Tag Archives: health care

Millions of Women Now Pay Nothing for Birth Control. Thanks Obamacare!

by Jane Adams Posted on December 11, 2013

Mother Jones

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The percentage of privately insured women who didn’t pay a dime for birth control pills almost tripled this year, rising from 15 percent in 2012 to 40 percent in 2013. That’s according to a new study from the Guttmacher Institute, a think tank that backs abortion rights. The study, which was published in the journal Contraception, examined the effects of an Affordable Care Act rule requiring private insurers to cover contraceptive products and counseling with no co-pay.

This same rule has come under sustained, delirious assault by Republicans who paint it as an attack on employers’ religious beliefs. During the debt ceiling crisis this fall, some House Republicans were willing to let the government default if the final financial deal did not include a “conscience clause” allowing employers to sidestep the mandate if it violated their religious beliefs. (The Obama administration has already exempted a narrowly defined set of religious institutions.)

That battle will come to a head this spring, when the Supreme Court will hear arguments in Sebelius v. Hobby Lobby Stores, Inc. Citing their Christian beliefs, owners of the Hobby Lobby chain of craft stores are refusing to provide their female employees with insurance that covers contraceptive services. A decision in favor of Hobby Lobby could blow a hole in the contraception mandate, allowing any private employer to withold birth control coverage simply by citing their religious beliefs.

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Millions of Women Now Pay Nothing for Birth Control. Thanks Obamacare!

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How Vulnerable Is a Congressman Without Health Insurance?

by FSZLazarots Posted on December 10, 2013

Mother Jones

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Members of Congress have spent the past few weeks grousing about their attempts to enroll in new health insurance plans they forced on themselves when they passed the Affordable Care Act. The law requires members of Congress to get their insurance, and employer subsidy, through the DC health exchange rather than through the Federal Employee Health Benefits Network, where they’d been getting it for decades—at a good price.

Not every member is signing up for the exchange. Some, like Sen. Ted Cruz (R-Texas), have cushy coverage through a spouse’s employer. Others are eligible for Medicare, the government’s plan for the elderly. And then there’s Rep. Louie Gohmert, a Texas tea party luminary and an outspoken opponent of the ACA. Rather than participate, Gohmert says he intends to pay a fine the law imposes and remain uninsured when the ACA’s individual mandate kicks in early next year. “I’ve pledged that I’m not taking the subsidy,” he told Politico. “Too many people in my district have lost their insurance because of Obamacare…and because of Obamacare, the remaining insurance is just too expensive. So I’m not going to have insurance, it looks like.”

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How Vulnerable Is a Congressman Without Health Insurance?

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Obamacare Will Prevent Millions of People From Being Gouged by Hospitals

by AngelikaSantacr Posted on December 8, 2013

Mother Jones

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When President Obama said that if you like your health insurance, you can keep it, he was clearly taking some liberties with the strict truth.1But as Ezra Klein points out this weekend, the reason he pressed this point so hard is that Americans have an understandable fear of losing their health insurance. And why not? You can lose it if you lose your job. Or if you lose access to Medicaid. Or if your insurance company decides to effectively eliminate your plan by jacking up its price. And that’s not even counting the millions of people who don’t have health coverage in the first place.

So, yes, it’s true that Obama was wrong when he guaranteed that every single person could keep their current plan if they wanted to:

What Obamacare comes pretty close to guaranteeing, though, is that everyone who needs health insurance, or who wants health insurance, can get it.

It guarantees that if you lose the plan you liked — perhaps because you were fired from your job, or because you left your job to start a new business, or because your income made you ineligible for Medicaid — you’ll have a choice of new plans you can purchase, you’ll know that no insurer can turn you away, and you’ll be able to get financial help if you need it. In states that accept the Medicaid expansion, it guarantees that anyone who makes less than 133 percent of poverty can get fully subsidized insurance.

