Be Skeptical of the Affordable Care Act

Of course I picked a sloth picture. I'm a Skepchick, aren't I?
Of course I picked a sloth picture. I’m a Skepchick, aren’t I?

So apparently the government is about to shut down! That’s pretty scary. I, of course, have had more important things to pay attention to this past weekend (i.e. Breaking Bad), so I’ve mainly been tuned out of whatever temper tantrum the Republicans are having right now, although I assume it has something to do with the Affordable Care Act (cursory reading tells me I’m correct).

Well, I think the House Republicans are really onto something here. We, as skeptics, should really be skeptical of Obamacare! Like this lady, for instance. Quote Stacie Smeal: “In general, I don’t need health care. I exercise and eat healthy, so I’m generally a healthy person.”

Wow! What a great outlook! The 27 year old fitness entrepreneur said the Affordable Care Act “disgusts” her. You know, the same thing that gives women free preventative medicine, and that allows young people to stay on their parents’ insurance plans until they’re 26, and that prevents insurance companies from discriminating against people for preexisting conditions, and that dictates that insurance companies must spend 85% of premiums on health care…you know, that thing. It disgusts her.

And why wouldn’t it? She eats all organic food, which makes her emit a forcefield that prevents her from ever falling down the stairs or being assaulted.  And since she does yoga, that means she will never get pregnant or have any concerns related to aging. In fact, doing the warrior pose in yoga makes all of the cancer cells that have accumulated in her body fall out of her vagina! In other words, Woman Becomes Invulnerable To All Injuries and Illnesses With This One Weird Trick (A+ job to my friends on twitter for responding hilariously to this article).

Of course, I’m not saying that exercising and eating well aren’t good for your health. Of course they are (when possible). But they’re also not a cure-all or a replacement for…you know, actual medicine. Smeal said, “Unless I get into a life-critical accident, I don’t need health insurance.” I agree. There should be something you can buy in case you do get into a life-critical accident that would help you pay for the exorbitant bills that would accumulate from being in such an accident. That’d be pretty useful, wouldn’t it?

It’s almost like insurance serves an actual purpose and that no one really plans on getting sick or injured, but unfortunately those things happen all the time. I’m actually pretty skeptical of the article’s claim that “Millennials threaten success of [health care] reform,” considering they only cite three people who have objections to the plan, but I haven’t seen any data that specifically refute or support that claim.

Anyway, tomorrow is the first day that you can enroll in the health plans available from the Health Insurance Marketplace. ThinkProgress has a good article for you to check out if you still have questions on it. If you’re not sure how the Affordable Care Act will affect you, or you want to see what plans you’re eligible for, check out healthcare.gov. If you’re more concerned with how adorable animals will affect you, then check out the Adorable Care Act.


Sarah is a feminist, atheist vegan with Crohn’s Disease, and she won’t shut up about any of those things. You really need to follow her on Twitter (and probably Google+, just to be safe).

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  1. Apparently, Australians last night set a new all time record for illegal downloads of the final Breaking Bad episode!
    Sadly, I was not among them and I have yet to see season 3 of GOT:(
    Let’s just say we are so SICK of being kept waiting for months or years and being ripped off pricewise to see the latest movies and TV series.

    1. Soryy Sarah, that was for Mary’s thread, something wrong with my brain these days!
      But great post, I’m glad the USA is finally joining the rest of the advanced world with healthcare.
      After a year or so, most Republican supporters will also be glad and realise what bullshit they have been sold against their own best interests.
      At least, we wait and hope!

  2. This is great! Actually, I do have some issues with the ACA, mostly that it doesn’t go far enough, but it is way better than the system that was already in place.

    1. It’s definitely not my ideal, but it also allowed me to get on to my partner’s insurance after I had been diagnosed with a chronic illness, so I’m pretty happy about that.

  3. Wait, so, you mean hospitals will be paid their fees because patients will have insurance and that the small 20-bed hospitals that write off millions of dollars a year in losses (let alone the tens on tens of millions at bigger hospitals and hundreds of millions at enormous ones) will be paid? So, the ACA will actually MAKE BUSINESSES MONEY IN ADDITION TO PROVIDING CARE TO A GREAT MANY PEOPLE?! Preposterous!

