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Darn you, Michael Moore, for telling the politically uncomfortable truth

Ugh. I’m a couple of days late noticing Michael Moore’s New York Times op-ed piece titled “The Obamacare We Deserve.”

Moore starts out trashing Obamacare. It’s “awful,” he says. It’s flaws derive from the fact that “the Affordable Care Act is a pro-insurance-industry plan implemented by a president who knew in his heart that a single-payer, Medicare-for-all model was the true way to go.”

But President Obama wasn’t willing to take on the insurance industry, Moore implies, so he settled for an approach of filling in around the holes between the private insurance megalopoly and the existing single-payer systems (Medicare and Medicaid). As a result, millions of Americans who had no access to affordable health insurance got some, and many more got better insurance than they previously had. That’s why (as Moore doesn’t mention until he’s halfway through) “Obamacare is a godsend.”

Most liberals have been so focused on defending the law from its unfair critics that they haven’t much allowed themselves to notice, nor to mention, the many flaws in the plan, which have recently gotten so much attention that the godsendiness of it has almost disappeared from view.

This is a service Moore has occasionally performed, saying what many liberals would like to say but don’t because they worry about giving ammunition to a certain kind of righty critic to whom everything is socialism.

Moore points out (as many have before) that Obama formerly supported the idea of single-payer. Moore assumes (and I don’t particularly doubt it) that Obama still understands in his secret heart that single payer would have covered more Americans and cost less.

The kindness that Moore doesn’t do for Obama, at least in this piece, is acknowledge that the president seems to have proceeded on the basis that it was better to push through a flawed plan that could actually pass — and that would extend a sort of jury-rigged Rube Goldberg system of health insurance to most of those currently uninsured — than to propose a simpler, less costly, more efficient, more understandable system that would be defeated by the opposition it would invite from the health insurance industry.

Was he right?

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Comments (36)

  1. Submitted by Greg Kapphahn on 01/03/2014 - 09:08 am.

    Of Course Obama Was Right

    It is, indeed, very tempting to fault Obama for how the Affordable Care Act turned out, but we must remember, first and foremost, that it was the product of the sausage factory we know as congress as it existed at that time.

    There’s plenty of blame to go around. Plenty of people, including our own House of Representatives members were looking out for their own political fortunes, catering to a small number of noisy “jihadist,” (we’ll do whatever it takes to get our way, even if that means destroying our own political party) tea party folks while ignoring the needs of their real constituents, which resulted in the ACA we now have.

    Could it have been better? Of COURSE it could! Would that BETTER we all wish for have been possible AT THAT TIME? No, it clearly was not possible. It was primarily the Blue Dog Democrats who prevented that.

    What we on the left need to do is propose a bit of cleaning up and improvement of the ACA, now that we understand a bit more about how it is and is NOT working.

    Where there are good reasons for people to be unhappy with how the ACA is working we need to make it very publicly clear we understand WHY folks are unhappy and very noisily do what it takes to FIX those problems (where possible). Who knows? We may yet “improve” it, in small steps, right into a single payer system.

    Of course we also need to be equally noisy in pointing out that among many of our “conservative” friends, any and all efforts they claim to be making to “improve” the ACA or government in general are really designed (sometimes unconsciously) to DESTROY government.

    It is far past time that we make sure that the general public understands that, like the “One Ring” of “Lord of the Rings” fame, “Conservatism” as it’s currently practiced by those who claim that title, conserves NOTHING. It has “only the power to destroy.”

  2. Submitted by Ray Schoch on 01/03/2014 - 09:20 am.

    Was he right?

    Somewhere in the dim, dark mists of the recent past decade, I recall Mr. Obama being quoted as saying much the same thing as Eric’s last paragraph. That is, a flawed plan that could actually get through a Congress in the thrall of insurance companies was better than the plan he wanted, but that had no chance of being enacted into law. Call it a “foot-in-the-door” strategy. Time will tell if it works, but that’s what I remember as the rationale.

