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Obamacare Fails to Fail - NYTimes.com


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2014 Jul 15, 5:07am   20,512 views  62 comments

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http://www.nytimes.com/2014/07/14/opinion/paul-krugman-obamacare-fails-to-fail.html?_r=0

But the great majority of those who signed up did indeed pay up, and we now have multiple independent surveys — from Gallup, the Urban Institute and the Commonwealth Fund — all showing a sharp reduction in the number of uninsured Americans since last fall.

#politics

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1   curious2   2014 Jul 15, 5:39am  

Of course it didn't fail: it was designed to increase spending, which was already the highest in the history of the world, and spending has indeed increased. We are paying more than ever before to the corporations represented by the lobbyists who wrote the legislation. Instead of falling into line with peer countries' medical spending, even after the American industry was charging more than the market would bear, American medical spending continued to increase. We have neither a free market system nor a socialist system, either of which would be cheaper and better; we have a lemon socialist system, which maximizes power (including revenue) for its authors at the expense of everyone else. It operates as designed.

CL says

reduction in the number of uninsured Americans since last fall.

The number of uninsured remains around the same as it was before the current administration took office. In the interim, the number increased and then returned to where it had been previously. Besides, the insurance fetish is a commercial media creation: "health insurance" isn't "health care," and "health care" certainly isn't health. If your goal is to improve health, then obsessing over insurance makes no sense, but if you are deluded by commercial media to maximize spending, then the insurance fetish makes perfect sense, because mandatory subsidized insurance provides the most lucrative mechanism by which to maximize political power and lemon socialist revenue. The same process (and many of the same people, including the NY Times and Ezra Klein) who previously sold you the Iraq war have made even more $$$ selling you the legislation that you promote for them in threads like this one, while their clients have continued killing more Americans than the Iraq war and terrorists combined ever did.

2   Tenpoundbass   2014 Jul 15, 10:53am  

Amen Brother Crazy!

3   elliemae   2014 Jul 16, 9:56pm  

Wow, people are insured now? What a failure!

4   marcus   2014 Jul 16, 11:03pm  

THe captain and his brothers are identical to the forgotten loser old cranks who complained in the 1940s about social security and medicare. They went to their graves self righteously sure they were right.

No wonder that politicians are finally dropping the I hate Obamacare ball
if the average person on subsidized rates is paying $82/ month.

I'm sure though that when republicans have their fund raising meetings with groups of rich doners they still diss the ACA plenty. But there they are talking exclusively to people who are indeed worse off because of Obamacare (with taxes that is).

Seems like we switched from a system where the middle class had to pay for the health care of the poor (being inefficiently delivered and often late and from emergency rooms), to a system where more of that cost hits the rich. Either way it's redistribution, but this is clearly better, especially for those who are insured inexpensively.

5   Tenpoundbass   2014 Jul 17, 1:11am  

marcus says

the average person on subsidized rates is paying $82/ month.

BUT! The Average non Subsidized person has to pay 400% more than it should be, because the Liberals decided to play "you can't put a price on it" on MY Dime.

Fuck off already. I don't give a greasy good fuck, how much the "Subsidized Rates" fucking are. The rest of US can't fucking afford it you clueless Putz!

6   edvard2   2014 Jul 17, 1:15am  

And of course this news makes conservatives highly annoyed. Curses!

7   MisdemeanorRebel   2014 Jul 17, 1:16am  

curious2 says

. Besides, the insurance fetish is a commercial media creation: "health insurance" isn't "health care," and "health care" certainly isn't health.

You know what time it is.

Don't believe the Hype.
http://www.youtube.com/embed/8PaoLy7PHwk

I say no peace until the last case manager is hanged by the entrails of the last Health Insurance Broker.

8   dublin hillz   2014 Jul 17, 2:15am  

Optimus Prime gave an order to implement death panels and all the "victims" will be moved to research faciity for advanced genome study which will eventually lead to a living version of nietzsche's overman.

