Tag Archives: health care

WATCH: Anti-Obamacare Talking Points, Debunked Fiore Cartoon

Mother Jones

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Mark Fiore is a Pulitzer Prize-winning editorial cartoonist and animator whose work has appeared in the Washington Post, the Los Angeles Times, the San Francisco Examiner, and dozens of other publications. He is an active member of the American Association of Editorial Cartoonists, and has a website featuring his work.

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WATCH: Anti-Obamacare Talking Points, Debunked Fiore Cartoon

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8 Revelations From the Obamacare Hearing

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On Wednesday, Department of Health and Human Services secretary Kathleen Sebelius testified before the House energy and commerce committee regarding problems with the rollout of the Affordable Care Act. Here are the highlights, both factual and theatrical:

1. Sebelius says she’s responsible for healthcare.gov’s failures. At a similar congressional hearing last week on the failures of the federal exchange website, contractors that built the digital infrastructure blamed HHS leadership, but not Sebelius herself. “Hold me accountable,” she said Wednesday. “I’m responsible.” But Rep. Greg Harper (R-Miss.) pressed Sebelius to place blame squarely on President Barack Obama. “No sir, we are responsible,” Sebelius answered. Harper kept pushing. Sebelius finally retorted: “You clearly—whatever. Yes, he is the president. He is responsible for government programs.”

2. Why some Americans may be losing coverage: It’s complicated. GOP members on the committee emphasized the president’s long-standing promise that “If you have a plan you like, you can keep it,” and then argued that many Americans are now seeing their insurance plans canceled. But as Sebelius further explained, if you had a plan that you liked before the Affordable Care Act passed, you can keep it, because it was grandfathered in. If your insurance company changed the plan after the law went into effect, however, it is no longer exempted and has to comply with new protections offered under the Affordable Care Act, such as the prohibition against dropping a patient once he’s sick, or charging a woman more because she’s a woman. Plans that don’t comply must be canceled—but as Rep. John Sarbanes (D-Md.) pointed out, that’s a good thing, because such plans don’t provide adequate coverage anyway. “The notion that people are being turned way from an affordable plan the provides good quality care is preposterous,” he said.

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8 Revelations From the Obamacare Hearing

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Here’s Another Way the GOP Is Undermining Obamacare

Mother Jones

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Scott Messick is a 54-year-old retired health insurance consultant from Conroe, Texas. His wife runs a small yarn shop. They’re both on his former employer’s health insurance plan for retirees, and Messick says that he and his wife together pay $964 a month in premiums, and a $12,000 annual deductible (the amount of money they have to pay out-of-pocket each year before the insurer will pay any expenses). Starting in January, their premiums will shoot up to $1,283 a month, he says. Earlier this month, Messick logged on to the federal insurance exchange website to shop for a new plan. (The federal government’s health insurance website has so many problems that many Americans are not able to register for the site, let alone compare plans. But Messick got through.) Although the Messicks’ income is too high to qualify for a subsidy, they found a plan that would save them $6,000 a year in premium payments, and another $5,000 or so on their deductible. Despite the fact that Obamacare could cut their health care costs almost in half, the Messicks might not switch plans. Why? Because Republicans might repeal the law. “My wife is concerned that Republicans will try to get rid of this thing, and if they do, we’ve jumped out of a retiree plan,” Messick says. “We’d be left with nothing.”

Many retiree health plans stipulate that you can only enroll in the plan once, and if you drop coverage—say, by buying cheaper insurance on the exchange—you’re out for good. “The door swings one way,” Messick explains.

That one-way door could be a problem for many Americans if Obamacare is repealed, says Tim Jost, a healthcare law scholar at Washington and Lee University School of Law who has consulted with the administration on the implementation of the law. If people like the Messicks buy cheaper insurance on the exchange and Republicans gut the Affordable Care Act, insurance industry prices and practices could return to what they were pre-Obamacare. That means insurers could go back to rejecting older folks, who tend to have chronic health problems, or charging them astronomical prices. Messick has chronic back problems; his wife has suffered a minor stroke and has migraines. “Both my wife and I are uninsurable” in the private market, Messick says, adding that a few years ago he ran an “experiment” and tried to purchase insurance outside of his employer plan and was “turned down flat.”

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Here’s Another Way the GOP Is Undermining Obamacare

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Are All Those Insurance Company Cancellation Letters Too Good to Check?

