Skip to main content

President Obama stepped into the press room to discuss the crisis in Ukraine yesterday and to provide his sympathy for the Korean maritime tragedy on Thursday. And he had a confident hop in his step as he approached the podium—because he had something big to say about health care.

Actual Obamacare results are in. And in most cases they are exceeding expectations.

  • 8 Million+ citizens are now enrolled in Obamacare.
  • 35% of citizens enrolled in Obamacare are under 35 years old.
  • Obamacare has brought economic security to all consumers of health insurance.
  • Over 14 million have received insurance over the exchanges and via the Medicaid expansion to Obamacare.
  • Medical cost is now growing at less than 1/2 the previous rates.
  • Obamacare is shrinking the deficits.
  • It is fact that repealing Obamacare would increase the budget deficit, raise premiums, and take away insurance from millions of Americans.

When asked if Democrats should campaign on Obamacare, President Obama said:

Democrats should forcefully defend and be proud of the fact that millions of people like the woman I just described who I saw in Pennsylvania yesterday we’re helping because of something we did. I don’t think we should apologize for it. I don’t think we should be defensive about it. I think there is a strong good right story to tell. I think what the other side is doing and what the other side is offering would strip away protections from those families and from hundreds of millions of people who had health insurance before the law was passed but never knew if the insurance company would drop them when they actually needed it or women who were getting charged more because they are a woman.
Please read more about this strong stand below the fold.

In his preamble to the news conference, he actually laid out the talking points. They were not at all defensive. It was a narrative from a position of strength given the now-provable—and successful—Obamacare implementation realities.

I find it strange that the Republican position on this law is still stuck in the same place that it has always been. They still can’t bring themselves to admit that the Affordable Care Act is working. They said nobody would sign up. They were wrong about that. They said it would be unaffordable for the country. They were wrong about that. They were wrong to keep trying to repeal a law that is working when they had no alternative answer for millions of Americans with preexisting conditions who would be denied coverage again, or every woman who would be charged more for just being a woman again....

It is well past time to move on as a country and refocus our energies on the issues that the American people are most concerned about. And that continues to be the economy. Cause these endless fruitless repeal efforts come at a cost. The 50 or so votes Republicans have taken to repeal this law could have been 50 votes to create jobs. … 50 votes to make it easier for middle class families to send their kids to college. Or 50 votes to raise the minimum wage. Or restore unemployment insurance.... The repeal debate is and should be over.

The narrative got even better, moving from a simple recitation of facts to a fact-based moral statement when President Obama said the following:
States that have chosen not to expand Medicaid for no other reason than political spite. You have 5 million people who could be having health insurance right now at no cost to these states, zero cost to these states other than ideological reasons they have chosen not to provide health insurance for their citizens. That’s wrong. It should stop. Those folks should be able to get health insurance like everybody else.
In those few statements, the president laid out a narrative that instead of being defensive of Obamacare, presents an offense model. Americans do not like weakness or defensiveness—witness how Republicans have been winning elections with bad ideas because they are assertive in defending bad ideas. They are assertive in lying about helping even as their policies materially hurt the vast majority of their constituencies.

Obamacare now has fact-based numbers behind it. If these numbers are so good after a pathetically rocky rollout, just think what it could have been and what it will be going forward. That scares all of those who have made it a mission to kill it.

While President Obama’s narrative above is decidedly pointed, civil and characteristically presidential, Democrats must institute an Alan Grayson-like narrative in their stumps. Why? Because the outcomes of implementing a Republican repeal of Obamacare and subsequent expected inaction makes it true.

Republicans have been airing ads that lie about people who were hurt by Obamacare. Where are the stories like the Charlene Dill story in which the evidence is irrefutable? Charlene Dill is dead. Had she had the reliable health care the Medicaid expansion to Obamacare would have provided, she would be alive today.

Democrats must ignore ivory tower pundits. They must think outside of the box. Americans are waiting for politicians who will fight for them. Americans will show up if they think the politicians they are voting for have conviction. Americans want politicians who are willing to get into a street fight if necessary to defend and protect them. That is what the 2014 election must be. Running a status quo election will provide status quo results. We all know the definition of insanity.

Originally posted to Daily Kos on Sun Apr 20, 2014 at 07:30 AM PDT.

Also republished by Obamacare Saves Lives.

Your Email has been sent.
You must add at least one tag to this diary before publishing it.

Add keywords that describe this diary. Separate multiple keywords with commas.
Tagging tips - Search For Tags - Browse For Tags


More Tagging tips:

A tag is a way to search for this diary. If someone is searching for "Barack Obama," is this a diary they'd be trying to find?

Use a person's full name, without any title. Senator Obama may become President Obama, and Michelle Obama might run for office.

If your diary covers an election or elected official, use election tags, which are generally the state abbreviation followed by the office. CA-01 is the first district House seat. CA-Sen covers both senate races. NY-GOV covers the New York governor's race.

Tags do not compound: that is, "education reform" is a completely different tag from "education". A tag like "reform" alone is probably not meaningful.

Consider if one or more of these tags fits your diary: Civil Rights, Community, Congress, Culture, Economy, Education, Elections, Energy, Environment, Health Care, International, Labor, Law, Media, Meta, National Security, Science, Transportation, or White House. If your diary is specific to a state, consider adding the state (California, Texas, etc). Keep in mind, though, that there are many wonderful and important diaries that don't fit in any of these tags. Don't worry if yours doesn't.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.
Rescue this diary, and add a note:
Are you sure you want to remove this diary from Rescue?
Choose where to republish this diary. The diary will be added to the queue for that group. Publish it from the queue to make it appear.

You must be a member of a group to use this feature.