9   marcus   2014 Jul 17, 2:16am  

CaptainShuddup says

The rest of US can't fucking afford it you clueless Putz!

Says the retard who doesn't know what facts are. I guess in your world facts and truth are nothing more than liberal tools that they use to put ex-dixiecrats down.

Go back to your propaganda, before your brain functioning stops declining.

The funny thing is that you and the propaganda peddlers that you suck up to, have set expectations so low for Obamacare, that it's pretty much a guaranteed success.

http://www.factcheck.org/2014/02/aca-impact-on-per-capita-cost-of-health-care/

Note: Per capita cost includes medicare spending. I know that healthcare costs too much, but most of that increase occurred before Obamacare. Now a huge part of the population gets subsidized insurance.

10   Tenpoundbass   2014 Jul 17, 3:14am  

Time is on my side.

The shit will hit the fan when "EVERYBODY" starts getting the bill.

Only the Premiums are subsidized genius. These subsidized people are going to be shit out of luck when serious ailment hits and they go to the hospital under the misguided assumption that they are fully insured.

There's already been plenty of reports on the sticker shock, after the "Entitlements" of Obamacare stops, and the lining of your pocketbook starts.

11   Dan8267   2014 Jul 17, 6:06am  

The mark of success for a health insurance system is not how many people sign up, but rather when these people get sick, are they treated promptly and is that treatment covered.

Of course, you can use the violence of the state to force people to pay for insurance, fining them if they don't, ceasing their excess tax payments. But this does not force the insurance companies to stop hindering people from seeking treatment. They still play all the same games to delay and deny treatment making it truly a pain in the ass to seek treatment sooner while it is cheaper.

Nor does the ACA in any way address the true problems of our healthcare system.
1. Health insurance companies are parasitic and must cease to exist.
2. Hospitals create fraudulent bills that do not in any way reflect costs.
3. Pricing is secret and the bill for the same exact service varies hugely from person to person.
4. Administrative waste.
5. Health providers have a perverse incentive to keep people sick.

Yeah, the ACA won't collapse. Neither would the prior system. Hell, the ACA is almost identical to the prior system except that
- people are forced to buy insurance
- insurers can't bar you for a pre-existing conditions, but they can raise the rates for everyone because of these, hence the need for young, healthy people to subsidize the rich old people

But, in my opinion, the ACA is a disastrous failure. There was an opportunity for real reform and improvement, but because the ACA was passed, all political pressure to reform the system has deflated. The ACA has prevented real reform including single payer, which would have given us transparent pricing, no price discrimination, and greatly reduced administration costs.

I guess we'll have to wait for another generation of people getting screwed over by the health care industry before we get real reform.

12   Bellingham Bill   2014 Jul 17, 7:16am  

Dan8267 says

But this does not force the insurance companies to stop hindering people from seeking treatment.

"In California, plans offered by Blue Shield through Covered California included just 60 percent of the doctors that participate in the insurer's group plans and just 75 percent of the hospitals. On top of that, Blue Shield is reimbursing doctors and hospitals in Covered California policies up to 30 percent less than those not in the exchange, spokesman Stephen Shivinsky said."

http://www.sfgate.com/health/article/Covered-California-clients-have-trouble-finding-5169944.php

Gov. Jerry Brown on Friday signed a budget for the 2014-15 fiscal year that accommodates an influx of uninsured residents into Medi-Cal, the state's Medicaid program. But at Brown's request, the Legislature left in place a 10% recession-era cut to most doctors, dentists and other healthcare providers who treat Medi-Cal patients, many whom are children.

http://www.modernhealthcare.com/article/20140621/INFO/306219940#

hence the need for young, healthy people to subsidize the rich old people

ACA rates rise with age, too

But the extent there is cost-shifting going on, smoothing out health costs over one's lifetime is a good thing, assuming this rate structure subsidy still exists when today's youth become old people.

