Doctor Fate wrote:Am I confidently declaring victory? No, but I am confidently predicting it.

What would you define as "victory?"

Better yet, are there degrees of victory (i.e. Total, partial, Pyrrhic, marginal) and what would they be?

Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

geojanes wrote:

Doctor Fate wrote:Am I confidently declaring victory? No, but I am confidently predicting it.

What would you define as "victory?"

Better yet, are there degrees of victory (i.e. Total, partial, Pyrrhic, marginal) and what would they be?

It is not a "total, partial, Pyrrhic, or marginal" victory. I'll not define any of those. I will simply tell you what it is: I said this law would not work. It hasn't. It won't. It can't.

It is an epic failure. It has damaged the country, the President, and discredited (for the time being) liberalism.

Its failure is a political victory for those who believe in limited government.

danivon wrote:Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

That's certainly not what we have now.

To undo the damage this law has wrought will give some opportunity for genuine reform. My guess is the President will try to block anything that might actually help.

Doctor Fate wrote:

danivon wrote:Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

That's certainly not what we have now.

To undo the damage this law has wrought will give some opportunity for genuine reform. My guess is the President will try to block anything that might actually help.

This is not an answer to my questions - it's just an excuse for more politicking. I repeat:

"What does victory look like?"

(I remember similar questions about Iraq never really being answered back in the day...)

danivon wrote:

Doctor Fate wrote:

danivon wrote:Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

That's certainly not what we have now.

To undo the damage this law has wrought will give some opportunity for genuine reform. My guess is the President will try to block anything that might actually help.

This is not an answer to my questions - it's just an excuse for more politicking. I repeat:

"What does victory look like?"

(I remember similar questions about Iraq never really being answered back in the day...)

It is a fair question. What does victory for each side look like.

Since both you and DF have been leading the debate, I would love to hear both sides of a victory perception.

danivon wrote:

Doctor Fate wrote:

danivon wrote:Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

That's certainly not what we have now.

To undo the damage this law has wrought will give some opportunity for genuine reform. My guess is the President will try to block anything that might actually help.

This is not an answer to my questions - it's just an excuse for more politicking. I repeat:

"What does victory look like?"

(I remember similar questions about Iraq never really being answered back in the day...)

Does it matter if I answer your question or not? Since I'm the one claiming "victory," should you get to decide the parameters or should I?

My parameters for claiming victory are entirely political. I said the law would be a debacle. I'm being vindicated.

Now, does that obligate me to outline a substitute for Obamacare? Who died and put you in charge of me?

As for Iraq, I did answer it, even though I was opposed to the invasion. The problem was you all wanted a "seize and hold Pork Chop Hill" answer.

bbauska wrote:

danivon wrote:

Doctor Fate wrote:

danivon wrote:Indeed. What does 'victory' look like? Is it a healthcare system that is better than the one before 2009?

That's certainly not what we have now.

To undo the damage this law has wrought will give some opportunity for genuine reform. My guess is the President will try to block anything that might actually help.

This is not an answer to my questions - it's just an excuse for more politicking. I repeat:

"What does victory look like?"

(I remember similar questions about Iraq never really being answered back in the day...)

It is a fair question. What does victory for each side look like.

Since both you and DF have been leading the debate, I would love to hear both sides of a victory perception.

It's a fine question. I just have no desire to get into a policy debate.

Why not? Well, right now, it's moot. It likely will be for quite some time. As freeman3 has noted, and the President reiterated today, he's not interested in yielding, so it's quite likely all that will be done for now is to push back the ACA's effective date.

By the time the ACA is done wreaking its havoc, it is likely the problems will need a far more comprehensive fix than anything I'm prepared to spend time working through. How so? Millions more will lose their coverage next year. How does all of that get undone?

I don't know.

I do know the President's rhetoric has made "helping him" anathema to Republicans. I think it is going to be very difficult to get GOP buy-in for anything that fixes the ACA. They want it repealed and a do-over. Obama will want to throw more money at it. My guess is that there will eventually be a delay in the law with some kind of face-saving statement from the President, but that won't happen yet. In fact, it won't happen until Democrats start bailing on the plan because of the polling.

Doctor Fate wrote:By the time the ACA is done wreaking its havoc, it is likely the problems will need a far more comprehensive fix than anything I'm prepared to spend time working through. How so? Millions more will lose their coverage next year. How does all of that get undone?

I don't know.

