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Sarah Kliff over at The Washington Post highlights the amazing work of Kossack brainwrap (Charles Gaba), who has been tracking ACA signups:
Charles Gaba has been going to painstaking efforts to show the trajectory of health law sign-ups over the past three months. His graph (which is better viewed here, on his Web site) gives a helpful visual sense of what the last month has looked like for health-care enrollment. This uses all available data, including the monthly, federal reports and more up-to-date state data, too. [...]

By Gaba's count, we're at 5.75 million sign-ups, between those who have enrolled in private plans and those who have qualified for the Medicaid program. The balance still tips toward  public plan enrollments, but, as the chart cautions, this is still preliminary data. If we do see a similar December enrollment spike among the federally run state markets, that will be a pretty quick turn-around from October's dismal showing. If not, though, that's going to make the next three months of open enrollment, which runs until March 31, all the more crucial.

And the Associated Press reminds us that a shaky rollout doesn't mean the whole program is doomed:
President Franklin D. Roosevelt faced heavy skepticism with his launch of Social Security in 1935-37. Turbulence also rocked subsequent key presidential initiatives, including Lyndon Johnson's rollout of Medicare and Medicaid in 1965, Richard Nixon's Supplemental Security Income program in 1974 and George W. Bush's Medicare prescription drugs program in 2006.

Yet these programs today are enormously popular with recipients.

Much more below the fold.

Ryan Cooper at The Washington Post urges Democrats to run on, not from, health insurance reform in 2014:

A new poll shows that the Democratic edge on the generic congressional ballot has evaporated, and Republicans now have a slight edge. Unsurprisingly, this is stoking panic in moderate Democratic circles, where they rightly blame the bungled Obamacare rollout for their poor position.
The typical moderate Democrat instinct here is to make some move toward the Republican side. But no amount of distancing themselves from the president or Obamacare will help. In fact, if they are to rescue their electoral fortunes, the answer is more liberal health-care reform, not less.
Anthony Orlando destroys the GOP claim that ACA is killing the economy:
The latest GDP numbers are bad news for Obamacare critics.

You would think everyone would be happy when the Commerce Department announced our economy grew by a whopping 4.1 percent in the third quarter of this year. But according to the naysayers, that wasn't supposed to happen.

One of their biggest complaints against Obamacare was it would stifle the economy. Penalties and fines would raise the cost of doing business. High premiums would impoverish middle-class families. Forcing businesses to offer health insurance to full-time employees would make them switch to part-time employees — or stop hiring altogether.

Yet, the more of the law that's implemented, the better the economy seems to perform. How can that be?

Michael Tomasky at The Daily Beast points out something really important lost in all the inside baseball talk about Obamacare:
In 19 countries, 100 percent of the population is covered via public insurance. In 11 more, more than 95 percent are covered the same way. So all but four countries basically provide universal or near-universal public coverage. In Turkey, Mexico, and Chile, between 70 and 80 percent are covered—also publicly. In the United States, that number is 26.4 percent. That’s the seniors, the veterans, and the very poor who get direct public health care. We then add 54.9 percent who get private coverage. No other country even bothers with private coverage at all, except Germany a little bit (10.8 percent). Our two numbers add up to 81.3 percent, ranking us 31st out of the 34. The rest of the advanced world, in other words, with not all that much fuss and contention, has come around to the idea that health coverage is a right.

As I think back over 2013, in my sunnier moments, I try to think of it as the year that future historians will point to as the time when the United States finally and grudgingly started joining this world consensus. Sometime in the 2030s, after Medicare for all has passed and we’re finally and sensibly paying taxes for preventive cradle-to-grave care, people will note—with pride!—that the long process started with Obamacare (yes, conservatives: I’m admitting gleefully that the elephant’s nose is under the door, so spare yourselves the trouble of thinking you’re clever by tweeting it!).

Over at The Los Angeles Times, the editors profile the do-nothing Congress:
It's official: The Republican-controlled House and the Democrat-controlled Senate agreed on so few issues this year, Congress is on pace to pass the fewest bills in a two-year term since World War II. Pundits have compared the current occupants of Capitol Hill unfavorably to the infamous "Do-Nothing Congress" of 1947-48, which was a dynamo in comparison. Lawmakers passed 1,729 bills in that two-year term, compared to 58 in the first year of this one. Unless something changes dramatically in the second half of the 113th Congress, it will be the least productive in modern memory.

Yet the paltry number of bill signings coincides with a stunning inability to do the basic job of governance, let alone tackle bigger and more divisive issues. The legislative branch's most fundamental task is to authorize federal programs and appropriate money each year for the agencies to carry them out. This year, not only could lawmakers not get most of the spending bills through their own chambers, they couldn't agree on a stopgap bill to keep the government open, leading to a costly 16-day shutdown.

Finally, in a very important piece, Paul Krugman profiles the plight of the employed:
[E]mployment is a power relationship, and high unemployment has greatly weakened workers’ already weak position in that relationship.

We can actually quantify that weakness by looking at the quits rate — the percentage of workers voluntarily leaving their jobs (as opposed to being fired) each month. Obviously, there are many reasons a worker might want to leave his or her job. Quitting is, however, a risk; unless a worker already has a new job lined up, he or she doesn’t know how long it will take to find a new job, and how that job will compare with the old one.

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Comment Preferences

  •  Eugene Robinson on The GOP's growing divide (18+ / 0-)

    is my examination of and commentary upon his Washington Post column

    in this post to which I invite your attention

    If you are not interested in what I have to offer and just want to read Robinson (which you should do), use this link to do so

    peace

    "We didn't set out to save the world; we set out to wonder how other people are doing and to reflect on how our actions affect other people's hearts." - Pema Chodron

    by teacherken on Fri Dec 27, 2013 at 04:43:43 AM PST

    •  Brainwrap is the man on this (1+ / 0-)
      Recommended by:
      koNko

      His methodology is tight and conservative and no one has challenged his results.  His diaries and spreadsheet have gone viral across the internet and are used by all the "serious and important" publications now.  He's out-survived all other sources too, including those who were looking for ammunition against ACA.

      "It's too LATE to stop now!" - John Lee Hooker

      by Rolfyboy6 on Fri Dec 27, 2013 at 09:53:17 AM PST

      [ Parent ]

  •  Hey Boehner....it's the economy stoopid...just (4+ / 0-)
    Recommended by:
    JML9999, GreyHawk, Stude Dude, eps62

    like it was in 2010.....and you're not helping.

    http://www.politico.com/...

  •  So it Dawn'd on Tony Orlando (10+ / 0-)

    that the ACA is not killing the economy.......

    I want 1 less Tiny Coffin, Why Don't You? Support The President's Gun Violence Plan.

    by JML9999 on Fri Dec 27, 2013 at 04:53:14 AM PST

  •  last month I had to take my daughter to the ER (26+ / 0-)

    we have insurance so it was covered.  We still had to pay a $150 co-pay but when we got the bill weeks later I was astounded to see that it was $2500.

