The Left After the Failure of Obamacare
By Shamus Cooke for Truth-Out –
It’s satisfying to watch rats flee a sinking ship. This is because onlookers knew the ship was doomed long ago, and swimming rats signify that the drawn-out tragedy is nearing an end. A collective sense of relief is a natural response.
The rats who propped up the broken boat of Obamacare are a collection of liberal and labor groups who frittered away their group’s resources—and integrity— to sell a crappy product to the American people.
Those in the deepest denial went “all in” for Obamacare— such as some unions and groups like Moveon.org— while the more conniving groups and individuals—like Michael Moore— playacted “critical” of Obamacare, while nevertheless declaring it “progressive”, in effect adding crucial political support to a project that deserved none.
But of course Obamacare was always more barrier than progress: we’ve wasted the last several years planning, debating, and reconstructing the national health care system, all the while going in the wrong direction— into the pockets of the insurance mega corporations. A couple progressive patches on the sails won’t keep her afloat. It’s shipbuilding time.
It was painful to watch otherwise intelligent people lend support to something that’s such an obviously bad idea. So it’s with immense relief that liberals like Michael Moore, labor groups, and others are finally distancing themselves from Obamacare’s Titanic failure. Now these individuals and groups can stop living in denial and the rest of us can proceed towards a rational discussion about a real health care solution.
The inevitable failure of Obamacare is not due to a bad website, but deeper issues. The hammering of the nails in the coffin has begun: millions of young people are suddenly realizing that Obamacare does not offer affordable health care. It’s a lie, and they aren’t buying it, literally.
The system depends on sufficient young people to opt in and purchase plans, in order to offset the costs of the older, higher-needs population. Poor young people with zero disposable income are being asked to pay monthly premiums of $150 and more, and they’re opting out, inevitably sinking Obamacare in the process.
Those young people who actually do buy Obamacare plans—to avoid the “mandate” fine— will be further enraged when they attempt to actually use their “insurance”. Many of the cheapest plans—the obvious choice for most young people— have $5,000 deductibles before the insurance will pay for anything. For poor young people this is no insurance at all, but a form of extortion.
At the same time millions of union members are being punished under Obamacare: those with decent insurance plans will suffer the “Cadillac” tax, which will push up the cost of their healthcare plans, and employers are already demanding concessions from union members in the form of higher health care premiums, co-pays, deductibles, etc.
Lower paid union workers will suffer as well. Those who are part of the Taft Hartley insurance plans will be pressured to leave the plans and buy their own insurance, since they cannot keep their plans and get the subsidy that the lowest income workers get. This has the potential to bust the whole Taft Hartley health care system that millions of union members benefit from, which is one of the reasons that labor leaders suddenly became outraged at Obamacare, after having wasted millions of union member’s dollars propping it up.
Ultimately, the American working class will collectively cheer Obamacare’s demise. They just need labor and other lefties to cheer lead its destruction a little more fiercely.
Surprisingly, most of the rats are still clinging to Obama’s hopeless vessel, frantically bailing water. Sure they’ve put on their life preservers and anxiously eyeing the lifeboats, but they’re also preaching about how to re-align the deckchairs.
For example, in his “critical” New York Times op-ed piece, Michael Moore called Obamacare “awful”, but also called it a “godsend”, singing his same tired tune. Part of Moore’s solution for Obamacare—which was cheered on in the Daily Kos— is equally ludicrous, and follows his consistently flawed logic that Obamacare is worth saving, since its “progress” that we can build on. Moore writes:
“Those who live in red [Republican dominated] states need the benefit of Medicaid expansion [a provision of Obamacare]…. In blue [Democrat dominated] states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer.”
This is Moore at his absolute worst. He’s neck deep in the flooded hull of the U.S.S Obamacare and giving us advice on how to tread water.
Of course Moore doesn’t criticize the heart of Obamacare, the individual mandate, the most hated component.
Moore also relies on the trump card argument of the pro-Obamacare liberals: there are progressive aspects to the scheme—such as the expansion of Medicaid— and therefore the whole system is worth saving.
