Here’s the NY Times’ Bill Keller with The Rest Of The Story
Unless you’ve been bamboozled by the frantic fictions of the right wing, you know that the Affordable Care Act, familiarly known as Obamacare, has begun to accomplish its first goal: enrolling millions of uninsured Americans, many of whom have been living one medical emergency away from the poorhouse. You realize those computer failures that have hampered sign-ups in the early days — to the smug delight of the critics — confirm that there is enormous popular demand. You have probably figured out that the real mission of the Republican extortionists and their big-money backers was to scuttle the law before most Americans recognized it as a godsend and rendered it politically untouchable.
Just because people access a website doesn’t mean they’re going to purchase the product. And, they aren’t really purchasing the product. The Miami Herald has upgrade enrollees to “urban legand“. Yes, eventually people will sign up. They really do not have a choice. They’ll pay a fine/tax, otherwise. We do want people with health insurance, so that the rest of us aren’t paying for them. What they’re finding out is that it’s not particularly affordable.
What you may not know is that the Affordable Care Act is also beginning, with little fanfare, to accomplish its second great goal: to promote reforms to our overpriced, underperforming health care system. Irony of ironies, the people who ought to be most vigorously applauding this success story are Republicans, because it is being done not by government decree but almost entirely with market incentives.
Did Bill miss the point that these “market incentives” derive from government mandates and requirements? Sure looks like it. That’s not free market in the least.
Using mainly the marketplace clout of Medicare and some seed money, the new law has spurred innovation and efficiency. And while those new insurance exchanges that are now lurching into business will touch roughly 1 in 10 Americans (the rest of us are already covered by private employer plans or by government programs like Medicare), these systemic reforms potentially touch every patient, every taxpayer.
After telling us that we should be applauding these “market incentives”, which derive from government, he tells us that these “market incentive” actually derive from government and will touch virtually every single American. Why wouldn’t Conservatives love that?
Since the Affordable Care Act was signed three years ago, more than 370 innovative medical practices, called accountable care organizations, have sprung up across the country, with 150 more in the works. At these centers, Medicare or private insurers reward doctors financially when their patients require fewer hospital stays, emergency room visits and surgeries — exactly the opposite of what doctors have traditionally been paid to do. The more money the organization saves, the more money its participating providers share. And the best way to save costs (which is, happily, also the best way to keep patients alive) is to catch problems before they explode into emergencies.
There’s a lot of discourse regarding these ACOs, and whether they will work or not. Some say yes, some say no. Some say they will lead to substandard care, and cause people who should be referred to be left without the care they need. Time will tell. What this does do is insinuate The Government into more of our personal health care choices, meaning the decision is between the doctor and the government, not the doctor and the patient.
There’s no doubt that reducing ER visits can reduce health insurance costs. But people who should be heading to the hospitals may not be sent. That is dangerous. And based on Government interference. Anyhow, sure, there are some good parts to Obamacare. They’re the tasty pretzel bun covering the guano-patty. Said guano-patty is the Governmental interference in our lives, the increased control of our health care by Government, the increased costs, etc, you know the hit list. Just obtaining health insurance through the Exchanges involves a huge smattering of governmental agencies. Hugely complicated just to sign up.
One reason you may not have heard much about this part of the Obamacare story is that it is numbingly complicated.
The hell you say!
But I suspect another reason is partisan spite. The Democrats were passionately in favor of enrolling the uninsured, but many would have preferred a government-run program, or at least a public option. What Obamacare has wrought is the kind of market-driven reformation that Republicans pretend to believe in. Which makes you wonder how much of their opposition rests on the merits, and how much is just a loathing for anything associated with Barack Obama.
Got that? Liberal Bill Keller thinks a government driven program that’s incredibly complicated and involves a huge amount of government agencies enforcing a huge amount of government mandates is “free market.” But, we don’t like it cause of Obama. Right. Here’s free market principles in action
In order to fully appreciate that chart, you have to see it in full. Check at Rep. Kevin Brady’s website, where that is enlarged to 9000 x 7000. Yes, that big in order to understand all the connections. Which looked like this before passage of the ACA.
BTW, if Keller thinks the way the ACOs operate is great, having incentives to reduce costs, why don’t we try and do that for Government itself?
And then there is this article showing how people can actually save money by not making as much money because subsidies will kick in at th lower income level.
http://www.sfgate.com/business/networth/article/Lower-2014-income-can-net-huge-health-care-subsidy-4891087.php
Those subsidies will have to be paid by other people, but hey, according to liberals, the way to grow the economy is to drive people into to the lower class and then demand other people pay.
Well, yeah, they believe in the unicorn bottom up economy, that somehow people without money will create money. And that taking money from producers and giving it to non-producers will make an economy explode with awesomeness.
Yet, these same liberals who are producers refuse to do what they preach. Strange, eh? It’s just like with “climate change”. And taxation. And so many other things.
Right..and I bet you $10,000 that by 2016, half of republican candidates will be basing their entire campaign on “fixing the aca”, “improving the aca”, “making the aca work for the middle class”, or “strengthening the aca”, or “making sure the aca is around for the next generation”….
Just like they do for all the other socialist programs…
I won’t take that bet, Han, at least in terms of elected Republicans, because, sadly, you’re probably right. Many of them are squishy enough to do that.
Also, by 2016, repeal and replace is going to be much more difficult, what with the active exchanges. If they haven’t collapsed by then.
Right on Han. Unfortunately. Too many socialist programs are allowed to continue on despite having no purpose or being done over and over again with dozens of other programs. Repubs have always been squishy. I won’t take that bet as repubs have also shown themselves to be cowards. They’d be the Benedict Arnolds of a new Revolution. The current “bargain” is a pure example. Repubs bargain and give up, while Dems stand firm.
page access are not enrollment. BTW, please show us these millions of enrollees as no one else can find them.
it became that way because the FEDS kept getting involved.
Ummm.. He spends article touting up the federal law ACA, and then claims its not a federal law? A law that is forcing insurers to kill health plans, forcing people off of job-provided plans on to gov’t plans? Yeah, purely market driven, yeah, sure.
Medicare is a marketplace program?!?!?! I thought it was a government mandated insurance program that dictates price controls on the marketplace? hmmm
What seed money?!?! Who seeded this program with money? Was it the american taxpaying citizens? So, we’ve paid for it before we can use it? And please point to any gov’t program that has spurred innovation and efficiency. If you liberals can, then I’ll embrace ACA.
Yeah, why wouldn’t small\limited gov’t republicans love a growing all encompassing government program?!?!? DUH!
So, ACA created nearly 500 new health care companies? Really? And if true ,this is good news?
So, now doctors will be paid extra for not providing care to their patients? How will this save money? NOrmally, doctors will be paid for the surgeries they perform, now they will be paid extra for not doing surgeries? Hey, just give gma a pain pill for that liver problem she has.
REally? REALLY? Who knew. Am glad that we had to create a massive government mandated program, or else, in order to figure that out after all these years!!!!!
ROFL… I GET THAT. And I too can’t understand why so many places are doing pretzel buns. WTH!?!?
Ok, the libs push this ACA as the only way that the uninsured and poor can get health care coverage. Ummm.. yes, there is Medicaid for the poor. If you can’t get that, then you’re not poor. And, if you are too stupid to figure out how to get your own insurance, then maybe its best if you didn’t reproduce.
Who are many of the success stories we’ve heard about? COllege students. Students who may already have insurance thru their college or are healthy enough to not need insurance.
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