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Posts Tagged ‘ACA

The Congressional TP is wrong…and it is killing the GOP.

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Is the New Yorker wrong or has the GOP gone GOP Elephant Closes Governmentover the top? I’m of the opinion that the GOP is hurting themselves for a generation if the most hardline members of their base continue this quixotic campaign. There are a lot of things about the ACA that could and should be fixed that would enable better growth in our economy, but the GOP has not offered any alternatives that fixes the problems of coverage, affordability with consumer protections, or bends the medical cost curve that the nation, as a whole, supports. If the nation had, Romney would be president right now.

What the Republican intransigents were willing to deprive of funds, besides the Capitol police, included the following: The Centers for Disease Control, which said that it would have to stop its seasonal flu-prevention program and would “have significantly reduced capacity to respond to outbreak investigations.” The Environmental Protection Agency, which would close down almost entirely, and the Occupational Safety and Health Administration, which would stop most of its inspections. The WIC program, which provides healthy food supplements for millions of pregnant women, new mothers, and babies, and could run on temporary federal funds only through the end of the month. The Food and Drug Administration, which said it “will be unable to support the majority of its food safety, nutrition, and cosmetics activities,” and would have to halt “the majority of the laboratory research necessary to inform public health decision-making.” The National Institutes of Health, which announced that it would not be enrolling any new patients in ongoing studies or clinical trials.

Since Tea Party conservatives dislike the federal government on principle, the derailing of what the federal government does every day doesn’t bother them all that much. What should bother them, deeply, is the anti-democratic nature of the maneuver. To hold up a budget and shut down the government in order to sabotage a law you don’t like is not just nose-thumbing at the government; it’s flouting the will of the people. Obamacare passed both Houses of Congress nearly three years ago. In June, 2012, in an opinion written by Chief Justice John Roberts, the Supreme Court upheld the constitutionality of its fundamental elements. In November, 2012, Obama, who had devoted much of his political capital to the Affordable Care Act—it will likely be his signature legislation—was handily reëlected. And, last week, on the first day that you could sign up for insurance through the new health-care exchanges, 2.8 million people went on the federal government’s enrollment site. Surely that’s evidence that, whatever else Obamacare will prove to be, it is legislation that is fulfilling a real need: that of the fifteen per cent of the American population who are uninsured, as well as of individuals who are paying exorbitant sums for insurance on the open market, all of whom live with the insecurity of being unable to afford health care. In no small part, fixing this problem was what Barack Obama was elected to do.

In the meantime, the diehard opponents of the bill in Congress remain a faction within their own party, whom fellow-Republicans seem determined to identify by more and more outlandish epithets. To Representative Devin Nunes, a Republican from California’s Central Valley, they are “lemmings with suicide vests.” To Senator John McCain, they’re “wacko birds.” (He used the term in March, when Senators Rand Paul and Ted Cruz were filibustering the nomination of John Brennan for C.I.A. director; McCain later apologized, but Cruz, according to a profile in GQ, has embraced “wacko bird.”) To Representative Peter King, of New York, Cruz is the “con man” who knew “this would never work” but somehow “suckered” House Republicans. Cruz, meanwhile, compared those Republicans who were willing to vote on the budget—and let Obamacare proceed—to appeasers of the Nazis.

It’s worth remembering that in the early nineteen-sixties, when another health-care bill was under debate, the rhetoric of the Republicans who opposed it was just as over the top. We didn’t get socialism, as those opponents warned; we got Medicare, which turned out to be a very popular, mostly high-functioning program that saves elderly people from going bankrupt when they get sick. In the end, as the President says, that is the kind of outcome that the extremist Republicans running this budget battle fear the most: that Obamacare will work, and the Democrats will get credit for it. And what the mainstream Republicans fear the most is that voters will blame them for letting the lemmings run the show. If Obama refuses to back down, this could be a moment that will define his legacy—a fight for democracy as much as for Democrats. ♦

According to reports, the Dems already accepted the House budget numbers, which, in reality, are lower than the Ryan budget for the 6 week CR. Six weeks! It’s not like we’re talking about a full year, for heaven’s sake. That, in itself, is a great win for House Republicans. But attaching a defunding or delay in the individual mandate – that only applies to individuals who don’t get health insurance through their company – to the CR was always going to be a loser for the GOP which they should have known. First, most of the ACA funding is not part of the discretionary (aka annual) budget. It’s self-funded like Social Security or Medicare. Second, the Dems would never agree to delay it start up until close to the next election, making the ACA again another election year issue.

