In the open thread below commenter Martin illustrates a key benefit of near-universal coverage.
[A] colleague…has wanted to start her own business for a while but wasn’t willing to risk going without insurance and couldn’t find a decent price on the market before. She signed up yesterday with the intention of burning through her vacation in the next 3 months to set up her business and then resigning in Dec if everything goes well. She will pay about what our employee contribution now is (after subsidy assuming she earns a comparable salary in the new business). She’s really excited and scared, but says that this was key to her trying it. Her mom went through a bout with cancer and it basically bankrupted the family because she had no insurance.
Make it your email signature. Write it on facebook wall. The business side of entrepreneurship is hard enough. Add in the constant threat of bankruptcy from one health event and people will keep their crappy jobs for healthcare rather than take a chance on their million dollar idea. Obamacare will turbocharge the small business sector more effectively than any thousand clever tax breaks.
Ayuh. If I go out on a limb with my Cat Empire, knowing I have access to affordable health insurance will be key.
Sorry – there’s only enough room for entrepeneurs who start out with Ivy League degrees and a generous grubstake from daddy. Everybody else should feel the pressure of looming disaster, because otherwise, they may feel inclined to demonstrate independence at work.
I’ve got an old magazine from 1968 with a “Cat Fancy” order card that I like to laugh at from time to time.
Self-employed people paying absurd rates for policies with big deductibles has been a huge pool of money that should have been going into the economy and not being donated to insurance companies.
I had to leave a beloved western state when the 6K deductible policy went to 1K a month.
Lots of creative self-employed people in upstate NY joined the local Chambers of Commerce to get the lower insurance. NY is really going to benefit from Obamacare. If people have an extra 3 or 4 hundred a month they can spend on other things than health insurance premiums that is also going to benefit the communities where they’re spending.
If it weren’t insulting to such a good book, would name the House Republicans the Confederacy of Dunces.
The other side of that coin (sorta) is the so-called “union hate” for Obamacare. Yeah, I know unions have made health care coverage a centerpiece of their negotiations. But surely it is better for all workers to have an alternative to what their employer thinks they should have. And the number of folks who belong to unions is so small these days….
Is the “unions hate Obamacare” just a republican meme? Help! I’m in Florida and am forced to read the pathetic Tampa Tribune everyday.
Mrs. BG and I were kvetching about how stupid this whole GOP shutdown thing is last night, how they are doing it to protest (ostensibly, though not really) a law that offers people a basic human service, and so on. And it occurred to me that this is likely the last best moment they are going to have, these Republicans. They cannot stop what is necessary and rational, humane and decent.
They can delay it, but they are going to suffer from being the problem and not the solution. Even the media is going to turn eventually.
The back side of this also matters. Health insurance is a way that companies have been able to lowball wages and know their employees won’t quit, especially ones with a pre-existing condition (such as high blood pressure).
Modern ‘conservatism’ is about hate. It’s about hurting people. Even their tribalism has become a means to that end. Obamacare spits on everything they stand for.
Villago Delenda Est
People like this terrify the neo-feudalists.
ACA is breaking one of the chains.
They hate and fear entrepreneurs, because entrepreneurs upset the MBA static applecart.
See, I think a lot of the opposition is that for all their endless yapping about Reardon metal and creative genius, our Galtian overlords hate and fear entrepreneurship. Being in terror of losing your health insurance is an important chain that keeps the workers from bolting and starting a competing business using the Galtian Overlords’ valuable and important trade secrets (and don’t ask us what our “trade secrets” are, we’ll figure that out after we sue your ungrateful ass for daring to leave our employment after all we’ve done for you). And it definitely adds an extra terror to the fear of getting fired if you don’t keep your nose pressed sufficiently hard against the grindstone.
The Republican love of “entrepreneurship” is strictly reserved for the “entrepreneurs” who started a new business by cashing in securities given as birthday gifts or using money and business contacts provided by Pop-pop or borrowed from their trust fund.
Jim, Foolish Literalist
I always think if you’ve never made a major life decision based on work-related health insurance– from where to work and out from that where to live, whether or not to have a(nother) kid (Family values!)– you must know at least one person who has. I can think of three in my close family off the top of my head. I could never figure out why this aspect of it isn’t more obvious to people. But in that same group, my close family, I can name a lot more than three who think 1) insurance you get from work is “free”, and 2) gov’t exists to take their money to give it to THEM.