Of course it’s untrue that we need Obamacare to expand Medicaid. In fact, the expansion of Medicaid acted more as a Trojan horse to introduce the pro-corporate heart of the system; a horse that Moore and other liberals nauseatingly continue to ride on.
But Moore’s sneakiest argument is his advice to blue states to “…lobby for a public option on the insurance exchange…”
Again, Moore implies that it’s ok if we are “mandated” to buy health insurance, so long is there is a public option. But that aside, the deeper scheme here is that Moore wants us to further waste our energy “reforming” Obamacare, rather than driving it to the bottom of the sea.
Moore surely knows that very few people are going to march in the streets demanding a public option at this point; he therefore knows that even this tiny reform of the system is unachievable. He’s wasting our time. Real change only happens in politics when there is a surge of energy among large sections of the population, and it’s extremely unlikely that more than a handful of people are going to be active towards “fixing” Obamacare— they want to drown it.
Moore’s attempt to funnel people’s outrage at Obamacare towards a “public option” falls laughably short, and this is likely his intention, since his ongoing piecemeal “criticisms” of the system have only served to salvage a sunken ship.
Instead of wasting energy trying to pry Obamacare out of the grip of the corporations, Moore would be better served to focus exclusive energy towards expanding the movement for Medicare For All, which he claims that he also supports, while maintaining that somehow Obamacare will evolve into Single Payer system.
Most developed nations have achieved universal health care through a single payer system, which in the United States can be easily achieved by expanding Medicare to everybody. Once the realities of Obamacare directly affect the majority of the population and exacerbates the crisis of U.S. healthcare, people will inevitably choose to support the movement of Medicare for All, the only real option for a sane health care system.
I think Moore is right about mandates, after all Medicare is mandated health insurance. It had to be or it wouldn’t have worked. The difference is that your tax dollars go to your health care and not for some for health care profiteers bottom line.
There is one mandate in current Medicare that is an exception and that is the mandate to enroll in private insurance in Medicare Part D. Medicare recipients were required to buy private Medicare Part D drug insurance or be fined 1% per month for each month that you were not enrolled in a part D plan that did not measure up to Medicare standards. Isn’t it interesting that Republicans had no objection of mandated Medicare Part D insurance when it was a Republican George Bush idea.
Have we finally reached the only health care for all. Medicare for all is the solution for U.S. health care.
The ACA needed 60 votes to pass the Senate. That meant that Joe Lieberman and Ben Nelson had to vote for it. They opposed a public option. Do you think they would have voted for single payer? Do you think the current Congress, which is substantially more conservative than the Congress we had in 2009-2010, would vote for single payer? Do you envision any Congress on the horizon that would do so?
Millions of poor people have already received coverage through the ACA’s Medicaid expansion, and we know that lives will be saved as a result. As we saw with CHIP, it will take years, not months, for a program like ACA that depends on state-federal action to reach its enrollment goals. But already in states like CA, CT, and NY, which have administrations that are supportive, tens of thousands or hundreds of thousands of previously uninsured people, most of whom work in low-wage jobs, are receiving coverage.
Should federal policy-makers have said to these uninsured, poor and low-wage workers, disproportionately Latino and other people of color, the following: “We could pass the ACA and provide you with health insurance, thereby lowering your risk of death and illness. But we won’t. Because maybe some day the politics might be better than they have been in decades and better than any objective observer foresees them becoming as far as the eye can see, and maybe we could pass a single payer law.”
Let’s make this question personal. There’s a woman, a single mom, working as a waitress at two restaurants. She’s uninsured and so she hasn’t had her breast cancer detected; she can’t afford to go to the doctor. She’s going to die, needlessly, unless she gets health insurance and gets her cancer detected so treatment can start immediately. Across town, the wife of a CEO gets her incipient tumor detected right away and excised. No problem! Would you really say to that waitress and her kids, “Sorry, no health insurance for Mom. Too bad about that preventable death from breast cancer. Maybe some day a miracle will happen and we’ll get single payer. Till then, all good progressives must fight against any coverage increases that preserve private health insurance.”