Mother Jones

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Paul Waldman recounts yet another story of someone allegedly getting screwed by Obamacare. This time the victim is Deborah Cavallaro, profiled yesterday on the NBC Nightly News:

We learn in this story that her insurer is cancelling her current plan, which costs $293 a month, because it doesn’t comply with the new law. They’ve offered her a new plan at $484 a month. That sounds like it sucks!….But wait. Maybe she’s not a victim after all. How does the $484 plan her current insurer is offering compare to the other ones she could get? Did she or the reporter go to the California exchange and try to figure that out? Apparently, they didn’t. But I did.

It took less than 60 seconds. Let’s assume that Deborah has a high enough income that she isn’t eligible for subsidies. I put in that I was 45 years old and got nine different choices for a Bronze plan, which in all likelihood most closely resembles what Deborah has now. The average monthly cost was $258, or $35 a month less than what Deborah’s paying now for her bare-bones plan….She can get a Silver plan, with more generous coverage, for $316, only $23 more than she’s paying now. Congratulations, Deborah!

In a follow-up post, Waldman makes the right point about this:

I want to talk about the thing that spawns some of these phony Obamacare victim stories: the letters that insurers are sending to people in the individual market….There’s something fishy going on here, not just from the reporters, but from the insurance companies. It’s time somebody did a detailed investigation of these letters to find out just what they’re telling their customers.

….If the woman I discussed from that NBC story is any indication, what the insurance company is offering is something much more expensive, even though they might have something cheaper available. They may be taking the opportunity to try to shunt people into higher-priced plans. It’s as though you get a letter from your car dealer saying, “That 2010 Toyota Corolla you’re leasing has been recalled. We can supply you with a Toyota Avalon for twice the price.” They’re not telling you that you can also get a 2013 Toyota Corolla for something like what you’re paying now.

I’m not sure that’s what’s happening, and it may be happening only with some insurers but not others. But with hundreds of thousands of these letters going out and frightening people into thinking they have no choice but to sign up for a much more expensive plan, it’s definitely something someone should look into. Like, say, giant news organizations with lots of money and resources.

It’s true that there are some people who are going to end up paying more for coverage under Obamacare than they’re paying now. But Waldman is right: there’s something very fishy about these letters. Over the past three years, insurance companies have swapped their plans around so fast and so often that virtually no one today has a plan more than a couple of years old—something that seems an awful lot like a deliberate effort to evade Obamacare’s original intent that most individual policies would be grandfathered and therefore remain available to existing customers who wanted to keep them.1 Now, having engineered a situation where most current policies aren’t grandfathered, millions of people are getting letters canceling their existing plans and being told that the replacement is far more expensive.

I’m not sure what’s going on here, but there’s at least one lesson in this for the press: never take these letters at face value. If you find someone who’s going to end up paying more thanks to Obamacare, fair enough. Run with the story.2 But first, you’d better perform the due diligence to find out what a comparable plan really costs. That means getting income and coverage details from the subject of your story and then doing a detailed search of the local exchange to find out what’s on offer. We’re not seeing enough of that.

1Plans in existence before March 23, 2010, are grandfathered, which makes them exempt from most of the new requirements of Obamacare. However, if your insurance company switched you into a “better” plan after that date, it’s not grandfathered and can be canceled at any time.

2Of course, it would be nice if you also ran some stories about people who are benefiting from Obamacare, especially since they probably outnumber the other folks by 100:1 or so.

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Are All Those Insurance Company Cancellation Letters Too Good to Check?

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Here’s the Latest on the Obamacare Website

Mother Jones

Good news! HHS tweets: “FACT: In the first few days, very few could create an account on @HealthCareGov, we are now at an over 90% success rate.”

Bad news! Creating an account is nice, but apparently only about 30 percent can successfully complete an application.

Good news! “CMS spokeswoman Julie Bataille said that about half of the roughly 700,000 people who had completed applications [] came through healthcare.gov, which serves residents of 36 states.” And CMS claims that the website will be functioning smoothly for almost everyone by the end of November.

I dunno. Is this the kind of happy talk that’s common when teams are working to fix troubled programs? Or is it for real? And is the end of November soon enough to avoid a huge backlog of applications?