    Indeed, my own personal preference would be to extend Medicare to everyone, and then tweak Medicare itself to fill holes in coverage (i.e. dental care and treatment remains the unacknowledged elephant in the room). Medicare’s record for administrative efficiency is one few, if any, insurance companies can match because Medicare is about delivering health care to patients, not delivering profits to shareholders. Doing away with health insurance companies altogether once Medicare covers everyone strikes me as an excellent public policy. Most of the employees that matter would still be employed, but their collective boss would ultimately be the public, not an overpaid CEO. Health insurance company CEOs, however, might have to get real jobs.

    In any case, Obama characterized the current ACA as merely a start, and if it succeeds, as I expect it to despite the opening glitches upon which neoconservatives are so focused, other presidents and other congresses farther down the road will make further alterations until we get a system that’s more equitable and efficient – and effective in terms of patient outcomes.

  3. Submitted by RB Holbrook on 01/03/2014 - 09:57 am.

    Reality check

    Would single payer be a better, more effective system than Obamacare will ever be? Of course it would.

    Now, let’s stop to consider the chances of getting single-payer passed on a national level. “An exercise in futility” doesn’t begin to describe it. Instead of squandering political capital on an unreachable goal, the president decided to get what he could. Obamacare is not a great plan, but it is far better than what we had before.

  4. Submitted by Jeff Klein on 01/03/2014 - 09:57 am.

    He is right

    The thing about Americans is we treat capitalism as some kind of law of nature over which we have no control rather than an economic tool that we can use as we see fit. Some problems are simply ill-suited for capitalistic solutions. Capitalism is great at inventing iPods but when put to the task of health care (or fire protection or environmental regulation or…) the incentives are all wrong. It makes no sense.

    And lest we think it’s impossible to control things to such an extent, every other first world country has public health insurance. And a few of them even get more than half their energy from renewable sources. And they still have capitalism; it’s not as though people in Germany live in some kind of communist gulag where they can’t buy iPods. By being willing to make decisions about what capitalism is appropriate for and what it’s not, they get the best of both worlds.

  5. Submitted by Tim Walker on 01/03/2014 - 09:59 am.

    Did Obama miss Negotiating 101 in law school?

    As others have said, what President Obama should have done was push hard for single-payer from the outset, then agree to the jury-rigged structure in the ACA only after the GOP countered with that. It was, after all, their general idea.

    Then, the GOP would have declared victory because in their minds, they averted socialism and kept Obama from implementing a government takeover of health care.

    Of course, that’s only speculation, and while I suppose that such a scenario *might* have reduced GOP criticism for the ACA, that’s not 100% guaranteed, because there is, of course, a large section of the GOP who will virulently oppose anything connected with Obama.

  6. Submitted by Bill Hansen on 01/03/2014 - 10:05 am.

    He is right.

    Single payer health care would unleash the entrepreneurial spirit of the people who now stay in their job to protect their family’s health insurance. It would also be cheaper, freeing up capital for enterprise.

    It’s not surprising that the insurance industry opposes this, but we need to be realistic about what we get for our money from the private insurance system.

  7. Submitted by Tim Milner on 01/03/2014 - 10:15 am.

    The biggest problem with Obamacare

    is the failure to include any cost control measures, operational efficiencies, or tort reformation. It was all about access, which in and of itself is good.

    But access without these other steps will simply mean more people getting inefficiently delivered health at higher than it should be prices. This is going to get very expensive, very quickly.

    I am anxious to see who Congress decides will ultimately pay for this.

  8. Submitted by Jeff Klein on 01/03/2014 - 10:27 am.

    He is right

    The thing about Americans is we treat capitalism as some kind of law of nature over which we have no control rather than an economic tool that we can use as we see fit. Some problems are simply ill-suited for capitalistic solutions. Capitalism is great at inventing iPods but when put to the task of health care (or fire protection or environmental regulation or…) the incentives are all wrong. It makes no sense.

    And lest we think it’s impossible to control things to such an extent, every other first world country has public health insurance. And a few of them even get more than half their energy from renewable sources. And they still have capitalism; it’s not as though people in Germany live in some kind of communist gulag where they can’t buy iPods. By being willing to make decisions about what capitalism is appropriate for and what it’s not, they get the best of both worlds.