Yes, Steve. Let’s make this personal. First, the plan was completely sucko because it was the heritage foundation wet dream. Second, I am one of those people who is just over the 400% of poverty, and the cheapest plan here in Indianastan, whose main industry is Anthem and United Health care, would have to pay $1050 for a 60/40 bronze with a $5000 deductible. I currently have a $6000 deductible major medical. Another kicker with this Anthem plan is it puts both hospitals out of network. So, I am supposed to pay $1050 a month, send my daughter to college ($20,000 a year) all on $84,000 a year. When a talking head on MSNBC is forced to deal with this fact they then dismiss this as ‘statistically insignificant.’ I may not have had the best health insurance over the years, but I have always purchased it for me and my family. After this year is over (I am able to hang onto my crapola major medical) only because I am signed up as a ‘small business’
when the democrats were giving away the store some genius could have come up with the push back of open enrollment for medicare. That would have made Pharma and the insurance lobby simultaneously crap themselves. So, mr ‘what else could obama done but take it up the keester for us, ohthankyouthankyouthankyou’ maybe if he hadn’t taken all that money from the corporate lobbyists and realized he had a democratic majority, and used a little of that angry black man we would be in an entirely different situation now. Obama is as big of a sell-out at the Clintons, who could not have possibly passed NAFTA (insert more keening over ‘what else could we dooooooooooo) and killed welfare. You are part of the problem, Steve. Stop acting like this was all so ‘inevitable.’ Remember, Obama picked Max Baccus (https://www.youtube.com/watch?v=M5Y9X5ggxzA). Why do you think they took down Edwards? Remember his campaign? Open enrollment for medicare? He had to be gotten rid of–just like Spitzer or anyone else who can put a whole in those fleecing america. And you’re their cheerleader.
Gee, Stan, I guess you were asleep while all this was actually unfolding and just read the talking-point synopsis afterward. Allow me to improve your understanding:
1. girlcousin is entirely correct that had Obama come out fighting for real reform we would have wound up in a significantly different place at the end. Instead, within 4 months of taking office (before discussion in Congress had even begun) he cut a back-room deal with industry heavyweights to keep single-payer completely off the table and pass an industry-friendly bill (whether even the relatively mild public option was explicitly axed then or a bit later we don’t know).
2. I suspect that the CBO’s estimated 20 million people who STILL won’t be covered by Obamacare even at the end of this decade (assuming it survives until then, which I consider extremely doubtful) will, indeed, take that personally. That’s in addition of course to the tens (hundreds?) of millions of people who are ALREADY disgusted with it for good reason (as the original post describes).
3. The reason Obamacare likely won’t survive is less because it’s such an abominable mish-mash of industry-friendly band-aids than because the cost of its planned subsidies will be so high that it will be a (perhaps the) prime target for future budget trimming. If we returned to a tax system as progressive as the one we had for the first couple of decades after WWII we MIGHT be able to handle such a load, but I’m not holding my breath waiting for that to happen.
4. Oh, yeah: that ‘required 60 votes in the Senate’ thing. Leaving aside the fact that Obama and his democratic allies (certainly including Pelosi and Reid, as things turned out) had never actually pushed for the ‘public option’ in the first place (despite having campaigned vigorously on doing just that), when push came to shove at the end and the only way to get this abomination passed was to ensure that a fix-up package to the original Senate bill would immediately follow it which could only be passed under budget ‘reconciliation’ rules which required only 50 votes (plus a Biden tie-breaker) to pass, the opportunity arose to revive the public option in that reconciliation package (just as important health-care legislation had been passed via reconciliation in earlier decades) and pass it with only 50 votes until both Pelosi and Reid strong-armed their caucuses into keeping mum (even Bernie Sanders, who had publicly stated that he might do this, got bought off). Since the House had ALREADY passed a bill that included a public option there’s a good chance they would have agreed with this in the reconciliation package, and at worst it could have been TRIED and then taken out if it proved to be unpassable – but no, that wasn’t acceptable (perhaps the leadership was worried that it might embarrass the 54 or so Senators who had oh-so-progressively suggested that they’d support a public option when they thought they’d never actually be able to pass it due to the kind of filibustering that suddenly no longer existed in the reconciliation process).
