Where is GOP concern for born, breathing people, as opposed to couldn't-live-outside-the-womb fetuses? Where is the Christianity?
110
News flash:
The Affordable Care Act is meeting or beating its goals.
Having lost on health care, the Republican/Tea Party now turns its efforts to Benghazi.
The Affordable Care Act is meeting or beating its goals.
Having lost on health care, the Republican/Tea Party now turns its efforts to Benghazi.
60
The free market has failed to provide affordable healthcare. We should go to a single payer healthcare system. As much as it hurts American pride we should look to see what other industrial countries have done to provide universal care at half the cost that Americans pay. Though the American healthcare costs are hard to see buried in government subsidies, insurance premiums, job related policies, hospital costs and prescription drug costs.
But the average middle class family of four earning $60,000 a year spends $16,000 a year on healthcare insurance. So if Americans could do as well as other industrial countries that family would save $8,000 a year or $240,000 in thirty years-- in my region of the country that would buy a nice home.
It’s time for the Republican’s in Congress to admit the free market doesn’t solve all problems in fact it has made a mess of healthcare. And for working American it has created a financial burden that Congress could easily lift and put a huge chuck of earnings back in the pockets of those Americans. But of course, Congress would lose the political contributions of corporate healthcare profiteers. It depends on who the government choses to serve.
But the average middle class family of four earning $60,000 a year spends $16,000 a year on healthcare insurance. So if Americans could do as well as other industrial countries that family would save $8,000 a year or $240,000 in thirty years-- in my region of the country that would buy a nice home.
It’s time for the Republican’s in Congress to admit the free market doesn’t solve all problems in fact it has made a mess of healthcare. And for working American it has created a financial burden that Congress could easily lift and put a huge chuck of earnings back in the pockets of those Americans. But of course, Congress would lose the political contributions of corporate healthcare profiteers. It depends on who the government choses to serve.
82
The editorial;board missed the point, as reported by the New York Times during the Obamacare debate. Seattle's Group Health is more than a co-op, it's also an HMO. Doctors are salaried employees of their patients. The even own their own pharmacy. So pick up your prescription on your way out of the clinic and ... the biggie .... no claims processing. According to the Times, linked below THAT was to be the alternative to a public plan, endorsed as an alternative even at Daily Kos. What happened?
And plan that had lower costs than any government plan on earth, with more patient control and market competition than any private plan, was doomed by BOTH parties, who then sold us out. I was a member of GHC for 17 years. Awesome. And even has a local lower-cost competitor in Seattle. What's the problem? The political class. Both sides. Check the sorry details. The current co-ops are failing because they're not HMOs; they're co-op insurance companies. BIG difference, and I've lived it.
http://www.nytimes.com/2009/07/07/health/policy/07coop.html?_r=1
And plan that had lower costs than any government plan on earth, with more patient control and market competition than any private plan, was doomed by BOTH parties, who then sold us out. I was a member of GHC for 17 years. Awesome. And even has a local lower-cost competitor in Seattle. What's the problem? The political class. Both sides. Check the sorry details. The current co-ops are failing because they're not HMOs; they're co-op insurance companies. BIG difference, and I've lived it.
http://www.nytimes.com/2009/07/07/health/policy/07coop.html?_r=1
26
So let me get this straight. Obamacare was passed without a single republican vote. Costs are rising 20-45% a year. And it's the republicans fault? Hmmmm. Unions supported Obamacare but now want to keep their "Cadillac" plans tax-free. Our democratic leaders that voted Obamacare in have an entirely different healthcare plan. If you work for a company that provides healthcare, it is a tax free benefit. If you are self employed and have to buy your own healthcare, i.e. you utilize Obamacare, you see your costs rising annually, and the amount you pay is not tax free. Where's the equality in any of this? As usual, democrats want to take away from others but keep what they have for themselves. The Party of Me.
28
Btw, what is your plan?
30
It's well known that there was opposition to the plan. Why, then, was it designed to be so fragile?
11
It is always the republicans! We should just change their name to what they really are, The evil party.
They are against everything good and for everything bad.
To be a country means the same thing as being one huge family and NOT a cold, calculating business.
We are Americans, we should not be letting the the crazy uncles and the hateful, bullying cousins at the family reunion be running this family into the ground.
They are against everything good and for everything bad.
To be a country means the same thing as being one huge family and NOT a cold, calculating business.
We are Americans, we should not be letting the the crazy uncles and the hateful, bullying cousins at the family reunion be running this family into the ground.
37
Wow, I guess it would have been better had there been a public option that like Amtrack and Fannie Mae, have end endless supply of Federal dollars payed for with debt to cover up all that red ink.
10
We know full well that a G.O.P. president will strip away health cares from millions of Americans.
If we elected a G.O.P. president, people who lose their health insurance and who don't support a Democratic candidate have no one to blame but themselves.
If we elected a G.O.P. president, people who lose their health insurance and who don't support a Democratic candidate have no one to blame but themselves.
23
I still don't understand why this country feels the need to reinvent the wheel. Our healthcare system is completely broken from the standpoint of access, outcomes, and cost when compared to the rest of the civilized/industrialized world. Hell, using these metrics, Cuba has a better system than we do. The ACA is the same old, same old that the private healthcare insurance cartel knows very well how to exploit. Shame on the USA.
35
As usual, entitled America wants to have its cake and eat it, too. Can't do it. Universal health care is a desirable goal but not with a suffocating $18 trillion debt. Time to put first things first despite Paul Krugman's wrong-headed dismissal of the debt. Also, Medicare which is an entitlement is broke and soon so will Social Security which is not really an entitlement as we paid into it. Unfortunately, liberals and progressives can't help themselves when it comes to spending money we don't have.
8
Universal healthcare would actually be a less expensive system to run than the Frankenstein monster we currently have. Just ask Great Britain, Canada, France, Norway, Sweden, Germany, Austria, Australia, etc, etc. They all manage to do healthcare cheaper, way cheaper, than the US. We'd also have to adopt price controls on various aspects of the healthcare industry, including pharmaceuticals. People before profits.
American conservatives are shameful in their insistence that the US government put lower taxes above the lives of thousands of Americans who can't afford our very expensive healthcare. The GOP has no interest in helping Americans afford healthcare or even in controlling healthcare costs. What makes this particularly remarkable is that this is the party that is always touting their "Christian" values. There's nothing Christian about allowing thousands of your fellow countrymen to die so that your taxes don't have to go up. If it wasn't actually costing people their lives, it would be comically absurd.
American conservatives are shameful in their insistence that the US government put lower taxes above the lives of thousands of Americans who can't afford our very expensive healthcare. The GOP has no interest in helping Americans afford healthcare or even in controlling healthcare costs. What makes this particularly remarkable is that this is the party that is always touting their "Christian" values. There's nothing Christian about allowing thousands of your fellow countrymen to die so that your taxes don't have to go up. If it wasn't actually costing people their lives, it would be comically absurd.
52
Repubs almost do not have the right to lecture Americans about economic issues.
Fact: the Dems have rescued the economy from Repubs. Many times over. Fact.
Based on the records of both parties it is the Repubs who should shut up and listen to the Dems.
Fact: the Dems have rescued the economy from Repubs. Many times over. Fact.
Based on the records of both parties it is the Repubs who should shut up and listen to the Dems.
41
People without health care insurance will show up at Emergency Rooms. Who is going to pay for the health services needed by these people?
The American taxpayer, that's who.
People opposing Obamacare and the establishment of a one-payer national health care program are short sighted to say the least. Health care should be a service, not a business run for profit. Why can''t Americans understand this?
The Republican Party's answer to this problem seems to be "Dial-a-Prayer."
The American taxpayer, that's who.
People opposing Obamacare and the establishment of a one-payer national health care program are short sighted to say the least. Health care should be a service, not a business run for profit. Why can''t Americans understand this?
The Republican Party's answer to this problem seems to be "Dial-a-Prayer."
43
Translation for those new to the New York Times, "underfunded alternative" means inadequately subsidized.
The failure of the co-ops should be taken for what it is: proof that running a health insurance company isn't an essay test. It's a math test. It is hard to be simultaneously competitive and fiscally responsible. You can be really competitive on pricing and go broke. You can be too cautious and go broke.
Single payer would have been easier alright. Just put the IV into the taxpayers' veins and draw the subsidies.
The failure of the co-ops should be taken for what it is: proof that running a health insurance company isn't an essay test. It's a math test. It is hard to be simultaneously competitive and fiscally responsible. You can be really competitive on pricing and go broke. You can be too cautious and go broke.
Single payer would have been easier alright. Just put the IV into the taxpayers' veins and draw the subsidies.
10
The real wording is "buttress the alternatives". Classically when a liberal boondoggle doesn't work then the left will finance it and the taxpayers who never wanted it have to pay.
Democracy only works for the left, not the large moderate "MAJORITY"!
Democracy only works for the left, not the large moderate "MAJORITY"!
8
Still, in election after election Republicans are returned to office. Gerrymandering and voter suppression may be factors, but they pale in comparison to the number of people who claim to want a fairer healthcare system and yet can't be bothered to vote.
39
How many rocket scientists does it take to figure out that FOR-PROFIT insurance companies drive up the cost of health care for the consumer while simultaneously putting the screws to the health care providers?
Perhaps if insurance companies were legally required to have the phrase "For Profit" be the first two words their names, consumers might begin to understand that, above all else, the executive suite takes its cut, then the shareholders pockets are padded, the utilities and the taxes are paid and, finally, after the ocean of money paid in premiums has been reduced to a puddle, providers are told, "This is what will be paid. Take it or leave it."
Perhaps if insurance companies were legally required to have the phrase "For Profit" be the first two words their names, consumers might begin to understand that, above all else, the executive suite takes its cut, then the shareholders pockets are padded, the utilities and the taxes are paid and, finally, after the ocean of money paid in premiums has been reduced to a puddle, providers are told, "This is what will be paid. Take it or leave it."
60
Another decades-old consumer cooperative, Group Health Cooperative of South Central Wisconsin, is the highest rated health plan in the state. Plans like this one and the one in Seattle offer the best combination of great primary care, multi-specialty group practice, and a not-for-profit philosophy of putting patients--not shareholders or health care providers--first.
16
Since the US is well behind most other countries in a number of serious healthcare statistics, can we figure out how to hold liable those who continue to create this grand shortage?
Its about accountability for the American economy.
Its about accountability for the American economy.
9
Ours is closing and I'm sad. They were great. Always helpful and reliable.
5
You can have a pretty thriving business selling dollar bills for $.85 -- but only for a short while.
7
Right. And now 83,000 people in Colorado will have to look for other coverage, thanks to Congress refusing to fulfill its commitment--to the tune of $14.2 million short in reimbursement. Disgraceful.
17
Obamacare was a compromise, but Big Pharma, Big Hospital and Big Insurance lobbyists killed the public option - and sowed the seeds of failure into the alternative of non-profit cooperatives.
The public option (better yet, single payer) would have put a ceiling on the profit driven fee-market fee-for-service/drug reimbursement scheme. Who wins? Stockholders, of course. Another way to maintain a system rigged to favor the "haves." And the "Bigs" pretend to protect our collective health - yeah, right. What they protect are their stock prices and their clever executives' bonuses, so the latter can continue to fund the re-election of the politicians who serve their lobbyists.
Somewhere, a sick and worried patient sighs and wonders how s/he will pay these bills and that insurance premium.
The public option (better yet, single payer) would have put a ceiling on the profit driven fee-market fee-for-service/drug reimbursement scheme. Who wins? Stockholders, of course. Another way to maintain a system rigged to favor the "haves." And the "Bigs" pretend to protect our collective health - yeah, right. What they protect are their stock prices and their clever executives' bonuses, so the latter can continue to fund the re-election of the politicians who serve their lobbyists.
Somewhere, a sick and worried patient sighs and wonders how s/he will pay these bills and that insurance premium.
27
This is what a free enterprise system would give you, some new businesses are bound to fail. So if you lost a few others would pick up the slack/customers.
The whole premise of this op-ed is flawed. It is taking the insurance business as fait-accompli. ACA is the first step heading towards a single payer system, as we move forward we keep tweaking the system to keep improving it. The Republicans are not playing ball; we know that, the States which are run by Republicans such as Texas are running the system to ground and they are intent to hurt their population just to make President Obama look bad. Most people would not say it but I believe that their opposition to any proposal by President Obama is subconsciously the opposition is due to President Obama’s Race.
Delivery of healthcare should be just that Delivery of healthcare. Any step that do not add value to the process must be eliminated. The whole Insurance cartel that is in the center of this delivery mechanism between the Provider (Physicians, Hospitals, and Drug companies) and the Patient. Their presence does not add any value to healthcare and health outcomes for the patient. Eliminating them would ensure the reduction of pricing from the Providers as their work would be reduced.
With EMR all the billing is automated now. and the funds could be electronically transferred from the treasury to the provider. We use the ETF for paying our taxes now, it is not rocket science. Just do it.
The whole premise of this op-ed is flawed. It is taking the insurance business as fait-accompli. ACA is the first step heading towards a single payer system, as we move forward we keep tweaking the system to keep improving it. The Republicans are not playing ball; we know that, the States which are run by Republicans such as Texas are running the system to ground and they are intent to hurt their population just to make President Obama look bad. Most people would not say it but I believe that their opposition to any proposal by President Obama is subconsciously the opposition is due to President Obama’s Race.
Delivery of healthcare should be just that Delivery of healthcare. Any step that do not add value to the process must be eliminated. The whole Insurance cartel that is in the center of this delivery mechanism between the Provider (Physicians, Hospitals, and Drug companies) and the Patient. Their presence does not add any value to healthcare and health outcomes for the patient. Eliminating them would ensure the reduction of pricing from the Providers as their work would be reduced.
With EMR all the billing is automated now. and the funds could be electronically transferred from the treasury to the provider. We use the ETF for paying our taxes now, it is not rocket science. Just do it.
21
The national conversation on Obamacare continues to leave me gobsmacked and dismayed.
Six years and 408 comments later, we are still avoiding the conversation that has to happen before ANYTHING changes.
Obamacare, the Affordable Healthcare Act is not what it was sold to the American people as being, and Barack Obama lied the ACA into law.
Obamacare is a federal bureaucracy that gives insurance companies federal tax dollars to "subsidize" insurance (Medicare expansion, high risk pools for the uninsured and catastrophic illnesses that used to get patients dropped from their plan) that subsists by graft--young people like me who rarely visit the doctor or have health issues are paying anywhere from twice to three times as much for insurance plans that cover less and that have sky high deductibles. Seniors on fixed incomes are facing Medicare premium increases to offset the hideously low, fabricated Obamacare enrollment numbers, and once the employer mandate is fully implemented, and big employers stop insuring their employees, the money to keep the Obamacare bureaucracy going and freebies flowing to the older, sicker Americans, our insurance premiums are going to skyrocket.
Why? Because the insurance companies are using Obamacare as a revenue and profit stream. Not one word of the ACA holds insurance companies responsible for price gouging or regulates cost. Period.
Yet all we get is GOP bashing and no solutions.
Six years and 408 comments later, we are still avoiding the conversation that has to happen before ANYTHING changes.
Obamacare, the Affordable Healthcare Act is not what it was sold to the American people as being, and Barack Obama lied the ACA into law.
Obamacare is a federal bureaucracy that gives insurance companies federal tax dollars to "subsidize" insurance (Medicare expansion, high risk pools for the uninsured and catastrophic illnesses that used to get patients dropped from their plan) that subsists by graft--young people like me who rarely visit the doctor or have health issues are paying anywhere from twice to three times as much for insurance plans that cover less and that have sky high deductibles. Seniors on fixed incomes are facing Medicare premium increases to offset the hideously low, fabricated Obamacare enrollment numbers, and once the employer mandate is fully implemented, and big employers stop insuring their employees, the money to keep the Obamacare bureaucracy going and freebies flowing to the older, sicker Americans, our insurance premiums are going to skyrocket.
Why? Because the insurance companies are using Obamacare as a revenue and profit stream. Not one word of the ACA holds insurance companies responsible for price gouging or regulates cost. Period.
Yet all we get is GOP bashing and no solutions.
14
Why? Because democrats believed they'd buy decades of allegiance (votes).
4
Alas, the GOP rules out the single-payer solution that has been proven to work in most of the countries that implement it.
16
Whatever! You come up with a solid solution and we'll give you the time of the day. In the meanwhile GOPers have come up with nothing, obstruct everything and in the process are responsible for the lives lost from lack of healthcare.
Is the fact that GOPers' obstruction killed thousands of people who have not received healthcare alright with you?
Is the fact that GOPers' obstruction killed thousands of people who have not received healthcare alright with you?
18
The emphasis on profit in healthcare is leading to more and more troubles. And it will only get worse unless, in some way, the vision of healthcare in this country changes from how much can I profit from being a healthcare company to -- every citizen is entitled to receive truly affordable healthcare and particularly preventative healthcare. Think how much productivity and quality of life is lost through the amount of resources (including time and energy) used to worry about some aspect of healthcare including affordability, access to appropriate health professionals, reading through or keeping up with changes in chosen health insurance etc. etc. And this is for the healthy, the ill spend even more. Think of what could happen if all that time and energy could instead be used for positive pursuits. Ah, for a majority of elected representatives, senators and other national leaders who are not in cohoots with the healthcare money makers.
6
The co-op model has had long-term success in many rural areas to prepare crops for transport, to bring groceries and goods to small towns and in other sectors where a for-profit model is unlikely because of too few customers or too many high costs.
Unfortunately the whole non-profit health care model was contaminated by the use of for-profit management companies which paid outrageous salaries to executives and could pay share-holders outrageous returns from what was turned into a monopoly often financed by out-of-state taxpayers. The actual health care entity was indeed non-profit, but the out-sourced management was not.
It is too bad that so many decision makers live in urban bubbles of wealth and easy access to resources of all kinds. The House districts were intended to provide intimate representation, however the 25, 30 or even 42 year incumbent who lives in DC negates that opportunity to understand the needs of a home district by living closely with the people one is elected to represent.
And thus we have a well-intentioned ACA which removed pre-existing conditions, life-time caps and other barriers to access through health insurance. The remaining barriers which a public option would have challenged were simply lobbied away by those whose loyalties did not lie with the people they should have represented.
US health care can be fixed, but only by the courageous.
Unfortunately the whole non-profit health care model was contaminated by the use of for-profit management companies which paid outrageous salaries to executives and could pay share-holders outrageous returns from what was turned into a monopoly often financed by out-of-state taxpayers. The actual health care entity was indeed non-profit, but the out-sourced management was not.
It is too bad that so many decision makers live in urban bubbles of wealth and easy access to resources of all kinds. The House districts were intended to provide intimate representation, however the 25, 30 or even 42 year incumbent who lives in DC negates that opportunity to understand the needs of a home district by living closely with the people one is elected to represent.
And thus we have a well-intentioned ACA which removed pre-existing conditions, life-time caps and other barriers to access through health insurance. The remaining barriers which a public option would have challenged were simply lobbied away by those whose loyalties did not lie with the people they should have represented.
US health care can be fixed, but only by the courageous.
13
It was the worst mistake in the world to allow the medical profession to be overtaken by purely business interests.
That's what happens when "insurance" takes over respected professions.
That's what happens when "insurance" takes over respected professions.
19
According to the AP:
"As recently as the spring, the White House touted co-ops as an accomplishment. 'In states throughout the country, co-ops have competed effectively with established issuers and attracted significant enrollment,' said a report by the president's Domestic Policy Council on the fifth anniversary of the health law."
The article goes on to report on the IG's findings -- in other words, the truth versus the White House's spin.
******
* "Health law's nonprofit insurance co-ops awash in red ink",
http://bigstory.ap.org/article/f8832d33b334432d8b1742b1093eea8e/apnewsbr...
"As recently as the spring, the White House touted co-ops as an accomplishment. 'In states throughout the country, co-ops have competed effectively with established issuers and attracted significant enrollment,' said a report by the president's Domestic Policy Council on the fifth anniversary of the health law."
The article goes on to report on the IG's findings -- in other words, the truth versus the White House's spin.
******
* "Health law's nonprofit insurance co-ops awash in red ink",
http://bigstory.ap.org/article/f8832d33b334432d8b1742b1093eea8e/apnewsbr...
9
Public option was not really a developed product. There was all kinds of things that might not have gone as this editorial supposes. Was it to have been a public option or a public option for each exchange? On what basis can it be assumed that such a provider would have gotten more favorable provider contracts than the already established players? Would the law have required the internal costs to have been rigorously determined and segregated from other state activities...i.e. the public option needed to fund its employees health care, pensions, lease at fair market value the needed office space, create marketing from scratch out of its funds, IT, legal, HR. For the Times to assert that such an option(s) would have had lower premiums is wildly speculative.
1
Medicare for all is what most supporters had in mind, including allowing Medicare to bargain drug prices. Other than that, a national public option. You've brought up some problems with local public options, since they are non profit they gain from eliminating the "takeout", which averages 21% for insurance companies, but the start up expense is big and they need volume.
3
The problem with medical care in this country is the for profit insurance companies and the hedge fund pharmaceutical industry. I would happily pay higher taxes if it meant access to quality healthcare for next to nothing. And what is happening in the drug industry comes straight from Scroug's handbook. A 500% increase in the cost of some drugs should be illegal. The insurance companies are simply the middle man for doctor's and patients. They pocket money that should be going to patients and health care providers. I am truly disappointed in this country's approach to healthcare.
20
Should have had the Public Option. Now we need Single Payer, Medicare for all, and a pox on insurance companies. Bernie Sanders is the only one offering this approach to health care. Let's vote for him or die of something curable because of a lack of money.
21
Who decides who get what in the way of medical care? Who determines where care will be given? Who determines what doctors should maker? Who determines what kind of medical specialties will be permitted? Who determines where doctors will be allowed to practice? Who determines what care will be available to the elderly? IOW, who makes the decisions. my guess given the way libs love government laws, control, restrictions, regulations, control, bureaucracy, and bureaucrats, government bean counters.
2
Instead of insurance-company bean-counters? Those companies have at least as many and as much "restrictions, regulations, control, bureaucracy, and bureaucrats" as a governmental insurer -- and add hugely to the cost of the system compared to Medicare. I'll take the ones answerable to the public over the ones motivated by bonuses for "controlling costs" (denying treatment).
Insurance bean counters decide. Who are they accountable to? Shareholders, not their clients. They'd drop anyone who gets hurt or sick in a heartbeat absent Obomacare.
4
Another example of a broken health care system in this country. It defies understanding why my insurance company paid $900 for my daughters routine check up so she could play sports where in Canada that would have been a $35 doctors fee to insurance and maybe a private charge of around $100 for paperwork. Same goes for generic essential prescriptions such as a beta agonist asthma inhalers that are several fold more expensive here. Of course, in our favor, for the better half (or at least top 1%), medical care is some of the best in the world in the U.S.. It just does not make sense that the U.S. system with mainly private insurance should cost society so much more to benefit so few. Co-op or public insurance should be encouraged to streamline administration and forego profit to make our system cheaper. Yes we provide a large amount of R and D for the world but the cost seems way more than what we are paying for as a society.
8
It is way past time to get rid of the private medical insurance model. They are useless middle men who do nothing to enhance healthcare. They siphon off money for profit that could be used for medical care.
These medical insurance companies are NEVER exposed to risk that, for example, property insurers have to face. Healthcare insurance companies enjoy record high profits. As of late ACA has boosted their profits too. Billions can be saved.
We don't need them. I don't believe that anyone can come up with a good reason to keep them.
These medical insurance companies are NEVER exposed to risk that, for example, property insurers have to face. Healthcare insurance companies enjoy record high profits. As of late ACA has boosted their profits too. Billions can be saved.
We don't need them. I don't believe that anyone can come up with a good reason to keep them.
7
As with so many things the Republicans can't bare to acknowledge that government benefits for example Social Security, Medicare and even ACA are very popular with the public. If they are not careful the Republicans will create a single payer system without meaning to.
7
" If they are not careful the Republicans will create a single payer system without meaning to."
--From your mouth to God's ear.
--From your mouth to God's ear.
1
of course they are popular with the public. So would be giving 90% of your income to the 9)% who earn less than you... but does that make it right??????
"Such a plan would not have to generate profits and would have stronger bargaining powers to obtain discounts from health care providers.." In other words, stiff the health care providers. That's happening already and you can see the level of health care that has resulted.
Here's the truth: Americans never asked for affordable health insurance. We asked for affordable health care. The NYT opinion writers think government belongs in the insurance business. A business that exists not to heal but to make a profit.
I suggest that we'd be better served if our government got out of the health insurance business and instead invested our tax dollars more heavily in the health care business. Maybe build some government urgent care clinics funded by the military. I would prefer our government offer me affordable healthcare, even if it's not the same level of care the rich folks get.
