Originally Posted by Bri2k

The scary thing about the ACA (Obamacare) is the way the subsidies are paid out. If I understand it correctly, one has to pay the monthly premium in full and then gets reimbursed via tax credits when their tax return is processed the following year. I don't know how it is for most people, but I'd be unable to afford to add another $350 monthly bill to my budget. Even after one pays the premium, the coverage is very poor for the two least expensive plans and involves a lot of out of pocket expense and a high deductible. I fear the ACA will be unworkable for many if not most working people.

Bri2k

That's a key word *subsidies.* Nothing like more *subsidies* for the corporate insurance industry. Their CEO's are very grateful.

Originally Posted by Deb C

That's a key word *subsidies.* Nothing like more *subsidies* for the corporate insurance industry. Their CEO's are very grateful.

The subsidies go to the insurance industry in lieu of real money from real people. The insurance companies will get the money regardless. And no, I don't care for the way this plan was implemented either, but it's both too late and too soon to change it now. Perhaps, we'll get a consensus for real change, but this half-loaf will have to do for the foreseeable future.

We live in a republic that values the free market ... even when that means that the haves get more at the expense of the have-littles and have-nots. Those same people who chose to victimize themselves, make it impossible for people who know better to escape the same fate. That's what needs fixing. We're already convinced.

Originally Posted by Marx & Lennon

The subsidies go to the insurance industry in lieu of real money from real people. The insurance companies will get the money regardless. And no, I don't care for the way this plan was implemented either, but it's both too late and too soon to change it now. Perhaps, we'll get a consensus for real change, but this half-loaf will have to do for the foreseeable future.

We live in a republic that values the free market ... even when that means that the haves get more at the expense of the have-littles and have-nots. Those same people who chose to victimize themselves, make it impossible for people who know better to escape the same fate. That's what needs fixing. We're already convinced.

Now that's the M&L pragmatism that I like; I was starting to worry about you there a little.

The thing that Debs never mentions when she goes on one of her evil corporate bad-bad whins is that for the 1st time ever the insurers are locked into medical lost ratios (MLRs). That means that for group plans, 85 cents of every dollar (80 for individual plans) has to go to actual medical costs. That leaves 15 cents of every dollar to pay for the insurers' overhead (e.g., employees, the rent, electricity etc.) That is going to put real downward pressure on CEO salaries and on profits.

If you're locked into the private insurer mode, its hard to figure out what could be fundamentally better. There will be room within the ACA context to do more, e.g. squeeze the MLRs more, offer a public optin within state exchanges, gain more Medicaid coverage, etc.

What people want is to move out of that private insurer mode. I can understand people wanting something for what seems like nothing - that would be single payer where the federal govt pays for all medical costs. I actually believe in that more deeply than someone like Debs because I understand that the federal govt can spend for universal health coverage without raising taxes - the only non-political constraint would be if it causes undue inflation.

Neither Debs nor Bernie Sanders understand that - they believe that it needs to come about by taxing the rich and corporation. They also don't get that the inflation constraint will make their universal healthcare play out as Medicaid not Medicare; it will have cost controls that will drive the AMA and the hospitals to rebellion. As such, universal healthcare will never happen the way they believe it should happen.

All that makes it fun for Debs and Bernie and others like them because they get to play in their sanctimonious magic pony land forever and never have to make the tough effort to actually get something done. They never have to be the adults in the room.

Originally Posted by Marx & Lennon

And no, I don't care for the way this plan was implemented either, but it's both too late and too soon to change it now. Perhaps, we'll get a consensus for real change, but this half-loaf will have to do for the foreseeable future.

This is pragmatism? It sounds like defeatism. With the few rare exceptions like Deb, most of what I hear from the boomer left is a self-fulfilling prophecy of defeat.

When is it time to push back? When did compromise become a euphemism for surrender and celebrating defeat?

Meanwhile, the right carries on, checking off all the goals of their 4T to-do list...