5. Will we get a Congress any time soon that might pass Medicare for All? Hard to say, though we MIGHT have had one as recently as 2010 had Obama and the rest of the leadership actually pushed for it and the American public has demonstrated consistently in polling that it’s on board with the idea. It could even have passed in that reconciliation package without requiring Lieberman or Nelson’s support and even after Massachusetts liberals had become so disgusted with the way the health care debacle was unfolding that they elected Scott Brown to replace Ted Kennedy (why that wasn’t a wake-up call to the Democratic party about what would happen the following November I can’t fathom, unless they just didn’t care): the CBO had already shown that expanding Medicare had positive budgetary impacts.
That’s the Reader’s Digest Condensed Version, anyway. Hardly ideal, but better than what you started out with.
The real problem, and it is likely to persist, is the failure of most voters and politicians to understand how insurance works.
Yes, a single payer system IS the most mathematically efficient insurer possible (See “Standard Errors: Our Failing Health Care (Finance) Systems And How To Fix Them” at my website) but a single payer isn’t enough.
The single payer actually has to retain its insurance risks. Medicare does not do that. Medicare, through the Prospective Payment System, transfers its insurance risks to intermediaries and health care providers. The risk assuming health care providers: Physicians, Hospitals, Nursing homes and Home health agencies become their patients’ de facto health insurers.
For the same reason that more than a thousand health insurers is a terrible ides, that they are inefficient, offer lower benefits per premium dollar, are subject to wide swings in loss ratios and have inordinately high aggregate surplus requirements (Billions of dollars in idled assets if properly protected from insolvency), hundreds of thousands of Physicians, Hospitals, Nursing homes and Home health agencies is an even worse idea because they offer far lower benefits per premium dollar, are far more subject to wide swings in loss ratios and have astronomically high aggregate surplus requirements (Trillions of dollars in idled assets if properly protected from insolvency).
If we are again sucked into the notion that Medicare For All is an answer, rather than a distraction, we can finish out the decade with no real progress on a single payer, insurance risk retaining, national health insurer.
Here’s hoping we aren’t duped twice in a row…
Gee, that’s funny. I thought Medicare WAS working. It is according to my mom. Another single payer system that works? THE VA. The reason it works is they have price controls and a closed system. You go to a VA hospital, they do everything right there. Your tests get done there and the results are back to the doctor that day. We don’t need heal INSURANCE we need health care. What do you think the canadidan system is? Anthem? Gimme a break! The NHS? Single payer. Transactions cost money. This is ridiculous! With for profit health care, there are NO price controls, and the only way prices can go is up. Do you honestly think it is reasonable for me to be expected to pay over $1000 a month to BARELY insure a family of 3? But Medicare covers the oldest and sickest, and we provide that to seniors with 1.45% of your earned income. Now let’s apply that 1.45% to ALL income, put actual price controls in place, subsidize (and enlarge enrollment) education for MD’s and RN’s (all education, but that will do for now) and then we are talking. Instead, I have overpriced crap because at LEAST 1/3 of that premium is nothing but advertising, office expenses, payroll, golden parachutes for the executives, overpayment to directors, etc., etc. The administrative costs of medicare are LESS than 2%. Don’t tell me I don’t understand. I get it, I just CAN’T AFFORD IT.
That’s an interesting observation, Thomas, but it’s not clear why you think it constitutes an objection to extending Medicare (unless you advocating abolishing Medicare, which I certainly hope you’re not). Extending Medicare solves ONE important aspect of our national health-care crisis (the 20% or more waste of each dollar which is funneled through private insurers) without obviously exacerbating the one you’re describing (which subsequent reforms to Medicare could correct if that’s appropriate – and likely more effectively than trying to correct them in the mish-mash of profit motives that exists with our current insurance system).