IIRC one of Michelle Malkin’s I-told-you-so tweets was that her sister had lost the insurance that was the only thing keeping the sister in her miserable job with creepy boss. The system Malkin and her fellow travellers are fighting for is the one that forces people to remain in crappy jobs with creepy bosses.
Of course conservatives “should” love it, if they actually meant any of their BS. Small business creation is alive and well in the Scandinavian countries for precisely this reason – the stronger the safety net, the more people are energized to try starting their own business, and the easier it is for them to get back on their feet or try again if they fail. But the last thing conservatives actually want is to make it easier for people to start their own businesses. The more competition the hoi-polloi have, the harder it is for them to stay afloat.
“Small businessmen” are to economics what “the troops” are to foreign policy; a useful totem to hold up at election time and hit your political opponents over the head with, and otherwise to be stuffed in a drawer and pointedly ignored.
What, you think conservatives actually like that entrepreneurship hooey? Entrepreneurship is only useful as a club to whack libruls with. Other than that it’s a nonentity.
Between the entrepreneurs being able to risk money but not their healthcare and the ability of older workers to afford to retire so that younger workers can replace them, I am astounded at conservatives’ inability to see Obamacare as an opportunity rather than a horrible burden. Of course, their hatred for the poor and those who work for bosses is plainer each day they refuse to see the reality of what the Affordable Care Act can do for people.
@Villago Delenda Est: Employees who are not living in terror of losing their health insurance may not be quite as docile as the Galtian overlords would like. Maybe, just maybe, this could even lead to a bit of upward pressure on wages.
My husband and I have taken turns working corporate gigs so the other can freelance. Each of us is capable of earning a decent living solo, but we’ve never been able to do it at the same time because of the need for insurance. The old health care system fostered corporate dependency. Now we have more options.
Specification: it’s about hurting weaker people. People who can’t fight back. You see it in everything from whose services they choose to cut, to which countries they choose to invade, to which unions they choose to pick fights with, to which laws they choose to tighten and ruthlessly enforce.
What’s the Complicated-But-Scientific-Latin-Word for “bully mentality,” if there is one? Whatever it is, that’s what they’ve got.
The fact that small businesses and entrepreneurs are basically all going to depend on Obamacare is undoubtedly a major factor in Obamacare panic. Currently they’re a critical part of the Republican coalition. When every small businessperson in the country gets cold sweats of fear at the thought of Republicans winning because the Republicans will cut off their health care – well, that’s going to be really bad for Republican fundraising, social influence, and recruiting.
I was having some flashbacks of memory back to days of yore and a health industry not so focused on profit. This is important in terms of the 15 year history of aggressive demutualization.
The demutualization wave of the late 90s and early double naughts turned out to be very, very good for a certain class of well-dressed, well-connected, nicely suited white guys. Take, for example, the CEO of Anthem in 2004:
I keep trying to tell the young upstarts with no medical worries and no family that they are going to get their asses kicked by 30 to 50-somethings who know what they’re doing and can now risk doing a startup.
@Chris: Especially in places like New York and California, where people work as self-employed creative people, others want to, but fear the health consequences of leaving a job. I wonder how many musicians and artists we have lost because they can’t get coverage.
BTW, what about early retirements? Some people are just hanging on until Medicare. Or until their spouses qualify for Medicare. Some people even though they are vested for a pension stay because they couldn’t get sufficient medical coverage for a spouse or a late kid staying at home. ACA will free those people and not incidentally, open up a few jobs as well.
@Chris: Exactly. Well said.
Villago Delenda Est
They hate everyone who didn’t inherit millions.
They want a return to aristocracy, to Divine Right, they hate the Enlightenment.
If this shutdown continues I am going to withhold my productivity!
I had not realized how much they hated Obamacare for this reason until this week, actually.
I’m so used to them being utterly irrational that I forget they have semi-rational, borderline psychopathic, reasons for doing that thing they do.
There was an oddly positive article in Computerworld (I think) to this effect (re. entrepreneurship) a couple or a few days ago. Can’t look for it from work at the moment, though.
@EthylEster: One reason for many people to join unions is that they can negotiate health care with the employer. This takes away one of the reasons to join a union.
I’ve never read “Atlas Shrugged,” but I remember reading (probably here) that was one of the few things that Ayn Rand actually got right was that she differentiated between the actual “entrepreneurs” who invented stuff (that precious metal thing) and the corporate overlords who didn’t invent these things but sought ways to control and appropriate the work of those who did. Is that true?
I’m not going to read the book anyway, I’m just curious.
