danivon wrote: . . I'm asking you, because you made a pretty clear and unequivocal statement, and instead of substantiating it are just repeating the same partisan talking points over and over.

And, if you had ANY freaking support for the fact that "most" will get a better outcome, you would post it. It's not complicated: 1) more people in the system; 2) fewer doctors; 3) no pre-existing conditions permitted; and 4) a bunch of coverages many did not have before. Do those things add up to lower costs for insurance? Better outcomes? In what universe?

As for the jittery market, you did notice that the DJIA is at 16,000, and the S&P500 is at 1,800?

Did you notice the Fed is buying $85B in securities a month? It is putting maximum currency out there and keeping rates low. In such conditions, it is finding the only reasonable rate of return: stocks.

The overall US market seems to be doing quite well. Both are at unprecedented levels. The S&P contains a fair number of healthcare companies too. So maybe you mean just that sector.

But, the economy is stagnant, at best. Why is that? Why is the investor class doing so well while the lower class is getting whipped? Why isn't Obama changing that?

Except that the Healthcare sector index seems to have been rising smoothly all year, with no real instability in recent months or weeks (apart from the blip that hit everything during the shutdown).

The market in the market is not jittery. As a capitalist I guess you know what that means.

Btw, I was not, as should be obvious, referring to the stock market. Most people (consult any poll) believe the ACA will hurt their healthcare quality. So, again, quoting me:

If "most" are going to get better outcomes, when might we expect the Administration to be able to demonstrate that?

That's what they SHOULD be doing. And, if it was the case, they WOULD be doing it. However, they know this isn't working. They know they won't get the young and healthy into the system, so the whole thing is going to implode. They can't brag about outcomes they can't demonstrate.

The ship is sinking. You just refuse to see it. It's a performance worthy of Edward Smith.

Doctor Fate wrote:

danivon wrote: . . I'm asking you, because you made a pretty clear and unequivocal statement, and instead of substantiating it are just repeating the same partisan talking points over and over.

And, if you had ANY freaking support for the fact that "most" will get a better outcome, you would post it. It's not complicated: 1) more people in the system; 2) fewer doctors; 3) no pre-existing conditions permitted; and 4) a bunch of coverages many did not have before. Do those things add up to lower costs for insurance? Better outcomes? In what universe?

Sorry, but all you are giving me is 'more', 'fewer' etc. not any actual evidence to show that most will suffer. I don't have a view either way, but I'm interested in what is behind the rhetoric.

As for the jittery market, you did notice that the DJIA is at 16,000, and the S&P500 is at 1,800?

Did you notice the Fed is buying $85B in securities a month? It is putting maximum currency out there and keeping rates low. In such conditions, it is finding the only reasonable rate of return: stocks.

That stocks - and healthcare stocks - are showing a reasonable rate of return still demonstrates that the market may not be all that 'jittery',

The overall US market seems to be doing quite well. Both are at unprecedented levels. The S&P contains a fair number of healthcare companies too. So maybe you mean just that sector.

But, the economy is stagnant, at best. Why is that?

Because it isn't. The US economy is growing, and the rate was faster in Q3 than in Q2. GDP is well above the peak before the crash (which was arguably inflated by the circumstances leading to the crash).

Why do you have to do your country down to make a political point? And worse, use falsehoods?

Why is the investor class doing so well while the lower class is getting whipped? Why isn't Obama changing that?

it's called capitalism. And because he's not the Marxist you make him out to be, he's not actually doing more than gentle reform. If that.

The market in the market is not jittery. As a capitalist I guess you know what that means.

Btw, I was not, as should be obvious, referring to the stock market. Most people (consult any poll) believe the ACA will hurt their healthcare quality.

Again, a poll is a measure of opinion, but not of fact. On the other hand, the values of stocks in healthcare companies is a measure of the state of that market.

If "most" are going to get better outcomes, when might we expect the Administration to be able to demonstrate that?

Answering my question with another question is not really helping. Either you can substantiate your point, or you cannot. The more you dance around, it, the more I will tend to think you know you can't back your rhetoric up with evidence. To make it clear, I've not asserted that most will be better off. I would say that if they were it would be a good thing. It would be interesting to know.

