It has been said many times over the last few years that now that Democrats successfully passed a comprehensive overhaul of American health insurance, they own the health-care system, for good or ill. Every problem anyone has with health care will be blamed on Barack Obama, whether his reform had anything to do with it or not. Your kid got strep throat? It's Obama's fault! Doctor left a sponge in your chest cavity? Stupid Obama! Grandma died after a long illness at the age of 97? Damn you, Obama!
OK, so maybe it won't be quite as bad as that, but pretty close. Here's an instructive case in exactly how this plays out
Right now, as we’re stuck in a swamp of headlines about the failure of Obamacare’s rollout, it’s hard to imagine that there are bigger problems looming for the Affordable Care Act. But when the influx of newly insured Americans finally flounder their way through the health care website, there may not be enough doctors waiting on the other side.
The most often repeated attack on the Affordable Care Act is that the law is a "job killer"—an anti-business spool of red tape that will strangle free enterprise from coast to coast.
In fact, one of the biggest obstacles that entrepreneurs face when starting a new business is affording health insurance. Leaving a job where you have coverage to do your own thing has been very costly—since individuals have tended to face the highest premiums in a deeply dysfunctional insurance market.
Republican Senate leader Mitch McConnell is ordinarily a spinner of unusual skill. He's relentlessly focused on his message and doesn't let any interviewer frame a question in a way he (McConnell) doesn't like. Which is why it was a little odd to see Fox News' Chris Wallace catch him without a handy talking point when it came to covering the uninsured. This excerpt is a little long, but you have to see the whole thing:
Ten Reasons American Health Care is So Bad, Ezra Klein (November 2007) Of all the countries surveyed in a recent poll, Americans were the least likely to report relative satisfaction with their health care. Here are ten major ways our system is failing us.
The Cost of Delayed Reform, Harold Pollack (July 2010) The temporary federal high-risk pools won't reach most of the medically uninsured.
In tomorrow's New York Times, Annie Lowrey has an interesting story about a study researchers were able to do in Oregon when the state had to hold a lottery to give people Medicaid coverage, leading to the perfect conditions for a randomized field experiment on what effect obtaining insurance could have. The results were pretty encouraging:
In a continuing study, an all-star group of researchers following Ms. Parris and tens of thousands of other Oregonians has found that gaining insurance makes people healthier, happier and more financially stable...
Once the law is fully implemented, health care exchanges will be the part of the Affordable Care Act we likely notice most. The exchanges were designed to turn health insurance into something approximating a real market—unlike the current system which creates a myriad of blocks that prevent the consumers from purchasing health insurance as they would any good, forcing families to either receive insurance through their employer, pay exorbitant costs for individual, or go without any coverage. The exchanges—along with subsidies for low and middle-income Americans—will ease that burden, allowing consumers to select a plan from a central hub without worrying about pre-existing conditions affecting their coverage.
Maybe Republicans aren't so opposed to health care reform after all. After grandstanding against the Affordable Care Act for the past few years, Republicans aren't ready to let the entire bill die should the Supreme Court overturn the law later this summer. Congressional Republicans are crafting a contingency plan to reinstate some of the popular elements of the bill in that scenario, according to Politico. It's a clear indication that the GOP has learned the same lesson as Democrats: while the all-encompassing idea of Obamacare may fair poorly in the polls, voters typically support individual elements of the bill.
On Jay Leno’s show last night, Mitt Romney unveiled his answer for what he would do to replace the Affordable Care Act if it’s repealed—nothing. The exchange is a little long, but worth reading in full.
When the Supreme Court begins its extraordinary three days of hearings on the constitutionality of the Affordable Care Act, one of the oddities will be an amicus brief challenging the act’s individual mandate from 50 doctors who support national health insurance. They point out the inconvenient truth that, contrary to the administration’s representations, the government did not need to require citizens to purchase insurance from private companies in order to meet its goals of serving the health-care needs of the populace. Congress could have enacted a single-payer law.
Last night's Republican presidential debate featured an interesting exchange about health care -- I haven't been able to locate a transcript, but the gist was that Rick Perry was asked why Texas has the highest rate of people with no health insurance in the country (over a quarter of Texans have no insurance), and he responded that it was the federal government's fault, because they aren't giving states enough "flexibility" in Medicaid.
One of the parts of Judge Jeffrey Sutton's opinion upholding the constitutionality of the individual mandate that I think hasn't gotten enough attention is his dig at the idea that states, under some kind of incoherent, muddled Tenth Amendment reasoning, would be able to mandate purchases of health insurance even though the Federal government can't:
In a move that will no doubt cheer conservative states-rights advocates (OK, I'm kidding), the Vermont Senate passed a bill yesterday that will move the state toward a single-payer health system. Since it had already been passed by the state House, the two bills just need to be reconciled, and then Vermont will be on its way to creating its socialist health-care dystopia. What, you thought all the state-level action on health care was about suing to stop Obamacare?
Jamelle Bouie says that Obama's plan to let states waive the federal health-care law gives Republican governors what they want -- and increases the chance that the law itself will survive.
On Monday, President Barack Obama met with the nation's governors and announced his support for the first major amendment to the Affordable Care Act since the bill was signed last March. The proposal, crafted by Democratic Sen. Ron Wyden of Oregon and Republican Sen. Scott Brown of Massachusetts, would allow states to opt out of key planks of the health-care bill provided they met the administration's benchmarks.