Moreover, using the debt ceiling as a negotiating strategy, regardless of how much the deficit is hated, is not acceptable. It’s one thing to decry how on the House or Senate floor how much the country is going into debt when you know the increase will happen anyway, but it’s another to threaten the US economy with default on the nation’s promises of payment. The debt limit and promised payments to our all of our nation’s creditors, whoever they may be, should never, ever be put at risk.

Yes, there is an ongoing disagreement over the size of the federal government. Some are good arguments, such as should the US be the world’s police force or have a huge, expensive national security state that infringes upon the rights of privacy of citizens, but some are bad arguments such as throwing the least able into the trash can of history. Can government work better? Clearly the answer is yes. Our federal government continues as a model of the 19th Century. But *only* Congress can change that antiquated model…and that change will only occur when committee power and fundraising models change.

Regardless, PIMCO’s El-Erian notes, the failure to increase to increase the debt ceiling would lead to a Great Depression worldwide and cause irreparable harm to the US in prestige, authority, and, most of all, to our status as the world’s reserve currency and the special borrowing rates that status implies.

Further, China, in 2011, when Congress last threatened the debt ceiling as a serious negotiating point, entered into talks with other BRIC nations to replace the US dollar as the world’s reserve currency. China, apparently, received a lot of support among those nations. Does anyone in their right minds believe that China will let go of their ability to reduce the status of the US dollar as the world’s reserve currency when it obviously is in their own interest to reduce the influence of the US? Although the Chinese did not say as much publicly, I am quite sure they would like the Renminbi become the world’s reserve currency.

If US voters do not understand the perils on the world stage and to the US economy of the Tea Party strategy, then God help us all.

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Written by Valerie Curl

October 9, 2013 at 9:23 PM

Obamacare is Socialism?

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Obamacare is not seen as true socialism but as another program that politicians will raid while failing to tame heath care delivery costs in the USI live in a rural, Republican favored district so I’m something of an outlier. However, I’m always interested in what my neighbors and local businesses say about national policy and politics.

This afternoon, after getting my hair cut, I got into a discussion of Obamacare with my hairdresser after she remarked on the large rheumatoid arthritis caused lumps on my left wrist and hand. The truth is she wanted to know why I had not had them removed to which I replied that the reason why my right wrist looks like I’ve contracted some horribly disfiguring disease is because of money. The surgery could cost thousands…and since my right wrist causes no pain, the extraordinary cost of surgery is just not justified. I’d rather have surgery on the middle finger joint of my right hand where another major lump has appeared, pushing my middle finger to the right, and on my left wrist which continually aches.

In any case, we began discussing on health care costs…and Obamacare.

Using a disparaging tone that I’ve learned is common regarding President Obama in this neck of the Republican woods, she said Obamacare was socialism. So I mildly asked her did she not like Medicare or Social Security or Medicaid because they were certainly socialistic. Her reply was, “No, I don’t because they won’t be there for me.”

So, essentially, her argument against Obamacare was not, in reality, against socialism but in response to her belief that she will have paid into these systems for decades all for naught. That the federal government, as a result of self-absorbed, self-centered, self-greedy Congressional action, would bleed her of the hard-earned money she had made and contributed while giving nothing in return for her dollars.

My hairdresser is a hard-working sole proprietor. A mom with two kids in college and one graduating from high school. She needs to believe government won’t be taking advantage of her. But she doesn’t.

As we talked, I told her how much health care costs today – 17% of GDP – and if left alone how much health care is estimated to cost in 2025 – 25% of GDP. Her face sagged and took on an odd shade of gray as she absorbed those figures…and what they meant for her pocketbook. Like me, she admitted that this country must do something restrain and lower actual health care delivery costs.

I told her about the many provisions in Obamacare that seek to reduce costs and the numerous pilot programs across the country that ACA partially funds. She asked were those programs were actually working and where were they so I told her about TR Reid’s PBS program which discussed the many pilot programs across the country where doctors, insurers, Medicare, Medicaid, and company insurance programs came together to create programs that provided optimal health care at much lower costs.

