I believe that to improve the lot of the consumer-patient-insured stakeholder that we must relentlessly pursue changes to better our position within the US healthcare system and that Obamacare is not the best vehicle as it stands now to accomplish this.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public,” Theodore Roosevelt cited at http://www.voicesoffreedom.us/voices/theodoreroosevelt/theodoreroosevelt.htm.
For millions of consumers Obamacare is not working to make our protection as patients better and more affordable as we assumed it might be under a law pedaled as the Patient Protection and Affordable Care Act.
The ways in which the law has failed to keep its promises to the citizen-patient-stakeholder have become more marked and apparent since the 2014 implementations of many changes under the Act that makes the old-style rhetoric by Obamacare fans seem weird and misplaced as they try to convince us how great the law is circa 2008.
More than anything else it is becoming quite clear that the Act gravely sacrificed needed protections to patient-citizen stakeholders in order to create a complex system of government intervention into the healthcare industry designed to save the payers on insurance policies money whether those payers are governmental or private.
It is this failure that makes Obamacare and its legacy one of deceptive marketing for consumers who are facing the added insult of being dismissed as “haters” for voicing disapproval of the administrative scheme created by Obamacare that ultimately is designed to take more money from the majority of Americans to save insurers, whether the government or private insurance companies money.
In 2014, if you read the “IT’S WORKING” articles, you’d see that aside from omitting significant segments of the population and occasionally honing in on a fraction of the citizen-patient stakeholder population that defenders of Obamacare come up short in their ability to defend Obamacare on the basis of its success for the citizen-patient-stakeholder so that they shift to a strange defense of benefits that accrue to the government or to private insurers as “evidence” of the success of Obamacare.
Luckily, for those of us who realize that it’s likely we were fooled to a lesser or greater extent about Obamacare, consumers in the face of experiencing the real Obamacare are beginning to notice the failings of Obamacare. A recent Gallup poll reported by Justin McCarthy on November 17, 2014, in his article, “As New Enrollment Period Starts, ACA Approval at 37%,” the lowest ever.
Still some Democrats persevere hoping to shift the conversation, reframe the issues and selectively cite perceived positives in order to desperately try to convince the world that what isn’t working for the consumer-patient stakeholder really is.
Consider CNN’s response to the Gallup poll regarding the unpopularity of Obamacare as reported by Tami Luhby on 11/17/2014, “Americans don't like Obamacare, even if enrollees do,” Money.CNN.com.
As the title says, “Americans don’t like Obamacare…” but within the article instead Ms. Luhby reframes the conversation to talk about Americans who apparently do like Obamacare, its enrollees, that narrow group of Americans getting Obamabucks (subsidies) to help pay for health insurance like Obamacare. Surprisingly, actually, not even all of them are happy with it.
The CNN article continues, “Some three-quarters of those covered through an exchange said they would renew their current policies or shop for another Obamacare plan.” Sounds good doesn’t it?
Until we apply our brains to the statement. Of the 8 million individuals enrolled in Obamacare health plans (excluding free healthcare under Medicaid and CHIP), 75 percent would continue on Obamacare,” Tami Luhby, 11/17/2014, “Americans don't like Obamacare, even if enrollees do,” Money.CNN.com.
How does that connect with the article’s heading: “Americans don’t like Obamacare…”? It doesn’t even prove that enrollees like Obamacare since only 6 million (75%) of the 8 million enrollees of whom 85% are receiving government dollars (6.8 million) are “happy enrollees.” That leaves 800,000 unhappy enrollees who would not “renew…or shop for another Obamacare plan.”
In November of 2014, Senator Charles Schumer acknowledged that perhaps Obamacare was mistimed and that more meaningful economic policies that promised relief to the middle class would have been better to pursue first (see Schumer, National Press Club).
Even “THE NEW YORK TIMES,” included a December 2, 2014 op-ed by Thomas B. Edsall that discussed the failings of Obamacare in the view of the American public and concluded, “Whatever you think of Senator Schumer, you begin to understand why he spoke out as forcefully as he did.”
Instead of using the Senator’s comments as an opportunity to break the cycle of circling around the same Obamacare drain in the same brackish water of broken promises and misinformation about Obamacare, many Democrats predictably did the opposite and dug in their heels attacking the critic instead of considering the criticism.
On December 4, 2014, Jonathan Chait did just this and once again jumps in defending Obamacare in his article, “4 New Studies Show Obamacare is Working Incredibly Well,” Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014. Not only is it working but it’s working INCREDIBLY well.
Mr. Chait begins by characterizing Senator Schumer’s statements as a “brutally cold moral logic (that politicians should prioritize keeping power over enacting positive change),” Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014, “4 New Studies Show Obamacare is Working Incredibly Well.”
Few can avoid noticing his barely changed and uncredited reference to Nancy Pelosi’s response to Senator Schumer, “We come here to do a job, not keep a job,” (search Nancy Pelosi on Senator Schumer) when he defines his “brutally cold moral logic (that politicians should prioritize keeping power over enacting positive change).”
Regarding Schumer Chait says: “What makes this wave of regret—not even taking into account the unmitigated hostility from the political right—so strange is that Obamacare is actually working…extremely, even shockingly, well.”