I do know the President's rhetoric has made "helping him" anathema to Republicans. I think it is going to be very difficult to get GOP buy-in for anything that fixes the ACA. They want it repealed and a do-over. Obama will want to throw more money at it. My guess is that there will eventually be a delay in the law with some kind of face-saving statement from the President, but that won't happen yet. In fact, it won't happen until Democrats start bailing on the plan because of the polling.

Apparently all you have to do is step over the victory bar you've placed on the ground.

geojanes wrote:

Doctor Fate wrote:By the time the ACA is done wreaking its havoc, it is likely the problems will need a far more comprehensive fix than anything I'm prepared to spend time working through. How so? Millions more will lose their coverage next year. How does all of that get undone?

I don't know.

I do know the President's rhetoric has made "helping him" anathema to Republicans. I think it is going to be very difficult to get GOP buy-in for anything that fixes the ACA. They want it repealed and a do-over. Obama will want to throw more money at it. My guess is that there will eventually be a delay in the law with some kind of face-saving statement from the President, but that won't happen yet. In fact, it won't happen until Democrats start bailing on the plan because of the polling.

Apparently all you have to step over the victory bar you've placed on the ground.

Which is precisely what you're doing. Sorry old boy, but telling me I've got to solve the problem your man (and party) created is a pretty low bar. In fact, it's positively subterranean.

I realize that DF thinks that the verdict is already in, and that behooves Republicans to act as if the ACA is just not going to work, but I don't see the evidence, yet. I did not see any refutation that only 0.6 percent of Americans have bought individual plans, lost their coverage, and have to pay more on the exchanges to get coverage. Throwing numbers that millions of people will be affected whose insurance is covered by employers does not mean much when you're talking about three hundred million Americans. I am not seeing percentages and percentages are the main thing.
From what I can tell, states have exchanges and have expanded medicaid are doing ok. Until we see what happens with employers, I don't think we can assume that they are of a sudden going to start dump a lot of their employees on to the exchanges. As Ricky has pointed out, the percentage of employers offering health care has been steadily dropping, perhaps due to increased costs. But as I have already posted, the percentage of employers planning to drop health coverage for their employers due to the ACA was very low.
Yeah the roll-out has been choppy. The government is not necessarily that efficient. What conservatives forget is efficiency is not everything. Efficiency is not going to provide health care for those without insurance or those with pre-existing conditions. There is no free-market solution to those questions, because the free-market has decided that those people fall into a classification of not being insurable. Just like the elderly are uninsurable, so we have Medi-care.
I talked about some free-market solutions and certainly it is arguable that the ACA should have been set up better. But, remember, that there is no enthusiasm for any health-care reform in the Republican Party. Yeah, they throw out some ideas--but there is no energy to get that done. Their energy is in privatizing medicare and social security--unfortunately, the electorate just does not agree.
So it's a choice between the ACA and nothing. If after the dust settle and states that have expanded medicaid and have exchanges and are supporting ACA are doing well and states that don't are having problems...well, then i am not sure President Obama is going to get blamed for that. I think Republican governors might get a bit nervous.
I think we need to see what happens when employers deal with the ACA. If most people don't get affected by the ACA and they see that a lot more got covered, I think the ACA will be just fine. I don't see any hard concrete numbers from the other side. I still just see a lot of propaganda. And I think Obama is right to see this through. If it turns out that the ACA is a fundamentally flawed concept, then we'll know after it is implemented. But it is significant that the opposition is not able to say with any clarity how many people will pay significantly more for their health insurance because of the ACA. The 0.6% percent number for individual plans has not been challenged. If there is a similar number for employers covered under employer's health insurance, well, I feel pretty good about the ACA's chances. And if opponents to the ACA have concrete numbers what percentage of those covered by the ACA are going to lose their coverage, I would like to see that. I suspect that only about 5% or less , when they factor everything in, will feel that they have been negatively affected by the ACA. That ain't enough. I am not sure what the magic number would be, but I don't think 5% is enough. 15% or 20% or certainly by 25% but not 5% (or probably 10%). The dearth of numbers tells me that Republicans are playing games with statistics and anecdotal evidence.

freeman3 wrote:I realize that DF thinks that the verdict is already in, and that behooves Republicans to act as if the ACA is just not going to work, but I don't see the evidence, yet. I did not see any refutation that only 0.6 percent of Americans have bought individual plans, lost their coverage, and have to pay more on the exchanges to get coverage. Throwing numbers that millions of people will be affected whose insurance is covered by employers does not mean much when you're talking about three hundred million Americans. I am not seeing percentages and percentages are the main thing.