Here's the truth: Americans never asked for affordable health insurance. We asked for affordable health care. The NYT opinion writers think government belongs in the insurance business. A business that exists not to heal but to make a profit.
I suggest that we'd be better served if our government got out of the health insurance business and instead invested our tax dollars more heavily in the health care business. Maybe build some government urgent care clinics funded by the military. I would prefer our government offer me affordable healthcare, even if it's not the same level of care the rich folks get.
8
Interesting details left out, perhaps to make this a political hit piece -
the CO-OP's premiums were not priced properly,
they were underpriced for the demand and expected services,
this was known in 2013 when pricing was submitted,
the pricing was set in part by the state departments of insurance,
the adjustments were not made to 2015 rates in 2014 enrollment year,
the redistribution of premiums/profits that was to be managed by CMS has also failed,
perhaps because the profits were not there to be redistributed,
and many existing insurers are showing margins not acceptable to existing laws governing the operational reserves
a bit of honesty in the beginning could have eliminated a lot of this mess
the CO-OP's premiums were not priced properly,
they were underpriced for the demand and expected services,
this was known in 2013 when pricing was submitted,
the pricing was set in part by the state departments of insurance,
the adjustments were not made to 2015 rates in 2014 enrollment year,
the redistribution of premiums/profits that was to be managed by CMS has also failed,
perhaps because the profits were not there to be redistributed,
and many existing insurers are showing margins not acceptable to existing laws governing the operational reserves
a bit of honesty in the beginning could have eliminated a lot of this mess
6
John, are you sure you read the article? All of your "details left out" were mentioned in the report.
Health Care needed/needs to change. Why are we still dancing around the issue?!?
People are dying needlessly. People are losing their houses and going bankrupt.
People get sicker because they cant afford basic care.
Single payer works in every other 1st and 2nd world country. Why is America so exceptional that we cant have health care for ALL!?
Why must we pay the most expensive care in the world and get the worst outcomes? Only the rich deserve Health Care? That is not American.
That is a Capitalistic Death Care Plan. Hurry up and die!
Republicans have no replacement plan.
Go broke or die!
That is not American!
People are dying needlessly. People are losing their houses and going bankrupt.
People get sicker because they cant afford basic care.
Single payer works in every other 1st and 2nd world country. Why is America so exceptional that we cant have health care for ALL!?
Why must we pay the most expensive care in the world and get the worst outcomes? Only the rich deserve Health Care? That is not American.
That is a Capitalistic Death Care Plan. Hurry up and die!
Republicans have no replacement plan.
Go broke or die!
That is not American!
17
How does single-payer solve anything? OK, you save administrative costs, but that barely makes a dent. What we have is a population that wants everything. Are you ready to be told that your mother cannot have treatment beyond palliation for her terminal cancer?
Republicans exist to serve the rich. It's pretty obviousthat they believe that money is only meant for rich people.
Let's face it, they are not interested in working for the country or "We the People" - only the richest of the rich. They see healthcare for all Anericans as mooching and stealing money that belongs to the rich.
Let's face it, they are not interested in working for the country or "We the People" - only the richest of the rich. They see healthcare for all Anericans as mooching and stealing money that belongs to the rich.
22
The rapidly aging population means increased demand for health care services. There is no way to produce sufficiently trained doctors and nurses fast enough to keep up with the profound shift in demographics. Single-payer, private insurance or any combination is irrelevant. Health care rationing will occur as a matter of official policy or de facto standard operating procedure. The news today about revised mammogram guidelines is an example of the incremental shift toward rationing and resource management.
5
Absolutely correct. Until limits are put on care, costs will be staggering, regardless of who pays and how much they pay. Unfortunately, the American public is not ready to be told "No- you cannot have that." End of life expenditures, elective surgeries so that one can play golf, all of this needs to be given up to provide affordable basic care for all.
1
"Health care rationing will occur." ? Sorry to intrude on fantasy with reality, but health care rationing has always existed. And it appears that any attempt to "ration" health care by using objective measurements of outcomes will be blocked by those who insist on using wealth to determine who gets care.
8
The mammogram recommendations by the American Cancer Society were made to improve health care screening for women at risk for breast cancer. It is only your opinion this was done to ration healthcare. It is only in your reasoning that these decisions are always accompanied by a decision to ration healthcare.
It is only your opinion, which I find completely cynical and wrong.
It is only your opinion, which I find completely cynical and wrong.
4
It’s the Republican’s fault that the super majority of Democrats who passed Obamacare didn’t include a public option. Who cares that not a single Republican voted for it or had any legislative input, it’s still their fault! Now keep repeating this so others will believe it!
26
Of course it's the Republican's fault there was no public option included. They are the ones who were going to filibuster until it was removed. How is it possible to view that any other way?
And I'm pretty sure the Republicans were offered the opportunity to provide legislative input. They just rejected it. Conservatives conveniently forget that Mr. Obama was constantly criticized by the left for being too accommodating and trying too hard to compromise with Republican's during his first term.
And I'm pretty sure the Republicans were offered the opportunity to provide legislative input. They just rejected it. Conservatives conveniently forget that Mr. Obama was constantly criticized by the left for being too accommodating and trying too hard to compromise with Republican's during his first term.
6
Democrats had a super majority in Congress as you say, and used that super majority to pass the largest new entitlement ever enacted without bi-partisan support yet failed to be able to rally their own caucus to include a public option and it's the Republicans' fault?! Interesting...
4
Wow. In the space of one sentence you boast that not a single Republican voted for health care reform and also imply that the lack of adequate reform is not their fault. Are you suggesting that if only there had been a public option, the Republicans would have voted FOR it? Incredible!
12
Why can't the NYTimes and readers admit that the ACA needs a lot of re-work. Too much time has passed and too many changes have been made to our healthcare system (lots and lots of money spent on those changes too) to throw the whole thing out. But modifications are necessary and have been since day 1.
The purchasing of private physicians by hospitals is a nightmare for patients. Hospitals charge more than doctors did, by a significant amount. I pay over twice what I did before the ACA for a visit because a large company owns my doctor. The doctors say they don't have much choice, as the bureaucracy resulting from the ACA would require 2 FTEs just to cope. Nurses spend more time on paper work than they do in front of patients. And we all pay monthly premiums and an out of pocket amount that is obscene.
So costs have gone up, care has gone down, and the government continues to tout the success of this monster?! Give it up. Take the 2000 page law and make it 500 pages, limit HHS and CMS as to their bureaucracy. Eliminate the 'new' businesses hired by HHS to deny payment, and get a cut of the action. For 200 million Americans to suffer so that 9 million can get subsidies to insurance (which most can't afford to use) is nonsense.
The purchasing of private physicians by hospitals is a nightmare for patients. Hospitals charge more than doctors did, by a significant amount. I pay over twice what I did before the ACA for a visit because a large company owns my doctor. The doctors say they don't have much choice, as the bureaucracy resulting from the ACA would require 2 FTEs just to cope. Nurses spend more time on paper work than they do in front of patients. And we all pay monthly premiums and an out of pocket amount that is obscene.
So costs have gone up, care has gone down, and the government continues to tout the success of this monster?! Give it up. Take the 2000 page law and make it 500 pages, limit HHS and CMS as to their bureaucracy. Eliminate the 'new' businesses hired by HHS to deny payment, and get a cut of the action. For 200 million Americans to suffer so that 9 million can get subsidies to insurance (which most can't afford to use) is nonsense.
17
These insurance companies will wind up slitting their own throats.
Americans will realize that we do not need the insurance companies. We do not need the private insurance companies to just play middle man.
A middle man? To do what? Parcel out healthcare to maximize their profits? Pay outrageous salaries to the executives? Act as a toll keeper to decide who passes and who doesn't?
Travel agents are disappearing. Uber tossed out the taxi monopoly model.
The private insurance middle man model can be tossed out in an instant and we would not suffer from the change one bit.
We must rethink why we tolerate the insurance companies. There is no viable or urgent reason why insurance companies exist at all. In this way we can kill off a dinosaur, the private medical insurance companies. Because we do not need them
and we would be a lot better off without them.
Americans will realize that we do not need the insurance companies. We do not need the private insurance companies to just play middle man.
A middle man? To do what? Parcel out healthcare to maximize their profits? Pay outrageous salaries to the executives? Act as a toll keeper to decide who passes and who doesn't?
Travel agents are disappearing. Uber tossed out the taxi monopoly model.
The private insurance middle man model can be tossed out in an instant and we would not suffer from the change one bit.
We must rethink why we tolerate the insurance companies. There is no viable or urgent reason why insurance companies exist at all. In this way we can kill off a dinosaur, the private medical insurance companies. Because we do not need them
and we would be a lot better off without them.
12
If you are looking to eliminate things, start with private, for profit health insurance. They manage quite well without it in truly civilized societies.
10
Please explain to us how corporatization relates to the ACA. Doctors have been incorporating for years, and the increase in costs prompted the ACA in the first place. Retail stores have become franchises, which have become chains, siphoning off more layers of profits while paying the workers less. Private prisons and charter schools add corporate profits to costs while paying workers less and providing inferior services. How does it follow that the ACA caused costs to increase?
3
Those who would beat their chests that this is the 'greatest country in the world' seem completely out of touch with the fact that this country fails to provide an opportunity for its citizens to live a decent life. Access to healthcare is fundamental, for years insurance companies collected premiums and then denied compensation to those same policyholders citing 'pre-existing condition'.
What do we as a country have to show for it?
Bankruptcy for any person who has saved their own money and finds themselves in the unfortunate position of having a health crisis.
CEOs with ridiculous salaries (http://www.forbes.com/lists/2006/12/Health_care_equipment_services_Rank_...
People priced out of the market by political pettiness
And a nation that is being 'Wal-martized' into peasants
Wake up Americans!!!
What do we as a country have to show for it?
Bankruptcy for any person who has saved their own money and finds themselves in the unfortunate position of having a health crisis.
CEOs with ridiculous salaries (http://www.forbes.com/lists/2006/12/Health_care_equipment_services_Rank_...
People priced out of the market by political pettiness
And a nation that is being 'Wal-martized' into peasants
Wake up Americans!!!
41
"fails to provide an opportunity for its citizens to live a decent life?" I am not sure where you live. The possibilities are endless for anyone who wants to work... perhaps not in their generation, but in those that follow. Look at history. Those who are stuck are either here illegally, or who have made some very bad choices. The liberals seem to have abandoned the idea of individual responsibility. Give a man a fish, he eats one meal. Give him no choice but to learn to fish, and great things will happen. THAT is how the government needs to provide opportunity. Handouts have destroyed the country. All of the city riots and violence, the explosion of out of wedlock births, all happened after the Great Society.
1
What a simplistic response. I am so sick of the fish story. I truly believe people want to work but jobs are being outsourced. NAFTA and the TPP are antiAmerican. Both under Democrats. How disheartening.
All this article does is make a case for Medicare for all. Medicare is "non-profit" and its operating costs are lower than any for-profit plan. This is the real public option that should have always been the goal.
27
unless you count that
Medicare costs 12,000 per person per year
Medicare and CMS wages, benefits and retirement are off the Medicare and HHS books (see OPM budget)
Operational costs are off the books (see GSA budget)
Part B 20% copays, deductibles, and drugs are off the books - paid for by the person
So a medical stay of 130,000 ends up with a 26,000 copay on original Medicare only
who can afford that?
Medicare costs 12,000 per person per year
Medicare and CMS wages, benefits and retirement are off the Medicare and HHS books (see OPM budget)
Operational costs are off the books (see GSA budget)
Part B 20% copays, deductibles, and drugs are off the books - paid for by the person
So a medical stay of 130,000 ends up with a 26,000 copay on original Medicare only
who can afford that?
2
The one inescapable fact that we need in order to understand why this country "can't afford" universal health care: our obscene level of military (war) spending is nearly as great as the rest of the world combined.
16
Was this reprinted from The Onion news? The Government doesn't run anything efficiently. The suggestion that a Government run Co-op would have done a better job is comical. The Times did cover the Health Care roll out right?
6
Please give us just one example of something the government runs less efficiently than the private sector.
You can keep repeating the lie that government is inefficient in practice, but until you come up with evidence, it is still a lie.
You can keep repeating the lie that government is inefficient in practice, but until you come up with evidence, it is still a lie.
1
Are you old enough to be on Medicare. If not, when you are you will find a well run Government agency that gives the lie to your statement! Medicare is less expensive than private health insurance and has better outcomes.
1
When my 15 year-old son developed Type I diabetes, I also acquired a 20-30 hour per week second job: keeping after BC /BS, who for 5 years processed incorrectly 90% of the very straightforward claims we submitted for his day to day care. The overwhelming percentage of the errors were in favor of BC and BS, but I also corrected the faulty corrections in our favor. I'm a smart guy, and my wife is a medical professional. Most people would have given up, and their children's health would have suffered, and the long term costs of my son's care would have increased dramatically.
Don't tell me about the efficiency of private insurance.
Don't tell me about the efficiency of private insurance.
4
Al insurance is about risk. That's it. That's the whole business model. The simple answer was/is and always will be to create a high-risk pool for people with pre-existing conditions and those who need the most medical services. A small sliver of the population needs the overwhelming majority of the services and cost the most. To demand that the low-risk patients underwrite that expense is insane. They will — and have — balked at it. A high-risk pool with the reserves to fund to creates a separate entity that can handle that population just like a high-risk pool in the auto insurance business works. Sure, the premiums will be higher, but not as much that it can't be funded.
It also avoids the "death spiral" that Obamacare will undergo durnig the next two years.
It also avoids the "death spiral" that Obamacare will undergo durnig the next two years.
3
Healthcare is a right. It should not be lumped into the same category as car insurance. Plenty people do just fine without owning a car. No person can go through life without healthcare.
This entire mindset has to be changed, and will be changed. If we are to move into a more humane, intelligent way to take of the vital need to us all, healthcare.
Healthcare is a right, not a business model.
This entire mindset has to be changed, and will be changed. If we are to move into a more humane, intelligent way to take of the vital need to us all, healthcare.
Healthcare is a right, not a business model.
7
and 35 states did have thoes pools in place, and they were working!!!
1
We've already skimmed off a large percentage of the most at-risk population from the medical insurance pool, the elderly, and we spend less to take care of them than it costs for people approaching Medicare age, and thus are healthier, to buy private insurance. The rest of us already don't have to pay for most of the high risk individuals, and yet the private insurance companies still have found a way for us to pay for their $zillions in profits.
On the Senate side, from June to September, the Senate Finance Committee held a series of 31 meetings to develop a healthcare reform bill. This group — in particular, Democrats Max Baucus, Jeff Bingaman, and Kent Conrad, and Republicans Mike Enzi, Chuck Grassley, and Olympia Snowe — met for more than 60 hours, and the principles that they discussed, in conjunction with the other committees, became the foundation of the Senate's healthcare reform bill.
The above are the people responsible for killing the Public Option. Max Bauccus is appropriately at the head of the list of corporatist Democrats that also killed any chance of reasonable drug price controls and may be at least partially responsible for the underfunding of these programs.
The real issue here is why the non prophet health plans were not better publicized. It is impossible to join one if you do not know it exist. I believe this is the first time I'v read about them as their death is announced. It seems a lot of critical information is missing from this article as has been the case since the ACA came into existence.
The above are the people responsible for killing the Public Option. Max Bauccus is appropriately at the head of the list of corporatist Democrats that also killed any chance of reasonable drug price controls and may be at least partially responsible for the underfunding of these programs.
The real issue here is why the non prophet health plans were not better publicized. It is impossible to join one if you do not know it exist. I believe this is the first time I'v read about them as their death is announced. It seems a lot of critical information is missing from this article as has been the case since the ACA came into existence.
7
The reason why healthcare is so much cheaper in Europe (about half that of the per capita cost in the US) is that fees paid to doctors and prices to pharmaceutical companies are negotiated by one single entity - the National Health Service.
In the US, imagine the price-breaks that the Department of Health could get if it were negotiating on behalf of 315 million Americans. And since there is no cap on either prices or costs, they are astronomic in all senses of the word.
The US has the highest per capita healthcare cost of any developed nation on earth, and for what? A life-span that is 3-years less than that of, say, the European Union.
Hey, guys 'n gals, for the money you pay, you are really getting ripped-off ... !
In the US, imagine the price-breaks that the Department of Health could get if it were negotiating on behalf of 315 million Americans. And since there is no cap on either prices or costs, they are astronomic in all senses of the word.
The US has the highest per capita healthcare cost of any developed nation on earth, and for what? A life-span that is 3-years less than that of, say, the European Union.
Hey, guys 'n gals, for the money you pay, you are really getting ripped-off ... !
32
And the National Health Service does limit access to medication and care. This is easy to research - as the U K papaers publish it regularly
1
Consider this.
Medicare spends about $11,000 on medical care for the oldest and sickest among us. I'm healthy, in my 50s, and my medical insurance premiums top $12,000. We already have an efficient system, but we restrict it to a small portion of the population.
Medicare spends about $11,000 on medical care for the oldest and sickest among us. I'm healthy, in my 50s, and my medical insurance premiums top $12,000. We already have an efficient system, but we restrict it to a small portion of the population.
That's called "monopsony". It's the opposite of monopoly. The problem with a "monopsony", especially one that is politically motivated, is that in its zeal to hold down costs, it is capable of destroying its supplier base.
1
Liberals think that business is easy and automatically generates profits by the grace of the government. But business, especially the insurance business, is hard, and many of what the author of this article calls “entrenched insurance companies with deep pockets” lose money at it. The elimination of “automatic profit” by coops does not mean that success is guaranteed. The odds of success are even lower when the non-profit organizations are staffed by people who have no business sense or experience and who do not believe in self-sustaining business operations.
On the political side, the problem was not that Republicans “blocked” essential pieces of a successful reform program. It was that Democrats did not work with Republicans at all. And after the election of Scott Brown, the Democrats’ go-it-alone strategy required passing a half-baked version of the law that no one in either party wanted to be the final product.
On the political side, the problem was not that Republicans “blocked” essential pieces of a successful reform program. It was that Democrats did not work with Republicans at all. And after the election of Scott Brown, the Democrats’ go-it-alone strategy required passing a half-baked version of the law that no one in either party wanted to be the final product.
8
Meanwhile, Conservatives except for their 41 failed attempts at repealing ACA, still can't come up with a sound and workable alternative.
10
Then please tell us; what was the version of the law that the GOP supported, since it is pretty well documented that what we got was straight out of the GOP think tank.
Your final statement is then really at best a 'half-truth', or at worst a flat out lie, since there really is no GOP version of the law. Their only interest then and now is in defeating it, validated by the 50 odd votes to repeal it.
Your final statement is then really at best a 'half-truth', or at worst a flat out lie, since there really is no GOP version of the law. Their only interest then and now is in defeating it, validated by the 50 odd votes to repeal it.
6
The largest health insurers have seen their profits rise since the ACA went into effect:
"But there's one big industry group that owes a huge debt of gratitude to President Obama: health insurers. UnitedHealth (UNH) reported earnings that topped forecasts Wednesday morning and its stock rose 3% to a new all-time high as a result.
The other four members of the so-called Big Five health insurers -- Aetna (AET), Cigna (CI), Humana (HUM), and Anthem (ANTM) (formerly WellPoint) -- have all beaten the S&P 500 over the past five years or so as well.
Shares of the big hospital owners have done extremely well lately too. HCA (HCA), Universal Health Services (UHS) and Community Health Systems (CYH) all had banner years in 2014."
http://money.cnn.com/2015/01/21/investing/unitedhealth-earnings-obamacare/
So which insurers are losing money? Rather than generalities, how about naming names?
"But there's one big industry group that owes a huge debt of gratitude to President Obama: health insurers. UnitedHealth (UNH) reported earnings that topped forecasts Wednesday morning and its stock rose 3% to a new all-time high as a result.
The other four members of the so-called Big Five health insurers -- Aetna (AET), Cigna (CI), Humana (HUM), and Anthem (ANTM) (formerly WellPoint) -- have all beaten the S&P 500 over the past five years or so as well.
Shares of the big hospital owners have done extremely well lately too. HCA (HCA), Universal Health Services (UHS) and Community Health Systems (CYH) all had banner years in 2014."
http://money.cnn.com/2015/01/21/investing/unitedhealth-earnings-obamacare/
So which insurers are losing money? Rather than generalities, how about naming names?
2
A new approach to health care is needed, but ACA was not one one the American people needed or wanted. still it was passed by hook and crook. Now the ill conceived program is coming apart. It hardly is accurate to blame republicans for the mess others created. If it is the position of the paper that republicans are to blame, the paper loses credibility and the high ground. Why not advocate for reform that is actually what the American people want?
6
The Republican party has repeatedly stated their desire to 'repeal and replace' the ACA, and we're still waiting to see how they will replace the plan the Heritage Institute (a very conservative think tank) will be replaced.
As to what the American People wanted, if one looks at the polls you will see that the main reason the ACA doesn't get the broadest public support is that it doesn't include a 'public option'.
Fox news does not speak for the majority.
As to what the American People wanted, if one looks at the polls you will see that the main reason the ACA doesn't get the broadest public support is that it doesn't include a 'public option'.
Fox news does not speak for the majority.
5
Actually, it is a good plan. Fox News and Hate Radio soured the people on it with their misinformation and lies. Remember Death Panels..??
6
The US supposedly wants internal Balkanization to create 50 different universes of insurance companies and networks, all in the name of providing "choice", even though that is anathema when it comes to procreation.
1
What did republicans do to themselves? How did so many, supposedly religious, people manage to grow up so freaking mean spirited, small minded, and in cases flat out stupid?
26
you answered your own question, larry
6
the CO-OP's premiums were not priced properly,
they were underpriced for the demand and expected services,
this was known in 2013 when pricing was submitted,
the pricing was set in part by the state departments of insurance,
the adjustments were not made to 2015 rates in 2014 enrollment year,
the redistribution of premiums/profits that was to be managed by CMS has also failed,
perhaps because the profits were not there to be redistributed
they were underpriced for the demand and expected services,
this was known in 2013 when pricing was submitted,
the pricing was set in part by the state departments of insurance,
the adjustments were not made to 2015 rates in 2014 enrollment year,
the redistribution of premiums/profits that was to be managed by CMS has also failed,
perhaps because the profits were not there to be redistributed
For everbody screaming about these co-ops and "Obamacare."
1. Kff.org and the Times have run a series of excellent articles and studies on the PPACA, what it is, how it works, and what the results have been. i would read some,msince you've no idea what you're talking about.
2. "Non-profit," is a technical term, which largely refers to how your finances are viewed by the IRS. It's not a synonym for "socialist." Willya look things the heck up?
3. Kaiser Permanente is a co-op. So are all managed care organizations. And especially when they're associated with large teaching hospitals and universities, they pretty much all provide the best health care in the country.
Oh, and the PPACA really did start out as largely a conservative, market-based, Republican inspired plan. But I see we forgot Romneycare already.
i don't mind disagreement, but willful ignorance kinda cheeses me off.
1. Kff.org and the Times have run a series of excellent articles and studies on the PPACA, what it is, how it works, and what the results have been. i would read some,msince you've no idea what you're talking about.
2. "Non-profit," is a technical term, which largely refers to how your finances are viewed by the IRS. It's not a synonym for "socialist." Willya look things the heck up?
3. Kaiser Permanente is a co-op. So are all managed care organizations. And especially when they're associated with large teaching hospitals and universities, they pretty much all provide the best health care in the country.
Oh, and the PPACA really did start out as largely a conservative, market-based, Republican inspired plan. But I see we forgot Romneycare already.
i don't mind disagreement, but willful ignorance kinda cheeses me off.
19
I have been a member of Kaiser since the late 1950s, when my father's employer first offered heath insurance to its employees. At one point he paid $9.00 per month for five of us. My wife, who also grew up with Kaiser, stayed when it came time a couple of years ago. Because she went out on disability a couple of years ago and I had already retired, we get a subsidy that costs us around $10K per year, rather than the $20K per year it would be without a subsidy. Some of our costs have gone up, but we still save money.
2
Thank you for this editorial. While it saddens and sickens me to think what right wing continues to do, editorials like this help give us the information we need to continue the good fight.
But how can the GOP's sole purpose be to destroy institutions that help so many -- Medicare, Medicaid, Social Security, the ACA?
The GOP seems to want no government in actuality, although they try to cloak it in words like 'limited government.'
The GOP has been successful at taking food out of children's mouths, turning public education into a profit center! And the dems have let them get away with it.
It ain't easy to be hopeful in this era of ignorance and hate and destruction but to be an American is to have hope in the future.
