What I don’t understand about the insurance and state lines thing

Obamacare set up health insurance marketplaces. It didn’t take over health insurance like some would make you believe, but one thing it did was establish a website, not much different from expedia, where people can compare available insurance plans. Of course, it made some rules about the plans that can be sold on this platform, and each state has its own set of plans, so somebody from NY, for example, only gets to shop for plans in NY. Republicans latched onto this, and said that it hurt competition, because insurance companies should be able to sell across state lines. I’m not an expert in health insurance, so I’m sure I’m missing something (maybe something big), but the whole thing always seemed silly to me. I’m the first to warn against anecdote, and I should probably use my own advice here, but every now and then we all ignore the rules (even our own), so here goes.

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Sometimes when you win, you lose. Sometimes when you lose, you win. And sometimes when you win or lose you really tie.

 

 

The House of Representatives has voted, once again, to repeal the Affordable Care Act. This is not the first time they have done so, and it likely won’t be the last. They passed several bills and amendments since 2011 that repeal or limit Obamacare, and few of these became law. My guess is that this bill will die like the others have, but this time it will be killed by a more pensive (and smart?) Senate. Senate republicans are already saying that they can’t pass the current bill, and it’s not clear that they even have enough support for a vote. It’s hard to see how the House and President see this as a win, but they do, and they had a party at the White House about it. Vice President Pence rallied the crowd (of middle-aged to old white men) with a line, “Welcome to the beginning of the end of Obamacare.” Silly line. Doesn’t that assume that Obamacare will end? Doesn’t it assume that the previous votes weren’t the beginning of anything? Silliness all around.

Continue reading “Sometimes when you win, you lose. Sometimes when you lose, you win. And sometimes when you win or lose you really tie.”

Repeal, and replace with what?

Folks on the right often complain about government handouts, and accuse liberals of wanting something for nothing. It often, however, seems to be exactly the opposite, especially when it comes to discussions about Obamacare. And so much of the hatred about Obamacare concerns things that were just as bad, if not worse, before it.
Drew Altman, in a Times Op-Ed looks at sentiment in Trump voters about Obamacare repeal.
“If these Trump voters could write a health plan, it would, many said, focus on keeping their out-of-pocket costs low, control drug prices and improve access to cheaper drugs. It would also address consumer issues many had complained about loudly, including eliminating surprise medical bills for out-of-network care, assuring the adequacy of provider networks and making their insurance much more understandable.”
So, basically, they want it to do MORE than it does, not less? Isn’t that what democrats were pushing for, but scaled back as an attempt to compromise with republicans? Isn’t the republican philosophy to let the free market take care of it, not to mandate lower prices, regulate out-of-network care?
I’m continually baffled by how people make their decisions, and how comfortable people seem to be with their strong opinions, when there’s a clear lack of understanding serving as a basis of those opinions.
An old friend who I’ve kept in touch with almost entirely through FaceBook voted for Trump (or at least supported him in discussions on FaceBook before the election). In the run-up to the election, he said that all he wanted was lower taxes and affordable health care. This pained me. I don’t know his annual income, but I know his job and what he does, and I suspect that he doesn’t have income in any of the tax brackets that are targeted for reduction in any of the tax plans put forward by Trump or any of the republicans. But, more to the point here, what does he expect from a repeal of Obamacare? Maybe he expects to be able to buy a cheap plan again, without any requirements for minimum standards of coverage, like those that came with the ACA. Maybe he’s OK with a plan that won’t actually cover him if he gets sick, but makes him feel covered because it has low co-pays for routine stuff, and low premiums. Maybe he wants that, but of course that leaves the rest of us covering his bill if he gets sick and needs help that his insurance won’t provide, or leaves him broke and sick.
Of course there are things wrong with the ACA, and of course I’d like to see them fixed, but much like what I wrote earlier about government failures, the answer doesn’t seem to do less, it seems like the fix involves doing more. That means not repealing, but strengthening. Of course, that’s not what any of the GOP plans look like, but we’ll have to wait and see what we get.
The GOP needs to be very careful here, or they might end up shooting themselves in the foot, without a good insurance plan to cover the treatment.

Debating the Obama presidency before it even ended

A friend posted this on FaceBook the other day. It’s a blog post written about a challenge that was made to republicans to “Name any meaningful metric that got worse under President Obama.” The post is very detailed and long, and I’m actually a bit jealous that I didn’t write it first. Either way, this friend, the one who posted it on FaceBook, tagged one of his conservative friends to respond. He did it in a nice way, non-confrontational.

Scott, genuinely interested in your response to this. Not posting this as a provocation – I would really like to hear an informed rebuttal from a smart conservative person who plays fair, which you do.

But please limit your response to 20 or 30,000 words. Don’t want feel like I’ve burdened you with homework on 4th of July weekend.

I like that. Scott responded, and I wanted so badly to respond to his comment, but I don’t know the original poster all that well (the “friend” on FaceBook is really the husband of one of my wife’s high school friends who I’ve known for a while, but she doesn’t fall into the list-of-people-I’d-invite-to-my-birthday-party circle, and neither does her husband. For that reason, and because he specifically said he wasn’t trying to provoke, I resisted the temptation to post…and just relieved myself here. So here’s Scott’s response, and what I so badly wanted to say to him after.

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