So, are you suggesting it's working?

Enrollment in the Affordable Care Act through Colorado's health insurance exchange is barely half the state's worst-case projection, prompting demands from exchange board members for better stewardship of public money.

The shortfall could compromise the exchange's "ability to deliver on promises made to Colorado citizens" and threatens the funding stream for the exchange itself, according to board e-mails obtained by The Denver Post in an open records request.

The exchange, meant for individuals and small groups buying insurance, had projected a lowest-level mid-November enrollment of 11,108, in a presentation to a board finance committee. The exchange announced Nov. 18 that it had signed up 6,001 Coloradans so far.

The midlevel scenario for November was 20,186 members, and the highest projection 30,944 members.

As federal startup grants taper off under Obamacare funding, the exchange is meant to pay for itself with per-member charges on the private insurance companies offering policies. It needs 136,300 enrollees in 2014 to raise $6.5 million of its $51.4 million expenses.

From what I can tell, states have exchanges and have expanded medicaid are doing ok.

Interesting. Colorado has a Democratic governor. Wonder what's going on there? It expanded Medicare in keeping with the ACA. Hmm, well, maybe it's an outlier?

The first month of the new health law’s rollout reveals an unexpected pattern in several states: a crush of people applying for an expansion of Medicaid and a trickle of sign-ups for private insurance.

This early imbalance — in some places, nine out of 10 enrollees are in Medicaid — has taken some experts by surprise. The Affordable Care Act, which expanded Medicaid to cover millions of the poorest Americans who couldn’t otherwise afford coverage, envisions a more even split with an expanded, robust private market.

“When we first saw the numbers, everyone’s eyes kind of bugged out,” said Matt Salo, who runs the National Association of Medicaid Directors. “Of the people walking through the door, 90 percent are on Medicaid. We’re thinking, what planet is this happening on?”

The yawning gap between public and private enrollment is handing Republicans yet another line of criticism against President Obama’s health overhaul — that the law is primarily becoming an expansion of a costly entitlement program.

Supporters, however, caution against reading too much into the early numbers. Some of the states that set up their own exchanges, including Maryland, are suffering Web site glitches similar to those of the national system, and that is delaying private plan enrollments.

But if this trend continues, experts say it could prove costly for states that will have to help pay for some of these new Medicaid enrollees. It would widen disparities between the states that opted to expand the entitlement program and those that have not.

But, how bad can it be? (same article)

Budget forecasters projected this summer that 9 million people would sign up for Medicaid in 2014, slightly more than the 7 million shoppers who would purchase private insurance plans.

Of the states reporting enrollment data, most show a much wider gap between the two programs.

Maryland has enrolled 82,473 people in Medicaid expansion coverage, which accounts for 96 percent of total enrollment. Maryland’s exchange, the Maryland Health Connection, has enrolled 3,186 residents.

The high enrollment in the Medicaid expansion is because Maryland is automatically enrolling state residents in its Primary Adult Care Program, which offers limited health benefits to those who earn less than 116 percent of the poverty line, about $13,330 for an individual.

“If you include those people, the initial cohort will be through Medicaid,” Charles Milligan, Maryland’s deputy secretary for health-care financing, said.

During the first two weeks of October, Oregon cut its uninsured rate by 10 percent — without signing up a single person for private health insurance.

Instead, a surge of 56,000 Oregonians flocked to the health law’s expansion of Medicaid.

Wo-ah!

Until we see what happens with employers, I don't think we can assume that they are of a sudden going to start dump a lot of their employees on to the exchanges. As Ricky has pointed out, the percentage of employers offering health care has been steadily dropping, perhaps due to increased costs. But as I have already posted, the percentage of employers planning to drop health coverage for their employers due to the ACA was very low.

Great! I say dig in! Republicans have erased their deficit in the generic Congressional numbers. They usually run a bit behind even in years they win because of the nature of those polls, so for them to be up is huge.

The President's credibility, trustworthiness, and competence have all taken a huge hit. Keep going!

Yeah the roll-out has been choppy.

Sure, "choppy."

As the website misses its second deadline, "choppy" is about as accurate as saying the first cruise on the Titanic was "eventful."

The government is not necessarily that efficient. What conservatives forget is efficiency is not everything.

Sure, but let's not forget: from the time the ACA passed until the launching of the website was more time than from Pearl Harbor to the taking of Berlin. There is no excuse for healthcare.gov.