It seems that out of frustration, a lot of otherwise intelligent people are falling into some very faulty thinking. Living in some weird magic pony land and/or doing their own "Waiting for Godot" with "just you wait, when the Boomers are dead..." or "the Millies will come to da rescue." Yeah, right.

Here's a thought exercise -

Magic Pony land Scenario #1: Let's replace the 201 Dems in the House and the 54 in the Senate with clones of our very own Debs. At the WH, we'll replace Obama with the original Debs

Now will this stop the use of the filibuster in the Senate? Answer is probable no, because if Senate Majority Leader Debs pulls the nuclear option, Mitch McConnell will bring the Senate to a stop with all kinds of other Senate procedural moves.

Will it make the House GOP majority with its t-bagger caucus go away? Nope.

Will there be any fundamental change it what can be legislatated out of the 113th Congress? Absolutely not. What do you think this is magic pony land?

What else might occur? Easy, the Debs start threatening high taxes on the rich and the corporations setting off huge battles in the Congress with the resulting uncertainty crashing the stock market, another financial meltdown and an economic contraction that exceeds that of 2008/09. The Debs then start a Spanish Inquisition and go after any person who held stock or had a 401k or pension that held stock in evil corporations bad-bad. The backlash in 2016 sends the Dems into the political wilderness for several decades and any progressive policies or program (e.g., SS, Medicare, Civil Rights) since 1928 are excised from the public sphere. We enter a Randian Nightmare that last for 40 years.

Magic Pony land Scenario #2: Instead of replacing the Dems with clones of Debs, we instead replace with clones of our own Justin and put the original at 1200 Pennsylvania Ave.

Pretty straightforward outcome - we enter the 40-year Randian Nightmare immediately: going onto the Gold Standard, resulting in a Great Depression, and it's every person for themselves for the next 40 years.

Magic Pony land Scenario #3: In 2014, we elect 18 more Dems to the House and 6 more to the Senate; at least keep that in 2016 with a Hillary election to the WH.

GOP vanishes as a political force and Dems fight over how Progressive we should be. Public options through the state exchanges are offered with federal dollar support. Insurers cannot compete and move into other areas of profitability (e.g. insuring cell phones) - single payer begins to emerge.

------------------------------

Now I understand the frustration has lead some to wanting Scenario 1, but have you really thought through the possibility of that ever coming to pass let alone the eventual outcome if it did?

Those who want Scenario #2? Well they're fun to laugh at.

That leaves Scenario #3. Yea, it's a tough road, but really, compared to #1 and #2??? Think about it.

Originally Posted by JohnMc82

This is pragmatism? It sounds like defeatism. With the few rare exceptions like Deb, most of what I hear from the boomer left is a self-fulfilling prophecy of defeat.

When is it time to push back? When did compromise become a euphemism for surrender and celebrating defeat?

Meanwhile, the right carries on, checking off all the goals of their 4T to-do list...

No defeat comes from living in magic pony lands and not understanding the true politics of making change happen.

This notion of broadly blaming the govt for the policies and programs we have is just the means to excuse oneself from the real tough work of making change; one instead believes they are making a difference by using their keyboard to tell us "evil Obama/govt bad bad" over and over again.

The govt represents what the people want. The people are very divided: we have insane/uninformed t-baggers voting against their own self interest; we have Libertarians who do exactly the same thing, we have a shitload of Progressives of various strips including those on the Far Left that circle back to those t-baggers in both being insane and uninformed.

It's not the govt, its us. Or, it is the govt which is us. The hard work is getting more of us to be less insane and more informed. The defeatist are those that don't understand that, but sure like to be sanctimonious in telling us how its all evil bad-bad.

"ACA was a fraud from Day One, when the White House Health Care Summit was turned over to the very groups it allegedly was designed to regulate. At that Summit, groups favoring the single-payer system (and even the public option) were excluded or, as in the case of Physicians for Social Responsibility, picketing outside, were allowed two entrants–on condition they remain silent."
Norman Pollack

Originally Posted by JohnMc82

This is pragmatism? It sounds like defeatism. With the few rare exceptions like Deb, most of what I hear from the boomer left is a self-fulfilling prophecy of defeat.