Health insurance isn’t such a fraught topic in countries such as Canada and France because people don’t live in constant fear of losing their ability to get routine medical care. A decade from now, that will be true in the U.S., too. But it’s not true yet, and paradoxically, that’s one reason health reform is so difficult. The status quo has left people rightly fearful, and when people are afraid, change is even scarier.

Yep. I want to add one more point to this that doesn’t get as much attention as it deserves: Hospitals routinely charge uninsured patients rates that are 3-4x higher than those paid by insured patients. A heart attack that gets billed—profitably!—to Blue Cross at $50,000, can end up costing you $200,000 if you’re unlucky enough to suffer that heart attack while you’re uninsured. Think about that: for decades, the health care industry has deliberately taken ruthless advantage of the very people who are the weakest and most vulnerable—those who are poor or unemployed—and seems to think that this is a perfectly decent and moral way to conduct business.

It’s not. It’s shameless and obscene. It’s like kicking a beggar and stealing his coat just because you know the cops will never do anything about it.

This is something that Obamacare goes a long way toward fixing. If you’re covered by private insurance through an exchange, you’re not just protected against catastrophic illness. You’re also protected against being charged outrageous rates for non-catastrophic problems—broken legs, asthma attacks, etc.—just because hospitals have the brute power to do so.

Because of Obamacare, you no longer have to fear being shut out of the insurance market. But that’s not all. You no longer have to fear being gouged and possibly bankrupted because you’ve been shut out of the insurance market. Access to reasonable rates2 is one of the key benefits that Obamacare delivers to millions, and it deserves more attention.

1Though, let’s be honest, not that big a liberty. The vast, vast majority of people will see little or no change in their coverage thanks to Obamacare, and of the ones who will, most will be able to buy similar or better coverage at a lower price. The problem of rate shock isn’t an invented one, but it is a much exaggerated one.

2Reasonable by American standards, anyway.

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Obamacare Will Prevent Millions of People From Being Gouged by Hospitals

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Curing Blindness the Cheap Way vs. the Very, Very Expensive Way

by TarahFreeland Posted on December 8, 2013

Mother Jones

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The Washington Post has a long piece today titled “An effective eye drug is available for $50. But many doctors choose a $2,000 alternative.” It’s the story of Avastin vs. Lucentis, and it’s been making the rounds for years. Oddly, despite the length of the story, the writers never clearly explain precisely what’s going on.

You may recall the name Avastin because it’s been the subject of numerous unflattering news stories. It was introduced in 2004 as a cancer treatment, but it turns out to be mega-expensive even though it usually provides only a few months of extra life. For an average-size person, a single injection runs about 500 mg or so, and injections are required every two weeks. Genentech sells Avastin in vials of 100 and 400 mg priced at around $6 per mg, so a single dose costs around $3,000 and a full treatment can end up costing anywhere from $30,000 to $50,000 or more.

It turns out, however, that the Avastin molecule seemed like it might also be promising for treating Wet Age-Related Macular Degeneration (AMD), which can cause blindness in older patients. So Genentech created a modfied version of the drug and started testing it. While that was going on, however, a few opthalmologists got impatient and decided to just give Avastin a try. AMD treatment requires only slightly more than 1 mg of Avastin, so they’d buy a 100 mg vial and then have it reformulated into smaller doses. It seemed to work great, but the evidence of a few one-off treatments wasn’t as convincing as a full round of FDA clinical testing. So when Genentech brought its modified drug to market under the name Lucentis, it quickly became the treatment of choice for AMD. And even though the required dosage was even smaller than the equivalent Avastin dose, Genentech priced it at about $2,000.

Genentech, for obvious reasons, was very aggressively not interested in testing Avastin for AMD. But others were, and over the next few years several clinical trials were run. The results were pretty clear: Avastin worked great. Genentech claimed that the clinical trials showed that it was less safe than Lucentis, but virtually nobody bought that. In some of the smaller trials, Avastin showed a slightly higher incidence of adverse effects, but they were things that seemed completely unrelated to the drugs themselves. It was most likely just a statistical artifact. The opinion of the medical community is almost unanimous that Avastin works just as well as Lucentis.

