rickyp wrote:fate

On the other hand, when more people lose their insurance or find out how much it's going to go up this fall ...

Yes, this scenario is a game changer. After all, tt was over two decades of rapidly escalating health insurance costs, and health care costs, and the rapidly increasing size of the uninsured that finally forced the creation of the ACA.... (And the failure to offer up better alternatives or gain acceptance for Medicare for all...)

The ACA isn't the problem. Its just a not terribly good fix of the problem. That's why support for it can be low, but support for its repeal is so low as well.
There haven't been any ideas put forward that have also been accepted by a significant fraction of the populace. (With the exception of Medicare for all ...)

Fate

No, it doesn't. They wanted 7 million paid. We have no idea, according to the "always honest" Kathleen Sebelius, how many have actually paid. 20 million could have "signed up," but if only 3 million paid, then you've got . . . 3 million. It's funny: insurance companies tend to "not cover" those who don't pay

.

But they all vote. And they all have friends and family who vote. And if they are having their lives made better (By finally affording decent insurance) then how do you think they'll vote? And what will their stories do to influence people.

Familiarity breeds understanding, and acceptance.... And if you start trying to argue about taking it away (repeal) then you have a problem.
Those in the middle, who aren't ideologically blind, will care about how it affects the problem of health care costs and insurance costs and universal access.... And it has time for that message to be learned.

bbauska wrote:Not attributing anything to tribalism. Just asking what people think of Mr. Silver now. His predictions have been uncannily accurate.

Just sayin'...

rickyp wrote:http://www.salon.com/2014/02/21/are_republicans_even_trying_another_obamacare_horror_story_bites_the_dust/

I guess Fate, it will depend on how effective all the "horror" stories versus how many get debunked. And how effective the debunking is ....
Like the one linked to here....

Dear Congressman Brooks,



As a practicing family physician, I plead for help against what I can best characterize as Washington’s war against doctors.



The medical profession has never before remotely approached today’s stress, work hours, wasted costs, decreased efficiency, and declining ability to focus on patient care.



In our community alone, at least 6 doctors have left patient care for administrative positions, to start a concierge practice, or retire altogether.



Doctors are smothered by destructive regulations that add costs, raise our overhead and ‘gum up the works,’ making patient treatment slower and less efficient, thus forcing doctors to focus on things other than patient care and reduce the number of patients we can help each day.



I spend more time at work than at any time in my 27 years of practice and more of that time is spent on administrative tasks and entering useless data into a computer rather than helping sick patients.



Doctors have been forced by ill-informed bureaucrats to implement electronic medical records (“EMR”) that, in our four doctor practice, costs well over $100,000 plus continuing yearly operational costs . . . all of which does not help take care of one patient while driving up the cost of every patient’s health care.



Washington’s electronic medical records requirement makes our medical practice much slower and less efficient, forcing our doctors to treat fewer patients per day than we did before the EMR mandate.



To make matters worse, Washington forces doctors to demonstrate ‘meaningful use’ of EMR or risk not being fully paid for the help we give.



In addition to the electronic medical records burden, we face a mandate to use the ICD-10 coding system, a new set of reimbursement diagnosis codes.



The current ICD-9 coding system uses roughly 13,000 codes. The new ICD-10 coding system uses a staggering 70,000 new and completely different codes, thus dramatically slowing doctors down due to the unnecessary complexity and sheer numbers of codes that must be learned.



The cost of this new ICD-10 coding system for our small practice is roughly $80,000, again driving up health care costs without one iota of improvement in health care quality.



Finally, doctors face nonpayment by patients with ObamaCare. These patients may or may not be paying their premiums and we have no way of verifying this. No business can operate with that much uncertainty.



On behalf of the medical profession, I ask that Washington stop the implementation of the ICD-10 coding system, repeal the Affordable Care Act, and replace it with a better law written with the input of real doctors who will actually treat patients covered by it.



America has enjoyed the best health care the world has ever known. That health care is in jeopardy because physicians cannot survive Washington’s ‘war on doctors’ without relief.



Eventually the problems for doctors will become problems for patients, and we are all patients at some point.



Sincerely yours,



Dr. Marlin Gill of Decatur, Alabama

danivon wrote:A key difference. While politicians and rival pollsters attacked Silver in 2012 and are now, no one here is doing so now, but one or two here were keen to back then. And have the cheek to insinuate a paetisan motive in others.

