"Signature domestic legislative achievement."

October 28, 2011 1:22 PM

Public support for the new healthcare law has dropped significantly, with just 34% of Americans viewing the law favorably, the lowest level of support since the president signed the law in March 2010. A new survey by the nonpartisan Kaiser Family Foundation, deals a blow to the Obama administration as Republican presidential candidates keep up their pledges to repeal the president’s signature domestic legislative achievement. 'Much of the decline appears to have been driven by faltering support among Democrats, just 52% of whom said they view the law favorably, down from 65% a month earlier. Support among independents dropped from 36% to 32%. And support from Republicans fell from 14% to 11%.'

Meanwhile, even the largest businesses are openly saying the "The current healthcare system is unsustainable," - Greg Rossiter, Wal-Mart spokesman. "Like all businesses, we're making choices we wish we didn't have to make."

"Wal-Mart is coping with higher healthcare costs by reducing the number of its 1.4 million U.S. workers who qualify for coverage. New employees working fewer than 24 hours a week will no longer be insured.

The company is also jacking up rates for everyone else, with annual premiums for full-time workers soaring about 36%."

"When Wal-Mart, the country's largest private employer, announced the other day that it's cutting back on health coverage for workers, it wasn't just the latest sign that our healthcare system is out of reach for a growing number of people.

It was also the clearest indication to date that our employer-based health insurance system has let us down, saddling millions of families with rising healthcare costs and leaving millions more out in the cold.

"The system is failing us," said Alain Enthoven, a professor emeritus at the Stanford Graduate School of Business who served as a consultant to the Carter administration on healthcare issues. "It hasn't worked out as intended.""

'So if we ditched the employer-based system, what would replace it? A Medicare-for-all program would certainly fit the bill. Barring that, the solution may lie in the insurance "exchanges" that will be established in 2014 under President Obama's healthcare reform law.'

At the same time, that may not even be an option, should the Republicans capture the White House in 2012. Their promised repeal of the Obama healthcare reform law would be made a lot easier, given that the law finds so little support among the voters.

posted by VikingSword (91 comments total)

So, they love business so much they're going to repeal the healthcare law and put the burden on business?

I don't get it. Do we know what solution the right has presented to stop rising healthcare costs, other than repeating the tired mantra about how it's the government's fault?
posted by glaucon at 1:27 PM on October 28, 2011 [3 favorites]

I wish they divided the poll between people who feel the plan is too liberal and too conservative, even though that's flawed in that not every solution fits neatly on the left-right continuum.

For example, I'm not big on it, but I really hope Vermont's single payer plan works and becomes an example for the nation, as happened in Canada. And I also think the bill is better than the healthcare system we've had (and still mostly have as the bill is not 100% active yet), which isn't saying much.
posted by mccarty.tim at 1:28 PM on October 28, 2011 [15 favorites]

'Much of the decline appears to have been driven by faltering support among Democrats, just 52% of whom said they view the law favorably, down from 65% a month earlier.

That wouldn't have anything to do with the fact that, a month earlier, long-term care was part of the law? What was enacted was a watered-down version of what he'd campaigned on that many supporters saw as a gift of 40 million customers to the insurance companies. Since then it's been picked apart and now that long-term care is gone, there are few aspects of it that can actually be called health "care." So what's left to support?

And besides, what the hell difference does it matter what percentage of Democrats support it? It's not as though support from Dems is a factor in Obama's decisionmaking.
posted by headnsouth at 1:28 PM on October 28, 2011 [18 favorites]

the noise machine is doing the job it has been hired to do.
posted by edgeways at 1:28 PM on October 28, 2011 [23 favorites]

The support for the healthcare law reminds me of school lunch. The school gives you your sandwich for lunch, and you're not 100% behind tuna salad, but it's lunchtime and you're hungry and you want to eat that sandwich.

...and then some asshole kid comes by and grabs that sandwich off your tray. He doesn't even want the damn thing for himself, but he sure is going to fuck with you. And you try to get it back, all the while you want the sandwich less and less because he's had his grubby mitts on it and he's getting it gross and it's just such a pain in the ass to get this damn tuna sandwich back. Then, right when it seems like he's going to give it back, he takes a big lick right over the whole sandwich.

"Still want it?"

...and support for wanting the sandwich drops a few more percentage points.
posted by griphus at 1:29 PM on October 28, 2011 [99 favorites]

No mention as to why fewer Democrats are supporting the bill now, I notice. The right looks at these polls saying, "See? America doesn't like this legislation. Tear it down!" Nevermind that the reason may not be, "We don't want socialism", but rather, "We were expecting socialism!"
posted by charred husk at 1:29 PM on October 28, 2011 [44 favorites]

glaucon, I believe it involves the free market and bootstraps.

Seriously, they think that if we deregulate the industry so much that people buy services a la carte, the prices will fall so low that healthcare becomes affordable for everyone. At least, that's what the libertarians and tea partiers NPR has interviewed seemed to believe most often.
posted by mccarty.tim at 1:29 PM on October 28, 2011 [2 favorites]

Also I am pretty sure that if it were possible, Wal-Mart would fire all of its 1.4 million employees and replace them with robots, so long as the robots could be engineered to feel emotional pain and humiliation.
posted by griphus at 1:31 PM on October 28, 2011 [62 favorites]

Here's my own take on why public support is falling...