Sweet sweet schadenfreude, things are not going too well for Cucinelli in VA governor race, because too many people in VA, especially NoVa depend on the Federal Government.
:-p I wouldn’t bank on it. Republicans have plenty of opportunity to come back. They just need to get the crazies in check again. What we’re seeing isn’t a GOP that’s taking a last, desperate stab at getting what it wants. We’re seeing a GOP that honestly has no idea what it wants.
Corporate interests that fund the party don’t actually want small government. Neither do the theocrats pushing legislative homophobia and Islamophobia and abortion-phobia. It’s getting harder and harder for Republicans to claim they are interested in protecting Medicare or Social Security, despite the programs being as popular as they ever were. And the deficit is rapidly shrinking, so they won’t even have budget-carping to fall back on anymore. And unlike 1996, there’s no blow job scandal to harp on, so they can’t play the “Moral Majority” card without looking like they’re just waving the Republican Jesus banner.
The Republicans had full control of government between ’02 and ’06, and they proved their number one priority was fighting a war in the Middle East. War isn’t popular anymore. They can’t keep floating money to their buddies through entitlement “reform” privatization schemes. Dismantling government is proving far more difficult than anticipated. Their political agenda is… non-existent.
That doesn’t mean they won’t ever get power again. I just don’t think they’ll ever be organized enough to actually effect legislative progress. All they’ll manage to do is produce more gridlock.
This would make sense if the GOP was actually for small business. They give it lip service because their base, fiscal conservatives and libertarians eat it up. They are for mega-corporations which tend to crush small business. They also like people feeling like they have no choices other than hanging on desperately to whatever job they have. When workers have fewer choices, labor costs stay low.
@Capri: You join a union in order to negotiate with your employer from a position of strength. Can anyone honestly say that employees no longer need any kind of leverage over their employers?
@Zifnab: I would be more inclined to agree if the olds weren’t dying and the youngs weren’t becoming the driving force in our political life.
Damn, look what a wingnut just put up on my Facebook wall from FOX. He just had a big question mark after it. LOL!
Except when the GOP says “entrepreneurship” they don’t mean more start-ups, they mean greater maneuverability for large, established businesses. Or more start-ups put together by the kids of CEOs from such companies (remember Romney’s “borrow from your parents” line?).
There’s a reason that (until recently) the tech companies bucked business trends and supported Dems. That’s changing, but largely as they become entrenched parts of the business landscape whose leadership can expect personal and professional benefits to the upper class to roll back to them specifically.
That process is arguably pretty much complete with phone companies, which are very good contributors to the GOP now, and is on its way with computers and other newer products (which are showing some rather unattractive libertarian streaks already).
I made almost the identical argument on various USENET political groups during the Hillarycare debates. Sadly to no avail.
Conservatives supposedly love entrepreneurs, but then if you explain that increasing the Governmental social safety net would allow *more* people to become entrepreneurs, they look at you as if you had growqn a second head.
Just Some Fuckhead, Thought Leader
Let’s not forget that the Heritage Foundation and the health insurance lobby made up the bulk of what is now PPACA.
@Zifnab: There’s other things that a union could do. Better wages. Paid Sick leave. On-site child care. More Vacation time. And Unions can always be the wall between arbitrary/crazy decisions by the bosses and the inevitable “favoritism” where how well you fluff the boss determines job tenure, promotion, even pay raises and discipline.
Fox has been taken over by Muslin socalists! ‘Murika is doomed.
@Chris: Yes, I like to harp on that point. Most of our overlords would be the ones left behind by Rand’s industry leaders because they don’t invent.
In the book, after they are left behind, they realize that they’re not really going to be able to do the new things to make their companies grow. So they start proposing stuff like turning lights off on the upper floors, and making people by the same things every year that they bought before. In modern terms, it’s like Apple only changing it’s screen size or resolution now that Jobs is gone.
The flaw in Rand’s thinking was that only a few people would be the innovators. Everyone at the bottom was there because they weren’t good enough. Because the few real titans are gone, everything collapses. In reality, some of the lower people would go on doing their own work.
@GregB: I’m sure Gretchen Carlson is fixing this as we speak.
Sort of. There’s one major character in Atlas Shrugged (James Taggart) who has authority in business without superhuman invention or management skills, and he’s kind of a bad guy, although not really evil. But she never had the reverse – where some slimy businessman gets the money from some clever inventor’s work, even though that’s overwhelmingly the way it works in the real world.
@Mudge: Mmmmm….it’s complicated.
