Health Care

A Bold Obamacare Prediction

An ad from Organizing For America

Love may not mean never having to say you're sorry (what a dumb idea, anyway), but being a blogger means being able to make predictions and not really worrying about whether you turn out to be right or wrong. Oh sure, if you're spectacularly wrong, and wrong on television (see Kristol, Bill), people might make fun of you. But usually, nobody remembers. And if you're right, you can remind everyone of how clever you were.

In that spirit, let me offer a prediction. The implementation of the Affordable Care Act, aka Obamacare, begins with open enrollment for the state exchanges on October 1st, with coverage beginning on January 1st. Sarah Kliff, who knows as much about the law as pretty much any reporter, returned from a cruise to report that the regular folks she encountered, when they heard what she does for a living, all wanted to know whether Obamacare was going to work. This was true of supporters and opponents alike. Not that the people Sarah met on the Lido Deck are a representative sample of Americans or anything, but it does suggest that there are lots of folks who for whatever combination of reasons don't think the law was a good idea, but are still at least open to the idea that it could be a success. That's encouraging.

Sarah is modest and smart enough to say she doesn't know whether the law will succeed, but my prediction is...

How Long Do You Want to Live?

Flickr/Yann Gourvennec

Attentive readers will recall that I'm rather interested, as a human whose body stubbornly continues to age, in the prospect that science will one day enable us to extend our lives far beyond what is possible today. Throwing the "immortality" word around tends to turn people off, since it sounds so absurd (after all, nothing lives forever, not even our sun), but what about just living a whole lot longer than most of us expect to even when we're being optimistic? Is that something you'd want?

My answer has always been, "Of course—are you kidding?" If advancements in medicine and technology can dramatically extend our lives—and assuming that we don't end up like Tithonus, the figure from Greek mythology who was granted eternal life but not eternal youth, so lived forever in a tortuous ever-increasing decrepitude—then I'm all for it. There are strong arguments that living for an extra 50 or 100 years (or more) might be great for you as an individual, but bad for society as a whole, but I've been surprised as I've asked friends and relatives this question over the last few years that most of them say that getting 80 or 90 years on Earth is just fine with them. And now, the good folks at the Pew Research Religion and Life Project have asked a representative sample of Americans the question (or at least one form of the question), and they've gotten similar answers. Interestingly enough, most people think that while they don't want to live past 120, they think most other people disagree:

Big Pharma's Private War on Drugs

Pharmacy robberies have spiked in large part thanks to illegal demand for OxyContin. A look inside the drugmaker's efforts to protect its product and the pharmacists at the front lines.

AP Images/Graeme Roy

On a Wednesday afternoon this spring, with overcast skies and gas-slicked puddles on Utopia Parkway, some two hundred pharmacists gathered on the fourth floor of St. John’s University in Jamaica, Queens for the Fifty-Fourth Annual Dr. Andrew J. Bartilucci Pharmacy Congress. The plainclothes professionals sat around tables draped with red tablecloths, sipping plastic cups of coffee and occasionally glancing at their phones.

On Abortion, a Tale of Two Countries

Texas state senator Wendy Davis, whose unsuccessful attempt to stop a restrictive abortion law drew national attention. (Flickr/Texas Tribune/Todd Wiseman)

Conservatives may be in retreat on many different fronts these days, but in one area, they're having smashing success: restricting the ability of women, particularly non-wealthy women, from accessing abortion services. And they're doing it with a new tool: the 20-week abortion ban, offered as cover for a raft of restrictions that aren't about stopping later-term abortions but about stopping all abortions. They're succeeding not because of some change in Americans' views on the subject, but because of the exercise of raw political power. As you may have heard, opinions on abortion, unlike those on many other subjects, have been remarkably stable for decades.