    This is America! Doesn’t the President know that something that’s good for poorer citizens is socialism and can’t be good for big businesses?! He’s an evil witch full of lies!

    1. No, but seriously, the ACA will make, like, EVERY hospital millions of dollars per year. How is that NOT supremely Republican? I don’t get the defunding demands. Someone should really get on the House floor and tell the Republican holdouts (when this comes up again this month, and then every month after that because it doesn’t seem to go away) that women and poor people will not only receive basic care (“boo! I hate those people!”) but that they will become an exploitable money fountain for hospitals and the healthcare industry (“horray, exploitation of things I don’t like!” “Money fountain!”). I think there’s a real strategy there.

      1. While making millions of dollars for giant hospital corporations is great, it doesn’t come close to the joy a Republican experiences whenever they have an opportunity to fuck over the poor and—especially—women.

        1. What I don’t get is the insistence to piss off both ends of the spectrum, though. Upper middle and upper class people will be ranking in billions, like, no joke, billions of dollars per year with the ACA. Poor and lower middle class people will be able to afford basic care. Hell, even middle middle class people will get cheaper care from the competition. It’s very, very far from ideal, but this is money in the pockets of every single constituent base. I just do understand it. Economically, it’s (very broadly speaking) a complete slam dunk. I don’t get why that isn’t enough. “Oh, everyone gets more money and the economy grows? Yeah, I don’t want that.” WHAT?

          1. Yes, but it’s the Democrats’ project and not being stridently against it would suggest that the Democrats aren’t dirty, hippy, liberal, commie, homosexual, marxist, godless, heathen, socialist, evil, baby-eating scumdogs.

            And, of course, it would make the Democrats look good for actually accomplishing something.

            I don’t think there’s any reason to assume that it necessarily has to have anything to do with any qualities of the act itself. It’s to do with being able to say “Look, the democrats can’t get anything done!” when campaigning.

      2. The Republican concern is purely strategic. They took a decision to oppose Obamacare in 2009 in the hope that killing Obama’s signature domestic program would make him a one term president. Having made that choice and failed the Republicans are now looking at polls that show that about 15% of their base does not have health insurance at present. People are much more likely to vote for people who deliver important services for them. The GOP is facing an electoral annihilation if just half of that 15% was to switch because they prefer the party that gives them health care to the party that gives rich parasites tax cuts.

        The 2009 GOP strategy could hardly have been worse. They opposed the ACH on every vote and they linked it to the President by name. The term ‘Obamacare’ was meant to be a derisive term but now the program is going into effect, Obamacare is the name for the US universal health system.

        The GOP is not actually the party for the rich, it is the party for some of the rich. During the whole Bush Tax cuts debacle we were being told that it was necessary to curt taxes to encourage innovators, by which it was implied the beneficiaries would be people like myself who started or helped start successful technology companies. Only that is not how the tax cuts worked at all. The tax cuts all went to the idle parasites who live off passive investment income and to financiers like Romney. My taxes didn’t go down at all because the AMT schedule was not affected by the Bush Tax cuts.

        Don’t get me wrong here, I am not saying that I should have received a big tax cut or any tax cut at all. The point I am making is that the Bushies used the contribution made to the economy by people like me to justify a huge tax cut for parasites who contribute nothing and only take.

        Most businesses are behind the ACA because we really do not want to have the responsibility of choosing health plans etc. for employees. Negotiating with insurers takes a lot of time and costs us a lot of money and adds nothing to the bottom line.

  4. What I really don’t understand is why Republicans can’t see that having a healthier populace is good for business? Healthier people means fewer on disability and more of those workers they seem to want so much and affordable healthcare means more disposable income to be spent on products and services.

    I watched a BBC documentary a year or so ago and they said that the idea for some form of mass healthcare in the UK came during the Boer War. So many conscripts were medically unfit due to poor health that the government realised how much damage this was doing to the economy. Just think of all the work they could do if they were fitter! It took a few decades but the nucleus came from the appreciation that a healthy population is a wealthy population.

    While I think there are better arguments to be had for healthcare than economics if it’s the language the opponents to it speak in, then speak back in the same language.