    For what?  A couple of hours sitting around and really nothing much else.

    My daughter has a british citizenship and, if I do not have insurance, it would be cheaper to buy airline tickets and fly to England and go into an NHS clinic for the same care.

    there is something really wrong on the cost and pricing of medical services in this country.

    •  and what do you think it should cost? (4+ / 0-)
      Recommended by:
      DRo, GreyHawk, methylin, wintergreen8694

      just curious (a reality check).

      assume triage by nurse and exam by doc, rental fee for space and with or w/o tests.

      Do that exercise before checking this out.

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Fri Dec 27, 2013 at 05:08:40 AM PST

      [ Parent ]

      •  My question is why does it cost $2500 in the US (8+ / 0-)

        when the exact same service costs $0 for a patient in the UK?

        •  It would cost me that in London (13+ / 0-)

          It's only $0 for people who pay into the NHS. If you're a tourist or other casual visitor, you will get a bill.

          I don't know what your daughter needed the ER for, but this is why urgent care clinics are a key component of lowering health care costs -- saving the ultra-expensive ER visits for people in life-threatening emergencies where they absolutely need all the bells and whistles at the highly-trained doctor's fingertips. That's what you're paying for -- having the MRI and CT machines at the ready, plus the people to run them and interpret the results, 24/7/365, and same for the orthopedic OR, the cardiac OR, etc. etc.

          My last trip to the ER -- on advice from my insurance company's nurse 800#, as I reminded them when they balked at paying the bill -- could have been handled at the urgent care clinic, if it had been open on Sunday; and I actually could have waited until it opened on Monday.

        •  see my link (checking this out) (1+ / 0-)
          Recommended by:
          GreyHawk

          could cost a lot less, or a lot more.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 05:33:04 AM PST

          [ Parent ]

        •  Apples to oranges (1+ / 0-)
          Recommended by:
          SingularExistence

          If I follow you, you're comparing the cost billed to the patient (and then mostly paid by insurance if covered) with the cost billed to the patient in the UK. In that case, the NHS is essentially functioning as the insurance company. The true comparison might be between your co-pay ($150) and the cost to the patient in the UK ($0). That difference is because the US has chosen co-pays (and deductibles) as a way to keep costs down. Strictly an economic and political decision. Very little to do with the actual cost of healthcare.

          You could also compare what the hospital charges for the services: $2500 in your case and unknown, but certainly not actually $0 in the UK.

          The Empire never ended.

          by thejeff on Fri Dec 27, 2013 at 08:38:44 AM PST

          [ Parent ]

        •  Apples to oranges (1+ / 0-)
          Recommended by:
          red rabbit

          If I follow you, you're comparing the cost billed to the patient (and then mostly paid by insurance if covered) with the cost billed to the patient in the UK. In that case, the NHS is essentially functioning as the insurance company. The true comparison might be between your co-pay ($150) and the cost to the patient in the UK ($0). That difference is because the US has chosen co-pays (and deductibles) as a way to keep costs down. Strictly an economic and political decision. Very little to do with the actual cost of healthcare.

          You could also compare what the hospital charges for the services: $2500 in your case and unknown, but certainly not actually $0 in the UK.

          The Empire never ended.

          by thejeff on Fri Dec 27, 2013 at 08:38:57 AM PST

          [ Parent ]

          •  didn't see this comment before I posted, (0+ / 0-)

            similar to my response-it's not a valid comparison if you're looking at what was billed in the U.S., then comparing it to what the patient pays in the UK--as opposed to what a patient would pay in both countries with insurance.  

        •  $150 or $2500 (0+ / 0-)

          In your first comment you said that you had insurance and only had to pay the $150 co-pay, then you said you got a bill for $2500.  Was the bill just stating the costs of the ER visit, even though you weren't responsible for most of it?

          Then you say the same services would cost $0 for a patient in the UK, claiming it would be cheaper to fly over there for treatment.  Now if you actually only had to pay $150 for the same treatment, then it wouldn't be cheaper to fly overseas.  
          It looks more like you're failing to distinguish what things cost vs. how much a patient pays in order to paint a rosier picture overseas.  
          And you really didn't answer the initial question-exactly what treatment did she receive and how much do you think it should cost?  If all you did was sit around for a couple of hours then I wonder whether it was really an emergency, and why you bothered wasting time sitting in an ER.  

          •  The "bill" was the cost statement sent to the (0+ / 0-)

            insurance company (Blue Cross, which I already pay about $400 per month).  The hospital charged them $2500.  I had already chalked up the $150 co-pay at the hospital.  

            It was 4 AM in the morning and my daughter woke up with some crazy swellings.  Her hand and arm had ballooned up to to cartoon sizes.  It was actually frightening.

            We did hestitate to act and the only place open at the time was the children's hospital ER about 15 minutes away.  So we went.

            Now my wife is a British national and my daughter has dual citizenship.  Over there, she would pop into the local 24 hour NHS clinic and had the same service for no payment at all.

            BTW, a plane ticket between Boston and London runs about $900 round trip.

      •  Well Greg It will tell you this (10+ / 0-)

        An ambulance ride of a total of less than 2 miles round trip should NOT cost $866.  Yet that's what it cost when I got a concussion and had to take the ambulance from my house to the Danbury Hospital, which BTW I can see from my front window.  If I hadn't forgotten who I was or where I was I could have fucking walked to the damn hospital.  If the gas was that expensive they could have wheeled the damn gurney into the ER.  Either way it would have been cheaper than $866.  There is no rational justification for it to be that expensive, especially when the freaking ambulance company is located between my house and the hospital.  

        This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

        by DisNoir36 on Fri Dec 27, 2013 at 05:19:33 AM PST

        [ Parent ]

        •  check the link for range (8+ / 0-)

          Outrageous price, but my point is it's not a taxi and it has to cost something. You're not paying for distance (which is maybe $5-10 of the cost), you're paying for a rig and staffing, as well as medical control from the hospital.

          One of the problems with US med care is people are totally insulated from what things cost. Good to expose it, because most is unjustified, but some cost is.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 05:30:32 AM PST

          [ Parent ]

          •  Greg I get that (10+ / 0-)

            I get the range in prices and the costs.  My point is even if you factor in the staff at the central office, the driver, the EMS people in the ambulance, the equipment, the insurances and so on, the gas and time it took to drive me a few blocks to the hospital there's NO WAY that should cost $866.  Not when you factor that alot of those costs are divvied up by all the jobs they do and not just my call.  The problem with our healthcare system is that there is simply too much money being taken out of it which has nothing to do with providing care.  There is too much fat which the executives of these for profit corporations are taking out for their personal enjoyment and enrichment.  The only way the costs will ever be managed is if the whole system were non profit.  Anything short of that and we're wasting money to pay for a lavish vacation and lavish lifestyle of the head of that ambulance company and their family.        