And the snidey responses to geojanes don't help that perception. If you (and the Republicans) spend the energy and effort currently devoted to beating the Democrats over the head into formulating an actual workable solution (and not just one-liners like 'repeal ACA' or 'more free market', an actual plan), maybe things would be better.

Danivon, with all due respect, you're begging. You have zero evidence to support the notion that Obamacare will give better care and/or save money for most people. If anything like that were happening now, the polls would be in favor of it. People don't dislike that which is actually helping them.

Healthcare stocks have nothing to do with healthcare outcomes.

The economy is pathetic. Your stats are carefully and artfully phrased. Labor participation? Look, if the economy is so strong, ahem, why does Obama keep pivoting to it?

You know why the investor class is doing well. It has nothing to do with capitalism per se and everything to do with managing risk. Obama has created a climate of fear for corporations. They won't take risks.

If Obama wasn't the most fierce partisan in modern history, he would not be in the sorry position he's in.

For the record, the GOP has already helped modify the ACA.

Well there is one thing that has occurred since the ACA was passed--healthcare costs have not risen as much. That is a big deal. http://www.whitehouse.gov/blog/2013/11/ ... ers-recent
As for the rest of it, the reason DF cannot come up with numbers was due to the fact that nothing is that clear, yet. There are anecdotal stories of people who had individual plans, lost them because of the ACA, but have to pay substantially more. That is a whopping 0.6 percent.
Then there are the anecdotal stories of doctors not taking medicaid...
Then there is sheer speculation as to what is going to happen with employer plans...
What Republicans have done is make people fearful (and certainly the web site failures have not helped) And, of course, they have done what they can do to sabotage the ACA by not having exchanges and not expanding medicaid (we'll see how long that lasts btw--Michigan lost about 70 million dollars because the legislature delayed medicaid expansion three months)
And of course DF always, always forgets the millions and millions of people who will get insured that were not insured before (estimated to be up to 15 million people or so (so not just people with pre-existing conditions are going to be helped)
And current poll results are meaningless, really. The key is whether the ACA eventually is seen by most to have worked. If it that happens, the poll numbers will change. People are usually adverse to change (so they will be against it if they perceive some risk associated with it), but once the change occurs they can factually assess the effect of the change.
No one knows how the ACA is going to turn out.
Anyway, I think the ACA will wind up working-- and if it doesn't we'll have to come up with something else. What is not going to happen is Republicans scaring us from seeing whether it works.
And the alternative to the ACA is to go back to a situation where insurers did not have restrictions on how much profits they can make. Howard Dean said today that he cannot remember an occasion when a Republican said something positive about anything. I don't think a party with such a negative view of things is going to be very effective politically.

Doctor Fate wrote:Danivon, with all due respect, you're begging. You have zero evidence to support the notion that Obamacare will give better care and/or save money for most people.

Which is why I am not arguing that this is the case, so I'm not 'begging'. I am simply asking you to substantiate your claims that it will make things worse for most people. You can't, or you would have done.

If anything like that were happening now, the polls would be in favor of it. People don't dislike that which is actually helping them.

Well, polls are just a measure of opinion, not a reflection of fact - and certainly not a definitive prediction of the future. People sometimes do dislike things that actually help them. Such as eating their greens or doing their maths homework, or moderate exercise, or giving up smoking...

Healthcare stocks have nothing to do with healthcare outcomes.

I never said they did. You mentioned the market was 'jittery'. I pointed to an indicator - the market in the healthcare market - that suggests it is not. Your response? Moving the goalposts.

The economy is pathetic. Your stats are carefully and artfully phrased. Labor participation? Look, if the economy is so strong, ahem, why does Obama keep pivoting to it?

I didn't 'carefully and artfully phrase' anything. I looked up the GDP and growth rates. They show that the US economy is growing at 2.5% annually. That may not be stellar, but it's not, as you described it, stagnation. The Labor participation rate has been declining since it peaked in the late 1990s. Which suggests an underlying trend unrelated to the economic cycle.

You know why the investor class is doing well. It has nothing to do with capitalism per se and everything to do with managing risk. Obama has created a climate of fear for corporations. They won't take risks.

This is not due to Obama. It's due to the crash of 2008 and credit problems from 2007 to now. Banks are not lending, because they got hit by their own stupidity. The economy took a big hit in 2007-8, and that will take a long time to stop affecting confidence. But capitalism most certainly is about capital (and those who own and control it) accruing for itself. Otherwise, capital would not be invested, it would simply sit around doing nothing.

