cuts is that the general public becomes less aware of the law and its effects and becomes less supportive of that law.

  • Coastghost

    Obama can waive penalties and deadlines by fiat, whatever expediency requires for the health of Obamafraud.

    • Don_B1

      The PPACA, like many laws, was written to provide that flexibility.

  • toc1234
  • Yar

    This is a political football, southern states that didn’t expand medicaid will have to shift ER costs to insurance rate payers. Insurance companies can raise the cost of policies to shift the power in electoral politics, then refund the excess after the election to comply with the maximum administration charge limits.

    • notafeminista

      Who do you think would have paid for expanded Medicaid?

      • Yar

        Well, mostly through (delayed) inflation taxes. Insurance ‘tax’ (policy rates) is more regressive than just about any other form of ‘taxation’. We don’t even call insurance a tax. It is!

        • notafeminista

          Insurance in and of itself is not a tax. It is a service provided in exchange for monies tendered.

          • Yar

            Taxes are just that, we pay for defending the borders, for roads, and for insurance. When some don’t pay their fair share we pick up the difference. Insurance is the same, those that pay cover all that use services that don’t. Just like when you buy a product at a store you pay the store’s costs of shoplifting. There is a theft tax, it is part of doing business. When BP spills oil in the Gulf we all pay, even if we get our fuel from Exon. The overall price goes up as part of market prices. These are all hidden ‘taxes’.

          • notafeminista

            Careful, not the same. Roads,as we know, are a public good but susceptible to (pardon the pun) “free riding” because anyone can use the roads whether they pay taxes in a given locality or not. I don’t stop at the Texas border to pay a “road tax”.
            On the other hand, insurance is a very specific service (just like getting my hair cut or my taxes done) that I choose to buy. Because I choose to own a car, the state mandates I must purchase, at least, liability insurance for my car. However, should I choose to walk or bike I am not responsible for auto liability.
            Health insurance is exactly the same. I can choose not to have health insurance (although now the state will penalize me if I do not) and take my chances, much like with my car.

          • jefe68

            So in your small little libertarian world health care is not a public good.

            Some states do have toll roads.

          • notafeminista

            My state is one of them. It has one. There are alternate routes. Life always finds a way.
            One of my favorite books is “A Day in the Life of Ivan Denisovich”.

          • Don_B1

            When the specific service is healthcare insurance, it is a public good.

            Having a large number of people regularly sick, high costs the largest cause of bankruptcies, and the lack of productivity and the loss of that additional GDP due large numbers, all of which can be minimized through a better performing health care system, not just health outcomes for the most wealthy, but for all the citizens of the country.

            That means that everyone would benefit, rich, middle and poor.

          • notafeminista

            Health insurance is not a public good. People will be sick regardless of whether or not they have insurance – and insurance of ANY type was never intended for maintenance purposes. It is for catastrophic events – period. Not if one gets a head cold and goes to see any doctor for basic antibiotics. Catastrophic events.

          • Don_B1

            But without proper and in time care, people will be sicker and their treatment will cost more.

            The rest of your rant about the purpose of health insurance identifies the point in which you misapprehend the whole issue.

          • Ray in VT

            Agreed. My company invests in preventative care, such as annual checkups, so that issues can be identified and treated when they are small and cheap, rather than big and expensive.

      • Jill122

        The Federal Government — 100% for the first three years and then 90% for years thereafter. That means everyone. Close to single payer, but not quite since the insurance companies get their nickels (or dimes or dollars or millions).

        • notafeminista

          Where do you think the federal government gets that money?

          • Jill122

            Perhaps I’m over-rating the board and/or the program, but this is too silly for the company we are keeping.

            That said, to be kind and answer your question, that would be: ALL of us, which is what I wrote in the first post. EVERYONE contributes in one way or another. There is not one of us who is expendable and certainly NOT just because a few whiners believe we don’t have the money to care.

          • notafeminista

            No we don’t all of us contribute in one way or another. What you meant to say or should have said is from the taxpayers. Period. Having said that the US progressive tax rate begins at zero. Not everyone knows that . Zero. Which means if a US citizen earns at or below a certain amount, he pays no federal income tax. And that is where the federal government gets its money.
            European countries on other hand, have a progressive tax rate that start much higher than zero. Austria for example starts at 20% and goes up. That means Austrian citizens who earn at or a below a certain level still pay 20%, unlike in the US.
            And the whole point of the PPACA and other programs designed to “help” people was that some of us DON’T have the money, no?

          • Jill122

            Gee, I didn’t realize this was going to turn into a teaching lesson. Everyone in this country who works, pays taxes. They must pay SS and Medicare (whether they are legal or undocumented, unless they get paid under the table) and all that $$$ goes into the general fund. Even people on social security pay a little something for Medicare.

            If you believed that old 47% b—-hockey from Mittens, then well, I hardly know what to say.

          • hennorama

            notafeminista — not that one is surprised, but you seem ill-informed and ignorant of the facts.

            Federal income taxes are less than half of Federal Revenues (about 46 percent for FY 2012)

            Payroll taxes are about 35 percent of Federal Revenue, followed by corporate income taxes at 10 percent, and excise taxes (such as on gasoline, alcohol, etc.), estate taxes, and other revenue, taken together, at about 9 percent.

            So much for your simplistic claim that “…we don’t all of us contribute in one way or another.”

            Source:
            http://www.cbpp.org/cms/?fa=view&id=3822

          • notafeminista

            Are you suggesting taxpayers don’t fund the federal government?

          • notafeminista

            Speaking of teaching lessons, I just learned that in order to qualify for EITC, you must be at least 25 but under 65. You also cannot be listed as a dependent by someone else. But if you’re on Mummy and Daddy’s insurance til you are 26, does that count as being a dependent? Dearie me.

          • hennorama

            notafeminista — TY for your response.

            Despite your lack of responsiveness to your erroneous contention that the “…federal income tax … is where the federal government gets its money,” I’ll play along.

            No, I did not “say everyone contributes”; I merely refuted your simplistic and erroneous claim.

            Per taxpolicycenter.org, only about 1 out of 7 (14.4 percent) of US households pays neither Federal income tax nor payroll tax. And about two-thirds (9.7 percent of households) of those that pay neither income nor payroll tax “are elderly. Most of the rest [(3.4 percent of households)] are nonelderly with incomes under $20,000. Less than a tenth [(1.3 percent of households)] are nonelderly with incomes over $20,000.”

            While it is of course true that some small segment of US citizens and residents do not directly pay any Federal income, payroll, excise, and estate taxes, or any other form of Revenue, virtually every single US consumer contributes to Federal Revenues at least indirectly, via the taxes incurred in the production of goods and services.

            And it is of course true that each year, some segment of US citizens and residents do not pay any net Federal Revenue. That’s all by virtue of the design of the income tax and social insurance systems that have been in place for many, many decades.

            However, the fact that some might not pay any net Federal Revenue in one particular year does not mean they have never contributed during their lifetimes, as some routinely imply.

            Source:
            http://www.taxpolicycenter.org/taxtopics/federal-taxes-households.cfm

          • Don_B1

            What hallucinogenic are you on?

          • Don_B1

            And at least some (quite likely most) of that money that comes from the taxpayers would be taken from the amount that is already being paid to hospitals under Medicare/Medicaid to cover the treatments hospitals provide to indigents which they cannot refuse to provide.

            The cost of that provision was included in the CBO estimates for the cost of the PPACA and therefore is not unexpected.