Last year, Medicare’s inspector general released a report on this subject and concluded that the average physician cost for Lucentis ran to about $1,928 vs. $26 per dose of Avastin (including drug and compounding costs). Needless to say, since Medicare is prohibited from negotiating prices or turning down treatments, there was nothing much they could do about this. If Genentech wanted to sell Lucentis for $2,000, it could do it. If doctors wanted to prescribe it, they could. And even though Avastin worked just as well, Medicare couldn’t insist that it be used instead.

You can draw your own conclusions from all this. In one sense, you can sympathize with Genentech: they spent a bunch of money on clinical trials for Lucentis, and they want to see a return on that investment. The fact that AMD requires only a tiny dose doesn’t do anything to lower their research and testing costs. On the other hand, they could have done those trials a whole lot more cheaply using Avastin, but chose not to since that would make it clear that Avastin worked just fine—and Avastin, unfortunately, was already on the market at a price that was very low in the small doses needed for AMD. Likewise, doctors could have rebelled and refused to prescribe Lucentis, which would have benefited their patients since Medicare beneficiaries pay 20 percent of the cost of pharmaceuticals. But why would they? Lucentis is more convenient; doctors don’t bear any of the higher cost themselves; and, in fact, since Medicare reimburses them at cost plus 6 percent, prescribing Lucentis earns them about $100 more per dose than prescribing Avastin.

Quite the pretty picture, isn’t it? And here’s the most ironic part: Avastin continues to be widely used for cancer treatment, where it’s extraordinarily costly and of only modest benefit, but is less widely used for AMD, where it’s quite cheap and works well. This is lovely for Genentech, but not so much for the rest of us. Isn’t American health care great?

UPDATE: In the last paragraph, I said that Avastin “isn’t” used for AMD. That’s not right. In fact, it’s used more often than Lucentis. But as the Post documents, even with a smaller market share, Lucentis accounts for 73 percent of the cost of treating AMD nationwide. I’ve corrected the text.

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Curing Blindness the Cheap Way vs. the Very, Very Expensive Way

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8 Scary Facts About Antibiotic Resistance

by Megan Smith Posted on December 6, 2013

Mother Jones

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It’s flu season. And we’re all about to crisscross the country to exchange hugs, kisses and germs. We’re going to get sick. And when we do, many of us will run to our doctors and, hoping to get better, demand antibiotics.

And that’s the problem: Antibiotics don’t cure the flu (which is viral, not bacterial), but the over-prescription of antibiotics imperils us all by driving antibiotic resistance. This threat is growing, so much so that in a recent widely read Medium article, Wired science blogger and self-described “scary disease girl” Maryn McKenna painted a disturbingly plausible picture of a world in which antibiotics have become markedly less effective. That future is the focus of McKenna’s interview this week on the Inquiring Minds podcast:

“For 85 years,” McKenna explains on the show, antibiotics “have been solving the problem of infectious disease in a way that’s really unique in human history. And people assume those antibiotics are always going to be there. And unfortunately, they’re wrong.”

Here are some disturbing facts about the growing problem of antibiotic resistance:

Maryn McKenna. Scott Streble

1. In the US alone, 2 million people each year contract serious antibiotic-resistant infections, and 23,000 die from them.

These figures come from a new CDC report on antibiotic resistance that, for the first time, uses a blunt classification scheme to identify “urgent,” “serious,” and “concerning” threats from drug-resistant bacteria. The CDC currently lists three “urgent threats”: drug-resistant gonorrhea, drug-resistant “enterobacteriaceae” such as E. Coli, and Clostridium difficile, which causes life-threatening diarrhea and is often acquired in hospitals. Clostridium difficile kills at least 14,000 people each year.