If Obama wasn't the most fierce partisan in modern history, he would not be in the sorry position he's in.

So this excuses you for being the second most fierce partisan in modern history?

Pulling back just a little, for me the take away from all this is that you have to be very careful about unintended consequences when creating policy. I fear (and don't say this with partisan glee) that the ACA will distort a lot of markets. It will encourage more part time employment; it will force people to leave insurance plans that they are happy with, and to pay more for insurance plans that they do not want, and at some point the other shoe will drop -- people will have to change doctors that they would rather stay with.

If the problem is lack of health care for millions of Americans, I think it is much better to directly subsidize health care, as with Medicaid. That would directly achieve the objective instead of distorting markets to make it happen. Similarly, if the problem is lack of affordable housing, a voucher system is much better than rent control. The distortions of rent control end up impacting everyone in their attempt to help the few. We have a heart that there are some people who need assistance, often through no fault of their own. But that's not a good reason to distort the marketplace for the rest of us.

freeman3 wrote:Well there is one thing that has occurred since the ACA was passed--healthcare costs have not risen as much. That is a big deal. http://www.whitehouse.gov/blog/2013/11/ ... ers-recent

It would be if it was connected to the ACA. Unfortunately, you have been claiming that the ACA is not fully implemented and now you want to claim it is responsible for holding down prices.

Furthermore, any number of studies suggest costs are about to go much higher.

The estimated 149 million Americans under age 65 who get their health insurance through their employers could be the next group to feel the impact of the Affordable Care Act.

Open enrollment for 2014 is about to begin at thousands of companies, and many employers are blaming Obamacare—at least in part—for cost increases they are passing on to their workers.

Employees' costs are expected to rise 5 to 7 percent next year, according to early estimates. Those annual increases have been a fixture for years. But in some 2014 open enrollment documents reviewed by CNBC, companies are specifically citing the law as a factor in next year's pricing.

"(F)ederally mandated health care changes will require Comcast-NBCUniversal to pay new fees and implement plan design changes that will contribute to the increased cost of our plans," says the open enrollment guide for CNBC.com's parent company, where employee health care premiums are rising by double digits, and deductibles in some cases are doubling. The guide also cites rising health care delivery costs not directly related to the new law.

As for the rest of it, the reason DF cannot come up with numbers was due to the fact that nothing is that clear, yet. There are anecdotal stories of people who had individual plans, lost them because of the ACA, but have to pay substantially more. That is a whopping 0.6 percent.

That's not accurate. There are about 5 million who have lost coverage, which would be your 0.6%. HOWEVER, that was out of 15 million potential losses, so it's 33% of those who could have lost coverage. If that continues when the employer mandate hits, there will be revolution in the air (to paraphrase Dylan).

Then there are the anecdotal stories of doctors not taking medicaid...

Is it anecdotal or survival?

Medicaid pays doctors about 59 percent of what Medicare pays them—which is why doctors increasingly refuse to take new Medicaid patients. As I pointed out last week, the Centers for Medicare and Medicaid Services (CMS) recently released a document showing that 9,500 doctors who had previously accepted Medicaid patients refused to do so in 2012.

That's not an anecdote.

Then there is sheer speculation as to what is going to happen with employer plans...

Wrong again. The Obama Administration PREDICTED this in 2010:

“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.

Sorry, but you really don't know what you're talking about.

Danivon says I don't have numbers.

Those are not my numbers--they belong to Obama. He knows millions are going to lose coverage next year.

What Republicans have done is make people fearful (and certainly the web site failures have not helped)

Yes, how dare the Republicans not LIE to Americans like the Administration does on a daily basis!

And, of course, they have done what they can do to sabotage the ACA by not having exchanges and not expanding medicaid (we'll see how long that lasts btw--Michigan lost about 70 million dollars because the legislature delayed medicaid expansion three months)

Democrats can complain all they want. They wrote a bad law and passed it over Republican objections. Republicans helped make the law less of a mess on a couple of occasions. However, Democrats shot them down when they tried to make the President's words a realty:

Washington (CNN) - Senate Democrats voted unanimously three years ago to support the Obamacare rule that is largely responsible for some of the health insurance cancellation letters that are going out.