          • Jill122

            I’m not sure what you are writing. Most of the money from taxpayers will be used for indigent care? Or most of the Medicare/Medicaid money is being spent on indigent care?

            I don’t get it. Indigent care reimbursements are expected to go down over the next six years. I certainly hope, and I expect you do as well, that most people will covered by some kind of insurance at that point and so the decreased payments will still be sufficient.

            There’s definitely a problem with states that have not expanded their Medicaid. Those republican governors who have refused federal help have lost billions of dollars for their poor and middle class. But I remain hopeful that their constituents will begin to realize just what they’ve given up.

          • Don_B1

            The money that the federal government currently gives to hospitals to cover the costs of treating indigent patients is going away and is moving to Medicaid (total) cost coverage. That was the source of Republican claims that the PPACA was being cut $700 billion and one of the levers that would force hospitals to lobby their state legislatures to accept the expansion of Medicaid and be more supportive of the PPACA generally.

            Hope that the states will come to their senses is not foolish, but, unfortunately, it may be after 2016 before it happens.

  • http://hlb-engineering.us/ HLB

    Reality is ready for single-payer. Even if the chattering class is not. After all, no one opposes single-payer nuclear bombs. And we really need those, ‘eh?

  • jefe68

    The US will never have a single payer system.
    People should get real, we live in a plutocracy and corporate interest rules the roost.

    • ThirdWayForward

      Eventually even the plutocrats and the sub-plutocratic business interests will realize that it is cheaper to let the state handle health insurance for all — universal medicare would take the burden for providing health insurance benefits out of the hands of employers.

      We have a tax system in which the un-wealthy pay their own way re: Medicare and Social Security — the wealthy are not subsidizing the great middle class. They simply want a more pliable labor force in which their workers are more fearful of losing their jobs — the lack of universal healthcare keeps everyone in line that much better. This is why we have socialized access to health care mainly for only those who are retired. It is also why Republicans hate unemployment insurance — they think it makes workers less desperate for work, and therefore more pliable, and cheaper.

      It’s a really nasty worldview that they have, but they and their politician minions are all disciples of Ayn Rand, whose philosophy of exploitation and economic domination is the antithesis of co-operation and mutual aid (i.e. the basis of all that is good about human beings).

      • jefe68

        Your last paragraph is where the rub lies.

      • notafeminista

        Well you certainly need them to be.

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

      We can’t give up. If we give up, we *will* lose.

      • jefe68

        I think we have already lost in terms of ever having a single payer system. FDR toyed with the idea, I know Eleanor Roosevelt was trying to convince him to do this, and desegregate the military. I think he told that fighting WW2 was the priority.

        Truman then tried to pick up the gauntlet and then Clinton. Even Nixon was interested in doing something: He proposed a national insurance program.

        http://www.kaiserhealthnews.org/stories/2009/september/03/nixon-proposal.aspx

        That said I do think we will end up with something akin to Switzerland or Germany.

    • twenty_niner

      I know the left likes curl up in front of a warm fire and dream about this, but you can’t just take Finland with a completely homogeneous (both culturally and racially) population of 5.5 M and zero military obligations and extrapolate across a country with a completely diverse population of 317.8 M that has immense military obligations, well beyond its borders.

      • Bluejay2fly

        Yes!

      • notafeminista

        In their footie pajamas!

  • http://hlb-engineering.us/ HLB

    So Americans who don’t pay taxes {the poor, General Electric} won’t be penalized. Doesn’t sound like much of a dog bite.

  • LinRP

    Jenny just made the blanket statement that the “country is in no way ready for single payer.” SAYS WHO???? HER???? The pols in the pockets of the insurance companies? The oligarchs spending millions in the biggest power play ever to keep people uninsured?

    You have got to be kidding me. Find me a person who wouldn’t want to give up the worry and expense of health care, and be able to live knowing they are covered fairly and in a way equitable to what the Koch Brothers and every member of Congress has for coverage. .

    • Bluejay2fly

      A single payer system is no longer workable in America.

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

        Why not?

        • jefe68

          Look at all the corporate players and in there lies the answer. It’s the bottom line and we the people are the marks.

          • Don_B1

            I will not be easy, and it would currently be impossible, to pass a public option for the healthcare insurance exchanges.

            Unless every calculation is wrong, the costs of the public option will be lower that the private insurance options, so over time the public will select these options and employers will move to support those same options.

        • Bluejay2fly

          Scroll down and read my prior posts

    • Don_B1

      The public is too easily confused and fear-mongered into thinking “change” will not help them. As an example, consider the two-part “Dog Whistle Politics of Race,” presented on the Bill Moyers program, interviewing Ian Haney López.

  • toc1234

    don’t worry caller… Paul Krugman and Harry Reid say your predicament is pure fiction..

  • http://hlb-engineering.us/ HLB

    Pay the penalty like the oil companies and Duke Energy. It’s often much cheaper. Ask the WV coal industry.

    • Don_B1

      Those that choose to go the “tax penalty” route should look at the provisions carefully. The penalty is the greater of the fixed minimum fee and 1% of the individual’s AGI (Adjusted Gross Income). This can be multiple thousands of dollars, depending on the individual’s income.

      • Bluejay2fly

        So unlike big oil, who owns those who oversee the process and mandates lenient penalties, the ACA is a lot less friendly to those choosing the penalty option.

  • http://hlb-engineering.us/ HLB

    Not been achieved yet = not achieved ever.

  • http://hlb-engineering.us/ HLB

    Yep. I’m on VA. I don’t have to join the exchange. And at 65, we all go to Medicare. No ACA involved. Unless Obama rewrites more of his own legislation.

    • Bluejay2fly

      My private health insurance company gives me the boot at 65 ,so how much does that cost the US government?

  • Coastghost

    Would it not have been far easier and far more appealing for the Democrats simply to’ve passed a law making ALL Americans civil servants and employees of the Federal government? THAT kind of mandate would have assured that all of us got the care and concern we need to sleep soundly at night in the tender embrace of the all-caring nanny state.

    • jimino

      No. I would have started with making everyone pay income tax on the health care insurance benefit they receive from their employer. Allowing the employer to deduct the cost while not making the recipient count it as income is the largest tax loophole we have.

      This would also make clear to the current utterly-uniformed populace just how much their taxpayer subsidized health insurance actually costs.

      Then we could debate what to do about it.

      • Coastghost

        I’m alarmed that we never hear from anyone the proposal of de-linking “health insurance” from “employment benefits” altogether: this way of foisting health insurance enrollments on Americans seems to’ve been a post-WWII practice.
        Why is the ENTIRE health insurance marketplace not privatized? Then discuss how to tax income or how to regard health insurance expense.

        • jimino

          This would at least be intellectually honest.. And we would be at a single-payer system, or some variation implemented by other developed countries, in a New York second.

          • Coastghost

            I don’t understand your argument.
            “Health insurance” properly speaking (permit me to speak of a private and privately-secured policy, for the moment) I have always understood as the general equivalent to “catastrophic coverage”, to cover costs associated with expensive treatments, procedures, and medicines.
            Under Obamacare, co-pays, deductibles, and out-of-pocket expenses have been eliminated from NO plans being offered under any exchange or coming from any insurance carrier.
            “Health insurance” does not and need not qualify for any kind of “single-payer” Federal gimme: I haven’t read Hume’s treatises and asides on economics, but the sense to be gleaned from them apparently amounts to recognizing that the ubiquitous availability of “health insurance” would promote sickness. As I argued elsewhere in this forum, a single-payer scheme would quickly devolve to the equivalent of pro bono legal representation, and everyone knows just how valuable that is in securing sound representation in a courtroom.