The message across the board in TR Reid’s PBS program: healthy people, regardless of income and status, cost everyone less so everyone can pay less.

Providing quality health care at a lower cost when communities and health care providers come together can reduce costs and increase healthy outcomes. 27 provisions in Obamacare (aka ACA) provide funds for pilot programs and assist funding for new programs where the main objective is reducing delivery system costs while increasing healthy outcomes.

If this nation basically returns to the system that dominated the last 60 or so years, health care delivery costs will only continue to rise. Pushing those extraordinary, opaque, unknown costs onto patients, as Paul Ryan and the GOP advocate, will not reduce costs. It will only cause more bankruptcies.

Once my hairdresser grasped the overwhelming and nationally bankrupting costs we are paying for our health care delivery system which other nations are not, her opinion changed. She began to see the need to make a real change in health care before we all go broke.

Regardless, one thing is certain: returning to the same old “pay for service” system that dominated US health care for the last 60 years is a certain fiscal loser for the nation…moreover, the “socialism” argument among voters may have less to do with ideology than with the fear or belief, as my hairdresser stated, that Social Security and Medicare – and ACA – won’t be there in 20 years when needed because politicians will have given away yet another pot of taxpayer money to corporations or otherwise shifted their benefits’ money elsewhere in the budget. The real fear may be less about socialism and more about lack of political trust.

Written by Valerie Curl

April 26, 2012 at 10:34 AM

$116 Billion…

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That dollar number amounts to the unpaid health care costs in 2008. That $116 Billion cost is shifted to every person who does have insurance and amounts to an extra $1,000 per year in additional premium costs to every family.

Do you like paying $1,0000 more for your insurance because someone else chose to be irresponsible or did not have the financial resources to buy overly high priced insurance on the private, individual insurance market?

Nobody really likes mandates, let alone insurance. I didn’t like it when my state mandated I have car insurance. But being a responsible adult means doing certain things, not just for today but for potential eventualities down the road, that we may not like but prevent us from causing financial harm to others.

Yet, the new Ayn Rand libertarian, conservative mantra appears to be heading in the opposite direction of concern only for oneself and ignoring whatever impact our self interest has on the rest of society.

For example, when Solicitor General Donald Verrilli tried to explain to Justice Scalia that the health care market is unique because “getting health care service … [is] a result of the social norms to which we’ve obligated ourselves so that people get health care.” Scalia’s response is a curt: “Well, don’t obligate yourself to that.”

In other words overturn the mandate that requires hospitals to treat every patient, regardless of their financial resources, and let uninsured, financially handicapped people – and children – die in the streets. Is that really the kind of nation we want?

When I hear Republicans talk about person responsibility as a necessary virtue and then hear them say let’s go back to the old health care system that permit complete and utter irresponsibility as well as a system that neglects up to 30 million of its citizens, I don’t just get confused or frustrated, I get angry. Republicans can’t have it both ways.

They can’t say they care about the American people and are fiscally responsible when the nation shifts $116 billion onto responsibly insured families and say they believe in individual responsibility while championing the right to be irresponsible. But this is, as opposed to older Judeo-Christian beliefs, the measure of the new conservative movement.

Nevertheless, the argument most notable, hangs on opposing theories of what powers Congress has.

Akhil Reed Amar is Sterling Professor of Law and Political Science at Yale University, where he teaches constitutional law. He’s also author of the excellent book, ‘America’s Constitution: A Biography’, told Ezra Klein regarding the Constitution and the powers available to Congress.

In McCulloch vs. Maryland, Chief Justice John Marshall wrote in paragraph 28:

“A constitution [is] intended to endure for ages to come, and consequently, to be adapted to the various crises of human affairs. To have prescribed the means by which government should, in all future time, execute its powers, would have been to change, entirely, the character of the instrument, and give it the properties of a legal code. It would have been an unwise attempt to provide, by immutable rules, for exigencies which, if foreseen at all, must have been seen dimly, and which can be best provided for as they occur. [It is wrong] to deprive the legislature of the capacity to avail itself of experience, to exercise its reason, and to accommodate its legislation to circumstances.”

Health Care Spending

With regards to controlling costs, the ACA goes a long way towards that goal. 47 provisions in ACA tackle the problem of delivery system cost controls, through a variety of incentives that encourage communities, states, and health care organizations and providers to change how they have traditionally managed health care and its attendant costs. It’s currently estimated that we could be saving maybe $700 billion annually on what we spend on health care.