In September 2010, Senate Republicans brought a resolution to the floor to block implementation of the grandfather rule, warning that it would result in canceled policies and violate President Barack Obama’s promise that people could keep their insurance if they liked it.

And of course DF always, always forgets the millions and millions of people who will get insured that were not insured before (estimated to be up to 15 million people or so (so not just people with pre-existing conditions are going to be helped)

No, I don't forget. What YOU forget is that so far more people have LOST their insurance than have been signed up for it via the ACA.

You also forget that the CBO says that in spite of the ACA 30 million will be uninsured in 2010!

And current poll results are meaningless, really.

Sure, the fact that Obama is at an all-time low is "meaningless." That's why Democrats are getting nervous and getting ready to tell him where to go?

This is why the President is making another PR effort to sell the ACA?

A law that has NEVER enjoyed majority support after 4 years is getting less popular, is tanking the President's approval ratings, putting the GOP ahead in the generic balloting (which they rarely are), and it's "meaningless?" Okay.

The key is whether the ACA eventually is seen by most to have worked. If it that happens, the poll numbers will change.

Exactly right. And, when more people lose their insurance, have to go shopping, and find out that for all their efforts they are even or behind, they are going to like it even less.

There was no reason to create upheaval in the market for a small percentage of people. There were less disruptive ways to address the uninsured. So, why did they do this when they knew millions and millions would lose coverage?

People are usually adverse to change (so they will be against it if they perceive some risk associated with it), but once the change occurs they can factually assess the effect of the change.

Given that 80% were satisfied with their situation before the law was passed, "meh" is not likely to improve the popularity of the law. If it's worse than "meh" the torches and pitchforks will be out.

No one knows how the ACA is going to turn out.

Is there any reason, even one, to suppose nirvana is going to be achieved? The website, which should have been simple, is a fiasco. But, the plan, the law, the one no one can explain--that one is going to turn out well? #dubious.

Anyway, I think the ACA will wind up working-- and if it doesn't we'll have to come up with something else.

And you say you're an atheist!

What is not going to happen is Republicans scaring us from seeing whether it works.
And the alternative to the ACA is to go back to a situation where insurers did not have restrictions on how much profits they can make.

I keep saying: I hope Democrats stick to their guns! Please, go all-in on the ACA! Go! Go! Go!

There has never been a less popular law in my lifetime. Keep going! Don't stop digging!

Howard Dean said today that he cannot remember an occasion when a Republican said something positive about anything. I don't think a party with such a negative view of things is going to be very effective politically.

On the other hand, a party that lies to the American people and is ineffective in carrying out unpopular laws--that one will be very effective politically.

danivon wrote:

Doctor Fate wrote:Danivon, with all due respect, you're begging. You have zero evidence to support the notion that Obamacare will give better care and/or save money for most people.

Which is why I am not arguing that this is the case, so I'm not 'begging'. I am simply asking you to substantiate your claims that it will make things worse for most people. You can't, or you would have done.

All the evidence suggests it. Keep your eyes closed, cover your ears, and well, just be you. Read:

SAN DIEGO — Dr. Ted Mazer is one of the few ear, nose and throat specialists in this region who treat low-income people on Medicaid, so many of his patients travel long distances to see him.
Contribute to Our Reporting

But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: It does not pay enough.

“It’s a bad situation that is likely to be made worse,” he said.

His view is shared by many doctors around the country. Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.

Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. The Congressional Budget Office predicts that nine million people will gain coverage through Medicaid next year alone. In many of the 26 states expanding the program, the newly eligible have been flocking to sign up.

Community clinics, which typically provide primary but not specialty care, have expanded and hired more medical staff members to meet the anticipated wave of new patients. And managed-care companies are recruiting doctors, nurse practitioners and other professionals into their networks, sometimes offering higher pay if they improve care while keeping costs down. But it is far from clear that the demand can be met, experts say.

In California, with the nation’s largest Medicaid population, many doctors say they are already overwhelmed and are unable to take on more low-income patients. Dr. Hector Flores, a primary care doctor in East Los Angeles whose practice has 26,000 patients, more than a third of whom are on Medicaid, said he could accommodate an additional 1,000 Medicaid patients at most.

“There could easily be 10,000 patients looking for us, and we’re just not going to be able to serve them,” said Dr. Flores, who is also the chairman of the family medicine department at White Memorial Medical Center in Los Angeles.