Everyone here on the street have begun to be hit by all sorts of rate increases from insurers, doctors, etc. and they all are saying the government is forcing them to raise rates because of healthcare reform.
posted by Thorzdad at 1:31 PM on October 28, 2011 [17 favorites]

... should the Republicans capture the White House in 2012. Their promised repeal of the Obama healthcare reform law would be made a lot easier, given that the law finds so little support among the voters.

Because what we had before was better? It reminds me of a comment I saw on Twitter: it's as if the option were Obama or cancer, and you vote for cancer because Obama didn't do enough. Because this version of "Obamacare" is totally what he had in mind.

This is the watered down version that had enough support to pass, not what was any one person originally wanted. It's design by committee, and a committee intent on undermining each-other.
posted by filthy light thief at 1:31 PM on October 28, 2011 [13 favorites]

It's not as though support from Dems is a factor in Obama's decisionmaking.

Clearly it is! Such as the case of...er...you know. Remember? The campaign he had? Man, there was a case of factoring if I've ever seen one. Geesh, it was great. (Nose starts bleeding, head falls on desk)
posted by glaucon at 1:31 PM on October 28, 2011

Oh this is perfect!

Today in our company cafeteria (well, it's called the "dining center") I overheard a conversation, and I was hoping for an excuse to use it. It's slightly, off topic, but... whatever:

Guy 1 - Well, lookie-here! Your man Obama wants me to pay for these protesters' college tuition.

Guy 2 - Not really. He wants to cap the monthly payment on the loans.

Guy 1 - I'll end up payin' for it, somehow. He'd love to raise my taxes to give these lazy kids Obamacare and what else. That's real fair.

Guy 2 - 'Bout as fair as me paying the same health care premium as your fat ass.


They seemed like pals, but man, I've seen best friends move out of apartments for far less. Guy 1 kind of laughed it off, as if it was his shtick.
posted by Bathtub Bobsled at 1:32 PM on October 28, 2011 [29 favorites]

WAL-MART (NYSE:WMT)

Revenue		 US$ 421.849 billion (2011)
Operating income US$ 25.542 billion (2011)
Net income	 US$ 15.355 billion (2011)
Total assets	 US$ 180.663 billion (2011)
Total equity	 US$ 68.542 billion (2011)
Employees	 Approx. 2.1 million (2011)

Net Income per Employee = $7331

Average USA healthcare spending per capita (2007) = $7,439

(And these are Wal Mart's financials during a recession, mind you)

Assuming that not all of those 2.1 million employees are full-time workers, that Wal-Mart are already paying for and providing some health benefits, and that employees would pay a reasonable portion of their healthcare costs, we can easily conclude that Wal Mart could afford to provide each of its employees with excellent health coverage and still remain very profitable without making any other changes to its business model.
posted by schmod at 1:33 PM on October 28, 2011 [13 favorites]

headnsouth: Democratic support is a big deal because if Democrats don't support the bill, their congresspeople won't support the bill. If there are enough votes to repeal it (most likely meaning some Blue Dog Democrats get on board), and Obama doesn't get a second term, it could get repealed.

I think the house is probably going to get a bit of a shakeup, though, since approval ratings are so low.

But a repeal is certainly not viable until after the 2012 election winners are sworn in. The republicans lack the senate, much less the supermajorities to overturn a veto from the White House.
posted by mccarty.tim at 1:34 PM on October 28, 2011

I believe it involves the free market and bootstraps.

If only Democrats didn't have such an anti-bootstrap agenda and would unchain the regulations holding back the Bootstrap Industry!
posted by glaucon at 1:34 PM on October 28, 2011 [2 favorites]

I am in full favor of the next politician saying the word "bootstraps" having both their feet hacked off with a blunt machete.
posted by dunkadunc at 1:35 PM on October 28, 2011 [7 favorites]

I don't get it. Do we know what solution the right has presented to stop rising healthcare costs, create jobs, end the wars, stop illegal profiteering on wall street, or do pretty much anything, other than repeating the tired mantra about how it's the government's fault?

Not necessarily a FTFY, but you were missing a few things.
posted by Mister Fabulous at 1:36 PM on October 28, 2011 [2 favorites]

You don't suppose the fact that this report comes via a huge healthcare conglomerate has anything to do with the low numbers, do you?
posted by crunchland at 1:36 PM on October 28, 2011 [4 favorites]

Whose fucking stupid idea was it to not enact the important parts until 2014? Who agreed to that? Because those people are idiots.
posted by fungible at 1:36 PM on October 28, 2011 [19 favorites]

My wife heard a call-in radio show on this subject the other day, and told me she thought it was kind of tragically hilarious: one after another, people kept calling in complaining about specific problems they had with their health insurance--and one by one, it turned out their complaints (pre-existing condition exclusions, chief among them) were things the Affordable Health Care Act actually did address, they just didn't know what the act actually does and didn't realize most of it hasn't gone into effect yet.
posted by saulgoodman at 1:37 PM on October 28, 2011 [19 favorites]

the noise machine is doing the job it has been hired to do.