  9. Submitted by Dennis Tester on 01/03/2014 - 10:37 am.

    No republicans voted for Obamacare.

    Not a single one. Yet it still passed, since the democrats controlled congress and the White House. It seems to me that single-payer could have passed just as easily, also along party line.

    I’m curious as to why they didn’t even try. Were there too many moderate democrats who were philosophically opposed to single-payer to bother with a vote?

    Were there too many clear-thinking democrats who knew it isn’t a model for a free society and read the polls that show upwards of 70% of the people oppose the mandates behind it?

    Some now even say that the utter failure of Obamacare has destroyed liberalism … has destroyed any hope of the Left ever getting single payer because too many people have now been convinced that, in addition to ideological reasons, that government’s army of incompetent bureaucrats couldn’t manage such an undertaking.

    Over 5 million people have had to deal with the hassle of being dropped from their individual health insurance plan. But the second shoe has yet to drop. By this Fall when companies have to start dealing with the employer mandate section of the law, tens of millions of people will be adversely affected by their employer-based plan shooting up in price or being dropped altogether. When that happens, I don’t think the people will see single payer as the solution to the problem then either.

    In fact, look for the people to be chasing down politicians of a certain stripe with buckets of tar and feathers.

    • Submitted by Hiram Foster on 01/04/2014 - 09:14 am.

      Republicans

      While no Republicans in Congress supported Obamacare, it’s important to understand that Obamacare was passed with considerable support from Republican constituencies.

  10. Submitted by Neal Rovick on 01/03/2014 - 11:00 am.

    Was he right?Yes.Can you

    Was he right?

    Yes.

    Can you (or any reasonable, aware person) doubt the correctness of that answer after all of the villainous attacks on the “Kenyan Muslim communist” and the underswell of impeachment that has been there ever since he has come into office?

    People are covered now who would not have been covered. And the millions who will end up using their coverage instead of unloading the costs onto society of untreated treatable illnesses are better off (as is society also).

    But it is not universal coverage and it is not as cost-efficient as it needs to be in order to be sustainable.

    Unhappy with Obama? How about President McCain or President Romney?

    Feel better now?

  11. Submitted by Jeff Ross on 01/03/2014 - 11:52 am.

    Was he right?

    I regret to say Michael Moore is right. I expect to see many more uninsured than expected. If I was still working, the options presented to my family on MNsure could be appealing. They are cheaper than many options I had when employed.

    Here’s the rub… Something isn’t working for disabled and low-income applicants. Since becoming disabled with a catastrophic illness over 10 years ago and having been the primary income earner until then, my family had MinnesotaCare to help replace the insurance we had previously. We paid premiums for this, it wasn’t free to us.

    When it became obvious that I was never going to get better, I was put on Social Security disability and Medicare. It was better in some respects, worse in others. Although it may sound good, Part B and D premiums,and uncovered medical costs add up. Most of my SSDI goes to these costs. I have to put off office visits because I can’t afford to drive there or the copay… The way income is calculated, the expense allowances are based upon minimized, out of date “Cost of Living Standards” data. Furthermore, it only allows for “average” medical expenses. I assure you, I haven’t experienced anything remotely near average in years… $47,000 for Chemo drugs alone, Really?

    Anyway, even though my family has less than ever, we apparently no longer qualify for MinnesotaCare… So my wife and kids won’t have insurance, cheaper to pay the fine than $500/mo premiums they say we can afford…

    Before you start calling me names…
    I paid thousands for private disability insurance, which never paid me a cent. I had credit life/disability that was supposed to pay my mortgage and debts, they all found it cheaper to stall me in court until my money ran out, than to pay…

    What is needed, IS someone to take on the insurance companies. They need serious regulation and oversight. If you think a piece of paper will protect you from catastrophe, guess again… Visit New Orleans or New Jersey if you don’t believe it.