Add a quick update to your diary without changing the diary itself:
Are you sure you want to remove this diary?
(The diary will be removed from the site and returned to your drafts for further editing.)
(The diary will be removed.)
Are you sure you want to save these changes to the published diary?

Comment Preferences

  •  It would be really nice if the medical cost (11+ / 0-)

    growth holds up to scrutiny, which means we need to wait and see.

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

    by dinotrac on Sun Apr 20, 2014 at 07:40:31 AM PDT

    •  What exactly are you waiting for? (14+ / 0-)
      In the decade before the Affordable Care Act, employer-based insurance rose almost 8 percent a year.  Last year, it grew at half that rate. Under this law, real Medicare costs per person have nearly stopped growing.  The life of the Medicare Trust Fund has been extended by 10 years.  And the independent Congressional Budget Office now expects premiums for plans on the marketplace to be 15 percent lower than originally predicted.  
      •  The time needed to make a determination (2+ / 0-)
        Recommended by:
        dfarrah, patbahn

        ACA has just gone into effect.  Insurance companies were widely accused of jockeying rates around pre-ACA. The current rates may merely reflect that jockeying.

        As to Medicare costs -- I don't know what to make of that.  Is it an actual reduction in health care costs, a reduction in fraud, or what?

        Is it coming at the cost of quality care, or is it conommitant with better care?  I'm just 3.5 years from Medicare age myself. Will I be able to find good doctors when I need one?

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

        by dinotrac on Sun Apr 20, 2014 at 07:55:07 AM PDT

        [ Parent ]

        •  So I am wondering where we will be if we go to (1+ / 0-)
          Recommended by:

          single payer in 3.5 years or around that time. Remember HRCs baby? It's looking like HRC will be the one.

        •  Insurance Jockeying (3+ / 0-)
          Recommended by:
          dinotrac, Galtisalie, Jesse Douglas

          When it comes to medical care, I'm a Socialist who believes in a single-payer system and no passive profit entities within the medical industry. Yes, yet some rates will increase more than expected. It will take time to examine the areas of abuse and fix them.

        •  Fraud IS a Cost (0+ / 0-)

          As for your assertion. . .

          Insurance companies were widely accused of jockeying rates around pre-ACA.
          . . .that is, to borrow a phrase, "Republican vaporware," created and bruited about by Avik Roy and a pair of his colleagues from the Manhattan Institute, a conservative think tank.

          If you want to wait around and see if any more manufactured out of wishful hate right wing "concerns" and prediction come true, go ahead.

          The rest of the reality based community and all the beneficiaries of ACA will continue to march forward without you.

          Readers & Book Lovers Pull up a chair! You're never too old to be a Meta Groupie

          by Limelite on Sun Apr 20, 2014 at 08:39:13 AM PDT

          [ Parent ]

        •  it's ending wasteful medicare billing (1+ / 0-)
          Recommended by:

          now the DHHS can tally up who bills for what
          and what works and they are using evidence based

          procedures are now approved to codes.

        •  In regards to Medicare, part of the (1+ / 0-)
          Recommended by:

          ACA encompasses tools to root out fraud and waste in Medicare costs.  Billions of dollars has already been recovered.  Medicare has always been a sought after target for companies that make medical devices; jack up the price to the government and you are on easy street; the double billing of hospitals and doctor's offices has also been abused.

          The ACA addresses these problems and has had good results.  Is there still fraud?  Of course, but we are on the road to combat it.  What is recovered is put back into the Medicare program.

          •  Yes, the DOJ recovered $4 billion last year. (0+ / 0-)

            Health care fraud task forces now operate in several major cities.  People, including several doctors, are are being sentenced to upwards of 30 years in prison.   This began when Obama was elected, before the ACA was enacted unfortunately that $4 billion is only a fraction of the estimated $60 billion or more paid out in Health Care Fraud.

            Freedom of speech, in my view, does not mean the freedom to buy the United States government -- Bernie Sanders

            by OnePingOnly on Sun Apr 20, 2014 at 06:37:10 PM PDT

            [ Parent ]

            •  Yes, you are right, it has been known (0+ / 0-)

              since the beginning of Medicare that fraud and waste took place.  However, it was the ACA that gave the CMS (Centers for Medicare & Medicaid Services) the tools to better enforce the measures used.  The crooks were fined but rarely prosecuted.  

        •  I'm ON Medicare (0+ / 0-)

          Relax, I'm on Medicare and have zero about which to complain.  I'm not getting the 100% coverage I used to have (yup, no co-pays, 100% coverage) but I'm not having to pay the rates that straight Medicare offers.  I'm on Medicare Plus and if you are fortunate enough to have it available, great, but if not, you can get Medi-Gap insurance.
          You will pay around $110 a month for your Part B coverage, but it's worth it.
          My ONLY concern is if the Licans win in the mid-term elections, they will try to cut the payments to the Medicare providers, I hope they lose big time.
          Also, prior to the prohibition of refusing to insure people with preexisting conditions, I could not get Medi-Gap insurance, now I can, but because of cost, I won't.
          So as I said, RELAX, unless the Licans screw around with Medicare payments, you'll do okay.

    •  Wait & See? (11+ / 0-)

      Anyone w/ a preexisting condition who was denied insurance before has already seen what they need to see.
      They've already waited too long.  

      Families who couldn't afford insurance no longer have to take their kids to the ER during a medical crisis.  They've
      already waited too long.

      Seniors who had to split pills, can now take their full prescriptions.  And....they are saving an average of $640
      dollar on their prescription meds.  They've already waited too long.  

      14 MILLION people are not required to wait any longer.

      •  The reference was to costs, not to insurance (0+ / 0-)

        Out of curiosity...

        I keep seeing all these strange numbers. Another day, another number.

        What does that 14 million represent?