  • SJP

    the only way to get people to sign up is to make it Very clear that if you get sick or have an accident and end up in the hospital, any/all medical bills will be your responsibility,..Period! And if it bankrupts you, ..well, so be it! It’s Personal Risk Management. But if you want to take that risk and pay the penalty for not signing up, that is certainly your right.

    • http://hlb-engineering.us/ HLB

      People with pneumonia, HIV, or gunshot wounds won’t care. Living now is a much better alternative than punishment later. Hoober Doober

      • Bluejay2fly

        You are very correct, Hoober, and would it be fair for a convicted child murderer to get free healthcare?

    • Bluejay2fly

      That would be the capitalist model which would have worked had we allowed many people to die or be financially ruined. What we have is the government and private health insurers covering the tab. A terrible hybrid.

    • nj_v2

      That’s right! Support a corrupt, profit-driven, manipulated system or die!

    • ThirdWayForward

      Medical debt is already the #1 cause of personal bankruptcy — you have absolutely no control over costs (and the doctors have absolutely no idea how much anything costs).

      The problem is that we as a society do not (and should not) allow people to die simply because of their own folly and/or personal financial irresponsibility. There was a point in my life when I was in the emergency room for an acute very painful condition, I didn’t have health insurance at that point, and they wanted to do all sorts of expensive procedures that I knew were unnecessary, but because they could not tell me how much all of this would cost — how much I would be responsible for — I refused those treatments and they kicked me, amidst great pain, out of their ER.

      The present system is horrible — health care reform means that many fewer of these circumstances will arise in the future.

      A more rational and simpler way to deal with this would be to have the state cover everyone for emergencies and catastrophic situations. This is less efficient in terms of preventative and ongoing care, but then there would not be the necessity to compel people to buy insurance — they could go without insurance (and medical care) if they wished, but if they present themselves at an emergency room with a life-threatening condition (e.g. heart attack), then that care would be covered automatically, no questions asked.

      Presently we have an uninsured care pool for hospitals in which paying customers subsidize the uninsured indirectly. I think the annual cost is around $40-50 billion/yr (half the annual cost of the Afghan War).

      Unfortunately, almost half the country supports Republicans and conservative Democrats who will block any kind of positive reform of the system. They don’t have enough votes to govern nationally (and they have no plan for governing), but they do have enough votes to paralyze the government, and lack any scruples that would inhibit their obstructionistic and destructive tactics. Were it not for Republican gerrymandering, they would not control the House.

      Why do we have a costly, inefficient, patchy health care system? It’s because we have radical conservatives who would rather shut down the government than to help it work effectively (or at least get out of the way and let it work).

  • sarahrm

    Look: what we need is national single-payer healthcare for all, funded by taxes, full coverage, not depending on employer. Cut the military budget to fund it. Healthcare is a human right. Obamacare was a cave-in to the HMOs.

    • Don_B1

      Actually, it was a cave-in to reality. There were at least three Democrat Senators [Sen. joseph Lieberman (I/D, CT), Sen. Ben Nelson (D, NE) and Sen. Blanche Lincoln (D, AR)] who would never have voted for even a public option, not to mention single payer. And with 60 votes required for cloture and no Republican votes in the Senate, all 60 Democrats would have had to vote for it.

      But there is a path to single payer from where the country is right now: pass a law to add a public option to each exchange and watch patients move to the lower cost policies offered there.

  • http://hlb-engineering.us/ HLB

    The arc of the cost curve always bends to more costs for the average American.
    –famous old saying I just invented

  • nj_v2

    Progressive critics of the health care “reform”—not the phony-liberal/Obama-apologist crowd—criticized this mess from the beginning, not for the ludicrous, bull-excrement reasons fabricated from the insane right-wingers (death panels, etc.), but, in part, because it was obvious there was no effective cost control built in to the system.

    The insurance industry, was, of course, ecstatic at this, which is why they made the few concessions they did re. no pre-existing conditions, etc. and supported this disaster. Small price to pay for the huge windfall they would reap from having millions of new customers forced to buy whatever minimal, crappy products they’re able to get away with.

    Since Obama has shown himself to be a corporate tool at every turn—appointment of industry lobbyists to high positions after promising to purge lobbyists from the administration, failure to prosecute Wall Street criminals, etc.—and pre-compromised by pulling the public option off the table, the new Insurance-Company-Windfall Act entrenches the new system and will give the insurance industry untold millions of dollars to fight any move toward the only sensible solution to the country’s health-care mess—universal coverage/single payer.

    If i were younger, i’d seriously consider selling everything and moving out of this disfunctional country.

    • StilllHere

      Right, all talk no walk.

      • jefe68

        Troll alert ^^^^

    • Bluejay2fly

      You Cannot. I married a Greek and still cannot move there. Unless, you opt for some third world nightmare country moving abroad is not as easy as coming here.

  • StilllHere

    Mostly people who had insurance have been signing up, assuming they can get the website to work.

  • Coastghost

    Is Obamacare as presently constituted achieving higher health insurance enrollment rates across the board? Is it achieving lower health insurance coverage rates across the board? (It was given to us to achieve both, correct? but has it given the country either?)

    • OnPointComments

      According to a cost summary provided by eHealthInsurance:

      — Premiums have increased by 39 percent to 56 percent, compared to pre-Obamacare coverage. As of Feb. 24, the average premium for an individual health plan selected through eHealth without a subsidy was $274 per month, a 39 percent increase over the average individual premium for pre-Obamacare coverage.

      — The most recent average premium for plans without a subsidy chosen by families was $663 per month, a 56 percent increase over the average family premium in Feb. 2013, which was $426 per month.

      • Jill122

        Politifact says no (at least for the state they surveyed). Increases occurred before ACA and will continue. I actually have a website reference (which I consider de rigueur for quoting internet sites).

        http://www.politifact.com/wisconsin/statements/2013/dec/15/ron-johnson/obamacare-health-insurance-premiums-havent-gone-do/

      • Jill122

        I finally found your reference. Looks like coverage went way up, and deductibles went way down. Even without ACA, if an insured upgrades their coverage either way, by raising coverage or lowering deductibles, the plan is bound to cost more money. And with ACA you will know in advance what is covered.

  • http://hlb-engineering.us/ HLB

    You go into the massive societal change with the White House organization We The People have put in place. {Bush, Clinton, Bush, Obama, Clinton, Bush, Obama, ad nauseam}

    What a revoltin’ development this is.
    –Chester A. Riley

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

    This “religious freedom” argument to not pay for abortion or birth control is *bogus*.

    • Bluejay2fly

      Since when did we become a theocracy.

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

        Huh? Did I say that?

        • Don_B1

          He must be agreeing with you?

    • notafeminista

      How right you are. The Little Sisters of the Poor are not only charlatans, but stupid as well.
      Man I love the Left.

      • jefe68

        The word bogus could be used to describe your comment. So by your argument a business run by Jehovah Witnesses could also refuse to cover anyone because they don’t believe in blood transfusions.

        • notafeminista

          So you don’t think religious people are stupid hucksters? Is that what you’re saying?

          • jefe68

            No, I don’t think religious people are stupid in general. I think there are a lot of stupid people who happen to be religious though.

            Some of them do seem to harbor the notion that we live in a theocracy or would like it if we did.

          • Bluejay2fly

            As long as it is their theocracy.