Efficiency is not going to provide health care for those without insurance or those with pre-existing conditions. There is no free-market solution to those questions, because the free-market has decided that those people fall into a classification of not being insurable.

That is a grotesquely inaccurate statement. As you should have acknowledged by now, there never was a "free market" in health insurance. I posted the list of the thousands of regulations on the so-called "free market."

Additionally, of course pre-existing conditions were not covered. Insurance "companies," like any "company," exists to make money. The question is whether the ACA was the "only" way to address this need. I suggest it was not.

I talked about some free-market solutions and certainly it is arguable that the ACA should have been set up better. But, remember, that there is no enthusiasm for any health-care reform in the Republican Party. Yeah, they throw out some ideas--but there is no energy to get that done. Their energy is in privatizing medicare and social security--unfortunately, the electorate just does not agree.

There is no "agreement" on the ACA either. Somehow that doesn't seem to bother you.

So it's a choice between the ACA and nothing.

False.

If after the dust settle and states that have expanded medicaid and have exchanges and are supporting ACA are doing well and states that don't are having problems...well, then i am not sure President Obama is going to get blamed for that. I think Republican governors might get a bit nervous.

You're such an optimist that you can't see your premise is already impossible. The public has decided the ACA is a loser. Democrats are going to hit the panic button when the website doesn't work on Nov. 30.

Sources who attended a meeting of House chiefs of staff on Monday say the room was seething with anger over the immense damage being done to the Democratic Party and talk was of scrapping rollout events for the Affordable Care Act.

“Here we are, we’re supposed to be selling this to people, and it’s all screwed up,” one chief of staff ranted. “This either gets fixed or this could be the demise of the Democratic Party.

“It’s probably the worst I’ve ever seen it,” the aide said of the recent mood on Capitol Hill. “It’s bad. It’s really bad.”

Meanwhile, at a recent caucus meeting with Senate Democrats and White House chief of staff Denis McDonough, one senator stood up and asked for a political point of contact at the White House.

“There’s been an increase in frustration because people feel like they are continuing to be blindsided,” said one Democrat who attended the caucus meeting, adding that there’s a “check-the-box” mentality at the White House in dealing with lawmakers.

Democrats around Capitol Hill say there are lots of people to blame for the debacle that has engulfed them. But increasingly the anger is directed at one person only: Obama.

“Is he even more unpopular than George W. Bush? I think that’s already happened,” said one Democratic chief of staff.

I think we need to see what happens when employers deal with the ACA. If most people don't get affected by the ACA and they see that a lot more got covered, I think the ACA will be just fine. I don't see any hard concrete numbers from the other side.

Really? So, when I've cited the CBO--that means nothing to you? Tens of millions are going to lose their insurance. The White House has known this for 3 years:

Section 1251 of the Affordable Care Act contains what’s called a “grandfather” provision that, in theory, allows people to keep their existing plans if they like them. But subsequent regulations from the Obama administration interpreted that provision so narrowly as to prevent most plans from gaining this protection.

“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34,552 of the Register. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and become illegal. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013.

Another 25 million people, according to the CBO, have “nongroup and other” forms of insurance; that is to say, they participate in the market for individually-purchased insurance. In this market, the administration projected that “40 to 67 percent” of individually-purchased plans would lose their Obamacare-sanctioned “grandfather status” and become illegal, solely due to the fact that there is a high turnover of participants and insurance arrangements in this market. (Plans purchased after March 23, 2010 do not benefit from the “grandfather” clause.) The real turnover rate would be higher, because plans can lose their grandfather status for a number of other reasons.

How many people are exposed to these problems? 60 percent of Americans have private-sector health insurance—precisely the number that Jay Carney dismissed. As to the number of people facing cancellations, 51 percent of the employer-based market plus 53.5 percent of the non-group market (the middle of the administration’s range) amounts to 93 million Americans.

I still just see a lot of propaganda.

Obviously, so maybe you should read more than just what Jay Carney emails you?

And I think Obama is right to see this through.

We agree. I think he should stick to his guns, er, convictions. I don't care what it costs him, he can't give up! I'm counting on you, Mr. President!

If it turns out that the ACA is a fundamentally flawed concept, then we'll know after it is implemented. But it is significant that the opposition is not able to say with any clarity how many people will pay significantly more for their health insurance because of the ACA. The 0.6% percent number for individual plans has not been challenged.

Horse hockey.