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

        by dinotrac on Sun Apr 20, 2014 at 08:54:17 AM PDT

        [ Parent ]

        •  The Rate Of Uninsured Has Dropped From l8%..... (0+ / 0-)

          last fall to 12.9% in the first half of April 2014.  That represents the l4 MILLION now insured under the Affordable Care Law.

          If the numbers were skewed and/or rigged, the rate of uninsured in this country would have remained flat.

          Not happening.  

          •  12.9% is a very nice number. Last number I (1+ / 0-)
            Recommended by:

            saw was a Gallup poll through the end of February and it was 15.4%.

            If 12.9% is true, then we've finally got the rate of uninsured people below the levels of the Bush administration, which were in the 14.5% range.

            By my calculations, that would actually be closer to 16 million than to 14 million, but that is just an outside number based on highest to lowest, ignoring polling error. The real number would be something less than 16 million.

            Your wording is very interesting -- "under the Affordable Care Law".

            I think I like that, because it doesn't imply anything one way or the other about why the numbers are lower. Strikes me as more honest than the White House has been.  Certainly some of those 14 million (or 16 million or whatever) are due to the Affordable Care Act. Likely as not, the lion's share of them.  However, employment has also been creeping up, so some of those people would have been insured anyway.

            As to fudging numbers -- I think the conversation was about insurance companies jacking up rates, not fudging statistics.

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

            by dinotrac on Sun Apr 20, 2014 at 09:28:41 AM PDT

            [ Parent ]

            •  Gallup has more recent results (2+ / 0-)
              Recommended by:
              dinotrac, Patango

              Here are Gallup's April survey results.

              They are saying 4% of the ADULT population are newly insured. That comes to about 10 million. Some children will also be newly insured.

              •  And just over half of those -- about 5 million, (1+ / 0-)
                Recommended by:

                signed up through the exchanges.

                A little disappointing given how much disruption, pain, and money has gone into the process, but next year could be better, especially if the process is fixed.

                I wonder how many people either stayed away or gave up this year because of all the problems?  This year's very low penalty made it easier to say "screw it" than will future penalties.

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

                by dinotrac on Sun Apr 20, 2014 at 10:47:05 AM PDT

                [ Parent ]

            •  Later Gallup (2+ / 0-)
              Recommended by:
              dinotrac, Shawn87

              The 12.9% uninsured is their preliminary polling result for first half of April, as such should be considered tentative. But it's very hopeful.

              These findings were announced at “An Inside Look at Gallup’s Healthcare and ACA Data,” an event held today at Gallup’s World Headquarters in Washington D.C. some key findings: There has been a statistically significant and meaningfully large decline in the percentage of uninsured U.S. adults. The uninsured rate peaked at 18.0% in the third quarter of 2013, the highest rate measured since Gallup and Healthways began tracking in 2008. The uninsured rate has been consistently trending downward since then, falling to 15.0% in March and further to 12.9% for April 1-14 polling. If the rate for the first half of April holds throughout the month, it will be the lowest monthly uninsured rate in 76 months of tracking.

              The GOP bet on [Obamacare] failure. And they lost the bet - Josh Marshall

              by rsmpdx on Sun Apr 20, 2014 at 11:20:58 AM PDT

              [ Parent ]

        •  The ones who have been (1+ / 0-)
          Recommended by:

          crowing the most about ACA refuse to answer questions about deductibles.  There has been some strong objection to ACA based on the deductibles.

          Sure, all these people can now go for regular doctor visits and pre-existing conditions can be covered.

          What happens when the big stuff hits?  

          And why are people so excited about enrollments when ACA required enrollment [or pay the fine]?  It's like DK has become one big propaganda machine.  

          The banks have a stranglehold on the political process. Mike Whitney

          by dfarrah on Sun Apr 20, 2014 at 09:24:25 AM PDT

          [ Parent ]

          •  The CBO Predicts Premiums Will Be l5% Lower.... (1+ / 0-)
            Recommended by:

            than expected under the Affordable Care Law.

            Medical costs are now growing at less than l/2 the previous rates due to the Affordable Care Law.

            Previous to the Law, employer based insurance increased almost 8%.  After 2013, it grew at half the rate.

            And....the life of the Medicare Trust Fund has been extended 10 years due to the Affordable Care Law.

            •  Again, why doesn't (2+ / 0-)
              Recommended by:
              dinotrac, Patango

              anyone ever say anything about the deductibles?

              So what if premiums go down?  In and of itself, the data on premiums means nothing.  Lower premiums usually mean higher deductibles in the insurance world.

              Further, just repeating the same thing over and over is not convincing.  

              The banks have a stranglehold on the political process. Mike Whitney

              by dfarrah on Sun Apr 20, 2014 at 10:48:05 AM PDT

              [ Parent ]

            •  That's a loaded phrase, btw -- (0+ / 0-)

              Two squish zones:

              "Predicts" and "than expected".

              If previous expectations were set high, it's easier to come in lower.

              And -- previous expectations were, by definition, themselves predictions, so...

              it amounts to "We were wrong before, but surely we're right this time."

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

              by dinotrac on Sun Apr 20, 2014 at 10:54:25 AM PDT

              [ Parent ]

          •  Yeah, and the most popular plans are Silver and (0+ / 0-)

            Bronze, which leave us on the hook for a substantial pile of money.

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

            by dinotrac on Sun Apr 20, 2014 at 10:52:40 AM PDT

            [ Parent ]

            •  Some people like big deductibles and lower premium (0+ / 0-)

              and in fact for some people it makes more sense. So the popularity of these plans by itself can't really be considered either a good thing or a bad thing without more understanding of the situations of the people who chose them. There need to be more "what if" scenarios for people to consider when signing up for a plan.