  12. Submitted by Karen Sandness on 01/03/2014 - 05:11 pm.

    Obama lost me on several counts:

    1. Holding closed door sessions with the insurance industry but refusing to meet with single-payer advocates. There wasn’t a Democrat who didn’t howl in protest when Cheney met with the energy companies in closed door sessions, so why were Obama’s meetings all right?

    2. Not keeping the public informed about the nature of the proposal. Both proponents and opponents were under the impression that the Obama administration was working on a single-payer plan. This gave false hope to the left and gave the right-wing propaganda machine the opportunity to feed their audiences every health care horror story from the British tabloid press, even though Obama’s plan was nothing like the British plan (which is nothing like the Canadian plan, except for not requiring payment at point of service).

    3. Not using the PR resources available to him. Obama was elected with thousands upon thousands of the most enthusiastic volunteers I’ve ever seen. If he had said, “I want you to take some of the same energy you used to get me elected and talk up single payer in your communities,” they would have done it.

    Furthermore, thinking back to how Ronald Reagan did things, I recall him going on TV, explaining what he wanted, and telling the audience to pester their Washington representatives. I didn’t like Reagan’s policies, but I have to admire his ability to get what he wanted.

    4. Compromising with himself. Someone else has already mentioned that Obama *started* by offering the Republicans the Heritage Foundation/Romney Care plan with a public option tacked on. If he had started by proposing single payer, then Romney Care with a public option (perhaps a Medicare buy-in) would have been the compromise position. Or perhaps we would have ended up with a system like the one in Germany, with private insurance but with the insurance companies on a choke chain, required to pay promptly unless they can prove fraud and forbidden to pay more than a certain amount to their executives, among other things. What we ended up with was Romney Care, whether Republicans like to admit it or not. (Don’t tell me Romney would have proposed anything different if he had been elected.)

    5. Not wanting to offend the Republicans. Once it was clear that no Republicans were going to vote for his plan, Obama should have said, “Forget about it; I’m going for single payer.” Unfortunately, instead of forcing the small number of Blue Dogs to vote for the Progressive Caucus’s plan, he forced the much larger Progressive Caucus to vote for Romney Care by pleading that they needed to make him look good.

    What a disappointment. What a lost opportunity.

    There are those who say that I’m not realistic, that what I’m talking about would not have been possible. Funny thing, though, the Republicans never seem bound by what conventional wisdom says is possible. Only the Democrats suppress themselves.

  13. Submitted by Steve Rose on 01/03/2014 - 05:45 pm.

    Pining for single payer is a diversion

    As the ACA unfolds to be the disaster that it was clearly destined to be, let’s divert attention from it by claiming that we didn’t want it anyway. Good times.

    Let’s consider how a single payer system would be used, as part of the ACA (Medicaid) is a single payer system. Newly minted Medicaid recipients will likely go to ERs regularly instead of their local doctors, according to a research study published yesterday by Science Magazine. As we know, ER is an expensive mode of healthcare distribution, and our President promised that ER visits would be reduced by the ACA.

    Study Abstract:

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

    http://www.sciencemag.org/content/early/2014/01/02/science.1246183

    • Submitted by Paul Brandon on 01/04/2014 - 10:57 am.

      The question is

      whether this trend will persist, or whether it’s an artifact of people who had no health care initially going to the source most readily available. ER’s will hopefully provide some guidance to these people so that they can find regular health care providers.
      And note the real numbers:
      baseline rate: .68 visits per year before Medicaid.
      new rate: .96 visits per year after Medicaid.

      The full original article (which would probably include the authors’ Discussion of the meaning of the numbers) is of course behind a paywall.

    • Submitted by Pat Berg on 01/04/2014 - 12:46 pm.

      An education issue

      It’s hard to know from the limited information available in the abstract of a single study, but what occurred to me when I heard this reported was that it could very well be an education issue. That is, you take a population that has probably had little or no experience with being insured – they probably then have also had little to no experience with finding and establishing a primary care relationship with a doctor or health care facility.