When is it time to push back? When did compromise become a euphemism for surrender and celebrating defeat?

Meanwhile, the right carries on, checking off all the goals of their 4T to-do list...

The first attempt at this was launched by Teddy Roosevelt. That we only got this far after this long tells me that we need to take this stinking half-loaf and hope we have the wherewithal to make it better. Starting over is a return to the status quo ante, which will be where we sit until the Millies get around to needing coverage ... 30 years from now.

I'm eligible for Medicare and get to use my company plan as a suppliment in retirement. Overall, I'm set. How about you?

Originally Posted by Deb C

"ACA was a fraud from Day One, when the White House Health Care Summit was turned over to the very groups it allegedly was designed to regulate. At that Summit, groups favoring the single-payer system (and even the public option) were excluded or, as in the case of Physicians for Social Responsibility, picketing outside, were allowed two entrants–on condition they remain silent."
Norman Pollack

How do you handle this issue? Do you have an employer-based plan, something else, or just hope? The insurance industry isn't going down easily, and none of us will live long enough to wait them out. That's been tried. So what else do you suggest to actually address the issue? Your fellow citizens aren't willing to do the most sensible things, so something else other than that.

Originally Posted by Marx & Lennon

How do you handle this issue? Do you have an employer-based plan, something else, or just hope? The insurance industry isn't going down easily, and none of us will live long enough to wait them out. That's been tried. So what else do you suggest to actually address the issue? Your fellow citizens aren't willing to do the most sensible things, so something else other than that.

First of all, I refuse to accept the rhetoric that the ACA is such a great plan. While I do see it as better than nothing, it is a cash cow for the insurance industry. That should give anyone who claims to be a progressive many red flags. But maybe my paying almost $1,000 a month in premiums, so I can continue with my specialists who have kept me alive, makes for a great incentive to pursue a better way.

Instead of being a cheerleader for this far right wing dysfunctional system, I see that there are other ways to address our healthcare issues. But one things for sure, one has to first own the underbelly of the ACA to be motivated to work for a much better way forward.

Here's an article from The Physicians for a National Health Program, which I highly recommend. This particular article answers some of the questions that you asked me.

Excerpt:

Similarly, some people who make too much money to qualify for any federal assistance but cannot afford increasingly expensive health insurance on their own will continue to pay state and federal taxes to finance Medicare, Medicaid, the VA and other programs for others. They will also pay higher federal taxes to compensate for the fact that private insurance for union members, corporate executives, and others with employment-based coverage, some of it quite comprehensive, is tax exempt.

The ACA does not go nearly far enough in restraining ballooning health care costs or reforming the way we pay those providing health care products and services. These abuses have been brilliantly and persuasively documented in Steven Brill’s Time Magazine cover story “ Bitter Pill.” Health care prices are completely out of control and the uninsured, many of them the least able to pay, are often the only ones charged full sticker price.


The only persuasive reason that has been given for our failure to address these glaring problems is that the power of the health care industry (that spends three times as much on lobbying as the defense industry) is too great. Pretty pathetic, and yet another example of your health care dollars at work — this time against you.


It doesn’t have to be this way. It is now well-documented that Medicare, a far simpler program than the ACA, spends much less on administration and is much more effective in controlling prices than private insurance. Apologists for the existing system of private insurance claim that it preserves “choice” of insurers, and that Americans want that choice.


But the choice people really want is a choice of health care providers, not insurance. Medicare beneficiaries can already choose any participating provider they wish. I have never heard a single Medicare patient complain about not having more choice of insurance companies.


Even Sen. Harry Reid, one of the ACA’s architects, now admits that it must be a way-station to a Medicare-like, single-payer plan. He has said he thinks the country has to “work our way past” insurance-based health care.