            This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

            by DisNoir36 on Fri Dec 27, 2013 at 05:40:05 AM PST

            [ Parent ]

            •  i don't disagree (2+ / 0-)
              Recommended by:
              salmo, DisNoir36

              some folks seem to expect it should cost $50 or maybe twice a copay. it's a a lot more than that, but (as my link shows) your tale doesn't begin to cover the outrageous prices charged.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Fri Dec 27, 2013 at 05:48:13 AM PST

              [ Parent ]

            •  Relatively speaking, I'm not sure you're correct (1+ / 0-)
              Recommended by:
              SoCalSal

              I'm thinking of some of the repair bills I had on a Buick my elderly Dad gave to me. OMG, I could spend $866 in 10 minutes for something I probably didn't even need.  

              OTOH, I was driving up I-35 in southern MN yesterday and came upon an accident out on the open prairie which had obviously happened only a few minutes previously but the second ambulance was already pulling up to the scene.  I'd pay quite a bit to make that happen had it been me hitting that icy patch.  It's not cheap to provide the infrastructure for rapid emergency response.

              •  Seriously? (1+ / 0-)
                Recommended by:
                TerryDarc

                The infrastructure needed is already provided by the city.  The offices for the ambulance company are less than a mile from my house and about a mile from the hospital.  All public roads.  Total distance per Bing maps from the ambulance company to my house and to the hospital is 2.6 miles and 10 minutes total drive time plus additional time to get me in the ambulance.

                The bill for the ambulance only covered the cost of that company to provide me with ambulatory service from my house to the hospital.  The bill did not include ER or anything else.  I understand that the bill covers costs of the business.  That includes someone to take the call and send the call out to the ambulance.  The cost of that driver to drive from the office or wherever they were  to my house and back to the hospital.  The cost of the people in the ambulance to put me on the gurney.  The cost of the ambulance, gurney and all equipment inside it which was used for my case.  The cost of the gas and wear on the ambulance.  All the applicable insurances for the vehicle, employees and business.  The cost of the office and it's operation, taxes and so on.  Plus any other associated costs to do that type of business.  But those costs are not exclusive to my case alone.  That business has all those costs which are then divided by every single person they provide services for throughout the normal 24 hour day, 365 days out of the year.  

                If it costs them $866 to drive me a grand total of 2.6 miles then that company is doing poor business which is not covering their expenses and that company should be OUT of business. There's no fucking way it should cost $866 for that service.  

                This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                by DisNoir36 on Fri Dec 27, 2013 at 08:19:49 AM PST

                [ Parent ]

                •  I'm not so sure (0+ / 0-)

                  Again, thinking of the accident I came across on the interstate yesterday, I'm not even sure what state those cars were from.  They don't ask when you call 911 if you are a resident of the city, county, state or even country or if anyone is really even hurt.  They just send the bus out. There is a huge fixed cost in having the capability to do that and as someone said below, they don't recover that cost from everyone they carry.  

                  A friend's brother had a blood vessel burst in his brain out on the farm.  They sent an ambulance and they figured out they couldn't treat it in the local hospital so it's a coptor into the city where they do their magic and save his life and health.  They have to be ready to do all that and everyone they can charge pays part of the cost.  It's part of that golden hour or whatever they call it.  If they can't get to you quickly you may die so if you don't have something life threatening, you're probably going to find the cost excessive because you're paying part of the cost to get to the person who'd have died if they did it more cheaply.

                  Again, what I don't understand are the hundreds of dollars they charge me to diagnose what they're going to charge me thousands of dollars for on the Buick.  But thank Gawd I got rid of the Buick.  

                •  Standby time is expensive (0+ / 0-)

                  While you may only see the EMTs for 20 minutes or so, they probably spent about an hour or more dealing with paperwork and cleaning and restocking the ambulance.

                  But a single ambulance can't realistically handle 24 calls a day on average.  If the community expects a level of service where the response time is less than ten minutes, each ambulance will handle 4-8 calls a day.  In sparsely populated areas the call volume might average below 2 calls a day.

                  For 24/7 support, using the rule of thumb of 5.4 people per position, you need about 16 full time EMTs for a three person crew per ambulance.  So with the average EMT salary of $30,000 and 5 calls per day, the labor cost of providing you your 20 minutes of care is about $260. Double the salary costs to account for taxes, benefits, training, etc.  and reduce the call volume to 3 calls per day and the labor cost is $876 per call.

                  Ambulance services can reduce their costs by utilizing taxpayer-paid firemen or volunteers for some care and going with two-man crews.  Services also often receive grants or subsidies from the city or county so that the amount of money they need to recoup from patients is less.  But all of that is just shifting costs around.  The true cost of the service per patient is mostly dependent on the call volume per ambulance.

                  I am sorry that you are outraged by the cost of your ambulance treatment.  Without knowing the call volume for your area and the subsidies available to the service, it is hard to say how much of your $866 went to labor and material costs and how much went to profit and administrative bloat.  If ambulance services were strictly taxpayer supported like the police and fire department,  then communities could balance expected response times against call volume and individual patients wouldn't have to foot the bill for having emergency services available.

        •  does not surprise me (3+ / 0-)
          Recommended by:
          wintergreen8694, Miggles, snazzzybird

          when my mom was alive she took an ambulance ride to a hospital that was WALKING DISTANCE from our apartment and it cost over $500 (I think it was $515).

          That was 7 years ago, so the price has undoubtedly gone up since then

          I know we were paying for the sophisticated equipment and the staff cost of two highly trained EMTs.  But still.

          Politics is like driving. To go backward put it in R. To go forward put it in D.
          Drop by The Grieving Room on Monday nights for support in dealing with grief.

          by TrueBlueMajority on Fri Dec 27, 2013 at 05:49:00 AM PST

          [ Parent ]

        •  Let me be the devil's advocate (2+ / 0-)
          Recommended by:
          Heart of the Rockies, greenbell

          since you knew were the hospital was, but had forgotten it, it might be fair to say that you were suffering some altered mental status; driving there would have put you and others at risk had you stroked out or otherwise lost consciousness.  

          You also had immediate access to two or three trained medical personnel and equipment had that happened.

          An ambulance is not a taxi service.

          Sigline? What Sigline?

          by Khun David on Fri Dec 27, 2013 at 06:47:02 AM PST

          [ Parent ]

          •  You're not a very good devils advocate (0+ / 0-)

            I had a concussion.  I wasn't suffering some altered mental state.  I lost all memory per my son and didn't know what anything or anyone was.  Obviously driving to the hospital would have put others at risk and the scary part is I had driven home with no ill effect until I was practically on my street and couldn't remember where I lived and he gave me directions.  I pulled into our driveway and he called the ambulance.  Frankly I wish he HAD called a cab because I would have gotten to the hospital in very little time and the bill would have been far cheaper.  Even access to two or three highly trained medical personnel and equipment does not add up to $866 for the limited amount of time that they were available to me and considering there was very little they could do for me.  There is simply no explanation for that high a bill for the service provided.  

