Almost everyone who has health insurance in the United States gets help from the government to afford it. For the elderly, that’s Medicare. For the disabled and the poor, that’s Medicaid. For full-time workers it’s the tax subsidy for employer-provided health insurance.
Obamacare faced ferocious opposition from the right, but the underlying idea — get more people signed up for coverage — was one that public health advocates and liberals could rally behind. Now, as the priority shifts to quality and cost, the policy problems become much more difficult to tackle and the solutions less clear.
Policies that reduce cost systemwide often leave consumers paying more out-of-pocket for health care. That can split coalitions that came together around the more unifying goal of covering the uninsured.
Building coalitions in the multi-billion health-care industry, where each stakeholder has different priorities, is excruciating work. A litany of failed attempts at health reform (including Hillary Clinton’s own 1994 efforts) provide a gloomy backdrop. So some are skeptical that, after the Obamacare battle left many badly bruised, health care will become a prominent agenda item on the next Democratic president’s docket.
Just like Obamacare, the battle to lower costs will require new coalition building, and risks turning one-time friends into enemies. The doctors and hospitals who benefit from expanded coverage — and a wave of new consumers — are the exact same constituencies that stand to lose the most if America spends less on medicine.
But in this new round of reform, insurers arguably stand to be one of the biggest winners. They benefit if costs go down because they can sell less expensive coverage — and that makes them the more natural partner of Democrats in this new era of reform.
“There is sometimes a Washington perspective that ‘the Democrats did health care,’” Emanuel says. “You don’t ‘do’ health care once. You do health care forever. It’s not a marathon. It’s life.”
And there you have it. It’s a great racket that allows doctors to extort loads of money from those in the most pain and with the least ability to fight back. None of them want the gravy train to end, and that’s your “financial interests” right there. It’s shameless and venal and there’s no excuse for it. And that’s America’s health care system.
The right is failing to turn the American people against “Obama care.” Mark Strauss reports on their failed ad campaign featuring the man in the odd “Uncle Sam” costume.
Opponents of the Affordable Care Act have spent an estimated $450 million on political ads attacking the law, outspending supporters of Obamacare 15-to-1. But a state-by-state comparison of negative ads and enrollment figures suggests the attacks ads actually increased public awareness of the healthcare program.
I hope he’s right about this. I felt like posting his entire argument here, but that would be against the rules. Anyway, I’d like to know what you think of his idea. I’m no legal scholar, but I think it might work.
This thought suddenly occurred to me Monday night as I was prepping for a Google Hangout to discuss the Hobby Lobby ruling: The majority opinion gave a roadmap for how the Obama administration can essentially moot the ruling unilaterally. In fact, they can do it today if they want. Let me explain.
Obamacare opponents have already run more than 30,000 television ads attacking the health law and Democratic candidates who support it, according to the media tracking group CMAG — a staggering 12-fold increase from four years ago. Many of the ads are being run in states with high uninsurance rates where hundreds of thousands of poor people could benefit from the Affordable Care Act, including Arkansas, Kentucky, and Louisiana.
Nearly half of all ads that have been run about the health law in House and Senate races through March 9 are critical of the ACA. And in a reflection of the post-Citizens United political landscape, spending by outside groups without any official connection to a particular organization or party accounts for almost three-fourths of all the commercials, compared to just 13 percent in 2010.
“We knew there would be heightened public awareness around the implementation of the law, and we thought it was important to go up early with a heavy effort,” said Tim Phillips, president of the Koch brother-funded group Americans for Prosperity (AFP), in an interview with Bloomberg.
AFP has run the most anti-Obamacare ads of any political group by a large margin, targeting vulnerable Democrats who are up for re-election, such as Sen. Mark Pryor (D-AR) and Sen. Mary Landrieu (D-LA). The organization’s spots play up misleading “horror stories” related to the health law, such as Americans who have had their insurance policies cancelled or seen their premiums spike. But the ads’ content tends to range from exaggeration to outright misinformation — and AFP has even been caught hiring paid actors to play the roles of “real” local residents.