Fortunately, in Maine we have a couple of ways to do that. Next year, hearings will be held on L.D. 1345, co-sponsored by Rep. Charlie Priest and Sen. Geoff Gratwick. That bill would start us on a path toward a statewide nonprofit, unified and universal health care system, similar to the route recently taken by our neighbors in Vermont.

Failing approval of that measure, Maine (unlike Vermont) has a referendum process, a direct vote of the people for sanity in health care. If we were to follow either path, Maine would once again have the right to say “Dirigo” — I lead — and set a historic example for other states to follow.

More: http://www.pnhp.org/news/2013/septem...th-care-reform

PS: I also recommend subscribing to PNHP.

Originally Posted by Marx & Lennon

So what else do you suggest to actually address the issue?

What Deb said bears repeating-in-paraphrase:

At least, stop spreading bullshit about how good this will make things. Whatever else you do or don't do, is that little bit too much to ask? If you are honest enough to recognize a thing as, "crappy, but the best I think we can do"... then say that's what it is. Don't pretend that it's something it very obviously isn't and never aimed to be.

Perhaps we would be better off with a lesser goal-helping the poor-so long as it is done well.

Originally Posted by TimWalker

Perhaps we would be better off with a lesser goal-helping the poor-so long as it is done well.

How is that possibly a lesser goal?

Originally Posted by Deb C

First of all, I refuse to accept the rhetoric that the ACA is such a great plan. While I do see it as better than nothing, it is a cash cow for the insurance industry. That should give anyone who claims to be a progressive many red flags. But maybe my paying almost $1,000 a month in premiums, so I can continue with my specialists who have kept me alive, makes for a great incentive to pursue a better way.

Instead of being a cheerleader for this far right wing dysfunctional system, I see that there are other ways to address our healthcare issues. But one things for sure, one has to first own the underbelly of the ACA to be motivated to work for a much better way forward. ...

The ASA looks dysfunctional to me, but how can this be a 'far right wing' system since ASA was passed by the Democrats without GOP support?

Originally Posted by Justin '77

What Deb said bears repeating-in-paraphrase:

At least, stop spreading bullshit about how good this will make things. Whatever else you do or don't do, is that little bit too much to ask? If you are honest enough to recognize a thing as, "crappy, but the best I think we can do"... then say that's what it is. Don't pretend that it's something it very obviously isn't and never aimed to be.

I don't know of anyone who thinks this is an optimum solution. After all, it's a plan designed by a hedge-fund guy. It is better than nothing, which was the default plan in the past. When and how it gets better is the unanswered question.

Originally Posted by Justin '77

How is that possibly a lesser goal?

Here in the southland, the charity fundraising jars are everywhere, because some uninsured someone's child got leukemia or fell out of a tree and broke her neck. We all contribute our change, and it adds up to almost nothing.

It's not the goal that's lesser so much as the result.

Originally Posted by Deb C

"ACA was a fraud from Day One, when the White House Health Care Summit was turned over to the very groups it allegedly was designed to regulate. At that Summit, groups favoring the single-payer system (and even the public option) were excluded or, as in the case of Physicians for Social Responsibility, picketing outside, were allowed two entrants–on condition they remain silent."
Norman Pollack

You sure have a weird definition of "fraud" when you attempt to apply that to a law that was past by the Congress, signed by the President, and upheld by the Supreme Court.

Oh, wait, I forgot, you live in magic pony land. Silly me.

Originally Posted by radind

The ASA looks dysfunctional to me, but how can this be a 'far right wing' system since ASA was passed by the Democrats without GOP support?

Paul Krugman calls it ObamaRomneyCare. Aptly, I think.

Originally Posted by Deb C

.... But maybe my paying almost $1,000 a month in premiums, so I can continue with my specialists who have kept me alive, makes for a great incentive to pursue a better way...

If you're paying a grand a month, then you have some very serious medical condition going on.

However, if you're paying $1000/month, then your actual medical bills are much higher that the ACA OOP limit of $6,350 for an individual and $12,700 for a family. And guess what? It's those evil insurer bad-bad's that are going to foot most of your bill under the ACA.