          • Ray in VT

            Yeah. I bet that they wouldn’t want to be forced to wear the FSM’s collander hat.

          • notafeminista

            Really? How so precisely?

          • jefe68

            Do really want to go there?
            The recent hubbub being made by right wing christians that the new Cosmos show should air their inane ideas about creationism. That’s a perfect example of people who are religious and saying stupid things.

          • notafeminista

            I do really want to go there. I want to know how you think the US with its freedom OF religion which means only the state will not recognize one religion and one religion only compares to an actual theocracy. Point by point and be specific.

          • Ray in VT

            If one is arguing that America’s laws should be based upon the Bible and the laws of the God of the Bible, then that certainly seems to me as a sort of society wherein a religion and its dictates are placed at the center of the legal process and would certainly seem to violate the Constitutional prohibition against the establishment of religion.

          • notafeminista

            If one is arguing that, perhaps yes. Is one arguing that?

          • Ray in VT

            Some do, including some how have sought a major party presidential nomination within the past half dozen or so years.

          • Don_B1

            You haven’t heard of Dominionism? See:

            http://en.wikipedia.org/wiki/Dominion_Theology

          • jimino

            No. The comment simply says YOU are, as your reply illustrates. Why don’t you just answer the question?

          • notafeminista

            There was no question asked.

          • jimino

            OK. Could a business run by Jehovah Witnesses also refuse to cover anyone for a blood transfusion because they don’t believe in blood transfusions?

          • notafeminista

            Yes.
            How about a business run by Muslims refusing to pay for an employee who contracted trichinosis?

      • Jill122

        The Catholic Church is exempt from paying for contraceptives, that includes the Little Sisters of the Poor.

        Clearly Neil is talking about Crabby Lobby.
        Man, I truly love low information listeners.

        • notafeminista

          It doesn’t matter. Freedom OF religion doesn’t say “except for those who make a profit.”

          Man, I love people who don’t read the Constitution.

          • Jill122

            No it does matter. The Supreme Court has written that there will be no discrimination when it comes to employment and serving customers. As far as I know, that is stare decisis and has been so for very long time — they are adding classes of people, not subtracting.

            I personally want a new amendment entitled Freedom From Religion.

          • notafeminista

            Ah but it cuts both ways. You don’t force me to give up my freedom of religion to ensure your no-cost birth control.
            Want a new amendment? Work for one. It’s been done before.

          • Jill122

            You don’t have to subsidize birth control. Every state offers at least once policy that does not require you pay for birth control. And some states offer many more. You wanna shove your myths down my throat? You should have to pay me.

          • notafeminista

            I should have to pay you for the way I believe? Not hardly. You pay for the policy that supports your way of life, not me.

          • Don_B1

            It has been shown that providing birth control REDUCES the cost of health care, so premiums do not go up when birth control coverage is included in the policy.

          • Ray in VT

            Absolute freedom of religion has never been something that has existed under our Constitution, in part because adhering to the laws of our nation may require some people to not practice their religion as they see fit, and that is, I think, the way that it should be. It has yet to be established that it is a violation of anyone’s religious liberty to provide a range of health insurance coverages to one’s employees, and I do not think that the religious beliefs of one’s employers should dictate what health benefits and employee should be able to access.

          • notafeminista

            Religious beliefs don’t dictate whether or not a woman has access to birth control. Right where I live – a small to medium city, any woman can get a variety of birth control – the cost of which is based on her salary or lack thereof. No employer needed.

          • Ray in VT

            No, but there have certainly been at least one very prominent candidates for office who has made it very clear how terrible he thinks that contraception is, and currently some employers seem to believe that their religion should dictate what health benefits are available to them. I could get my prescription too, but it costs me far less by going through my employer’s plan, just so long as my employer doesn’t develop the religious belief that my prescription is against the faith.

          • Coastghost

            Well, let’s get going: I would welcome at this stage a Constitutional amendment requiring a strict separation of science from state, insofar as science is authoring its own secular theodicies and prophecies and hallowing its own sanctities and privileging its own idolatries.
            “Applied technology giveth and applied technology taketh away: blessed be the name of applied technology.”

          • Jill122

            hohoho — that’s a riot. Yeah, let’s live in a country that doesn’t subscribe to science. Might as well include math, engineering and technology. Looks like we’ve already begun — in fact we have a head start (get it?) on 23 other countries (in science) and well below average in math and reading as well.

            http://www.businessinsider.com/pisa-rankings-2013-12

          • Coastghost

            I’m sure our sciences all remain healthy enough to indulge quite a bit of informed skepticism and criticism (Feyerabend for one seems to’ve been quite well informed about the limitations of the conduct of the scientific enterprise), but we hear arguments all the time about whether a lot of the funding our governments steer to the sciences and scientific research would not be well spent elsewhere.
            –which Is to say at least in part: certainly there’s insufficient evidence to claim that the millions we spend on science education and science apologetics each year yields quite the return on investment commonly attributed to the effort.

          • Ray in VT

            One party is already working hard to promote ignorance over knowledge, but I don’t see the GOP being able to get an amendment passed to protect their base any time soon.

        • keltcrusader

          and nota is one of the best here

  • Human2013

    The last caller was right. I commend Obama and others for attempting reform, but we really need a single payer system. Capitalism and healthcare don’t mix and never will. We have to remove health insurance from the private sector.

    • Joan

      Yes. We’re paying more and more for less and less care. There was a time when drs allowed an hour for annual physicals and 1/2 hr for regular visits. They’re no longer allowed to do that. 20 min if you’re lucky. The money is going to the mahogany suite — hosp execs earn $1- $2 million a year, insurance execs 10x that. (Obama earns about $500,000.) So why is healthcare so expensive? Can’t imagine.

  • http://hlb-engineering.us/ HLB

    The ACA website ought to work like a video game. The better you play, the higher levels you achieve, the lower your insurance costs. Get to the end and save the princess!
    –Mario and Luigi

    • Bluejay2fly

      Or like Grand Theft Auto where you steal health coverage from others.

  • OnPointComments

    The first amendment to the Constitution does not say “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof, unless you organize as a corporation, then you forfeit all of your rights.”

    • Jill122

      That’s not true. If you have created a private, non-profit charitable outlet that only serves people in your religious community and employees have signed a contract that excludes benefits generally available to the rest of the population, then no problem.

      Crabby Hobby should simply change its model to non-profit, charitable outlet. They shouldn’t be able to make profits off unsuspecting customers who wouldn’t support that kind of “bidness” model for a NY second if they knew the facts.

      • notafeminista

        You would be incorrect.

    • jimino

      Are there corporations in heaven or hell?

  • Pete

    I have heard plenty on the health care issue here, and it will only take time to show what really is happening. It’s an attempt to correct a broken system that has been gouging many people for decades. Along this same line, I would like to hear more about what hospitals charge patients and how they do it with the mythical “charge master.” Recently, I was pricing an operation for a friend and found that UVA charged 2-3 times more than some surrounding hospitals for the same treatment. Plus, try to find out from the hospital how much an operation would cost. How many request an itemized bill for their service and see how much a bandage or a visit by an unknown person costs?
    Some think that ACA is a monster, but at the same time there has been little discussion about the broken system we have in our hospitals, how they work and are controlled.

    • jefe68

      What you are describing is partly why health care costs are out of control in this country. It’s being treated as if it’s a commodity but there are little to no regulations in regards to what hospitals can charge and why.

      • Jill122

        Transparency is the key. You might get lucky just by going on line. Hospitals want to bring you in and they will, over time, become more competitive.