Is The New Yorker part of the "noise machine?
posted by John Cohen at 1:37 PM on October 28, 2011 [3 favorites]

Previous polls have shown that there are many Democrats who don't like the current healthcare bill because it doesn't GO FAR ENOUGH and the one we now have was too much of a compromise.
posted by ericb at 1:37 PM on October 28, 2011

the noise machine is doing the job it has been hired to do.

And the printer machine that prints out all the bills with the bigger numbers on them.
posted by furiousxgeorge at 1:37 PM on October 28, 2011

I've always seen it as more of a placeholder than the finished thing. With the idea being that once the GOTP was through self-destructing and rendering itself a permanent minority through it's obstructionism and disenfanchisement of most of the country, the adults in the room could get on with making it a real single payer system.

So,, that's what I'm holding out for after the Dems take the House back and keep the Senate and Obama of course cruises to re-election.
posted by Skygazer at 1:38 PM on October 28, 2011

Whose fucking stupid idea was it to not enact the important parts until 2014?

Indeed, this was a total fucking freebie for Obama's 2012 campaign and they gleefully flushed it down the toilet. I really have zero empathy for the Democrats' current predicament, given their sheer ineptitude.
posted by mek at 1:39 PM on October 28, 2011 [4 favorites]

We employ 2.1 million associates globally, including almost 1.4 million in the United States.

Fully a third of Wal Mart's employees are outside the US.

Net Income per Employee = $7331

Needs to be adjusted, methinks.
posted by chavenet at 1:39 PM on October 28, 2011

support for wanting the sandwich drops a few more percentage points

That kid who wouldn't fight the bully fucking with his sandwich seems like kind of a wimp.

I don't think I want to hang out with him.
posted by Trurl at 1:40 PM on October 28, 2011 [1 favorite]

So,, that's what I'm holding out for after the Dems take the House back and keep the Senate and Obama of course cruises to re-election.

Sadly, I think there's no way the Dems hold the Senate. IIRC, they have nearly twice as many Senators up for re-election next year as Republicans.
posted by drezdn at 1:40 PM on October 28, 2011

I thought the same thing, crunchland, but their website says, "The Kaiser Family Foundation is not associated with Kaiser Permanente or Kaiser Industries."
posted by soelo at 1:40 PM on October 28, 2011 [2 favorites]

Ok. My mistake... Kaiser Family Foundation apparently no longer has any affiliation with the Kaiser Permenente and Kaiser Industries.
posted by crunchland at 1:40 PM on October 28, 2011 [1 favorite]

Correction: *...the current healthcare bill law...*
posted by ericb at 1:42 PM on October 28, 2011

It's pretty silly to put democrats down as 'not supporting the healthcare law.' It's coming off as if they're not supportive of healthcare reform, when the real problem is that the law is a compromised, watered-down version of a republican proposal from nearly two decades ago. It doesn't have democrat support because it doesn't go far enough.

And yeah, Wal-Mart could probably afford health care for their employees right now. The problem is that health care costs are so far out of line with inflation that it's not going to be an option in the very, very near future.

The system is a wreck. It's right there in black and white, compare US health care costs and outcomes to other industrialized nations, and the US system is a clear failure. There's no serious debate, only religious debate at this point.
posted by mullingitover at 1:43 PM on October 28, 2011 [8 favorites]

So, they love business so much they're going to repeal the healthcare law and put the burden on business?

The healthcare law forces most businesses to offer coverage to their employees and gives small businesses tax credits for doing so. Repealing the healthcare law will allow large employers to drop coverage for most of the rank-and-file without being hit with a massive tax.
posted by Talez at 1:43 PM on October 28, 2011

... we can easily conclude that Wal Mart could afford to provide each of its employees with excellent health coverage and still remain very profitable without making any other changes to its business model.

In related news:

Walmart CEO Makes Average Workers Annual Salary Every Hour.

posted by ericb at 1:45 PM on October 28, 2011

The "non-partisan" (but founded by founded by industrialist Henry J. Kaiser also of Kaiser Permanente .... please.

I question the source, it's like trusting the Koch Brothers on Environmental policy.
posted by NiteMayr at 1:46 PM on October 28, 2011

Thorzdad: "Here's my own take on why public support is falling...

Everyone here on the street have begun to be hit by all sorts of rate increases from insurers, doctors, etc. and they all are saying the government is forcing them to raise rates because of healthcare reform."

Yep - my insurance which was pretty good for the mental health stuff started to charge a copay when they didn't before. I asked why that was, and the lady said they "had to provide equal coverage for everyone"
(IOW - we're going to charge you to make our profits, in order to insure Bobby -- which *I* understand so I do pay it, even though i hate the profit motive, but OK, if Bobby is covered, then fine -- but Joe Dumbshit is gonna hear that and go "WHAT THE HELL AM I PAYIN FER? STUPID GOVERNMENT MAKING THINGS MORE EXPENSIVE")

So yeah - they are, and it's bullshit, and ... ugh.
posted by symbioid at 1:47 PM on October 28, 2011

The drop in Dem support is a real outlier for the last year. It's about 13% down in a month. I find that to be fairly strange. There's always been negative news in the background month to month. I can't believe the Walmart thing had such a big effect. Does the Repub primary suck all the oxygen out of the debate with a steady drone of repeal(!!) cause the dem responders to be more pessimistic and depressed?