How can Jeb propose dismantling the ACA, spending BILLIONS OF TAXPAYER MONEY to do it and leave millions vulnerable once again?
When will the GOP stop bowing to money as the supreme arbiter of success?
Who do you want your children to admire -- Donald Trump whose family made its fortune through building low income housing with lots of government underwriting? OR a Nelson Mandela who stood for human dignity and helped change his country and the world?
Jerrymandering has given a sliver of America almost total power over the majority.
I will always have hope that American will overcome this terrible time in our history, but it sure takes a lot of energy to remain hopeful.
But how can the GOP's sole purpose be to destroy institutions that help so many -- Medicare, Medicaid, Social Security, the ACA?
The GOP seems to want no government in actuality, although they try to cloak it in words like 'limited government.'
The GOP has been successful at taking food out of children's mouths, turning public education into a profit center! And the dems have let them get away with it.
It ain't easy to be hopeful in this era of ignorance and hate and destruction but to be an American is to have hope in the future.
How can Jeb propose dismantling the ACA, spending BILLIONS OF TAXPAYER MONEY to do it and leave millions vulnerable once again?
When will the GOP stop bowing to money as the supreme arbiter of success?
Who do you want your children to admire -- Donald Trump whose family made its fortune through building low income housing with lots of government underwriting? OR a Nelson Mandela who stood for human dignity and helped change his country and the world?
Jerrymandering has given a sliver of America almost total power over the majority.
I will always have hope that American will overcome this terrible time in our history, but it sure takes a lot of energy to remain hopeful.
35
Yesterday's article that 58,000 in America are homeless, due largely to evictions speaks volumes about the need for extreme health care reform, i.e. universal health can is the only answer for all Americans!
3
Non-profits are just unacceptable. How much money can the CEO of a lousy non-profit make? Often, not enough to give significant campaign contributions. Enough said.
7
A "non-profit" is simply an organization where all the net profit is spent on executive pay.
1
These healthcare Insurance cooperatives are failing because not enough customers are signing up for them... it has nothing to do with doctors or politicians.
1
Richard, I don't think that you know too much about this topic. Many coops had to fold because they were inundated with too many members and were unprepared to handle so many people. Iowa was one of those states. Those coops needed more resources to serve all the people they signed up. These coops were all startups that needed more resources to make them work. We are all too familiar with the Repub tactic "to starve the beast."
I miss you Group Health Cooperative! (no joke). After having GHC for my insurer for 10 years, I moved and am back on a big HMO. With GHC everything was streamlined, no going to the ER to get X-rays on your wrist, no separate specialty ultrasound center or ophthalmologist or bloodwork. Everything about my for-profit healthcare is a clear attempt to wear me down, so I'll give up. No searching online to find a place that takes my insurance, calling around to find one of those places taking patients, no stupid referrals (which need to be filled out by me on paper and faxed). Not to speak of my medical records which are already spread across a wide variety of offices (in various paper and digital firms). At at GHC I had a single digital file with all tests and records accessible by all my doctors.
2
"When it became clear that no public plan could survive a Republican filibuster, . . ."
It is not the Republicans who are to blame. The Democrats had 60 votes in the Senate, and the public behind them. Instead, it was Lieberman (D-CT) and Nelson (D-NE) who sold out the public. Both of these fine gentlemen hailed from states where the insurance industry sets up shop. Both of these fine gentlemen took money from the insurance companies. Both of these fine gentlemen deserve the blame for the travesty which is Obamacare, a/k/a the Republican health care plan.
The Democrats could have gotten this done, if they had been true to their stated ideals, if they had been true to the claptrap they spew so readily to defraud the voters. Instead, the politicians demonstrated very clearly who they actually work for.
It is not the Republicans who are to blame. The Democrats had 60 votes in the Senate, and the public behind them. Instead, it was Lieberman (D-CT) and Nelson (D-NE) who sold out the public. Both of these fine gentlemen hailed from states where the insurance industry sets up shop. Both of these fine gentlemen took money from the insurance companies. Both of these fine gentlemen deserve the blame for the travesty which is Obamacare, a/k/a the Republican health care plan.
The Democrats could have gotten this done, if they had been true to their stated ideals, if they had been true to the claptrap they spew so readily to defraud the voters. Instead, the politicians demonstrated very clearly who they actually work for.
4
I've seen it all now. Blaming Republicans for the ACA. Black is white and up is down, eh?
4
Correct, it was not the Republicans who are to blame for the lack of the public option, but they also aren't to blame for the current iteration of Obamacare, aka the Democrat health care plan with universal Republican opposition.
2
Connecticut Senators Dodd and Lieberman were never ever going to support the government public option anymore than current Connecticut Senators Murphy and Blumenthal would support any such changes to the ACA that would compete with the Health Insurance industry. This is not a Democrat versus Republican issue.
6
It sort of is a Democrat vs Republican issue. How do you explain every Republican on one side, and almost every Democrat on the other side?
Obamacare and tax bracket incentives have created a bracket gulf that is destroying anyone between the government dependent lower middle-class and rich.
It has become near impossible to traverse the gulf in brackets. There is no longer any option to stay or strive for the classic American self-dependent middle/upper middle class bracket. It is a bracket that requires triple the work for almost no extra profit. Most of the extra money you earn will be taken away to support those smart enough to stay just beneath your bracket.
For example: 2 parents + 3 kids. If they make $60-65k (pre-tax) per year (lower middle-class) they qualify for free expanded Medicaid + pay no tax after child credits)
If they have the temerity to try to work harder or add another job, making an extra $20,000 per year, or $80k total per year (pre tax) they will now have to pay approx. $700 per month premium (8k) plus another 2-3k to reach their deductibles. (That's with Obamacare "savings") subtract $10,000 + 4-5k in taxes and they are right back to where they started.
Let me make this clear: After Obamacare and tax bracket calculations there is almost no difference (family of 5) between making $65k per year and making $90k per year in America today, aside from the extra work you put in!
In the past you could get through this gulf by buying emergency insurance (only) for your family. Taking a small calculated risk until you made it to $100 thousand+. That is no longer an option due to Obamacare.
It has become near impossible to traverse the gulf in brackets. There is no longer any option to stay or strive for the classic American self-dependent middle/upper middle class bracket. It is a bracket that requires triple the work for almost no extra profit. Most of the extra money you earn will be taken away to support those smart enough to stay just beneath your bracket.
For example: 2 parents + 3 kids. If they make $60-65k (pre-tax) per year (lower middle-class) they qualify for free expanded Medicaid + pay no tax after child credits)
If they have the temerity to try to work harder or add another job, making an extra $20,000 per year, or $80k total per year (pre tax) they will now have to pay approx. $700 per month premium (8k) plus another 2-3k to reach their deductibles. (That's with Obamacare "savings") subtract $10,000 + 4-5k in taxes and they are right back to where they started.
Let me make this clear: After Obamacare and tax bracket calculations there is almost no difference (family of 5) between making $65k per year and making $90k per year in America today, aside from the extra work you put in!
In the past you could get through this gulf by buying emergency insurance (only) for your family. Taking a small calculated risk until you made it to $100 thousand+. That is no longer an option due to Obamacare.
6
As a strong ACA supporter, I am not blind to this problem. The subsidies for ACA insurance are determined by an income ceiling, marital status and number of children. They are absolute--you either qualify or you do not. This means that you lose the entire subsidy (worth thousands of dollars) if you earn one dollar too much. The fix should be obvious (just like Social Security Benefits when you collect them and also earn other income.). Over the cutoff, reduce the subsidies by one dollar for every 2 or 3 that are earned. Tossing out ACA because there is no effective roll-off seems well beyond foolish. Sort of like junking your car because you ran out of windshield wiper fluid.
North of our yet un-walled border, Canadians just voted out of power their scorched-earth, destroy-all-social-service-in-sight government of entrenched "conservative" interests.
Here, we have a Party that demonizes the poor, immigrants, public servants, women and minorities, suppresses participation in democratic life, makes ludicrous analogies with Nazism, advocates turning all public places into shooting ranges, sabotages diplomacy, renders government inoperable even within its own ranks, opposes everything and proposes nothing.
Let us hope that we can follow the sane and sober example of our northern neighbors. Thank you, Canada, for showing that good political sense is possible, at least in a parliamentary system of government.
www.endthemadnessnow.org
Here, we have a Party that demonizes the poor, immigrants, public servants, women and minorities, suppresses participation in democratic life, makes ludicrous analogies with Nazism, advocates turning all public places into shooting ranges, sabotages diplomacy, renders government inoperable even within its own ranks, opposes everything and proposes nothing.
Let us hope that we can follow the sane and sober example of our northern neighbors. Thank you, Canada, for showing that good political sense is possible, at least in a parliamentary system of government.
www.endthemadnessnow.org
8
I have been reading the posts her, and have found that many are calling foe universal Medicare/Medicaid with stringent cost, price, and fee control by the government, in effect making physicians government employees and determiining exactly what their salaries would be. I wonder how posters calling for this would feel if the government set their salaries and working conditions
4
Just wait!
1
The government sets my salary, I'm OK with it.
Are doctors who now accept Medicare and Medicaid government employees? Just wondering.
The ACA was passed with no Republican input or support. At that time there were people warning that was not a good way to have a program that costs this much and affects every American be passed on a solely partisan basis. Yet, because the Democrats were so desperate to pass what they wanted, they hadn't even read it, this is where we are. And the Times blames Republicans. Simply amazing. This is a Democratic party bill. They own it. It is now rapidly becoming a disaster. You were warned. This bill was sold on lies. Sow the wind ...
7
Obamacare is a success, and Dems and Obama will take the credit. Thank you!
5
Every possible effort was made to bring Republicans into the discussions.
As I recall the main obstacle was that the Senate Minority leader had set the agenda for the Republican Caucus when he stated that their main goal was to make Mr. Obama a one term President (that didn't work either).
As I recall the main obstacle was that the Senate Minority leader had set the agenda for the Republican Caucus when he stated that their main goal was to make Mr. Obama a one term President (that didn't work either).
6
In a democratic free economy mutual cooperatives that forgo profits in order to lower the cost of services for members seems reasonable.
But, here the editors of the New York Tomes speak to a far more substantive public issue than just treatment of public health cooperatives
The editors, in effect point out that the republican party problem with the economics of a cooperative business model is that capitalists, the 1%, those who own the nation’s wealth, are positioned to pull a smaller bit of income from the 99%, essentially the labor class.
Hence the republican party opposition to not-for-profit health insurance cooperatives.
This sums up the republican party approach to budgeting - collection of income taxes to discretionary spending on public programs.
Reduce taxes on the 1% and reduce public spending for the 99% - infrastructure, research and development, improvements in cost of living, and so on.
A major tenet of the republican party - moving our national wealth into the hands of the 1%.
And of bringing down the 99% to living at some subsistence level.
Created by governments that constitutionally represent the 100%, but in reality are owned by the 1%.
Too often the congressional democrats lack sufficient legislative power to overcome the republican treatment of the 99%.
And fair, open, investigative media are reduced to whining about the 1% - 99% movement toward a worse political inequality.
But, here the editors of the New York Tomes speak to a far more substantive public issue than just treatment of public health cooperatives
The editors, in effect point out that the republican party problem with the economics of a cooperative business model is that capitalists, the 1%, those who own the nation’s wealth, are positioned to pull a smaller bit of income from the 99%, essentially the labor class.
Hence the republican party opposition to not-for-profit health insurance cooperatives.
This sums up the republican party approach to budgeting - collection of income taxes to discretionary spending on public programs.
Reduce taxes on the 1% and reduce public spending for the 99% - infrastructure, research and development, improvements in cost of living, and so on.
A major tenet of the republican party - moving our national wealth into the hands of the 1%.
And of bringing down the 99% to living at some subsistence level.
Created by governments that constitutionally represent the 100%, but in reality are owned by the 1%.
Too often the congressional democrats lack sufficient legislative power to overcome the republican treatment of the 99%.
And fair, open, investigative media are reduced to whining about the 1% - 99% movement toward a worse political inequality.
2
The lack of better alternatives to underfunded co-ops lies squarely with President Obama and former Senator Max Baucus (D-MT.) Baucus was the chair of Senate Finance and drafted the basic ACA, omitting any form of the public options that would have taken away some business from insurance companies. Despite the statements he made while campaigning for president in 2008, President Obama went along with Baucus and did not use any of his own political capital to fight for a public option...whether is was Medicare for all or some public-private arrangement like the French have.
No one should have been surprised when it turned out that the main recipient of campaign contributions from the health insurance industry and major health corporations was...drum roll...Max Baucus, Democrat from Montana, one more "rented" politician who sold out the American people.
No one should have been surprised when it turned out that the main recipient of campaign contributions from the health insurance industry and major health corporations was...drum roll...Max Baucus, Democrat from Montana, one more "rented" politician who sold out the American people.
7
The coops have gobbled up hundreds of millions of US taxpayer dollars and still cannot stay in business because they don't charge as much as their services cost. In other words, the only way you can deliver services at less than the actual cost is by subsidies (funded by US taxpayers of course -- but for liberals that is an unlimited source of funding), and these co-ops were so inefficient that even with subsidies they lost money hand over fist.
In fact, the whole of the ACA is designed to siphon money from taxpayers and give it those who don't pay for their own healthcare (largely smokers, dopers and alcoholics) in return for those non-payers to vote for Democrats.
The liberal, NYT solution -- indeed the liberal, NYT solution for ANY problem -- is to take more money from taxpayers and give it to those who support the Democrat Party. Why am I not surprised?
In fact, the whole of the ACA is designed to siphon money from taxpayers and give it those who don't pay for their own healthcare (largely smokers, dopers and alcoholics) in return for those non-payers to vote for Democrats.
The liberal, NYT solution -- indeed the liberal, NYT solution for ANY problem -- is to take more money from taxpayers and give it to those who support the Democrat Party. Why am I not surprised?
8
With Al Franken's felon-assisted victory in Minnesota, the Democrats had 60 votes, enough to overcome any Republican filibuster for the "public option." The Times is entitled to its opinions, but not its facts.
7
It seems as if some of the state co-ops might have made the mistake of including expected revenue from the federal risk corridor, adjustment and reinsurance payment program in the financial and actuarial analyses used to set rates. Rates were set too low and revenue was insufficient to meet state insurance commission solvency standards. If this is true, are there any lessons to be learned by all the financial advisers who include expected revenue from the federal Social Security program in creating retirement financial analyses?
2
The editorial unfortunately ignores a long, often (but not always) sad history of alternatives to for-profit insurance. There is plenty to be said about the shortcomings of private insurance. However, what also needs to be acknowledged and assessed by anyone advocating alternatives (non-profit, government, co-op, mutuals or whatever) is that sustainable success is much harder than it looks. Ideological conviction is a poor substitute for understanding what you're getting into.
6
Make sure it fails is the Repub mission. Its interesting how much so many of them Hate government but try to be paid by the government and are constantly running for some government office. There health plans are also government paid, their retirement government paid, salaries, government paid. most of their expenses, government paid. But they just hate the government.
2
correction - taxpayer paid
Lets get some facts into this.
Why did the Colorado Health CoOp go under? It was stiffed some $ 14 million in expected payments from The Centers for Medicaid and Medicare, or CMS, which is only paying out 12.6% of invoices received. Why is the CMS doing that? Because the Republicans slipped language into the last budget bill that removed any funding flexibility for Health Human Services. HHS was specifically prohibited from transferring funds to fully fund the Risk Corridor program should there be a shortfall. So, as usual, the Republicans will do Anything to deny health insurance to ordinary americans. And, continuing his pattern of being lousy at executing his programs and/or having any ability to pay attention to details, Obama Let Them Do it.
http://www.denverpost.com/business/ci_28979488/colorado-healthop-says-it...
http://talkingpointsmemo.com/dc/obamacare-cromnibus-risk-corridors
Why did the Colorado Health CoOp go under? It was stiffed some $ 14 million in expected payments from The Centers for Medicaid and Medicare, or CMS, which is only paying out 12.6% of invoices received. Why is the CMS doing that? Because the Republicans slipped language into the last budget bill that removed any funding flexibility for Health Human Services. HHS was specifically prohibited from transferring funds to fully fund the Risk Corridor program should there be a shortfall. So, as usual, the Republicans will do Anything to deny health insurance to ordinary americans. And, continuing his pattern of being lousy at executing his programs and/or having any ability to pay attention to details, Obama Let Them Do it.
http://www.denverpost.com/business/ci_28979488/colorado-healthop-says-it...
http://talkingpointsmemo.com/dc/obamacare-cromnibus-risk-corridors
4
There are stories like the one you recount all around the country. Where is the reporting of such sabotage throughout the country by Repubs in this article? Repub politicians colluded with major health insurance companies to kill off the coops.
Agree that many Repub. politicians want to hamstring or destroy Obamacare. Remember it is insurance, tho, not health care. Many insurance companies--or all types--are grossly mismanaged. Many nonprofit orgs are mismanaged, e.g., pay their execs much too much. In care itself, the most rapacious, greedy hospitals centers, including the nation's finest, are almost exclusively nonprofit/university, and they pay outrageous salaries to executives and doctors who actually see patients. So, we need to be wary of nonprofits of any sort, including insurance companies. And watch out for the best and brightest of the nonprofit hospitals that want to get into the insurance business, too. Lets not create another rigid entitlement for patients or for greedy nonprofit employees.
Other countries have universal health care that costs on average 30% less than what we spend in the US, while our politicians waste time, energy and money trying to sabotage affordable nonprofit options - and enable the for-profit sector to gouge us without shame. Politicians in general, and Republican politicians in particular, seem to hate the middle class in this country. In any conflict between big business and the rest of us citizens, profits are always considered first.
The best Congress money can buy.
The best Congress money can buy.
4
The winger never miss a chance to hurt people.
1
I guess when you start from the abosutist's position that non for profits are destined to out-perform for-profits, then the only reason for their failure can be that it's somebody else's fault.
For humor though let's consider another possibility - that non-for-profits are actually less efficient organizations in the health care space and that despite the advantage of not having to generate a profit, they still underperform for-profits by a wide margin.
Insurance companies earn on average 12% profit, which is returned to shareholders. In theory this means that non-for-profits need to be 12% more efficient to be a better deal for consumers. The facts have shown this past year they aren't. They are actually woeful.
Let's think about leadership and hiring. In a for profit, the leader is determined by the votes of the people who own the company, so they are highly incentivized to choose the best person for the job. In turn the leader, who knows he needs to deliver a profit, hires the best people capable of producing a good product that will sell.
With non-for-profits health care co-ops, leaders are chosen by the bureaucrats who commission and fund the entities. You think they choose the best people for the job, or somebody who has their back politically? They choose the person who is best for them politically. The leader can then be leaned on to hire the bureaucrat's friends and family and campaign supporters as payback.
For humor though let's consider another possibility - that non-for-profits are actually less efficient organizations in the health care space and that despite the advantage of not having to generate a profit, they still underperform for-profits by a wide margin.
Insurance companies earn on average 12% profit, which is returned to shareholders. In theory this means that non-for-profits need to be 12% more efficient to be a better deal for consumers. The facts have shown this past year they aren't. They are actually woeful.
Let's think about leadership and hiring. In a for profit, the leader is determined by the votes of the people who own the company, so they are highly incentivized to choose the best person for the job. In turn the leader, who knows he needs to deliver a profit, hires the best people capable of producing a good product that will sell.
With non-for-profits health care co-ops, leaders are chosen by the bureaucrats who commission and fund the entities. You think they choose the best people for the job, or somebody who has their back politically? They choose the person who is best for them politically. The leader can then be leaned on to hire the bureaucrat's friends and family and campaign supporters as payback.
5
Do you really believe this humorous hypothetical garbage?
I would help if you could do the simplest of things right:
"Insurance companies earn on average 12% profit, which is returned to shareholders. In theory this means that non-for-profits need to be 12% more efficient to be a better deal for consumers."
That's nuts. One might simplistically assume that not-for-profits could be 12% LESS efficient, and still match for-profit entities ... but it turns out that "simple" doesn't work here ... it's not simple. For-profits have two big advantages: they are not required to do charity service to keep their status, and they can accumulate and carry reserves that non-profits cannot.
"Insurance companies earn on average 12% profit, which is returned to shareholders. In theory this means that non-for-profits need to be 12% more efficient to be a better deal for consumers."
That's nuts. One might simplistically assume that not-for-profits could be 12% LESS efficient, and still match for-profit entities ... but it turns out that "simple" doesn't work here ... it's not simple. For-profits have two big advantages: they are not required to do charity service to keep their status, and they can accumulate and carry reserves that non-profits cannot.
The truth is that for numerous reasons many people at both ends of the political spectrum did not like the ACA. If the Republicans had truly been interested in blocking it they could have formed coalitions with those people. Instead they started nonsensical ranting about "Nazi health plans" and "death panels" forcing reasonable people into polarized positions that actually had little to do with the merits of the ACA. My theory is that the Republicans actually did not want to stop the ACA. What they wanted was to have it pass, but in such a crippled condition that they would have a wedge issue they could use for years to come. They've got their wedge issue and the rest of us are paying the price.
2
Jim - the republicans all voted NO, the democrats all voted Yes.
You are unhappy with what Yes got you - and you want to blame those who voted NO?
Only in the NYT.
You are unhappy with what Yes got you - and you want to blame those who voted NO?
Only in the NYT.
3
No one was allowed to read the law before it got voted on.
1
The NYT writes "when it became clear that no public option could survive a Republican filibuster, Sen. Conrad proposed setting up these cooperatives to compete with the profit-making plans".
A complete and total falsehood. The Democrat party had a filibuster proof majority in the Senate in 2009, and maintained it until Massachusetts voted Scott Briwn into the Senate specifically to kill Obamacare. Then the radical democrat party used an arcane rule of Reconciliation, bribes and deceit to jam the train wreck into law. Harry Reid bribed democrats to push it through; the Conhusker Kickback, $300,000,000 to Louisiana's Landrieu, a new hospital in CT for Dodd, $10 billion to VT for Bernie Sanders's community health centers, Florida exemption for Sen. Bill Nelson, and others. The public option could not survive democrat objections from the few moderates (that have been run out of the Senate by their voters for allowing Obamacare to become law).
The GOP couldn't stop the carnage we are seeing now, even though it has been proven correct to try and stop this terrible law which is still despised by more than 60% of the country.
Stop trying to rewrite history blaming the GOP for the failings of this disaster as perfectly described by sen. Conrad as "a train wreck". The demcorat party owns it, and can't blame anyone else for the numerous blunders enacting it.
A complete and total falsehood. The Democrat party had a filibuster proof majority in the Senate in 2009, and maintained it until Massachusetts voted Scott Briwn into the Senate specifically to kill Obamacare. Then the radical democrat party used an arcane rule of Reconciliation, bribes and deceit to jam the train wreck into law. Harry Reid bribed democrats to push it through; the Conhusker Kickback, $300,000,000 to Louisiana's Landrieu, a new hospital in CT for Dodd, $10 billion to VT for Bernie Sanders's community health centers, Florida exemption for Sen. Bill Nelson, and others. The public option could not survive democrat objections from the few moderates (that have been run out of the Senate by their voters for allowing Obamacare to become law).
The GOP couldn't stop the carnage we are seeing now, even though it has been proven correct to try and stop this terrible law which is still despised by more than 60% of the country.
Stop trying to rewrite history blaming the GOP for the failings of this disaster as perfectly described by sen. Conrad as "a train wreck". The demcorat party owns it, and can't blame anyone else for the numerous blunders enacting it.
14
Bob P - well said.
More simply, how can the Republicans be blamed for legislation for which they all voted No?
Alas - give the people what they want. As soon as they have it, they will see what they bought and won't like it.
More simply, how can the Republicans be blamed for legislation for which they all voted No?
Alas - give the people what they want. As soon as they have it, they will see what they bought and won't like it.
4
Please site your sources for the $ amounts listed.
Wow. Literally not a true claim in the lot. Congrats, I guess.
1
More government subsidies for these co-ops. This is nothing but crony capitalism at its' finest. They should never have been created; remember, this law requires at least 80% of premiums be spent on care, with rebates should an insurer spend less than that. With that provision in place why do we even need these failing co-ops? Why should we thrown more money down these sinkholes? It sounds like Solyndra 2.0. No wonder the left wants higher taxes.
8
Of course if you'd look it up or read the article, you'd find that the co-ops set premiums too low, but hey, why bother with that?
1
Nope. The 'cronyism' came in 2009-10, when the Republican party decided to take insurance company money to defeat reform, rather than hear the decades of the American public demanding reform. The best they could do was handicap it. Then they refused to vote on it in protest, showing their true agenda. Now they cry 'foul' when the rest of us try to remove the handicap.