As a small employer, I’m delighted by the possibilities. We’ve never been over 50 people, so our options for buying group benefits have been expensive and lousy.
Over 15 years, our staff has been made up of highly capable people who need more flexibility than our larger competitors offer their minions–who have a spouse (or lately parent) with health coverage.
Decoupling health coverage from employment gives me thousands of potential staff to recruit among, because they’re not staying in jobs that don’t work for them solely because they need coverage. All we have to do is offer market wages and a flexible schedule, and we’re going to be able to peel away staff from the behemoths.
This is big, and I used to be a Republican back when that made sense.
The Twitter machine is telling me Fournier has an article titled “Why is President Obama Lecturing Me?”, with the lede being ‘He is right on the substance but wrong on the tone’.
The wingnuts are trying to destroy the country, but Fournier is worried about tone. F’n hack.
@Chris: Sort of. Being rich and in the private sector doesn’t make you a hero in Atlas Shrugged. Dagny’s brother is rich and in the private sector and he’s as worthless a weasel as the rest of the moochers.
It’s not really entrepreneurship that she’s touting, though. Hank Rearden is a self-made industrialist of the old school, but Dagny comes from money and runs a major corporation, whereas D’Anconia comes from Old Money and runs a major corporation. Even Galt himself, before he goes Galt, just works for a company.
Her idee fixe is just that there’s a finite amount of competence in the world. She doesn’t necessarily think they are all entrepreneurs.
What they need is a new base of crazies. In the early 20th century, Republicans might have done better for themselves if they’d been able to harness the conservative elements in the white Southern and “ethnic white” urban demographics, like Nixon eventually did – but that wasn’t possible back then, the Northern WASPs in their base would never have accepted outreach to these filthy Jews and Catholics, while meanwhile Southern politicians were still running against Lincoln.
They’re in the same situation now. Their chosen demographic of “Real American” chauvinists is getting too small, but cultural walls are still too strong to allow them to reach outside and look for new allies. Eventually those walls will break down, just like Northern/Southern/Immigrant walls did in the 20th century, and they’ll be able to form a new coalition like Nixon did. But that’s going to take time. (And a lot of it, judging by how intractable their current base is).
Villago Delenda Est
See Edison, Thomas Alva.
Once the Borg assimilated the Blues, this was all done.
Villago Delenda Est
It’s a damn good thing there is no law that prohibits stupidity, because if there were, Fornier would be before a death panel faster than you can say Captain Jack Sparrow, and Bob’s your uncle.
That story deserves it’s complement.
A family friend is running one of the new co-ops. Basically he retired as an exec from the monopoly insurer in his state, somewhat out of disgust with the direction the industry was going in (with his employer following). Once ACA passed and the co-op opportunity arose, he called up a former insurance commissioner from his state and floated the idea of the co-op. He knew there was a large unserved market in his state and a neighboring one (from his days as an exec he knew well what markets they were abandoning because they were unprofitable) and the commissioner knew that as well. They wrote up the business plan and applied and got funded, with HHS providing the seed money (securing your reserves is a big challenge with launching a new insurer).
They’re now on the exchange in two states focused mainly on serving the agricultural marketplace. Farmers trust co-ops, and the model for covering them is different enough from covering urban/suburban markets that the monopoly insurers are inclined to cut them loose. It’s a big opening, but it’s also something that could never have happened without the exchanges. The seed funding helped, but they could have gotten that in other ways. What they could never have done is get the level playing field against the much better funded entrenched company. They’d have been out-marketed and flat-out blocked from the marketplace. But the exchanges give their plans the same exposure as the BC/BS or Anthem plans. They’re competing on the same costs – no kickbacks or volume deals that upstarts can’t match. It’s an absolute game-changer for the marketplace, and with new entrants on the insurance side, it’s going to mean the rules of the game on the care provider side are going to change as well. Health insurance in many states has become a vertically integrated market where contracts connecting care providers and suppliers to insurers blocks any real hope of competition leading to better prices.
The status quo was not in any way a ‘free market’ that could lead to price efficiencies. Free markets demand that both consumers and providers be free to enter and leave the market if conditions are adverse. Consumers cannot leave the healthcare market – when they are sick they are forced to participate, and providers are not free to leave (too big to fail) nor are they free to enter because the contractual obligations to participate are both too onerous and rigged in favor of the major players. The exchanges and various other rules go a long way to address this problem. It’s not perfect, but it’s vastly better. Entrepreneurs can now enter the market both on the insurer side and soon (once the exchanges really take off) on the care provider side.