Anyway, I don't believe this single month figure should be taken too much to heart in the great war. There have been some good (albeit wonky, policy, rule stuff) wins in the background lately for healthcare : see here, for instance. Health reform's not going anywhere soon.

This is 24/24 news cycle fodder and not too concerning yet.
posted by peacay at 1:47 PM on October 28, 2011 [1 favorite]

Repealing the healthcare law will allow large employers to drop coverage for most of the rank-and-file without being hit with a massive tax.

That's what I was looking for. Thanks.

Is part of the rush to stop the law an effort to prevent Republican voters from experiencing parts of the law that benefit them? I mean, that has to be the case. I get the sense (and please challenge me) that poor Republicans are so confused about this law they have no idea that even as a watered down bill that it will ultimately provide benefits.
posted by glaucon at 1:48 PM on October 28, 2011 [3 favorites]

I'm tired of seeing anything that might be a step in the right direction getting undermined by a party that's on the wrong side of everything- poverty, nationalism, xenophobia, pretty much anyone's rights as long as it's not 'rich people's rights'. It's time to stop compromising.

Who will rid me of this turbulent ruling class?
posted by dunkadunc at 1:49 PM on October 28, 2011 [5 favorites]

crunchland: "You don't suppose the fact that this report comes via a huge healthcare conglomerate has anything to do with the low numbers, do you?"

Also, Kaiser Permanente would probably stand to benefit from nationalized healthcare, as their business model aligns almost perfectly with European-style socialized medicine.

They actually make quite a big deal about the fact that they exchange knowledge with the UK NHS on a fairly routine basis.

(Yes, I use KP. I get better care with less hassle, and pay less for it than I ever did with a "traditional" private insurer.)
posted by schmod at 1:52 PM on October 28, 2011 [2 favorites]

Who will rid me of this turbulent ruling class?

Hmm... Good question. I dunno. El Justiciero?
posted by saulgoodman at 1:52 PM on October 28, 2011

Maddow had a bit the other day about how confusing and rambling most of the Democratic political commercials are.

I have to say it's the same thing with this law. The PR/public education part is broken.

I know people who think that it's going to take away their ability to choose their doctor and give free plastic surgery to people on public assistance. AND it's going to cost them $BIGNUMBER.

The Dems need some better PR people.
posted by sio42 at 1:53 PM on October 28, 2011 [7 favorites]

NiteMayer, I don't agree with your conclusion in any way shape or form. It's wrong on substance and it's hugely wrong in the comparison. I have been an AVID (I mean: every single day) follower of health care law sausage making since day one of the administration. Kaiser does good work generally speaking.
posted by peacay at 1:53 PM on October 28, 2011 [2 favorites]

Whether it's a good law or bad there would be negative public reaction to it right now, as much furor the Republicans have been making about it. These are the same people who basically made questions as to whether Obama was eligible to be president into a political football just by mentioning it a hundred times on-air. Make no mistake, they'd still be doing it now if people hadn't finally started wising up. They view public opinion and influencing it entirely in terms of cost/benefit analysis.

Until something substantive is done regarding the influence of propaganda, or the malign influence of Murdock, Ailes, the Koch Brothers and their imitators is countered or defeated, we'll continue to have difficulty effective positive change in this country.
posted by JHarris at 1:53 PM on October 28, 2011 [4 favorites]

Whose fucking stupid idea was it to not enact the important parts until 2014?

This is definitely the crux of the problem. Enactment is being stretched out too long. All teh better to kill it, I suppose.

In contrast, Medicare was enacted in the course of one year.
posted by Thorzdad at 1:59 PM on October 28, 2011 [8 favorites]

I'm a temp with no benefits. The other day I had a suspected seizure. Due to this bill I am still on my parents' health insurance, and was able to go to the hospital. I would have been straight fucked without that.
posted by showbiz_liz at 2:03 PM on October 28, 2011 [22 favorites]

The new Consumer Protection Agency is being stalled to death in congress and whittled away relentlessly on the behalf of lobbyists all the while, too. It could have really been something--as it originally had some very broad rule-making authority--though I've been surprised how few in the public ever seemed to rally around that either.
posted by saulgoodman at 2:06 PM on October 28, 2011

I never heard about the Consumer Protection Agency much outside of sites like Consumerist.

I think it died a death of underexposure coupled with knee-jerk reactions against it.
posted by mccarty.tim at 2:08 PM on October 28, 2011

There's a difference between disliking the law because it doesn't go far enough and disliking the law because it exists at all.

"Approval ratings" don't make that distinction.

The Republican candidates -- may they all die sick and in terrible poverty -- are on the wrong side of that distinction.
posted by edheil at 2:08 PM on October 28, 2011 [1 favorite]

why doesn't OWS just morph into a movement to guarantee universal health care? Everyone wants it but it can't happen without some serious leverage on Congress. Politicians need to be able to go back to their employers and tell them that their hands are tied - the people are going to vote me out if I don't give them this. Universal health care will change corporate hegemony virtually overnight. No longer will corporations have a stranglehold of fear around the neck of every American family working for them.
posted by any major dude at 2:17 PM on October 28, 2011 [4 favorites]

There's another possible explanation for why people have a negative impression, or rather more of one than before:
"the law won’t make much difference for them and their families" is what was asked.
In a major recession, with protesters in the street getting arrested for decrying the bad effects of cutthroat capitalism, I wonder if people are simply disheartened. Yeah the health care bill won't make much difference, because they won't have a job to give them money to buy insurance, even though now they could be covered. It's general malaise.

