I think it somewhat ameliorates the “dishonesty” that this rhetoric about “keep your plan” and “keep your doctor” was a response to lies about how Obamacare would control your doctor’s decision and involving a government takeover of healthcare. The goal was to get people to understand that Obamacare was not about replacing the current system of health insurance, really, but instead about getting everyone into the fold.
As you say, people concerned about whether their plan would be grandfathered in could have heard those words in exactly the way you describe and have been misled. I think it’s especially galling that the grandfathering regulations are so ridiculously narrow (which I take to be true based on this thread, though I haven’t actually read them). And that’s a legit criticism. But I’m not persuaded that this rhetoric was designed to mislead those people, as distinct from countering the actual lies of people like Sarah Palin and John Boehner about what Obamacare involved.
The problem is that insurance companies are not offering those plans anymore. So the problem is with the insurance companies, not with the ACA.
If I offered you a service called Totally Spotless Complete Housecleaning, which included mopping all your floors, dusting every surface of furniture and shelving and doing all your dishes and laundry, then a year later I changed it so the service was still called the same thing, but now only involved me spitting on a plate and pooping on your floor, would you say that it was the same plan, or the same in name only? And why would you want to keep it if it was the same in name only?
It’s definitely been great for the big insurance companies.
Just look at the performance of their stocks vs. the broad market over the past 5 years. Here’s a chartof a US Healthcare Providers fund vs. the S&P 500. They’ve outperfomed the market by almost 100%.
There’s a way to counter lies without lying yourself. For example, on the “We’re not going to pull the plug on grandma” thing which he talked about a lot, he just left it at that. It was such a ridiculous attack that simply reassuring people that it wasn’t going to happen was enough.
The accusation that you wouldn’t be able to keep your insurance or your doctor, while often overblown, was somewhat accurate. The President could have said what Jay Carney is saying now, “some plans won’t qualify, so yes, some people won’t get to keep their insurance”. Instead, he categorically denied it.
I respect your research, but there is a caveat that some states had requirements to follow when offering health insurance. There was a state I used to live in that was absolutely horrible at making insurance regulations, so much so that you couldn’t get good coverage there (to save your life, terrifyingly enough). Moving across the border (about 25 miles away in this case) gave you an incredible amount of options in a state market that was comparatively unregulated.
I get your point that we are all consumers of health care. But that is separate from health insurance. If health care was reasonably priced, we wouldn’t need anything but the catastrophic insurance plans. Part of the problem was that insurance companies helped drive up the costs of care by demanding a vast percentage cut to advertise with. Health care providers drove up the cost of health care to give them that percentage. So your walk-in-off-the-street payment became something ridiculous, like $25 for a dose of aspirin at the ER.
At the same time, the insurance companies drove up the price of insurance based on any rationale they could find.
And instead of trying to address this heavenward spiral, we rewarded the companies that sought to manipulate the ostensibly free market to their advantage by giving them a 100% captive market, where the cheapest rates aren’t that low, and offering “values” such as a $4,000 deductible and an 80/20% cost split of your medical bills is considered somehow good.
The ACA isn’t better than what we had, it’s just different. There are a few good aspects, such as the pre-existing condition mandate, but that’s like saying the Ford Pinto was a good car because the engine had a good power-to-weight ratio. The ACA isn’t a good law, and we should work to fix what it never addressed (costs) or work to move to a different system (such as single payer, which I advocate for).
I didn’t intend them to be scare quotes. I was actually quoting you. And note that your further post on the subject was also incorrect about what is actually due to the market and what is due to government interfering with the market.
Was he asked something like “Obamacare will involve minimum standard for insurance, will you ensure that all currently-existing insurance plans will be grandfathered into those minimum standards for the purpose of the individual mandate?”
In the absence of that kind of clear context, I don’t agree that this rhetoric was clearly addressing that situation as opposed to the arguments about the federal government displacing private healthcare more broadly.
If this context was present, then I think your claim that he lied would be much more persuasive (though even then I suppose you could argue that they had not yet seen the need for narrow grandfather provisions and he was just wrong instead of lying, but the case would be much stronger, IMHO).
I am trying to agree with you. You are making it difficult. I should have used scare quotes myself, because my use of “free market” was meant sarcastically.
How about this: “I agree with your statement. The quotes you have used there work as scare quotes. The free market in this situation is not actually free, as you can see I even specifically pointed out myself in my following post. I think you are a nice person and I like your user name. Have a lovely Tuesday.”