      What they – or at least their friends and acquaintances – possibly DO have experience with is obtaining health care via the ER. This would be their “go to” mode when getting sick, so it wouldn’t surprise me if some of them who would have previously “toughed it out” now feel free to go to the ER because now they have help paying for it.

      So I wonder if that expansion in Medicaid included any education for the new enrollees on how to find a primary care physician or health facility and why this is an essential component of life with health care coverage? Or did they just assume the new enrollees would somehow automatically know this was part of the process?

      • Submitted by Steve Rose on 01/04/2014 - 06:23 pm.

        The Law of Unintended Consequences

        I think that the law of unintended, but easily foreseeable, consequences is at play.

        As a result of the ACA, many new Medicaid recipients were just added to the rolls. I could find no information that indicated that they were offered nor required any education. Likely, the same was true of the population in the Portland study.

        • Submitted by Pat Berg on 01/04/2014 - 07:31 pm.

          Outcomes

          I’m not sure how “easily foreseeable” this was.

          If the study subjects had been given some education in the concept of the importance of establishing a primary care provider, that may have improved the outcomes. The information available from the abstract of this single study isn’t adequate to know whether this was done, or to what extent, so I’m not ready to rule out lack of education as a possible explanation for this study outcome.

          This could have value moving forward to emphasize the importance of providing such education to new Medicaid enrollees.

          • Submitted by Steve Rose on 01/05/2014 - 03:27 pm.

            Try on those shoes

            Consider that you are a person that has never experienced for yourself the benefits of a relationship with a primary care provider. Will you accept that concept as fact because it was sincerely delivered by a government employee?

            When your options are seeing a doctor today or making an appointment to see a doctor next month, which will you choose? As the results of the study of the Portland study indicate, many will opt to see the doc today.

            Putting yourself in the shoes of many Medicaid recipients allows the study outcome to be easily foreseeable.

            • Submitted by Pat Berg on 01/05/2014 - 07:00 pm.

              Glass half empty v.s. glass half full

              Or, you could say that the results of the study can help to inform a more proactive response to the phenomenon. Rather than a fatalistic “If you give them Medicaid they’ll just use the ER more”, instead use the results of the study as something to learn from and take steps to repair.

              If the issue is “today v.s. next month”, then that could highlight the need for a more systemic solution to appointment wait times and a need to learn more about the factors that go into that.

              Just because a study had a negative outcome doesn’t mean the response should be automatic gloom and doom. Sometimes we learn things from those studies that help us make things better for everyone as time goes on. That’s the great thing about science!

              • Submitted by Steve Rose on 01/06/2014 - 06:31 am.

                More than a “negative outcome”, it is the outcome that makes sense when you consider the incentives.

                Any education would have to be sufficiently powerful to override the incentives of being able to see a doctor on the day that you decide that you want to see a doctor. The reduction of ER visits under the ACA will be yet another unfilled promise from our President. The average ER visit carries a price tag of $1265. Consider how much money governments spend on education regarding tobacco use. Coupled with increased taxes and limitations on where a person can smoke, smoking should be responding with a sharp decline. According to the CDC, 44 million Americans, just counting adults, smoke.

                Perhaps a mechanism in the plan, rather than a costly education program, would be prudent. My plan has one; it costs me a lot more money for an ER visit than for a office visit. Calling obamacare the Affordable Care Act is laughable. We were told that once everyone was on a plan, ER visits would be reduced. What would cause them to be reduced? It seems that this is the question that was never asked.

                By the way, the answer is nothing.

                • Submitted by Pat Berg on 01/06/2014 - 08:10 am.

                  I expect you’ve heard the saying . . . . .

                  “Hindsight is 20/20”

                  In any event, I’m far more interested in starting to explore solutions – whatever they may be – that will help everyone have access to needed healthcare rather than playing “I told you so!” games that yearn for a time when people were suffering and dying because of bad choices or bad luck.

                  Higher charges for ER visits that could could have been handled on a primary care basis might be one such solution. I’m sure there are more.

                  And I still don’t rule out education as being beneficial.