Stick your head in the sand, but don't tell me I'm not making the case. You just don't want to accept the truth.

People sometimes do dislike things that actually help them. Such as eating their greens or doing their maths homework, or moderate exercise, or giving up smoking...

So true, but you know what's funny? Take money out of their pockets, make them drive further to a doctor they don't know, and force them to make other changes, and guess what? They're not going to like it no matter what you think.

Healthcare stocks have nothing to do with healthcare outcomes.

I never said they did. You mentioned the market was 'jittery'. I pointed to an indicator - the market in the healthcare market - that suggests it is not. Your response? Moving the goalposts.

Not my fault you misunderstood my original point. That's not moving the goalposts.

I didn't 'carefully and artfully phrase' anything. I looked up the GDP and growth rates. They show that the US economy is growing at 2.5% annually. That may not be stellar, but it's not, as you described it, stagnation.

It is the worst recovery in history. It's bounced up and down like a yo-yo. The "saving grace" has been the Fed.

The Labor participation rate has been declining since it peaked in the late 1990s. Which suggests an underlying trend unrelated to the economic cycle.

The unemployment rate for blacks? Youth?

The fact is many, many Americans are underemployed or unemployed and have given up. Measure that.

You know why the investor class is doing well. It has nothing to do with capitalism per se and everything to do with managing risk. Obama has created a climate of fear for corporations. They won't take risks.

This is not due to Obama. It's due to the crash of 2008 and credit problems from 2007 to now. Banks are not lending, because they got hit by their own stupidity.

Businesses don't want to expand because of the swath of EPA and other regulations coming out of DC. Furthermore, the ACA isn't exactly a job-creating machine.

If Obama wasn't the most fierce partisan in modern history, he would not be in the sorry position he's in.

So this excuses you for being the second most fierce partisan in modern history?

If I was President, this might be a problem. He is and it is.

One more thing . . . MA is supposed to be the "model" for the ACA, the place that shows it works. Um, maybe not--even the radical dimwit who helped the President and now wants to be governor here admits it's a failure:

Former CMS administrator Don Berwick is running for Governor in Massachusetts. He has an uphill battle in the ever growing primary for the Democratic nominee. Yet his controversial tenure in DC, his pursuit of the Corner Office in the state that birthed RomneyCare (a state that is home to some of the best medical research institutions in the world), and his devoted following on the left — all grant extra weight to his comments on healthcare.

Berwick’s campaign released his platform on healthcare for the Bay State last week. Even with little detail, it served to reinforce many of the charges critics have levied against him for years, mainly that he desires a single-payer system in America. As he distances himself from the “staff-level” dire implementation of his “majestic” ACA, one has to wonder why he would advocate for a government takeover of healthcare at this time.

His proposal should be seen in light of the makeup of Democratic primary voters in the state, and should only serve to open the Pandora’s box that are the policy logistics of a single-payer system being run at a state-level. Any other single-payer conversation is similar to discussing the merits of the shiny outside of a new car without looking under the hood where there is no motor.
HealthCare Remains a Huge Issue in Massachusetts

The race for Governor includes two doctors (Berwick and Joe Avellone), a lawyer that worked for a healthcare company (Evan Falchuk) a former health insurance executive (Charlie Baker), and an Attorney General (Martha Coakley) that has been very involved in healthcare discussions in the state.

Healthcare accounts for almost 20 percent of the state’s GDP, and employers spend the most for insurance in the country. Massachusetts is home to multiple medical schools, and the state is first or second for research and investment dollars spent in the medical device industry. The state spends over 40 percent of the budget on healthcare related programs.

The state has a history of tinkering in health policy, and more recently the legislature has passed major healthcare bills every two years since 2006, most recently culminating in a “cost-containment and payment reform” law in July of 2012 that sets a growth gap on the industry, and puts in place many bureaucratic bodies to “fix” healthcare.

(Bold added)

Wow! Sounds like it's just sooooo good!

Ray Jay wrote:Pulling back just a little, for me the take away from all this is that you have to be very careful about unintended consequences when creating policy. I fear (and don't say this with partisan glee) that the ACA will distort a lot of markets. It will encourage more part time employment; it will force people to leave insurance plans that they are happy with, and to pay more for insurance plans that they do not want, and at some point the other shoe will drop -- people will have to change doctors that they would rather stay with.