It’s the same tale as my coworker, but from the other angle.
Villago Delenda Est
Well, for sure the ranks of the competent don’t include hack novelists/”philosophers” who are Russian emigres.
Just caught this at Think Progress
THIS is why the GOP are so scared of Obamacare.
Thanks for all the Atlas Shrugged answers, also too.
Pah. Like “conservatives” are in favor of class mobility? That would require a base level of the dreaded Soshumalizm.
Conservatism has always been, and always will be, about preserving the present social structure. Anything that can upset that is to be resisted.
@Jim, Foolish Literalist:
My husband calls it “find the health insurance”. When self-employed people here bitch about medical bankruptcies or Medicaid, he asks them how they get their health insurance.
Behind every self-employed maverick is a teacher or a union member.
Maybe you have to go without it or “experiment” with all the “options”?
We’ve had every flavor – his employer, my employer, neither employer (go without) and neither employer (purchase privately). Right now we have his employer and the one and only reason he does a particular part-time contract job for the county is because it comes with health insurance.
@Hill Dweller: OMG, I just read that Fournier shithead. It reads like a FB post from your crazy grandmother who can’t think about anything that doesn’t fit into a righteous morality sampler.
He gets paid for this?
You have to look at how labor laws, including Taft-Hartley, have constricted the ability of unions to organize, not just membership, but group actions. Wildcat strikes, sympathy strikes, sit-down strikes, secondary boycotts, etc.,, strong tools in the union arsenal, have been made *illegal*.
It’s amazing that unions have any leverage against employers given all this.
The irony is that as laws were made that mandated corporate behaviors that unions negotiated for (40-hour work-week, etc.), the unions became less necessary. Heathcare/Obamacare is another nail in that coffin.
This is a predictable benefit of unshackling people from employer-sponsored health care.
As nice as this is, it’s really just a half-measure.
Single-payer would unleash a wave of entrepreneurship like nothing this country has ever seen.
Fascism. You’re welcome.
@Fair Economist: Was that during Lincoln’s time?
@H.K. Anders: The monopolists who run capitalism would never allow that much capitalism.
OTOH, the News and Observer (Raleigh NC) is reporting on a woman who “stayed up all night crying” because her family will “end up paying almost twice as much under plans mandated by the Affordable Care Act.”
Anyone have any idea why this might be?
Read more here: http://www.newsobserver.com/2013/10/01/3245945/nc-residents-praise-pan-new-federal.html#storylink=cpy
FYI, my youngest daughter was up in Columbus marching today.
@H.K. Anders: Flying horses would end the need for cars and increase the need for stout umbrellas.
ETA: Not meant to be that snarky, but I think we’ll have a much better chance to get to some type of universal system when people start seeing the benefits of this, as long as there are people pushing us in that direction.
There are a lot of warts that get smoothed when we think of the “liberal consensus” era of 1932-1980, and one of the big ones is the postwar-1940s conflict between President Truman and the newly resurgent Republicans in Congress who were eager to drown the New Deal in a bathtub. Taft-Hartley was probably their biggest success, reversing a bunch of gains that unions had finally made under Roosevelt. And the effects of that are still with us.
(Lots of similarities between that era and this one, actually, right down to the “Dewey Defeats Truman” election we saw repeated in “Unskewed Polls” 2012).
I keep making comments on Facebook and keep asking myself, why? I am continually amazed at the number of people who say both sides are to blame for the shutdown, even when you very specifically point out that the heart of the shutdown is funding and implementation of the ACA. One person accused a friend of being brainwashed by the Liberal media and another stuck to the “nuh uh, they’re both wrong” argument.
I actually avoid Facebook for political issues because there is not much you can say in a post and I really only want to post Golden Girls quotes and funny cartoons, but sometimes I just can’t contain myself.
I could have founded a company that does what ScaleMP is doing (virtual SMP servers using clusters and infiniband for remote shared memory, basically turning beowulf clusters into NUMA SMP machines) back in 2001-2002. I didn’t because I had a step son getting treatment for a brain tumor and needed to maintain coverage for him.
It wasn’t a shitty job and my company was very progressive in allowing me to cover my domestic partner and her dependents on my health insurance. But the idea and development of products could have made me a lot wealthier and I’d have taken that risk if I’d known Cody would get the treatment he needed.
I’ve told this story on FB many times.
Maybe if you make it a less-direct reference, like calling them the Dunce Confederates?
Jay in Oregon
But it’s got “Obama” RIGHT IN THE NAME!
