Archive for health care reform

Is America politically mature enough for single payer healthcare?

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Back in 2011, I wrote Single payer to replace Obama health care plan in Vermont? Possibly. In a post of 2012, Rep. Jim McDermott's legislation may enable states to offer single payer healthcare, the L.A. Times ticked off reason after reason why such a plan would be superior to what we have now. Then our own Sherry Howarth asked this back in April: Are the Green Mountain Progressives Going to Pull Off Single Payer?

And now, one of my faves, Michael Hiltzik, has written another thoughtful column for the Los Angeles Times. This one asks if America has the "political maturity" to support single payer healthcare, especially after the dreadful Hobby Lobby decision by the Supreme Corp. Justices.

Hiltzik narrows it all down to the perpetual fight over abortion being the real obstacle to a single payer system. Once we stop our bitter squabbling and resolve that issue (not an easy task), it would open the door to enacting the same successful system so many countries around the world currently use. As Hiltzik notes, "That's not a permanent condition -- sooner or later, the gridlock will have to give, because the public won't stand for total inaction forever."

The entire column is worth a read, so please link over. He begins by responding to something Ezra Klein wrote. He ends this way:

[O]nly a mature system will be able to enact single-payer, so it's pointless to worry about it being hampered by childishness once it's in place.

Let's think again about abortion. There's no point in worrying that a single-payer program would bar abortion -- the thing to worry about is that the abortion debate will be an obstacle to enacting a single-payer plan at all. So clearly, the abortion issue will have to be resolved first.

Ezra Klein is right. Single-payer does have many virtues, and it does have some problems.

But under our current system post-Hobby Lobby, scientifically uninformed employers can interfere in the medical decisions of thousands of their workers. Obviously, that's the worst of all possible worlds.

Single-payer's problems, however, are either resolvable or conjectural, while its virtues are manifest. We should keep our eye on those, and worry about the problems when the time comes.

As we say on Google Plus: +1.

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ENTIRE VIDEO- Obama on health care: "We did not wage this long and contentious battle just around a website"

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obama speaks obamacare glitches

And this happened:

Visit NBCNews.com for breaking news, world news, and news about the economy

Transcript courtesy of WaPo. Here are some excerpts:

So there are a wide range of consumer protections and benefits that you already have if you've got health insurance. You may not have noticed them, but you've got them and they're not going anywhere and they're not dependent on a website. Here's another thing that the Affordable Care Act does. In states where governors and legislatures have wisely allowed it, the Affordable Care Act provides the opportunity for many Americans to get covered under Medicaid for the first time.

So in Oregon, for example, that's helped cut the number of uninsured people by 10 percent just in the last three weeks.

Think about that. That's 56,000 more Americans -- (applause) -- who now have health care. That doesn't depend on a website...

And the idea is simple. By enrolling in what we're calling these marketplaces, you become part of a big group plan, as if you were working for a big employer. A state-wide group plan that spreads risk between sick people and healthy people, between young and old, and then bargains on your behalf for the best deal on health care. What we've done is essentially created competition where there wasn't competition before. We created these big group plans, and now, insurers are really interested in getting your business. And so insurers have created new health care plans with more choices to be made available through these marketplaces. And as a result of this choice and this competition, prices have come down. When you add the new tax credits that many people are eligible for through the law, then the prices come down even further....

So the fact is, the product of the Affordable Care Act for people without health insurance is quality health insurance that's affordable. And that product is working. It's really good. And it turns out there's a massive demand for it. So far, the national website, healthcare.gov, has been visited nearly 20 million times. (Applause.) Twenty million times. And there's great demand at the state level, as well because there are a bunch of states that are running their own marketplaces...

The product is good. The health insurance that's being provided is good. It's high quality, and it's affordable. People can save money -- significant money -- by getting insurance that's being provided through these marketplaces. And we know that the demand is there. People are rushing to see what's available.