But that stability masks some stark differences on abortion, differences that create just enough space for Republicans in parts of the country to make abortion all but illegal. Yesterday the Pew Research Center came out with a new poll, showing some rather dramatic gaps by region on what people think about abortion. Check out this graph:

Iowa's High-Tech Abortion Battle

Free Verse Photography (

One night in 2007, Jill June, CEO of Planned Parenthood of the Heartland, couldn’t sleep. She was grappling with a problem that vexes rural pro-choice advocates everywhere: the lack of access to abortion. At the time, Planned Parenthood of the Heartland, which performs most of the abortions in Iowa, had 17 clinics in its network but only three with an on-site physician. Doctors would travel, sometimes as far as 200 miles, to three other clinics in the state to perform intermittent care. The remaining 11 clinics did not offer abortion services. In all, 91 percent of Iowa’s counties, the more sparsely populated regions that are home to more than half of the state’s women, lacked an abortion provider.

Is Obamacare a Republican Job Creator?


AP Photo

Almost 50 years ago, Congress passed and Lyndon B. Johnson signed the law establishing Medicare. It was, soon, wildly popular—so much so that to this day Republican opposition to the program can only be expressed in terms of  “saving” Medicare from supposed instability.

The Next Phase of the Obamacare Battle Begins

President Obama speaking yesterday on health care. (White House photo by Chuck Kennedy)

We're beginning a new phase of the battle over Obamacare—and the fact that we can continue to refer to it as a "battle" tells you something—one that in some ways takes on the appearance of an electoral campaign, with television ads, media events, PR stunts, and a universal assumption that the whole thing is zero-sum. If anything related to Obamacare goes well—like, say, people getting health insurance at affordable prices—then that's bad for Republicans and something they'll do what they can to stop.

What we have here is something truly unprecedented: an opposition party not just insisting that a significant government program was a bad idea, not even just hoping that in its implementation it doesn't work, but committing itself to actively working to make sure the program fails and that as much human misery as possible can be created along the way, so that eventual repeal of the program will become possible.

The Obama administration is facing a huge administrative task, laid on top of which is a challenging political problem. Try to imagine a government trying to build a new bridge, while all throughout their political opponents were not only telling people they'd die if they drove across it, but going out to throw rocks at the construction workers.

Nevertheless, the Obama administration seems to be cautiously optimistic about its ability to overcome the obstacles.

Rhode Island’s Small Victory

AP Photo/Susan E. Bouchard, File

When Governor Lincoln Chaffee signed the Temporary Care Giver’s Insurance law last week, Rhode Island became the third state—along with California and New Jersey—to grant paid time off to care for a sick loved one or a new baby.

Rhode Island’s law, which goes into effect in 2014, will not only provide most workers with up to four weeks off with about two-thirds of their salaries (up to $752 a week), it will protect employees from being fired and losing their health insurance while they’re out.

Under Obamacare, Millions Will Die

Barack Obama may be trying to kill this woman's son.

I have questions. For instance, are Charles and David Koch actually aliens from the planet Fnerzblax 6, come here to feast on the entrails of Earth humans to give them strength for their coming war with the barbarians of Fnerzblax 4? We really don't know, and that's what has me so concerned.

I ask because Americans for Prosperity, the group through which the Kochs channel much of their political activism, is initiating a new television campaign to get people afraid of and angry about Obamacare, and this seems to be the method of the campaign. The first ad, called "Questions," asks whether Obamacare is going to take money from a worried-looking young mother and deprive her sick child of the care he needs to survive. Not that it would actually do these things, but hey, she's just asking:

The Part-Timer Problem

The Obama Administration’s decision to delay for a year the penalty that employers (in firms of 50 or more employees) must pay if they don’t provide health insurance to their workers shines a light on a problem that may be even more profound than getting health coverage for every American: that is, the decline of the American job.

The employer mandate was designed for an economy in which American workers were employed in what had been normal jobs. In firms of 50 or more, all workers who put in at least 30 hours a week were either to receive coverage from the firm or else the firm would have to pay the government a $2,000 yearly penalty.