            This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

            by DisNoir36 on Fri Dec 27, 2013 at 08:28:51 AM PST

            [ Parent ]

            •  concussion v. altered mental status (0+ / 0-)

              You're basically arguing a distinction without a difference, the concussion obviously caused an altered mental status, loss of memory.  
              At any rate, if you're willing to take the risk that you didn't suffer some other injuries that you weren't aware of, or that you wouldn't require some sort of emergency treatment on the way to the hospital, then by all means take a taxi next time.

              "Even access to two or three highly trained medical personnel and equipment does not add up to $866 for the limited amount of time that they were available to me and considering there was very little they could do for me."

              And you know this how?  You could say definitively at the time that you wouldn't require some sort of emergency treatment on route, as opposed to dying in a taxicab?

              "There is simply no explanation for that high a bill for the service provided."

              Actually there is, you just want to ignore it in favor of your own spin.

              •  The other part is... (0+ / 0-)

                They can't provide ambulances with only the specific emergency equipment and personnel with only the specific training needed for each patient.
                When you call the ambulance, you essentially get the full service, prepared for anything, whether you need it or not. And you'll get charged for that.
                And of course, while they're transporting you, they can't respond to another emergency.
                That's why you should really avoid the ambulance unless you really need it. Much like avoiding the emergency room, except when it's really an emergency.

                It's also may be charged much like a tow truck charges. A flat amount to come out at all and then a fee per distance. Looks really silly on a per mile basis if you only need to be towed a quarter mile or something.

                The Empire never ended.

                by thejeff on Fri Dec 27, 2013 at 11:38:03 AM PST

                [ Parent ]

                •  Even a tow truck (0+ / 0-)

                  doesn't charge $866 for 2.6 miles.  They charge a fee to go out there and then a per mile above that.  Ambulances aren't super hi tech labs equipped with the most advanced medical equipment you can buy.  They have the necessary equipment to all but ensure that even the worst cases can get the basic treatment while en route to a medical facility which can better care for you.  That equipment surely costs alot but it's expenses are broken down over a long period of time and over the numerous calls that private company gets over the course of a year.  Those costs when broken down only add tens of dollars to the overall bill.  Payroll similarly doesn't explain the high costs of transporting someone.  Even if you factor that there are 4 maybe 5 staff to pay for that one hour and even if you are generous and pay them $50 per hour for that hour, the payroll doesn't even come up to half the total costs.    

                  Like I said, if that company is charging that much to stay afloat then that company by all rights should be out of business.  It simply does not cost that much.  There is either ALOT of fat in that price or that business is failing.  Either way for profit businesses shouldn't be in the business of providing healthcare, not if you want good and cheap care.

                  This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                  by DisNoir36 on Fri Dec 27, 2013 at 12:04:12 PM PST

                  [ Parent ]

                  •  No it doesn't. (0+ / 0-)

                    Might well charge you $80-$90 though.
                    And the tow truck is one guy with a lot less training.
                    And the ambulance surely has more expensive equipment than the tow truck, which isn't all that cheap itself.

                    Plus response times are far more critical, which means more redundancy, which means you're paying for more people sitting around waiting so they'll be ready when you call. 45 minutes to an hour is acceptable for a tow truck. Not so much for an ambulance.

                    I suspect the ambulance probably costs more to insure too.

                    The Empire never ended.

                    by thejeff on Fri Dec 27, 2013 at 01:58:22 PM PST

                    [ Parent ]

              •  My spin? (0+ / 0-)

                Seriously what fucking planet do you fucking live on that an ambulance ride costs $866 even with 2-3 EMT's?

                Please by all means educate us dumb fucks.  Illuminate us with your obvious brilliance.

                It's not spin.  It's called math.  Maybe you should learn it.  EMT's don't make that much for less than an hour worth of work.  

                This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

                by DisNoir36 on Fri Dec 27, 2013 at 11:52:59 AM PST

                [ Parent ]

      •  And liability insurance... (2+ / 0-)
        Recommended by:
        methylin, DRo

        ...and the cost of the uninsured who shared that space with you. Frankly, a bargain.

        •  The Burden of the Uninsured (3+ / 0-)

          Covering those ambulance rides for the uninsured is certainly a significant part of the cost. I really haven't understood why Dems haven't been able to pound that issue home when selling the ACA. That should be an easy button to push on the conservative psyche. Conservatives should be on board with requiring people to pay for their own healthcare insurance, and outraged about covering "freeloaders" with free care (and ambulance rides).

          Anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that 'my ignorance is just as good as your knowledge.' ― Isaac Asimov

          by GoodGod on Fri Dec 27, 2013 at 07:56:38 AM PST

          [ Parent ]

    •  Consider fire company medallions. Long ago we (0+ / 0-)

      in this country began to decide that it was worth covering everyone's burning buildings with general taxation rather than a fire company looking for their medallion to see if the owner had paid for coverage. After all, your burning house can become my burning house with a change of wind.

      In some more advanced civilizations that is the way of health and medical care. We figured it out for fires (and the retrograde perverts of the TP/GOP would like us to go back to that system I think), but got stuck on the way. Unfortunate for two specific public reasons.

      First, unhealthy people can diminish the health situation for us all. Think of your low wage food worker with an infectious problem without time off or health coverage to address and what just might get into your food. Ah ha!

      Second, our fully privatized, for profit system of health care providing and insuring has little or no reason to really control costs. That is why, with what is mediocre overall health care by most Western European standards we also have absolutely outrageous costs. Why, even in our single payer example, the pressure from the for profit provider side goes nuts rather often.

      Consider the story I remember from Germany and examples I've seen there and in France. The story was years ago and about retraining sex workers to be elder care workers and how that was working rather well. What I observed very casually was the mail delivery. The delivery person made a point of waiting to see the elderly recipient, took a moment to chat and moved on. I asked. It was part of the job to sort of keep an eye out to detect a problem before it became a crisis.

      The only foes that threaten America are the enemies at home, and those are ignorance, superstition, and incompetence. [Elbert Hubbard]

      by pelagicray on Fri Dec 27, 2013 at 11:21:46 AM PST

      [ Parent ]

  •  Why am I not surprised? (17+ / 0-)

    Via  Atrios Couple of weeks old but still...

    Outrageous HSBC Settlement Proves the Drug War is a Joke

    If you've ever been arrested on a drug charge, if you've ever spent even a day in jail for having a stem of marijuana in your pocket or "drug paraphernalia" in your gym bag, Assistant Attorney General and longtime Bill Clinton pal Lanny Breuer has a message for you: Bite me.

    Breuer this week signed off on a settlement deal with the British banking giant HSBC that is the ultimate insult to every ordinary person who's ever had his life altered by a narcotics charge. Despite the fact that HSBC admitted to laundering billions of dollars for Colombian and Mexican drug cartels (among others) and violating a host of important banking laws (from the Bank Secrecy Act to the Trading With the Enemy Act), Breuer and his Justice Department elected not to pursue criminal prosecutions of the bank, opting instead for a "record" financial settlement of $1.9 billion, which as one analyst noted is about five weeks of income for the bank.