              Perhaps in the next enrollment period, people who are re-enrolling could be given the chance to enter their actual costs incurred in the current period, along with whether they expect their healthcare utilization to be similar, higher, or lower, and give an actual total out-of-pocket cost comparison taking into account premiums, deductible, and co-insurance.

              It also strikes me that if we know the annual premium, deductible, co-insurance rate, and out-of-pocket maximum for each plan, that it then becomes possible to calculate the actual dollar amount of healthcare utilization where a higher-premium/lower deductible plan crosses the threshold of being less costly than a lower-premium/higher deductible one. Granted, it is extremely difficult to estimate one's healthcare utilization amount given the murkiness of medical billing. But there can be average costs of various procedures within one's region presented if a decent job of data gathering is done.

              Given the embracing of electronic medical records that is part of the ACA, it might even be possible to automatically aggregate past utilization and present it in a format like:

              Based on your previous utilization of $X per year, plan A provides the lowest total out-of-pocket cost if the same amount holds. If it goes down by at least $Y, then plan B would become less costly. If it goes up by at least $Z, then plan C would become less costly. And so on, for other plan levels. Then list the actual differences in cost at various thresholds so people can see just how much of a financial risk each choice is.
              Of course, it must be worded only to give the results of calculations based on various scenarios. It should never say that based on one's history, that a certain plan is recommended. In fact, this might even be forbidden if I recall correctly.

              Too much of the jargon of insurance is gibberish to an average consumer. If I went around my workplace and asked what the difference is between deductible and co-insurance, I expect to get way more blank stares than actual answers. But saying that if your total bills are this, then your actual annual out-of-pocket cost is that, and making these numbers easy to compare from plan-to-plan, we just might see more people making closer to optimal decisions.

              •  Agreed. It isn't necessarily a bad thing to take (0+ / 0-)

                a smaller premium, and assume more back-end risk yourself.

                One unfortunate side effect of ACA is that it's harder to make optimal decisions when you have fewer choices.  Might be unavoidable.  Not sure.

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

                by dinotrac on Mon Apr 21, 2014 at 12:42:20 PM PDT

                [ Parent ]

    •  Thanks for the right wing talking point (3+ / 0-)
      Recommended by:
      tb mare, Patango, Shawn87

      We can depend on you.

  •  If the GOP must only think about their pocket book (4+ / 0-)

    The lives saved by insured medical care will pay taxes -- balance sheet humanity.

  •  Roseanne Roseannadanna narrative may soon (3+ / 0-)
    Recommended by:
    88kathy, tennegirl, rsmpdx

    be all that the Republicans have left on ACA and Medicaid expansion:

  •  12 Nation Comparison (6+ / 0-)

    Roughly, the U.S. spends nearly twice as much as peer nations to obtain the same outcomes.

    And most of that comes from our higher overhead costs, not by overtreatment. Insurance companies, even under new obamacare regulations, are allowed to have 30% overhead. In addition, providers easily spend 20% of their income on the overhead needed to deal with insurance companies (e.g. billing, prior authorizations, fighting denials, etc.).

    The dirty secret of public health programs is that most of the savings they get is from reducing administrative costs by cutting out the middle man, not really from rationing care. Many European countries have higher per-capita annual hospital days, doctor visits, etc. than the U.S.

    The next biggest chunk of savings is negotiating discounts on everything from pharmaceuticals to physician services.

    These 2 things alone, without even beginning to change how health care is actually delivered (e.g. eliminating unnecessary care, improving preventive care, etc.) would get us 95% of the savings that other countries see.

    That means that aside from eliminating the 50% in overhead that we tolerate here in the U.S., public health systems aren’t really spending less, or somehow making more efficient use of medical advances than the U.S.

    The 12 nation comparison report can be found at the Commonwealth Fund, A private foundation working toward a high performance health system.

    You Don't Happen To Make It. You Make It Happen !

    by jeffrey789 on Sun Apr 20, 2014 at 07:50:55 AM PDT

    •  Your linked article seems orthogonal (0+ / 0-)

      to the points you write about.

    •  Greatly exaggerated (3+ / 0-)
      Recommended by:
      hooper, rsmpdx, Sophie Amrain

      The Medical Loss Ratio (or in English, what insurance companies have to pay out) is either 80% or 85% of premiums collected, depending. Overly generous, but nothing like the 30% you seem to be quoting with no actual source given. The 30% number appears only in a comment to this Right wing article which claims to be quoting an unpublished editorial.

      Please learn to distinguish between facts and truthiness.

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Sun Apr 20, 2014 at 08:52:22 AM PDT

      [ Parent ]

      •  please provide a source for 85% (2+ / 0-)
        Recommended by:
        jeffrey789, Greyhound

        While you're getting that source, let me note that the comment you are attacking is making an incredibly important point.  US health care is expensive mainly because of payer structure, not because of overuse of healthcare resources.

        Why anyone would dispute that obvious point is beyond me, and that's true even if you give me a good source for 85%.

        The ACA is better than the Republican alternative, of course, and Democrats should campaign on that, but it still retains and subsidizes the inefficiencies of multiple for-profit health insurers and the provider level bureaucracy needed to deal with the insurers.

        Democrats should embrace it because it's better than the Republican alternative, but I'll still support moving to something even better.

        •  US healthcare is too expensive because everyone - (1+ / 0-)
          Recommended by:

          absolutely everyone - charges waaay too much.

          Every tube, medicine, device, billing service, furniture provider, hospital, insurance company, surgery supply maker, etc.

          They're just pigging out on a market that can't say No.  

          If you really want to understand this, please read Elizabeth Rosenthal's truly awesome series from the NYT.  Here's a review of it...

          And here's the series ... rosenthal

          Single-payer would be an improvement but is not a magic answer.  These costs must be cut, which means less profits for the pigs.  Not necessarily less care or service.