        • jefe68

          Not where I live. Partners owns MGH and Brigham and Women’s which are the largest health care providers in the metro-Boston area. In the city of Boston they employ about 50,000 or so between the two.

        • Don_B1

          Possibly even more important than transparency will be the move to a system that does not charge by individual procedure, but by case, where the hospital/physician is paid a flat fee for the total treatment of things like a broken arm, breast cancer, etc., possibly with some exceptions for special cases.

          Many times the various types of treatment for a health problem range widely in cost and the different approaches are hard for a non-medically trained person to evaluate (and hard even for trained individuals).

          This type of change is encouraged by some provisions of the PPACA.

          • Jill122

            Yeah, it could work. I’d sure like to see it tried. I’d also like to see patients enter the hospital with advocates or to be able to call a volunteer to do that. I fear people will be offered treatment they must pay for themselves and never be told until they get the bill.

            I also believe that if people shared their experiences we would be better off. Republicans have been kind enough to share their ghastly experiences – but we have needed the press to tell us they were all fairy tales.

            In any case, we all need more honest information. How to get it is the next question.

    • hennorama

      Pete — indeed, the difficulty in comparing prices and quality by provider is a major factor in the frustration many have with the US health care system.

      As more and more Americans become more and more personally liable for their health insurance premiums and out-of-pocket healthcare expenses, whether through their employer-based plans or individual plans, they will become more aware of the actual costs, as well as the variation in price and quality among providers.

      This is a good thing.

      • Don_B1

        But it will always be difficult for the patient to evaluate which medical procedure is the most effective for a medical condition.

        That is why healthcare is not like going out and buying a car, for which the option of not buying the car is always on the table.

        • hennorama

          Don_B1 — TYFYR.

          Yes, we rely on health care professionals to evaluate and recommend courses of treatment. Patients do have access to far more information these days though, and motivated ones can at least try to determine what questions to ask during the diagnostic process.

          But I was talking about cost and quality of care, not detection and diagnosis.

          Indeed, as you wrote, for emergent conditions, almost no one will refuse treatment, regardless of cost.

          OTOH, when time is less of the essence, it is still difficult to compare cost and quality across a range of potential providers, although this is improving.

          Slowly, but surely.

          TY again.

    • StilllHere

      If you don’t have to pay, why would you care about the prices. Patients haven’t cared until recently.

      • TFRX

        “Patients haven’t cared until recently”?

        Talk to the working class folks whose insurance was “bare bones” two years ago about what their deductibles and copays were.

  • wjober

    Please clarify what is meant by the term “deductible”. Is it the amount you have to pay in medical costs before you get any coverage or is it the maximum out of pocket cost beyond which you would pay nothing for health care.

    • Jill122

      In general, deductible refers to the out of pocket expenses paid by the insured before the policy begins to pay. You must submit all charges to the insurance company so that they know when you have met your deductible. Maximum out of pocket is generally referred to as capped coverage. You may have $100,000 in capped coverage for a particular procedure or disease.

  • hennorama

    For anyone interested, a website developer in Michigan has compiled all sorts of info on PPACA signups, including a graph of the numbers of enrollees, here:

    http://acasignups.net/graph

    • TFRX
    • Bruce94

      I haven’t had a chance to listen to today’s show yet, so some of this may have been clarified by the guests earlier. Thanks for sharing the chart; it reflects the same estimates I’ve gleaned from other sources including KFF, Politico, Washington Post, etc. The figures for those signing up on the Exchanges (3-4 million) and those obtaining coverage under their parent’s insurance (over 3 million), don’t seem to be in dispute. What appears to be somewhat problematic to determine is the proportion of new Medicaid/CHIP enrollees that can be attributed to the ACA (between 4 and 7 million?).

      Accordingly, as I interpret the data, the most conservative estimate for the total number of people who have benefited directly from the initial stages of ACA implementation would be consistent with your chart–approx. 11-13 million, not too shabby considering the rocky-rollout that was, in part, due to Republican sabotage and scare tactics.

      Of course, it remains to be seen if the proportion of new enrollees 18-34 years old (i.e. 25%) will be sufficient at this phase of implementation. I’m assuming it will have to rise to some higher level in order for insurance in the individual market to remain affordable and for the overall program to remain sustainable. Do you happen to know what percent of young invincibles most informed sources say will eventually have to sign up to make it work for everyone?

      Here’s some more corroboration for the data your link provided. Again, thanks for your input.

      http://www.newrepublic.com/article/116981/obamacare-enrollment-now-4-million

      http://kff.org/health-reform/issue-brief/medicaid-enrollment-under-the-affordable-care-act-understanding-the-numbers/

      • hennorama

        Bruce94 — TYFYR.

        The “conventional wisdom” figures being bandied about for “young invincibles” range from 35 to 40 percent of total enrollees. There’s a good discussion and analysis as to the ramifications of a shortfall in enrollment, from the Kaiser Family Foundation. They ran two scenarios, at enrollment levels of 25% and 33% respectively, and found that “because premiums are still allowed to vary substantially based on age, the financial consequences of lower enrollment among young adults are not as great as conventional wisdom might suggest.”

        One very large caution, however. The health of enrollees is far more important than their age. If only the sickest enroll, regardless of age, then look out below. Here’s a pertinent excerpt:

        From the perspective of keeping insurance premiums stable, how enrollment is distributed by health within each age group is, in fact, more important, since premiums cannot vary at all by health status under the ACA. In other words, the goal is to enroll healthy as well as sick young adults, and also healthy older adults. (Older adults are more likely to be sick than younger people, but that is mostly accounted for by the fact that premiums can vary by age.)

        See:
        http://kff.org/health-reform/perspective/the-numbers-behind-young-invincibles-and-the-affordable-care-act/

    • OnPointComments

      Some facts about Charles Gaba from
      http://www.washingtonpost.com/blogs/wonkblog/wp/2014/03/19/this-guy-knew-when-obamacare-enrollment-would-hit-5m-before-anyone-else-now-hes-predicting-6-2m/

      self-employed Web developer; not a professional statistician, heath-care expert or political operative; self-described “numbers geek”; admits there’s some guesswork involved in his projections; He admits that he does have a rooting interest in seeing the law succeed – he’s a volunteer for the local Democratic Party.

      As Newsbusters states, “Gaba In, Gaba Out,” the Obamacare enrollment equivalent of “Garbage in, garbage out.”
      http://newsbusters.org/blogs/pj-gladnick/2014/03/20/gaba-gaba-out-wapo-hails-nonpolitical-blogger-spouting-rosy-obamacare-n

      From Politifact
      http://www.politifact.com/truth-o-meter/statements/2014/feb/25/barack-obama/barack-obama-says-medicaid-expansion-has-brought-h/

      “Charles Gaba, a website developer and blogger in Michigan, has been tracking enrollment figures at his ACASignups.net site. His most recent estimate from late February shows 2.6 million Medicaid sign-ups…Meanwhile, Avalere, a health-care consulting firm, concluded that over the three-month period, between 1.1 million and 1.8 million people newly enrolled for Medicaid due to Obamacare…There’s a significant difference between 1.1 million and 2.6 million…”

      • hennorama

        OPC — Mr. Gaba is not claiming any particular expertise, but he seems to have been fairly accurate, according to the WaPo article to which you linked:

        The Obama administration on Monday announced that 5 million people had signed up for Obamacare exchange plans. Hours earlier, a self-employed Web developer from Michigan had already predicted the milestone would be hit on Monday.

