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Tuesday, March 27, 2012

Is Obamacare now worth supporting?

Yes, yes, I know: You are a liberal/progressive and you want a Euro-style health insurance system. Me too. But do you have a workable plan to bell that particular cat? No, you do not -- certainly not anytime soon. You can't let the ideal be the enemy of the at-least-it's-better-than-the-libertarian-nightmare. Not when lives are on the line.

Obamacare is what passed. Obamacare is what we have. Obamacare is what the Republicans are after with a vengeance -- and they wouldn't hate it so much if it didn't actually help low-income people.

With the mandate cut out of it (thank you, 11th Court of Appeals!), what is Obamacare?
That decision no doubt sent shivers down the spines of some insurance executives. Striking down the mandate could be a nightmare scenario for the health insurance industry, since the rest of the law compels them to accept sick customers and to not charge higher premiums based on a customer's health, age or gender.
Shivering spines in the insurance racket? Excellent! Tell me more...
The Congressional Budget Office estimated that premiums in the individual market would increase 15 to 20 percent if just the mandate is struck down, since millions of healthier Americans would could forgo buying insurance and thus not offset the costs of new sick customers. But a study by the Rand Corporation estimated a more modest premium increase of less than 3 percent.
Without the mandate, Obamacare still offers "an expansion of Medicaid to cover all low-income people and federal subsidies for lower-income and middle-class people to buy insurance."

Look, I'm still mightily pissed off at Obama (see the important post below), and of course I would prefer a simple, straight-up Medicare-for-all system. But covering low-income folk is a damned fine thing. Snark ye your snarks. I really don't care.

I happen to be low-income myself, and I ain't gettin' any younger. Waiting for utopia isn't an option. You may recall what Keynes said about the long run.
Obama had the perfect chance to do a back door implementation of single payer. He could have expanded eligibility for CHIPs and Medicaid for the un/underemployed to give them relief from the depredations of Wall Street. Instead his ego got in the way and with the help of Nancy Pelosi, who I think is jealous of Hillary, shoved O-care down our throats. HCR wasn't done so much as to help the people but to stick a finger in Bill Clinton's eye passing a bill he wasn't able to get through Congress.
There are definitely some good things in Obamacare: people cannot be rejected for preexisting conditions, expansion for the coverage of the poor, even kids being able to go on their parents' policies until age 26 [since there are no jobs out there].

But I don't think it's utopia-seeking for being pissed that costs are not contained, that pharmaceuticals and insurance companies were given back room deals, while American citizens still pay through the nose for health coverage that doesn't get the results other countries offer for far less money. Sorry, but healthcare should not be controlled by a bunch of greedy bastards, who don't give a hoot about anyone's well-being.

Obama offered us a plan that was designed by the Heritage Foundation. The crazy thing is watching the Republicans fall all over themselves with outrage when Obamacare was 'their' response to Hillary's reform plan.

Whatever the good points of healthcare reform are
[and we won't see full implementation until 2014], the Administration has done a lousy job of selling and explaining it. Pelosi said it all--we have to pass it to see what's in it.

Par for the course.

For me personally, the subject of your last post, was the bitter end. The NDAA is so egregious that I, as a lifelong Dem, will not vote for Obama's reelection. I refuse to support this system because it's completely broken and corrupt. The Republicans are insane and corrupt and the Dems have bought into corporatism and sold their souls as well. The answer is no longer at the election box.

Personally, I think "medical care" in the USA is more dangerous than not having any.......except for trauma, which modern medicine is pretty good at dealing with. However, the system of going to the doctor because of some ailment, seeing them just long enough to have a prescription written, then having side effects from the prescription that necessitate another prescription, etc., etc., is NOT a good system. Not to mention most doctor's total lack of knowledge about nutrition and preventive measures that people can take. They should be prescribing exercise and proper diet (and the government should be subsidizing broccoli and spinach, not corn and soy). Of course, there aren't huge profits to be made doing that, so it won't happen in our for profit medical system.

That out of the way, I have to admit that Obamacare is not as terrible as nothing at all. With the mandate gone, it's really not such a big deal to me anymore. I would like to be positive for a change and say that it could, possibly, be a step in the right direction.

I will still never, under any circumstance, vote for Obama though (well, I suppose if he suddenly reversed all his totalitarian secrecy and powers, and immediately ended all our wars, overt and covert, I would probably give him my vote......but we all know that's never going to happen).
Disagree with Mr. Mike.

Obama mainly took himself OUT of the crafting, because of a lesson perhaps mislearned from the Clinton case, where the POTUS crafted something outside the Congressional framework, and basically the Senate Democrats, especially the prideful committee chairs (esp. Moynihan), helped sabotage the effort.

As we may remember, ALL (3 of) the House bills passed included the public option. Obama let the Senate negotiations go far too long, seeking ANY GOP backers who could be wooed over.

Still, the whole failed history of trying to pass this kind of thing showed how the perfect became the enemy of the good (i.e., perhaps Nixon's plan could have been passed decades ago, but Dems thought they could easily do better). Going by the first draft of a law, Social Security was also a failed legislation, but the framework laid down was added to incrementally.

Some say, and I somewhat agree, that this current law is the nose of the camel under the tent, and will lead to either a public option, or single payer, inevitably, as market forces come into play. As much from flaws in this law's regime as any other reason.

Gus, I do have a libertarian side on many issues (none of them economic, or DIRECTLY economic -- indirectly, everything is economic). I think too many drugs are prescription-only.

Hell, I even think we ought to be allowed to buy opiate pain relievers over the counter, in small yearly amounts. This would result in a lot of black market sales, but I don't care. When a toothache flares up in the middle of the night, people should be capable of meeting the challenge.

Do oral contraceptives NEED to be by prescription? Make them over the counter. That would solve the whole current controversy in one swell foop.

Albenza (used for tapeworm) is OTC in other countries. Why not here?

Canada allows 400 mg doses of Ibuprofin over the counter; the US does not. Why not? Nothing stops you from taking multiple 200 mg pills. I've even had doctors tell me to do just that. If I have severe pain, I'll use 800, maybe even 1000 mg, even at the risk of becoming nauseous. It's my choice. (For toothache, I recommend Peppermint oil on the tooth combined with as much ibuprofin as you can take without making yourself upchuck.)

What if amoxicillin or other antibiotics were OTC? Yeah, stupid people would abuse those drugs. On the other hand, do I really need a doctor to tell me I have strep throat? I KNOW when I have strep.

Antivirals. Rogaine. Viagra. Give people plenty of education on side effects and so forth, and then let them make their own decisions.
Joesph, I actually agree with you. Mainly for the fact that drug company profits wouldn't be tied so tightly to the medical profession (though doctors could still give you recommendations).

Personally, I avoid "medicine" like the plague, but what you suggest wouldn't change that or affect me in any way.

Also, with the opiates, I think what you are saying is that illegal drugs should be legal, with regulations to keep them under control. I think that would solve a lot of problems we have, even if it might create a few more (though probably only in the short term). Drug legalization seems to be something both Liberals and Libertarians agree on (and years ago was what got me interested in Libertarianism......though the incompatibility of their views on government with Democracy kept me from identifying with them).
I agree with all the commenters above (including Gus' aside on how medical "care" is worse than none at all these days)and only want to add that the most inexcusable thing Obama did was make women's private parts and medical care subject to her fellow (emphasis on FELLOW) citizens' scrutiny. Snouts out of our crotches, fellows! We need to elect more women who will burden men with laws forcing them to comply with absurd procedures to get Viagra, etc. See how they like it.
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