What kind of titled obfuscation is this? “Insurance risk retention”? “wide swings in loss ratios and have high inordinately aggregate surplus”? “Trillions of dollars in idled assets if properly protected from insolvency”? I too have a Ph.D (in biology) and I’m not impressed with this kind of gobblygook. Health care is a human right, insurance risk has nothing to do with it except in a for profit commodity driven private health insurance system.
As far as Medicare for All goes, perhaps it soon won’t be what we wish for— Improved Medicare for All HR676. Current Medicare has undergone considerable privatization which many Americans claim to oppose and I for one do not wish it extended as is. Current Medicare was 20% privatized at the insistence of Republicans at the time of enactment. Further privatization came with Medicare Part D which is entirely private insurance. Medicare was further privatized with the conservative Trojan Horse subsidized Medicare Advantage Plans (MAPs). About 30% of Medicare eligible seniors have been enticed to opt out of traditional Medicare into MAP private insurance. Instead of reducing MAP subsidies 2.2% as called for in the Affordable Care Act, the Obama Administration under pressure from insurance companies and Congressional conservatives increased the subsidies 3.3%.
It is possible that eventually current Medicare will be extended, but will it be a system most Americans want, a system free of health care profiteering? One thing you can do to try to prevent further privatization is to write, call, and email your congress people to demand repeal of MAP subsidies so that Medicare can compete on an even playing field or sign a petition by clicking on http://petitions.moveon.org/sign/medicare-advantage-plans
You seem quite confused, John, which may be why you can’t understand Thomas’s points as anything but ‘gobblygook’:
1. You can pompously proclaim health care to be a human right until the cows come home, but in practice it simply is not (save perhaps for minimal emergency care) in this country – so your statement to that effect carries no weight in this discussion until such time as this situation changes (at which time there won’t be much left to discuss).
2. Insurance risk is by no means limited to conventional insurers, as Thomas notes: Medicare as currently implemented shifts significant parts of it to health-care PROVIDERS (though exactly how important this may be in practice I don’t claim to know: one would expect at least SOME of that shifted burden to balance out statistically, though perhaps not for some smaller providers).
3. I certainly know of no polling data suggesting that ‘most Americans want’ a government-run health CARE system (devoid of private providers and profit) as, for example, Great Britain has: the polling I’m familiar with suggests only that they want a government-run health INSURANCE system (such as Canada has) to get costly and negative-added-value private insurance vampires out of the equation.
I do consider a Medicare for All approach to be (unlike the ACA) a significant first step toward the kind of cost-effective universal health-care system we need in this country. But zealots need to realize that not everyone who shares this vision has viewpoints as didactic as theirs often seem to be, and that this larger population (whose support they really need) may be more put off than energized by polemics such as yours.
Steve Dorn’s tired defeatist liberal arguments are a shining example of why the American working class finds itself so disorganized and defeated. We’ve heard it over and over again and not just with the ACA, but with sell-out labor leaders forcing bad contracts on their members, and half-hearted reforms that help the corporate state more than the working class– “It’s the best we can get right now so we need to take it. It’s better than nothing.” Wrong, it’s worse than nothing.
You’re right Steve, let’s make it personal how about a union member who went on strike for 6 months to keep quality healthcare now losing their plan because it’s over the cap and is heavily taxed as a “luxury”? How about the millions of union members who are going to see their Health & Welfare Funds, and their pensions and good health insurance along with it, destroyed over the next few years? How about the worker who just got their hours cut from 40 to 29 so their employer won’t face a penalty for offering them shitty insurance? How about the millions in Southern states who won’t benefit from the Medicaid expansion, are poor, but will still be forced to buy shitty health insurance coverage? How about the generations of people we are further enslaving to the corporate interests who have been fighting single-payer reform for decades by forcing them to buy their product?
Perhaps most importantly, how about the millions of the best organized sectors of the American working class (unionized workers) who’ve just been convinced that the right-wing propaganda about the government getting involved in health insurance being a disaster is true?