OK, maybe I was reading your posts incorrectly. If so, I apologize.
It’s just that every time we have one of these threads, someone has to harp on the idea that the free market didn’t work, and so that’s why we need Obamacare. Now, I’m happy to admit that the free market might not work for HCI, but we have not had a free market in HCI in this country form decades. At least not since WWII when our whole crazy system came into being in the first place.
Yes, my point, which I freely (ha) admit I was maybe not the clearest about, is that saying that Obamacare is going to ruin the free market is ridiculous, because there is no free market in health care. The best you might find is a state like Farin describes, in which there are perhaps fewer regulations/more choices for individuals.
IMO the ACA is a smaller pile of crap than the previous system, which was a giant mountain of crap. I am not really qualified to say whether a true free-market system would be a Jupiter-sized crap pile or not crappy at all or somewhere in between, although I suspect that the free market might indeed not be the best solution for health care. But neither is this. And for Og’s sake, neither is employer-based health care.
Not really. You don’t by “insurance” for a pre-existing condition. Can you buy car insurance after you total your car? Fire insurance for your house when it is actually on fire? The free market can’t offer you free health care, if that’s what you mean. But that’s not surprising.
You can buy car insurance after you repair your car.
As I say, the insurance companies will pay for as little as they can get away with. And we’ve seen for a fact that they will institute pre-existing condition limits or lifetime caps. The employer model doesn’t change that.
I understand this is rational on the insurance companies part. But it leads to shitty outcomes. Which is why regulation is necessary.
And no free market will make it possible for someone of average means to have a heart bypass (at least with today’s technology). Without insurance’s power to spread risk, many more people will die without regulation.
But “uninsurablility” is a big fucking deal. In fact dealing with this problem is the goal behind which the whole ACA architecture is based. Sure it would be nice if everyone could get affordable care just pay for the things they need. But the problem is that there is a class of people that through no fault of their own need help paying astronomical medical bills. Prior to ACA the solution was one of a few options
Be massively independently wealthy
Have employee sponsored health care, which through some miracle continues even though you are too sick to work, or are fired/never hired because your prior medical condition would cost them too much. And don’t have your insurance drop you on a technicality …
Have you and your family become destitute until you can finally fall under Medicare
Die painfully and reduce the surplus population.
This is a minority of people, but that is the whole point of insurance: protecting the minority from catastrophe by taking a small amount from the majority.
Yes, this means that health insurance is a net-negative for most people, but everyone is just one small mutation away from getting pancreatic cancer or having a child with cystic fibrosis. The fortunate helping the unfortunate, even involuntarily, is what it takes to live in a civilized society, rather than a dog-eat-dog dystopia.
I agree that more broad reform would have been nice but given the political climate that wasn’t doable. But taking care of the uninsurability issue was the most critical flaw that needed to be taken care of as soon as possible.
Obama’s claims about honesty and openness make me recall an old Chinese proverb:
“The chicken thief is posing as a pillar of the community-he hasn’t stolen a chicken in 3 days”
Sums it up.
Another option would be to not buy any insurance at all until there is a hurricane within 50 miles of your house; then buy insurance; then drop it once the hurricane passes.
I guess this thread makes me have a question for Adaher, Magellan, Terr, and the other folks who are gleefully jumping on the “We were lied to” bandwagon. Are you actually concerned for those people who are having to change policies or are you just seizing on another opportunity to make political hay against Obama?
Because the “Obama is the sukkor”/“ACA is the anti-Christ” schtick is getting old. And I’m not really seeing any suggestions for actually improving health care coming from that camp. I think the ACA is a flawed but sincere attempt to improve health care for most Americans. So when you say that we were lied to about Obamacare – for what purpose? To maliciously drain money from the pockets of innocent Americans? Do you really think that this was their motivation?
It’s a very mixed bag for the insurance companies. They get a lot of new customers, but the new customers may well turn out to be just the ones they are trying to avoid, which would make them lose a lot of money. And there is to be more oversight of the rates.
[IIRC, the insurance companies ultimately decided they were in favor of the ACA, but they would have been measuring it against alternative types of reform, not against the status quo. Plus, there’s a lot of horsetrading in these bills, e.g. “we’ll throwin this provision that you want if you agree to lobby for the overall bill”, and so on.]