        Meet Charles Gaba: He’s not a professional statistician, heath-care expert or political operative. He’s a self-described “numbers geek” who just wants to know how the new health-care law is doing.

        He’s been tracking the most up-to-date enrollment information and offering his own projections on his blog, ACAsignups.net. On the same day that he predicted the 5 million signups milestone, he accurately predicted that California would hit the 1 million mark. For policy wonks and health-care journalists who have clamored for more information about Obamacare enrollment, Gaba’s blog has become a must-read.

        The politifact.com piece used Mr. Gaba’s work as a fact-checking source, indicating that his work has some credibility.

        And a piece from the anti-all-things-Obama “newsbusters”? Not exacty an unbiased source.

        Thanks again for your response.

        • OnPointComments

          The data from Charles Daba brings to mind the saying “consider the source.” I put as much credence in the numbers from Charles Daba as I would if my conservative, Republican barber presented me with ACA enrollment data, no matter how accurate my barber’s guess turned out.

          As one of the linked articles pointed out, it’s interesting that he’s described as not a political operative in one paragraph, and several paragraphs later states that he’s a volunteer for the local Democratic Party.

  • Ray in VT

    And how is the ACA paying for or promoting abortions?

  • Coastghost

    Obamacare still sounds like an invitation to pro bono healthcare, just as valuable a commodity as pro bono legal representation (where “pro bono” equals “pro forma”).

  • MOFYC

    Vermont is one of the few states that’s not controlled by corporate interests so if the eminently sensible single payer will succeed anywhere in the US, it will be in VT.

  • hennorama

    Suzanne — a few questions:

    1. Have you checked into Health Savings Accounts (HSAs)? They may provide you with tax savings for those health care expenses not covered by insurance.

    2. Are there no neurologists whose services would be covered by this insurer’s plans?

    3. Same question regarding your medications — are there no alternatives covered by this insurer’s plan?

    • Jill122

      Oops! Isn’t that always the way? You dig into the details and find out there’s no there there.

      • hennorama

        Jill122 — thank you for your response.

        To be fair, without answers to these and other questions, it’s difficult to determine whether or not Suzanne’s circumstances are here or there, both or neither. ;-)

        TY again for your response.

        • Jill122

          I hope you don’t think my comment was about your questions! It was about her answers to your questions. :)

          • hennorama

            Jill122 — TYFYR.

            Again, to be fair, that was Suzanne’s first comment ever, and combined with the time elapsed between her comment and my reply, her lack of reply to me is not terribly surprising.

            Still, “I hear ya.” ;-)

            Thanks again.

  • WorriedfortheCountry

    Obamacare was supposedly about expanding the number of insured and lower insurance costs. We were promised $2500 annual cut per family.

    The regime is touting 5 million insured under Obamacare. What they don’t say is surveys have shown that only 27% of those signing up were uninsured prior to Obamacare. Unfortunately, “the most transparent regime in history” is not providing the information. So they are either hiding it or incredibly, they are not tracking this important metric. So it is either deceit or more incompetence.

    Further, they have not reported how many of the 5 million ‘signed up’ have actually paid. You aren’t insured until you pay up. Industry surveys report that up to 20% of the ‘sign ups’ haven’t paid. So again, more misleading cheer-leading by the regime.

    Hopefully, accurate data will be forthcoming soon but I’m not holding my breath.

    • Don_B1

      At what point in the development of the PPACA law was the “$2500 annual cut” made and what was it in respect to?

      The rise of premium costs, which has been averaging at least 8% to 10% a year for several decades, has been less than that for the last 3 years, and there are strong indications this trend will continue, plus the cost data that will be collected will make big contributions in ways to further reduce costs in the future.

      That $2500 reduction is quite likely to appear in 5 to 10 years if not sooner, inflation adjusted of course.

      • WorriedfortheCountry

        It is a failed promise primarily because cost containment was never a priority. IMO, central planning could have lowered costs but CP isn’t the most effective and efficient method to lower costs.

        • Don_B1

          That cost containment was never the top priority is true, as it was with Romneycare in Massachusetts. There are two steps necessary to go from the healthcare industry of last year to the much better state that all other developed countries have attained.

          1) Get everyone coverage

          2) Improve the delivery system in a way that will reduce costs.

          Because it was felt that the second would be easier to do if the first was already accomplished. Massachusetts made the steps toward doing the second last year and while it is too early to see how successful they will be, Romneycare was at least partially successful with some cost control over the last eight years.

          • pete18

            Massachusetts has the highest individual market premiums in the country.

      • hennorama

        Don_B1 — off the top of my head, the $2500 figure was an “up to” amount, and was over a ten year timeframe, and compared to what would have occurred without the PPACA.

        I’d look it up, but no amount of factual information will convince anyone who is wedded to the factually inaccurate figure.

  • ThirdWayForward

    Obamacare’s most popular provisions are its least well known

    Credits to small businesses to buy insurance
    Close Medicare donut hole
    Health insurance exchanges
    Extension of dependent coverage (to age 26)
    Subsidy assistance to individuals
    Medicaid expansion
    Guaranteed issue (no pre-existing condition preclusion, cannot drop sick patients)

    http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/22/obamacares-most-popular-provisions-are-its-least-well-known/

  • Coastghost

    Google is celebrating 102-year-old women of late: perhaps we can wonder aloud how these women managed to survive an entire century when health insurance was not construed as a “human right” and when the practice of medicine itself was only beginning to differentiate itself from quackery.

    • Ray in VT

      Surely some people did not attain long life prior to germ theory and vaccinations and the like.

      • Don_B1

        People like, say, Benjamin Franklin, John Adams, Thomas Jefferson come to mind; their life spans are probably exaggerated like that of Methuselah in the Bible.

        • Jill122

          No — they were among the wealthy and it’s true that they have always lived longer than the poor.

          “Life expectancy for the nation as a whole has increased, the researchers said, but affluent people have experienced greater gains, and this, in turn, has caused a widening gap.”

          http://www.nytimes.com/2008/03/23/us/23health.html?_r=0

          Money means access to care.

          • Ray in VT

            I think it very likely that Don was joking regarding that latter point. One of my undergraduate professors did take especial note of the quite long lives of some of the Founding Fathers. It was something of a feat to attain such long life, considering the times, although long life was not unknown even in ancient times. Being of means certainly helped with that.

          • Don_B1

            I only mentioned their names because they were widely known to most present-day Americans as long-lived.

            It is certainly true that the wealthy have always lived longer, and lately they are just about the only ones with lengthening lifespans (the conditional expected life at 65 is the relevant statistic). But in Colonial days the state of medicine was not nearly as important for chronic diseases, etc., being mostly good for setting bones, etc.

          • Ray in VT

            It is amazing to look at the rates for death in childhood. I think that about 1 in 3 died before reaching adulthood. There was also an issue with pregnant brides, although supposedly things like that did not happen in the good old days.

        • jefe68

          Michelangelo lived to about 80. Titian lived to 90. Raphael did at age 35. It’s well known that Michelangelo lived like a monk and ate simply and most likely was not promiscuous. Raphael on the other hand liked to paint the town red, no pun intended. He was known to have lived a rather “lively” life.

          Some people are just lucky and also have good genes.

    • jefe68

      … and 100 years ago we had Jim Crow laws and the convict lease laws in the South, or another version of slavery if one really wants to get serious about this.