And those who've already had a chance to enroll are thrilled with the result. Every day people who were stuck with sky-high premiums because of preexisting conditions are getting affordable insurance for the first time, or finding, like Janice did, that they're saving a lot of money. Every day women are finally buying coverage that doesn't charge them higher premiums than men for the same care. Every -- (applause) -- every day people are discovering that new health insurance plans have to cover maternity care, mental health care, free preventive care....

The point is the essence of the law, the health insurance that's available to people, is working just fine. In some cases, actually, it's exceeding expectations. The prices are lower than we expected. The choice is greater than we expected.

But the problem has been that the website that's supposed to make it easy to apply for and purchase the insurance is not working the way it should for everybody. There's no sugarcoating it. The website has been too slow. People have getting stuck during the application process. And I think it's fair to say that nobody's more frustrated by that than I am. Precisely because the product is good, I want the cash registers to work, I want the checkout lines to be smooth, so I want people to be able to get this great product. And there's no excuse for the problems. And it's -- these problems are getting fixed.

But while we're working out the kinks in the system, I want everybody to understand the nature of the problem.

First of all, even with all the problems at healthcare.gov, the website is still working for a lot of people, just not as quick or efficient or consistent as we want. And although many of these folks have found that they had to wait longer than they wanted, once they complete the process, they're very happy with the deal that's available to them...

Second, I want everybody to remember that we're only three weeks into a six-month enrollment period when you can buy these new plans. (Applause.) Keep in mind the insurance doesn't start until January 1st. That's the earliest that the insurance can kick in. No one who decides to purchase a plan has to pay their first premium until December 15th.

And unlike the day after Thanksgiving sales for the latest Playstation or flat-screen TVs, the insurance plans don't run out. They're not going to sell out. They'll be available through the marketplace -- (applause) -- throughout the open enrollment period. The prices that insurers have set will not change. So everybody who wants insurance through the marketplace will get insurance, period. (Applause.) Everybody who wants insurance through the marketplace will get insurance.

Third, we are doing everything we can possibly do to get the websites working better, faster, sooner. We got people working overtime, 24/7, to boost capacity and address the problems. Experts from some of America's top private-sector tech companies, who've, by the way, have seen things like this happen before, they want it to work.

They're reaching out. They're offering to send help. We've had some of the best IT talent in the entire country join the team. And we're well into a tech surge to fix the problem. And we are confident that we will get all the problems fixed.

Number four, while the website will ultimately be the easiest way to buy insurance through the marketplace, it isn't the only way. Now, I want to emphasize this. Even as we redouble our efforts to get the site working as well as it's supposed to, we're also redoubling our efforts to make sure you can still buy the same quality affordable insurance plans available on the marketplace the old-fashioned way, offline -- either over the phone or in person...

You'll find information about how to talk to a specialist who can help you apply over the phone or to receive a downloadable application you can fill out yourself and mail in.

We've also added more staff to the call centers where you can apply for insurance over the phone. Those are already -- they've been working, but a lot of people have decided first to go to the website. But keep in mind, these call centers are already up and running. And you can get your questions answered by real people 24 hours a day in 150 different languages.

The phone number for these call centers is 1-800-318-2596.

Once you get on the phone with a trained representative, it usually takes about 25 minutes for an individual to apply for coverage, about 45 minutes for a family. Once you apply for coverage, you'll be contacted by mail, by email or postal mail, about your coverage status.

But you don't have to just go through the phone. You can also apply in person with the help of local navigators. These are people specially trained to help you sign up for health care. And they exist all across the country. Or you can go to community health centers and hospitals. Just visit localhelp.healthcare.gov to find out where in your area you can get help and apply for insurance in person.

And finally, if you've already tried to apply through the website and you've been stuck somewhere along the way, do not worry. In the coming weeks, we will contact you directly, personally, with a concrete recommendation for how you can complete your application, shop for coverage, pick a plan that meets your needs and get covered once and for all.