                  But like any complex problem, it will have complex solutions. That’s no reason for wanting to turn back progress.

                  • Submitted by Steve Rose on 01/06/2014 - 02:28 pm.

                    Hindsight, Seriously?

                    On Day 4 of the ACA, predicting that ER visits will rise is considered hindsight? Has Week 1 data been compiled?

                    A mechanism to prevent some ER visits, like turning people away for non-emergency medical issues, seems like a more effective and less expensive solution than education. But, that is not going to happen.

                    • Submitted by Pat Berg on 01/06/2014 - 03:14 pm.

                      Hindsight. Seriously.

                      You’re the one who brought up that “Newly minted Medicaid recipients will likely go to ERs regularly instead of their local doctors, according to a research study published yesterday by Science Magazine” and later followed up with “As the results of the study of the Portland study indicate, many will opt to see the doc today”

                      So ask yourself, “On Day 4 of the ACA, predicting that ER visits will rise is considered hindsight?”. After all, I’m not the one who brought up the study as a predictor in the first place.

                      However, I prefer to take a less fatalistic viewpoint with an understanding that studies such as this are information gathering devices and – if used well and not short-circuited by ongoing political machinations – can be valuable vehicles for learning to “do it better”. But this discussion is now going in circles, and neither one of us knows whether the future of this study and others like will be as a vehicle to promote progress or as a cudgel to prevent it. I can only hope for the former rather than the latter.

                    • Submitted by Steve Rose on 01/06/2014 - 05:54 pm.

                      “will likely go to ERs regularly”

                      That is a prediction, a forward looking opinion of what will come to pass. I sited one research study to bolster my position, as I thought that without it you and other MinnPost commenters would discount my prediction.

                      I think my prediction is not fatalistic, but realistic. Let me know when the education starts and how much that will cost us.

    • Submitted by John Peschken on 01/08/2014 - 10:04 am.

      Emergency Room Triage

      It seems to me that hospitals should be a little creative and have a role in the solution. People who do not have an ongoing relationship with a primary care doctor will go to the emergency room with routine problems.

      The emergency room could do some triage and reroute these people to a less expensive urgent care type facility staffed with a rotating staff of primary physicians. The doctors gain more patients, the patients start a relationship with a primary care doctor, and the system saves money.

      Maybe the hospitals wouldn’t want to do this because they take in lots more money if the patient is seen in the emergency room.

      • Submitted by Steve Rose on 01/08/2014 - 11:30 am.

        You Make an Important Point

        People that moved from the rolls of the uninsured to the rolls of Medicaid will now be viewed by hospitals as an asset instead of a liability. Treating the uninsured, hospitals absorbed the cost, taking the hit on their bottom line. With Medicaid, these hospitals we now be paid for their services by the taxpayers.

        Once you consider the incentives, the picture becomes quite clear in the world of unintended, but easily foreseeable, consequences.

        • Submitted by Neal Rovick on 01/08/2014 - 02:13 pm.

          Easter bunny and Santa Claus, hand in hand

          ….hospitals absorbed the cost, taking the hit on their bottom line….

          Really, now?

          You never heard of government reimbursement for uncompensated care, and cost-shifting by adding the costs of indigent care to the other patients and payers that pay?

          ….With Medicaid, these hospitals [will] now be paid for their services by the taxpayers….

          You don’t think they already were?

          And you have never heard of the medical industry’s complaints of “too low” unprofitable Medicare/Medicaid reimbursement?

          And, to complete the trifecta, I bet you think that people work for free at “non-profit

          • Submitted by Steve Rose on 01/08/2014 - 03:57 pm.

            “some hospitals report losing up to $10 million a year”

            “These hospitals face a dilemma because they feel it is their ethical obligation to provide care to those who show up at their door, according to The New York Times, but some hospitals report losing up to $10 million a year caring for these types of patients.”

            Read it for yourself, at this link and in other places.

            http://www.healthleadersmedia.com/content/HOM-221616/CMW-News-Hospitals-absorb-costs-of-treating-uninsured-immigrants.html

            Do the math, “too low” is more money than not paid.