Extremely even shockingly well? Mr. Chait outlines his 4 NEW STUDIES to support his claim. His first piece of evidence that Obamacare is working shockingly well concerns “Increasing Access to the Uninsured,” where he cites his FIRST STUDY, a report by the Urban Institute that indicates a 30 percent drop in the number of the uninsured, Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014, “4 New Studies Show Obamacare is Working Incredibly Well.”
It’s interesting that this “study” can do something the Federal government has been unable to do, track the number of newly insured thus concluding that Obamacare has reduced the number of uninsured by 30 percent. The government cannot determine accurate enrollment numbers let alone the number of “newly” insured to date.
On November 20, 2014 there was a report in Bloomberg.com that “Obamacare Sign-Ups Were Inflated With Dental Plans,” where the Administration admitted it had overstated enrollment by about 380,000 people who were only dental plan subscribers as reported by Alex Wayne. This was an over-counting error admitted by the Administration.
There was another significant government admission this summer that the number of fraudulent enrollments was likely a problem when the Government Accountability Office reported that “Eleven out of 12 fake applications for government-subsidized health insurance got through a verification process and the bogus beneficiaries are still covered, the Government Accountability Office said Tuesday,” (emphasis added) as reported everywhere including NBC NEWS by Maggie Fox and Joel Seidman, “GAO Sting Finds it Easy to Fake It, Get Obamacare Premiums, 7/22/2014.
There is also no indication that the STUDY Mr. Chait cites takes into account the millions of individuals who are caught up in the Family Glitch and those who were if-you-like-your-plan-you-can-keep-it casualties.
We also know that as reported in March of 2014, (search Gary Cohen) that it was widely reported that Gary Cohen admitted that there was no way of knowing who were among the “NEWLY” insured, the number that would indicate how many more people were insured than before Obamacare because, “That's not a data point that we are really collecting in any sort of systematic way," Cohen said, http://www.upi.com/Top_News/US/2014/03/07/Gallup-Majority-of-uninsured-say-theyll-get-insurance/35011394207335/#ixzz3MLXDSS9C.
Mr. Chait’s second STUDY is about “Reducing Overall Health-Care Costs,” where he cites a CMS report showing that THE GOVERNMENT is spending less on health expenditures. This is an argument that is actually against Obamacare as far as consumers go. We already know that Obamacare was concerned with saving the payers of insurance, whether private insurance companies or government insurance money, but it’s our costs that are relevant.
For CONSUMERS, we’re paying more as reported in Modernhealthcare.com, by Melanie Evans on September 24, 2013, “Consumers paying more out-of-pocket, despite slow healthcare spending growth.”
You can also examine the Health Care Cost Institute’s 2013 information at 2013 Health Care Cost and Utilization Report that concludes: “ Spending Per Privately Insured Grew 3.9% in 2013, as Falling Utilization Offset Rising Price.” (Obviously 2014 isn’t over yet so the report is for 2013).
What Mr. Chait is really focusing on is insurer savings not consumer-patient stakeholder savings, not quite what we thought we were getting with a claim of reduced health-care costs.
Third Mr. Chait considers “Hospital Errors,” and has yet another study that shows that “hospital-acquired medical conditions has fallen by 17 percent since 2010. (This has not only saved huge amounts of money, it has also saved 50,000 lives.)” Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014, “4 New Studies Show Obamacare is Working Incredibly Well.”
I really don’t get what Mr. Chait’s point is here. The study only has to do with hospital-acquired medical conditions from infections to viruses and points to new provisions (which are largely about non-reimbursement for institutions who make patients sicker) that are helping reduce the number of people getting sick in hospitals. But in citing this study, Mr. Chait ignores a more broad-based PROBLEM and that is that “Deaths by Medical Mistakes Hit Records,” as reported by Erin McCann on 7/18/2014, HEALTHCARE IT NEWS. In that article 400,000 deaths a year are attributed to preventable medical errors…It’s the number three killer in the US.
Mr. Chait’s final claim is about “Insurance Competition,” Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014, “4 New Studies Show Obamacare is Working Incredibly Well.” Chait relies on a Kaiser study showing a “’…surge in health insurer competition.’” Jonathan Chait, NEWYORKMAGAZINE.com, 12/4/2014, “4 New Studies Show Obamacare is Working Incredibly Well.”
What Mr. Chait seems to ignore is that until 2016 there is essentially a no-lose situation designed for insurers joining the “Marketplace” in the form of risk corridors and reinsurance and risk adjustment provided for in the PPACA that protects insurance companies from losses incurred if their plans are less expensive. Unfortunately, two of those provisions expire in 2016 under the PPACA sections 1341 and 1342.
As I discussed in “Fool Us Once…Risk Corridors and Elections,” on 9/26/2014, “CMS defines REINSURANCE as Federal dollars that “Provides funding to issuers that incur high claims costs for enrollees,” (which prevents the issuer insurance company from bearing those losses). RISK CORRIDORS “Limits issuer losses (and gains),” and RISK ADJUSTMENT “Transfers funds from lower risk plans to higher risk plans.” Only risk adjustment survives past 2016 under the Act.
The success of Obamacare for consumer-citizen-patients is at this point in time at least lopsided and defies a generalization of going well. It would be really a good thing for Democratic credibility to update the arguments in favor of Obamacare rather than to continue to cherry-pick isolated “positives” that do little to persuade those of us experiencing the REAL Obamacare.