So here's the bottom line. The product, the health insurance, is good. The prices are good. It is a good deal. People don't just want it; they're showing up to buy it. Nobody's madder than me about the fact that the website isn't working as well as it should, which means it's going to get fixed. (Laughter, applause.) And -- and in the meantime, you can bypass the website and apply by phone or in person.

So don't let problems with the website deter you from signing up or signing your family up, or showing your friends how to sign up, because it is worth it. It will save you money. If you don't have health insurance, if you've got a pre-existing condition, it will save you money and it will give you the security that your family needs...

I recognize that the Republican Party has made blocking the Affordable Care Act its signature policy idea. Sometimes it seems to be the one thing that unifies the party theses days. In fact, they were willing to shut down the government and potentially harm the global economy to try to get it repealed...

But I just want to remind everybody, we did not wage this long and contentious battle just around a website. That's not what this was about...

Our goal has always been to declare that in this country the security of health care is not a privilege for a fortunate few, it's a right for all to enjoy. (Applause.) That's what the Affordable Care Act's all about. That's it's promise. And I intend to deliver on that promise.

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Democrats have already compromised by abandoning the goal of a single-payer system

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compromise cartoon

How many times have many of us on the left have openly wished for Medicare for All instead of a health care system centered around Big Insurance?

We get sick, they profit. We don't get sick, they profit. We kvetch, they profit. We vote for Progressives, they profit. We point and laugh at Fox and Friends, they profit. We endure endless Cialis commercials, they profit. We hold our ears and scream "Lalalalala!" they profit. We mock Miley Cyrus, they profit. Miley Cyrus mocks us, they profit. We write inane lists like this one, they profit.

In the Los Angeles Times, there's an op-ed by Jane Mansbridge, a professor at Harvard University's Kennedy School and a member of the Scholars Strategy Network. She reminds us of how much we've already given (given IN):

Fundamentally — and infuriatingly for the Democratic base — Obamacare is inherently a compromise because it is a health insurance reform law rather than an overhaul of the structure of our nation's healthcare system. [...]

Yet the single-payer system had already been compromised away when the final 2009-10 healthcare negotiations began. ... [M]any Democrats compromised, even those who considered the single-payer approach to be by far the best policy.

Instead of pushing for single payer, they rallied around another approach: the "public option." The public option would have preserved the current employer-based system of private health insurance coverage while providing a government-run healthcare insurance alternative as well as a safety net for the uninsured. Importantly, it would have also injected much-needed competition into an environment where private insurance plans are increasingly consolidated.

But even that wasn't good enough for Republicans and some ConservaDems. The most conservative Democrats were the ones who really got my blood boiling, but that's another post for another time.

For many Democrats, these compromises have been hard to swallow... Despite all these compromises and concessions, House Republicans still forced a government shutdown.

Indeed, now we have the Affordable Care Act, a law that is based on Romneycare, a Republican health insurance plan.

But Dems are the ones who aren't compromising. Got it. Jane Mansbridge called it a "shell game." She's right:

The Democrats have compromised over and over again. Now it's the Republicans' turn to play fair.

That last sentence? Great sentiment, impossible demand. Republicans don't know the meaning of the word fair.

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The Obama administration has been busy

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I'm about to run out the door, but I wanted to get a couple of newsy, good news/bad news items out there for you. First, via an email alert from the New York Times, the good news:

Justice Dept. Files Lawsuit to Block US Airways-American Merger

The Justice Department, along with the attorneys general of six states, filed a lawsuit on Tuesday seeking to block the proposed merger of American Airlines and US Airways.

The $11 billion deal, announced in February, took American out of bankruptcy. It would create the nation’s biggest airline, a company with the size and breadth to compete against United Airlines and Delta Air Lines, which have grown through mergers of their own in recent years and are currently the biggest domestic carriers.

But in the complaint filed Tuesday in Federal District Court in the District of Columbia, the Justice Department said that the merger “will leave three very similar legacy airlines — Delta, United and the new American — that past experience shows increasingly prefer tacit coordination over full-throated competition.”