            By the way, snark plays better if there is some component of truth in what you are saying.

            • Submitted by Rachel Kahler on 01/08/2014 - 05:34 pm.

              And the solution…

              Interestingly, the solution that is suggested in that Health Leaders Media is the same as mentioned above–public education. Regardless, it’s hard to actually understand what “absorb” means in this context since the cost of medical care changes depends on whether you’re insured, and if you are, which insurer you use. The differences can be staggering, and you can be that those absorbed costs don’t actually result in losses.

  14. Submitted by John Bracken on 01/03/2014 - 06:45 pm.

    Our System Stinks,But…

    Healthcare in America is broken. Republicans have no plan and Democrats have no plan that controls costs or increases personal responsibility. Obamacare redistributes from the middle class and rich but asks NOTHING of those that receive cheap, if not free, healthcare. Obamacare jettisons America over a debt cliff a few years ahead of schedule.

  15. Submitted by Jon Kingstad on 01/03/2014 - 07:59 pm.

    What about the “public option”?

    Maybe “single payer” would never have passed but the President never even tried to get a public option into the Act, which I think if you recall, was passed by a majority of Democratic votes without the vote of a single Republican. What was the argument against a “public option”? There wasn’t any argument against the public option that was any stronger as the Affordable Care Act that was passed. The difference. The number of Democratic politicians who are lackeys for the insurance industry. So-called “Blue Dogs” like Max Baucus and Colin Peterson come to mind.

    Having said that, I disagree with those who criticize the ACA for lack of cost control measures, operational efficiencies and tort reform. Sen. Al Franken’s amendment to limit insurance companies to 20% of revenues for admnistration is one of the best things about the Act. That’s true cost control. You will never obtain any operational efficiencies in a system with multiple insurance companies each with their 20% overhead charge to cover “administration”. Only recognizing “health insurance” as a form of “social insurance” with is inherently unlike a ripoff form of insurance like a credit default swap will you begin to attain “operational efficiencies.” Tort reform is irrelevant to the discussion. Tort recoveries and settlements against doctors impact the cost of care only about 0.4% of the total cost. This is a red herring and baloney argument floated by the right to irritate plaintiff’s lawyers.

  16. Submitted by Ilya Gutman on 01/03/2014 - 08:29 pm.

    be careful what you wish for

    Michael Moore is a big fan of the Cuban health system and wants to see something similar in America. Of course he never actually lived in Cuba and has no clue how it actually worked. Since I lived in the Soviet Union, I can attest that its system, which I assume the Cuban one had been modeled after, was not good. Shortage of everything was the rule, bribes were necessary to get a decent treatment, and long lines were the norm. And that was in Leningrad, the western face of the socialism; I can just imagine what was going on in smaller towns and villages. So we should all be careful what we wish for…

    • Submitted by Dennis Tester on 01/04/2014 - 09:16 am.

      Ilya

      I risked my life for 8 years riding around in a steel tube to ensure that the policies of the Soviet Union would not become the policies of the United States of America. Imagine how I feel when I have to read these comments from naïve people who’s only objective is to get their health care paid for by someone else, free society be damned.

      • Submitted by Karen Sandness on 01/04/2014 - 11:11 am.

        Because Canada, Australia, Japan, and the nations of Western

        Europe (not to mention Taiwan, South Korea, and Costa Rica) are totalitarian dictatorships?

        Some people seem unaware that there are data points between laissez-faire private sector profiteering and the Soviet (and post-Soviet) medical systems.

  17. Submitted by Matt Snyders on 01/04/2014 - 02:36 pm.

    Obama scrapped the public option in July 2009…

    …voluntarily and behind closed doors. http://www.salon.com/2010/10/05/public_option_24/

    This revelation–that for all his rhetoric, Obama was allowing the medical and insurance cartels to write the ACA–created quite a stir among people actually paying attention. Little more than three years later, we find the president’s comically inept apologists trying to convince themselves and others that IT NEVER HAPPENED. http://www.salon.com/2010/10/05/public_option_24/

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