An emotional anti-ACA ad from a cancer patient is the newest example of how low Americans for Prosperity will sink when it comes to attacking the Affordable Care Act.
At worst, under the ACA, this woman will pay $2. more per year in out of pocket cost. Her monthly premiums have been cut in half, she gets to keep her doctors…so what is the real issue here?
At best, if she goes into remission (which I sincerely hope she does) , she will save a lot of money in the out years and she can no longer be cancelled at the Insurer’s whim.
I am afraid we will see more and more of these outright deceptive ads in 2014. Democrats must be vigilant in exposing this. They must be called out every time until it is no longer politically advantageous for them to continue with their lies.
First of all, many viewers might think Boonstra lost her doctor, as she mentions her “wonderful doctor” and then says her plan was canceled. But AFP confirms that she was able to find a plan, via Blue Cross Blue Shield, that had her doctor in its network.
Local news reports recount that Boonstra, like many Americans, initially had trouble getting a plan because of the botched launch of healthcare.gov. No doubt that was a difficult experience. She then was invited by her local member of Congress to attend the State of the Union address and participated in a Republican National Committee news conference that highlighted problems with Obamacare’s stumbling launch.
At that news conference, Boonstra said, “I’m paying a higher cost now as far as out of pocket costs and the coverage is just not the same.” But in the new ad she says “the out-of-pocket costs are so high, it’s unaffordable.”
The claim that the costs are now “unaffordable” appeared odd because, under Obamacare, there is an out-of-pocket maximum of $6,350 for an individual plan, after which the insurance plan pays 100 percent of covered benefits. The Blue Cross Blue Shield plans in Michigan that appear to match Boonstra’s plan, as described in local news reports, all have that limit.
Meanwhile, Boonstra told the Detroit News that her monthly premiums were cut in half, from $1,100 a month to $571. That’s a savings of $529 a month. Over the course of a year, the premium savings amounts to $6,348—just two dollars shy of the out-of-pocket maximum.
We were unable to reach Boonstra, but on the fact of it, the premium savings appear to match whatever out-of-pocket costs she now faces.
A study released in March by the University of Wisconsin’s Population Health Institute has found that recent female mortality rates are worsening in 42.8 percent of counties nationwide, while male mortality rates have increased in only 3.4 percent of counties. The researchers responsible for the findings are Population Health professor David Kindig, MD, PhD and Eric Cheng, PhD candidate at the UW. The Statistics were studied from county information collected between the years of 1992-96 and 2002-2006. Researchers have identified several factors, including lower education levels, living in the South or Western parts of the United States and high smoking rates as contributing to the women in those counties living shorter lives.
There’s a little discussion of the possible reasons :
“Socioeconomic and behavioral factors are underappreciated for their effects on health, but with data like this, we see that those factors are important again and again,” says Kindig, who was recently named to lead an Institute of Medicine roundtable to learn why Americans have worse health and shorter lives than people in other rich, industrialized nations despite spending more on medical care than any other nation.
“Our results underscore the complicated policy reality that there is no single silver bullet for population health improvement,” the authors concluded. “Investments in all determinants of health - including health care, public health, health behaviors and residents’ social and physical environments - will be required.”
There’s a little more discussion here:
Erika Cheng: I might have expected men to have improved more than women because women tend to do better in health studies, so maybe there’d be less room for them to improve. But we certainly didn’t expect the opposite to be true, for women to be doing worse. You expect health to improve over time. You just do. So it was shocking for both of us to find that it wasn’t true for females.
The full report is here, but you have to pay for it.
What I don’t see is any consideration of access to reproductive health services as a factor. I think it is implicated by the fact that women in rural areas are doing the worst.
The war on women is not without casualties.
Van Jones spells out how no matter how hard Democrats try to compromise, the Republicans want none of it.