Which is totally a valid reason to say that, don't get me wrong.
posted by Lemurrhea at 2:19 PM on October 28, 2011

I think it died a death of underexposure coupled with knee-jerk reactions against it.

House Republicans are refusing to fund the CFPB adequately, stonewalling any nominee to lead the agency and have been keeping pro-forma sessions of the house going to make sure Obama can't slip a recess appointment in.

Believe me the Republicans are doing everything they can to slander and strangle the CFPB before the proles figure out what it's supposed to do and demand that the CFPB be allowed to do it.
posted by Talez at 2:24 PM on October 28, 2011 [1 favorite]

any major dude: why doesn't OWS just morph into a movement to guarantee universal health care?

Because they are not a hivemind, but thousands of individuals, and only some of whom have banded together. Universal health care would change things drastically, but the people of OWS have other desires, too.
posted by filthy light thief at 2:26 PM on October 28, 2011

why doesn't OWS just morph into a movement to guarantee universal health care?

Fixing themselves on a single issue would immediately make OWS far easier for media to pigeonhole and ignore. Fixing on universal healthcare as that single issue would make OWS far easier to be branded as socialistic and enemies by the right...who also happen to own the above-mentioned media.
posted by Thorzdad at 2:35 PM on October 28, 2011 [1 favorite]

It is overbroad to assume that opposition to this bill equals opposition to major healthcare reform. I support broadly expanding healthcare access, but do not support the healthcare bill. The system as it is currently configured is broken, and the healthcare bill does not fix it. The Atlantic Monthly - another dastardly cog in the "noise machine" - printed a long article about a different way to look at healthcare that is really good.

It is crazy to me that in nearly every aspect of our life, we know what we are buying and how much we are paying for it. In healthcare, not only do we not know the price, sometimes we can't know the price. The lack of transparency hurts consumers, and should be a centerpiece in any reform.
posted by AgentRocket at 3:00 PM on October 28, 2011 [3 favorites]

Lack of spine and marketing ineptitude are a huge part of the problem. Ironically the Democratic party market like Microsoft, the Republicans like Apple.
posted by MarvinTheCat at 3:20 PM on October 28, 2011

1. In light of the average per capita spending amount of $7,439+ (from 4 years ago, mind you), I'm guessing that it probably costs large employers somewhere in same $7-10K annually range to offer insurance to its employees. If that's the case, then why wouldn't a large employer with lots of low-wage workers (i.e., WalMart) just pay the $2,000/year/employee annual penalty in the ACA instead of incurring not only the huge direct cost of providing insurance but also the large indirect costs of administering a plan?

BTW, here's a good summary of ACA provisions (PDF).

2. As a small-business owner with less than 50 employees, it looks like I could get a 50% tax credit of the costs of a health insurance plan if I pay at least 50% of the premiums. But for only 2 years. What about the next 20 I expect to be in business? Pfffft.

#OWS
posted by webhund at 3:21 PM on October 28, 2011

It is crazy to me that in nearly every aspect of our life, we know what we are buying and how much we are paying for it.

Just like primary education, police services, air traffic controllers, clean air, bridge maintenance... Heck:
Maybe a little more economic transparency in elections themselves wouldn't be a bad idea, too.
posted by ~ at 3:24 PM on October 28, 2011

Hmm... That was unnecessarily snarky. I just meant: it really depends on what you're used to.
posted by ~ at 3:31 PM on October 28, 2011

It is crazy to me that in nearly every aspect of our life, we know what we are buying and how much we are paying for it. In healthcare, not only do we not know the price, sometimes we can't know the price.

When I came to the USA, it took a very long time for me to be able to wrap my head around this concept.

Being a fiscally responsible individual, the idea that I had to sign up to pay a shitload of money for something - but couldn't know what I would owe until after I owed it, blew my mind.

And the fact that depending on insurance company whim, the amount I would end up owing could range from "pocket change" to "complete bankruptcy" is just beyond crazypants. There are no words. No words.

What's the point of being fiscally responsible individual when all your efforts in that regard are regularly dwarfed by a crapshoot roll of the dice that you have no say in and no way to opt out of?

Well, I try to minimise this banana republic "healthcare" bullshit by getting most of my healthcare overseas. It's only sensible.
posted by -harlequin- at 3:37 PM on October 28, 2011 [11 favorites]

And just what would repealing HCR do to the federal budget? Disaster.

But of course, long-term fiscal stability isn't really a concern for the GOP and blue dogs.
posted by munchingzombie at 3:41 PM on October 28, 2011

You could just do what Sarah Palin did and live close to Canada.
posted by Slackermagee at 3:57 PM on October 28, 2011 [2 favorites]

This is a perfect example of why I hate our modern Democracy. In a logical, sane world we would hold a series of round tables on TV and the subject of how we are going to solve the health care crisis would be debated. Then after it was thoroughly discussed we would all vote on the best ideas.