2. We’ve been warned about antibiotic resistance since at least 1945. We just haven’t been listening.

From the very first discovery of antibiotics, scientists have known that resistance is a danger. Alexander Fleming himself, credited with the discovery of penicillin, warned us as early as 1945 that antibiotics could lose their effectiveness. His eerily prescient Nobel Prize speech cautions that “there may be a danger, though, in underdosage of penicillin. It is not difficult to make microbes resistant to penicillin in the laboratory by exposing them to concentrations not sufficient to kill them, and the same thing has occasionally happened in the body. The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”

3. Antibiotic-resistant strains of bacteria are on the rise.

Clearly, antibiotic resistance is not a new phenomenon. Nonetheless, the frequency of these “antibiotic resistance events” is increasing. For example, from 1980 to 1987, cases of penicillin-resistant Streptococcus pneumoniae (the bacteria that causes pneumonia) remained steady at about 5 percent of all strains. By 1997, 44 percent of strains were showing resistance. Similarly, Enterococci bacteria can cause urinary tract infections and meningitis (among other diseases), and in 1989, fewer than .5 percent of strains found in hospitals were resistant to antibiotics. Four years later, though, that number was at 7.9 percent, and by 1998, some hospitals reported levels as high as 30 to 50 percent. “The more antibiotics are used, the more quickly bacteria develop resistance,” says the CDC.

4. There has been a steady decline in FDA approvals for new antibiotics.

And even as more bacteria are becoming resistant and our treatments are becoming less effective, we’re also producing fewer new drugs to combat infections. One figure says it all—a clear downtrend in FDA approvals for antibiotics began in the 1980s:

Decline in FDA antibiotic approvals. CDC; data from FDA’s Center for Drug Evaluation and Research.

Why has this happened? “There’s a kind of curve to antibiotic development,” says McKenna, noting that there was a boom in the 1950s, when Eli Lilly collected samples of biological materials from all over the world in order to capture antibiotic properties in natural substances. By the 1980s, though, much of the low-hanging antibiotic fruit had been harvested. Now, the development of new treatments is becoming increasingly difficult and costly, even as pharmaceutical companies are cutting R&D budgets and outsourcing drug discovery more and more. “The faucet from which antibiotics come has been turned down and down and down and now it’s just a drip,” McKenna says.

5. As many as half of all antibiotic prescriptions either aren’t needed or are “not optimally effective.”

A huge part of our problem is that we’re misusing and abusing antibiotics. “Resistance is a natural process,” says McKenna, but “we made resistance worse by the cavalier way that we used antibiotics, and still use them.” Sick patients pressure their doctors for drugs, and doctors too often yield and dash off a script. Indeed, a recent study found that doctors prescribed antibiotics 73 percent of the time for acute bronchitis, even though, as Mother Jones‘ Kiera Butler reports, “antibiotics are not recommended at all” for this condition.

Adding to the evidence of misuse is another statistic: According to the CDC, almost one in five ER visits resulting from adverse drug events are caused by antibiotics. Children are the most likely victims. Despite the fact that antibiotics are generally safe, they can cause allergic reactions and can also interact with other drugs, harming patients who are vulnerable because they already suffer from other medical conditions. So if we stopped over-prescribing antibiotics we’d not only head off resistance; we’d also lessen adverse drug effects.

6. And it’s not just human medical misuse—a large volume of antibiotics is inappropriately used in livestock.

ChameleonsEye / Shutterstock.com

Antibiotics are also often used in the agricultural industry; in fact, there is reason to think that more antibiotics are used to treat animals than to treat people. And these livestock drugs are not just used to fight off infections, but are often fed to animals in smaller doses to encourage weight gain and growth—a practice, the CDC says, that is “not necessary” and “should be phased out.” A recent draft document from the FDA similarly states that “in light of the risk that antimicrobial resistance poses to public health, the use of medically important antimicrobial drugs in food-producing animals for production purposes does not represent a judicious use of these drugs.” For now, though, the FDA’s approach to curbing this threat has been limited to issuing voluntary guidelines.