The overall principle seems to have been reasonable, but the execution, and the detail have not been very good. Many of the problems relate to those two, rather than to the principle.

If the problem is lack of health care for millions of Americans, I think it is much better to directly subsidize health care, as with Medicaid. That would directly achieve the objective instead of distorting markets to make it happen. Similarly, if the problem is lack of affordable housing, a voucher system is much better than rent control. The distortions of rent control end up impacting everyone in their attempt to help the few. We have a heart that there are some people who need assistance, often through no fault of their own. But that's not a good reason to distort the marketplace for the rest of us.

Well, I think both direct subsidies and housing vouchers would also distort the market. Indeed, they clearly do where they operate, or where similar policies are tried out in other markets. So I don't see your point. And there would be 'unforseen consequences' to them too.

Distorting a market that is not working well for the general social needs is surely the point. The question will be, of course, whether the distortion is toward the good or bad end, and what the overall consequences are (and what the marginal cases end up doing).

Of course, both direct subsidies or a voucher system for rent would be poltically unpalatable in a nation that apparently abhors 'socialism'. And those polices are closer to social welfare or social democracy/socialism than they are to what the ACA or rent control are, which is 'regulationism' (not a real word, yet).

Danivon:

Well, I think both direct subsidies and housing vouchers would also distort the market.

Substantially less distortion because you aren't mandating that all people/businesses purchase a particular financial product (insurance) that the government actively structures, defines and regulates.

Of course, both direct subsidies or a voucher system for rent would be poltically unpalatable in a nation that apparently abhors 'socialism'.

They already exist. http://en.wikipedia.org/wiki/Section_8_(housing)

And those polices are closer to social welfare or social democracy/socialism than they are to what the ACA or rent control are, which is 'regulationism' (not a real word, yet).

It's a good word if we can agree on a definition. I'm saying that regulationism is worse than direct payments to the poor (which is not socialism, but is social welfare). Whereas they both try to accomplish the same goals, the former ends up being more expensive to society because it creates much greater distortion of markets which has a long term deleterious impact on the middle class whereas the simple payments to the poor may appear to be more expensive (because it becomes a line item in a budget), but in fact is a less expensive way to go.

Ray Jay wrote:Danivon:

Well, I think both direct subsidies and housing vouchers would also distort the market.

Substantially less distortion because you aren't mandating that all people/businesses purchase a particular financial product (insurance) that the government actively structures, defines and regulates.

So it's not that the market is distorted, it's how much. And different scheme can have wildly different effects regardless of the 'method' - the devil is often in the details.

Of course a subsidised system, such as extended Medicare, would also involve government defining and regulating what they subsidise. As Medicare already does.

Of course, both direct subsidies or a voucher system for rent would be poltically unpalatable in a nation that apparently abhors 'socialism'.

They already exist. http://en.wikipedia.org/wiki/Section_8_(housing)

Yep. Not without controversy over the unintended consequences though. One aspect of this is that it in reality subsidises landlords rather than tenants (and increases in the value of available subsidy will simply increase the rent, which also impacts the wider market rate that un-subsidised tenants pay. And thus the wider value of housing to build, buy and sell.

I meant extending them - or bringing them in now would be politically difficult, especially with deficits the way they are.

And those polices are closer to social welfare or social democracy/socialism than they are to what the ACA or rent control are, which is 'regulationism' (not a real word, yet).

It's a good word if we can agree on a definition. I'm saying that regulationism is worse than direct payments to the poor (which is not socialism, but is social welfare). Whereas they both try to accomplish the same goals, the former ends up being more expensive to society because it creates much greater distortion of markets which has a long term deleterious impact on the middle class whereas the simple payments to the poor may appear to be more expensive (because it becomes a line item in a budget), but in fact is a less expensive way to go.

And I would agree that it's worse in some ways, particularly the last. But I don't think it's as simple as your generalisation makes out. Over-regulation is a problem, for sure.

What makes the situation in the USA more complicated is that in addition to a large amount of existing Federal regulation, there are 50 States with their own regulations that complement or clash with them. Meaning that reforming regulations becomes a case of fudging huge numbers of existing ones.