I don't think any president could get any health care reform legislation passed without clearing it with the insurance industry first. ACA was the best anyone could have done, given the lock on power of the insurance industry and others. The big corporations legislate the government. Not the other way around.
10
When you use raw political power to (very narrowly) pass partisan legislation that affects 17% of the economy as well as altering employer/employee and patient/doctor relationships you own the legislation, for good and for bad. There is no 'attack on health care reform', there is only the unraveling of a poorly designed, democratic party implemented program. Remember Nancy Pelois's famous quote: "we have to pass the bill to find out what's in it"? Well, what was in it in this case is co-ops that have failed due to:
"...wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care, as well as severe reductions in the amount of money available to the co-ops from federal loans and for risk adjustment payments..."
The Democrats, including Obama, have campaigned on their 'success' in passing health care legislation over Republican opposition. They cannot claim now that Republican opposition is the reason their legislative creation is failing.
"...wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care, as well as severe reductions in the amount of money available to the co-ops from federal loans and for risk adjustment payments..."
The Democrats, including Obama, have campaigned on their 'success' in passing health care legislation over Republican opposition. They cannot claim now that Republican opposition is the reason their legislative creation is failing.
13
Obamacare is a unequivocal success. Millions are now covered, the rate of healthcare inflation has been reduced to near zero from double digit annual increases, we are starting to have real adult conversations on how to do healthcare.
Democrats will take the credit for Obamacare. The first step to finally reform healthcare in America.
We are not through yet. America will have single payer one day.
Democrats will take the credit for Obamacare. The first step to finally reform healthcare in America.
We are not through yet. America will have single payer one day.
3
They cannot claim now that Republican opposition is the reason their legislative creation is failing.
-----------------------
Of course they can and when the "paper of record" is so far in the bag for the Democratic party they even have an outlet for more of their lies.
-----------------------
Of course they can and when the "paper of record" is so far in the bag for the Democratic party they even have an outlet for more of their lies.
3
The frustrating thing about comments like yours is that they never attempt to address the most fundamental problem with healthcare in the US, that millions of Americans go without proper healthcare because it's unaffordable. The ACA has problems, but the best fixes to those problems are things that conservatives won't consider. At least Obama made a serious, genuine effort to help Americans who can't afford health insurance, and it's probably the only option currently available to us, thanks to the conservatives' influence in our Congress, and the stranglehold the insurance, pharmaceutical and healthcare industries have on our legislators, with their bribes and threats.
The fact that conservatives have put so much energy into opposing the ACA without offering a viable alternative makes one thing crystal clear, that conservatives don't care about their fellow Americans, to the extent that conservatives are willing to sacrifice the lives of thousands of Americans rather than see their taxes go up. Money before American lives. No wonder conservatives are so willing to ship American troops off to fight in foreign wars. Who cares if they die?
With that in mind, the rest of America, the majority, needs to come together and demand that our government start legislating in ways that WE support, in ways that protect and benefit all Americans, and not just the filthy rich.
The fact that conservatives have put so much energy into opposing the ACA without offering a viable alternative makes one thing crystal clear, that conservatives don't care about their fellow Americans, to the extent that conservatives are willing to sacrifice the lives of thousands of Americans rather than see their taxes go up. Money before American lives. No wonder conservatives are so willing to ship American troops off to fight in foreign wars. Who cares if they die?
With that in mind, the rest of America, the majority, needs to come together and demand that our government start legislating in ways that WE support, in ways that protect and benefit all Americans, and not just the filthy rich.
1
It should be obvious that the real problem is the schizophrenic attitude that Americans have with respect to the healthcare system or more precisely, paying for that care.
At this point, we all should be convinced that any government-sponsored payment system, or even a system in which the government tightly regulates insurers (e. g., Germany, the Netherlands) are non-starters. The stated reason for this is of course, the oft-heard cry of excessive government interference, but the real reason is fierce opposition from both the insurance and health care industries who would see their profits diminish significantly.
Given that, and given the preeminence of the capitalist system, even in health care, the only way to reduce both health insurance and health care costs is to essentially abolish insurance and make individuals responsible for paying for their own care. This is not a particularly new idea - David Goldhill mooted such a scheme in a 2009 article in The Atlantic:(http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-....
Goldhill's idea is vehemently opposed by groups on both the Left (wanting either a socialized or single-payer system) and the Right (wanting to protect health care industry profits). That such diametrically opposed interest groups should be united in opposing such a scheme should be an indication that at the least, the idea merits serious consideration.
At this point, we all should be convinced that any government-sponsored payment system, or even a system in which the government tightly regulates insurers (e. g., Germany, the Netherlands) are non-starters. The stated reason for this is of course, the oft-heard cry of excessive government interference, but the real reason is fierce opposition from both the insurance and health care industries who would see their profits diminish significantly.
Given that, and given the preeminence of the capitalist system, even in health care, the only way to reduce both health insurance and health care costs is to essentially abolish insurance and make individuals responsible for paying for their own care. This is not a particularly new idea - David Goldhill mooted such a scheme in a 2009 article in The Atlantic:(http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-....
Goldhill's idea is vehemently opposed by groups on both the Left (wanting either a socialized or single-payer system) and the Right (wanting to protect health care industry profits). That such diametrically opposed interest groups should be united in opposing such a scheme should be an indication that at the least, the idea merits serious consideration.
1
Charlie - "...the real reason is fierce opposition from both the insurance and health care industries who would see their profits diminish significantly. "
That's not true. I am against govt plans and have nothing to do with the insurance industry. It's just very, very difficult for me to find many Gov't programs that are well-run and serve with quality for the amount of money put into it. Therefore, I prefer to determine my own level of care, from a provider of my choice, along with the doctors of my choice.
That's not true. I am against govt plans and have nothing to do with the insurance industry. It's just very, very difficult for me to find many Gov't programs that are well-run and serve with quality for the amount of money put into it. Therefore, I prefer to determine my own level of care, from a provider of my choice, along with the doctors of my choice.
In the end, as Colin Powell famously advised Dubya and Cheney on Iraq, “You break it, you own it”.
At least in part, Barack Obama drew needed moderate votes from the center and right in his 2008 bid for the presidency, for his campaign promise that he was would reform our fiscally unsustainable entitlements, specifically those that involved healthcare. But through re-election and a total of seven years, what has he done to redeem that pledge? He’s done nothing. Indeed, he stamped his name on a “reform” as the editors put it that in addition to dividing us starkly has further entrenched healthcare as so complex, so expensive and so subsidized that it probably will be the largest single component of our expenditures for the rest of the lives of everyone reading this comment. Not defending ourselves, not infrastructure, not education, not basic research: Band-Aids.
There isn’t any aspect of ObamaCare that isn’t a financial disaster, so evident today but clearly an impending catastrophe for our posterity that will need to tax itself like Britain to pay for it while watching every OTHER investment wither and die for lack of funds.
The co-ops’ planning seems to be about as effective as that of the IT team that launched the federal portal – keeping the same faces could be counter-productive. But the implication that the president can unilaterally fund the co-ops flies in the face of the constitutional requirement that our government expends only what Congress has approved.
At least in part, Barack Obama drew needed moderate votes from the center and right in his 2008 bid for the presidency, for his campaign promise that he was would reform our fiscally unsustainable entitlements, specifically those that involved healthcare. But through re-election and a total of seven years, what has he done to redeem that pledge? He’s done nothing. Indeed, he stamped his name on a “reform” as the editors put it that in addition to dividing us starkly has further entrenched healthcare as so complex, so expensive and so subsidized that it probably will be the largest single component of our expenditures for the rest of the lives of everyone reading this comment. Not defending ourselves, not infrastructure, not education, not basic research: Band-Aids.
There isn’t any aspect of ObamaCare that isn’t a financial disaster, so evident today but clearly an impending catastrophe for our posterity that will need to tax itself like Britain to pay for it while watching every OTHER investment wither and die for lack of funds.
The co-ops’ planning seems to be about as effective as that of the IT team that launched the federal portal – keeping the same faces could be counter-productive. But the implication that the president can unilaterally fund the co-ops flies in the face of the constitutional requirement that our government expends only what Congress has approved.
9
i adore the fact that you've no earthly notion of how George Bush "financed," the Iraq War, trillions in tax cuts for the wealthy, and Medicare Part D.
Please continue, governor.
Please continue, governor.
Uh, where are "Dubya and Cheney?"
We are stuck with their mistakes, they got off scot free and laughing.
We are stuck with their mistakes, they got off scot free and laughing.
Robert:
I adore Scarlett Johansson.
But I'm amused at the notion that the only president who failed to finance what he wanted to do was Dubya. Barack Obama funds hundreds of billions per year in entitlements by debt, even AFTER sunsetting the sunsetting of the Clinton tax increases. And at least both Bush and Obama were honest about being debt-hogs: Clinton had to steal hundreds of billions from Social Security surpluses, as other presidents, Democrats and Republicans, had for many years.
I adore Scarlett Johansson.
But I'm amused at the notion that the only president who failed to finance what he wanted to do was Dubya. Barack Obama funds hundreds of billions per year in entitlements by debt, even AFTER sunsetting the sunsetting of the Clinton tax increases. And at least both Bush and Obama were honest about being debt-hogs: Clinton had to steal hundreds of billions from Social Security surpluses, as other presidents, Democrats and Republicans, had for many years.
The premiums on these plans are going up because ObamaCare simply does not work.
It is about time that the whole colossal failure is repealed and replaced with a national health care system that does work.
Once again, Obama gets an F-.
It is about time that the whole colossal failure is repealed and replaced with a national health care system that does work.
Once again, Obama gets an F-.
7
Gee Vincent ... why don't you spell out your "national health care system that does work."
This has nothing to do with the GOP- it is related to the overall stalling out and now slow failure of the ACA that the NYTimes wants to ignore. Fewer people signed up now than a year ago, and people just don't want to pay for the poor coverages
6
They don't stop. Like an irresistible force of nature the Greed Over People party keep pounding away at the social safety net. Decent living soon to be available only to the top 5% of Americans.
Ya gotta admire that kind of single minded devotion to a bankrupt ideology.
Ya gotta admire that kind of single minded devotion to a bankrupt ideology.
4
Healthcare should not have anything to do with profit. Shortly after the ACA was passed, healthcare corporations began buying up each other; we will very soon have probably about 3 giant "healthcare" corporations to milk the public dry. These so-called healthcare corporations do not provide anything to do with actual healthcare; the medical profession and their allied professions do that. These corporations are distributors of healthcare prevention, trying their best to limit or even eliminate healthcare services to the individuals who pay them ridiculous sums of money for this non-service so that the corporations can make huge profits and enormous salaries for their CEOs. Meanwhile, Medicare operates at about 3-5% administrative costs (and please, quit insinuating that Medicare is a corrupt, inefficient system) and provides healthcare administration for millions. Having been in this system for the past seven years, I have not experienced one single instance of ineptness and no errors on my account. The private insurer who is my supplement has made plenty of errors and constantly prints documents twice, even three times and has even reimbursed in duplicate for services to a provider! I'm sure the CEO of that company makes big bucks! We need single payer healthcare in this country, and many of us will keep at our elected officials until we get it (probably not in my lifetime, but I'd like to think so).
8
How is single payer working out for the Veterans at the VA? I agree that if single payer is run by well-minded,intelligent people who have the right goals and incentives to get the job done, it would be great for our country. I disagree that if indeed we enacted single payer, it would be run by such individuals. The VA is the prime example of this - it has all the funding it needs, and a greater goal (serving those who risked their lives for our country), and yet it is a colossal failure. What makes you think our government can effectively run for 330mm people, what it cannot for 5mm, given likely less funding per person?
The co-ops have gone bankrupt because they never had a viable business model in the first place. They only exist because the Obama administration funded them to make sure there was someone who insure applicants in areas where the major major insurance companies refused to participate. These companies refused to participate because they knew the business could not be substained based on demographics, size of the market, etc.
Why did the co-ops go into these markets? They were loosing someone else's money. When the someone else's money ran out, they couldn't survive.
Why did the co-ops go into these markets? They were loosing someone else's money. When the someone else's money ran out, they couldn't survive.
8
Gaping hole:
Then who do you suggest will insure people in those areas where private insurer refuse to serve?
Then who do you suggest will insure people in those areas where private insurer refuse to serve?
The answer is Medicare For All; government managed, regulated, with serious provider-insurance-price controls. The value of OUR lives should not be decided on the predatory profit-at-all-cost "stock markets".
16
What else do you want price controlled by the government?
NJGLEA - no problem - don't use any of the "predatory profit-at-all-cost" health providers. Just go use one of the not-for-profit organization the article talks about.
What's the problem?
What's the problem?
if government pays for all health care, government controls all health care. Do you think they're going to pay for that new hip for your 80 year old grandma? She's not going to contribute anything back to the government, and it's not going to prolong her life.
the further you remove the cost from the person receiving care, the less the person cares about price. I think we need to have an actual incentive to use health care resources responsibly, not more incentive to waste.
the further you remove the cost from the person receiving care, the less the person cares about price. I think we need to have an actual incentive to use health care resources responsibly, not more incentive to waste.
1
Their problems have been attributed to wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care...
------------------------
The problem is that not many are enrolling in ACA and the estimate for the next year for enrollment is half that the budget office projected. Many who are signing up are old, infirm, otherwise uninsurable. So, the coops which rely exclusively on O-care enrollment have no chance of surviving.
Why blame the Republicans when you know the real reasons why the coops are floundering and failing?
------------------------
The problem is that not many are enrolling in ACA and the estimate for the next year for enrollment is half that the budget office projected. Many who are signing up are old, infirm, otherwise uninsurable. So, the coops which rely exclusively on O-care enrollment have no chance of surviving.
Why blame the Republicans when you know the real reasons why the coops are floundering and failing?
8
The co-op, CoOpportunity Health, set up in Iowa had modest goals when it began. They projected a certain amount of enrollees to their program. That projection was shattered when enrollment began. All the numbers for membership were easily exceeded in the first months of operation.
The final demise for CoOpportunity was a combination of too much success, or members, and the inability within it's startup to handle such large numbers. CoOpportunity failed because it was not big enough to do what it was supposed to do in the first place. As a startup it needed more resources to handle the flood of business.
In Iowa the Repub governor did nothing to help this coop's efforts. In fact he did as much to defeat the coop with a low profile effort. Blue Cross/Blue Shield of Iowa has about 80% of the business there. BC/BS maintained a war chest of billions to counter any progress CoOpportunity could make and sought to kill them too.
Details. Facts. Things Repubs have no use for. Facts and the truth that always trumps wrong Repub assumptions.
The final demise for CoOpportunity was a combination of too much success, or members, and the inability within it's startup to handle such large numbers. CoOpportunity failed because it was not big enough to do what it was supposed to do in the first place. As a startup it needed more resources to handle the flood of business.
In Iowa the Repub governor did nothing to help this coop's efforts. In fact he did as much to defeat the coop with a low profile effort. Blue Cross/Blue Shield of Iowa has about 80% of the business there. BC/BS maintained a war chest of billions to counter any progress CoOpportunity could make and sought to kill them too.
Details. Facts. Things Repubs have no use for. Facts and the truth that always trumps wrong Repub assumptions.
Why blame the Republicans? Ha. At every turn, at every suggestion to cover a wider breath of citizens, they erected walls, stumbling blocks and any other convenient method to thwart any attempt at broader health care. Ironically, the very individuals who are at the forefront of these moves have themselves (more than likely) the best health plans available. More than half the congress are millionaires. Let the Republicans come up with a viable alternative to ACA and then I'll listen.
Sonny also got the demographics completely wrong, and apparently opposes getting the "sick and infirm," taken care of, but what the heck, I guess.
Obamacare is completely the creature of the Democratic party. Republican fingerprints are nowhere on the thing. It is a spectacular failure, and it is completely the responsibility of the Democratic politicians who passed it without a single Republican vote.
7
Yes, I'm glad you are proud that no Republican hands had a hand in increasing healthcare. Lots of Republican fingerprints though on blocking any sane gun control, doctoring planned parenthood videos, and passing racist voter id laws.
2
Of course Republican fingerprints are all over the parts that aren't there, like the lack of a public option or the states that have refused to expand Medicaid. And spectacular failure? Which part--the part where millions more are insured? Where the sick can't be tossed off or denied coverage? Where adult children can benefit from their parents' coverages? Or the part where the US has tentatively begun to join the rest of the civilized world on the issue of health? Please, Jonathan from Texas, go on . . . .
1
It is modeled on Romneycare in Massachusetts. Do you remember who Romney is? What party he belongs to?
2
The editorial fails to mention that the Republicans didn't have the votes to block the ACA and that it was passed on a straight party line vote - how could the GOP block the public option? When it comes to higher premiums (as well as higher deductibles and less choice of doctors and hospitals) the ACA has done that all by itself - its built into the law.
The only part of healthcare reform that works is expanded Medicaid. That and Medicare should show the way to real reform - we need single payer health insurance. Let's end socialism for the helath insurance companies and capitalism for the insured.
The only part of healthcare reform that works is expanded Medicaid. That and Medicare should show the way to real reform - we need single payer health insurance. Let's end socialism for the helath insurance companies and capitalism for the insured.
16
Republicans blocked the public option by threatening to filibuster the entire ACA.
2
Wrong Chris. That is what come from relying on NYT editorials for facts. Republicans would have filibustered the bill with or without the public option - so after Scott Brown won Ted K's seat, the bill was passed in the Senate using the reconciliation maneuver to avoid the filibuster. The public option was dropped at the insistence of a number of emocrats. They got the bill they wanted.-
2
Chris, the Democrats had 60 votes in the Senate until the election of Scott Brown in January 2010. One cannot rewrite history merely because they don't like it, unless one belongs to INGSOC and the Party is telling them to do so.
The clueless Republicans who loathe the ACA and all of its details continue to prove that they don't have anything better to offer because their ideological political religion doesn't accommodate those who are not wealthy. Saying no to anything that doesn't fit their preconceived beliefs, which are unattached to the real world, is all they have. They're empty suits who don't solve problems but make them worse.
Eclectic Pragmatist — http://eclectic-pragmatist.tumblr.com/
Eclectic Pragmatist — https://medium.com/eclectic-pragmatism
Eclectic Pragmatist — http://eclectic-pragmatist.tumblr.com/
Eclectic Pragmatist — https://medium.com/eclectic-pragmatism
21
But saying no to bad legislation is a good idea right?
The ACA has turned out to be bad legislation passed entirely by Democrats.
The ACA has turned out to be bad legislation passed entirely by Democrats.
1
"they don't have anything better to offer" is beside the point, they don't want to offer another solution - any solution they could offer would be in favor of the private sector, negatively impacting its ability to play the Wall ST casino with our premiums and the K Street money would go elsewhere.
Why is it bad legislation, exactly? be specific. Use numbers.
I am self-employed and work in the arts, so I went without health insurance in the USA for much of my life. Then I moved to Europe, where for an affordable cost I have participated in a single payer universal system. I've received basic health care I could not afford in the USA. As far as health care goes (as well as some other civilized social policies), the USA is very much like some of the underdeveloped countries I've spent time in. The nonprofit insurance co-ops are a band-aid for a bad health care system. I do hope the USA decides to enter the 21st century soon.
115
How much more in taxes did you have to pay for your health care in Europe?
1
Christopher, in Europe, healthcare is affordable to *you* because someone else picks up the tab. By working in Art, may be your earnings are not enough to pay for all your needs. May be in the US, you could have taken up another job or worked in a grocery store or one of those artsy cafes to get access to healthcare and any other needs.
Just because you chose to work in a profession that doesnt pay enough, doesnt mean that you can keep your needs high and expect everyone else to pay for it.
Just because you chose to work in a profession that doesnt pay enough, doesnt mean that you can keep your needs high and expect everyone else to pay for it.
Where were you in Europe? i'm asking because none of those countries actually have a simple single payer system.
Oh, and as for the taxes? Health care in America is now eating 19% of our GDP.
Oh, and as for the taxes? Health care in America is now eating 19% of our GDP.
Re the plan that never was: "Such a plan would not have to generate profits and would have stronger bargaining powers to obtain discounts from health care providers, enabling it to charge lower premiums than private plans."
Democrats passed a healthcare law without one Republican vote. Why didn't they write this exalted "plan" into the law?
But back to the quotation: the problem, of course, is that government plans always generate other costs due to waste, inefficiency, cheating, and incompetence that invariably make them more expensive and less efficacious in the end.
It's not Republicans attacking the co-ops that is making them fail. It's the concept itself which was unworkable and cobbled together without any Republican support that makes them fail. This is what happens when one party writes a law that reflects their ideological biases and contempt for existing institutions that were, for the most part, serving a large majority of the population rather well.
That's no way to pass a major piece of social legislation, which to this day does not have majority support.
Democrats passed a healthcare law without one Republican vote. Why didn't they write this exalted "plan" into the law?
But back to the quotation: the problem, of course, is that government plans always generate other costs due to waste, inefficiency, cheating, and incompetence that invariably make them more expensive and less efficacious in the end.
It's not Republicans attacking the co-ops that is making them fail. It's the concept itself which was unworkable and cobbled together without any Republican support that makes them fail. This is what happens when one party writes a law that reflects their ideological biases and contempt for existing institutions that were, for the most part, serving a large majority of the population rather well.
That's no way to pass a major piece of social legislation, which to this day does not have majority support.
13
There was no way to get republican support. They just oppose anything from Obama. The democrats never had a solid 60 votes.The blue dog democrats were much more like republicans in many areas. Joe Lieberman had the 60th vote and since he was a representative of the insurance companies, he wouldn't allow the public option. You wingers should really learn some history before making inaccurate posts.
4
I'm sorry you really don't remember the process. While it's true that the plan was passed with 60 Democratic votes, unfortunately, Democratic Senators from red states didn't want a public option, either because of principle or because (more likely) they were afraid they would lose the next election if they voted for a public option. The House or Reps., then under Democratic control, wanted a public option. Then Ted Kennedy died, a Republican took his place, so the Democrats lost control of the Senate (because they needed sixty votes to stop a filibuster and then had only 59). Hence we got what we got.
My understanding is that most people do want almost all the aspects of the ACA, but don't want the mandates, high copay, etc. In other words, they want the advantages of the ACA but not the costs. They want the goodies but not the bill.
My understanding is that most people do want almost all the aspects of the ACA, but don't want the mandates, high copay, etc. In other words, they want the advantages of the ACA but not the costs. They want the goodies but not the bill.
3
My counter example is Gov. Rick Scott (R) of Florida, who was fined $300 million for medicare fraud. The private plans are more efficient for SOME people
1
The Op-Ed mentions Seattle's Group Health, but not Kaiser Permanente (not every entity of K-P is a non-profit, some are professional corporations), or any of the other large established (PRE-EXISTING!) non-profits.
It's also of relevance to understand why Blue Cross / Blue Shield ended up going for-profit, and what Anthem is today ... also that HCSC exists as a customer-owned BC/BS licensee -- effectively a mutual-insurance company. The legal organization of health-care gets very confusing.
There are multiple competing story lines -- but changes in tax law have driven much of this, also opportunities for some to make a great deal of money.
At the present one of the big issues is that the IRS effectively demands that non-profits do more charity work to maintain their non-profit status than for-profit entities. This means that non-profits cannot be the lowest-cost entities for their enrollees, in comparison to well-run entities seen as nominally-for-profit mutual insurance.
Non-profits also have tax-problems carrying reserves, so it is hardly surprising that they fail more frequently.
It's also of relevance to understand why Blue Cross / Blue Shield ended up going for-profit, and what Anthem is today ... also that HCSC exists as a customer-owned BC/BS licensee -- effectively a mutual-insurance company. The legal organization of health-care gets very confusing.
There are multiple competing story lines -- but changes in tax law have driven much of this, also opportunities for some to make a great deal of money.
At the present one of the big issues is that the IRS effectively demands that non-profits do more charity work to maintain their non-profit status than for-profit entities. This means that non-profits cannot be the lowest-cost entities for their enrollees, in comparison to well-run entities seen as nominally-for-profit mutual insurance.
Non-profits also have tax-problems carrying reserves, so it is hardly surprising that they fail more frequently.
13
Thanks Lee. You bring up probably the most important point about cooperatives in health care. It is not apples to apples comparison to private insurance. The laws that govern cooperatives are hidden from view, the media does a miserable job to explain and we are basically in the dark to understand what is happening.
Healthcare in America is 18% of our entire GDP. Of course it is complicated. Of course it is huge and cumbersome. But some clarity of the rules need to be explained.
Healthcare in America is 18% of our entire GDP. Of course it is complicated. Of course it is huge and cumbersome. But some clarity of the rules need to be explained.