7. Before antibiotics, death rates were much higher from very common occurrences like skin infections, pneumonia, and giving birth.

In her Medium article, McKenna gives some disturbing stats. Just giving birth could be deadly: Five out of every thousand women who had a baby died. Pneumonia killed 30 percent of its victims. And “one out of nine people who got a skin infection died, even from something as simple as a scrape or an insect bite.” If we run out of antibiotics, our future looks rather bleak.

8. The next major global pandemic may involve an antibiotic-resistant superbug.

For millennia, infectious diseases have reshaped civilization, culled our species, and spread fear, superstition and death. But over the last century, we haven’t seen anything as devastating as the 1918 global flu pandemic, which killed some 50 million people around the world.

But with drug-resistant bacteria, the threat rises. “Plagues still really have power and almost a hundred years later, we shouldn’t think that we’re immune to them because we’re not,” warns McKenna. For instance, tuberculosis kills over a million people a year, and it is becoming increasingly drug resistant, according to the World Health Organization.

Meanwhile, although the 1918 flu was of course caused by a virus rather than a bacterium, recent research suggests that most victims actually died from bacterial pneumonia. Viruses can weaken our immune systems just enough to allow bacteria to take hold and, often, death results from secondary bacterial infections that, at least until recently, were largely curbed by effective antibiotics.

So are we doomed to recede back into a time when infections were the most significant health threat that our species faced?

According to McKenna, it is not clear that we can fully curb antibiotic overuse. So the better approach is to get the drug industry research engine firing again. “There’s a really active discourse around what’s the best way to get pharmaceutical companies back into manufacturing antibiotics,” she says.

Our future, then, once again lies in the hands of scientists, whose quest to find new treatments for drug-resistant bacteria is now of the utmost importance.

For the full interview with Maryn McKenna, you can listen here:

This episode of Inquiring Minds, a podcast hosted by best-selling author Chris Mooney and neuroscientist and musician Indre Viskontas, also features a discussion of the surprising reasons that US students are so bad at math (just 26th in the world, in a recent study). Plus, Indre takes apart a highly controversial new study purporting to show that male-female gender stereotypes are rooted in different wiring of our brains.

To catch future shows right when they are released, subscribe to Inquiring Minds via iTunes or RSS. You can also follow the show on Twitter at @inquiringshow and like us on Facebook.

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8 Scary Facts About Antibiotic Resistance

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You Can Also Blame Newt Gingrich for the Obamacare Website Screwup

by alka24 Posted on December 6, 2013

Mother Jones

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As the Obama administration continues to unsuck its health care website, one questions lingers: How did this important government project get so screwed up? If you ask technologist Clay Johnson, the insurance exchange’s problems began, in a way, in 1995, when “Congress decided to lobotomize itself.”

Johnson was referring to a specific action lawmakers took then: They killed a tiny federal agency called the Office of Technology Assessment. Established in 1972 as Congress’ nonpartisan in-house think tank, the OTA studied new technologies and offered recommendations on how Washington could adapt to them. But then Speaker of the House Newt Gingrich (R-Ga.) turned off its lights.

Today, members of Congress have legislative counsels to help draft laws. They have the Congressional Budget Office to analyze how much laws will cost. But they don’t have the OTA’s experts to tell them how those laws will work.

“An OTA review might have prevented some heartburn and embarrassment” associated with the Healthcare.gov rollout, argues Rep. Rush Holt (D-N.J.), an astrophysicist who has previously introduced legislation that would resurrect the agency.

Warning Congress about problems with Healthcare.gov—and explaining them—would have been right in OTA’s wheelhouse. The office, Rep. George Brown (D-Calif.) dryly remarked in 1995, was a “defense against the dumb.” During its 24-year existence, the agency developed a reputation for sharp, foresighted analysis on the problems of the new information age: It called for a new, reinforced tanker design a decade before the Exxon-Valdez spill; emphasized the danger of fertilizer bombs 15 years before Oklahoma City; predicted in 1982 that email would render the postal service obsolete; and warned that President Ronald Reagan’s Strategic Defense Initiative (better known as “Star Wars”) would likely result in a “catastrophic failure” if it were ever used.