    1. They don’t care about an economically fit populace. They care about an economically fit elite, chosen by God or the “invisible hand” of capitalism or whatever.

      1. But surely to make an economically fit elite they need minions to do their bidding? If the masses are all laid up at home missing limbs and dying of curable diseases who’s going to do the work or buy their products? You can’t create an economically fit elite without shitting on the workers but if you have no workers you have no elite.

        1. Realistically, it’s what’s been going on lately, which is why you see a widening gap between rich and poor. It’s a bit fictional to believe that there would be NO workers even under such conditions such as the days of the American Robber Barons.

          Additionally, there’s a dissonance when certain issues become too large, like farmers leading up to the Great Depression who continued to grow more and more produce to make up for falling prices, all the while contributing to the falling prices.

          1. Yeah, I know I was being hyperbolic (and even further to the left than I am really) but this whole thing baffles me. There are so many positives to having universal healthcare and so few negatives. Yes, you might feel you’ve paid in more than you get out, but even if you don’t get to benefit hugely directly, chances are your friends and family will.

            When I first started watching Breaking Bad my initial reaction (other that ‘I want to see more’!) was “that could never happen here’ (the UK). Someone gets diagnosed with cancer, someone gets treated with cancer, life goes on (hopefully). My next-door neighbour was diagnosed with breast cancer a couple of years ago and went through about a year of treatment. It was a stressful time but money was never a significant part of that stress because while she lost some money from having to be away from work so much, there was no treatment costs. Now she’s better, she’s back to work and she’s moving on with her life. I don’t know how it benefits anyone, individually or societally, to make people have to decide between their health (and potentially their lives) and the financial security of themselves and their families. It’s inhumane.

          2. I am currently in like $12k of debt (or more? idk lol) because I had a recurring anal abscess (three fucking times!) and, recently, a kidney stone. NONE of these resulted in more than 4 hours at the hospital at a time. I wasn’t even given a fucking IV. I got some pills, a few shots for the kidney stone. That’s IT.

            And yet I am in so much medical debt, I’m likely to never get out from under it (and let’s hope I don’t get “sick” again).

            And it’s not as if any of these were really my fault — the anal abscess just sort of happened and sometimes it takes a few tries of antibiotics to fully get rid of (it may have been MRSA… I wasn’t even tested… lol). The kidney stone was a fluke — I don’t drink much more than water, but hey, it happens sometime; it wasn’t even a bad kidney stone and I passed it with only some percocet.

            I haven’t been to a dentist in like 5+ years. Who the fuck can afford the dentist without insurance? Even WITH insurance that shit is expensive.

            I’m a pretty healthy person and YET I am still $12K in debt. For almost no reason. Crazy.

          3. And I DID try to go to Urgent Care for the anal abscess. Twice. They COULD have helped me but I basically paid $80 twice for them to do nothing except throw pain pills at me (actually, the first time, I had to beg for pain pills. I WAS CRAWLING ON THE FLOOR UNABLE TO WALK.) Finally I said fuck this, and just went to the hospital, where they treated me exactly as they were supposed to. And I don’t even think you can go to Urgent Care for kidney stone problems.

  5. I think it’s because if people aren’t spending all their money on health care, they’ll spend it on education instead, and education is Satan’s work, or something. Also, if everyone is treated for their health problems because money is less of an obstacle, how will you know who to hate for being constitutionally inferior? People will be able to live out in society with their congenital illnesses, taking spots from the people who worked really hard at not being born with heart defects, or were more rigorous with their breast milk intake and jolly jumping and did not acquire childhood leukemia. Also, way harder to find cheap foreclosed property to flip.

  6. Look at that sloth. You just know his doctor has made a mistake on his paperwork somewhere and yet he still gets to keep all his healthy snacks.

  7. I’m really at a loss that so many “skeptics” are either unintentionally or willfully ignorant of the facts, implications and probable 2nd/3rd order of Obamacare. These comments read like partisan Democratic talking points. I have no problem with partisan Democrats mind you, but I hope you’re all self-aware enough to realize you’re leaving skepticism at the door when you make comments like this.