And the bad news, via The Hill. Surprisingly, this has been the Labor Department's site since February, but nobody said a peep about it. Republicans will. It feeds right into their talking points:

Administration delays ObamaCare caps on out-of-pocket costs

The Obama administration has delayed a main provision in President Obama's healthcare reform law that would limit out-of-pocket insurance costs for consumers until 2015.

The cap, which includes deductibles and co-payments, was supposed to limit consumer costs to $6,350 for an individual and $12,700 for a family. But administration officials have quietly delayed the requirement for some insurers, allowing them to set their own limits starting in 2014. [...]

An administration official said the health law would “protect consumers from the worst insurance company abuses, by banning discrimination based on a pre-existing health conditions [sic], ending lifetime and annual limits on what an insurance company will cover, and capping out-of pocket spending to protect Americans and their families.”

A-a-nd the GOP takes full advantage and ups their Obama/Obamacare bashing in 5...4...3...2...

heavy sigh

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"In the case of Congress... eliminate all health insurance benefits... Obamacare will begin to look like a great idea."

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brat I want it now

Another L.A. Times letter to the editor, because our voices matter:

Re "Focus on fixing, not gutting, the healthcare act," Column, July 12

David Lazarus wants our lawmakers to act like adults when weighing healthcare reform. However, when that large group of mature men and women in the House votes 37 times to repeal a democratically enacted law upheld by the Supreme Court, and also lies about the law's effects, we are dealing with the tantrums of children.

The way to make a child modify his behavior is to take away some of his privileges. In the case of Congress, I strongly suggest that we eliminate all health insurance benefits.

After they see how much they will have to pay for individual policies covering high blood pressure, high cholesterol and other preexisting conditions, doubtless Obamacare will begin to look like a great idea.

Bruce R. Feldman
Santa Monica

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Zombies, No. Heartless, Yes

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Science keeps us going.  And here's what may be happening next. A heartless society. And that may be the key to living forever -- or at least as long as we wish.  Tomorrow is nearly here -- thanks to science today.  Don't let the Republican led fight for education and scientific cuts go through.  You want good health?  You need good research and well-educated minds.  It costs money.  But aren't we all worth it?

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ACA money will save lives, improve health, promote wellness, said anti-Obamacare GOP hypocrites who solicited grants

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Via aaateeshirts.com

A pal and terrific investigative journalist Lee Fang has new story out in the Nation today about Republican double speak on President Obama's Affordable Care Act. Through a Freedom of Information Act request, he reports on over twenty GOP lawmakers requesting health reform money for their constituents, arguing that the money will save lives, improve health, and promote wellness -- the very opposite of the arguments these lawmakers make when calling for repeal.

The story mentions NRSC chair Sen. Jerry Moran (R-KS) breaking ground at an opening ceremony for an Obamacare-funded health clinic, and Congressman Bill Cassidy (R-LA) cutting the ribbon at a health reform-funded health center in his district:

NRSC chair Sen. Jerry Moran Obamacare health care gop hypocrites

Congressman Bill Cassidy GOP hypocrites Obamacare

Lee:

Even before President Obama signed the Affordable Care Act into law, Republicans were vowing to repeal it. It’s no wonder, because polls showed that the basic elements of the ACA were quite popular, and there was a real danger that it would become more so as people found out that the plan denounced as a “monstrosity” by the National Republican Senatorial Committee would not trample on their liberties so much as help protect their health. Desperate to avoid this, the GOP-controlled House has voted no fewer than thirty-seven times to repeal Obamacare in the three years since it was enacted.

Now letters produced by a Freedom of Information Act request reveal that many of these same anti-Obamacare Republicans have solicited grants from the very program they claim to despise. This is evidence not merely of shameless hypocrisy but of the fact that the ACA bestows tangible benefits that even Congress’s most extreme right-wing ideologues are hard-pressed to deny to their constituents.

Please proceed, Republicans.

Much more at the link.

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