So what exactly is your point about doctors not wishing to take medicaid, DF? Do you favor making less people eligible for medicaid (meaning less people will be covered)? Do you support increasing reimbursement for doctors? Your cite articles indicating that medicaid patients will be less able to served by doctors who see too many patients already, but the alternative is at that some of these patients will not have any coverage at all...

As for the employer plans, your quote is pretty amusing. "Employees' costs are expected to rise 5 to 7 percent next year, according to early estimates. Those annual increases have been a fixture for years. But in some 2014 open enrollment documents reviewed by CNBC, companies are specifically citing the law as a factor in next year's pricing." So annual increases have been a fixture for years but now employers get to blame those increases on the ACA! (there is nothing to indicate that those increases were different from prior years)

The numbers I cited were that 3.6% of Americans bought individual plans and 0.6% of Americans would lose their plan and not able to find coverage at similar rates (after subsidies were factored in). More like 1 in 6.

As far as the employer-plans, all that is nonsense. The reasoning is hilarious. Oh my gosh, we're losing our company plan....but why are we losing our company plan...because plans change all the time in the industry and thus grandfather status is lost when there is a "new" plan and that new plan must comply with the ACA. The ACA is not forcing you to lose your plan, factors unrelated to the ACA are causing the plan not to exist anymore, so you have to get a new plan that complies with the ACA. What is relevant is what kind of plan employers are going to get and you just posted something that said that employers estimate a 5-7 percent growth in costs for employers, an amount that is comparable to prior years. From what you posted, employers will pay about the same increase in costs as a normal year but they will provide their employees with better coverage (because many of them will have to get a new plan that complies with ACA mandates) Wow! That sounds like a win-win to me.

Danivon:

So it's not that the market is distorted, it's how much. And different scheme can have wildly different effects regardless of the 'method' - the devil is often in the details.

Of course a subsidised system, such as extended Medicare, would also involve government defining and regulating what they subsidise. As Medicare already does.

In the case of ACA, the government has redefined minimum insurance for not just the poor, but for everyone. Insurance requirements for birth control, mammograms, colonoscopies, etc. have all be redefined. The Gov't has mandated 4 levels of insurance (bronze, gold, etc.); they've created or mandated exchanges where we purchase the insurance (vs. the existing agency system), and they've mandated compliance via the IRS including penalty provisions; they've mandated a new definition for full time employee, and they've mandated employer insurance requirements based on the employer's size.

The problem in my view is not that the government has defined and regulated what they pay for (i.e. as they do for Medicaid) but they have overly defined and regulated what individuals directly pay for, including individuals who get no subsidy from the state.

Going back to SNAP (aka food stamps) which we've talked about before. I'm fine with the government mandating that food stamps are not used to buy potato chips or soda. (Unfortunately there is no such mandate.) However, I'm not okay with the government mandating that I as a free citizen do not buy these products with my own money. (Not a perfect analogy, but a close one.)

freeman3 wrote:So what exactly is your point about doctors not wishing to take medicaid, DF?

For starters, more people are going to be on Medicaid. That's a "feature" of the ACA. Now, what kind of "quality" care are they getting? Apparently, the kind of "quality" that suggests they should be willing to pack some bags and prepare for a long trip because no doctor within driving distance will be available.

Do you favor making less people eligible for medicaid (meaning less people will be covered)? Do you support increasing reimbursement for doctors?

The ACA is supposed to solve every problem. That's the way it was packaged. That's why it had 2000+ pages--"comprehensive." Yet, when the rubber hits the road, it's a bill filled with "unintended consequences."

Your cite articles indicating that medicaid patients will be less able to served by doctors who see too many patients already, but the alternative is at that some of these patients will not have any coverage at all...

False. The answer to every problem is not "the Federal government."

If the Federal government ran Facebook, no one would use it. Ditto amazon.com. Obama and his acolytes fancied themselves the new government entrepreneurs. Instead, they've turned out to be of the same stripe of the guys who paid $600 for toilet seats. They have no idea what they're doing.

As for the employer plans, your quote is pretty amusing. "Employees' costs are expected to rise 5 to 7 percent next year, according to early estimates. Those annual increases have been a fixture for years. But in some 2014 open enrollment documents reviewed by CNBC, companies are specifically citing the law as a factor in next year's pricing." So annual increases have been a fixture for years but now employers get to blame those increases on the ACA! (there is nothing to indicate that those increases were different from prior years)

I might think that someone who reads and speaks for a living could understand things without constant bolding. I guess I'd be wrong. You really feel the need to repeat what the article says and claim it as a proof that the article is "amusing?" Okay. But, you missed the point, so let me bold it for you:

"(F)ederally mandated health care changes will require Comcast-NBCUniversal to pay new fees and implement plan design changes that will contribute to the increased cost of our plans . . .