2
If Republicans are unhappy with their own Obamacare, they really won't like Hillarycare.
3
No, Republicans will like Hillarycare very much. Hillarycare will have an enrollment of one person, who will get free healthcare as an inmate of one of our fine federal prisons.
1
The insurance lobby wins again! A large part of our health care problem is a large amount of the health care dollar goes to non-value-added activities such as insurance company profits and lavish executive perks as well as drug marketing and advertising, liability insurance, lawyers fees, etc. etc. As a nation, we should be focused on spending our health care dollars on hospitals, doctors and nurses, not on things that add no value to our care. These non-profits which were the model of the original health insurance companies are exactly what we should be promoting if we cannot achieve the proper solution of a single payer system.
30
So the other day I was speaking to a retired public employee who, given is job when he was working, had great health insurance, now he's retired and has medicare along with additional coverage provided by his public employee insurance coverage. He's against Obamacare, feels that no one is turn away from a hospital because they're unable to pay and so that's good enough.
Funny, those most against Obamacare, have good coverage from their jobs or medicare, or whatever.
Basically it's I got mind the heck with you.
Funny, those most against Obamacare, have good coverage from their jobs or medicare, or whatever.
Basically it's I got mind the heck with you.
50
In two weeks, the Republicans will not have to attack the ACA any longer. My non ACA plan just went up 60%. My elderly friend's Medicare Advantage plan just went up 52%. The canary in the coal mine is alerting us. If everyone else's plan goes up like our did, the whole thing will fall apart. It will fall apart if rates only go up half as much.
The problem is and always has been fee for service. The ACA does not address that issue. Healthcare does not operate on market principles because it is a necessity. It operates with 100% inelastic demand. Sellers can and do charge whatever they want. Healthcare is a cartel. The insurance companies calculate their premiums by estimating their expenses and then multiplying that figure by a percentage. The more the industry bills, the more the insurance companies make.
Neither the Democrats nor Republicans will address this fundamental issue. Not even Bernie mentions it. The healthcare industry has the nation by the throat and they know it. They know it to the tune of $3 trillion a year and climbing.
The problem is and always has been fee for service. The ACA does not address that issue. Healthcare does not operate on market principles because it is a necessity. It operates with 100% inelastic demand. Sellers can and do charge whatever they want. Healthcare is a cartel. The insurance companies calculate their premiums by estimating their expenses and then multiplying that figure by a percentage. The more the industry bills, the more the insurance companies make.
Neither the Democrats nor Republicans will address this fundamental issue. Not even Bernie mentions it. The healthcare industry has the nation by the throat and they know it. They know it to the tune of $3 trillion a year and climbing.
36
I say that the so-called grip by the private insurance companies is not so permanent. The insurance companies know that they are no better than middle men, and nothing else. They collect the tolls, will decide how much to charge and, most important, decides who gets to pass and who does not. And pay their executives exorbitant salaries.
Why do we need the insurance companies?
We don't have as many travel agents as we used to.
Uber has completely upset the "permanence" of the taxi industry.
We can in short time replace the private insurance company, and their business model, with the same ease as Uber has transformed the taxi industry.
The private health insurance model is on track to hit a brick wall. The brick wall that is written all over it: America does not need or want the private health insurance model. We can and will find a better way. The floodgates have been opened. They won't close at this point.
Why do we need the insurance companies?
We don't have as many travel agents as we used to.
Uber has completely upset the "permanence" of the taxi industry.
We can in short time replace the private insurance company, and their business model, with the same ease as Uber has transformed the taxi industry.
The private health insurance model is on track to hit a brick wall. The brick wall that is written all over it: America does not need or want the private health insurance model. We can and will find a better way. The floodgates have been opened. They won't close at this point.
3
Bernie Sanders certainly mentions this every day. From Senator Sanders website, "The American people must make a fundamental decision. Do we continue the 40-year decline of our middle class and the growing gap between the very rich and everyone else, or do we fight for a progressive economic agenda that creates jobs, raises wages, protects the environment and provides health care for all? Are we prepared to take on the enormous economic and political power of the billionaire class, or do we continue to slide into economic and political oligarchy? These are the most important questions of our time, and how we answer them will determine the future of our country."
1
You are wrong....Bernie calls for single payer.
https://go.berniesanders.com/page/s/medicare-for-all
https://go.berniesanders.com/page/s/medicare-for-all
Liberals who champion the ACA as a universal health care plan have drunk the Kool Aid. The ACA has accomplished two things. It has expanded Medicaid in a manner deemed unconstitutional by the Supreme Court and it has insured a number of folks who don't get insurance through work. Its most far-reaching reforms -- pre-existing conditions and lifelong limits on coverage -- are apart from the fundamental plan. If you'd gut the overall plan, and expanded Medicaid in a constitutional manner, you would eliminate those 20 red state holdouts and insure far more Americans than are currently insured. Democrats who see the ACA as a finished product are satisfied with form over substance. When the Dems beat the divided Republicans in 2016, their first initiative should be to get health care to all Americans constitutionally. Obama tried and came out with a half measure that Republicans have never accepted. Thinking Democrats don't defend the ACA just because the Republicans attack it. They ignore the Republican whining and keep their eye on the prize -- universal health care.
14
What's needed is an attack on allowing the quality of our health care to remain below than that of other nations, while it's cost is higher!
11
We've done an incredibly poor job of health insurance reform with the ACA. That's what it is really, an attempted reform of the private insurance market, rather than any semblance of national healthcare, designed to enable poor, low income and those with pre-existing conditions to buy subsidized health insurance through Medicaid or the exchanges.
While the Administration promised the law would bring much needed improvements, particularly to the individual market, it has done very little to restrain rising premiums and deductibles or improve access for people who don't qualify for heavily subsidized coverage. In many cases these people are paying more, and frequently a lot more. And many are angry. Healthcare access is a very touchy subject.
Thus, it remains quite unpopular and continues to face headwinds. Now the so-called Cadillac Tax is about to die a quick bipartisan death and with it much of the projected funding designed to keep the ACA budget neutral.
The problem for the co-ops is simple. The newly insured are far more costly to cover than anticipated. Greater use of care and inadequate premiums are a huge problem for all the insurers in the marketplace. The expected funds from the federal government to make the insurers whole are not going to be forthcoming.
Time to revisit and design a far less complicated system that offers all Americans, low-income, middle-income, high-high income, sick or healthy truly affordable healthcare.
While the Administration promised the law would bring much needed improvements, particularly to the individual market, it has done very little to restrain rising premiums and deductibles or improve access for people who don't qualify for heavily subsidized coverage. In many cases these people are paying more, and frequently a lot more. And many are angry. Healthcare access is a very touchy subject.
Thus, it remains quite unpopular and continues to face headwinds. Now the so-called Cadillac Tax is about to die a quick bipartisan death and with it much of the projected funding designed to keep the ACA budget neutral.
The problem for the co-ops is simple. The newly insured are far more costly to cover than anticipated. Greater use of care and inadequate premiums are a huge problem for all the insurers in the marketplace. The expected funds from the federal government to make the insurers whole are not going to be forthcoming.
Time to revisit and design a far less complicated system that offers all Americans, low-income, middle-income, high-high income, sick or healthy truly affordable healthcare.
62
Of course you're right. But your criticism seems a little harsh. Sure, Medicare should be for everyone. But change in this country (corptocracy) is incremental. So you have to go for what you can get now, and figure out a way to get what you really want later, through the back door, so to speak.
Regarding: "Time to revisit and design a far less complicated system that offers all Americans, low-income, middle-income, high-high income, sick or healthy truly affordable healthcare". The only less system that qualifies is Medicare for all - very simple because it already exists. ACA is complicated because it represents a political compromise. However reality is that no alternative is possible, because the 'Freedom Caucus', which drives the current Republican party, doesn't believe in compromise - and 'no plan' is the only alternative that the ideologically fractured Republican party can agree on internally.
You forget. Obama wanted health care for all. Republicans said no. Obama had no choice other than to settle for what little the Republicans would agree to.
I believe the current administration sold out it's citizens to big pharmaceutical giants and health insurers. Had President Obama not caved to Joe Lieberman and the health care lobbyists, we would not be experiencing all the problems we are today. What we now have is a winner take all economy that has put it's citizens in harms way to corporate predators.
14
Imagine if all the time, effort, and zeal that Republicans and allies have thrown into destroying Obamacare had been marshaled in some productive cause to benefit Americans, whether through government, the private sector, civil society, or religious/non-profit organizations. What a total and shameful waste -- it really has turned into a mindless obsession with little relationship to any public policy goals or social needs.
25
It's clear by the lack of facts that this article needed to be filed under "Opinion."
A good follow up editorial would cover how much taxpayer money has been wasted on funding these co-ops.
A good follow up editorial would cover how much taxpayer money has been wasted on funding these co-ops.
2
Single-payer financing of health care is the most viable system. But the health insurance companies will oppose this, using every dollar of ours that they can steal.
19
Entering a comment is as delicate as neurosurgery on this site for some reason.
We need a national education campaign as to how the pre-ACA health care coverage limited who could be served and why and also why it cost us twice as much to cover people's most basic health care needs less well than in other countries, just to make the discussion rational. Then we need to educate all as to the inadequacies of the ACA model, too.
Non profit entities of considerable size and duration have worked for years in both providing health care and in providing insurance. If well designed and managed the cooperative plans should work.
The Republicans opposition to public health care coverage is just a silly refusal to accept that markets sometimes cannot fulfill all of society's needs, that sometimes in order to get things done society has to define the role of markets with thought and care. Some times free market advocates seem to think that markets are controlled by invisible and supernaturally wise forces instead of being simply another kind of social interaction.
We need a national education campaign as to how the pre-ACA health care coverage limited who could be served and why and also why it cost us twice as much to cover people's most basic health care needs less well than in other countries, just to make the discussion rational. Then we need to educate all as to the inadequacies of the ACA model, too.
Non profit entities of considerable size and duration have worked for years in both providing health care and in providing insurance. If well designed and managed the cooperative plans should work.
The Republicans opposition to public health care coverage is just a silly refusal to accept that markets sometimes cannot fulfill all of society's needs, that sometimes in order to get things done society has to define the role of markets with thought and care. Some times free market advocates seem to think that markets are controlled by invisible and supernaturally wise forces instead of being simply another kind of social interaction.
17
Republicans seem primed, at a hair trigger moment, to fight endless wars on terror for a fleeting respite of peace, fight to end social security to make it "better", fight to reduce Medicare to improve it, fight hammer and tong to abolish Obamacare to replace it with for-profit private insurance industry plans, fight to cut aid to education because it is failing our children.
Yet, unbelievably, Republicans mantra of government shrinkage does not apply to other aspects of spending. They are more than willing to pour tons of funds into a bloated military industrial complex to beef up our nebulous War On Terror, although, our multi-layered systems, loaded with redundancies, designed to cover us with maximum security, utterly failed us on 9/11/01.
What requires a massive overhaul is a national defense system which though armed to the teeth was completely hapless in preventing any one of four commercial aircraft from reaching their targets. The only plane brought down occurred over a field in Pennsylvania and it was done so by a make-shift group of civilian passengers on board. The result of this insulting wake-up call? More funding is poured into national security.
Right.
Republicans Attack Plan: Tax cuts for the Rich, more money for national security, less for social security. How they manage to fool even a small percentage of the populace into voting for them is a marvel.
DD
Manhattan
Yet, unbelievably, Republicans mantra of government shrinkage does not apply to other aspects of spending. They are more than willing to pour tons of funds into a bloated military industrial complex to beef up our nebulous War On Terror, although, our multi-layered systems, loaded with redundancies, designed to cover us with maximum security, utterly failed us on 9/11/01.
What requires a massive overhaul is a national defense system which though armed to the teeth was completely hapless in preventing any one of four commercial aircraft from reaching their targets. The only plane brought down occurred over a field in Pennsylvania and it was done so by a make-shift group of civilian passengers on board. The result of this insulting wake-up call? More funding is poured into national security.
Right.
Republicans Attack Plan: Tax cuts for the Rich, more money for national security, less for social security. How they manage to fool even a small percentage of the populace into voting for them is a marvel.
DD
Manhattan
131
Be honest and lead with your last paragraph: you want more money for these co-ops (to waste).
1
Seems the government wants to turn all businesses into co-ops managedand funded by the government with taxpayer money. Bernie, we need you. Please don't move to Denmark. .
4
The non-profit plans set premiums too low to cover the cost of care. Now those consumers who paid too little will have to find plans that cost more but presumably WILL cover the cost of care. Sounds like simple math to me: you get what you pay for. If you buy a car for $1,000 it's unlikely to run as smoothly as a car that costs $10,000. I'm not against nonprofit insurance or the ACA, I just think people need to understand that healthcare will never be "free" (as much as they would like to pretend it should be).
3
It's nice to be naive, isn't it? Nobody is saying it should be free. People in Denmark know it's not free. They chose a different approach so everyone could get coverage and pay for it through their taxes. They've done a much better job of it than we have where we only seem to care about the rich getting coverage.
We've made different rules for the non-profits which hurt them competitively. If they are truly non-profit, they should easily be able to compete because they aren't paying out multi-million dollar salaries and bonuses.
We've made different rules for the non-profits which hurt them competitively. If they are truly non-profit, they should easily be able to compete because they aren't paying out multi-million dollar salaries and bonuses.
Without the words, it is socialism vs capitalism.
1
If failure is their standard, Republicans should consider opposing capitalism where the failure rate of new enterprise is about 90%.
9
Not surprising in the current Obama economy.
Exactly who is doing this? Please name these people, do not simply roll them up into a big generic "Republicans and other critics of health care reform". The public deserves to know who they are. And these elected officials - who are paid by the public and receive publicly funded heath care - do not deserve anonymity.
8
Health Republic of NY is one of these co-ops that's is discontinuing coverage at years end due to a lack of promised funding, and the inability to raise capital. The carrier had attractive premiums and a robust network in contrast to the anemic networks of some of its long standing competitors such as Emblem and Blue Cross, and consequently attracted over 210,000 individual and group members in it's brief history. Brokers such as myself are now faced with the dilemma of finding alternate coverage for our clients among the the few remaining carriers. The choice will be affordable plans with limited networks and higher costs for care, or unaffordable plans with large networks and lower costs to access care.
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2
Not only that, but Health Republic is the only insurer on the exchanges that includes Memorial Sloan Kettering in network (and there are no out of network benefits on the exchanges). Without this plan, there are no options for self-employed individuals and their families or small businesses to purchase insurance on the exchanges and receive care at the premier cancer center in the state. And this means--no option at any price, as many patients would be willing to pay higher premiums in return for cutting edge cancer care.
Republicans will not be happy until we are all stepping over the bodies of sick people lying in the streets because there is no healthcare they can afford.
14
Walk around Washington DC or Atlanta and that's exactly what you see, in broad daylight, sick people lying on rags.
Perhaps it's time to consider Steven Brill's solution. Let the large healthcare systems have their own regulated insurance companies, thus aligning the interests of the provider and the payer. It would be a market-based solution which should please conservatives.
Other writers here are correct, for-profit insurers have no business in healthcare. The built-in conflict of interest of the current insurance system is glaring, yet we seem to ignore the glare.
Other writers here are correct, for-profit insurers have no business in healthcare. The built-in conflict of interest of the current insurance system is glaring, yet we seem to ignore the glare.
6
" a weak, underfunded alternative to a much stronger option that the Republicans blocked from passage."
Nice attempt to lay the blame for the ACA's failings at the feet of Republicans, but since the mess passed without a single Republican vote, I can only believe that it could have have contained anything the Dems wanted. This is their doing.
Nice attempt to lay the blame for the ACA's failings at the feet of Republicans, but since the mess passed without a single Republican vote, I can only believe that it could have have contained anything the Dems wanted. This is their doing.
1
Nice attempt to ignore the term "filibuster" which is how the minority party blocks stuff they don't like.
This is revisionist history by the Times. Enough Democrats, including nominal independent Joe Lieberman, opposed the public option to ensure that it would never be part of the final legislation. It is true that Republicans never supported the public option, but it was lack of unanimous Democratic support of the public option that doomed it.
5
Lets face it. Non-profit coops do not have the deep pockets that Big Insurance has to make big campaign contributions to their wholly owned party hacks who are there to make sure that policy and money flow in the same direction, to those very same deep pockets.
Aren't there some people who have gone to jail for doing the same thing on a smaller scale?
Aren't there some people who have gone to jail for doing the same thing on a smaller scale?
6
Another ignorant, lopsided, misleading effort from the NYT Editorial Board on behalf of their lord and savior, Barack Obama.
Couching valid legal challenges to an unconstitutional law with populist suggestive rhetoric (oh, the mean GOP is going after "nonprofit" groups) misses the entire point of the lawsuit.
Let me repeat this, and I do so as a lawyer in Washington DC.
The NYT attempt to define the GOP lawsuit in terms of a nonprofit healthcare entity misses the entire point of the lawsuit. It's like critiquing the high heel shoes opposing counsel is wearing as grounds for granting an acquittal at a murder trial.
I just had to say that. Now back to another comment board filled with nonsensical comments from Obama supporters who STILL don't realize that it is legally IMPOSSIBLE to covert Obamacare to a single payer system because the FOR PROFIT insurance companies who wrote most of the ACA made sure of it.
The only legal path to single payer or Medicare for all is to repeal Obamacare fully, which will get you vilified in the NYT as an enemy of the State.
Oh the irony.
Couching valid legal challenges to an unconstitutional law with populist suggestive rhetoric (oh, the mean GOP is going after "nonprofit" groups) misses the entire point of the lawsuit.
Let me repeat this, and I do so as a lawyer in Washington DC.
The NYT attempt to define the GOP lawsuit in terms of a nonprofit healthcare entity misses the entire point of the lawsuit. It's like critiquing the high heel shoes opposing counsel is wearing as grounds for granting an acquittal at a murder trial.
I just had to say that. Now back to another comment board filled with nonsensical comments from Obama supporters who STILL don't realize that it is legally IMPOSSIBLE to covert Obamacare to a single payer system because the FOR PROFIT insurance companies who wrote most of the ACA made sure of it.
The only legal path to single payer or Medicare for all is to repeal Obamacare fully, which will get you vilified in the NYT as an enemy of the State.
Oh the irony.
7
On DCBarrister's last point, he is correct. Congress, some day, will have the votes to pass a new universal health care law, based on good models elsewhere (Canada, Switzerland, etc.). Of course, when this happens, current laws including the ACA will cease to be in effect. But the sequence is the opposite of what DCBarrister implies. First the new law, then the "repeal" (end) of other current laws that are no longer needed or are superseded by the new law. Not the other way around.
2
"An unconstitutional law?" You may be a lawyer/barrister in D.C.- congratulations and thanks for pointing it out numerous times- but you do seem to have difficulty grasping reality. Which legal entity, other than yourself and your partisans, has declared the law unconstitutional?
1
Betty,
Greetings from Washington DC. I absolutely love Germany and miss Europe every time I fly back to the States. Guten Tag!
When I moved to Washington after law school, and began employee orientation, I learned that around 1 in 12 professionals here are lawyers. Each of us are legal entities to the extent of our practice, and roles as officers of the court.
There are tens of thousands of lawyers and legal scholars who agree with me, including counsel for the House GOP bringing the lawsuit.
Grasping reality? Okay I will try to do that now.
1. Obamacare was re-written by Chief Justice John Roberts and "made Constitutional" after the opinion clearly established the ACA, as written was unconstitutional. A Supreme Court Justice re-writing an act of Congress? Now that's unconstitutional.
2. More reality. The ACA went to the Supreme Court a second time, this time because the law, as written by Congress in plain language was unconstitutional. To save the ACA a second time, the language clearly stated in the ACA was ignored, in favor of a reality-challenged claim that the Supreme Court knew better what Congress meant than Congress.
Betty, the law is my day job. And I am considerably blessed.
Greetings from Washington DC. I absolutely love Germany and miss Europe every time I fly back to the States. Guten Tag!
When I moved to Washington after law school, and began employee orientation, I learned that around 1 in 12 professionals here are lawyers. Each of us are legal entities to the extent of our practice, and roles as officers of the court.
There are tens of thousands of lawyers and legal scholars who agree with me, including counsel for the House GOP bringing the lawsuit.
Grasping reality? Okay I will try to do that now.
1. Obamacare was re-written by Chief Justice John Roberts and "made Constitutional" after the opinion clearly established the ACA, as written was unconstitutional. A Supreme Court Justice re-writing an act of Congress? Now that's unconstitutional.
2. More reality. The ACA went to the Supreme Court a second time, this time because the law, as written by Congress in plain language was unconstitutional. To save the ACA a second time, the language clearly stated in the ACA was ignored, in favor of a reality-challenged claim that the Supreme Court knew better what Congress meant than Congress.
Betty, the law is my day job. And I am considerably blessed.
1
It's an old story that has been going on since health care was thought of.The Conservative position on all things not just non profit health insurance is power to the powerful, while liberalism is power to the people.Politics is a profit making vocation.The Republicans found a way to support their big business supporters by incorporating religion to cover up their greed,Their attack against Planed Parenthood which in it's self is a threat to profit making health Insurance vultures, was covered up by their position against abortion,, which was what drove the religious blue collar voters to vote against their own economic interests.Throughout History Religion has always been the Darling of the Powerful.Nothing has changed, It's not a issue about small or large Government, as the Republicans would have you believe, its no more than keeping the powerful in control, & the weak obedient.
5
I can't imagine the amount of money lining the pockets of those opposed to ACA and properly priced prescriptions for all. It must be staggering ..
2
Oh dear what is the future of our Ostrich Republic.
In all major western industrial countries, including the much loved Israel ,Universal health care works, gun control works,tax codes are fairer, infrastructure is maintained and developed,the environment is cared for.
Why do we continue to ignore alternatives and not work for the overall good of our people .
In all major western industrial countries, including the much loved Israel ,Universal health care works, gun control works,tax codes are fairer, infrastructure is maintained and developed,the environment is cared for.
Why do we continue to ignore alternatives and not work for the overall good of our people .
10
Just what is it that republicans have against healthy people? Do they think that if enough poor people die off that will only leave the wealthy to vote? It does seem obvious to me that republicans really believe only the wealthy should lead the country and the poor should meekly follow along like good little sheep.
10
As someone who has had serious med problems since birth...It was Very expensive for me and this country to cover my healthcare costs when I was constantly denied health insurance coverage due to "pre-existing" conditions. The funny thing is -- we all share the worst pre-existing condition of all -- it's called Mortality. Everyone dies! Some just don't know which ailment is most likely to kill them. Now that I have medical insurance for the first time, it's much cheaper to cover all of my needs -- out of my own pocket -- and for the country. Go figure. Single-payer would be even better...but racism and disdain for the working poor will never allow that.. Many don't seem to realize that Hitler began tossing all of "us" who were seriously ill or disabled into the ovens before he went after the Jews! Has human nature changed much since then? What about moving toward the common good?...It's morally superior and it actually costs less! Why do you think Romney tried to take that approach in MA? Toxic greed is so transparent -- along with racism and the childish, narcissist belief that wealth equals superior intellect.
8
Sorry folks, but the Democrats drove this bus into the ditch all by themselves. Not a single Republican voted for ACA in the House or in the Senate – not one. No provisions were included in ACA to garner GOP votes (because none were needed) and no provisions were left out of ACA to garner GOP votes (because, see above, none were needed). The public option was dropped by Democrats at the request of other Democrats – with no input from the GOP. Democrats could have passed any bill they agreed to amongst themselves, and ACA is the mess that came out of that golden opportunity. To take the position now, as the Editorial Board does, that the “bad” elements of Obamacare are the Republican elements is disingenuous at best, and a real disservice to readers who, based on the comments so far, seem to rely on NYT for honest reporting.
4
this was a GOP plan in the state of MA. The GOP in congress opposed it as part of their goal to make Obama a 1-term president, and to heck with everyone else.m
1
Let's see. Co-ops are failing because they can't cover their costs and subsidies are running out. Medicare is spending more money than it's taking in and is increasing premiums on some beneficiaries - but it's still headed for insolvency. Medicaid has become the single largest budget item for many states, squeezing out spending on education and other government programs.
And the NYT wants a public option - another open-ended, unaccountable program to be funded by the "rich" - which of course means anyone who makes more money than the NYT editorial board.
And the NYT wants a public option - another open-ended, unaccountable program to be funded by the "rich" - which of course means anyone who makes more money than the NYT editorial board.
3
Social Security is 80 years old. When Social Security was still in the crib FDR had opponents to try to kill it before it began. Just like the GOPers are doing now with healthcare reform.
One of FDR's most ardent opponent to Social Security was Fred C. Koch. That's right, father to Charles and David Koch. They have been at trying to kill Social Security for it's entire life.