Should the Employer Mandate Be Eliminated Altogether?

President Obama signing the Affordable Care Act.

This week the Obama administration announced that it was delaying implementation of the "employer mandate" part of Obamacare, so companies won't be required to cover their workers until the beginning of 2015 instead of the beginning of 2014. Their stated reason is that they need more time to work with employers to implement the somewhat complex reporting requirements, and they're trying to be flexible and respond to employers' concerns. Which is probably true, but it's also true that the issue has become something of a political headache, with lots of news stories profiling employers saying the mandate is going to destroy their businesses or lead them to lay off workers and cut back their hours so they don't have to comply.

We'll get to what's true and false about those news stories in a moment, but it's important to understand that the "mandate"isn't really a mandate at all.

Progressives' Post-DOMA To-Do List

AP Photo/Alex Brandon, file

Two of my favorite writers on legal subjects, Dahlia Lithwick and Barry Friedman, wrote a piece for Slate earlier this week wondering if the progressive agenda hasn't been exhausted by recent victories on same-sex marriage. "While progressives were devoting deserved attention to gay rights," they argue, "they simultaneously turned their backs on much of what they once believed." I share their sense of frustration, but I interpret the landscape differently. To me, the problem isn't the lack of a robust progressive agenda. The problem is that progressives generally lack power. Last week, I saw strong defenses of progressive goals at every level of politics, from ordinary citizens to the highest offices in the country. From the opposition of activists and state legislators to barbaric attacks on the welfare state in North Carolina and reproductive freedom in Texas, to the President Obama's climate change speech and the eloquent defenses of fundamental values of equality made by Supreme Court justices Ruth Bader Ginsburg and Elena Kagan, a broad progressive agenda directed at urgent problems was seen in a brief window of time. The problem, of course, is that much of this came in the wake of defeat; even the stirring victory in Texas is likely to be merely delaying the inevitable.

Still, an extensive progressive agenda is out there. It's worth trying to define some of the most important issues that the American "left," broadly construed, should be and are trying to address. I do not claim originality or an exhaustive list; my intent is to generate discussion and thought about what problems to focus on and how to move forward.

Christian Employers Claim Their Religion Puts Them Above the Law

Sacred ground, where worldly laws don't apply. (Flickr/prariedogking)

Ready for the next court fight over Obamacare? Get to know Hobby Lobby, the chain of stores fighting the Affordable Care Act's requirement that the health insurance employers offer their employees cover contraception, and the next Christian martyr to the unholy scourge of health coverage for employees. Hobby Lobby's owners are conservative Christians, and though their company isn't a church, they'd like to choose which laws they approve of and which they don't, and follow only the laws they like. And a federal appeals court just ruled that not only can their suit go forward, but they're likely to win. Because apparently, "This law violates my religious beliefs" is now a get-out-of-jail-free card.

The decision is simply mind-blowing, essentially finding that private business are just like religious institutions, and therefore they can decide which laws they have to obey:

The ACA's Obamacare Problem

The law is going to make health care better for many Americans. A lot of them just won't realize it's the same thing as the Obamacare they hate. 

AP Images/Evan Vucci

Obamacare is well on its way to being permanently unpopular. A problem for supporters of health-care reform? Not really—because the Affordable Care Act could become just as untouchable as Medicare or Social Security. That’s right—get ready for “keep your Obamacare away from my Affordable Care Act!”

If Pot Becomes Legal

What will become of its secretive California hometown?

AP Photo

At one point in Humboldt: Life on America’s Marijuana Frontier, Emily Brady’s account of her year in a remote Northern California county where pot is the cash crop that drives the local economy, one of the book’s subjects—a native of the area named Emma Worldpeace—talks to a new friend about the pictures of deceased classmates that hang on tackboard on Emma’s dorm room wall.

“Did you know all these people who died?” she asked.
“Yeah, I grew up with all of them,” Emma replied.
“Oh my god, that seems so tragic.”