      Very few Jews or people of color were considered for entry into Harvard.
      At Yale and Princeton it was almost impossible for non-whites or Jews to get in. I could go on about a host of human rights that our nation has embraced.

      100 years ago women were still property nor could they vote. Children were also considered property as well.

      Comments such as this one does lend credence that some right wingers are regressive and mendacious.

      • Coastghost

        I have never been an apologist for the forward-thinking, progressive Ivy League schools, not in their current incarnations and not in their prior avatars.
        A century ago American women were not enfranchised, ’tis true: it’s also true that just as soon as they were enfranchised, they helped pass Prohibition, that darling social experiment that required a Constitutional repeal barely a decade later but whose odious appeal continues to this day.
        I don’t know that I qualify as a right-winger or that my practice of mendacity is any more regrettable than anyone else’s, but certainly I don’t subscribe to your implication that conservatives are “regressive”: conservatives simply concede that Progress is an illusion when not qualifying otherwise as an idol. (“Progress”, when not simply a synonym for “change”, can be properly construed as “the fresh opportunity to create new and less manageable problems”.)

        • Bluejay2fly

          While many suffragettes supported prohibition it was the South that really wanted it to become a national policy.

          • jefe68

            The temperance movement came out the Southern evangelical movement in the 19th century.

        • Cutler Hamilton

          Your understanding or idea of progress is not shared by many people. The idea of progress is to engineer or devise something better for the vast majority in a society. Removing the rights of women gained in the past 100 years, using religion as a government institution or guide for new laws, disenfranchising voters, racial and ethnic bias, and making education more expensive for all citizens is not progress. That is regression. Backtracking, Degeneration, Detrioration, Corruption, Reversion,

          • Coastghost

            Progress is regressive, when it’s not being fatal.
            Your naïve view of Progress illustrates well what has occurred in the past two centuries. Humanity simply had learned to outlive the horse: so voila! there are so many more of us traveling so much faster these days (at least as much as errant airliners permit), and more of us, and more of our immediate descendants, will be choking to death, drowning to death, and dying from cancers and other nasty ailments all because a handful of generations thought that “progress” consisted of faster transportation.

          • Cutler Hamilton

            Faster transportation? What in the heck are you talking about? This particular show was about the ACA and it’s progressive impact on the nation’s health i.e. health and care services for it’s citizens. Transportation has nothing to do with what I said. I was merely trying to illustrate to you that progressive ideas are meant to be inherently good for the vast majority of citizens. Will their be flaws? Yes. But that doesn’t mean we all fall back to regressive society just because you couldn’t keep your current health plan. It’s like getting a small dent in your car from someone parked to close you in the parking lot. You can’t find the exact guy who did it, but does that mean you shut down every facet of your life and the lives of every one else and find the culprit? Do you try to lambast every person you come into contact with that has not had a car accident? Do you blame the dent of the shoddy manufacturing of the car manufacturer? No. You file an insurance claim, get reimbursed, car repaired and get on with your life like everyone else. The point is no one’s perfect. No law is perfect. No service is perfect. No product is perfect. Perfection in your eyes is completely different than perfection in my eyes. We are individuals, not a hive mind that conforms to one thought or idea. Protest all you want, but the idea that progress is bad is the only thing upside down in both your mind and mine.

          • Coastghost

            I am wedded to viewing “Progress” as “fatal fatalism”. It neither cures nor ameliorates, it simply shifts problems from one population to another.
            Or I suppose I can say: I cannot believe in Progress because I believe the future does not exist (no one has cured me yet of the growing block universe hypothesis).

          • Cutler Hamilton

            Some part of the population will have to take the brunt of an unpopular decision. The real question is which portion of the population is better equipped to deal with adversity. On one hand you have a small population that controls an immense source of wealth. That is an undeniable fact. According to most academics and economists who study trends like this for a living, we haven’t had this disparity in wealth inequality since the era surrounding The Great Depression. You have more “middle class” families living just above the poverty line now than ever before. The result is more children growing up in this new type of middle class. What will be the result? Will they falter due to the lack of investment in their educations, soaring costs for college, and lack of employment opportunities? Or can we right the ship, throw out all this tainted bathwater in the form of ridiculous, so-called “political leaders” in DC and get down to business. We need investment. We need wise investment in our future. All these boomers holding onto wealth like they’re gonna take it with them is absolute horsesh%t. All that money and power serves no good to one person. Those are conservative values. Looking out for yourself and making sure nothing bad happens to just you. It’s selfish, arrogant, and leads to nothing but misunderstanding, hatred, and bigotry. Get over the fact that we must stop being selfish. This whole planet is nothing but a speck in a grain of sand in the scope of the whole universe. If you do not believe the future exists, (by the way, what kind of f*$ked statement is that? Are you depressed or something?) then get the heck out of the way of others who want positive progress. Not to much to ask. Just quit being selfish and making everybody else miserable.

        • Jill122

          Please don’t get all pseudo-philosophical on us. Semantics aside, progress IS change to a more just and equitable society. Change is a the constant and will always bring problems and opportunities.

          Stagnation and entropy bring their own set of opportunities and problems.

          • Coastghost

            Your assertion aside, Progress is offered by its apologists and advocates as “change to a more just and equitable society”.
            I become convinced that discrepancies in the perception of temporal velocity account for most political disputes (and are not well accounted for in contemporary physics). The result, I begin to argue, is widespread confusion concerning the nature of time itself. Advocates and apologists for Progress seem to believe that “change” comes to us or beckons us from the future. Yet astronomy and photography alike demonstrate each and every day that the ONLY reality we are apt to encounter in this universe is the past itself. The only reality we ever behold is the past, whether immediate or not so immediate.

        • jefe68

          Prohibition was about revenue as much as it was about trying to deal with the social ills of the period. Women and children were on the bad receiving end of the abuse of alcohol. As to you’re claim about being a right wing, well your comments on this forum are hardly what one would call liberal.

  • Bluejay2fly

    I agree we need to do better ,but it is extremely complicated. The working poor get hardest hit.

  • hennorama

    Amir Genovese — congratulations that your income is high enough to not qualify for subsidies, and I feel your pain.

    Keep a couple of things in mind:

    You may be able to manage (lower) your Modified Adjusted Gross Income (MAGI) through retirement plan contributions and various other means so that you can qualify for a PPACA tax subsidy.

    Assuming you are going to pay the penalty, your actual net cost, if you instead decide to obtain health insurance, would be the difference between the premiums and the penalty

    If you have assets, a significant bill for health care could put them at risk.

    Finally, a question:

    You indicated that you are “in the labor force as a tradesman…” Are you an employee, or are you self-employed?

    • Amir Genovese

      While I appreciate the thought, the fact is that there just aren’t any extra dollars in my budget. Increasing the amount that I output in no way increases my income. My budget is already cut to the bone. In order to “contribute” anything further, I would have to eliminate an expense, such as rent (the roof over my head) or say my car payment (how I get to work, to pay for everything), or food so barring an increase in income, that’s just not feasible. The difference between the penalty and the actual cost of coverage is simply too great for me to bridge the gap.

      As to my employment, I am an employee, but I work for a lot of companies. Last year alone I earned 25 W-2s, so really, it’s more akin to self Employment. Lots of uncompensated expenses, including around 30k miles on my car per year just to get the work. The most common response to this from people who are privileged enough to have regular jobs with regular hours and regular pay is that I (and apparently everyone else in my industry) should “just get a regular 40hr/wk job with benefits…” In reality, if everyone in my industry were to do that (presuming it were even possible) then you would never be able to go to another show again, whether ballet, concerts, tradeshows, etc, because there would be nobody to staff backstage. Not all employment in the US is created equal, and accordingly, blanket decisions made by privileged politicians in a one size fits all manor, simply don’t fit all. The only asset that I have is the car which gets a monthly payment to my bank.