A New York Times columnist has expressed substantially more negative sentiments about FiveThirtyEight since it left The New York Times, according to a FiveThirtyEight analysis.

The columnist, Paul Krugman, who writes about economics and politics for The Times, has referred to FiveThirtyEight or editor-in-chief Nate Silver 33 times on his blog. FiveThirtyEight classified each reference based on whether it expressed a favorable, unfavorable or neutral sentiment toward FiveThirtyEight.
Date FiveThirtyEight’s Status Sentiment
9/10/08 Independent Neutral
9/11/08 Independent Neutral
10/17/08 Independent Favorable
6/22/09 Independent Favorable
1/20/10 Independent Favorable
4/1/10 Independent Favorable
8/8/10 Independent Unfavorable
4/13/11 NYT Favorable
7/14/11 NYT Favorable
9/11/12 NYT Favorable
9/26/12 NYT Neutral
9/30/12 NYT Neutral
10/25/12 NYT Favorable
10/27/12 NYT Neutral
10/28/12 NYT Favorable
10/30/12 NYT Favorable
11/3/12 NYT Favorable
11/4/12 NYT Favorable
11/4/12 NYT Neutral
11/6/12 NYT Favorable
11/7/12 NYT Favorable
11/7/12 NYT Favorable
11/8/12 NYT Neutral
11/10/12 NYT Favorable
11/21/12 NYT Favorable
11/27/12 NYT Favorable
11/30/12 NYT Favorable
1/22/13 NYT Unfavorable
8/5/13 Dormant Neutral
3/18/14 ESPN Unfavorable
3/18/14 ESPN Unfavorable
3/23/14 ESPN Unfavorable
3/26/14 ESPN Unfavorable

One of my longstanding fixations, going back almost a decade now, is that we make a mistake when we think of liberalism and conservative as symmetric ways of thinking. On economic policy, at least, they are asymmetric. Liberals believe in activist government entirely as a means to various ends. Pollution controls are useful only insofar as they result in cleaner air; national health insurance is valuable only to the extent that it helps people obtain medical care. More spending and more regulation are not ends in and of themselves. Conservatives, on the other hand, believe in small government not only for practical reasons — this program will cost too much or fail to work — but for philosophical reasons as well.
A new political science paper by Matt Grossman and David Hopkins bears out this way of thinking about American politics. The authors find a fundamental asymmetry between the Republican and Democratic coalitions. They examined survey results and other data among voters, activists, and elites, and found that Republicans express their beliefs about government as abstract ideology (big government is bad) while Democrats express their beliefs in the form of benefits for groups. The differences are enormous:

Suppose a new barbecue restaurant opens up in town. Is it any good? On the one hand, you have traditional food critics. Imagine that you also have an equal-size group of meat-is-murder activists evaluating it. And whether or not you share their views on the ethics of meat, which you’re entitled to do, it stands apart from the question of whether people who do eat meat will like it. The traditional food critics may or may not like the place. They will tell you if the chicken is too dry. If the owner bungles the paperwork and can’t serve any food on opening night, they will probably be caustic. On the other hand, they’ll also tell you if it’s good.
The meat-is-murder activists, on the other hand, will predictably rip it to shreds. And, since the potential customer base for the restaurant does not include committed vegetarians, they will emphasize other reasons to shun the new animal death factory. The food is awful and overpriced. If the opening is delayed, maybe it will never open at all! Oh, it’s open now? The owner is probably cooking the books!

The real problem with Obama's announcement wasn't the tone; it was the false premise. Most of the people who he touted today had insurance before Obamacare came along. In fact, we've had two surveys in recent weeks. The McKinsey survey found that just 27 percent of sign ups were previously uninsured. Yesterday the LA Times revealed details from an unpublished RAND corp. survey which found that "about one-third" of all sign-ups were previously uninsured.

If we assume, best case, that 33 percent of the 7.1 million were previously uninsured, that works out to to about 2.3 million people. But as we all know by now, not everyone who signs up actually pays. The McKinsey survey found that previously uninsured people were far less likely to pay. In fact, just 53 percent followed through. To be generous, let's assume they bring this up to 80 percent. That means the total number of enrolled but previously uninsured people will be about 1.85 million.