          •  So... (0+ / 0-)

            1) You didn't address my point about the number "85%", but in fairness, you aren't the person I asked.

            2) You don't seem to disagree with me that the primary difference between the US health care system and other rich nation health care systems is the existence of a Byzantine network of private insurers, and the administrators needed to deal with that.  I assume you agree that this is the primary difference.  

            "Single-payer would be an improvement but is not a magic answer."

            No-one said anything about "magic" except you.  But it would certainly have a profound impact.

            "These costs must be cut,"

            I probably don't disagree with this, but still, this is just you sounding exactly like some right wing authoritarian pundit.

            Instead of bloviating about what "must" be done, let's ask a relevant question - are these costs different in the US from in other rich countries?  If they are higher in the US, what to comparable economies do to keep them down?

            "which means less profits for the pigs.  Not necessarily less care or service."

            There are two words here which disturb me.  "Pigs", of course, but also "necessarily".  

            Well, it seems as if you have some private crusade against, in your own words "Every tube, medicine, device, billing service, furniture provider, hospital, insurance company, surgery supply maker, etc".  There may be some validity to your view.  Alternately you may be motivated by some sort of unreasonable personal animus.

            I'm a simple person, I just think that Americans should enjoy similar quality health care at similar cost to other rich nations, rather than paying more and receiving less.  

            •  I guess you didn't read the info? (0+ / 0-)
              •  lazy answer (0+ / 0-)

                I'm not saying that medical disposables aren't excessively marked up in the US.  They probably are.

                I'm pointing out that the big difference is the payer system.  Either say you agree with that or say that you don't.

                I'm also asking whether you have information that medical disposables are more marked up here than in other rich countries.  If you do, say that it is and link DIRECTLY to a citation that supports you.  Don't do the troll trick of claiming it's buried in some massive pile of links.

                I'll ask another question - if medical disposables are more marked up here, how much of the cost difference between us and other rich countries does that account for?

                Actually, though, don't worry.  The above was all rhetorical, just to demonstrate to third party readers that you won't engage in a rational discussion.  Don't do anything.  I won't be checking for a reply anyway.  

                •  I'm tempted to match your rudeness. Do you treat (1+ / 0-)
                  Recommended by:
                  Sophie Amrain

                  others this way, or just people on blogs?  But, to stay on topic...

                  You seem to be attached to the idea that the payer system is the entirety or most of the entirety of the problem with medical costs.  I provided extensive (and a non-extensive summary) evidence that other factors are very big.  You did not read any of the info, calling my providing of data backing up my point a "troll trick."

                  I do actually agree that the payer system is an important factor.  Maybe not the most important, now that it's been improved, but important.  A single-payer system could put more pressure on suppliers, for example, depending on how it's written.

                  The 85% figure you asked about is the medical loss ratio, that provision of the ACA that stipulates that private insurance companies are required by law to spend 85% of premium dollars on actual patient care.  If administrative costs exceed 15%, the insurance company is forced to send rebates to the patients.  Not 30%, as someone wrote above, but only 15% can go to profits & other overhead.

                  Anyway, you'll believe what you believe.  I still recommend Elizabeth Rosenthal's fine reporting (linked above) if you'd like to learn more.

                  Happy Spring.

        •  Source for mokurai's 85% (1+ / 0-)
          Recommended by:
          Sophie Amrain

, Medical Loss Ratio

          The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement, also known as the Medical Loss Ratio (MLR). It also requires them to issue rebates to enrollees if this percentage does not meet minimum standards. MLR requires insurance companies to spend at least 80% or 85% of premium dollars on medical care, with the review provisions imposing tighter limits on health insurance rate increases. If they fail to meet these standards, the insurance companies will be required to provide a rebate to their customers starting in 2012.
          let me note that the comment you are attacking is making an incredibly important point.  US health care is expensive mainly because of payer structure, not because of overuse of healthcare resources.

          Why anyone would dispute that obvious point is beyond me, and that's true even if you give me a good source for 85%.

          Good general point. Better still when not exaggerated and supported by authoritative sources.

          The GOP bet on [Obamacare] failure. And they lost the bet - Josh Marshall

          by rsmpdx on Sun Apr 20, 2014 at 01:19:39 PM PDT

          [ Parent ]

  •  The key here is to... (5+ / 0-)

    encourage the GOP to continue their drumbeat of lies and deception regarding the ACA. It is becoming more and more obvious to the masses every day. Once people realize that the GOP has been lying about the ACA all along, we set a benchmark that can be referenced going forward.
    Note, they use the same tactic on EVERY issue. They bombard the citizenry with a steady diet of fear/hate mongering. Next time they do this, we can say, "there they go again, remember what they said about the ACA?"

  •  GOP looks on as Americans die (4+ / 0-)

    There are many positive things to say about Obamacare, but  the GOP must be held responsible for deliberately withholding from millions of Americans the health care those Americans could have had but for the obstruction by GOP governors and state legislatures in certain states.  The GOP Medicaid deniers have the blood of Americans on their hands and they should be made to pay, if not criminally, at least politically.

    •  ^^THIS^^ needs to be told, LOUDLY (1+ / 0-)
      Recommended by:
      Calamity Jean

      It isn't Democrats who are deliberately denying healthcare to many citizens. It's the freakin Republicans - from the Conservative wackos on SCOTUS, who decided to make Medicaid expansion optional, to those states who took the SCOTUS' marching orders, and followed through by refusing to expand Medicaid in their states.

      Denying healthcare to millions, under the guise of fiscal responsibility just flies in the face of EVERY possible kind of Christian compassion and COMMON FREAKIN SENSE!

      "Save a buck - kill a citizen".