Analyzing health care spending was one of OTA’s specialties. One of its final reports, “Bringing Health Care Online,” published in 1995, focused on the potential (and potential for mishaps) in electronic data interchanges. “Changes in the health care delivery system, including the emergence of managed health care and integrated delivery systems, are breaking down the organizational barriers that have stood between care providers, insurers, medical researchers, and public health professionals,” the report warned.

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You Can Also Blame Newt Gingrich for the Obamacare Website Screwup

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Chart of the Day: We Are Deliberately Destroying Our Medical Future

by Jeff Howard Posted on December 4, 2013

Mother Jones

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Over at Pacific Standard—a pretty good magazine that you should check out—Michael White shows us what’s happened to the National Insitutes of Health ever since 1998, when Congress decided on a bipartisan basis to double its research budget over five years. The budget was indeed doubled, but when the five years was up its funding was immediately put back on its old path. Then, when the recession hit, it was cut even further:

The tighter competition for funding has put the squeeze on younger scientists with fledgling labs; the proportion of young scientists with NIH grants is half of what was in 1998, while the proportion of funded scientists over 65 has doubled. Because scientific training typically takes over 10 years, students who decided to enter graduate school in the boom days of the mid-Aughts are now entering a job market that looks nothing like what they expected.

Keith Humphreys adds more:

On the ground in my daily work in both a university medical school and a public hospital, it’s a rare month that some bright young person doesn’t tell me they are quitting science because it’s too hard to get funded. These are usually not reversible decisions. Even a well-trained young physician who leaves research for 5 years to treat patients full-time is very hard to tempt back into science if the funding picture improves (and is even harder to bring back up to speed on the cutting-edge scientific questions and methods of the day).

….A decade or two from now, when an antibiotic resistant bacteria or new strain of bird flu is ravaging humanity, that generation will no longer be around to lead the scientific charge on humanity’s behalf. That’s why we constantly need a new stream of young people committing to health science careers. That seed corn is currently being consumed at an alarming rate, and if we don’t act immediately to rectify the situation we will suffer for many years to come from the loss of a generation of health researchers.

Because NIH grants typically last a long time—five to ten years or more—budget reductions have an oversized effect on new research proposals. When funding goes down thanks to austerity-obsessed politicians, existing grants have to keep getting funded, which means that virtually no new money opens up for new projects. And this is coming at the same time that the drug pipeline is slowing down, antibiotic-resistant superbugs are surging, and we’re still struggling to figure out how make use of the genomic revolution.

We are insane.

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Chart of the Day: We Are Deliberately Destroying Our Medical Future

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Chart of the Day: The Obamacare Website Has Been Working Pretty Well Since Early November

by london Posted on December 2, 2013

Mother Jones

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Yesterday the Obama administration released a report showing that the healthcare.gov website is now working pretty well. Not perfectly. Not flawlessly. But pretty well. This confirms anecdotal reports that the site is now quite useable, and it’s important because it’s a proof of concept: if the site can go from disaster to workable in a couple of months, it means that its problems aren’t so deeply structural that they’re never going to be fixed. They were just bugs. And bugs get corrected.

But here’s the thing that struck me when I looked at the HHS report last night: if their metrics are to be believed, they actually had the site working pretty well by early November. It’s just that they didn’t say much about it, instead waiting until their self-imposed December 1 deadline—due, I assume, to an abundance of caution after the horrible rollout. Still, take a look. The charts below are both big and barely legible (perhaps suggesting a whole different federal government IT problem) but what they consistently show is that the site was working tolerably well by November 9 and pretty acceptably well by November 16 (marked by the red bubbles). These metrics still don’t show great performance—especially the 95 percent uptime metric, which really needs to be 99+ percent—but if you need to buy health coverage via healthcare.gov, you can do it. And that means that Obamacare is working too.