How about the Dunces of the Confederacy?
@BGinCHI: Yes, especially when you consider that people who don’t need to hold on to their jobs primarily for the health insurance might not continue to put with the low pay and lousy treatment they have had to endure for so long. Can’t have people thinking they have options. Wouldn’t be good for business.
This morning on the local NYC Brian Lehrer show (a very well done call in/guests show), Brian brought up exactly this point and posed it to a guest (or a caller, don’t remember). I was shocked. The usual ritual in many talk show venues is “obamacare blah blah destroys jobs, causes employers to cut hours” while I’m thinking “but but but what about the increased entrepreneur-ism effect?” and “they were going to cut jobs/hours anyway, the lying sociopaths”.
I’m so glad. My friend Ann went, but I had to work. I have an appeal that is giving me fits. She’s actually a federal employee, but she was taking a personal day anyway.
I looked for pix earlier. Did they get a good turn out?
@J.D. Rhoades: The article describes a big reason: NC didn’t opt to create its own exchanges, so there’s not nearly enough competition. At the same time, my company offers two plans, and I will be switching from BCBS because they are seriously jacking up their premiums (10-24%, and I would be doing 24% based on my income) next year after doing it a lot last year. I don’t attribute all of that to ACA requirements since the other plan is only going up 3%.
Congratulations. You have won the Internet today.
Looked decent as far as turnout went.
@Botsplainer: The Blues, and some of the similar organizations, were also formed so doctors would have a reliable income as what we would recognize as (primitive) modern medical technology arose , and also to help with patient payment problems in during the Great Depression.
Most of them already fit into pointy hats.
@Litlebritdifrnt: Bingo. The GOP loses guys like that, they’re fucked. Health care costs are huge for employees and owners of small businesses. For the life of me, I can’t see why they took this route. They could have owned the ACA, but instead they shit all over it just because Obama was associated with it. I guess it shows how bereft of talent they really are. Reagan worship must have selected for the least creative and most dogmatic personality types. Remember how they used to call themselves “The Party of Ideas”?
The Other Chuck
Sort of. She had James Taggart and Orren Boyle depicted as nothing more than corrupt and lazy plutocrats, but they were just there to mua-ha-ha and twiddle their mustaches at the Good And Righteous Paragons Of Virtue like Hank Reardon and Dagny Taggart. The archetypes who really get the mustache-twiddling bad guy speeches with their “we aim to enslave humanity” agenda and all are the folks on the left. In the Randverse, basically anyone out for social justice is a moocher, a taker, a looter, and in fact The Enemy Of Humanity. Rand spills a lot more undiluted vitriolic ink demonizing the left, while the James Taggarts and Orren Boyles are merely forgotten in the march of progress.
They do own the ACA, that’s the madness of it all. It’s their idea. Dreamed up by the Heritage Foundation as the “market based alternative” to Clinton’s “socialist” health care proposal. Implemented as “Romneycare” by their future presidential candidate. Their fingerprints are all over it. But now that the Keyan Socialist Muslim passed it, it’s unclean and they’re all running from it.
” Flying horses would end the need for cars and increase the need for stout umbrellas. ”
There is statutory single payer and de facto single payer. I figure, in long run ACA goes like Australian Medicare system for all, or some public/private hybrid like in Netherlands or Switzerland. The Netherlands system is basically single payer, but much of it is administered by private sector. I have heard the Netherlands system described as ‘hidden single payer’. There is still some waste, since private involvement means a lot of insurance companies and providers try to game the system. I’ve read that medical groups are trying to find ways to self-refer patients preferentially through their own organizations, when no medical or patient convenience reason to justify it, in order to increase revenue. But, not nearly as much waste as in the U.S.
The U.S. could end up with hidden single payer system too.
Heck, Arnold flew in a bunch of Dutch health care economists and insurance wonks for a conference and said he wanted a Netherlands system for California. So it would be OK with the GOP, right?
Or maybe one of his health consultants sold Arnold on the idea that the Netherlands had a totally ‘privately run’ system with better outcomes and fewer medical cost problems, and Arnold fell in love at first sight and didn’t ask any questions.
Thanks. That does look good. The War On Women actually got my daughter engaged in politics. She votes, and describes herself as “very liberal” but she just has whole other areas of interest. Anyway, she was personally offended by the fake-debate around contraception-genuinely horrified by the old man panel they seated in Congress. She hadn’t seen that before. Her only adult experience with “Congress” (to the extent she paid attention) was Pelosi’s House. She didn’t know how bad it can get.
