Saying that someone accepted something because it was the best they could get is not the same thing as being “for” it.
Again, a big group of Democrats only voted for the bill because the compromises were in it. So the compromising that Democrats are now blaming Republicans for they were actually doing for other Democrats.
So you’re saying that Democrats proposed all the amendments that were put in the bill?
Or are you just asserting your conclusion without making an actual argument?
I am proposing (and I don’t think you can really dispute that) that there were quite a few Democrat lawmakers who would not have voted for the bill if those amendments were not in it. And some that had to be bribed into voting for it even with those amendments.
Well, as I said, I think the bill looks more or less how Ben Nelson wanted it to look.
But I think you’re being far too black-and-white about it. This was a huge bill, with many moving parts, crafted in part to obtain GOP votes. It didn’t get those votes, in the end. But it didn’t get changed back for reasons more complicated than “the Democrats didn’t want to change it.” The process for passage ended up being quite unusual and kept in place a lot of stuff that might otherwise have been altered.
I think it’s not a crazy argument at all that the GOP influenced the final bill, *even if *you disregard the intellectual influence of Heritage and Romney.
But you blame Republicans for it.
Why did Republicans insist on proposing 210 amendments to the bill if they never at any point had any intentions of ever voting for any law regarding healthcare then? Bad faith? Pointless waste of government time and resources? What would you have said if the 210 amendment suggestions were just ignored? You don’t seem to actually be suggesting that it was really Democrats that proposed these amendments, so you are admitting that it was in fact the Republicans that wanted these things in the bill. The majority of these 210 Republican amendments were added to the final bill, yet this does not count as compromising to you? You sure seem to use a funny definition for that word.
“Compromising”, since roughly January 2009, has had the definition, “Do what the Republicans want and expect to get torpedoed anyway.”
I blame Republicans for much of what has gone wrong, because of their efforts to undermine it.
Compare it, if you will, to the Federal 55 mile per hour speed limit. It was a good idea; it would (and did!) save many lives and tons of fuel.
But it was publicly unpopular, and has to count as a failure. It was good legislation, but the will of the people was not behind it.
The ACA may end up that way. But in this case, it will be in part because of the Republicans’ concerted efforts to convince the people that it is a failure. They’ve been bad-mouthing it with unprecedented vigor and viciousness.
If We The People participate in the ACA, it will be a success. It will save lives and reduce costs. If We The People don’t participate, it will fail. If that happens, the Republicans bear much of the blame, for their negative publicity campaign undermining domestic confidence in the program.
(As an old peace campaigner and opponent of the war in Vietnam, I can’t complain too hard when this kind of thing happens.)
Include me among those once pessimistic about ACA. The good news is: It looks like we were wrong!
Almost every expert on healthcare economics in U.S. signed a letter in 2011 explaining that ACA “contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending.” And now, almost three years later, Paul Krugman has reasons, and links to evidence, that the economists’ predictions are already coming true.
(But perhaps this should be kept hush-hush. News of success may just enflame GOP efforts to sabotage Obamacare.)
The public health aspects and economics of socialized medicine has been studied for years and years. Whole academic careers have been spent on it, all over the world, and a solid consensus has developed. The shit works. Nowadays, opponents find themselves falling back on metaphysical arguments about what a state should or should not do, as if there were an eleventh Commandment that got left behind on the mountain. Or dark insinuations that it is all an academic ruse cooked up by liberal professors with leather elbow patches on their Goodwill sportcoats.
Now, it must be fairly noted that economics and public health are not “hard” sciences, there are no experiments to conduct that can conclusively prove any given economic thesis. But the abundance of evidence is a fair and reasonable basis for judgement, and the data have rolled in. The shit works.
It’s this sort of argument that has eventually won me over and made me less and less of a federalist. I used to make those metaphysical arguments, shouting about states rights, and how I wasn’t really opposed to government health care as long as it was done on a small scale and done locally and supported locally.
But I’ve seen it works on national scales and really, the evidence is quite clear.
I’ve said it before and I’ll say it again, you’re never going to win over folks like Terr who have their heads in the sand, but for those of you liberals who yell and shout about UHC, you might win over more people like me who are a tad more open minded.