That's a lot of newly insured people but it's only a tiny fraction of the 7.1 million announced today or the 45 million uninsured the administration said Obamacare was supposed to address. We've spent four years and hundreds of millions of dollars on websites and media outreach to pick up fewer than 2 million enrollees. And that's not to mention that the vast majority are receiving a government subsidy to offset the cost.

Obamacare will cost large U.S. employers between $4,800 to $5,900 per employee.

Large employers expect overall Obamacare-related cost increases of between $163 million and $200 million per employer, or an increase of 4.3 percent in 2016 and 8.4 percent in 2023 over and above what they would otherwise be spending.

Based on these data, the total cost of Obamacare to all large U.S. employers will amount to between $151 billion and $186 billion, or 5.9 percent more than what they would otherwise be spending.

geojanes wrote:Slightly off topic till the end but here's an illustrative anecdote:

An old family friend just got health insurance through Obamacare. He had a troubled life. He is an ex-con, and currently has a terrible truck driving job, which was the only thing he could get after being laid off from his factory job.

He has Hep-C and he’s been living without health insurance for at least five years. My brothers helped him figure out Obamacare and got him signed up a few weeks ago. Our family was going to pay for his premium, but it was only like $64 a month and he said he could swing that. For this 50+ year-old man, ex-con, former substance abuser, Obamacare is really awesome and will likely extend his life by many years: it’s not trivial.

So here's a guy who lived a bad life. He describes his younger years as completely crazy and he’s shocked he’s still alive. Some people might say that Obamacare is rewarding his previous anti-social behavior: it’s not like he spent his youth in college, or learning a trade, or even having a legal job: it’s not like he contracted Hep-C from a blood transfusion; he’s where he’s at in life for good reasons. Yet, here we have the American public subsidizing his health insurance and, depending on your point of view, rewarding his anti-social behavior.

I can understand how the law and order types can chafe when they hear stories like this one. I get it, but I’m also glad our friend will likely live much longer because Obamacare has come at the right time.

As far as how this might effect public opinion: I'm sure that Obamacare is helping a lot of marginalized people like our friend, but a lot of those marginalized people don't or can't vote. Their opinion, essentially, doesn't matter. How much will people like me see the people that Obamacare helps and be swayed by their stories? I don't know, but I think that's key: For most Americans ObamaCare is largely neutral, or it slightly screws them, but if you're like our friend, it's a literal life-saver, and for that reason alone, I've become much more likely to be favorable disposed toward it, despite its serious failings.

How many people will have similar experiences? I really don't know. Social classes generally don't mix all that much in the US, so I expect my story won't be common for people like me, but if it becomes common, it may move those who recognize that compassion is important.

Doctor Fate wrote:

geojanes wrote:

How many people will have similar experiences? I really don't know. Social classes generally don't mix all that much in the US, so I expect my story won't be common for people like me, but if it becomes common, it may move those who recognize that compassion is important.

This seems to be a common misnomer with liberals. Conservatives have "no compassion." Hogwash.

Doctor Fate wrote:My concern is more about "Why?" Why did all Americans have to suffer some kind of disruption so that people like your friend could get covered. We know that a fraction of those the President is bellowing about are actually "new" to the system. Why is that? Why didn't we just target those without insurance to begin with?

My concern is more about "Why?" Why did all Americans have to suffer some kind of disruption so that people like your friend could get covered. We know that a fraction of those the President is bellowing about are actually "new" to the system. Why is that? Why didn't we just target those without insurance to begin with?

I used to go on Twitter and ask conservatives to lay out what the criteria for Obamacare working as intended would look like. I never got a satisfactory response. You don’t take your barbecue reviews from people who think meat is murder.

geojanes wrote:

Doctor Fate wrote:My concern is more about "Why?" Why did all Americans have to suffer some kind of disruption so that people like your friend could get covered. We know that a fraction of those the President is bellowing about are actually "new" to the system. Why is that? Why didn't we just target those without insurance to begin with?

Well, that would have clearly been better. But the system we want is not necessarily the system we have. Throughout the whole Obamacare debate, my position was essentially, the system is terrible, but it's got to be better than what we currently have, and I still expect that it is. Hoping for incremental improvement.