And if you financially can no longer pay that premium or any premium, it is gong to be the evil govt bad-bad that's going to foot those bills as well.

The ACA is far from perfect, but for you, it's a Godsend.

Originally Posted by Justin '77

What Deb said bears repeating-in-paraphrase:

At least, stop spreading bullshit about how good this will make things. Whatever else you do or don't do, is that little bit too much to ask? If you are honest enough to recognize a thing as, "crappy, but the best I think we can do"... then say that's what it is. Don't pretend that it's something it very obviously isn't and never aimed to be.

No, it's bullshit to ignore the real good it is going to do and just press on that it didn't provide magic ponies that poop perfect health for free!

10s of millions are going to be covered under the Medicaid expansion. Another 6 million people are gong to get health insurance for the first time for under $100 a month.

Moreover, millions more are going to get insurance through exchanges that will make clear what they are getting and allow them to comparison shop to a degree never seen before except in what has been provided to federal workers for decades. Insurers’ profits are going to be heavily regulated by the new MLRs to the point that they might go out of business. All together that is setting up the situation for public options in those exchanges and that can be something eventually supported by new federal legislation once we shit-can all the Randian nightmares out of Congress and Hillary is set to sign the paper.

I'm really enjoying the increasing desperation from the Far Right and Far Left as we approach the point of this being obviously locked in (in reality, it already is locked in). The next big shutter through you all will be the start of 2014 when millions sign up and become dyed-in-the-wool supporters. This time next year, bringing up your posts from now should provide for some pretty good humor – not to say you all won’t be still moaning and whining every step of the way.

Your tears make me smile.

http://talkingpointsmemo.com/edblog/...ah+Marshall%29

Stepping Back from the Heady Storm

We are now witnessing what is presumably one of final, antic, dying twilight struggle efforts to kill Obamacare before its full roll out next month. We also continue to see an unprecedented effort to sabotage implementation of the plan at the state level. Not just most Republican governors refusing to participate in the law's various components - that's their legal right in most cases. But actually getting down to the grassroots level and organizing efforts to prevent people from learning how the program works. But it's worth stepping back for a moment and refocusing on why the stakes seem so high to many Republicans.
Yes, there are many Republican partisans who've imbibed the hocum of death panels, skyrocketing costs and all the rest. But the real fear among Republican strategists is that reform will work and in so doing become an ideological and political defeat of immense proportions for the Conservative movement.

It's edifying again to go back to the brilliant and notorious 'Kristol Memo' of 1993, an encapsulation not only of the massive defiance strategy against Health Care Reform but in many ways the initial manifesto of manufactured gridlock as a political strategy that now rules our national politics. Kristol, of course, is Bill Kristol of the Weekly Standard, Fox News and more. But at the time he was only coming into his role of ur-GOP big think strategist - a role which has dimmed somewhat in recent years but grew through the 90s and well into the Bush administration. Going back to Kristol's basic argument about the political effects of Health Care Reform is key.

Not only would passage of Health Care Reform in 1994 not hurt Clinton's reelection prospects in 1996, he wrote, "the long-term political effects of a successful Clinton health care bill will be even worse--much worse. It will relegitimize middle-class dependence for "security" on government spending and regulation. It will revive the reputation of the party that spends and regulates, the Democrats, as the generous protector of middle-class interests. And it will at the same time strike a punishing blow against Republican claims to defend the middle class by restraining government."

Take this out of con-speak and you have a very candid statement that health care reform would work. Average people would like it. And it would "rekindle" the belief that government activism can be part of the solution in helping sustain and protect the middle class. Kristol was clear that this would not only an ideological defeat but also a political one inasmuch as Democrats are the party of government.

The irony of course is that 'Obamacare' is actually something like what 'responsible' Republicans were putting forward at the time as the market-based alternative to the dreaded ClintonCare. (Yes, for you youngins', before Obamacare there was ClintonCare, nee HillaryCare.) But the key is government reform being allowed to work.