I’m not sure. But that’s the latest. If there’s a reason for caution, it’s this: teams that are fixing bugs are usually under enormous pressure to offer up the most optimistic date possible for getting the system working. This suggests that the end of November is the absolute earliest plausible date for getting the Obamacare website working well. Take it with a grain of salt.

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Here’s the Latest on the Obamacare Website

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The Science of Tea Party Wrath

Mother Jones

If you want to understand how American politics changed for the worse, according to moral psychologist and bestselling author Jonathan Haidt, you need only compare two quotations from prominent Republicans, nearly fifty years apart.

The first is from the actor John Wayne, who on the election of John F. Kennedy in 1960 said, “I didn’t vote for him, but he’s my president and I hope he does a good job.”

The second is from talk radio host Rush Limbaugh, who on the inauguration of Barack Obama in 2009 said, “I hope he fails.”

The latter quotation, Haidt explains in the latest episode of Inquiring Minds (click above to stream audio), perfectly captures how powerful animosity between the two parties has become—often overwhelming any capacity for stepping back and considering the national interest (as the shutdown and debt ceiling crisis so unforgettably showed). As a consequence, American politics has become increasingly tribal and even, at times, hateful.

And to understand how this occurred, you simply have to look to Haidt’s field of psychology. Political polarization is, after all, an emotional phenomenon, at least to a large degree.

Jonathan Haidt thinks our political views are a by-product of emotional responses instilled by evolution.

“For the first time in our history,” says Haidt, a professor at NYU’s Stern School of Business, “the parties are not agglomerations of financial or material interest groups, they’re agglomerations of personality styles and lifestyles. And this is really dangerous. Because if it’s just that you have different interests, that doesn’t mean I’m going to hate you. It just means that we’ve got to negotiate, I want to win, but we can negotiate. If it’s now that ‘You people on the other side, you’re really different from me, you live in a different way, you pray in a different way, you eat different foods than I do,’ it’s much easier to hate those people. And that’s where we are.”

Haidt is best known for his “moral foundations” theory, an evolutionary account of the deep-seated emotions that that guide how we feel (not think) about what is right and wrong, in life and also in politics. Haidt likens these moral foundations to “taste buds,” and that’s where the problem begins: While we all have the same foundations, they are experienced to different extents on the left and the right. And because the foundations refer to visceral feelings that precede and guide our subsequent thoughts, this has a huge consequence for polarization and political dysfunction. “It’s just hard for you to understand the moral motives of your enemy,” Haidt says. “And it’s so much easier to listen to your favorite talk radio station, which gives you all the moral ammunition you need to damn them to hell.”

Here’s an illustration of the seven moral foundations identified by Haidt, and how they differ among liberals, conservatives, and libertarians, from a recent paper by Haidt and his colleagues.

Jonathan Haidt and colleagues, PLOS One

To unpack a bit more what this means, consider “harm.” This moral foundation, which involves having compassion and feeling empathy for the suffering of others, is measured by asking people how much considerations of “whether someone cared for someone weak and vulnerable” and “whether or not someone suffered emotionally” factor into their decisions about what is right and wrong. As you can see, liberals score considerably higher on such questions. But now consider another foundation, “purity,” which is measured by asking people how much their moral judgments involve “whether or not someone did something disgusting” and “whether or not someone violated standards of purity or decency.” Conservatives score dramatically higher on this foundation.

Vintage

How does this play into politics? Very directly: Research by one of Haidt’s colleagues has shown, for instance, that Republicans whose districts were “particularly low on the Care/Harm foundation” were most likely to support shutting down the government over Obamacare. Why?

Simply put, if you feel a great deal of compassion for those who lack health care, passing and enacting a law that provides it to them will be an overriding moral concern to you. But if you don’t feel it so strongly, different moral concerns can easily become paramount. “On the right, it’s not that they don’t have compassion,” says Haidt, “but their morality is not based on compassion. Their morality is based much more on a sense of who’s cheating, who’s slacking.”

For Haidt, the political moment that perfectly captured this conservative (and Tea Party) morality—while simultaneously showing how absolutely incomprehensible it is to those on the left—was Wolf Blitzer’s famous 2011 Republican presidential debate gotcha question to Ron Paul. Blitzer asked Paul a hypothetical question about a healthy, 30-year-old man who doesn’t get health care because he doesn’t think he needs it, but then winds up in a serious medical situation. When Blitzer asked Paul whether society should just “let him die,” there were audible cheers and cries of “yeah” from the audience—behavior that was appalling to care-focused liberals, but that is eminently understandable, under Haidt’s paradigm, as an emotional outburst based on a very different morality. Watch it:

“My analysis is that the Tea Party really wants the Indian law of Karma, which says that if you do something bad, something bad will happen to you, if you do something good, something good will happen to you,” says Haidt. “And if the government interferes and breaks that link, it is evil. That I think is much of the passion of the Tea Party.”