All taxes come out of rents, so the more we pre-pay our future costs in our 20-40s, the less we will bid up the cost of housing. That's my theory at least.

13   Bellingham Bill   2014 Jul 17, 7:22am  

marcus says

But there they are talking exclusively to people who are indeed worse off because of Obamacare (with taxes that is).

ooh, the 1% must hate the new 3% medicare tax on investment income with the heat of a million suns.

That's what the GOP's "repeal and replace" bullshit is/was really all about.

14   Bellingham Bill   2014 Jul 17, 7:26am  

curious2 says

it was designed to increase spending

ACA was designed to be the maximal change the system's "stake holders" would tolerate.

Tough for politicians to go toe-to-toe with the biggest industry this nation has. People are deathly afraid of losing what access they enjoy, and any reform has to "change" things, not necessarily for the better of everyone.

PPACA creamed Russ Feingold in 2010, and that was thanks to outright lies about what ACA was changing.

(Ironically a medical device corporation owner took his seat, LOL)

15   CL   2014 Jul 17, 7:34am  

Bellingham Bill says

curious2 says

it was designed to increase spending

ACA was designed to be the maximal change the system's "stake holders" would tolerate.

Tough for politicians to go toe-to-toe with the biggest industry this nation has. People are deathly afraid of losing what access they enjoy, and any reform has to "change" things, not necessarily for the better of everyone.

PPACA creamed Russ Feingold in 2010, and that was thanks to outright lies about what ACA was changing.

(Ironically a medical device corporation owner took his seat, LOL)

Which is why "big reform" gets killed in its crib. A little cost shifting and subsidy deal helps reduce the number of uninsured, and by a lot. In the end, I would suspect that more would end up in PRIVATE insurance, not the Government plan. Both parties believe in various levels of laissez-faire free-market Reagan-style capitalism. The Democrats are hardly paternalists any more.

Since we all believe in the magic of the market, why not push them into the miracle of insurance markets? Watch it, praise it, and pray to it. Why wouldn't it look kindly upon us for our offering?

16   Dan8267   2014 Jul 17, 7:37am  

Bellingham Bill says

But the extent there is cost-shifting going on, smoothing out health costs over one's lifetime is a good thing, assuming this rate structure subsidy still exists when today's youth become old people.

The ACA does not do that. It would be one thing if the Boomers paid into the system their entire lives, but that's not the case. The Millennials are paying for Boomers who did not have to have insurance when they were young.

This is easily fix, but won't be since the entire point is to steal from the young to pay for the greedy, old folks who own all the stocks and real estate. All we'd have to do is set age brackets for the spending. All money received from a given bracket can only be spent in that bracket. Problem solved.

Health insurance should get more expensive as you get older as your health care costs go up. The purpose of insurance is to spread risk, not costs. Buying health insurance does not make health care costs go down. For that, you need to fix the problems with outrageous care costs.

17   Bellingham Bill   2014 Jul 17, 8:38am  

Dan8267 says

Health insurance should get more expensive as you get older as your health care costs go up.

Gold 80 Plan for 30 yo is ~$380/mo; Silver 70 is ~$330

For 60 yo this is ~$900 and ~$750

rates go from ~$4500/yr to ~$11,000 as you get older

I'd like to see more subsidy, not less, actually. People retiring on Social Security in the 40s and 50s got a good deal, too, but that's OK

The purpose of insurance is to spread risk, not costs.

to a point, yes. But there's also a social element here. Not everything has to have a goddamn hard-ass economics element. That's the secret of the nordic socialist paradises I bet, though of course in certain areas (wrt household debt) they're skating on pretty thin ice it looks like.

18   Dan8267   2014 Jul 17, 9:35am  

Bellingham Bill says

Not everything has to have a goddamn hard-ass economics element.

But it should be socially just. I see no justice in having a poor generation subsidize the richest generation in American history, especially when that generation is the reason the careers of the younger generation are so dismal.