      Honestly, I’ve had this conversation probably more than fifty times, and always end up in the same place: The affordable care act is flawed in that it is not affordable for everyone!

      • hennorama

        Amir Genovese — thank you for your response.

        30K miles certainly is a high price to pay “just to get the work,” but there are many who commute that much annually. No doubt you’ve looked into whether any of those miles might be tax-deductible, so I won’t bore you those details.

        Again, congratulations that your income if high enough that you don’t qualify for tax subsidies. Perhaps one day legislative fixes to the PPACA that address the so-called “cliff” will be possible. Until then, all you can do is earn more, spend less, or do both.

        I’ll let you know if I find a magic wand that makes that happen, OK?

        Thanks again for your response.

        • Amir Genovese

          And that right there sums up why this system simply doesn’t, and likely never will work without major changes. Universal health care is a good idea. ACA as designed by our corporate masters is a bad one.

  • C.White

    Re: the phonecall from married recent college grad, 31 yo Susie.
    The unaffordability of premiums is not good, no doubt a shortcoming in the intent of the law. But as someone whose wife is pregnant and insured, I wonder if this is something that many young women in particular will fail to think of when they are weighing the risk of being uninsured and paying a relatively small fee vs. paying high premiums. Our pregnancy is a normal one without complications, and without insurance, proper prenatal care would be incredibly expensive, not to mention the costs of delivering in a hospital. God forbid having to be admitted for several days because of a c-section or other wrinkle. These aren’t catastrophes or things that only happen to the unlucky, they are things that most 20-30 something women are going to do. Either way she is going to pay, but probably much less with insurance.

  • twenty_niner

    You’re on a board with some seriously hard-core statists and collectivists, and the notion that 20,000 pages of knotted-up central-planning cat yarn could actually backfire is like telling Dr. Zeus that men evolved from apes – next thing you know you’ll be strapped to a table getting re-programmed.

  • l84wrk

    Amir, there are hardship exemptions.

  • WorriedfortheCountry

    Classic liberal response. No substance and then lob personal insults.

  • hennorama

    ts1971 — thank you for adding your personal perspective.

    The circumstance you described, when “98 year old patients have open heart surgery then not recover well,” is testament to the massive amount of health care costs that are incurred in the last year of life.

    And these costs are often incurred with little extension of life, and seemingly without concern about either the quality of life or a dignified death.

    • Jill122

      Without talking about death panels or triage or even fear of lawsuits, Americans have to get into a discussion with their elders to talk about end of life care.

      The answer to that should be part of the admitting process for everyone entering the hospital.

      And if ever we can get enough democrats in the Senate, we should be talking about tweeking this bill so that treatment for people who cannot get well must be terminated.

  • Jill122

    Amir, I hope you are not living in a republican run state that refused the Medicaid expansion. The ACA rules are if you earn up to 104% of the poverty level you can receive help IF your governor accepted the billions of dollars from the federal government and expanded Medicaid.

    I would keep checking around. See if you can find a navigator (another signal that you are in a state that’s working with the feds) to help you get through this. Even with a big deductible I’m hoping you can find something.

  • jefe68
  • TFRX

    Eh, I save my scorn for the preaching the rich pols (and media elite) give about UI, TANF, Soc Sec, Medicare and Medicaid.

  • Ray in VT

    Fox News judicial analyst: “As everybody knows, the Affordable Care Act requires anybody that employs 50 or more people to provide health care for them that includes contraceptive services. Contraceptive services means contraception, euthanasia, and abortion.”

  • Don_B1

    Your complaints basically fit the conditions that Republican policies have created since 1981, particularly the 1986 tax reform which lowered the maximum marginal tax rate and then the Bush administration tax cuts of 2001 and 2003, which “restored” the lower taxes on capital gains and dividends, moving the way that the rich have income from “earned” (salaried) toward wealth (investments). This gives the wealthy ways to convert earned income from its “high” tax rates to the lower tax rates on capital gains and dividends, while leaving the worker to the tender mercies of the normal tax rates.

    When business owners pay lower taxes, they have a larger incentive to take more money out of their businesses as investment income, rather than reinvesting the company’s growth. That is a big part of the lack of “supply side” growth over the last ten or more years. The other part is the correct perception of business owners that the Great Recession and its balance-sheet consequences (overleveraged debt) was preventing a large segment of the public from buying their goods and services.

    Note that the rich never spend as much of their income as the poorer people.

    • OnPointComments

      We are in the sixth year of the Obama presidency, which includes two years with Democratic majorities in the senate and house. It takes a truly blind, dedicated liberal to say that the problems listed by Jaimye Bartak are caused by policies that are over 30 years old, and to give none of the credit (or blame) to President Obama and the Democrats.

  • Oh bummer

    How many members of Congress who voted for Obamacare, signed up for it? That’s because they know better.

    • Ray in VT

      Or because they already get health insurance from their employer.

      • jefe68

        This guys a real pill. I’m not sure we should feed his trolling activities. He’s been here before.
        My guess he was banned and found a way back on to fill up the forum with this trash.

        Oh well, freedom of speech, one must take the good with the bad…

        • Ray in VT

          Indeed, although I do sometimes feel the need to point out basic factual errors, which is why I sometimes feed them.

  • Rob House

    The thing that is never discussed is the cost of actual health care products and services (as opposed to the cost of insurance). I think people would be surprised to learn that health care services are not actually as expensive as people think. The cost of insurance on the other hand is skyrocketing… people should google David Belk (MD with an Internal medicine practice in the San Francisco Bay Area) on youtube and watch his video on “The True Cost of Health Care”. I would highly recommend that On Point should have him on the show, because this is really the elephant in the room. http://www.youtube.com/watch?v=r9q1Id41wGo

  • Oh bummer

    Obamacare was designed to fail and it is. Look for a Canadian style (universal health care) to be implemented in the US, then some commite of government bureaucrats (death panels) will decide who gets what treatments (who lives and dies).

    • jefe68

      Go away troll.

      • pete18

        If instead, Oh Bummer just posted things like “regressive right winger,” and “meme” over and over again would he no longer be a “troll”? I’m confused, how does this work?

    • ExcellentNews

      Yep. What Americans REALLY want is some obscenely rich religious nut CEO deciding for them how many babies they should have, and some obscenely rich insurance company CEO deciding who lives and who dies (another name for how insurance companies cut costs by denying medical treatment).

  • Oh bummer

    It’s good to see so many Americans, particularly young Americans, refusing to sign up for Obamacare. You can already hear the system collapsing.

  • MisterNiceguy

    Rob House: “…people would be surprised to learn that health care services are not actually as expensive as people think…” What part of the US of A do you live in? I am a healthcare professional and most product and services here are 3+ times more expensive that for the exact same product/service in other developed countries

  • ExcellentNews

    The real name of “Americans for Prosperity” should be “Prosperity for Global Billionaires Build Upon the Misery of the American 99.99%”. As a country, we spend 5% of our GDP to pay the overhead of private insurance companies. Do you think this money goes into paying worker salaries? Some of it yes, it goes to pay call centers abroad. The rest is pocketed by executives and management parasites, and just as fast, exported to offshore accounts and hedge funds. The rapine of America continues….

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