In other words, while you may think your political opponents are immoral—and while they probably think the same of you—Haidt’s analysis shows that the problem instead is that they are too moral, albeit in a visceral rather than an intellectual sense.

As a self-described centrist, Haidt sometimes draws ire from the left for comments about how liberals don’t understand their opponents, and about how conservatives have a broader range of moral emotions. But he certainly doesn’t claim that when it comes to political animosity and the polarization that we now live under, both sides are equally to blame. “The rage on the Republican side is stronger, the Republicans have gotten much more extreme than the Democrats have,” Haidt says.

The data on polarization are as clear as they are disturbing. Overall, feelings of warmth towards members of the opposite party are at terrifying lows, and Congress is perhaps more polarized than it has been in the entire period following the Civil War:

Increasing polarization of the U.S. Congress, based on analysis of congressional votes by University of Rochester political scientist Keith Poole. Keith Poole/PolarizedAmerica.com

But this situation isn’t the result of parallel changes on both sides of the aisle. “The Democrats, the number of centrists has shrunk a bit, the number of conservative Democrats has shrunk a bit, but it’s not that dramatic, and the Democratic party, certainly in Congress, is a mix of centrists, moderately liberal and very liberal people,” says Haidt. “Whereas the Republicans went from being overwhelmingly centrist in the ’50s and ’60s, to having almost no centrists,” Haidt says.

And of course, the extremes are the most morally driven, the most intense.

From the centrist perspective, Haidt recently tweeted that “I hope the Republican party breaks up and a new party forms based on growth, not austerity or the past.”

“This populist movement on the right,” he says, is “sick and tired of the allegiance with business.” And more and more, business feels likewise, especially after the debt ceiling and shutdown disaster.

“I think this gigantic failure might be the kind of kick that some reformers need to change how the Republicans are doing things,” says Haidt. “That’s my hope, at least.”

For the full interview with Jonathan Haidt, listen here:

This episode of Inquiring Minds, a podcast hosted by bestselling author Chris Mooney and neuroscientist and musician Indre Viskontas, also features a discussion of new research on how marmosets are polite conversationalists (seriously) and of how Glenn Beck doesn’t understand statistics.

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

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The Science of Tea Party Wrath

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Raising the Medicare Age to 67 Is a Lousy Idea

Mother Jones

The CBO has a new estimate of the budget savings from raising the Medicare age to 67. Here it is:

Please note: this is not percent of GDP. This is actual dollars. Over the next ten years, raising the Medicare age would save the government a whopping $2 billion per year on average. Austin Frakt and Aaron Carroll give the nickel explanation for why the number is so low: “The more people you kick off Medicare, the more you get on Medicaid. That increases federal expenditures. More people will also need exchange insurance, too, which means more people needing subsidies….And we’re not even counting the increase to state expenditures for the added Medicaid, the increased cost to employers who have to provide insurance, the increased cost to all Americans in higher premiums for adding those elderly people to the private risk pools, or the increased out of pocket expenses to those seniors.”

Bottom line: raising the Medicare age to 67 accomplishes almost nothing. And if you take into account the increased costs in other areas (Medicaid and private insurance), it’s a net negative. This is a zombie idea that needs to die once and for all.

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Raising the Medicare Age to 67 Is a Lousy Idea

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WATCH: The Obamacare Rollout, 200 Years Ago Fiore Cartoon

Mother Jones

Mark Fiore is a Pulitzer Prize-winning editorial cartoonist and animator whose work has appeared in the Washington Post, the Los Angeles Times, the San Francisco Examiner, and dozens of other publications. He is an active member of the American Association of Editorial Cartoonists, and has a website featuring his work.

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WATCH: The Obamacare Rollout, 200 Years Ago Fiore Cartoon

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Republican Clown Show on Obamacare Has Already Started

Mother Jones

Today’s hearing into the Obamacare website almost immediately descended into farce. Emma Roller provides the basics:

With a look of what can only be described as pure glee, Rep. Joe Barton (R-Tex.) pointed out a warning on healthcare.gov saying the information users enter is less private than typical medical forms.