Also, the math does not work. Even Call it Crazy, who has the IQ so low you have to frack for it, realizes this.

The Boomers are a big generation. They can parasitically leach off the Millennials, another large generation. It will greatly impoverish the Millennials, but there's enough blood to suck. However, when the Millennials retire and there's a much smaller generation of young people, the system will collapse. Eventually this must happen as population cannot grow forever and eventually there will be generations that are smaller than their parents or grandparents.

In fact, even ignore the unethical aspects of leaching off the younger generations, it's simply not practical. Whenever a system pays out generation N of investors with the revenue collected from generation M > N, the system is by definition a Ponzi Scheme. And the thing about Ponzi Schemes is that they are mathematically doomed to fail. They cannot end any other way. It's just math and math doesn't lie.

The correct way to set up any social program is to have each generation pay its own way, neither taking nor giving to any other generation. This has nothing to do with meanness; it's just the only sustainable way to run a system because generations can and do fluctuate in terms of both population and wealth.

For example, a large and wealthy generation will pay more for health care because it has greater demand, but it can afford to pay more. A small and poor generation won't be able to pay as much, but won't have to because the demand will be far less. This is called a negative feedback. Negative feedback are the critical component of any sustainable system whether economic, ecological, biological, or anything else. Without strong negative feedback mechanisms, all systems are unstable.

Politics cannot invalidate mathematical law. If you want a health care system that can be sustained for generations, you have to do the math.

http://www.youtube.com/embed/CLv3SkF_Eag

19   HydroCabron   2014 Jul 17, 9:41am  

CaptainShuddup says

Time is on my side.

The shit will hit the fan when "EVERYBODY" starts getting the bill.

Yep.

Global warming? Fake.

Saddam's WMD's? Real.

Tax cuts? They boost revenue.

Obamacare? Failure.

Obama? Born in Nairobi.

The proof is coming in, any day now. I just know it.

20   Tenpoundbass   2014 Jul 17, 9:55am  

Hydro this is the Obamacare failure thread if you'd like to debate me on any of his THOUSANDS of other failures please pick one of the Millions of other threads on the subject, or start a new thread about a new calamity. I would be happy to join you there.

21   Tenpoundbass   2014 Jul 17, 12:29pm  

Responding to more of my POINTLESS dribble I see.

You're getting pretty good at doing nothing.

22   marcus   2014 Jul 17, 12:40pm  

HydroCabron says

Yep.

Global warming? Fake.

Saddam's WMD's? Real.

Tax cuts? They boost revenue.

Obamacare? Failure.

Obama? Born in Nairobi.

The proof is coming in, any day now. I just know it.

Good summary. Apparently the captain doesn't like to see so many of the right's key delusional tenets at one time. It causes cognitive dissonance, and then he has to spend time at the fox news website until he feels better.

23   Bellingham Bill   2014 Jul 17, 12:44pm  

Dan8267 says

But it should be socially just. I see no justice in having a poor generation subsidize the richest generation in American history, especially when that generation is the reason the careers of the younger generation are so dismal.

following generations inherit the richest generation's stuff anyway; it's all a wash in the end

24   Dan8267   2014 Jul 17, 2:21pm  

Bellingham Bill says

it's all a wash in the end

If you believe that than you'd have no problem with the old subsidizing the young instead.

In any case, you have not addressed any of the objections I had to the ACA including it's ultimate doom.

25   marcus   2014 Jul 17, 3:26pm  

Bellingham Bill says

Dan8267 says

But it should be socially just. I see no justice in having a poor generation subsidize the richest generation in American history, especially when that generation is the reason the careers of the younger generation are so dismal.

following generations inherit the richest generation's stuff anyway; it's all a wash in the end

That's some irrational boomer hate right there.