      America's LAST HOPE: vote the GOP OUT in 2014 elections. MAKE them LOSE the House Majority and reduce their numbers in the Senate. Democrats move America forward - Republicans take us backward and are KILLING OUR NATION!

      by dagnome on Sun Apr 20, 2014 at 01:26:05 PM PDT

      [ Parent ]

  •  Reacting To Or Try To Change Public Opinion (2+ / 0-)

    Always though that people who get into politics do it because they want to change public opinion not just react to it. Maybe Democrats in contested districts start out that way and feel that they have to change to the reactive approach to survive. Couple of things about public opinion regarding the ACA. It has been shown that approval lose a few percentage points because of liberals who do not think it goes far enough. So even after people accept it as policy I feel it will be quite awhile before it ever gets to 50% approval. Second public opinion changes and the numbers will drift up in approval. Will drift up even more if the Party that passed the damn thing stand up in unison in promoting it right now. Many point out the disastrous Democratic midterms of 1994 and 2010. Examples are made of people who went down fighting for the party. Might be wrong but I think there are many more who went down because they tried to moderate their views in the face of the GOP onslaught. Ben Franklin's words at the signing of the Declaration fit here.  "You must all hang together, or assuredly you shall all hang separately"

    •  I'm one of the liberals... (2+ / 0-)
      Recommended by:
      Leo Flinnwood, Calamity Jean

      Who doesn't think it goes far enough.  About one in six Americans feels this way (although I could easily increase that to about 70% by asking in a poll "would you prefer a Canadian style system to either the ACA or what we have now?")

      That means that Democrats can count on my vote.  I won't be supporting Republicans.

      Therefore they should see that they can campaign positively on the ACA.  They've got my vote.  The percentage of the public who opposes the ACA because it "isn't conservative enough", and prefers doing nothing, is about 35%.  The other two thirds either like it, or want even more.

      But they won't, because the fundamental point of being a Democrat politician is to ignore all the low-hanging fruit of progressive ideas that super-majorities support, and hamstring yourself trying to be a Republican Lite.  I'm not totally sure why that is, but I think it's because all the "Democratic strategists" are yuppies who graduated from college in the 1980's, and haven't had a new idea since.  Also because the logical leap that campaigning on popular ideas is good even if a few big donors are uncomfortable about them, because donors aren't worth crap if you lose the election anyway, is hard to make.

      •  Don't Have Faith In The Advisors Who Work With (0+ / 0-)

        Democrats in contested districts. Think the factors you mention enter in to why they approach it in this fashion. Think they are also very cynical and think that is the only way they can win. Not impressed with their track record though. Have had really only 2 successful election years of late. I've read where some of them are proud of their victories in 2006 and 2008. In 2006 the GOP was seen as mismanaging  two wars and lying to get us into 1. In 2008 the wars were still continuing an the economy was in free fall. Never easy but that made it a whole lot easier to win. So I guess for Democrats to do well we have either a Presidential election or the GOP completely fuck up.

  •  Skewed numbers (3+ / 0-)
    Recommended by:
    snapples, Delevie, mjd in florida

    The Right are now complaining that the numbers are phony, but when asked how, they hit the mute button.

    If the enrollment numbers were phony, the uninsured rated would be flat, but organization like Gallup show that isn't true.

  •  It was refreshing (2+ / 0-)
    Recommended by:
    Delevie, Calamity Jean

    to see the President stand in the endzone and spike the football with his speech. It will be an interesting next 6 months.

    If you are not the lead dog, the view never changes.

    by RepresentUsPlease on Sun Apr 20, 2014 at 08:09:33 AM PDT

  •  Outstanding! (6+ / 0-)

    Republicans always align themselves as fiscally conservative and morally righteous job creators who are in a tizzy about the deficit.  Yet, here Democrats have them by the shorts on every angle.

    It's fiscally radical to be against Obamacare which reduces premium costs and has cut rising medical costs in half;

    It's morally reprehensible for Republican governors and legislatures to behave as death panels and condemn the citizens of their states to suffering and early mortality out of spite;

    It's rank lying to say tax cuts create jobs when Obamacare does -- hundreds of small business entrepreneurs can now fearlessly risk opening businesses without fearfully risking bankruptcy and non-competitveness because of soaring health care coverage and benefits;

    It's hypocritical to wrap oneself in the banner of reduced deficits while trying to kill (repeal ACA) the gift horse that is lowering the deficit.

    Only an idiot would oppose Obamacare.

    Only an idiot would not campaign as an enthusiastic supporter of Obamacare and as one who wants to improve it and enlarge its scope.

    Unfortunately, there are a lot of idiots in the marketplace.

    Readers & Book Lovers Pull up a chair! You're never too old to be a Meta Groupie

    by Limelite on Sun Apr 20, 2014 at 08:10:13 AM PDT

  •  Dems - don't play defense (1+ / 0-)
    Recommended by:

    I think Obama was, in typical fashion, way to timid in his "advice" to Democratic candidates.

    Do not "defend" the ACA. Trumpet the ACA and the good it's done already.

    • Eight million signed.
    • Elimination of the horrific pre-existing conditions exclusion denial
    • Young adults can be covered under their parents policy
    • Financial assistance to make decent healthcare available to all

    That's just a few starters.

  •  "Economic security"?!?! Seriously? When you (2+ / 0-)
    Recommended by:
    a2nite, dfarrah

    have a $4,000 deductible on your Obamacare plan, you're totally fucked if you get sick. Single-payer now!

  •  What % Of The 14 MILLION Have $4000 Deductible? (1+ / 0-)
    Recommended by:
    Sophie Amrain

    Where can we go to find that statistic?  