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Chart of the Day: The Obamacare Website Has Been Working Pretty Well Since Early November

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Obamacare is a Done Deal

by LucasHarbin Posted on November 26, 2013

Mother Jones

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Ezra Klein gives us a progress report on Obamacare:

A spin through HealthCare.Gov this morning went smoothly. The site loaded quickly. The process progressed easily. There were no error messages or endless hangs….My experience isn’t rare. There are increasing reports that HealthCare.Gov is working better — perhaps much better — for consumers than it was a few short weeks ago. “Consumer advocates say it is becoming easier for people to sign up for coverage,” report Sandhya Somashekhar and Amy Goldstein in the Washington Post.

….Reports from inside the health care bureaucracy are also turning towards optimism. People who knew the Web site was going to be a mess on Oct. 1st are, for the first time, beginning to think HealthCare.Gov might work….The Obama administration is certainly acting like they believe the site has turned the corner. Somashekhar and Goldstein report that they’re “moving on to the outreach phase, which had taken a back seat as they grappled with the faulty Web site.

….It’s clear that HealthCare.Gov is improving — and, at this point, it’s improving reasonably quickly. It won’t work perfectly by the end of November but it might well work tolerably early in December. A political system that’s become overwhelmingly oriented towards pessimism on Obamacare will have to adjust as the system’s technological infrastructure improves.

I think the best translation of that last sentence is, “Republicans will soon have to find something else to gripe about.” But it won’t work. Conservatives have always known that once Obamacare is up and running, it will become a popular program that’s impossible to repeal. That’s one of the reasons they’ve been so frantic to stop it before January 1. And they’ve been right about this. People respond far more passionately to the prospect of losing something than they do to gaining something, and once they have Obamacare they’ll fight to keep it. In a few months, it will be nearly as enshrined in the American social welfare firmament as Social Security and Medicare.

Republicans have run out of time, and they know it. Their fixation on Obamacare already looks sort of balmy—this weekend’s deal with Iran was designed to draw attention away from Obamacare? Seriously?—and it’s only going to look loopier as time goes by. Getting Obamacare to the end zone wasn’t easy, and Obama almost fumbled the ball at the one-yard line, but he’s finally won. There’s nothing left for conservatives to do. Love it or hate it, Obamacare is here to stay.

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Obamacare is a Done Deal

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Americans Are Surprisingly Clear-Eyed About American Health Care

by 41laowo Posted on November 25, 2013

Mother Jones

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Austin Frakt draws my attention to a new Gallup poll with this tweet: “Consistent with my hypothesis that people think their care is good/efficient, others is bad/wasteful.” Here’s the poll:

I’d draw a different conclusion. For starters, keep in mind that public sentiment on this question hasn’t changed much over the past decade. There are some ups and downs in recent years about the quality of national health care coverage, possibly based on the ups and downs of Obamacare, but it mostly looks like noise to me.

More importantly, though, I don’t interpret this as a belief that coverage for other people is either bad or wasteful. I interpret it as a surprisingly accurate assessment of U.S. health care. About two-thirds of Americans have either Medicare or company-provided health care (or something similar), and they correctly tell Gallup that their own personal coverage is pretty good. And it is! At the same time, most people also think that overall health care coverage in America is pretty mediocre, and that’s true too. How can you call national coverage good or excellent when 50 million people are uninsured and have crappy access to medical care?

If Gallup had called me, this is precisely the response I would have given them. My own personal coverage is quite good. Thanks, MoJo! However, I’d also say that overall coverage in the U.S. is terrible. Obamacare will, perhaps, upgrade that to merely unsatisfactory, but that’s about it.

Continued here:  

Americans Are Surprisingly Clear-Eyed About American Health Care

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