But no. We have an electorate that would rather watch anything other than televised politics. We have politicians that play the game of Team Politics and muddy the waters by spouting misleading statements. We have legislators that are incapable of writing simple, easy to understand legislation. We have an entire country that would rather hide its head in the sand than figure out what to do about the soaring costs of medical care for everyone.

Where are we headed? When more companies slash their benefits, when more insurance companies cut their coverage, when more people find themselves unemployed, uninsured, and unable to pay their medical bills where will it all end? How bad will it get? Will my daughter have to drop out of college to pay for her bout of pneumonia? Will we have to use up all our retirement funds if I get breast cancer? Will we have to sell our house if my husband breaks his leg?
posted by Secret Life of Gravy at 4:54 PM on October 28, 2011 [4 favorites]

Secret Life of Gravy, the healthcare system isn't a magic machine. It can't charge one cent more than people are willing to give it. If employers and the government decide to reduce benefit dollars and private payers can't or won't make up the difference, prices will go down.

Those who say that's impossible said the same thing about townhouses in Vegas. (And are saying the same thing about college tuitions, and just as wrong about that.) Any system that has built itself around endless increases in prices funded by other people's money gets very good at making higher prices seem inevitable, but it is just not so.
posted by MattD at 5:48 PM on October 28, 2011

It can't charge one cent more than people are willing to give it... If employers and the government decide to reduce benefit dollars and private payers can't or won't make up the difference, prices will go down.

The AMA is deliberately keeping doctors scarce by forcing med schools to keep the numbers of docs and specialists enrolled low. This is why your kid has to see a Nurse Practitioner for checkups and has to wait a month to see an ENT specialist. Meanwhile, intelligent and motivated kids are being sent to law school in record numbers.

The system is unsustainable, and when it breaks, it's going to hurt a lot of people. Higher education is at that point now - eternal debt for a degree that didn't deliver a career, or even much of an education (Up to ten papers per course per semester. That's a fucking meat grinder, that's not a learning experience.)

When medicine breaks, it's going to result in mass waves of bankruptcies and public health catastrophes like epidemics, because, yes, artificial scarcity means they can do just that... keep charging far beyond what the market will bear.

There's no fucking soft landing for this... it's either boom or bust if you let the market forces drive things. That's no longer acceptable.
posted by Slap*Happy at 6:17 PM on October 28, 2011 [6 favorites]

I have a pre-existing condition. I had applied for and been denied insurance several times. Didn't have coverage for more than 10 years (after having some ridiculously awesome insurance during a brief couple of dot-com insanity years). Thanks to "Obamacare" (dude, I am not even sure I recall the real name of the plan it's so bland. Democrats pay attention! These things matter!)... anyway, I now have insurance thanks to this plan! It is amazing! It is (only) a couple of hundred dollars a month, with something like a $7000 deductible, but I HAVE INSURANCE. I havn't even used it yet, but if I wind up having to have that surgery I will not be several-ten-thousands-of-dollars in debt. And the doctor's office isn't terrifying, because I know I am part of some system and not some out cast "self-payer" doomed to skipped tests, sad looks, and long-wait mail order foreign pharmacies.

All this is to say, they really really really should have insisted that most people began to see results pretty much immediately.
posted by tingting at 6:24 PM on October 28, 2011 [4 favorites]

It can't charge one cent more than people are willing to give it. If employers and the government decide to reduce benefit dollars and private payers can't or won't make up the difference, prices will go down.

No. That's when the financial industry steps-in with healthcare payment products. They're already doing it in the dental industry, with dental-specific extended-payment schemes through 3rd-party finance corporations. There's no reason to think the same won't happen in general medicine.

No one really gives a shit how deep in-debt consumers go...certainly not the finance sector, despite their crocodile tears to the contrary. All they care about is keeping those payments coming in.
posted by Thorzdad at 6:58 PM on October 28, 2011 [2 favorites]

Sure is a good thing the prez spent up all that political capital getting a worthless insurance care law passed instead of pushing for something with some real teeth that would have actually had some real value that could translate into immediate returns and immediate goodwill, like a single payer option. Real nice.
posted by Civil_Disobedient at 8:11 PM on October 28, 2011 [2 favorites]

Why is health insurance tied to employment? i'm self-employed, party of one, and in CA, I can't get competitive bids from insurance providers.
posted by Ideefixe at 8:41 PM on October 28, 2011

Because if you aren't employed, to a substantial portion of the political and economic leadership of our country, you are a parasite.
posted by saulgoodman at 8:42 PM on October 28, 2011 [5 favorites]

(And I don't think self-employed people even exist in their ideal world.)
posted by saulgoodman at 8:44 PM on October 28, 2011

...and this is why I drink.
posted by Theta States at 8:54 PM on October 28, 2011 [4 favorites]

What this means is simple. If Obama gets reelected, health care reform survives. If he doesn't, it doesn't. Apply your energy accordingly.
posted by msalt at 9:03 PM on October 28, 2011 [2 favorites]

Well, God forbid, if the Republicans take the Senate and manage to keep the House, that could spell doom, too. (And it would for a lot of other reasons.)
posted by crunchland at 9:24 PM on October 28, 2011

True. Difference is, if Obama is president, he can still veto Republican craziness (including HCR reform).
posted by msalt at 9:26 PM on October 28, 2011 [1 favorite]

charred husk: Nevermind that the reason may not be, "We don't want socialism", but rather, "We were expecting socialism!"