If there is a similar number for employers covered under employer's health insurance, well, I feel pretty good about the ACA's chances. And if opponents to the ACA have concrete numbers what percentage of those covered by the ACA are going to lose their coverage, I would like to see that. I suspect that only about 5% or less , when they factor everything in, will feel that they have been negatively affected by the ACA.

See numbers I posted above. And, my source is the government and White House, so you'll probably accept it.

That ain't enough. I am not sure what the magic number would be, but I don't think 5% is enough. 15% or 20% or certainly by 25% but not 5% (or probably 10%). The dearth of numbers tells me that Republicans are playing games with statistics and anecdotal evidence.

I've already shown your numbers are way off. That's without going to speculative numbers I've seen that are much worse.

Again, I hope Mr. Obama fights to the bitter end. It will be glorious to watch the Democratic Party fragment and work it's way to the 20 percent of the electorate it deserves.

Just saw this. Yeah, sure, if States would only embrace the ACA things would go well:

Oregon once led the country in implementing Obamacare. Now it’s just about dead last.

Not one person has yet enrolled in the Cover Oregon insurance exchange — a major embarrassment to state policymakers who early on had wholeheartedly embraced the Affordable Care Act even as other states tried their best to hinder it.

After repeatedly delaying its website’s enrollment feature because of technical problems, exchange officials are still scrambling. Gov. John Kitzhaber announced new efforts Friday toward that goal, but mid-December is the soonest officials expect online enrollment could be available, and even that date is in doubt. Until then, the only way to sign up for coverage through the state-run program is via paper — a very long way from where Oregon had originally envisioned itself this far into open-enrollment season. The breakdown illustrates how even a gung-ho, tech-savvy state can stumble badly while attempting to expand coverage.

“I think just about everybody in Oregon is surprised and frustrated with where we are right now,” said Jesse O’Brien, a health care advocate for the Portland-based consumer advocacy group OSPIRG. “With Oregon having a reputation as a state that supports health reform and with a governor that is very enthusiastic, I think everyone was expecting we’d be in a much different position.”

“It is such an epic failure, literally it’s mind-boggling,” said state Rep. Jason Conger, a Republican from central Oregon who’s running for Sen. Jeff Merkley’s seat next year.

The state has been throwing significant resources into its backup plan, assigning hundreds of workers to deal with the paper applications, yet making little headway. Nearly 30,000 individuals and families have applied via paper, but the state hasn’t been able to finish processing even one submission. And simply trying to turn in the application itself has some people exasperated.

Read more: http://www.politico.com/story/2013/11/o ... z2lnCiFXMJ

Doctor Fate wrote:Does it matter if I answer your question or not? Since I'm the one claiming "victory," should you get to decide the parameters or should I?

My parameters for claiming victory are entirely political. I said the law would be a debacle. I'm being vindicated.

Now, does that obligate me to outline a substitute for Obamacare? Who died and put you in charge of me?

I thought it was an important issue affecting millions of Americans, where some were not covered, some were finding themselves bankrupted, many were seeing their premiums rising faster than inflation or wages year on year (even before the ACA), with the costs of State and Federal programmes speeding up...

But if all it is to you is a means of playing out the two-party rivalry and cheering on your team in DC and booing the other team, fine.

So basically 'victory' to you means repeal or chaos, followed by a win for the Elephant team in 14 and 16.

As for Iraq, I did answer it, even though I was opposed to the invasion. The problem was you all wanted a "seize and hold Pork Chop Hill" answer.

Who says I was referring to you - it was a general observation, not specifically about DF.

Which is precisely what you're doing. Sorry old boy, but telling me I've got to solve the problem your man (and party) created is a pretty low bar. In fact, it's positively subterranean.

So are you saying there was no problem before the ACA? Heathcare in the USA was perfectly fine, a fair and equitable market with no drawbacks whatsoever? Sheesh...

bbauska wrote:It is a fair question. What does victory for each side look like.

Since both you and DF have been leading the debate, I would love to hear both sides of a victory perception.

Well, even though DF is steadfastly refusing to answer (because politics is more important that policy, or something)...

First of all, don't mistake this for being the Democrat view. I'm not a Democrat, and they are not my preferred party in the USA. Secondly, it's really just my impression of the intent behind the ACA.

So 'victory' would be the ACA working, and being seen to work, in terms of reducing the numbers of those not covered at all, improving the minimum level of cover of those who are covered, and curbing the rate of premium increases.

I'm not sure that's all happening - it won't happen for everyone all the time.