He went on to press Campbell an executive at CGI, trying to get her to say the website violates the Health Insurance Portability and Accountability Act. “You know it’s not HIPAA compliant,” he told her. “Admit it! You’re under oath!” Campbell demurred, and Rep. Frank Pallone swooped in to save the day:

Pallone: I started out in my opening statements saying there was no legitimacy to this hearing, and the last line of questioning certainly confirms that. HIPAA only applies when there’s health information being provided. That’s not in play here today—no health information is required in the application process, and why is that? Because pre-existing conditions don’t matter! So once again, here we have my Republican colleagues trying to scare everybody—

Etc.

That’s all funny enough. But the cherry on top comes from Sarah Kliff, who provides a snapshot of the HTML code that Barton is upset about:

The warning that Barton is objecting to isn’t even active code. The HTML tag in the pink oval means that everything which follows has been “commented out.” The seven lines of code above don’t show up anywhere on the actual website and are never executed in any way. It’s just boilerplate that was taken from somewhere else, and then edited.

This is what I was talking about earlier this morning when I suggested that Republicans are unlikely to hold serious hearings. This kind of thing is just embarrassingly ignorant. A few more like this, demonstrating that Republicans are flailing around looking for partisan cudgels rather than genuinely trying to investigate a procurement process gone wrong, and the press will simply lose interest. And they’ll be right to.

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Republican Clown Show on Obamacare Has Already Started

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Can Republicans Investigate Obamacare Without Making Fools of Themselves?

Mother Jones

The latest from Capitol Hill is a Republican push to investigate the Obamacare rollout and get to the bottom of what happened. Greg Sargent comments:

Interestingly, Republicans believe the new push will get the public to forget GOP excesses during the last battle — even though both revolve around the party’s central organizing point, i.e., the drive to destroy the Affordable Care Act before it’s too late. As the Washington Examiner’s David Drucker put it: “House GOP leaders are looking to revive their majority’s political strength by focusing on the nuts and bolts of legislating, a policy agenda centered on jobs and economic growth — and concerted oversight of Obamacare, a law still unpopular with many Americans.”

….Serious Congressional oversight would be absolutely welcome here. The question is, are House Republicans capable of supplying it? Obamacare’s problems are inexcusable, and there should be accountability for them. There are real and legitimate problems here that could be exposed.

But when it comes to supplying genuine oversight, previous House GOP probes — into Benghazi and the IRS scandal — devolved into circus stunts. Those investigations got knocked off kilter by lurid and fanciful charges that seemed directed at a hard right audience that remains firmly in the grip of the conservative closed information feedback loop.

Yep, that’s a good question, all right. I doubt it, because I doubt that Darrell Issa has learned his lesson from the events of the past year. I don’t really blame him for the IRS scandal going south, since that one really did look legit at first and it was a helluva juicy target. But his overreach on Benghazi likely ruined what could have been a decent investigation. I don’t think Republicans would ever have found a big-time smoking gun in Benghazi, but a more sober investigation might very well have done some damage, especially since Republicans basically had the press on their side. Instead, they went bananas, and the investigation became a joke.

Ditto for the recent government shutdown. Republicans overreached, and instead of winning a modest political victory that might have been popular with the public, they became the target of massive public anger.

There’s plenty of meat available in an investigation of the Obamacare rollout. But a good investigation will go slowly, taking pains not to drown officials in a blizzard of subpoenas while they’re in the middle of fighting a fire. A good investigation will also focus a lot of its effort on real issues of procurement and how the federal government handles IT projects. It won’t be just a fishing expedition for emails that might be embarrassing to Obama staffers.

There will almost certainly be plenty of the latter. There’s already evidence that political considerations contributed to Obamacare’s rollout problems. But those will get exposed in a serious investigation. Maybe it will take a little longer, but they’ll come.

Can Issa restrain his attack dog personality enough to understand that? Will the tea party caucus allow it? Or will the whole thing quickly devolve into a barrage of subpoenas that are so obviously politically motivated that no one takes them seriously anymore? We’ll see, but I’d put my money on the latter right now.

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Can Republicans Investigate Obamacare Without Making Fools of Themselves?

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