Kaiser, Gunderson Lutheran, Geisinger Health Systems, the Mayo Clinic and Intermountain as some key leaders in delivery system reforms/innovation. These organizations have had remarkable success, and as Sen. Whitehouse points out, the goal of those 47 provisions is to incentivize pilot programs that actually do work at providing quality health care to communities, regardless of which type of health insurance they have, and reduce the cost of delivery which can then be deployed nationally. Whitehouse, added, the savings would be a huge economic benefit to not only the taxpayer, but also to our competitive industries, if they’re able to spend less on health care. And these savings in the Affordable Care Act aren’t about taking something away, but rather about delivering more efficient care. It’s a true win-win, and positively the road we ought to be on.
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A few facts about the costs of the American health care system:
Total expenditure on health per capita: $7,960
Expenditure as % of GDP: 17.4% (the most)
Annual growth of total health expenditure: +2.2% (14th least)
Life expectancy: 78.2 years (27th highest)

Source: 24/7 Wall St.

Written by Valerie Curl

March 29, 2012 at 6:39 PM

Getting the Facts Right

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In an article posted on FactCheck.org, the Republican primary claims regarding the fiscal and job killing claims are disputed. FactCheck has done a nice job of reporting the real facts on the fiscal and job impacts of the newly enacted health care law. doctor and patient discussing medical care

As we all know, politicians often distort or skip over facts that weaken their arguments. Both sides do it. So, it’s worthwhile to look elsewhere, to some other organization, with no political or financial stake in the game for independent, accurate information. FactCheck.org has done a pretty good job at this.

A ‘Job-Killing’ Law?
House Republicans misrepresent the facts. Experts predict the health care law will have little effect on employment.

January 7, 2011

Summary

When it comes to truth in labeling, House Republicans are getting off to a poor start with their constantly repeated references to the new health care law as “job-killing.”

We find:

* Independent, nonpartisan experts project only a “small” or “minimal” impact on jobs, even before taking likely job gains in the health care and insurance industries into account.
* The House Republican leadership, in a report issued Jan. 6, badly misrepresents what the Congressional Budget Office has said about the law. In fact, CBO is among those saying the effect “will probably be small.”
* The GOP also cites a study projecting a 1.6 million job loss — but fails to mention that the study refers to a hypothetical employer mandate that is not part of the new law.
* The same study cited by the GOP also predicts an offsetting gain of 890,000 jobs in hospitals, doctors’ offices and insurance companies — a factor not mentioned by the House leadership.

There’s little doubt that the new law will likely lead to somewhat fewer low-wage jobs. That’s mainly because of the law’s requirement that, generally, firms with more than 50 workers pay a penalty if they fail to provide health coverage for their workers. One leading health care expert, John Sheils of The Lewin Group, puts the loss at between 150,000 and 300,000 jobs, at or near the minimum wage. And Sheils says that relatively small loss would be partly offset by gains in the health care industry.
Analysis

Attaching misleading labels to legislation is a well-worn tactic in Washington. Conservatives got rid of most of the estate tax after labeling it a “death tax,” as though it taxed death instead of multimillion-dollar fortunes. And liberals once won passage of an “assault weapons ban” that didn’t really ban fully automatic military assault rifles, which were already illegal for civilians to own without a very-hard-to-get federal license. Now House Republicans are seeking to repeal what they call “Obamacare: A budget-busting, job-killing health care law.” That’s the title of a study issued by the House Republican leadership Jan. 6.

And the GOP is clearly pushing the “job-killer” claim. House Speaker John Boehner used the phrase “job-killing” to describe the health care law seven times on Thursday in a press conference that lasted less than 14 minutes — that’s once every 2 minutes. He also used the phrases “destroy jobs” and “destroying jobs” once each when talking about the law. Perhaps not surprisingly, the Republicans named their bill to repeal the health care law: “Repealing the Job-Killing Health Care Law Act.”

But is the health care law really “job-killing” as claimed? We find that to be another case of exaggerated and misleading labeling.

Click to read the entire article, detailing the findings of each of the current claims made against the health care law.

Written by Valerie Curl

January 11, 2011 at 9:09 AM

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