    The banks' laundering transactions were so brazen that the NSA probably could have spotted them from space. Breuer admitted that drug dealers would sometimes come to HSBC's Mexican branches and "deposit hundreds of thousands of dollars in cash, in a single day, into a single account, using boxes designed to fit the precise dimensions of the teller windows."

    The new and improved DoJ

    "If you pour some music on whatever's wrong, it'll sure help out." Levon Helm

    by BOHICA on Fri Dec 27, 2013 at 05:03:37 AM PST

  •  I put my daughter on my plan (7+ / 0-)

    once I could get over some mis-information with my NYS employee health insurance plan about timing.

    So I was an early buyer into ACA. For the two of us, since I just paid the premium for Jan, 2014 it cost $7 more than 2013 premiums. A whopping ca $325/month.

    She will age out in 2014, but should have a job (in nursing) that should give her insurance.  She knows something about the system and has used Medicaid to have four wisdom teeth removed. No dental/vision/hearing on my policy. Sigh.                        

    Americans, while occasionally willing to be serfs, have always been obstinate about being peasantry. F. Scott Fitzgerald, the Great Gatsby

    by riverlover on Fri Dec 27, 2013 at 05:03:46 AM PST

  •  A kid with Type1 diabetes can't be denied coverage (20+ / 0-)

    and can stay on their parents health care plan until they are 26 years old. This alone makes the whole ball of wax worth the trouble. And this is only one story in the naked city.

  •  Krugman: "If employers value their workers (11+ / 0-)
    they won’t make unreasonable demands.
    Fat chance of this without the Labor Movement. The corporatist-right understands that, as Krugman points out, the employment relationship is about power. Unions have been successful at getting a bigger piece of the economic pie to workers. This success is why, not to put too fine a point on it, the right wants to destroy unions. If the Republicans ever take control of Congress and the White House, they will.
  •  So THAT'S why my stuff hasn't come in the mail (2+ / 0-)
    Recommended by:
    GreyHawk, TrueBlueMajority

    yet.

    I'm apparently signed up for medicaid, and was supposed to receive my card about a month ago.

    Seems they're overloaded. My application is still "Being Processed."

    An Fhirinn an aghaidh an t'Saoghail. (The truth against the world.) Is treasa tuath na tighearna. (The common people are mightier than the lords.)

    by OllieGarkey on Fri Dec 27, 2013 at 05:22:24 AM PST

    •  Print out the confirmation letter and carry it (5+ / 0-)

      That's my "Plan B" if my ID card doesn't arrive. For the first half of January, I trust that medical providers will be lenient about the "I have coverage -- here's the proof -- but haven't gotten my card yet."

      •  I don't even have the confirmation letter yet. (1+ / 0-)
        Recommended by:
        Dvalkure

        My application is still being processed.

        An Fhirinn an aghaidh an t'Saoghail. (The truth against the world.) Is treasa tuath na tighearna. (The common people are mightier than the lords.)

        by OllieGarkey on Fri Dec 27, 2013 at 07:25:10 AM PST

        [ Parent ]

        •  Ollie - call 'em up (1+ / 0-)
          Recommended by:
          OllieGarkey

          It can't hurt and it may help. I felt stuck in limbo after sending in extra info and never hearing back. My application was  'In Progress' and then 'Completed', but I didn't hear back. When I called, I was able to ascertain that all was really, truly well and it seemed to get the process going forward again.

           Good luck and Good health !

          “Good things don’t come to those who wait. They come to those who agitate!” Julian Bond

          by Dvalkure on Fri Dec 27, 2013 at 07:49:53 AM PST

          [ Parent ]

  •  Free Kindle editions available through Saturday: (3+ / 0-)
    Recommended by:
    emmasnacker, wintergreen8694, DRo

    The Kindle versions of Her Final Year: A Care-Giving Memoir and Communion of Dreams (both books by Kossacks) are available for free download through Saturday 28 Dec. Great gifts for people getting new e-readers, phones, tablets or computers.

    A third freebie: you don't need to own a Kindle to take advantage of free Kindle content. You can download a free Kindle reader from Amazon for your device. (You'll need to set up a free account at the Kindle store, tho, in order to download anything.)

    To date, we've offered the Kindle versions of these books periodically as free downloads, and there have - literally - been thousands of downloads in response during those times.

    Communion of Dreams is a hard science fiction book with at least 69 reviews up on Amazon, and the average rating is 4 1/2 stars out of 5.

    Her Final Year is the true-life story of caregiving and recovery that  Shadan7 & I co-authored with our wives - much of the story was, in fact, drawn from diaries that we'd each posted on Daily Kos as we journeyed along the well-worn path of home caregivers.  HFY has had 21 customer reviews on Amazon, and holds a 5 star rating.

  •  people paying more in 2014 prob won't vote Dem (3+ / 0-)
    Recommended by:
    GreyHawk, methylin, Stude Dude

    People paying more for their health care in 2014 probably won't be voting for Democrats.

    Why would they?

    The people getting health care in 2014 under the ACA for the first time tend to be in demographic groups that typically have lower voter participation.

    Voters don't much care whether other countries have more readily available health care or whether years' earlier roll outs of social safety net programs (Social Security in the 1930s or Medicare in the 1960s) were rocky or smooth.

    Voters tend to vote for their own or their perceived own self interests.  

    If the voter's health care costs in 2014 are higher than they had been in 2013, the voters are likely to associate the increased cost to the family budget with the Democrats' ACA (whether their individual increases are in fact associated with the ACA or not) - and they will mostly not vote for the Party they believe has cost them more money.

    •  Depends on whether they get better value (6+ / 0-)

      I already know people who have added up the savings in birth control costs, preventative care, flu shots, etc. and realized that yes, they're paying a bit more but they're getting a lot more too.

      So yes, some may vote GOP in protest, but not all.

      And for many people, I suspect the ACA is not at the top of their list (or even on the list) in deciding who to vote for at all.

      •  Too few may have experienced the value (1+ / 0-)
        Recommended by:
        ArcticStones

        I'm thinking of a conversation I overheard at the family Christmas dinner among the cousins, doctors and nurses among them.  I think there's a general worry about how the ACA is going to impact healthcare overall and that's going to take awhile to play out.   People may vote their concerns not their experiences in 2014.

        Communication of all kinds has been an enormous failure from the getgo on the ACA.  Too much spin and not enough attention to what Americans needed to know.  

    •  maybe, unless they see the benefits (like kids (5+ / 0-)

      staying on until 26, no preexisting conditions which can affect half the population, etc).

      Couple that with a growing economy, which people think is more important, and your assumptions are not as solid as you assume.