But no, I’m sure you would rather not look at those examples because then you’d have to face your own myopic, cowardly, and ultimately destructive liberal politics, and you would no longer be able to sit upon your high horse declaring yourself a “realist” and a “pragmatist” and the rest of us “political purists.” I know your type and I know it well, your kind has been unknowingly undermining the American working class for many decades, all out of the best of intentions, because your vision is short-sighted and your resolve weak.
You are SO right–we just got sold to the company store by our democratic president. It takes a democratic president to really hammer the nails in the coffin of working americans. We expect it from republicans, but the democracts, thanks to gary hart and the clintons, and now the obamas, we’re at the end game of the ‘reagan revolution.’ Welcome to hell, folks.
I find myself in reluctant agreement with this article, despite various friends thinking Obamacare is going to lead to “something better” and the fact that my own daughter, who has suffered with medical problems and no health insurance, was just able (after calling support and being on hold for a full hour, then nearly another hour on the phone after going in circles on the NY state exchange website) was able to get a “Medicaid HMO” with no monthly payment. She will certainly benefit, but I know many others will be stuck with those “bronze” plans that only cover 60% of your costs and come with high deductibles. My husband and I have Medicare, the best coverage I’ve ever had after a lifetime of being self-employed and having nothing but high-priced crappy coverage. I put all my frustrations and thoughts on this lifetime of suffering under “free-enterprise health care” into an impassioned rant: read it at http://www.theseekerbooks.com/articles/WhatsWrong.html.
Thanks, Theresa. I had to turn off the MSNBC non-stop cheerleading for Obamacare. I about threw the TV through the window when I was described as ‘statically insignificant–‘ you know, one of those at 401% of the poverty level, so my premiums skyrocketed.
It is a personal question for me, Stan. I was one of those supposedly helped by this Democratic solution to unaffordable health care and health insurance. I tried to raise concerns throughout the process but was never given a seat at The Table.
I’ve studied up on my options since this porker was passed, and have diligently tried to get insured since October. It has been impossible to get my questions answered so that I could make an informed decision. Let me give you a clue: anything you think you know about the ACA, may or may not be true. They had to pass it to allegedly know what is in it. Since then it’s a series of exemptions, and there is some serious fine print being completely ignored.
For example, this lauded Medicaid extension comes with an asset recovery program for those over 55. In other words, you aren’t insured, you aren’t being caught by a safety net program, your cost is simply hidden and deferred until after your death at which time you are subject to a 100% death tax.
Think you’re safe when you’ve made it to Medicare? No, you must buy part D drug coverage and if you can’t afford it that cost will also be taken as a death tax. In making it so that all ordinary households will not pass on their wealth to the next generation, the ACA is the most efficient impoverishment machine yet invented.
And that is saying something. Recap: we need healthcare reform to help people afford care and/or insurance. ACA as implicated: How dare those people not be able to afford the exorbitant inflation we created by endlessly subsidizing the healthcare industry. We;ll squeeze it out of them even when they’re dead.
The other personal issue the ACA ignored is how stupendously absurd it is for the self-employed. You are expected to KNOW how much you will make. If you get it wrong, you will have to repay the premium subsidy paid for your coverage. So be careful if you change jobs are get a raise as you might pay more than that at tax time to insure private insurers get profits that are not subject to claw back.
The BEST thing the ACA did was put the whole discussion of the healthcare in this country out in the open. Have you noticed how many times the term “single payer” has been out there now? That’s one thing for which us single payer activists should be grateful and use it to keep the momentum going.
I am appalled at the vitriol allies of single-payer heap upon each other if their strategy is not exactly as there own. I think that the ACA is a walk in the weeds,but I do not impugn the motives of it’s advocates.
I think this fairly encapsulates the issue, shorn of any “liberal” or “conservative” rhetorical nonsense:
http://www.globalresearch.ca/the-patient-protection-and-affordable-care-act-aca-an-endeavor-in-social-reform-or-another-trojan-horse/5367556