A "medicare for all" single payer type system would be better and more efficient, but it would be the same in the sense that the young pay in for benefits they mostly receive when they are older. And like the ACA, the older people are paying an amount that is less than their commensurate risk.

Dan doesn't seem to realize that what's bothering him is a sort of one time benefit that the older people just starting on the ACA now receive, not having had to be insured when they were younger and healthier, or if they did, it cost less.

This is like people that were say 45 when social security started. They ended up taking out far more from the system than they paid in. Some will try to complain that it's a pay as you go "ponzi scheme" even now (which it isn't - especially if done right).But sure - the people that were older when it started and didn't pay in their whole lives benefited in a way that later generations didn't.

It's a one time phenomenon, and the government picks up the tab, through debt or whatever - spread out over time. Not sure why this is hard to comprehend or deal with - unless as I say, it's just some sort of irrational boomer hate.

Bellingham Bill says

Dan8267 says

especially when that generation is the reason the careers of the younger generation are so dismal.

Maybe some kind of soylent green is the answer ?

How does an entire generation, including many millions whose careers are non existant or reaaly weak, take the wrap for the time interval that bad government policies from Reagan to GWB took place ? What, just becasue they are closer in age to Reagan or GWB ? I don't get it.

26   Homeboy   2014 Jul 17, 4:05pm  

elliemae says

Wow, people are insured now? What a failure!

It's a "failure" in the minds of rich white male right-wingers, because they honestly believe that nobody else in the country deserves to have anything that they have.

27   Homeboy   2014 Jul 17, 4:09pm  

Call it Quits and Captain Shuddup have invested so much of their personal self-worth and energy into hating ACA, that it doesn't matter WHAT happens. It could be the most wildly successful healthcare program on earth, and they would NEVER admit it to be anything but a failure. Their beliefs were already pre-determined 5 years ago, before the law was even passed.

29   anonymous   2014 Jul 17, 10:05pm  

I feel like heritagefoundationcare has been wildly succesful. Look how profitable and easier to soak even more people, to an even higher degree of soaking, ppaca has been for the "health" industry.

Party on, wayne

30   Y   2014 Jul 17, 10:50pm  

Precisely.
What kind of non-coverage astronomical deduction/copay plan do they get for 82 bucks/mo? They would be better off with no insurance and living a stone's throw away from the country's emergency rooms, where it all can be had basically for free.

Call it Crazy says

Wait, they're getting screwed paying $82/month...

They need to be FULLY subsidized by the rest of the country and go on Medicaid!!!

31   Y   2014 Jul 17, 11:00pm  

This appears to be true as long as you ignore the fact that we own the printing press...

Dan8267 says

Whenever a system pays out generation N of investors with the revenue collected from generation M > N, the system is by definition a Ponzi Scheme. And the thing about Ponzi Schemes is that they are mathematically doomed to fail. They cannot end any other way. It's just math and math doesn't lie.

32   Y   2014 Jul 17, 11:05pm  

Wow. We finally agree...

marcus says

Dan doesn't seem to realize

33   indigenous   2014 Jul 18, 12:05am  

If there is a $6000 deductible for people who can't afford healthcare. How does that make sense? They will use the insurance in a catastrophic situation, but that is it, or more likely they will go to the ER and not pay the bill.

So what has changed?

I guess they now pay $82.00 a month?

34   indigenous   2014 Jul 18, 12:56am  

Call it Crazy says

NOTHING!!! Except a quicker road to bankruptcy when they find out that $6000 has to be paid by them for their NEW FREE Obamacare...

This is just not going to work. I predict that the ACA will be repealed. Even the libs are not this stupid, er ah I hope?

35   monkframe   2014 Jul 18, 1:21am  

marcus says

..."if the average person on subsidized rates is paying $82/ month.

I'm sure though that when republicans have their fund raising meetings with groups of rich doners they still diss the ACA plenty. But there they are talking exclusively to people who are indeed worse off because of Obamacare (with taxes that is).