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Fri Dec 27, 2013 at 05:37:04 AM PST

      [ Parent ]

      •  It doesn't matter to many (4+ / 0-)

        Whether they get better value or not or even pay less than they did prior to ACA or even have coverage.  Their hatred for Obama is so great they will vote for the GOP even if the Republicans take away their newly acquired and/or better health care coverage.  

        I have dealt with people who vote GOP and constantly complain about ACA, yet provide no real details about what the issue is except they "think" they will have to pay more.  

        So for many who the law will benefit, they are already mentally preparing themselves that it sucks and therefore will vote GOP and somehow (I would bet a paycheck) believe the Republicans gave them better healthcare in the future with no thanks to President Obama or the Democratic Party.  Or if the Republicans take it away, that it was a good and right thing for the GOP to do.

        I don't think we understand the impact of rightwing and Fox brainwashing on the people who listen and watch their crap.

        •  O voters are the Q (1+ / 0-)
          Recommended by:
          Miggles

          no one gives a crap what republicans do. They are not a mjority.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 06:09:17 AM PST

          [ Parent ]

          •  LOL, blind leading the blind (0+ / 0-)

            I find it funny, actually that that is your response.  Surely, the GOP didn't vote for Obama in 2008 and 2010 was a GOP tidal wave.  Unfortunately, I suspect the same in 2014 because the GOP will get out and vote in a non-Presidential election year.  

            So, I for one, do give a crap what Republicans do--especially how they vote since Democrats seem not to show up in off year elections.  

            •  point is, you can predict their response (0+ / 0-)

              but what indies and moderates do is far more important than what Ds and Rs do.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Fri Dec 27, 2013 at 11:39:55 AM PST

              [ Parent ]

        •  Those people didn't vote for Obama last time. (3+ / 0-)
          Recommended by:
          Dvalkure, katesmom, Stude Dude

          And he won.

          Peace is not merely a distant goal that we seek, but a means by which we arrive at that goal. - Martin Luther King, Jr.

          by Gentle Giant on Fri Dec 27, 2013 at 07:31:18 AM PST

          [ Parent ]

    •  Not so fast ... (4+ / 0-)

      I know the GOP will try to sell that story but as Wendell Potter correctly points out health care costs have been continually rising before ACA.  It's a little tough to honestly pin rising costs on ACA.

      "The real wealth of a nation consists of the contributions of its people and nature." -- Riane Eisler

      by noofsh on Fri Dec 27, 2013 at 05:58:28 AM PST

      [ Parent ]

    •  Really not a very large universe of voters (1+ / 0-)
      Recommended by:
      Stude Dude

      And odds are other factors make most of them not "our" voters to begin with.

      Change does not roll in on the wheels of inevitability, but comes through continuous struggle. --Martin Luther King Jr.

      by Egalitare on Fri Dec 27, 2013 at 06:21:05 AM PST

      [ Parent ]

    •  by the way... (1+ / 0-)
      Recommended by:
      Brainwrap

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Fri Dec 27, 2013 at 06:39:53 AM PST

      [ Parent ]

    •  Not everyone is penny wise and pound foolish. (0+ / 0-)

      I have non-Dem relatives who support the ACA even though they are self-insured and don't qualify for subsidies. Why do they support something that they actually have to pay a little more for? Because they WANT good, reliable insurance.

  •  Hotting up over in Gooperville..... (4+ / 0-)
    Recommended by:
    GreyHawk, Stude Dude, Brainwrap, IM
  •  Allowing them to forget (10+ / 0-)

    Two months ago it was "obvious" that Dems were going to take back the house. After all, perhaps 30 billion dollars were wasted on a government shut down. Then virtually no one--neither party nor prospective candidate--kept those facts in the public mind and now "generic" republicans again rule in surveys of prospective voters. How stupid are we, anyway? Would Luntz let this die?

  •  Go, Brainwrap! (7+ / 0-)

    First it was the Rape Chart, now this. You're an internet sensation!

    "Back off, man. I'm a scientist."
    -- Dr. Peter Venkman


    Join me, LOLGOP, Anne Savage, and Amy Lynn Smith at Eclectablog.

    by Eclectablog on Fri Dec 27, 2013 at 05:43:56 AM PST

  •  nice roundup g10 (2+ / 0-)
    Recommended by:
    Greg Dworkin, GreyHawk

    always good to see your name :-D

    Politics is like driving. To go backward put it in R. To go forward put it in D.
    Drop by The Grieving Room on Monday nights for support in dealing with grief.

    by TrueBlueMajority on Fri Dec 27, 2013 at 05:44:38 AM PST

  •  NYT: GOP realizing it's over (9+ / 0-)
    “The hardest problem for us is what to do next,” [Sen. Lindsay] Graham said. “Should we just get out of the way and point out horror stories? Should we come up with a mini Contract With America on health care? Should we just kill ourselves?"
    Okay, I made up the last sentence.  Article here.
  •  . (15+ / 0-)
    @KagroX @Deoliver47 none of those ACA numbers count, because freedom and you didn’t pay your premium yet.
    @DemFromCT
    @KagroX @Deoliver47 none of those ACA numbers count, because Reagan and Medicaid.
    @DemFromCT
    @KagroX @Deoliver47 none of those ACA numbers count, because your insurance company complained to a reporter.
    @DemFromCT

    "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

    by Greg Dworkin on Fri Dec 27, 2013 at 05:50:07 AM PST

  •  I think the hysteria over signups is laughable (10+ / 0-)

    This just shows how stuck we are in the 24 hour news cycle.  In the long run, what happens the next 3 months matters little compared to what happens the next 3 years.

    Given that the Massachusetts system took about 4 years to reach 90+ coverage, I think you can expect the ACA to take at least as long if not longer to work to maximum effectiveness.  Sadly, I do not think we will reach 90%+ coverage but that is a topic for another debate.

    "The real wealth of a nation consists of the contributions of its people and nature." -- Riane Eisler

    by noofsh on Fri Dec 27, 2013 at 06:01:12 AM PST

  •  So does this mean (2+ / 0-)
    Recommended by:
    Gentle Giant, IM

    That ACA is only 1.25 million shy of the reputed 7 million signups needed by March. So this does seem like it can be done.

    "If this Studebaker had anymore Atomic Space-Age Style, you'd have to be an astronaut with a geiger counter!"

    by Stude Dude on Fri Dec 27, 2013 at 06:07:31 AM PST

    •  7 million was a CBO estimate (2+ / 0-)
      Recommended by:
      Stude Dude, IM

      it was never a WH goal and not a hard deadline number.

      "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

      by Greg Dworkin on Fri Dec 27, 2013 at 06:40:44 AM PST

      [ Parent ]

      •  wasn't that "private" plans, though? (2+ / 0-)
        Recommended by:
        Brainwrap, Stude Dude

        Medicaid/SCHIP does not contribute to the success of ACA.  It is, in fact, a drain on the system.

        •  7 mill was private plans (3+ / 0-)
          Recommended by:
          TerryDarc, Brainwrap, Stude Dude

          and the original idea was 1:1.