GOPers will spend the next 80 years trying to kill healthcare reform. And all efforts will be made in vain.
GOPers have no clue what average Americans want and need. They will fail in this effort also.
I wouldn't worry too much about these GOPers. They are incompetent and they can get nothing done. With only a little concerted effort by the voters, you know like showing up to vote, these GOPers can be made to high tail it.
So remember. GOPers have tried for 80 years to kill Social Security and they have failed. The GOPers will fail to kill healthcare reform. Because they are stupid and have no idea how to get anything done.
One of FDR's most ardent opponent to Social Security was Fred C. Koch. That's right, father to Charles and David Koch. They have been at trying to kill Social Security for it's entire life.
GOPers will spend the next 80 years trying to kill healthcare reform. And all efforts will be made in vain.
GOPers have no clue what average Americans want and need. They will fail in this effort also.
I wouldn't worry too much about these GOPers. They are incompetent and they can get nothing done. With only a little concerted effort by the voters, you know like showing up to vote, these GOPers can be made to high tail it.
So remember. GOPers have tried for 80 years to kill Social Security and they have failed. The GOPers will fail to kill healthcare reform. Because they are stupid and have no idea how to get anything done.
72
Republicans voted 81-15 in the House and 16-5 in the Senate to pass social security. I know this because one of Republicans voting in favor was my great-grandfather.
The fact that not one Republican voted for the ACA should tell you something about the bill.
Some Republicans have tried to repeal Social Security because it's an anachronism that will become insolvent at some point in the future. Do you want to bankrupt the country based on legislation passed 80 years ago? There was a time when Democrats understood that sometimes you have to reform your own handiwork when it proves outmoded. That no longer appears to be the case.
The fact that not one Republican voted for the ACA should tell you something about the bill.
Some Republicans have tried to repeal Social Security because it's an anachronism that will become insolvent at some point in the future. Do you want to bankrupt the country based on legislation passed 80 years ago? There was a time when Democrats understood that sometimes you have to reform your own handiwork when it proves outmoded. That no longer appears to be the case.
This is a laughable comment. Your state is in an inexorable death spiral of Democrat incompetence and corruption. The last time I had to go through Chicago, shops were begging me to buy.... We can ship out of the city to avoid taxes! And yet your hatred of republicans rules everything you think. Good luck with that as you follow Detroit down the rabbit hole, and we will not bail you out at the bottom.
...save genocide of fellow Americans based on income level and, possibly, race through malign neglect.
The Affordable Care Act is far from perfect. It has done little to improve quality of care (most newly enrolled people are in Medicaid a low quality provider) or cost of care. Thankfully some people with pre-existing illnesses can now be covered. My main reservation about the editorial, though, is that it does not make positive suggestions about fixing the Act and just keeps on criticizing Republican's unhelpful attacks on the ACA.
3
It's not affordable care. It's unaffordable health insurance. It's Obamacare.
It should be the opposite! Making a profit on healthcare? Seems unethical. I still cannot believe our country does this.
1
Unethical? It is simply immoral!
We've been here before.
Many Medicare-eligible seniors dropped traditional Medicare and enrolled with private health insurers offering better benefits at lower cost when Medicare was changed a couple decades ago to add an option now now known as Medicare Advantage plans that are partially government-subsidized. Enrollees had to pay little or no additional premiums and co-pays as small as $1. Some of those insurers were HMOs, many non-profit.
What happened? First, the insurers underestimated their healthcare outlays. Some went bankrupt. Others dropped out of Medicare Advantage. The rest jacked up their premiums and co-pays.
Then, the Obama administration figured out the reason Medicare Advantage plans were able to deliver more benefits at lower cost than Medicare was that the federal government was subsidizing Medicare Advantage plans by paying even more to those plans than it paid for traditional Medicare. That subsidy is being reduced under the Affordable Care Act (ObamaCare).
Even so, close to a third of all Medicare-eligible seniors get their healthcare benefits, including prescription drug coverage, from Medicare Advantage plans.
Many Medicare-eligible seniors dropped traditional Medicare and enrolled with private health insurers offering better benefits at lower cost when Medicare was changed a couple decades ago to add an option now now known as Medicare Advantage plans that are partially government-subsidized. Enrollees had to pay little or no additional premiums and co-pays as small as $1. Some of those insurers were HMOs, many non-profit.
What happened? First, the insurers underestimated their healthcare outlays. Some went bankrupt. Others dropped out of Medicare Advantage. The rest jacked up their premiums and co-pays.
Then, the Obama administration figured out the reason Medicare Advantage plans were able to deliver more benefits at lower cost than Medicare was that the federal government was subsidizing Medicare Advantage plans by paying even more to those plans than it paid for traditional Medicare. That subsidy is being reduced under the Affordable Care Act (ObamaCare).
Even so, close to a third of all Medicare-eligible seniors get their healthcare benefits, including prescription drug coverage, from Medicare Advantage plans.
3
Republican obstructionism has become, by now, a trademark of sorts, anything to make Obama's life more difficult. What they willingly forget, however, is the tremendous harm they do to the poor and indigent. Little empathy (if any), much pettiness, and hypocrisy in claiming to represent their interests. Affordable health insurance is a given for members of Congress; perhaps it shouldn't, in strict justice.
33
You don't understand. The poor are best served by transferring their money to the wealthy.
So at some point in 2009, the Democrats had a fillibuster-proof majority of 60 Senators, after Al Franken stole the election in Minnesota. If this provision was so important, why wasn't it too rammed down the throat of all of us like the rest of Obamacare? Could it be that even some Democrats were a bit scared to vote for a public option? I don't remember all the details, but surely the Times should be focusing their criticisms on the then Democrat Leadership in Congress who neglected to get such a critical program thru when they had the chance.
Not just Mr. Obama, they will react the same way to any Democratic President as their 'rank and file' membership, abetted by the folks at Fox, and of course Rush, Laura, Ann, and Co. spewing hate radio, don't really accept democracy.
The Satanic Party is at it again. God forbid, Americans have a less expensive alternative than the greedy for-profit insurance companies, and they have to destroy it. Always, always, they dance with the ones who brung 'em: AETNA, Anthem, Blue Cross/Blue Shield, Cigna, etc. Unless and until we get campaign finance reform, this will continue to happen. And, to add to the problem, a dumbed-down, low-info electorate that votes against its own interests.
8
Health care reform (as opposed to Insurance reform) will only come when for-profit insurance companies are kept out of the conversation.....
52
Can't some rich Democrats remedy this by putting together a national coalition of state non-profit insurance companies, reminiscent of the old Blue Cross-Blue Shield network before it went for profit? Bernie Sanders' futile dream of a single-payer plan aside, I think a robust non-profit healthcare insurance sector, like we had when I began in the business in the 60s, would go a long way to putting patients ahead of profits. Now back to the ICD-10 conversion.
7
Since opposition has always existed, it makes little sense to blame opposition for its failures. It's not as though opponents suddenly sprang into existence the moment the ACA was passed. Did democrats never think about funding? When was that miracle supposed to happen?
7
Did you read the story? Paragraph 2.
10
Ray Clark:
I read an excuse for their failure. Where was that funding supposed to come from?
I read an excuse for their failure. Where was that funding supposed to come from?
2
FDR had opponents to Social Security who tried to kill it in the crib. One of those opponents was Fred C. Koch. That's right, grandfather to Charles and David Koch. These people have been trying to kill Social Security since it's inception and they have no intent to stop.
After 80 years they still persist. These misanthropes have plans to kill healthcare reform. They think this is one way to do it. But it won't work. Nothing will.
Because GOPers will have to deal with Hillary Clinton when she is president. And she was the one who not only tried to reform healthcare but she recognized the GOP and their "vast, rightwing conspiracy."
After 80 years they still persist. These misanthropes have plans to kill healthcare reform. They think this is one way to do it. But it won't work. Nothing will.
Because GOPers will have to deal with Hillary Clinton when she is president. And she was the one who not only tried to reform healthcare but she recognized the GOP and their "vast, rightwing conspiracy."
3
The only thing wrong with the so-call Patient Protection and Affordable Care Act is that is the conservative Republican Heritage Foundation monstrosity concocted as an allegedly "free enterprise capitalist" response to the failed Clinton era healthcare reform effort. The PPACA does not protect nor is it affordable nor fair. Candidate Obama was opposed to it because of the individual mandate to purchase health insurance from private companies with no public option alternative. Along with no cost nor quality controls on private pharmaceutical, medical device, hospital and health care provider industries. President Obama abandoned candidate Obama. While the Republicans turned against any and every aspect of their own plan terminally infected by Obama's endorsement.
I favor single payer quality affordable government health care for all. And no member of Congress nor the Executive nor the Judicial branch of any national, state or local government should have cheaper nor more quality health broader coverage than the least American. While the wealthy can purchase more on their own dime. We do not need nor deserve a permanent elite class of government employment and benefit welfare kings and queens like Paul Ryan and Michelle Bachman.
I favor single payer quality affordable government health care for all. And no member of Congress nor the Executive nor the Judicial branch of any national, state or local government should have cheaper nor more quality health broader coverage than the least American. While the wealthy can purchase more on their own dime. We do not need nor deserve a permanent elite class of government employment and benefit welfare kings and queens like Paul Ryan and Michelle Bachman.
52
It never fails to amaze me how people can concoct an excuse. Blaming it on the Heritage Foundation plan is like blaming England's system because it's across the ocean or Canada's system for being in another country.
It takes a reality and twists it into a silly excuse.
It takes a reality and twists it into a silly excuse.
1
Only Repubs claim that Obamacare is a failure. If everything in the Repub world is a failure, which you have to say is true, then there is nothing that doesn't look like a failure.
Poor Repubs, on their way toward more failures.
Poor Repubs, on their way toward more failures.
So it will be the insurance market, not the housing market, that causes the next Great Recession.
5
My for profit Insurance company is leaving the business at the end off this year. Blue Cross Blue Shield of Texas and NM are dropping PPO plans the end of this year for the exact same reason.
The Times got some of the story right.
"Their problems have been attributed to wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care."
This problem is facing for profit health care providers and many are vastly reducing networks of good providers and raising premiums because they are faced with increase costs of health care as more sick people sign on and less healthy people sign on. There is zero evidence that a public option wouldn't have had the same exact problems.
The Times wants to have this both ways, attack Republicans for a poor health care plan that was passed entirely by Democrats while denying the increases needed for this same health care model to deliver quality care to their newly enrolled sick patients.
Granted the Republicans offer nothing, do nothing and have no plan to cover more people and make health care more affordable. That still doesn't make the ACA their fault. The ACA which is marginally better than the previously disaster is entirely the Democrats fault. They had the votes and they passed this mess.
The Times got some of the story right.
"Their problems have been attributed to wrong estimates for how many people might enroll and to setting premiums too low to cover the cost of care."
This problem is facing for profit health care providers and many are vastly reducing networks of good providers and raising premiums because they are faced with increase costs of health care as more sick people sign on and less healthy people sign on. There is zero evidence that a public option wouldn't have had the same exact problems.
The Times wants to have this both ways, attack Republicans for a poor health care plan that was passed entirely by Democrats while denying the increases needed for this same health care model to deliver quality care to their newly enrolled sick patients.
Granted the Republicans offer nothing, do nothing and have no plan to cover more people and make health care more affordable. That still doesn't make the ACA their fault. The ACA which is marginally better than the previously disaster is entirely the Democrats fault. They had the votes and they passed this mess.
22
A public option would (ideally) not have had to make a profit or even break even. The idea was that it would eventually capture all or most of the business from for-profit insurance and become a de-facto national system. Of course this was anathema to insurance companies, so it could not be passed, or apparently even seriously considered. The opposition was not entirely from Republicans.
3
The Health Ins. lobbyists worked overtime to steer the reform proposal away from single payer, which would put all the ins. companies out of business overnite , which is just what the country needs. Profits generated by health insurance companies are an immoral outrage, and an example of the excesses of capitalism. The CEO's take home $10M/year.
" There is zero evidence that a public option wouldn't have had the same exact problems. "
Actually there is tons of evidence from the success of the world wide single payer systems to refute that assertion. It's nit like the US has to re-invent the wheel coming up with a decent healthcare model. Basically, Americans are choking on their own market propaganda...you know, "socialism...eek!"
Actually there is tons of evidence from the success of the world wide single payer systems to refute that assertion. It's nit like the US has to re-invent the wheel coming up with a decent healthcare model. Basically, Americans are choking on their own market propaganda...you know, "socialism...eek!"
3
The problem with the ACA is that it didn't do enough to control costs so healthcare is still more expensive than it should be whether provided by Co-ops, private insurance or Medicare. We've got to stop letting the market monopolies have their cake and eat it too. Private insurance is able to manage the high costs by passing it on to consumers. A Medicare for all plan would only work with reform to drug patent laws, bargaining prices for drugs, devices, etc. Republicans aren't interested in fixing these problems. They would rather see the ACA fail than fix the glaringly obvious problem. But that is because there is nothing conservative about them. They are a party of destroyers.
15
They failed because they set the premiums too low & poor estimates of sign ups & that's the Republicans fault? Laughable liberal logic.
Why don't the Democrats take responsibility for their own failures?
Why don't the Democrats take responsibility for their own failures?
7
Democrats designed the system starting from Heritage Foundation plan, which obviously has its faults, but there was no way to anticipate the crippling action by the Supreme Court, which allowed Republicans in states to deny coverage to some of those who need it most.
3
In a bill as long and convoluted as the ACA, action by the courts should have been assumed as a given.
And the party of "NO" , is qualified to manage the governance of our heterogenous and complex nation ?
2
Maybe if the republicans would have cooperated with the wishes of the American people and found a way to fix the health care system, and it needed fixing, it would be more of a success. As long as the Obama name was attached to it, it was demonized. Over 200 amendments were put in it to get the republicans on board. This did not make the bill any cleaner, Still millions of people have healthcare.
13
And President Obama has illegally delayed or cancelled many, many moving parts of the program to allow for a 24hr news cycle to promote stories about robust enrollment and results. Laughable..
You write that the "public option" was abandoned "when it became clear that no public plan could survive a Republican filibuster."
Readers of this paper may remember a different history here: Mr. Obama abandoned the "public option" at the insistence of industry lobbyists, as the Times itself reported at the time:
http://www.nytimes.com/2009/08/13/health/policy/13health.html
What followed was the usual kabuki, where Joe Lieberman threatened to filibuster any bill with a public option -- another great contribution by Joe to American civilization.
Mr. Obama later claimed, falsely, that he never campaigned on the public option.
The failure of the coops, which were in fact designed to fail, is the result.
Readers of this paper may remember a different history here: Mr. Obama abandoned the "public option" at the insistence of industry lobbyists, as the Times itself reported at the time:
http://www.nytimes.com/2009/08/13/health/policy/13health.html
What followed was the usual kabuki, where Joe Lieberman threatened to filibuster any bill with a public option -- another great contribution by Joe to American civilization.
Mr. Obama later claimed, falsely, that he never campaigned on the public option.
The failure of the coops, which were in fact designed to fail, is the result.
33
I have always opposed the public option. I believe the insurance companies will find ways to attract the young, the healthy, and the wealthy leaving the older, sicker, poorer to the public option greatly increasing its cost. Also since many people will stick with the private plans offered by their employers, we will still have a lot of private insurance with its huge overhead and compliance costs--about $600 Billion a year.
What is required for a healthcare system to be efficient, to get better results at much less money is that it covers everyone so there is one large pool and the it is run by a single institution like government so it can tackle the difficult problem of overutilization. The public option meets neither of these requirements. Its failure would provide much ammunition to those who selfishly favor the status quo. The failure of coops is an example.
All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/dataoecd/46/2/38980580.pdf
What is required for a healthcare system to be efficient, to get better results at much less money is that it covers everyone so there is one large pool and the it is run by a single institution like government so it can tackle the difficult problem of overutilization. The public option meets neither of these requirements. Its failure would provide much ammunition to those who selfishly favor the status quo. The failure of coops is an example.
All other industrialized countries have some form of universal government run health care, mostly single payor. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at 40% of the cost per person. If our system were as efficient, we would save over $1.5 TRILLION each year.
www.pnhp.org & www.oecd.org, especially
http://www.oecd.org/dataoecd/46/2/38980580.pdf
10
How does the "everyone in one pool" work with private insurance, a staple in government-run systems?
2
AACNY - I am not sure what you mean. Even if the gov farms out out the insurance to private companies, everyone is still in the same pool since the gov can and does subsidize the companies.
I agree that there is not one pool in the Swiss system and part of the Dutch system and that wealthy Germans can opt out (but few do), but effectively there is one pool in most other systems. If we had Medicare for All there would be only one pool.
I agree that there is not one pool in the Swiss system and part of the Dutch system and that wealthy Germans can opt out (but few do), but effectively there is one pool in most other systems. If we had Medicare for All there would be only one pool.
5
AACNY, it would operate just like Medicare. Those who chose can buy Medigap insurance off the private insurance market.
1
I'm sorry but every dollar spent on the insurance industry is a dollar not spent on providing health to Americans. Cooperatives are the most efficient component of the plan except when so constrained they are barred from taking the measures to operate, doomed to fail thanks to typical republican policy bought by the insurance industry. To then blame cooperatives for their failure when they've done everything to ensure it short of burning the places down, shows up the republican powerbase at one of it's most cynically destructive along with environmental denial and sparing the wealthy from paying taxes is good for everyone.
People are wising up, though. Even those who vote republican. Even if the moneyed powerbase wind this one, it will be winning the battle but losing the war the more a centralized wealthy power base wins ground. They don't realize it but the more they win, the more they are putting themselves on the run.
People are wising up, though. Even those who vote republican. Even if the moneyed powerbase wind this one, it will be winning the battle but losing the war the more a centralized wealthy power base wins ground. They don't realize it but the more they win, the more they are putting themselves on the run.
5
Here's a thought -- since we can't pass single payer, why can't we require that exchange insurance companies be non-profits, like the old Blue Cross plans? That would remove the profit incentive that motivates insurance companies to harm their customers, without the government role that Republicans wrongly fear.
4
The federal government "loaned" the TN non-profit cooperative close to $100M to assist its startup. Now just three years later the cooperative is broke and shutting down. Lack of funding ($100M from the federal government alone for a single state cooperative) was obviously not the problem. Let's face it, sometimes the private sector does things better.
$100M in taxpayer dollars down the drain...
$100M in taxpayer dollars down the drain...
6
As the rest of the advanced societies prove.
Well, no.
Well, no.
Down the drain? Nobody got any health care?
Health care isn't cheap it is necessary. You want to hold down the cost go after the drug companies that gouge the people and a system that out sources every procedure. That is why the system got so bad. Health care is a right not a commodity.
10
The operative word in the piece was PROFIT.
Ferengi Rules of Acquisition sum up the GOP platform rather succinctly, but I would call your attention to Rules #1 - "Once you have their money, you never give it back," and #23 - "Nothing is more important than your health... except for your money." (http://trekguide.com/rules.htm)
Being a fictional ethnic group, one might think their positions on Profit are a construct. However, the GOP has proven that the Rules of Acquisition are most applicable, especially when it comes to the social contact. To that end, the lack of a profit motive in the co-op structure is enough for the reigning GOP oligarchs to deem them unfit for continuation.
Now that medicine, once upon a time a profession of caring for individuals as well as the common good, has been turned into a high profit money machine, it is no longer about caring for the sick, it has become about caring for who can pay the most. When hospitals became money laundering facilities and drug companies became gold mines, the idea of a common good disappeared, leaving in its place something that the even the estate-owning founding fathers would have found untenable.
But here's the real conundrum: the poor, the sick, and the dead cannot shop. They cannot spend money. And they cannot clean your houses and pools. Until the GOP figures out a healthy population is worth having, nothing will change. Ever.
http://wifelyperson.blogspot.com/
Ferengi Rules of Acquisition sum up the GOP platform rather succinctly, but I would call your attention to Rules #1 - "Once you have their money, you never give it back," and #23 - "Nothing is more important than your health... except for your money." (http://trekguide.com/rules.htm)
Being a fictional ethnic group, one might think their positions on Profit are a construct. However, the GOP has proven that the Rules of Acquisition are most applicable, especially when it comes to the social contact. To that end, the lack of a profit motive in the co-op structure is enough for the reigning GOP oligarchs to deem them unfit for continuation.
Now that medicine, once upon a time a profession of caring for individuals as well as the common good, has been turned into a high profit money machine, it is no longer about caring for the sick, it has become about caring for who can pay the most. When hospitals became money laundering facilities and drug companies became gold mines, the idea of a common good disappeared, leaving in its place something that the even the estate-owning founding fathers would have found untenable.
But here's the real conundrum: the poor, the sick, and the dead cannot shop. They cannot spend money. And they cannot clean your houses and pools. Until the GOP figures out a healthy population is worth having, nothing will change. Ever.
http://wifelyperson.blogspot.com/
5
This problem is precisely why the Healthcare Law should have had a basic option of single payer that is not a for profit corporation. Only when healthcare is provided by a government option is there less problem of the large for profit insurers ganging up on the Healthcare Law.
Under this plan those who want more coverage or other options can purchase a traditional for profit option in addition to the basic non-profit option.
Under this plan those who want more coverage or other options can purchase a traditional for profit option in addition to the basic non-profit option.
4
The only way the healthcare system will work is, universal healthcare for everyone with a single insurer, like they do successfully in many countries around the world. Health for-profits is oxymoron.
5
The problem for the coops is they are in a competitive situation with major insurers which are growing in size daily and contrary to popular wisdom actually have a pretty good grasp of how to manage the funding process for healthcare with all its exigencies. Setting up a new insurer from scratch and overcoming all the barriers to entry that exist in this market is incredibly hard. It's not exactly an accident that the insurance industry itself has been steadily consolidating for years. The example from Seattle the NYT quotes is ridiculous. They've been in business for 70 years and are a substantial player in the state. While one would like them to succeed this is probably going to be an experiment that fails.
2
When is the Times editorial board going to get sick and tired of being so wrong so often? The main reason for the failures of those insurance co-ops is that they are being run by people who are not competent in that field. The best and the brightest don't work there simply because those co-ops are non-profit. They cannot compete with the prevailing wage scale (be that scale right or wrong).
5
Nothing says a non-profit must pay low salaries.
Republican Senators and House Members seem very happy with THEIR OWN government provided health care. We can't have it, but they love it. It won't work, except for them.
I don't see any of them turning it down for private for-profit health care plans.
I don't see any of them turning it down for private for-profit health care plans.
16
So? They are government employees. You're not. What's the point?
1
By relentlessly and continuously sabotaging health insurance the Republicans hope to finally convince a heretofore unconvinced public the PP&ACA should never have been legislated in the first place...of course, if 'Obama care' really was the wasteful boondoggle the Republicans have contended - ad nauseum - their efforts already would have been fruitful and would not be the 'mission impossible' it is and becoming more-so as the success and utility of the PP&ACA keeps becoming more evident to all save the intensionally obtuse.
6
When will this all end? When will the Republicans stop trying to destroy the country and try to make it better?
Enough already!
The uncertainty that is created by the constant political infighting has to stop.
Have your campaign contributors not been loosing money because of you?
Everyone must become informed about the issues and VOTE - NO EXCUSES
Enough already!
The uncertainty that is created by the constant political infighting has to stop.
Have your campaign contributors not been loosing money because of you?
Everyone must become informed about the issues and VOTE - NO EXCUSES
7
The country would in fact be better if successful people didn't have pay for other people's freebies. Some of us studied hard in school and for those who didn't tough luck.
1
BlueCross is a non-profit started originally as a co-op. Profit does not increase costs, lack of competition does. We do have a government sponsored non-profit with a limited network, it's called the VA. And we all know the level of service, but know very little of the waste. Perhaps Sanders could nationalize all the private insurance companies, that way all the liberals will stop complaining, and we can all go stand in line at the VA. It is truly mind boggling what people do not understand about the health care market.
4
Yes, mind-boggling that people don't understand that all other industrialized countries provide universal health care that results in better outcomes for their citizens, at an average of half the cost per capita. The first rule in life is, "if what you're doing isn't working, then do something else." It's well past time to do it differently in this country.
1
It is truly mind boggling how provincial and poorly educated conservatives are. I lived with a single payer system. It works perfectly well. There are no lines, no postponement of treatment, no anxiety that a serious disease will bankrupt you. The government negotiates prices with pharmaceutical companies and health-care providers. True, not everything is covered. This is why you can get an additional private insurance that will cover whatever exotic treatments you think you might need. These private plans can be pretty expensive but they are supplementary, not primary. When I tried to explain the American system to my Italian and Israeli friends this summer, they just gaped at me, unwilling to believe that such a ridiculous, expensive and inefficient thing can exist. Incidentally, the Israeli government recently passed a law limiting medical tourism because it strains the resources of the country's hospitals. Most medical tourists are from the U.S. Sonmuch for "quality of care" shibboleth!