Darn right! Cursed commies managed to kick my grandpappy out of China, and now they can't even get a simple health care law passed! Heck, he got kicked straight to Taiwan, which has universal heath care now!

But yeah, I'm sticking with Obama. Fat good that does though, since I'm in California.
posted by FJT at 9:35 PM on October 28, 2011 [1 favorite]

this country is un-fucking fixable.
posted by ninjew at 10:06 PM on October 28, 2011 [2 favorites]

The Democrats won't be losing enough to prevent them from filibustering. It only goes if the Democrats agree.

Or the courts strike it down, which is far more likely.
posted by furiousxgeorge at 10:14 PM on October 28, 2011

The notion that we can do away with the Affordable Care Act because it is too "watered down" makes me angry. Really angry. Stab-you angry.

I thought this was just Republican spin but then I started to hear it out of the mouths of liberal friends of mine. It's a declaration of ignorance. People who talk this way are either trying to be provocative or literally haven't read the provisions of the bill. People are quite literally arguing that we should remove an improvement because it's not the best outcome of all possible worlds, and it makes me want to scream.

Come 2014, should the law still exist, no one in the US will be denied health coverage due to a pre-existing condition. For this reason alone the law is invaluable. Also in 2014, the health care exchanges open up. The health-care exchanges are the seed planted in this law that may eventually lead to a single-payer option.

The US healthcare system is a disgusting failure. It is an inflexible, expensive and confusing patchwork of private care, public care and no care. It is shameful. People should be as mad about this as they are about Wall Street. There is no reason to even list the statistics, as a quick google search will show you that, while a first-rate system in terms of responsiveness, we fail in just about every other conceivable metric used to evaluate health systems of developed countries. The PPAC Act will not necessary fix this overnight, or even over a matter of years...but it is a step in the right direction and an improvement over the broken status quo. I would bet the farm that if the mechanisms set to enact in 2014 had enacted in 2010 that the approval ratings would be above 50 percent. That the most useful parts of the act kick in after so much time I suspect was a brilliant maneuver by those who realized just how popular they would make the law.

My girlfriend would not have coverage right now had the insurance for young people part of the bill been enacted - coverage she needs to manage her anxiety disorder. I suspect I would not have coverage now if it weren't for the threat of whats coming in 2014.

See, up until recently I was "uninsurable" simply because I took Lexapro in 2009 for 4 months. The fact that I am a fitness nut, clean food freak and have virtually zero physical health problems means absolutely nothing to an insurance conglomerate. I would bet I am fitter and healthier than most health company employees, but they do their due diligence and during underwriting as long as they saw that I had taken Lexapro, and therefore had "Major Depression" in their terms (even though I had evidence indicating that my depression was work-related and short lived), I was a bad bet and they could not insure me.

Understand that this precluded me from even catastrophic coverage - so, mental health coverage aside, I couldn't even get insurance to protect me if a bus hit me while I rode my bike to work. This would be comedy if it weren't so appalling. I was rejected twice for each Blue Shield and Kaiser Permanente both initially and when I appealed.

Imagine my surprise when, after applying to Kaiser Permanente recently to obtain a fresh rejection letter to use to apply to my states high risk insurance plan, I was accepted. I believe this would not have been the case without the threat of pre-existing coverage in 2014. I think insurance companies, preparing for that possibility, are trying to fill their ranks. I fear that if the law is repealed...I will once again be dropped.

At any rate, I've rambled...but this law is worth fighting for.
posted by jnnla at 10:52 PM on October 28, 2011 [21 favorites]

Thorzdad wrote:

Fixing themselves on a single issue would immediately make OWS far easier for media to pigeonhole and ignore. Fixing on universal healthcare as that single issue would make OWS far easier to be branded as socialistic and enemies by the right...who also happen to own the above-mentioned media.

you can't ignore 99% of the electorate who take to the streets. Are we that far gone that we think we are even appealing for this change? We've already tried that through our conventional political system and what has it gotten us? One corporate plant after another who pays us lip service then stabs us in the back behind closed doors. We are done appealing to Congress, it's time to start demanding it. How many fucking sob stories do we have to read about just on this website alone of people looking for some desperate way to navigate our health care system without going bankrupt? How many? It's time to fucking fight for our right to affordable healthcare. If OWS can accomplish just that it would be the most successful movement since civil rights.
posted by any major dude at 11:11 PM on October 28, 2011 [1 favorite]

Come 2014, should the law still exist, no one in the US will be denied health coverage due to a pre-existing condition.

Because of the loophole-free nature of the law, as vigilantly enforced by government regulators.