Seems like we switched from a system where the middle class had to pay for the health care of the poor (being inefficiently delivered and often late and from emergency rooms), to a system where more of that cost hits the rich. Either way it's redistribution, but this is clearly better, especially for those who are insured inexpensively. "

I seem to be one of the very few people posting here who has any experience w/the new system. Premium: $126.13 per month for Kaiser Silver. Max yearly deductible: $5,600. I now have higher co-pays and drug costs.

I fully expect that my premiums will rise next year, because I'm not paying 16 percent of my GROSS income to Kaiser for premiums alone. So my taxes should reflect a rise in income and I will pay more. And I know lots of other people who've seen their medical premiums go down because of this new law.

Is it single payer? Of course not. Maybe, instead of the Fed handing out trillions to banksters in free money to speculate with, they should fund a REAL single payer system and take this issue off the table.

36   Dan8267   2014 Jul 18, 2:23am  

marcus says

Dan doesn't seem to realize that what's bothering him is a sort of one time benefit that the older people just starting on the ACA now receive, not having had to be insured when they were younger and healthier, or if they did, it cost less.

I'm fulling aware of what's bothering me about the ACA and why. What you mentioned above is not insignificant by any means, yet it is only one of many objections, ethical and practical, that I have about the ACA.

marcus says

Maybe some kind of soylent green is the answer ?

You may joke about it, but essentially disproportionally shorter lives for later generations is the effect that is inevitable when earlier generations exploit later ones. Again, the math ensures this.

You can trump up false virtues of the ACA all you like, and you may convince people that the ACA is far better than it really is. You might even get the world to ignore all the warnings from rationalists like myself. However, that does not change that the ACA is disastrous. Ultimately, the health care system is a technology and should be treated as such, built to engineering standards, and not determined by politics and popularity contests.

For a successful technology, reality must take precedence over public relations, for nature cannot be fooled.

37   Dan8267   2014 Jul 18, 2:25am  

SoftShell says

This appears to be true as long as you ignore the fact that we own the printing press...

Dan8267 says

Whenever a system pays out generation N of investors with the revenue collected from generation M > N, the system is by definition a Ponzi Scheme. And the thing about Ponzi Schemes is that they are mathematically doomed to fail. They cannot end any other way. It's just math and math doesn't lie.

The number of monetary units is irrelevant. Printing money does not create wealth.

38   Dan8267   2014 Jul 18, 2:25am  

SoftShell says

Wow. We finally agree...

marcus says

Dan doesn't seem to realize

What further indication is required that you are both wrong?

39   monkframe   2014 Jul 18, 4:30am  

Call it Crazy says

monkframe says

I seem to be one of the very few people posting here who has any experience w/the new system. Premium: $126.13 per month for Kaiser Silver. Max yearly deductible: $5,600. I now have higher co-pays and drug costs.

Have you had to change your doctor or hospital selection on this plan and what else changed in coverage on your plan?

For all its shortcomings, I have Kaiser Permanente, which means no changes in doctors or hospitals. The increased co-pays and drugs, and the high deductible are the major changes. I'm very fortunate in that regard, and I know it.

The profit motive is really what's wrong with the present system. Once that is removed and we have health care provided as a right, and the administrative costs are brought down to a level of, say the Social Security system, (3 percent) we'll have a chance at universal health care, single-payer, whatever you want to call it. We pay more and get less than any other industrialized country on earth right now.

40   dublin hillz   2014 Jul 18, 4:44am  

Doctors are getting into close to mid 6 figure debt in med school because there is payoff at the end. That is the crux of the problem. ACA and previous system maintain the status quo from that standpoint, money just gets shuffled around. Lowest 20% do benefit, for the middle class it is at best a wash over the long term in aggregate. The ones that are truly "screwed" are not the high roller ballers with their investment taxes, it is a single person who makes perhaps around $70K in bay area with no health coverage at work. Those guys will get roasted good.

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