    •  Not the very low income with Silver (4+ / 0-)

      People with less than something like 250% or 300% of poverty who  bought a Silver had their deductibles and copays subsidized. They aren't looking at $4000+ deductibles.

    •  I thought more (0+ / 0-)

      had $12,000 deductibles.  

      What is correct?  A FP-er wouldn't respond to a poster's question about deductibles.

      The banks have a stranglehold on the political process. Mike Whitney

      by dfarrah on Sun Apr 20, 2014 at 09:33:53 AM PDT

      [ Parent ]

      •  Highest annual out-of-pocket is $6350 (1+ / 0-)
        Recommended by:
        Sophie Amrain

        which includes both deductibles and copays.

        So for a couple, that could be a total of $12,750 if they are both really really sick the same year.

        Different policies are different on how much of the out-of-pocket is in co-pays and how much is deductibles that you have to pay 100% before any coverage kicks in at all. (The navigator who helped me choose was very good at pointing that out.) My policy (Bronze) begins paying immediately -- less of the $6350 is a straight deductible, and more is in higher co-pays. For example, when I see a specialist later this month, I will pay I think $60 co-pay, and Blue Cross will pay $90. That will be the first co-pay I've made; my annual check-up, cholesterol check, and mammogram had zero co-pays as "preventative." So I would have to have extremely high medical costs to get near the $6350 out of pocket, and in the meantime, the coverage is already saving me money.

        •  The 6,000 is definitely (0+ / 0-)

          better than 12,000.

          What do you pay monthly, if you don't mind?  I'm covered by my employer and I pay part of the monthly premium.  I'm with Kaiser; my co pays are fairly low.

          The banks have a stranglehold on the political process. Mike Whitney

          by dfarrah on Sun Apr 20, 2014 at 11:14:45 AM PDT

          [ Parent ]

  •  In fact, (0+ / 0-)

    Back off, man. I'm a logician.—GOPBusters™

    by Mokurai on Sun Apr 20, 2014 at 08:31:15 AM PDT

  •  Trouble is the neocon base... (1+ / 0-)
    Recommended by:

    They have no trouble sticking their hands in their rich Uncle Sam's pockets to get theirs...but when it comes to voting, they still vote religiously for their neocon politicians...and the failed policies that they have clung to for over three decades...even if it goes against their best interests.

    It might be religious fundamentalism or just plain stupidity, but until this problem is pinned down and corrected in some way, we will always be stuck with a political party that can use people to further it's own ends...and that of their greedy rich campaign the detriment of the rest of society.

  •  Strong Stand (2+ / 0-)
    Recommended by:
    Galtisalie, dfarrah

    Since, when it comes to medical care, I am a Socialist who believes in a single-payer system paid for by a progressive health care tax, there should be no for-profit entities involved in the medical industry. The private insurance industry should not exist. ObamaCare is a small step which tries to correct some flaws and abuses in the present system.
    It has weaknesses that are being exploited by the medical industry. The motives for good medical care and those for corporate profits are in opposition to each other.

  •  Latest Fox News update (1+ / 0-)
    Recommended by:
    Calamity Jean

    As I imagine it:

    •  You are the third one to do that (0+ / 0-)

      @LOLGOP did one, and another appeared elsewhere on dKos. I put them both into my ACA Signups Diaries. BTW, brainwrap is back doing those diaries. He thinks he may be able to resume posting here regularly now that the fire hose of data is supposed to be coming down to a trickle.

      But what about the flood of Republican exploding heads, with 8 million exchange signups, and 26 million or more covered overall? That's what we really want to know about.

      Back off, man. I'm a logician.—GOPBusters™

      by Mokurai on Sun Apr 20, 2014 at 08:58:09 AM PDT

      [ Parent ]

      •  yeah, i know (0+ / 0-)

        It's pretty irresistible. Meanwhile, I doubt many GOP heads will be exploding. Most are still in denial about Obama's election, and I don't particularly expect the people who still think ACORN is behind every "stolen" election to admit that the ACA is working. Years of "unskewing" is more likely.

  •  Obamacare (1+ / 0-)
    Recommended by:

    Folks need to remember that Republicans and Democrats wrote the ACA and voted for it in the House and Senate, and signed by the President.  The Supreme Court declared it Constitutional.
    Folks also need to think about who is benefiting from the ACA and who is not.  Republicans, Democrats, Independents, and members of smaller Political parties have signed up from all 50 states for an ACA plan they like. The people in the states where the legislatures and governors expanded medicaid for those qualifying in their state. All Democratic governors expanded medicaid for their citizens and a few Republican ones did as well. (I recall (AR, AZ, PA, and maybe another).
    Obamacare is here to stay and this is only the beginning and will expand as states and governors participate.

    SO, let's all calm down and get well together.  

  •  BO, the gasbag: (0+ / 0-)

    Democrats should forcefully defend and be proud of the fact that millions of people like the woman I just described who I saw in Pennsylvania yesterday we’re helping because of something we did. I don’t think we should apologize for it. I don’t think we should be defensive about it. I think there is a strong good right story to tell. I think what the other side is doing and what the other side is offering would strip away protections from those families and from hundreds of millions of people who had health insurance before the law was passed but never knew if the insurance company would drop them when they actually needed it or women who were getting charged more because they are a woman.

    My eyes were glazing over before I even finished reading this.

    BO's speechwriters need to think:  how would EW say this, and then pare it down.

    From now on, dems need to use a Warren speech-translator to change all the wind into something easy on the ears and easy to understand.

    The banks have a stranglehold on the political process. Mike Whitney

    by dfarrah on Sun Apr 20, 2014 at 09:15:51 AM PDT

  •  The healthcare message should also be the (1+ / 0-)
    Recommended by:
    Calamity Jean

    following. It can be modified for the governors of other states.