          Medicaid/SCHIP is not a "drain on the system", it's an alternative way to give millions of working poor health insurance.

          SS is not a "drain on the system" either, unless you consider caring for nonwealthy people in any capacity a drain on the system.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 08:21:16 AM PST

          [ Parent ]

          •  It's an expenditure. (1+ / 0-)
            Recommended by:
            Stude Dude

            Call it whatever you like, but it is an outgoing expense.  No funds are put into the system through Medicaid/SCHIP.

            That is not a comment on the desirability of the program, it is simply a statement of fact.

            And when talking about the viability of ACA, it is the paying insured that will make or break the system.

            •  no they won't (1+ / 0-)
              Recommended by:
              Stude Dude

              because the health system that ACA supports was built to support the existing private insurance structure. Private side, they collect the money, not the feds. what makes that system work or not work is healthy people signing up. medicaid has nothing to do with it any more than pre-ACA.

              Now, you're right to suggest the medicaid payments/expenditure systems are different. But, in the context of this diiscussion, that does not matter.

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Fri Dec 27, 2013 at 09:24:16 AM PST

              [ Parent ]

        •  by the way (2+ / 0-)
          Recommended by:
          Brainwrap, Stude Dude

          how many sign up and whwether it's 1:1 private:medicaid won't be known until mid April.

          But as you can see on brainwrap's site, CT NY and VT have private>medicaid. That's the likely future.

          http://www.acasignups.net/

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 08:24:18 AM PST

          [ Parent ]

        •  another point folks make is that (2+ / 0-)
          Recommended by:
          Stude Dude, ArcticStones

          the number of younger vs older pts matters.

          yes it does, but one has to consider 2 points:

          1. up to 26, you can be on parental insurance and
          2. young'uns signed up last minute in MA, expected to do so here.

          what's absurd is trying to judge things now as already failing.

          "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

          by Greg Dworkin on Fri Dec 27, 2013 at 08:27:48 AM PST

          [ Parent ]

          •  Exactly. (1+ / 0-)
            Recommended by:
            Stude Dude

            As I said below.. I'll withhold judgement until next spring.. and maybe even longer for when the Employer stuff kicks in.

            Medicare Part D took a while to catch on, but turned out to be wildly successful and much less costly than first estimated.

            •  yes, very fair point (I wasn't accusing you... (2+ / 0-)
              Recommended by:
              JJ In Illinois, Stude Dude

              you've actually pointed that out to people iirc).

              "It is difficult to get a man to understand something, when his salary depends upon his not understanding it!" — Upton Sinclair

              by Greg Dworkin on Fri Dec 27, 2013 at 09:25:29 AM PST

              [ Parent ]

            •  Depends on who you talk to -- (0+ / 0-)

              Medicare Part D is VERY unpopular on my street. All the Senior Citizens say more of their retirement money is going into the Donut Hole.

              And these are folks who would be considered "well off" -- so if they're having problems, I have to wonder what it's doing to those who don't have a lot of money.

              I know that ACA eventually closes the Donut Hole...but I doubt that will have much influence on my Republican neighbors.

  •  Minden (0+ / 0-)

    I may have found out that the underperforming school district that brought Iowa's Open Enrollment law upon itself may have Minden. I need to look into it and actually confirm it.

    So why can't or won't a district fix things if they have upset parents are working two jobs or doing without to pay tuition or rental in the next district over?

    "If this Studebaker had anymore Atomic Space-Age Style, you'd have to be an astronaut with a geiger counter!"

    by Stude Dude on Fri Dec 27, 2013 at 06:20:16 AM PST

  •  Don't post policy analysis from The Daily Beast (4+ / 0-)

    From the Daily Beast article excerpted:

    In 19 countries, 100 percent of the population is covered via public insurance. In 11 more, more than 95 percent are covered the same way. So all but four countries basically provide universal or near-universal public coverage...No other country even bothers with private coverage at all, except Germany a little bit (10.8 percent).  
    This is misleading, and then plunges into being out-and-out wrong. For instance, in The Netherlands the public insurance is ONLY for long-term hospitalization and disability. Other than that (i.e. for doctor's visits, emergency visits, etc.), they have an individual mandate for PRIVATE insurance...it's basically Obamacare with a Social Security-like public safety net for long-term hospitalizations and disability.

    http://en.wikipedia.org/...

    Getting health care analysis from the Daily Beast is just a small step above getting foreign policy analysis from Parade Magazine. You'll be presented with things that look like facts, and some broadly true statements, but you'll also be misled into simple-mindeding thinking.

    it fitfully blows, half conceals, half discloses

    by Addison on Fri Dec 27, 2013 at 06:59:16 AM PST

  •  The media drones on . . . (2+ / 0-)
    Recommended by:
    Gentle Giant, Stude Dude

    The rollout was a disaster worse than Krakatoa, and Democrats (who are doomed) will run away from Obama and the freedumb loving voters will usher in a new wave of Transvaginal Probers who will make this country "great" again . . . just like they say on Fox Nooz.

    Or not?

    And God said, "Let there be light"; and with a Big Bang, there was light. And God said "Ow! Ow My eyes!" and in a flash God separated light from darkness. "Whew! Now that's better. Now where was I. Oh yea . . ."

    by Pale Jenova on Fri Dec 27, 2013 at 07:05:07 AM PST

  •  Erza Klein also posted the graph to FB (2+ / 0-)
    Recommended by:
    Brainwrap, ArcticStones

    Happened to go from this diary to my FB feed and found the very same graph. Yesterday, Erza Klein linked to the WaPo story via his FB page.

  •  1.8 Million private plans is rather pathetic (2+ / 0-)
    Recommended by:
    Gentle Giant, Sucker Politics

    at this point.

    The success of ACA does not depend on Medicaid/SCHIP enrollments.

    The success of ACA depends on people enrolling in private plans.  And ACA needs a lot of those to be young healthy individuals to offset the large numbers of those with pre-existing conditions who, likely, signed up for ACA immediately.

    Now, the Obama admin has exempted people from the individual mandate whose plans were cancelled - and is allowing them to purchase catastrophic plans heretofore reserved for those under 30.  The whole idea of the individual mandate was to force everyone into full service plans to offset the costs of insuring the sick.  Now, they have even undercut that!

    I surely do not understand taking any glee in these numbers.  As I said.. rather pathetic - especially given that 1 million plans were cancelled in California alone, and it is estimated 4-6 million plans total across the country were cancelled.

    But, let's wait and see.  I will withhold judgment until at least March when open enrollment is over.

    A limited single-payer (even a catastrophic safety net) would have worked much more efficiently, IMHO.

    •  If our side manages to (0+ / 0-)

      retain the Senate and gain the House in 2014, and the ACA fails to attract healthy youth, then we would have the impetus to enact single payer.

