[blackshoe]

Winstonm, on 2014-February-07, 13:56, said:

These free marketers are more anti-government activists than free market supporters - they are still pretending to be fighting the cold war and they preach the evils of socialism.

They are so driven by their ideology that they display an instant knee-jerk reaction to anything that hints of government involvement, which is why these same types of ideologically-driven people tried to destroy the science and scientists who proved the cancer link to tobacco, the coal link to acid rain, and who are now fighting tooth and nail to disavow climate change as man-made.

I see you have taken the Mark Twain quote in your sig to heart.

[Winstonm]

blackshoe, on 2014-February-08, 19:26, said:

I see you have taken the Mark Twain quote in your sig to heart.

Naturally.

Although my opinion is rarely considered a "statement of fact", especially from those who disagree.

[ArtK78]

The Markets Go Mad for Obamacare

http://www.businessw...ampaign_id=yhoo

[hrothgar]

"What's with the weak Obamacare Horror Stories?"

Good discussion of

1. The fact that all of the current Anti ACA poster children's stories seem to be non credible
2. What does it mean that the Republican Noise Machine can't find a legitimate example

http://dish.andrewsu...horror-stories/

[y66]

From a Gallup poll released today:

Quote

WASHINGTON, D.C. -- In the U.S., the uninsured rate dipped to 15.6% in the first quarter of 2014, a 1.5-percentage-point decline from the fourth quarter of 2013. The uninsured rate is now at the lowest level recorded since late 2008.

The uninsured rate for every major demographic group declined in the first quarter of 2014. The uninsured rate for lower-income Americans dropped 3.2 points to 27.5% -- the largest decline within any key subgroup -- while the uninsured rate for blacks fell 3.3 points to 17.6%. Hispanics remain the subgroup most likely to lack health insurance, with an uninsured rate of 37.0%, though their rate dropped 1.7 points in the first quarter.

[kenberg]

Thanks for the data. If you had asked me what I thought the figures would be, I would not have come close. I think the one that really grabs me is "the uninsured rate is is now at the lowest recorded rate since late 2008". With 7 million plus sign ups I guess I would have expected a stronger result than that. Similarly "The uninsured rate for lower-income Americans dropped 3.2 points to 27.5%". Well, 27.5 is certainly better than 30.7 but 27.5 is still a lot of uninsured.

I did a quick scan of the article and I did not see if people on Medicaid are classified as insured. If these 27.5% who are classified as uninsured are just not carrying private insurance but are covered by Medicaid, that would be good.

It appears that the roll-out problems are largely history (but not in Maryland, where we are scrapping our system and piggy-backing on Connecticut's) but we may have to wait a bit for a good summary of just what has been accomplished and what hasn't.

All politics aside, if we ever can have all politics aside, had you asked me what percentage of Americans are now without insurance I don't know what I would have said but it would have been significantly lower than 17.1. Progress is progress, true enough.

[Winstonm]

One thing that hurt was the 30 states that did not expand medicaid, which was unexpected and not accounted for in the law, and because of that many were too poor to get the tax subsidies that pay for insurance on the healthcare exchange.

[ArtK78]

There was a report on 60 minutes this past Sunday about how the failure of many of the red states to expand Medicaid was causing incredible hardship to those who would be eligible for assistance but who are otherwise uninsured.

[kenberg]

Maryland is definitely not a red state, we just made a terrible muddle of the state run exchange. I seriously doubt that our governor, Martin O'Malley,was going to be our next president but since the crash of the state healthcare system, there is no longer even any such talk. The Lt. Gov., Anthony Brown, was supposedly in charge of this although he now is speaking as if he never heard of it. Website? What website? He was supposed to be the shoo-in as the next gov. I guess he'll have to change his plans.

I'll stand with my comment that a full evaluation of just what has been accomplished and what has not does not yet seem to be available. Without a doubt, as the elections get near, we will be inundated with statistics showing either that the ACA is a massive success or a massive failure, depending on who is speaking. Joe Biden described it as a big effing deal. Probably everyone will agree with that much.

[ArtK78]

kenberg, on 2014-April-08, 08:58, said:

Maryland is definitely not a red state, we just made a terrible muddle of the state run exchange. I seriously doubt that our governor, Martin O'Malley,was going to be our next president but since the crash of the state healthcare system, there is no longer even any such talk. The Lt. Gov., Anthony Brown, was supposedly in charge of this although he now is speaking as if he never heard of it. Website? What website? He was supposed to be the shoo-in as the next gov. I guess he'll have to change his plans.

