Friday, November 29, 2013

Saturday, November 23, 2013

Call me a pragmatist; we have a problem; a solution; GOP wants to unsolve it

The shouting match between left and right on health care reform roars  with the  hyperventilating right calling anyone who supports Obamacare ideologically insulting names.  Just call me a pragmatist.
Earth to  ideologues: we have a problem here and whatever you call the solution, you want to unsolve it by replacing Obamacare  with nothing that protects consumers from bad insurer practices or  makes insurance affordable for the uninsured.  
Leave  it up to the free market system, you say. That is returning to  the same that  has refused  coverage of  so many for pre-existing conditions  and screwed its customers lucky enough to even get coverage. There is a good reason medical bills are the leading cause of bankruptcy.   Insurance had  small print clauses  capping dollar amounts of coverage or with  impossible to pay high deductible while  raking off more than 20% for overhead.
Legalized  monopolies extended  across state lines s that make true cross state free market competition a farce, permitting price   and benefit collusion. The only free market place, ironically,  is in the Obamacare exchanges where multiple carriers compete for your business with coverage and premiums  compared side by side, and all meeting at least   minimum standards. See
Heads up: your neighbors know we have a problem and need, want, and appreciate a solution as polls running in this newspaper this month have revealed .. More support Obamacare than want to repeal it; only 41% responding had employer provided insurance.   Surveys taken by Colorado Health Institute 2013 confirm the similar  numbers:  nearly 20% of your  Grand County neighbors do not have health insurance, 82% because of cost , and an additional  13% are underinsured.
Why?.  In order to make a living in this county many must  have one day job and two part time table waiting, drywall,  ski instructor , maintenance, hamburger flipping jobs.  Few   employers of such have ever  provided  insurance.
The newest fear hyping   prediction from the right is  that no young people will sign up so that only the sick and infirm with pre-existing conditions will be left in the insurance pool, causing Obama to  self destruct.  That did not happen in Massachusetts , the only testing grounds for a plan similar to  Obamacare. The young and healthy had more sense than what the old folks comfy with insurance credit them with.  It is not just the fines that got them into the system: though losing 1%  or $95 of your income this year and  much more in future years  with no insurance to show for it, too, is no  joke. What gets them into the system is the ability to afford insurance thanks to subsidies or to qualify for the expanded free  Medicaid  or  for those under 30 to get cheap catastrophic insurance.
Bike crashes and ski wipeouts happen  The cheapest knee replacement, per recent Aspen Times and Vail Daily surveys , costs $55 thousand  in Denver. Either you have cash, good credit,  or bankruptcy.
 Young people are  able to stay on their parents’ insurance policy until they are 26, thanks to Obamacare. An unemployed 19 year old  I know well tore his acl/ ncl and chipped a bone  and his parents said that since Obamacare let him stay  on his parents insurance, the coverage saved  $40 thousand  out of pocket.

Sunday, November 17, 2013

What a difference a year could make in the GOP's war on Obamacare

What a difference a year could make
In the GOP’s  war on Obamacare,   Republicans are taking a risk  if they rely on anti Obamacare messages  in the November  2014 midterms. The issues  today will not be the same  a year from now. There is time for a  significant number of their voters to realize while Republicans want Obamacare to fail, they also will begin to realize that the GOP also wants them to fail to be able to get good affordable insurance.  
While the GOP has had a field day attacking the administration for  the  botched web site rollout and shaming the President’s failure to live up to his alleged “promise” to allow “all to keep their insurance if they liked it”,  these are short term jolts.  A year from now the federal  web site will have been  up and running for  months. .   Enough customers will have signed up for Obamacare  by mid term elections in 2014  to have heard good things  from friends and family and  realize the GOP fear hyping predictions were   more hot air than not.    After four years of trying, the GOP still  would not be able to propose  a comparable alternative  and have concluded  that it is political suicide to repeal  benefits many already  enjoyed.
 The President’s administrative fix , allowing consumers to keep their substandard policies for a year and to allow insurers to sell substandard plans to existing customers,  takes the wind out of the sails of that issue . All holders of cancelled policies will  have had a year’s chance to seek better, cheaper policies.  In fact, in  Colorado ( )and in fourteen other states,   they  have the opportunity now  to shop in the state run exchanges that are functioning well.  
The President’s fix  shoves  the responsibility to reinstate cancelled policies to the insurers and the state insurance commissioners. However,  as insurance executives  complain about  administrative hardships and  a few  state insurance commissioners  sided with insurers,  other  commissioners, including Colorado’s, announced they would cooperate with Obama’s plan.
During the shaping and passage of the health reform law,  President Obama had studiously avoided bad mouthing insurance companies whose anti consumer practices were  the reasons for the reform law in the first place..  He needed their participation in the exchanges. But Democrats in Congress feel no constraints. Democrats have already indicated they will  go on the offensive, threatening to hold insurers’ feet to the fire  for excessive rate increases in advance of the health care law taking effect as a way to pressure them to go along with the President’s “fix”.
The GOP overreached and lost a chance to override a veto promised by the President. Some  Democratic members of the House   facing re-election in unsafe seats, voted for a Republican bill, but not enough of them  to make the bill veto proof.  In addition to allowing individual policy holders to keep their old policies,  the GOP    proposed that even new customers  could buy  substandard policies .  This was a subtle time bomb. It  would  cancel out  Obamacare’s purpose to protect consumers from insurer’s unfair practices and divert the healthy from buying insurance through the exchanges,  undermining the law’s financial soundness that depends on a diverse pool of healthy young   and others that are  all paying in.