Mike in NC
@Roger Moore: Back when he was running for the Senate, Virginia Governor George “Maccaca” Allen was the subject of a magazine article called “Dunce of the Confederacy”, which revealed that he started wearing the Stars & Bars as a lapel pin back when he was a “rebellious” teenager in California. Even his Southern drawl is fake.
And the love affair continues…. Boehner turns down Reids offer to restart grand budget bargain negotiations if House GOP can find a way to keep government running.
Shutdown Impasse Deepens As Boehner Rebuffs Dem Proposal
” [The Democrats] want to initiate negotiations on an actual budget, with everything on the table, to resolve the parties’ fiscal differences and stop governing from crisis to crisis. ”
Looks like the House GOP lunatics told Boehner to say no.
Is there a way to impeach, convict and remove Boehner for being a complete heel?
I’m late to the party, and this point may have already been made, but the basic assumption of the post is that the Republicans have some principled reason to be against the ACA. I think we all know that if George II or Reagan had put it forward, it would be hosannas & adulation. It would probably be a worse law, with more payouts to Big Insurance, but still.
Their opposition to the law (IT ISN’T A BILL ANYMORE) is based entirely on the person whose name they’ve stuck to it. FSM willing, may they choke on it.
Those are hoods, not hats.
@flukebucket: Perhaps Fox can read the writing on the wall, and this is step one of claiming the ACA as a conservative policy. After all, the Heritage Foundation wrote it, and Romney was the first to implement it!
No. Arnold was a RINO and is now very much a persona non grata in California Republican circles.
@Botsplainer: There’s another unintended consequence here that we’re still grappling with. Blue Cross was the equivalent to Medicare A – hospitalization coverage. Basically, the type of care that Socialist St. Reagan mandated that citizens could not be denied. The ability of individuals to opt out of that system is exceedingly limited. Nobody interrogates the EMT over the cost of various procedures at the hospital they’re taking you to. Often you’re unconscious and participating in the market against your consent. There is no free market here and expectations that consumers will simply refuse that ER treatment because it is too expensive are absurd. There’s simply no way to make it work as a free market system without such crushing regulation that it would be rendered unrecognizable. It’s like trying to call the Postal Service a private enterprise.
Blue Shield was the equivalent to Medicare B – physician coverage. Getting your checkup, a flu shot, maybe dealing with a sprained ankle. All of the GP stuff, most of the ob/gyn stuff, etc. This can work much more like a free market. It still falls short in various ways, it’s subject to price fixing because consumers often can’t opt out at all, but it’s more functional. With good regulation it can work though. Consumers often have enough economy of time to shop around (I don’t need my check up right this minute, I can buy crutches from pretty much anywhere, etc.), and most of the things that get covered here aren’t benefitted from risk pooling. Getting a checkup is common, and running the payment through the insurer only drives up the cost. Rather than give $50 to your doctor, you’re giving $60 to your insurer in premiums who is keeping $10 and giving $50 to your doctor because everyone gets a checkup, so nobody is having their costs offset by people who don’t get checkups, unlike what happens with catastrophic care.
Blue Shield was mainly a way for your employer to pay you more at a time when they weren’t allowed to pay you more – during the wage freezes during WWII and after (like under Nixon). Insurance doesn’t really make a lot of sense here, much like life insurance for 80 year olds doesn’t make sense. Rather than putting that money into premiums, just stuff it in the bank. It’s not like you’re at some risk of not dying – you’re fucking 80, you’re going to die pretty soon.
But the hospitalization and physician coverage got mashed together because the latter is very predictable in terms of cash flow and steadily profitable while the former is kind of all over the map, so the latter makes the former a lot easier to manage and you can do all kinds of underhanded things in terms of borrowing from Peter to pay Paul. I still contend that ACA would have been better all around if we had gone back to the Medicare A/B model. Hospitalization would be single payer (as it is in Medicare) and B would be like the current free market approach with exchanges and subsidies and all that jazz (as it is in Medicare). Asking for the latter to go single payer is of questionable merit (it’s not without merit, but there are compelling arguments against it). Asking for the former to remain even under the ACA model will eventually fail us. Unfortunately the health care debate didn’t even bother to note the distinction between the two types of health care, so we’ve gone nowhere on that.