I'll stand with my comment that a full evaluation of just what has been accomplished and what has not does not yet seem to be available. Without a doubt, as the elections get near, we will be inundated with statistics showing either that the ACA is a massive success or a massive failure, depending on who is speaking. Joe Biden described it as a big effing deal. Probably everyone will agree with that much.

But I bet Maryland is all-in on Medicaid expansion.

[y66]

Maybe Joe has been talking to Zeke.

Quote

Obamacare advisor Ezekiel Emanuel says that Obamacare is ending the health insurance industry as we know it.

Ezra Klein: How does Obamacare change the health insurance industry?

Zeke: The Affordable Care Act is going to change how we buy insurance. Instead of insurers selling it to companies, they're going to sell it to individuals. Individuals are going to be looking for value. They want a low premium, low deductible with a high quality program. That is going to force the insurers to not just take the premium and pay doctors, but to actually get into the business of how care is provided to make sure people are kept healthy - and not use a lot of unnecessary services or services that could have been avoided.

The places that really have transformed their care and focused on keeping people healthy, keeping them out of the hospital – those places can cut about 20% off the cost. That's a lot of money.
Similarly, providers are going to come in, and they're going to say, "Hey, I can offer insurance too, and I can take care of the whole patient, and I can do it cheaper than the insurance company." You're going to have this big competition between providers which are now offering insurance, insurance companies that are now contracting or owning hospitals and doctors, and I think that's going to make the whole system more efficient.

It'll be more of a keep-patients-healthy health-care system rather than what we've had, which is a sick-care system.

[y66]

Krugman posted this today:

Quote

The good news for Obamacare just keeps coming in. Via Charles Gaba, the Rand Survey, which was the subject of a report in the LA Times, but which wasn't publicly available, is now in. And it says that as of mid-March, that is, before the final enrollment surge, the Affordable Care Act had already produced a net gain of 9.3 million insured adults. Again, that's a net gain; so much for claims that more people are losing insurance than gaining it.

At least some Republicans are realizing that (a) the ACA is not going to collapse and (b) they can't simply take away insurance from millions of Americans. So they have to come up with an alternative.

And as Sahil Kapur reports, at least a few of them are coming to a terrible realization: there is no alternative. You can't just support the popular pieces of reform, in particular coverage for preexisting conditions, and scrap the rest. As Jonathan Gruber taught me, and I and others have said many times, reform is a three-legged stool that requires community rating, the individual mandate, and subsidies; take away any leg and it collapses. And Kapur finds a GOP aide who admits to the awful truth: any workable GOP plan would look pretty much the same as Obamacare. I don't know how many GOP leaders, as opposed to aides, understand this. And even those who do won't dare to admit it. The party line, literally, has been that Obamacare is an unworkable monstrosity, and the base will destroy anyone who points out, this late in the game, that it's both workable and pretty much the only doable alternative to single-payer.

And if that's not a case of politics making people stupid, I don't know what is.

[kenberg]

ArtK78, on 2014-April-08, 13:57, said:

But I bet Maryland is all-in on Medicaid expansion.

Oh yes. We may be dumb, but we ain't stupid.

[kenberg]

y66, on 2014-April-08, 14:38, said:

Krugman posted this today:

Oops, I got the Krugman link mixed up with the Gallup link. Oh well. Anyway. it's the Gallup link I am getting the numbers from.
http://www.gallup.co...owest-2008.aspx

I have adjusted my comments some to reflect the fact that the figures were not Krugman's.

Let's just see how the percentages and the absolute numbers match. Of course if you get to choose the numbers you want, they will match fine.
The Gallup graph shows a 16.3 uninsured rate at the beginning or 2013 and a 15.6 rate at the end of Q1, 2014. That's a change of 0.8 I am not sure if this rate refers to adults or to all Americans. Their later charts break the data into age groups starting at 18. But perhaps they mean all Americans, all 330 million or so of us. If I multiply 0.008 by 330 I get 2.64. I see the gallup chart does say it is concerned with those over 18. But maybe we should just extrapolate.

Now it is true that I could use, instead of the 15.6 number associated with the beginning of 2013, the number 18.0 associated with mid 2013. The problem with that is that the number seems to be a historical anomaly. At the very least, it is higher than the number at any other point on the graph. What we see is a steady increase from 15.6 to 18.0 during the first half of 2013, and then a steady drop to 15.6 at the end of Q1 this year.