Be patient. This isn’t like guns, where I do believe that the true believers can never be swayed. This is more like medicare, where – even though I have seen some opposition in this thread – the way things are will start feeling like the way things should be.
By stressing the people who had their insurance cancelled, the GOP is setting up a situation in which they are setting a standard – keeping your insurance – that makes it impossible to ever repeal the ACA. January 1, 2014 is the point of no return, when repeal would mean taking away insurance from millions who couldn’t get health coverage elsewhere.
If ACA fails, the most likely alternative is single payer. That’s what happened when Australia went from a repealed Medibank to their Medicare.
The US is still a center-right country and will probably wind up with multiple-payer universal coverage, such as in Germany or the Netherlands. But if we ever do go single-payer, it will be because ACA failed. And the biggest failure point now visible is refusal of GOP-led states to accept Medicaid expansion.
Canada’s system (Medicare) is federalized, and works quite well. State-level delivery and management isn’t incompatible with an efficient, effective universal health care system. That article includes a section about Ontario embarking on some new, experimental approaches to care in the '90s, many of which succeeded and spread to other provinces, demonstrating one of the advantages of a federal approach.
I (a moderate libertarian who generally votes Republican, though with increasing reluctance in recent years) was won over a few years back, just on the strength of the efficiency argument. We Americans pay more than anyone else for our care, and don’t get the best care or universal coverage out of the deal. Nuts to that.
You might be right, but that isn’t my impression. I’m not sure I fully trust my next link, which is from a Canadian conservative, but it sounds thoroughly centrist by US standards:
One omission in the above link: Health care competition in the praised countries is almost all competition between non-profits.
In Taiwan, another country with a well-functioning system, government hospitals are among those competing with non-profits. Our son, who is insured in their system, lives quite near a military hospital seeing civilian patients just as do non-profit competitors. We should do something similar here, with for-profit hospitals and de-mutualized health insurers having to go back to being non-profit.
It’s going to be fun watching the liberals trying to spin things when the newly-minted Obamacare participants next year, eager to use their benefits, will frantically try to find doctors who accept their plans and fail.
Independent insurance brokers who work with both insurance companies and doctor networks estimate that about 70 percent of California’s 104,000 licensed doctors are boycotting the exchange.
http://www.bloomberg.com/news/2013-12-05/-doc-shock-on-deck-in-obamacare-wars-.html
Call it “doc shock,” though the biggest outcry will not come when people try to schedule an appointment with their physician, but when someone gets sick and they learn they cannot go to whatever top-notch hospital they want, only to the hospital that is included in their plan.
I found one Obamacare health plan that offers access to only seven pediatricians for a county with 260,000 children. Another Obamacare plan offers access to only nine dermatologists, most 100 miles away. A systematic analysis we did of the plans shows that, on average, their networks include about 40% to 50% of the number of specialists that are available in comparable commercial PPO health plans.
That narrower network comes as particularly bad news for the residents of Concord, New Hampshire.
Concord’s one hospital won’t accept any policies offered by the marketplaces. To see a doctor, specialist or primary care provider affiliated with the hospital, patients on these Obamacare plans will have to pay out of their own pocket. The closest in-network hospital is in Manchester.
“Can you imagine having to go 25 miles away to Manchester to get access to a health care provider that is covered by your insurance?”
It’s centrist in that the program was created by a national law, but the provinces have quite a bit of flexibility in how they spend the money earmarked for it and how care is delivered. This article is an overview, and includes differences in practices between provinces.
Why would doctors boycott getting paid for their services by legitimate and (if I may say) pre-existing insurance companies?
Can they even tell if a patient is covered by a company via an ACA sign-up or was, instead, a Blue Shield customer since 1974?
I know it is hard for a Medi-Cal (California state medicare) patient to find doctors who will accept this program. But why would doctors boycott Blue Shield (et al) just because a customer signed up via CoveredCA?
I think the claim of 70% boycott is probably just another right wing lie, promoted by the usual right wing liars. (No, not Terr, but the places Terr goes to get his talking points.)
Did you read the articles? They explain it.
All I know is that the medical group I belong to – one of the most prominent in Northern California – says on its website that it is participating in Covered California. On the website they list the CC plans that they accept.
Which is a good thing because just having been laid off, CC is a better deal for me than COBRA, I’ve figured.