      Peace is not merely a distant goal that we seek, but a means by which we arrive at that goal. - Martin Luther King, Jr.

      by Gentle Giant on Fri Dec 27, 2013 at 08:10:51 AM PST

      [ Parent ]

    •  How many people bought ACA compliant (3+ / 0-)
      Recommended by:
      katesmom, JJ In Illinois, Brainwrap

      plans without going through the exchanges?  Are those numbers being captured?  No need to use the exchanges if income is too high to qualify for  subsidy.

      “The future depends entirely on what each of us does every day.” Gloria Steinem

      by ahumbleopinion on Fri Dec 27, 2013 at 08:30:02 AM PST

      [ Parent ]

    •  Indeed. There's only so long the spin can work. (0+ / 0-)

      I'll put aside the failure to keep with the CBO-projection schedule in terms of bulk numbers, for there's probably some merit to the idea that the 7-million figure doesn't really matter, the upcoming political disaster notwithstanding.

      The diversity of the enrollments, however, is something that can't be ignored for the viability of the program. Nobody here seems to be talking much about diversity.

      And right-wing attack or not, the "How many have paid?" question is legitimate. You don't get off just by ridiculing the question's source or by being able to "predict" it as a new talking point.

      http://www.propublica.org/...


      That’s slow going, according to consultants and some insurers, raising the prospect that actual enrollment will be far lower than the figures HHS is releasing.

      “There is also a lot of worrying going on over people making payments,” industry consultant Robert Laszewski wrote in an email. “One client reports only 15% have paid so far. It is still too early to know for sure what this means, but we should expect some enrollment slippage come the payment due date.”

      Another consultant Kip Piper, agreed. “So far I’m hearing from health plans that around 5% and 10% of consumers who have made it through the data transfer gauntlet have paid first month’s premium and therefore truly enrolled,” he wrote me.

      I also haven't seen much around here about the latest CNN/ORC poll showing that only 35% approve of Obamacare, with support on the decline, the same ongoing poll that has been quoted extensively when the numbers were more favorable. (And, no, the poll questions don't use either "ACA" or "Obamacare," so that excuse about it being a name thing doesn't cut it.)

      Time is a cruel mistress, and once the objective facts start rolling in, I'm expecting a frantic meltdown on this site. It's a shame that knowledgeable health-care writers such as nyceve have admitted to self-censorship on the disasters ahead.

  •  Time for the Dems to run on the success (1+ / 0-)
    Recommended by:
    Stude Dude

    of this next year, as well as the economy with its huge 4.1 % gdp growth, the success of the  stock market, which under Obama has never been this big, and to point out all the negative about the GOP, and there are plenty!!!

  •  The spike tells us how badly the rollout was (0+ / 0-)

    botched.

    I wonder how many people were like us -- trying to sign up in October and failing, November and failing, early December and failing, finally getting on a phone call and getting through in mid December, finally getting a screwed up plan and hoping to fix it after things calm down?

    Some sort of spike was going to be there no matter -- some people just put things off.  A spike of that magnitude, however, was not required.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Fri Dec 27, 2013 at 07:51:26 AM PST

    •  The shape of the spike (1+ / 0-)
      Recommended by:
      IM

      has to do mostly with the way people procrastinate. Even with the best website in the world, signups would look exponential at this point. Just like they did with Massachusetts.

      And it'll look exponential again around the end of March, even though the website woes will be over. Because humans procrastinate.

      •  The shape of the spike is a combination of factors (0+ / 0-)

        One of which is how badly the healthcare.gov site was bungled.

        Because screwed-up technology makes it hard for people to do things.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Fri Dec 27, 2013 at 08:28:37 AM PST

        [ Parent ]

        •  That would be a constant multiplier (0+ / 0-)

          If the technology had worked better, the graph would still be a spike, but at every point, there would have been more signups. That is, it would be shaped the same but bigger.

          •  You cannot wish away the truth. (0+ / 0-)

            I know that we were part of the last-minute spike.
            I have trouble believing that we are unique.

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Fri Dec 27, 2013 at 09:52:29 AM PST

            [ Parent ]

            •  Are you saying that the signups in March (0+ / 0-)

              are not going to be exponential, just like the signups in December? Because the website woes will have been worked out?

              •  I am saying that the people who could not (0+ / 0-)

                sign up when they wanted to had to sign up later.
                Add in the holiday season, and you have two hour hold times, not to mention an amplified spike in registrations.

                The spike was always going to happen, but the glitches in the healthcare.gov site amplified it.

                Numbers are wonderful things, but "pure empiricists" can find themselves striking out when they forget to do reality checks.

                If you don't want to check in with the real world from time to time, there are other quantitative areas that can use your talent.

                LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

                by dinotrac on Fri Dec 27, 2013 at 10:01:58 AM PST

                [ Parent ]

  •  While the website gave us frustration... (6+ / 0-)

    the phone support was excellent.  My wife was able to get all of her questions answered the first time she called.  We discussed her options afterwards and she then signed up the day after Christmas in about 30 minutes.

    She commented that the representative that she talked to was extraordinarily pleasant & knowledgeable.

    So, while the software rollout sucked, the human assistance is remarkable.

    Thanks to those who staff the phones.

    •  And were you satisfied with the cost? (0+ / 0-)

      Compared to previous plans if you happened to be covered?

      BTW - it's nice to hear an actual success story in place of all the fear, uncertainty and death we've been (and still are being) fed.

      What stronger breast-plate than a heart untainted! Thrice is he arm'd, that hath his quarrel just; And he but naked, though lock'd up in steel, Whose conscience with injustice is corrupted. Henry VI Part II Act 3 Scene 2

      by TerryDarc on Fri Dec 27, 2013 at 09:24:21 AM PST

      [ Parent ]

      •  Definitely! (0+ / 0-)

        We are on a relatively fixed income (social security, now aged 64) plus limited funds from a business not doing very well in this economy.

        The subsidized price is around $110 per month for a plan associated with the best HMO in our state.

        We only need the plan until my wife reaches 65 in late 2014, but it brings peace of mind to have insurance through then.

        •  Thanks! (0+ / 0-)

          We're already on Medicare and whatever we pay comes out of our SSI payments. Nice not to have to worry about insurance.

          What stronger breast-plate than a heart untainted! Thrice is he arm'd, that hath his quarrel just; And he but naked, though lock'd up in steel, Whose conscience with injustice is corrupted. Henry VI Part II Act 3 Scene 2

          by TerryDarc on Sat Dec 28, 2013 at 05:04:58 PM PST

          [ Parent ]

  •  Any current or former teacher can tell you (1+ / 0-)
    Recommended by:
    RadGal70

    That, given a deadline, people will wait until the last minute to complete their work. And that technology issues may be involved at some point. America.

  •  Wow, I think that's the first time I've been FP'd (1+ / 0-)
    Recommended by:
    ArcticStones

    ...since the GOP Rape Advisory Chart!

    Of course, as I noted above, I'd rather be known as "The ACA Chart Guy" than "The Rape Chart Guy" any day...

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