1
Hawk -- you can have competition among non-profits ... indeed one of the ways to look at what is happening is that some of the weak non-profits are getting weeded out, in favor of the stronger non-profits.
1
Hopefully the Democratic Party has learned a valuable lesson from the GOP circa 2000-2015. Never, ever back down, like the Dems basically did during the election of 2000, in supporting the Iraq War in 2003, and in thinking they could compromise on healthcare when they knew that the public option (and truthfully single-payer) was the proper way to construct that healthcare plan. The Dems were weak in all of those situations when they should have been strong, and now we are left with a petulant GOP that has redistricted itself into Congressional power well into 2020 when they can again gerrymander into immovable power until 2030.
7
Lamplighter -- while I too am upset with the crazy right, "never back down" amounts to "be crazy like them."
That's not a solution.
That's not a solution.
Yes, Lee, you are right. I was looking for a good start to the sentence and got carried away. Still, the Dems need to develop a stronger method of dealing with GOP intransigence, and I believe they have gave way too much ground in yhe last 15 years. Better?
The key word in this article is destroy. This is what Reoublicans do: destroy.
81
Yes, and now, they are destroying each other.
While perfecting their politics of anti, Republicans have forgotten what they are for. Sooner of later, people notice.
23
I had Blue Cross/Blue Shield when it was a non-profit. Give the new kids on the bloc a chance. I wish BC/BS was still a non-profit. They wouldn't be so arrogant.
34
The ACA is sausage. President Obama spent enormous political capital to move the country toward reform of health care delivery (it was not a system) leading a cowardly Congress to act. The political calculation to co-op a conservative model tempered by progressive amendments was, it turned out a pretty effective tactic, resulting in a health care system in the United States, albeit a deeply flawed one. The fact that it took damaging compromises to make anything happen at all is testimony to political cowardice, mainly by conservative Democrats. The fact that we are absolutely stuck with it, is testimony to political right wing extremism. What are the radicals who want to repeal the ACA offering? Not one plausible alternative to a complex challenge, just accusation and rhetoric. No surprise there, global climate change, income inequality, crumbling infrastructure, all need action but none is forthcoming, just more shouting. Here's an idea, Republicans offer legislation to fix the co-op problem. That alone won't fix the ACA it will just make health insurance more affordable for some; no? What is your plan, tell us.
20
The Romney model and/or Heritage Foundation model were never embraced by conservatives. Certainly conservatives would never embrace any model enacted by liberals. That would be easy to predict.
1
What is your repub plan?
It is time to do a "Harper" on the GOPers down here.
They deserve no less.
They deserve no less.
1
Many low income families rely on non profit health care providers.. Evidently the GOP congress is bent on destroying this option for them. Just another way to punish people who may have the nerve to vote for the Democrats.
15
My M.O. H.C. Exchange type of solution.The content shortly: connect the private and public h.c.providers with a computerized network following the patient.Secondly,using my new kind of 3 double secure M.O.-derivate instrument or project payment form in H.C. The idea: if provider's project proposal (plan) has better productivity results (defined in a broad way,by legistlation in co-operation with the market providers,doctors,etc) than the proposed deal (plan prices,other terms) the resulted "over-value" would be sold to buyers (plan users-patients,workers,providers,investors) on win-win base-50-50%.These could be of type I (lower earning profit,for lower price plans) or type II,for higher plans) where the profit-% would be higher than in type I.Pros: the political struggle could maybe be excluded/endend as the partial market (investment) solution,providing profitability solutions defined in a broader way than only money profit (fe. working conditions,security for patients long term interests and own co-operation in research etc) could provide better H.C. than today,in the federal H.C. exchange.The patient co-operation and possibility to be part of the investing base.The threefold security base of the M.O.-option for investments (secured by insurance companies during the project time,and payable after the end of the project under the surveillance/transparency to taxing bureaus.
Vidorg compony builder a.odds,philosopher-social sc,writer
Vidorg compony builder a.odds,philosopher-social sc,writer
2
As Bernie Sanders says, we need single payer healthcare. If he is elected perhaps we will finally join the rest of the civilized world in providing universal healthcare to all its citizens. If the Republican "threaten" to filabusterr this proposal please show it on regular TV, let people see them standing there telling everyone why they don't deserve the government healthcare that they themselves get.
33
It is estimated to cost $5,000 per person.
That's $20,000 per year per family of 4.
Since half can't pay working family's will have to pay $40,000.
Sounds fair to me.
That's $20,000 per year per family of 4.
Since half can't pay working family's will have to pay $40,000.
Sounds fair to me.
2
Miriam - I agree with you, however you might Google "Health Benefits for Members of Congress", dated June 17, 2015, to find out how members of Congress are covered with health insurance.
1
Bernie's home state, Vermont, is one of the most liberal in the country. And they couldn't even get single-payer healthcare done. Why ? Because they said it would have required an 11% increase in payroll taxes and a 9% increase in income taxes. So people loved single-payer healthcare .... right up to the point where they had to pay for it. Liberals love to eulogize Europe and their single payer plans. But most have high taxes applied to everyone to pay for it. For example, the UK funds their health system with a 17% VAT (sales tax) that hits everyone. Thatcher was right. At some point, you run out of other people's money.
14
The Counterfactuals are at it again.
Big Corporations, Big Banks and a wholly owned congress in one way or another busy transferring Debt and Risk to the people, as long as we aren't organized to counter them.
No developed nation--and most others -- fail to provide health care as a right.
Big Corporations, Big Banks and a wholly owned congress in one way or another busy transferring Debt and Risk to the people, as long as we aren't organized to counter them.
No developed nation--and most others -- fail to provide health care as a right.
14
If we really stop and think, why do we expect for-profit health insurance to work in favor of the consumer?
235
On that basis, why do you expect for-profit car manufacturers or restaurants to work in favor of the consumer ? Companies provide goods and services that are appealing to consumers not because they are charities, but because such practices earn you customer demand for what you sell. And this demand allows you to sell your goods and services for a profit. The profit-seeking motive and the desire to please customers are not in conflict ... they are inter-connected. It is the alternative when government or a monopoly providing a service that really isn't affected by good or bad service that you more often find problems.
I'm losing my coverage thru Health Republic, a co-op which is closing as of 12/31/15. I'll return to a major provider, identical plan, $250 more per month.
27
So sorry to hear that. Contact Bernie's campaign, and hopefully he will put out the word re: what's happening.
I love all the people on Medicare who don't want the government involved in healthcare!
23
Health care is a right not a commodity.
If you never worked in the system I suggest you try it sometime. After 17 and a half years working in hospitals I know what I am talking about.
If you never worked in the system I suggest you try it sometime. After 17 and a half years working in hospitals I know what I am talking about.
Sure, any system like Medicare is bound to be attractive when people (on average) pay (in payroll taxes and premiums) only about 1/3 of their Medicare expenses. The rest is paid by Income Taxes of which 84% are paid by the affluent (top 20%).
Again we are victims of our myths of rugged individualism, our nearly religious views of "markets", and our delusion of "American Exceptionalism".
In our minds we still have a frontier where every one is on their own. All those other countries that have decided on national healthcare are surely misguided. Every person for themselves (conservatives would still rather it be every man), no programs imposed by that evil "government" that St. Ronnie said was the problem.
In the meantime we refuse to see that healthcare is inelastic and will not be available to all from the "magic of markets" or the "invisible hand".
Healthcare should be a right of citizenship.
In our minds we still have a frontier where every one is on their own. All those other countries that have decided on national healthcare are surely misguided. Every person for themselves (conservatives would still rather it be every man), no programs imposed by that evil "government" that St. Ronnie said was the problem.
In the meantime we refuse to see that healthcare is inelastic and will not be available to all from the "magic of markets" or the "invisible hand".
Healthcare should be a right of citizenship.
24
Why?
First, the demand for healthcare may be somewhat elastic. But there's no reason to think that the demand would be. The fact that almost all medicines are developed in this country is strongly related to the fact that America offers the closest thing to a free market in drug pricing.
And as far as single-payer may a "right of citizenship" in other countries, recognize that most other countries have much higher taxes that affect everyone in order to pay for healthcare. It's not a free ride. For example, Denmark (that liberals love) charges a flat 25% VAT (sales tax). Somehow people don't like single-payer as much when they realize that they need to pay for it.
And as far as single-payer may a "right of citizenship" in other countries, recognize that most other countries have much higher taxes that affect everyone in order to pay for healthcare. It's not a free ride. For example, Denmark (that liberals love) charges a flat 25% VAT (sales tax). Somehow people don't like single-payer as much when they realize that they need to pay for it.
To Princeton 2015: Of course we have to pay for it. We are paying for it now. Take out the profit motive (even "non-profits" strive to make money) and it would cost less. If I were a captain of industry I would like nothing more than to get out of the health care business.
There is a rather large health insurance provider called Medicare. I sure hope the republicans don't find out about it.
69
I sure hope democrats give more thought to the outcomes/consequences of their proposals next time. Even moving everyone onto Medicare or Medicaid would have unforeseen consequences.
Is it too much to expect politicians to stop making outrageous promises and to spend more time on implementation than sales?
Is it too much to expect politicians to stop making outrageous promises and to spend more time on implementation than sales?
2
Medicare is completely inadequate and that's why 90 percent of Medicare eligible recipients carry supplemental private insurance.
The dirty little secret is Democrats are gutting it and getting away with it because the Republicans want to get rid of it entirely.
The dirty little secret is Democrats are gutting it and getting away with it because the Republicans want to get rid of it entirely.
1
The TP/GOP can't stand Americans Party has found it. Their standard bearer, Paul Ryan, wants to privatize it. We must remain vigilant.
2
Let this be a lesson for voters: In its current configuration, the Republican Party will never, ever, do or support anything that can even remotely be perceived as being helpful to, or needed by, the greatest number of Americans, because on issue after issue the GOP demonstrates it is simply incapable of doing the right thing.
That is why we ended up with an ACA that, while better than the Republican "nothing option", falls short of the health care and insurance reform that would benefit our nation's citizens and economy the most.
That is why we ended up with an ACA that, while better than the Republican "nothing option", falls short of the health care and insurance reform that would benefit our nation's citizens and economy the most.
15
Attah boy Republicans, way to go after those poor people. And it was Joe Lieberman who intitially put the cahoots to the public option. Then some of the other insurance back moderate Democrats followed or they would have had enough votes override a filibuster. But only the Democratic Party can have a guy (Liebermann) that endorses the Republican nominee over their own nominee (Obama) caucus with them. Don't care what other policies he supported with the Dems. It was an embarrassment to even associate with a guy that openly campaigns against the Democratic nominee for President.
12
Yes, it was Joe Lieberman, corporate Democrat from Ct, who put the kibosh on the Public Option. Ben Nelson was not onboard as well. They had to bring in some moderate GOP Senators, Olympia Snow, etc in order to get a ACA passed. None of these folks backed a public option. Shame on them!
The message from the republicans is clear. Too many people have health insurance and something must be done to take it away.
If you agree you know which party is on your side.
If you agree you know which party is on your side.
19
My premiums went from $174 to $450 when Obamacare started.
This isn't about the freeloaders its about the payers.
This isn't about the freeloaders its about the payers.
No amount of non profit insurance would save this Obamacare program. The Republicans did not vote for it nor do they have to do anything but stand back and let it fail on its own then pick up the pieces and get a plan that works. One third of the exchanges have failed, premiums though for some low the deductible is upwards of five thousand dollars. That is another $416 a month. We still have close to the same amount uninsured as before. A scam was laid on the American people. Another broken promise in a long line. Remember you can keep you doctor and a decrease of $2500 per year per family??? My insurance increased 300 percent in three years. Thanks Obama!
19
What's your plan to mitigate the tragic high cost of health care?
3
C Tracy
We still have close to the same amount uninsured as before
A typical republican lie. Millions more Americans have health insurance than ever before.
We still have close to the same amount uninsured as before
A typical republican lie. Millions more Americans have health insurance than ever before.
4
@C Tracy, you should check your facts and state your sources before posting. What is the source of your claim that one-third of the state exchanges have failed? As far as I know they are all up and running. And please cite your source for "We still have close to the same amount of uninsured as before." The ACA has covered millions of Americans who weren't covered before.
@NYT, how does this rate a Times pick with such assertions?
@NYT, how does this rate a Times pick with such assertions?
9
So...... the democrats came up with this model, the model doesn't work and this is the Republicans fault..... how? The republicans said this wouldn't work when it was in the planning stages yet the republicans are being demonized for being right?
7
Actually, the Heritage Foundation came up with it, and Obama thought it would be a good will gesture, as well as good politics to start with the Republicans' plan. Little did he know that there would be no good will in return from the Republicans.
6
Jordan: "Demonized for being right?" You do mean "right-wing" don't you?
1
It absolutely is Congress' fault. Majority of GOP along with a few corporate Dems blocked the passage of a more robust plan with a public option. Defending them, at this point, is very irresponsible.
1
I am no fan of the GOP as it currently operates. Laying the problems of the ACA seems a little silly. As I recall, hardly any of the GOP members voted for the thing. It is fair to say that they have not had any interest in fixing the thing, but they did not create it and they did not vote for it. And, going back to what Massachusetts did when Romney was Governor is pretty absurd.
5
The co-op plans were an absurd "compromise" in lieu of having a good, strong public plan option in the ACA. They were designed to fail, and sure enough, they are. The pity is all the federal dollars wasted in a half-hearted attempt to get some of these plans going and temporarily prop them up.
4
Totally agree. As a taxpayer, having these boondoggles wasting our money is absurd. You can't be solvent if you take in 25% of what you pay out. The math is pretty clear. The numbers don't like. Don't blame the GOP. This was set up on a Democratic watch. I hate seeing my hard earned money thrown down the drain.
Do you think we employees of the co-ops can sue the government if we lose our jobs. We took them under the promise of the loans and the risk adjustment payouts which have been reneged on by the government in the ninth hour, so essentially the government perpetrated fraud on us. Any lawyers out there interested in taking on the government?
Does anyone else see the number of times fraud is perpetrated in this country by those in power, our own government and by the rich elite? The number of times they are bailed out when doing so and how many times they just get away with it. It has become the hallmark of doing business in America to perpetrate fraud. The new motto of America should be "Watch your back as our word is definitely NOT our bond".
Does anyone else see the number of times fraud is perpetrated in this country by those in power, our own government and by the rich elite? The number of times they are bailed out when doing so and how many times they just get away with it. It has become the hallmark of doing business in America to perpetrate fraud. The new motto of America should be "Watch your back as our word is definitely NOT our bond".
6
When my employer hires me, the intention is to have me solve problems in order to make things work. Politicians' efforts should be to make health care work, not to make sure that it fails.
16
Replace "health care" with "government" and you've nailed it!
GOP = Greedy Old Party.
10
Democrat definition of greed: Wanting to keep the money you earned.
1
Greed On Parade
2
Good one!
1
When will those so opposed to ACA produce a legitimate alternative? I've seen and read the "proposed alternatives" and every single one of them is nothing but smoke and mirrors dependent on something happening in the "market" that is never specified. Yes, things would be different if Congress had had the guts to open Medicare to all as a single payer system. But Congress, politicians and politics blocked that, not the President. Some day, hopefully not before it is too late, we will actually grasp how important it is to have health insurance for everyone at a reasonable cost. A healthy population is more productive, more energetic, and more likely to continue to support all the things we tend to value in this country. Sadly, it would seem that the 1% does not want those things.....greed has surpassed abundance and they do not realize the difference.
163
You are truly correct! As we all know who fully believe in the concept of equality in America -- healthcare is critical for everyone. Unfortunately, racism is so prevalent -- along with a deep hatred of the working poor -- that the spiritually dead 1% can't see how transparent they really are!
1
Was going to respond to some of those attacking the ACA, but I refuse to engage with nasties who think it's a bad thing that my son and I have health insurance for the first time in fifteen years. I live in one of those states with a wonderful healthcare co-opertive. It enabled me to have an eye operation that would otherwise have severely strained my family's finances. Some complain that the ACA is not perfect. I say it's more important that some kind of healthcare legislation got passed, and the Republican's certainly proved they were never going to do anything in that regard. The ACA is a monumental achievement of the Obama Administration. Government doing what it is supposed to do - improving peoples lives.
45
Lovely to hear that! Unfortunately, there is a strong libertarian mind-set in this country that says, "If you can't afford health insurance, tough luck." Sadly, the majority of the TP/GOP in Congress believe that, and their obstructionism is evident of that. Instead of being a 'we', we've become 'it's all about me'! Bernie Sanders is the ONLY way to go in order to fix this. Corporate Dems and TP/GOP dreck have little interest in helping Americans obtain what should be a right, health care!
1
Affordable health care, like a living wage, affordable housing, a comfortable retirement pension, vacations and human dignity are best reserved for the 1%.
Greed Over People is a simple governing principle.
Gild the rich and wreak never-ending economic violence on the poor.
How dare citizens want affordable healthcare ?
What thieves ! What takers of 'free stuff' !
Tax cuts for the 1% is the solution to affordable healthcare.
Kill the poor, early and often, with a vast array of economic bludgeons.
GOP 2015
Greed Over People is a simple governing principle.
Gild the rich and wreak never-ending economic violence on the poor.
How dare citizens want affordable healthcare ?
What thieves ! What takers of 'free stuff' !
Tax cuts for the 1% is the solution to affordable healthcare.
Kill the poor, early and often, with a vast array of economic bludgeons.
GOP 2015
353
Correction: Hyper Opponents of GOP 2015.
Sorry but the GOP you describe exists only in the very skewed minds of extreme partisans.
Sorry but the GOP you describe exists only in the very skewed minds of extreme partisans.
In 2014 NYT and others celebrated one of PPACA's successes through its creation of greater competition and (supposed) lower premiums, exhibit one being the Health Co-Ops. We now know the truth, it was another fantasy built on the ideological driven assumption (as exhibited by NYT here) that high prices are driven by profit motive of insurers, and if we only had more "good" non profit insurers. To blame Co-Op failures on poor Federal funding and entrenched competition is now the cover up excuse for the failure of another progressive fantasy. The fact is CoOps are poorly managed and mis-priced their products, and failed to correct their pricing errors even when it was obvious. So instead of acknowledging that perhaps the original assumption was wrong (i,e. for profit business is cause of all problems) they dig up the corpse of a government run alternative, as if government run program would be more financially successful. I assume Commentators will use Medicare and Veterans Healthcare as examples of success.
(Lastly, for NYT to compare PPACA Health Co-Ops to Group Health Cooperative exhibits NYTs ignorance of the health insurance marketplace, for the only thing these organizations have in common is the word "Cooperative")
(Lastly, for NYT to compare PPACA Health Co-Ops to Group Health Cooperative exhibits NYTs ignorance of the health insurance marketplace, for the only thing these organizations have in common is the word "Cooperative")
3
Nowhere in this piece does the board explain how the GOP is getting rid of the non-profits. The narrative explains they are closing due to financial losses. I did not see any statement, much less any evidence, that the closings are due to action by GOP legislators. I am decidedly not on the side of the GOP, but I am a big advocate of fairness. This piece is not fair by any measure.
4
The GOP is not "getting rid of the non-profits." The problem is that the non-profits were an alternative that came about "When it became clear that no public plan could survive a Republican filibuster,...." They were not an ideal solution but an attempt to make at least some lower cost coverage available.
I cannot figure out the Republican game plan. Why are they so intent on making sure that so many of us die, and die broke? Are they banking on a Malthusian solution to the growth of aging population and unemployment?
Between the fervid actions to remove any hope of health care from as many as possible, while promoting the sale of as many guns as possible, the Republicans view people as very expendable.
Between the fervid actions to remove any hope of health care from as many as possible, while promoting the sale of as many guns as possible, the Republicans view people as very expendable.
8
Yet another op-ed or article, this one from the NYT but they come from a variety of sources, which shows that if some idea makes the lives of any pne other than wealthy Americans or large corporations more difficult, it likely had its genesis in a Republican mind,
For decades, as every American without health insurance through work or Medicare/Medicaid (combined with an inability to afford outrageous premiums or a pre-existing condition) had to pay for their own inflated healthcare premiums out of their own pocket, Republicans sang the repeat chorus of: "we need change, but its just pre-mature." Of course, decades went by and it was still pre-mature until President Obama and the Democratic Party finally stood up to the huge insurance companies and gave Americans a much better deal for their dollar in the health insurance market, as well as new coverage for millions. But, the Republicans still blocked the American People from having the choice to have national healthcare - and as a result we see these cooperatives, which tried to replicate national healthcare, fail.
In there meantime, all the Republicans have done is pass double digit bills, and shut down the government, all to reverse the paltry less than complete overhaul of our healthcare system. We need to kick the evil Republicans out of power, and invite the head of France's national healthcare system (the best in the world) over to the USA to supervise a complete reinvention of the way we deliver medical care.
For decades, as every American without health insurance through work or Medicare/Medicaid (combined with an inability to afford outrageous premiums or a pre-existing condition) had to pay for their own inflated healthcare premiums out of their own pocket, Republicans sang the repeat chorus of: "we need change, but its just pre-mature." Of course, decades went by and it was still pre-mature until President Obama and the Democratic Party finally stood up to the huge insurance companies and gave Americans a much better deal for their dollar in the health insurance market, as well as new coverage for millions. But, the Republicans still blocked the American People from having the choice to have national healthcare - and as a result we see these cooperatives, which tried to replicate national healthcare, fail.
In there meantime, all the Republicans have done is pass double digit bills, and shut down the government, all to reverse the paltry less than complete overhaul of our healthcare system. We need to kick the evil Republicans out of power, and invite the head of France's national healthcare system (the best in the world) over to the USA to supervise a complete reinvention of the way we deliver medical care.
72
The French pay up to 45% in income tax & a 20% VAT tax. 65% total.
They also have almost no army.
They also have almost no army.
I do not understand the editorial's argument. Are you saying that the public option would have been better because it could keep loosing money and still staying in the market thanks to the use of other tax revenues?
2
Imagine if both parties wanted to see all Americans covered by health insurance and were working to improve the ACA.
We have one party that is hell-bent on dragging us into third world status, while keeping us distracted by calling for war anywhere, everywhere.
Until a loyal opposition returns that puts the country and governing ahead of party or ideology we'll have nothing but articles like this, where sabotage and obstructionism never sleeps.
We used to be better than this, and still can be if we can get Big Money out of our politics.
We have one party that is hell-bent on dragging us into third world status, while keeping us distracted by calling for war anywhere, everywhere.
Until a loyal opposition returns that puts the country and governing ahead of party or ideology we'll have nothing but articles like this, where sabotage and obstructionism never sleeps.
We used to be better than this, and still can be if we can get Big Money out of our politics.
7
A single payer medicare-like healthcare system for all would not cost nearly as much if the patients were made responsible for what they ate, drank or smoked. That way it could be for the older people who need it, not the young people who should be healthy.
That being said, regulation of Doctors and their sometimes enormous egos would become commonplace. Act like a uncaring jerk, your pay will suffer. Treat patients like pieces of meat, lose your bonus. And lastly, screw up at treating people and lose your job.
Now that alone would be worth overhauling the entire system.
That being said, regulation of Doctors and their sometimes enormous egos would become commonplace. Act like a uncaring jerk, your pay will suffer. Treat patients like pieces of meat, lose your bonus. And lastly, screw up at treating people and lose your job.
Now that alone would be worth overhauling the entire system.
Government projects - whether created wholly by government or motivated by it - fail. In a free market, failures close up shop and successes keep driving ahead. But under government, failures must be propped up because .... otherwise, the government looks like it's wrong.
Blame the politicians for letting the failures become an increased burden on taxpayers. The failure of co-ops - funded by taxpayers - should be allowed, and no more taxpayer money should go to keep them running. Why should taxpayers be forced to keep funding ventures that were clearly run by people whose lofty ideas and goals were destroyed by the reality? Instead, NYT and the current administration want to throw more good money after bad, believing, blindly, that somehow this can be turned around.
Sometimes when reality slaps you upside the head, you should believe it, instead of clinging to faith like an emotionally deranged child.
Blame the politicians for letting the failures become an increased burden on taxpayers. The failure of co-ops - funded by taxpayers - should be allowed, and no more taxpayer money should go to keep them running. Why should taxpayers be forced to keep funding ventures that were clearly run by people whose lofty ideas and goals were destroyed by the reality? Instead, NYT and the current administration want to throw more good money after bad, believing, blindly, that somehow this can be turned around.