And that coverage will be adequate and acceptably priced because of...
posted by Trurl at 8:44 AM on October 29, 2011

Sorry for stating the obvious, but even in this thread there are people suggesting solutions without looking outside of the US. All of your neighbors have better healthcare, and Cuba and Mexico are developing countries. How can this happen? For a friendly outside observer, the whole healthcare debacle is the strongest proof that the American political system has been rigged to screw the 99% I disagree with the logic behind deregulation of banking and lending, but there is a logic and it is believable that some people honestly thought a deregulated market would work.
With healthcare, no head-wringing anywhere can come up with a real and plausible explanation for how the richest country in the world had gotten itself the most expensive and least efficient health-care system. Tort-reform won't change anything, and the "research is bigger and better in the US"-argument doesn't hold up either.
posted by mumimor at 8:58 AM on October 29, 2011 [4 favorites]

And that coverage will be adequate and acceptably priced because of...

A mandate for health insurance that will see any large company penalized for not offering health insurance while providing incentives for small businesses to offer health insurance where they couldn't before thereby increasing the size of the risk pool.
posted by Talez at 9:35 AM on October 29, 2011

Why is health insurance tied to employment? i'm self-employed, party of one, and in CA, I can't get competitive bids from insurance providers.

Because you're a party of one. The insurance business model is to collect a small premium from a large pool of people and spread the risks out among them. The larger the pool, the more predictable the risks are and the easier it is to find the right premium. Insurance companies want to build their pool in large, predictable chunks.

Unless you're extremely low risk, insurance companies don't want your business. There's too much overhead in dealing with you as an individual to make it worth their time, unless you're so low risk you can bring down the expected costs of their pool.

The place to search for competitive bids is from the actual healthcare providers. Next time you need an ambulance, call around and get a good rate. Don't just let them take you to the nearest hospital - shop around for a good deal. Maybe postpone any surgery you might need until you can find a coupon.
posted by heathkit at 10:14 PM on October 29, 2011

Don't just let them take you to the nearest hospital - shop around for a good deal.

God I wish I could do this. I'm self-employed and in need two separate surgical procedures for no life-threatening conditions and I can't get numbers from anyone.
posted by the_artificer at 11:45 PM on October 29, 2011

The place to search for competitive bids is from the actual healthcare providers. Next time you need an ambulance, call around and get a good rate. Don't just let them take you to the nearest hospital - shop around for a good deal. Maybe postpone any surgery you might need until you can find a coupon.

This is hilarious advice. Tragically, absurdly hilarious.
posted by headnsouth at 5:48 AM on October 30, 2011 [1 favorite]

A coupon? A coupon???!!!! WTF Do you live in the US? I have never heard of a surgery coupon. Once in awhile you see some deal on general tests-- 5 health screenings for $300.00 say done in a mobile unit-- but I have never heard of a hospital issuing coupons.

Because you're a party of one. The insurance business model is to collect a small premium from a large pool of people and spread the risks out among them. The larger the pool, the more predictable the risks are and the easier it is to find the right premium. Insurance companies want to build their pool in large, predictable chunks.

One thing that I have never understood is why our Representatives and our Senators have gold-plated insurance that is not available to the general population. That is insane. No wonder we cannot get health insurance reform when we allow the legislators to have insurance coverage that the voters have no access to.
posted by Secret Life of Gravy at 7:38 AM on October 30, 2011

One thing that I have never understood is why our Representatives and our Senators have gold-plated insurance that is not available to the general population. That is insane.

The gold-plated, nobody-else-can-get-it, super-duper, so-good-it's-shameful health insurance that Representatives and Senators get is...

wait for it...

the Federal Employees Health Benefits Plan. Which is to say the SAME FUCKING INSURANCE as a new full-time GS-1.

There are exactly three things that members of Congress get that other federal employees don't.

(1) They can pay to get some outpatient care from the office of the attending physician.
(2) They can get free outpatient care at DC-area military hospitals.
(3) They can receive inpatient care at DC-area military hospitals, who then bill whichever FEHB plan they've selected.

All the expensive shit, like trauma surgery if they're hit by a bus or cancer treatment or heart surgery, is covered by THE SAME HEALTH INSURANCE AS ANY OTHER FEDERAL EMPLOYEE.

...for now. Under the ACA, members of Congress and some of their staff are being kicked off of the FEHB and forced to get health insurance from the exchanges.

In other news, members of Congress also don't receive gold-plated, super-duper, so-good-it's-shameful pensions, much less just get paid for life. They get... one of the standard federal retirement plans. And they pay into Social Security like any other schmuck.
posted by ROU_Xenophobe at 8:20 AM on October 30, 2011 [1 favorite]

With regard to this debate, I think everyone should be aware of the McCarran-Ferguson Act.
posted by Trochanter at 10:01 AM on October 30, 2011

Scalia and Thomas dine with healthcare law challengers as court takes case
posted by homunculus at 7:45 PM on November 14, 2011

That's a somewhat misleading headline though...

"Clement’s law firm, Bancroft PLLC, was one of almost two dozen firms that helped sponsor the annual dinner of the Federalist Society [..]

It’s nothing new: The two justices have been attending Federalist Society events for years. And it’s nothing that runs afoul of ethics rules. In fact, justices are exempt from the Code of Conduct that governs the actions of lower federal justices."

Look, I'm as lefty as they come, but this is drawing a big bow in all the circumstances. Is there anyone on earth who thinks Scalia & Thomas aren't conservative? No. Do they go to these things regularly? Yes. The LA Times appears to making a mole hill out of the timing.
posted by peacay at 8:09 PM on November 14, 2011