Sunday, November 10, 2013

Twisted grammar and changing vocabulary are the stuff of the GOP anti Obamacare crusade and Obama's stumbles

Twisted grammar and ever changing vocabulary are the stuff  of which the continuing GOP crusade to destroy Obamacare is  made and the Democrats have their stumbles, too.  The anti Obamacare talking points get the present tense of verb mixed up with future tense.  Some words, like “replace”  disappear from the  talking points, new ones emerge like “repair”. Old words, like “lie”  get new definitions.
One GOP approach is to   turn present tense into a future certainty.  The lines go like this.” No one has signed up for Obamacare now, they will not do it later”, ignoring that. a working web site and  penalties have not even kicked in yet..Another line is.. “ No young, healthy will sign up so it will collapse of its own weight”, though 98% are insured  in Massachusetts, the state system after which Obamacare was patterned.   If  “the tech surge” succeeds in fixing the web site , their verb tense will   become past perfect.
Since Rep. Joe Wilson  interrupted   President  Obama’s 2009 State of the Union speech with, “You lie”, “lie”  has also become a standard GOP phrase.  Mitt Romney, interviewed on NBC’S  Meet the Press  Nov. 3, used the less inflammatory  words,”fundamental dishonesty” instead of “you lie”, but the meaning was the same.
When is a “lie” a lie ?  When it is true at the time when it is told but  it is not true now?  That seems to be how  the GOP defines it. When Pres. Obama made his statements before mid March 2010 when the law was passed it was true at that time,  that” if you liked your insurance,  you could keep it”.      Not explained then ,if the individual insurance you had then is not the one you have now or your policy terms changed in the meantime  and it does not meet new standards, you may have to get a new  policy..   Pres. Obama’s  sin, for which he apologized November 7 was  not qualifying his statement with the adjective  “most”  will keep their insurance, and then doing nothing to clarify  then or later.  
 The President has promised to fix the problem for those who have hardships because of the cancellations.   What would happen without changes ? All would get better, more comprehensive  insurance, about half would  even qualify for a subsidy and pay less  and  others  would pay more. It is the latter the President hints he will take administrative action to help.
For the most apolitical, factual explanation of how Obamacare will impact you personally, go to What's up with Obamacare and my health care? -  at  . It is a good way to get real  in future tense. Remember Colorado manages its own marketplace and web at: and it is up and running. Do not go to the federal site.
In the Nov. 3 interview,  Gov. Romney did add  a new word to our  health care reform  vocabulary: “repair”   .  “Repair” should  not mean a “fundamental change”.   
 “Repeal and  defund”, the “throw the baby out with the bathwater” approach,   will be only  a whisper  by March 31, 2014 when many  have signed up. Taking away better understood  and valued  benefits from so many will be a tough sell . “Delay” will still be on the tips of some tongues,  but expect no action unless the federal web site is not “repaired” by the end of November.  There is still plenty of time between December 1 and  before the end of March to sign up customers.
 “Replace”  used to be coupled with the word “repeal”, but it  has disappeared from the GOP  lexicon.  Nothing Republicans  ever proposed  in the past four years “replaced” what Obamacare offers: insuring 30 million uninsured and protecting consumers , while providing  a plan  to pay for it without adding to the deficit.