Krugman is a smart guy, he may understand the reasons for both the rise and the fall. I hope he will address such issues seriously, he has the training to do it.

The story beneath the graph says that the rate is continuing to fall. This could be good news, perhaps very good news. We shall see.

Incidentally the graph shows a rate of 15.4 at the beginning of 2009 so it's hard to see this as great progress. But there was this one sharp drop, coming right after a sharp increase.I don't know what to make of it, but it seems as if a place to start looking for an explanation would be that many people dropped insurance that they had, sending the rate of uninsured up, and then got insurance through ACA, sending the numbers back down. Or maybe it is something else entirely

The point is that it is not reasonable to look only at the numbers that are going down, and ignore the fact that they went down mostly by undoing a recent significant increase.

So back to what I was saying: It will be a while before it is really clear what we have and have not accomplished. I have no enthusiasm for bad news, I just wish to see a sober analysis.


Added: Here is a practical issue for Democrats regarding November elections. Can they run on the success of the ACA? They will need to make the case that it has been successful. If they say "Look at how the percentage of unisured has gone down since the middle of 2013" but have no answer to those who note that the comparison with the beginning of 2013 shows a much less significant change, they will change no minds and change no votes. Those who were already planning to vote their way, some of them, will buy this argument, no one else will. So if indeed it has been a success, they need to start now with solid explanations of why this is so.Calling people stupid if they disagree, as Krugman does, isn't the way to change minds.

[Winstonm]

More good news for the ACA.

[y66]

kenberg, on 2014-April-08, 16:23, said:

Here is a practical issue for Democrats regarding November elections. Can they run on the success of the ACA? They will need to make the case that it has been successful. If they say "Look at how the percentage of unisured has gone down since the middle of 2013" but have no answer to those who note that the comparison with the beginning of 2013 shows a much less significant change, they will change no minds and change no votes. Those who were already planning to vote their way, some of them, will buy this argument, no one else will. So if indeed it has been a success, they need to start now with solid explanations of why this is so.Calling people stupid if they disagree, as Krugman does, isn't the way to change minds.

Quote

PRINCETON, NJ -- With the open enrollment period for obtaining health insurance through a federal government exchange now over, Americans' views on the broader healthcare law remain more negative than positive. Currently, 43% approve and 54% disapprove of the law, commonly known as "Obamacare." The approval figure is a bit higher than Gallup's estimates since last November, but disapproval is essentially unchanged.

Evidence is overrated.

[HighLow21]

y66, on 2014-April-15, 07:58, said:

Evidence is overrated.

You have to hand it to the right wing. They are very talented at disseminating BS and getting a large group of people to believe it. I mean, literally to the point where there is no changing their minds. Evidence be damned.

[y66]

More good news via Krugman:

Quote

Final enrollment for 2014, we now know, will be more than 8 million. The age mix has also improved, with more young people signing up at the end; as Jonathan Cohn points out in the linked article, the age mix in Obamacare's first year is now just about identical to the age mix in Romneycare's first year. Goodbye, death spiral.

How did enrollment manage to surge so impressively despite the initial debacle of healthcare.gov? Obviously they fixed the website; but the broader issue, as Sarah Kliff rightly points out, is that being uninsured is truly terrible. Uninsured Americans really, really wanted coverage, and they weren't ready to give up.

Kliff doesn't make this point too explicitly, but this diagnosis has another crucial implication: the benefits of Obamacare, for all its imperfections, are immense. Millions of people who lived extremely anxious lives now have far more security than before. Compared with those benefits, the complaints of some already insured people that they have less choice of doctors than before, or that they’re no longer allowed to retain minimalist plans, look like whining. (And of course not one of the more serious-sounding stories about soaring premiums and all that has held up under scrutiny.)

And speaking of whining, the GOP response seems to be to make every possible insinuation to the effect that. I actually don't think there's a game plan here; their whole position was premised on the inevitable collapse of health reform, and they have no plan B.

All around, as Cohn says, a very good day for reform.

[Winstonm]

On the negative side, an estimated 5.7 million too poor for the tax advantages offered by the ACA have been given the equivalent of a sentence of death by ideology injection due to the refusal of 24 red states to expand medicaid coverage.

[Winstonm]

Quote

Gallup reported that states that fully embraced Obamacare — setting up exchanges and expanding Medicaid — reduced their percentage of uninsured residents by 2.5 percent, compared to just 0.8 percent for states that resisted on one or both counts.