@jl: Marshall says Byron York doesn’t get why Boehner doesn’t put forth a clean CR because there is support for it in the GOP caucus. I’m beginning to think he’s doing it to get the teabaggers as far out on a limb as he can before the real Magilla comes up on the debt ceiling, with the hope being to discredit the hostage taking approach or at least scare enough of his caucus about it before it really can do lasting damage. We can stagger along with the shutdown for a while, but the debt ceiling may have immediate nasty consequences. Boehner’s fallback is that he can bring a clean debt ceiling vote up at any time up to the last minute and Pelosi and Reid will bail him out and allow everything to a bigger budget battle in conference. Cruz or some other grandstander in the Senate could screw that up, however. Boehner’s trying to draw to an inside straight to keep his speakership while avoiding catastrophe. I imagine Obama will be ok with that as long as Boehner doesn’t get greedy. Obama and Reid may even be standing firmer on the shutdown than they might have been inclined, because that actually helps Boehner with his caucus.
@hoodie: You should read what @robertcostaNRO is writing. The problem is much deeper and difficult to solve:
I’ve been saying this for years. I have friends and colleagues who work solely for the insurance. I knew a woman who worked at Safeway for 10 hrs a week so that her family could have insurance. She didn’t need the money from the job, just the insurance and Safeway employees being unionized had some sort of sliding scale where your contribution went down as your hours went up. I knew another woman who worked in order to have good insurance for her disabled son. The husband made a very good living but couldn’t get decent insurance. I worked with this woman who would work long enough to qualify for healthcare and then go on COBRA so that she could have her freedom for 18 mos.
I have extended family around the globe(UK,Germany,Australia, Canada,Portugal), who do entrepreneurial kind of stuff which would be impossible here pre-O-Care. I have three cousins who’ve had cancer. An uncle who had malaria. A cousin who got burned severely and had to have 16 surgeries over several years. Two aunts and an uncle with cancer. All but one have their own businesses. This isn’t rocket science.
@hoodie: I think it’s much simpler than that: Boehner still thinks that if he keeps the pressure up and looks intransigent, Obama will give in to his demands. And Obama’s presidency will at that point be nullified, because they can do this as many times as they want.
He wants to be the guy who broke Barack Obama once and for all. If it works, he’s the greatest hero of conservatism. At this point, it’s the only outcome that doesn’t make John Boehner a chump or a criminal incompetent.
David in NY
Former neighbor Amanda is starting her own business and getting a lot of help from ACA:
I worked in a Radiation Oncology clinic where treatments are very expensive. I remember one couple who both worked great jobs and both had teamsters insurance. They had to sell their house because the wife had reached her lifetime limit after a couple of years. Another woman’s insurance placed treatments like radiation and chemo to a yearly limit of something like 20,000. Radiation alone can easily cost that, let alone radiation plus chemo.
All of which really makes me wonder who these opponents of healthcare reform are? People with insurance and no real health problems? People who assume incorrectly just what their insurance covers? Or just assholes who only care about themselves? I’m guessing all of the above.
pseudonymous in nc
There’s enough fucking risk in starting up on your own without putting the lives and livelihoods of yourself and your family. If your business loses money, there’s generally a point at which you can cut your losses. If someone gets sick or injured without insurance, then it’s bye-bye everything. Maybe you get to keep your house if you’re lucky.
This is a ‘no shit, Sherlock’ thing. The idea that the impending risk of financial ruin creates better entrepreneurs is utter fallacy.
If the Repukes were truly a “business and competition”-friendly party (as opposed to a big-corporate profits through market manipulation and government looting party) they would have embraced this argument years ago. Entrepreneurialism and economic mobility is greatly aided in other western countries by decent access to health insurance. If they took off their “Murkan Exceptionalism” ego-blinders and actually observed and learned from other countries they might not be so bone-stupid.
But the Repukes would rather stand with corporations who want employees feeling trapped in their shitty jobs by lack of health options, and the grunting cavemen who scream “Marxism!” at any shadow on the wall their scared-stupid brains cannot understand.
Obligatory Django Unchained reference.
@J.D. Rhoades: I looked this up. Went to the BCBS site. Either this woman’s confused or lying. I get platinum coverage for a family of 4 for $19000 including the deductible and a gold plan for $14000 including the deductible with a copay for meds. And lets not forget under Obamacare they’re going to get preventive stuff free. And I wasn’t even figuring a subsidy. And,BTW, the woman who happens to be a physical therapist is whining about people getting stuff for free when in reality her son with cancer is probably costing the insurance co. more than what they’re paying. I don’t mean to sound callous, but people like this piss me off especially when you figure that you already are paying for people who go to the ER for primary care because they don’t have insurance.