    Many people are suffering and dying because Governor Deal refuses to expand Medicaid to hundreds of thousands of Georgians. The expansion is free the first three years, equals 95-93% the next three years and then equals 90% in subsequent years. The governor refuses to provide the critical care for which citizens have already paid.

    What Governor Deal is doing is cruel and political. Deal is partially responsible for the current and future sufferings and deaths of numerous residents of our state. I don't know how he sleeps at night.  

  •  honesty (0+ / 0-)

    Could we be honest enough to say that we've embraced both a culture and a socioeconomic agenda that stands in opposition to any agenda to improve the overall health of Americans, thereby reducing medical costs? This is the generation that brought the "war on the poor" to fruition, and the fact that we ignore it doesn't change the reality. Not everyone can work, due to health or circumstances, and there simply aren't jobs for all who need one right now. With this generation, America decided to cull out our surplus population, those who are not of use to employers/the corporate state. We cut them off, deciding they are undeserving of the most basic human rights of food and shelter. Without adequate food and shelter, living under the profound stress experienced by those pushed into poverty, health quickly deteriorates.

  •  Mr. President, Mr. President, a few questions (0+ / 0-)

    if I may?

    1 - Why were members of your State Department caught publicly encouraging protesters to overthrow the Ukrainian democratically elected government?

    2 - Why were those same "diplomats" also caught on tape discussing replacing the government and deciding who / who would not be in power?

    3 - As the U.S. State Department was openly plotting the overthrow of a foreign Democratically elected government, how do you reconcile such actions of your administration with rhetoric about self-determination and democracy?

    4 - If the U.S. State Department was caught openly plotting the overthrow, what covert actions - not exposed - did your administration take to destabilize the Ukrainian government?

    5 - The "Aid" package which has been given to Ukraine: Can you tell us what percentage will actually go to the Ukrainian people and what percentage will go to private banks to which Ukraine is indebted?  Can you elaborate on what Neoliberal Austerity measures, similar to Greece, Spain, Portugal, etc. - will be imposed on the people of Ukraine for accepting this "Aid"?

    6 - How do you explain the apparent coincidence between your foreign policy objectives & actions, relating to Libya, Syria, and Iran, and those which were published in the 90's by the Project For A New American Century?  Are you worried that the Democratic base might eventually catch on and begin to suspect D vs. R is a staged pie fight, using social issues to keep folks distracted while common Neoliberal, Military, and Police State policies are advanced with equal gusto by the D & R brands?

    Never mind. This is America.  Keep spying on us and tell us again how bad Assad, Putin, and Iran are.  I'm certain the majority of Americans will clap themselves silly.

    The 1% are Purists: They only support Candidates that Deliver Results They Can Bank On. Don't they know they should compromise? /sarcasm

    by Johnathan Ivan on Sun Apr 20, 2014 at 09:55:54 AM PDT

  •  Dems should campaign on what this is really about. (3+ / 0-)
    Recommended by:
    Matt Z, dagnome, Calamity Jean

    The people who own the Republican party don't want Americans to have affordable health care, because they want Americans who can't afford expensive health care to die.

    Make this the existential battle it really is.

    American Presidents: 43 men, 0 women. Ready for Hillary

    by atana on Sun Apr 20, 2014 at 10:15:44 AM PDT

  •  I'm a big believer in the ACA...but... (0+ / 0-)

    It's still not nearly enough.  We all still have to pay monthly premiums IN ADDITION TO all the money we're forking out for useless MIC spending.  In other words,  I'm already paying my premiums.   Give me total value for my tax dollars.

    What's the difference between the Federal government and organized crime? One's legally sanctioned.

    by FrankenPC on Sun Apr 20, 2014 at 10:25:48 AM PDT

  •  The new RW talking point (3+ / 0-)
    Recommended by:
    Patango, Sophie Amrain, Calamity Jean

    seems to be OMG!!!! Medical costs are skyrocketing as all those newly insured and Medicaided people get medical services!!!!

    I would anticipate a short-term spike in costs, as people address all the health issues they've been putting off. (That has happened regularly in the first year after people turn 65; I know plenty of people for whom that was their first-ever coverage, so the knee or shoulder or hip or digestive problem or diabetic work-up could finally get addressed.)

    It may take a year or two for the cost curve to bend -- for diabetics to stabilize, the backlog of stuff to get worked through, providers to put into place the measures to prevent rehospitalization, and the preventative care provisions to actually improve people's health.

    We won't have any data worth analyzing for a couple of years -- way too slow for the 24/7 instant "Breaking News!!!!!!!" cycles.

  •  I'm on Medicare Plus, but... (0+ / 0-)

    I fully intend on using the PPACA as a reason for people to get rid of the Licans who are so opposed to it but have NO ideas of what to replace it with.

    Let's face it, the Licans are opposed to ANYTHING that helps HUMAN BEINGS unless they have billions of bucks, then they want to give them MORE tax breaks.

    The Licans and their racist comrades who call themselves the tea party are out of ideas, out of date, and should be voted OUT of office, regardless of what office that is.

    If the Licans get the House and the Senate the people of the United States are screwed.

    President Obama might as well take a two year vacation because he will be totally impotent--there will be NO action on ANYTHING in Congress.

    If the American people think that the Congress is useless now, just wait...a Lican takeover will bring this country to a total halt, nothing will be done and the possibility of great damage will be essentially a done deal.

    One of the first things that will happen is that the Affordable Care Act will be repealed leaving millions of people without medical care...MILLIONS of people without affordable health insurance.

    If both houses are overtaken, there goes Social Security, Medicare, Medicaid...EVERYTHING THAT THE DEMOCRATS HAVE MADE POSSIBLE FOR THE PAST 70 YEARS!

    The Licans MUST lose or the American people will lose big.

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site