Now, you are AGAIN claiming simultaneously that the ACA has kept prices down AND that the ACA is not responsible for increases that are coming. That is cognitive dissonance of a record-setting type.

The numbers I cited were that 3.6% of Americans bought individual plans and 0.6% of Americans would lose their plan and not able to find coverage at similar rates (after subsidies were factored in). More like 1 in 6.

Yes, but you have no idea about whether they will be able to find coverage at similar rates. You're pulling that out of the ether. I know you like to do that. Here's a charming story for you:

"I thought it was supposed to help us," Liz Binns said in frustration. "I can't afford it. I cannot afford it."

Binns had been trying to navigate the government's health care website since October to find affordable insurance for her husband, a 60-year-old who has a pre-existing condition and whose job doesn't offer coverage.

What she finally found for him Monday carries a premium of more than $400 a month and a $5,000 annual deductible.

"How can I pay this kind of money out?" she asked. "It's going to take at least a second job and praying that I would make enough on a second job just to pay for this health insurance."

Assistant Summit County Health Commissioner Donna Skoda advises anyone who feels they cannot afford the insurance to talk with a Certified Application Counselor. She said there could be a simple solution to the problem or other coverage options.

You can also get information by calling 1-800-318-2596.

Meanwhile, the application deadline for those who want coverage to begin Jan. 1 has been extended one week to Dec. 23. Skoda, however, recommends people stay with the Dec. 15 deadline in order to get it done.

Binns isn't sure yet just what she's going to do.

"I thought this was going to be the miracle for us," she said, "and it's not."

Read more: http://www.newsnet5.com/dpp/news/local_ ... z2mSKjV0Ro

The problem is that the media, as much as they would love to continue to be the President's lapdog, can't make up enough stuff to cover the truth. Will some people come out ahead? I sure hope so. But, we know many people won't.

Again, suppose the Democrats had proposed this as a health tax on some and a give-away to others--would it have passed? Not a chance. But, that's what it is.

As far as the employer-plans, all that is nonsense. The reasoning is hilarious. Oh my gosh, we're losing our company plan....but why are we losing our company plan...because plans change all the time in the industry and thus grandfather status is lost when there is a "new" plan and that new plan must comply with the ACA. The ACA is not forcing you to lose your plan, factors unrelated to the ACA are causing the plan not to exist anymore, so you have to get a new plan that complies with the ACA.

No, what is hilarious is your capacity for spitting out WH talking points.

______________________________________________________________________

"The ACA isn't forcing the insurance company to cancel your policy."

"It's not?"

"No. Insurance companies are cancelling policies that are non-ACA-compliant, like yours."

"But, you said the ACA doesn't force the company to cancel it?"

"The ACA doesn't force the company to cancel it. They just can't offer a policy to you that is not ACA-compliant, therefore they cancelled it. See the difference?"

"Ah . . . "

_________________________________________________________

The "factors unrelated to the ACA . . . causing the plan not to exist anymore" are the requirements of the ACA--like pediatric coverage, maternity coverage, etc. So, you're either being disingenuous or block-headed.

What is relevant is what kind of plan employers are going to get and you just posted something that said that employers estimate a 5-7 percent growth in costs for employers, an amount that is comparable to prior years.

Which you said the ACA had stopped!

From what you posted, employers will pay about the same increase in costs as a normal year but they will provide their employees with better coverage (because many of them will have to get a new plan that complies with ACA mandates) Wow! That sounds like a win-win to me.

If you're right, great.

However, many companies, AS THE WHITE HOUSE ITSELF PREDICTED IN 2010 (shouting needed because you apparently don't notice it otherwise), will dump their employees into the exchanges.

Meanwhile, if you can get off your complete lefty websites for a while, read this: http://www.nationaljournal.com/daily/in ... e-20131202

Watch the comedians on the video going after the ACA. Even Colbert, "Get on the bus, kids! The President says the bridge is 90% complete!"