{"id":823,"date":"2013-09-27T09:08:00","date_gmt":"2013-09-27T09:08:00","guid":{"rendered":"http:\/\/admin.patheos.com\/blogs\/janetheactuary\/2013\/09\/making-the-case-against-the-case-for-obamacare.html"},"modified":"2013-09-27T09:08:00","modified_gmt":"2013-09-27T09:08:00","slug":"making-the-case-against-the-case-for-obamacare","status":"publish","type":"post","link":"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2013\/09\/making-the-case-against-the-case-for-obamacare.html","title":{"rendered":"Making the case against the case for Obamacare"},"content":{"rendered":"\n<\/head>

Yes, usually, the phrasing would be simply \u201cmaking the case against Obamacare.\u201d\u00a0 Why have I chosen the convoluted title above?<\/p>\n

Because the anti-Obamacare pundits, as far as I can see, aren\u2019t really trying to react to the claims of its supporters.\u00a0 They point to the new opportunities for healthcare coverage, and the subsidies that will reduce costs for people with lower incomes and larger families.\u00a0 Complaints of cost increases for those not cushioned by subsidies are met with disdain \u2014 they merit no more regard than people who complain about high taxes; if you can afford it, you should pay your fair share.\u00a0 And complaints about overall impact on the health system produce the response that it\u2019s uncaring to complain about the small details when the bigger picture is the alleviation of the misery of the uninsured.<\/p>\n

By \u201cthey\u201d \u2014 the \u201csupporters of Obamacare\u201d \u2014 I\u2019m not simply referring to the latest speech that Obama, or Pelosi or Reid gave.\u00a0 I\u2019m referring to newspaper coverage, which is really ramping up into a targeted campaign in support of the program, citing the most favorable figures of affordable, net of subsidy, figures.\u00a0 <\/p>\n

And the line in multiple newspaper columns is that, once Obamacare is implemented, all the bumps in the road will be forgotten, but prying the subsidies away from voters will be no more possible than any other cuts to major entitlement programs.<\/p>\n

So, look, first of all, complaints that Obamacare will increase the demand for doctors, and people won\u2019t be able to find a doctor accepting new patients because of that just sound petty.\u00a0 That\u2019s an \u201cI\u2019ve got mine\u201d approach that is thoroughly unpersuasive.\u00a0\u00a0Emphasizing the small size of the networks insurers are providing on the exchanges really\u00a0isn\u2019t going to get anywhere either \u2014 at least not as long as people can still continue to buy individual coverage through an insurance agent (which I understand is the case), for those who use the exchanges, subsidized coverage with a smaller network is better than full-price coverage with a large network.\u00a0 (And it\u2019s not clear to me yet what the final outcome of the small networks will be \u2014 are these the doctors having difficultly building up their practices so they\u2019ll accept lower reimbursements, or is there more going on?)<\/p>\n

But anti-Obamacare-ites really have got to have a clear message \u2014 something like this:<\/p>\n

Fellow citizens, here are the problems with Obamacare:<\/p>\n

First, the subsidies, while great for the individuals who receive them, are ultimately, a major new spending program that the federal government can ill-afford.\u00a0 It\u2019s supporters played budget tricks and instituted lots of hidden taxes to make it seem free, but there is no free lunch.\u00a0 (Yeah, I know, my Vouchercare<\/a> involves even more government spending, but done so honestly, without tricks but openly increasing taxes to fund it.)<\/p>\n

Second, the entire\u00a0structure is full of cut-offs and breakpoints and thresholds which can be incredibly destructive.\u00a0 If you\u2019re income\u2019s at 400% of poverty, you get a subsidy.\u00a0 401% \u2014 nothing.\u00a0 If you employ someone 30 hours, you\u2019re required to provide healthcare, 29 hours, not.\u00a0 Or, as a blog the other day (don\u2019t remember where any longer) pointed out, if you\u2019re married, your subsidies are significantly lower than if you\u2019ve just shacked up.\u00a0 <\/p>\n

Third, the entire system is too full of regulation and control by the government by its very nature.\u00a0 The exchanges suck up too much information, putting people at risk of identity fraud.\u00a0 Electronic medical records imperil medical privacy.\u00a0 Government determinations of acceptable coverage (maximum allowed deductibles, which \u201cpreventive care\u201d services are covered with no out-of-pocket cost and which not, etc.) increase costs.<\/p><\/blockquote>\n

OK, I just typed that up without too much effort so it\u2019s not very persuasive \u2014 but my continual irritation is that our elected GOP leadership, while opposing Obamacare, just isn\u2019t making a coherent case, nor coming up with a coherent plan, despite years to make such a plan rather than 15 minutes.\u00a0 \u201cDefund\u201d or \u201cdelay\u201d isn\u2019t really going to do much but repeat the same battles and you know how that\u2019s going to be covered in the papers.\u00a0 There has to be a systematic repair plan offered to the Democrats as a way of saving face<\/a>, in order to move forward \u2014 something that says, \u201cif you like the exchanges, you can keep them,\u201d for instance.\u00a0 A more honest way of providing premium support. (But please, not the idea of 2,500\/5,000 tax credits that\u2019s continually trotted out!\u00a0 Having a single flat benefit for single people of all ages and health conditions, and another for all married people\/families shows that there\u2019s been no serious thought to the proposal!)\u00a0 Instead of\u00a0an ongoing\u00a0\u201cno pre-existing conditions\u201d rule, a \u201cgrace period\u201d at the start of implementation, and a \u201ccontinuous coverage rule\u201d covering group and individual plans.\u00a0 <\/p>\n

Maybe, maybe the Republicans have such a plan \u2014 but I haven\u2019t seen it, and I follow the relevant blogs and news sites pretty regularly.\u00a0 Oh, sure, I\u2019ve read claims that they do have a plan, but it turns out to be nonsense like \u201cbuy insurance across state lines.\u201d\u00a0 <\/p>\n

And this is where I get really frustrated at the fact that there is no way for a private citizen without political connections to do any more than, well, write an irritated blog post before starting work for the day!<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"

Yes, usually, the phrasing would be simply \u201cmaking the case against Obamacare.\u201d\u00a0 Why have I chosen the convoluted title above? Because the anti-Obamacare pundits, as far as I can see, aren\u2019t really trying to react to the claims of its supporters.\u00a0 They point to the new opportunities for healthcare coverage, and the subsidies that will […]<\/p>\n","protected":false},"author":2209,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-823","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nMaking the case against the case for Obamacare<\/title>\n<meta name=\"description\" content=\"Yes, usually, the phrasing would be simply "making the case against Obamacare."  Why have I chosen the convoluted title above?Because the\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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