Republicans know that if Obamacare gets in place, they'll never be able to repeal it. Just as everyone across the political spectrum now has to pledge fealty to Medicare and Social Security even though they were in their time equally awfully assaults on America, freedom and everything else. That doesn't mean that Obamacare will be perfect. And our politics is so polarized today that it will take many GOP ideologues a very long time to warm to it. But going back will quickly become politically unviable. That's why they're fighting so hard.

...and then there's the Far Left that will have to learn a whole new approach to replace their incessant Obamacare whine. It will go something like this -

"Yes, yes, Obamacare did this and that for you; I understand it's been great for you. Why, I even supported it![fingers crossed behind back] But let me tell you what it didn't do and how we can now fix that since it has given us a foundation to do more - those health exchanges just need to add a public option and can't we just expand Medicaid just a tad more? Come on, most of the hard work's been done by your precious, whoops, I mean our precious Obamacare - which, as I said, I've always supported (fingers doubled crossed behind back) and that gives me credentials now to say we still need to do more"

Don't believe me? Watch it unfold in the next year or two. Mark my words!

Originally Posted by playwrite

If you're paying a grand a month, then you have some very serious medical condition going on..

Not that it's any of your business, I do have a serious medical condition that may require a transplant. If I can even get the organ that I need.

So now, go back to your vile comments and I'll go back to my ignoring your sorry ass.

Originally Posted by Deb C

Not that it's any of your business, I do have a serious medical condition that may require a transplant. If I can even get the organ that I need.

So now, go back to your vile comments and I'll go back to my ignoring your sorry ass.

Sorry, but it's hard to empathize with someone who wants to deny health insurance to 10s of millions because of their own high premiums.

But I do hope things work out for you in the best possible way.

Originally Posted by radind

The ASA looks dysfunctional to me, but how can this be a 'far right wing' system since ASA was passed by the Democrats without GOP support?

"The idea of an individual mandate was popularized by the Heritage Foundation and other conservative think tanks as early as 1989. Today, Heritage cites differences between their idea and the Obama version. Yet the basic principles are the same." ... The Patriot News

- of Obamacare is its potential for splitting the GOP into two parties - the baggers becoming a regional party and the left over old fashioned conservatives becoming an ideology that gets a guy in here and there.

Totally awesome potential here!

http://www.talkingpointsmemo.com/liv...acare-proposal

Senate Conservatives Fund: McConnell, Cornyn Move On Defund Obamacare Proposal Is 'Ultimate Betrayal'

The Senate Conservatives Fund called opposition by Senate Minority Leader Mitch McConnell (R-KY) and Minority Whip Sen. John Cornyn (R-TX) to a continuing resolution measure that also defunds Obamacare "the ultimate betrayal."

On Tuesday the fund sent out an email targeting Cornyn and McConnell, the two highest ranking Republicans in the Senate.

"We knew Mitch McConnell and John Cornyn weren't with us when they voted to fund Obamacare earlier this year," Senate Conservatives Fund Executive Director Matt Hoskins wrote in the email. "But then, under pressure from grassroots, they said they supported the effort to defund it. They even ran political ads in their home states to make voters think they were on their side.

"But now, faced with the prospect of having to fight for the things they claim to believe, these Senate leaders have surrendered," Hoskins continued.

"Mitch McConnell and John Cornyn have surrendered to Barack Obama, Harry Reid, and the Democrats. More importantly, they have surrendered to Obamacare -- the biggest job killer in America," Hoskins concluded in the email.

The Senate Conservatives Fund has long been critical of McConnell and Cornyn for, in the group's opinion, insufficient support for defunding Obamacare. On Monday McConnell and Cornyn both announced they would not engage in an effort to block the Senate from moving forward with a continuing resolution bill that defunds Obamacare. That decision gives Senate Democrats a wide opening to pass the measure and then remove the defunding provision.

Betrayal, by far, the strongest of human emotions.

Gotta love it!