Sometimes when reality slaps you upside the head, you should believe it, instead of clinging to faith like an emotionally deranged child.
5
Why are universal single-payer solutions in European nations so much cheaper, with the same or better standards of health care as the US (and covering everyone, to boot) so much less costly than they are here? In terms of GDP, those nations spend anywhere from half to two-thirds what we do. Maybe it's our precious "free market," in this case, which should be allowed to fail.
6
"Sometimes when reality slaps you upside the head, you should believe it, instead of clinging to faith like an emotionally deranged child. "
I cannot imagine a better description of the conservative rejection of single payer healthcare systems successfully employed for the last 30 years by nearly every other industrialized country in the world.
The simple key to creating a working healthcare system in the US is to follow suit of the rest of the world and remove for-profit insurance companies and hospitals from the equation.
The American conservative obsession with commodifying everything under the sun, including the suffering of the ill, is the central problem.
I cannot imagine a better description of the conservative rejection of single payer healthcare systems successfully employed for the last 30 years by nearly every other industrialized country in the world.
The simple key to creating a working healthcare system in the US is to follow suit of the rest of the world and remove for-profit insurance companies and hospitals from the equation.
The American conservative obsession with commodifying everything under the sun, including the suffering of the ill, is the central problem.
6
As many reporters have revealed, the White House bargained away the so-called "public option" very early in negotiations over the laughably-named Affordable Care Act -- which, at any rate, can hardly be called "health care reform." Subsequent history has repeatedly demonstrated that the ACA is in reality a state-sanctioned method for the insurance industry to wring more profit out of American citizens, health care be damned -- and no doubt, the failure of the non-profit insurance co-ops was part of the plan. The ACA is, in its very essence, a deeply cynical fraud perpetrated by both Democrats and Republicans in covert agreement.
14
Ando: You are exactly right. The ACA is the insurance industry's plan, and the Republican objections are the insurance industry's refinements, to up their profits at the expense of our health.
2
Republicans forgot to vote for it
The entire healthcare system needs to be converted to not-for-profit. Making a profit and shareholders wealthy because someone is ill is IMMORAL.
I have a rare kidney disease. I have faced this without insurance, and with a great employer-provided plan, and in some cases, testing, etc. can be negotiated for cash at a price that is remarkably similar to my co-pays. Where does all the other money go?...the insurance company! The fact that I am ill, and profits built into the system pay insurance execs and make millions of 401K plans increase in value makes my blood boil.... this isn't like going to the store and buying something you want ... I didn't have any choice here.
We are the only developed country that does this!
We are the ONLY country in the world that allows ads on TV for pharmaceuticals. Chew on that one for a minute.
Not-for-profit does not mean that the very skilled people in the industry should not be rewarded for their hard work and talent. It does mean that my illness should not be a commodity though.
This entire system needs a major overhaul, but enough folks are afraid of what this would involve, that they would rather be lazy or serve their own self-interests or those of the money interests keeping them in political office.
I have a rare kidney disease. I have faced this without insurance, and with a great employer-provided plan, and in some cases, testing, etc. can be negotiated for cash at a price that is remarkably similar to my co-pays. Where does all the other money go?...the insurance company! The fact that I am ill, and profits built into the system pay insurance execs and make millions of 401K plans increase in value makes my blood boil.... this isn't like going to the store and buying something you want ... I didn't have any choice here.
We are the only developed country that does this!
We are the ONLY country in the world that allows ads on TV for pharmaceuticals. Chew on that one for a minute.
Not-for-profit does not mean that the very skilled people in the industry should not be rewarded for their hard work and talent. It does mean that my illness should not be a commodity though.
This entire system needs a major overhaul, but enough folks are afraid of what this would involve, that they would rather be lazy or serve their own self-interests or those of the money interests keeping them in political office.
18
This is really about suppressing the vote. Republicans oppose health care for people with modest incomes, because the latter tend to vote for Democrats. Republicans figure that if Democrat-leaning voters are too ill to vote, or - even better - if they die prematurely, then the Republicans stand a better chance of winning elections.
1
In a rational, or at least reasonable world, health care policy wonks with or without political affiliation would by now have dissected, analyzed, and reworked the ACA and come up with something that makes the best of what made Romneycare a sound idea. If there's not enough in the core idea to work with, THEN scrap it. If the idea turns out to be sound, both parties, doing the job of good government, would work up legislation putting the new and improved ACA into law. Why does this have to be so hard?
3
The ACA is really the "anything, but single payer" plan. In an effort to curry favor from Republicans, they adopted the Mitt Romney care plan of Massachusetts, handed the financing of the health insurance exchanges to only private insurers, removed the public option, and gave loans rather grants to co-ops to ensure they were underfunded. Still not one Republican voted for this gift to the private insurance industry.
Expanding Medicare could have been much simpler, but was quickly squashed by the insurance lobby. With the closing of the pesky non-profit co-ops, the state choices are only private insurers and the great hope for the Republicans is for the entire health system handed over on a plate to private insurers.
Too big to fail anyone? Are we willing to bail out the insurers if they fail, or only if they are for profit?
Expanding Medicare could have been much simpler, but was quickly squashed by the insurance lobby. With the closing of the pesky non-profit co-ops, the state choices are only private insurers and the great hope for the Republicans is for the entire health system handed over on a plate to private insurers.
Too big to fail anyone? Are we willing to bail out the insurers if they fail, or only if they are for profit?
3
Only a Federal insurance agency, leveraging a risk pool extending from sea-to-shining sea, would have had the clout to challenge the bad actors who make the American health care system the financial debacle it is.
We spend 17%-18% of GDP in comparison to 11%-12% for our next most extravagant advanced industrial competitor - while not covering close to everyone.
But the Republicans insist, "stay the course" - with a daddy-based affirmative action baby like Jeb Bush pushing a 'reform' that would put working and middle-class Americans with preexisting conditions ever more at the mercy of the for-profit insurance industry.
We spend 17%-18% of GDP in comparison to 11%-12% for our next most extravagant advanced industrial competitor - while not covering close to everyone.
But the Republicans insist, "stay the course" - with a daddy-based affirmative action baby like Jeb Bush pushing a 'reform' that would put working and middle-class Americans with preexisting conditions ever more at the mercy of the for-profit insurance industry.
6
The affordable care act would be much better if it had not been diluted multiple times because of republican opposition.
3
Once again, the Republicans ran the car into the ditch, now they want to drive the tow truck.
4
Useless Republicans, they are a blight on society!
1
The Republican Way:
1. Oppose something because it's not your idea.
2. Make sure it will be less effective than it could be.
3. Make dire predictions about how ruinous it will be if enacted.
4. Seek to un-fund it at every turn after it's enacted.
5. Continue to make dire predictions that don't come true.
6. Point to its failings as evidence that your were right all along.
1. Oppose something because it's not your idea.
2. Make sure it will be less effective than it could be.
3. Make dire predictions about how ruinous it will be if enacted.
4. Seek to un-fund it at every turn after it's enacted.
5. Continue to make dire predictions that don't come true.
6. Point to its failings as evidence that your were right all along.
11
After point 1. should come a point 1A: oppose something that's your own idea because the current administration adopts it! This is what happened with the ACA, remember: it was based on a Republican idea called "Romneycare", but as soon as Obama promoted it, they disowned their own idea. These people are truly beyond belief.
2
"The co-op closures will mean that hundreds of thousands of people covered by those plans will have to sign up with other plans, probably with higher premiums."
Rather than "buttress up" foundering cooperatives, I'd like to see a time when Congress has a Democratic majority and we can expand Medicare to become the very "cooperatives" the ACA included in its design. Better yet, get rid of the rapacious, parasitic for-profit insurance industry and expand Medicare to everyone. I see no value-added from layer after layer of administrative costs that go to pay the CEOs of insurance plans. Get rid of them!
Until this country is willing to face the fact that the reason our health system is so screwed up, duplicative, and expensive is these middle men. Other countries don't have them. Denmark (!) doesn't have them. Do we have to wait till the US is on its knees to streamline our byzantine system?
The GOP would have us return to Darwinian healthcare, where those with means to pay insurance ransoms get coverage and the rest go without. I disagree with the Editorial Board here: don't throw good money after bad with these cooperatives. Let's concentrate our energy in developing coverage for all, where the only role for insurance companies is to process claims.
Rather than "buttress up" foundering cooperatives, I'd like to see a time when Congress has a Democratic majority and we can expand Medicare to become the very "cooperatives" the ACA included in its design. Better yet, get rid of the rapacious, parasitic for-profit insurance industry and expand Medicare to everyone. I see no value-added from layer after layer of administrative costs that go to pay the CEOs of insurance plans. Get rid of them!
Until this country is willing to face the fact that the reason our health system is so screwed up, duplicative, and expensive is these middle men. Other countries don't have them. Denmark (!) doesn't have them. Do we have to wait till the US is on its knees to streamline our byzantine system?
The GOP would have us return to Darwinian healthcare, where those with means to pay insurance ransoms get coverage and the rest go without. I disagree with the Editorial Board here: don't throw good money after bad with these cooperatives. Let's concentrate our energy in developing coverage for all, where the only role for insurance companies is to process claims.
151
Do you ever wonder why the musical "Urinetown" won a Pulitzer? It's an allegory of a lot that's wrong with American society--dependence on middlemen who add NO value to the system.
"Urinetown" concerned an individual who owned all the toilets in a town, and required payment of a quarter for anyone to heed a call of nature.
That pretty much defines the non-need for for-profit health insurers. They add NOTHING to healthcare, but just extract their tribute--like gangsters.
"Urinetown" concerned an individual who owned all the toilets in a town, and required payment of a quarter for anyone to heed a call of nature.
That pretty much defines the non-need for for-profit health insurers. They add NOTHING to healthcare, but just extract their tribute--like gangsters.
2
This is exactly what happens in standard, fee-for-service Medicare: healthcare insurers serve ONLY as claim processors.
1
The Republicans are a disgrace. They offer no solutions to common problems.
9
ONE TRICK PONY! Yaaawn! So the GOP extremists are at it again. Wasting voters' time and money with another way of sniping at Obamacare. Anything to avoid legislating and governing. After all, they will tell you right up front that the voters believe that Washington is BROKEN and something must be done to fix it.
Oh Yeah! Like getting rid of the GOP wingnuts who sabotage government while blaming it on others. Hypocrites they are!
Slash funding for successful programs that go counter to their ideology, then denounce them as a waste of federal money.
NOPE! The waste of federal funds is the salaries of the GOP saboteurs who refuse to do what they were elected to do: legislate and govern.
I just read today that the GOP operative who started the investigation of Hillary as Secretary of State has skipped a number of committee meetings. He was reminded by another member of the House that such conduct may be a violation of federal law. Aha! Washington's broken--so they want to break it even more--just for good measure.
I think the favorite sport of the GOP extremists is to Pillory Hillary! That garbage will be going on as a daily soap opera that our grandchildren will watch. That and Obamacare Eats Manhattan!
So creative, these artsie fartsie GOP types! Dontcha love it?
Since GOP extremists believe that government is the enemy, when they are elected, they view their mission as going to DC to destroy the enemy. Logical, right?
People--vote with your feet!
Oh Yeah! Like getting rid of the GOP wingnuts who sabotage government while blaming it on others. Hypocrites they are!
Slash funding for successful programs that go counter to their ideology, then denounce them as a waste of federal money.
NOPE! The waste of federal funds is the salaries of the GOP saboteurs who refuse to do what they were elected to do: legislate and govern.
I just read today that the GOP operative who started the investigation of Hillary as Secretary of State has skipped a number of committee meetings. He was reminded by another member of the House that such conduct may be a violation of federal law. Aha! Washington's broken--so they want to break it even more--just for good measure.
I think the favorite sport of the GOP extremists is to Pillory Hillary! That garbage will be going on as a daily soap opera that our grandchildren will watch. That and Obamacare Eats Manhattan!
So creative, these artsie fartsie GOP types! Dontcha love it?
Since GOP extremists believe that government is the enemy, when they are elected, they view their mission as going to DC to destroy the enemy. Logical, right?
People--vote with your feet!
24
The instant it dies, I will drop my coverage. Why should I waste my money on a product I will not use?
2
If "it" is the ACA, you should waste your money on it for the same reason you waste your money on homeowners or car insurance. You never use that, do you?
3
So you know you are never going to be sick or injured? How have you done it? We all want to know.
9
Time for America to join the rest of modern Western countries and establish a federal single payer system of universal health care for all!
****A Connecticut physician
****A Connecticut physician
16
The Republican Party cannot govern, it can only attempt to repeal, be it healthcare or safe gun laws. The lunatics have taken over the asylum and even the few moderate R's are now complicit. They must be routed come election time. Let us hope that the Canadian election is a harbinger of what's to come.
125
Obama will veto.
Republicans value the profits of the .1% above the health of the rest of the people of this country. If you care about your health, don't vote Republican.
117
HDNY-- I used to think that a statement like this was partisan, divisive and destructive to civil discourse. Then The GOP after 2010 happened...
5
Non-profit co-ops, as described here, seem to me to be a viable alternative to for-profit insurance plans in that they take away the profit motive, and can thus lower premiums. This is an alternative to the public option which the GOP, or the party of greed, stopped from happening. Yes, they should be funded in whatever way they can.
One way to fund the co-op program: take away the funding from one or two F-35 fighter planes, estimated to cost in total:
"The United States is projected to spend an estimated $323 billion for development and procurement on the program, making it the most expensive defense program ever." In another estimate:
"In 2012, the total life-cycle cost for the entire U.S. fleet was estimated at US$1.51 trillion over a 50-year life, or $618 million per plane."
Trim a million here, a million there, and who knows what we might be able to do.
One way to fund the co-op program: take away the funding from one or two F-35 fighter planes, estimated to cost in total:
"The United States is projected to spend an estimated $323 billion for development and procurement on the program, making it the most expensive defense program ever." In another estimate:
"In 2012, the total life-cycle cost for the entire U.S. fleet was estimated at US$1.51 trillion over a 50-year life, or $618 million per plane."
Trim a million here, a million there, and who knows what we might be able to do.
204
Don't forget the $200 million we waste each day in Afghanistan, all so that Obama can show the hawks how tough he is.
4
Jordan,
Surely you jest. Don't you know we need overpriced F-35 airplanes to maintain the empire for the benefit of the Wall Street bankers and financiers, and for GOP presidents a la George W. Bush!
We (Americans) must have more Mission Accomplished opportunities and Benghazi Committees. See, these Mission Accomplished and Benghazi Committee moments make us feel better as we suffer from extreme income and wealth inequality, as we watch our health deteriorate because we can't afford health care and as we watch our national infrastructure deteriorate.
Which way to America's Flavian Amphitheatre?
Surely you jest. Don't you know we need overpriced F-35 airplanes to maintain the empire for the benefit of the Wall Street bankers and financiers, and for GOP presidents a la George W. Bush!
We (Americans) must have more Mission Accomplished opportunities and Benghazi Committees. See, these Mission Accomplished and Benghazi Committee moments make us feel better as we suffer from extreme income and wealth inequality, as we watch our health deteriorate because we can't afford health care and as we watch our national infrastructure deteriorate.
Which way to America's Flavian Amphitheatre?
5
Excellent comment! Thank you.
If President Obama would have done what he promised, and not do "bait and switch", everyone would now be in Medicare. Mr. Obama caved in to the special interests and the oligarchs to create the ACA; plain and simple.
The GOP does not have to kill the ACA, its vast complexity, and its ever adding "exemptions" will kill it. The idea was universal health care fro all, what we got falls woefully short. The idea was to make health care affordable, very hard to do if no provisions were made to reign in health care costs.
If the GOP is to be blamed for anything was for coming up with the idea of buying insurance or pay a fine. For Mitt Romney implementing it in Massachusetts. And fro Mr. Obama, and in pocket politicians, to bow to lobbyists to thrust the ACA on America.
Too bad the US will never elect a person like Bernie Sanders to right the ACA wrong. Too bad our system has gotten so corrupt, that providing Medicare for All will be forever stopped by those who profit by misery. And too bad, we will not see a sweep like what was done in Canada last night. That is, sweep from power the "status quo".
Until Americas finally decide to take their government back; this country will continue down the road of ruin. Th ACA is just one part of a nation in very serious trouble. A nation whose priorities no longer service the masses, but the few.
The GOP does not have to kill the ACA, its vast complexity, and its ever adding "exemptions" will kill it. The idea was universal health care fro all, what we got falls woefully short. The idea was to make health care affordable, very hard to do if no provisions were made to reign in health care costs.
If the GOP is to be blamed for anything was for coming up with the idea of buying insurance or pay a fine. For Mitt Romney implementing it in Massachusetts. And fro Mr. Obama, and in pocket politicians, to bow to lobbyists to thrust the ACA on America.
Too bad the US will never elect a person like Bernie Sanders to right the ACA wrong. Too bad our system has gotten so corrupt, that providing Medicare for All will be forever stopped by those who profit by misery. And too bad, we will not see a sweep like what was done in Canada last night. That is, sweep from power the "status quo".
Until Americas finally decide to take their government back; this country will continue down the road of ruin. Th ACA is just one part of a nation in very serious trouble. A nation whose priorities no longer service the masses, but the few.
131
In the 2014 elections we saw the lowest voter turnout since 1942, which was a war year at that!
Until Americans know in their own brain, and not what the media tells them, that they need to come out and vote then we'll all be spitting in the wind.
Let's put the horse before the cart. Unless citizens vote nothing can be done.
Until Americans know in their own brain, and not what the media tells them, that they need to come out and vote then we'll all be spitting in the wind.
Let's put the horse before the cart. Unless citizens vote nothing can be done.
9
Some commentators are engaging in magical thinking worthy of Donald Trump. I too would favor a single payer system, Medicare for all, but given the razor-thin margin by which the ACA passed, I’m grateful for small favors. And please note that Germany, whose health care system outperforms ours by numerous metrics at a lower cost, has a system similar to the ACA with one significant difference: its insurance companies are all non-profit.
110
Without a Congress that goes along with him, a President Sanders would no more be able "to right the ACA wrong" than the actual President Obama was to get single payer or any other potentially better system in the first place.
8
Typical liberal thinking. When the vaunted solution -- that worked perfectly in theory and in the future -- doesn't actually materialize, they blame someone else for its failure.
It's time to own up to the unintended consequences of the Affordable Care Act. "I wanted a public option" is not a defense, nor is blaming wrong estimates on GOP opposition.
Aside from moving millions onto Medicaid, the mechanics of the Act are problematic. Time for democrats to own the monster they created.
It's time to own up to the unintended consequences of the Affordable Care Act. "I wanted a public option" is not a defense, nor is blaming wrong estimates on GOP opposition.
Aside from moving millions onto Medicaid, the mechanics of the Act are problematic. Time for democrats to own the monster they created.
24
Typical right wing thinking. Don't ever propose anything constructive, but do everything possible to make sure it fails. Then blame the "liberals" for any problems.
I'm sure health care would be so much better and so many more people would be covered if we just left it up to the corporations, right?
Let's not work together as a country to try and solve a problem -- that would be "socialism"!
I'm sure health care would be so much better and so many more people would be covered if we just left it up to the corporations, right?
Let's not work together as a country to try and solve a problem -- that would be "socialism"!
365
Ricky Barnacle:
This editorial blames republicans for the failure of the nonprofit insurance plans, using the by now standard excuse for the Act's failures: Republicans made us do it this way. In other words, they wouldn't let us get it right.
Democrats have to propose solutions that work in the real world, not in their fantasy world, in which there is no opposition. Chasing utopian solutions is unserious problem-solving.
This editorial blames republicans for the failure of the nonprofit insurance plans, using the by now standard excuse for the Act's failures: Republicans made us do it this way. In other words, they wouldn't let us get it right.
Democrats have to propose solutions that work in the real world, not in their fantasy world, in which there is no opposition. Chasing utopian solutions is unserious problem-solving.
6
@AACNY
No, it's time to transition from the Byzantine 'Rube Goldberg' cartoon wrought by compromise with those who not so secretly opposed ANY plan from the outset and optimize it into a single-payer plan.
No, it's time to transition from the Byzantine 'Rube Goldberg' cartoon wrought by compromise with those who not so secretly opposed ANY plan from the outset and optimize it into a single-payer plan.
53
Something which no Republican voted for is failing and it's because of Republican opposition? So if I say something you attempt won't work and it turns out not to work it's not that I was right it's that I'm attacking your plan?
Keep on spinning.
Keep on spinning.
25
Anyone that opposes orthodoxy is either conducting an "attack" or a "war" on it. For people with an anti-war mentality, they sure are at war with a lot of their own citizens.
12
I think you missed the point: repubs oppose things that work for most people, and support things that only work for the wealthy. see how long you can spin your own "success" before the majority sees that you have no clothes on.
6
Perhaps the key is not what Republicans say, but what they do, which includes blocking a public option and medicaid expansion in many states. Given that these things have thus not happened, it can't be an issue they turned out not to work.
In any case, before granting credence to Lilo's position, we need some evidence that Lilo has noted when things did work after he said they wouldn't. (An analogy: Remember when Obama's energy policies were a failure because gas prices were hear $4/gallon? Have we heard any Republicans say they were wrong about that in this time of much lower prices.)
In any case, before granting credence to Lilo's position, we need some evidence that Lilo has noted when things did work after he said they wouldn't. (An analogy: Remember when Obama's energy policies were a failure because gas prices were hear $4/gallon? Have we heard any Republicans say they were wrong about that in this time of much lower prices.)
3
If you don't like it, under fund it, and then when it breaks, call it a failure.
Just like what the Republicans did with the Benghazi diplomatic post.
Sure it's snide, hypocritical, short sighted, ineffectual, illogical and reprehensible, but that's the Republican way isn't it? The way of all spoiled five year olds who don't get their way.
Just like what the Republicans did with the Benghazi diplomatic post.
Sure it's snide, hypocritical, short sighted, ineffectual, illogical and reprehensible, but that's the Republican way isn't it? The way of all spoiled five year olds who don't get their way.
533
That Benghazi attack was the result of the Obama Administration's "small footprint" strategy. Once Benghazi became deadly, the Obama Administration was incapable of responding.
The lesson there was that if you are going to execute a small footprint strategy, at a minimum you need a compensatory strategy to protect Americans. That was the job the State Department failed to do.
The lesson there was that if you are going to execute a small footprint strategy, at a minimum you need a compensatory strategy to protect Americans. That was the job the State Department failed to do.
3
Wow, Chicago Guy. On Benghazi, funding was not cut, the requested increase was cut. Even a manager with marginal talent knows how to reallocate funds to provide extra security for an Ambassador negotiating an illegal arms deal in the most dangerous town on the planet.
Not a Republican problem. More like a Hillary problem.
Oh, and not on Republican voted for Obamacare. Good luck finding a Dem who'll admit to voting for it as well.
Not a Republican problem. More like a Hillary problem.
Oh, and not on Republican voted for Obamacare. Good luck finding a Dem who'll admit to voting for it as well.
4
This country cannot survive the century unless we utterly destroy the Republican Party as it now exists. It is an altar to Mammon and Moloch, and confuses Christ with the golden calf.
17
Many of us on both sides of the health care debate view the ACA as a patchwork solution which has to be modified in the long run because, whatever its merits, it is hopelessly complex, lack the relative simplicity of Medicare. The dialogue on health care is not settled. The view of the Editorial Board that it is and that the ACA is here to stay is not shared by millions of thinking people. The view of the Board that it is obstructionist for Republicans -- and presumably, Democrats -- to build a better mousetrap and move beyond the ACA is, I believe, out of touch.
23
" The view of the Editorial Board that it is and that the ACA is here to stay is not shared by millions of thinking people."
Until we expand Medicare for all, or create a single payer system, the ACA will remain, and most "thinking" people will vote accordingly.
Until we expand Medicare for all, or create a single payer system, the ACA will remain, and most "thinking" people will vote accordingly.
229
The dialogue on health care is not settled because millions of people do not want government involved in health care, including many on Medicare. If one side of the debate is government involvement, including perhaps single payer, the other side is to let the private sector provide health care to those who can afford it and private charity cover the rest.
10
"millions of people do not want government involved in health care, including many on Medicare."
Why on earth should anybody take seriously those individuals who are on Medicare and yet claim that they do not want government involved in health care?
As for entrusting private charity to the "cover the rest"--no way, period. Do that and you'll see farm animals receiving better health care than millions of low-income people.
Why on earth should anybody take seriously those individuals who are on Medicare and yet claim that they do not want government involved in health care?
As for entrusting private charity to the "cover the rest"--no way, period. Do that and you'll see farm animals receiving better health care than millions of low-income people.
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