    The number is issues I have with Obamacare could rival a Tolstoy novel in length. In short, consider this: the same government who spies on your emails, using the IRS to target political opponents, and running up over a trillion dollars in debt a year among other things is now in charge of your health care – and will have access to your medical information (whether they say they will or not). EVERYTHING about health care is now a political decision/consideration. That ought to scare the living shit out of you because your deal leader and your dear party won’t always be in charge in Washington. What happens when a Republican is in office?

    The USA became the worlds sole superpower because of two things, democracy and capitalism. Why we’re turning our back on the latter for 1/7th of our economy is beyond me. The results are predictable – the quality of health care in this country will fall. The skeptical among you could do some homework to either criticize or support this claim. The un-skeptical can parrot some talking points from Think Progress.

    I’m also more than a little annoyed about the title of this post, which the post itself makes clear is a joke. It is anything but.

    1. All you’ve done here is tsk tsk tsk’d us for not being skeptical enough but have said nothing else.

      If I wanted to get a bunch of vague talking points that don’t really say anything … I’d turn on FOX news.

    2. The un-skeptical can parrot some talking points from Think Progress.

      And yet here you are repeating the ridiculous accusation that the IRS was used to attack political opponents. They were simply making sure that these tax-exempt groups weren’t engaging in illegal campaigning, you know like THE IRS’s FUCKING JOB. Do you know how many of those “enemies” were denied their tax-exempt status? Exactly two, and both were liberal organizations. If Obama used the IRS to attack his enemies he didn’t follow through on it very well, and even if he did ask the IRS to double check those 401c cases so the fuck what, as written most of them should have not qualified, but then religion gets a special pass in this country and now it seems extremist political views are starting to be given that same status. Bully for us, democracy for sale, hallelujah. And speaking of which…

      The USA became the worlds sole superpower because of two things, democracy and capitalism.

      Yes, and thanks to the SCOTUS, now that the two have merged capitalism is strangling the life out of democracy, but you don’t hear all these tea-bagger patriots screaming about statements like “corporations are people, my friend”. That’s because their side is “winning” that argument, only problem is, if they win we all end up losing.

      I remember when non-profit used to not be a dirty word in this country, when hospitals and doctors could care more for their patients than how to word the pretty-please note to the insurance company so as not to bankrupt their patient, when necessities of life were provided at the lowest cost and in the best way possible without investors having their hands out because their weren’t investors. But then I was around before Saint Ronald Reagan started a racist war on drugs and the middle class in a race to see how fast we could fill up the newly privatized prisons.

      There is plenty about ACA that is problematic but most of them stem from it not going far enough, a nationalization of the health insurance industry would have been a step in the right direction. But then what do I know, I’m just a patriotic American except I don’t get to call myself that because I refuse to overlook our many flaws. So please tell me again how I am not being skeptical.


      Nice scare quotes on skeptic BTW.

      1. We’ve reached a weird point in our political environment whereby truth – real, actual truth – is either irrelevant or willfully ignored by some people. It is absolutely and unassailably true that the IRS targeted conservative groups for greater scrutiny and delayed applications for non-profit status during the 2012 campaign. See here for a comprehensive roundup: http://taxprof.typepad.com/taxprof_blog/2013/10/the-irs-1.html

        Yet in some of the far left corners of the web, this fantasy that the IRS was simply doing it’s job has grabbed hold and – in mrmisconception’s head apparently – become metaphysically true. I’d be interested to know why all those IRS officials resigned if they were just doing their job and doing it well.

        Lots of other non-sequiturs in your response except the “ACA didn’t go far enough” line. Look, I have no problem with having that debate. I will tell you up front that I am biased and will argue the free market case. Where “skeptics” piss me off, on this site and Ftb as well, is they don’t identify their political biases. When you argue politics you’re absolutely not being skeptical because you specifically are biased by your leftist beliefs (some would characterize them as “extreme”).

        You have an end state in mind for health care in this country – as do many other Democrats – just tell the rest of us what that is and make your case that it will be better for the country. I’ll do the same and we’ll see who persuades more people (you have the press on your side, and thus the advantage). But don’t pretend that your political views represent some kind of skeptical “truth” because politics are about value judgements which can’t be measured in the same way as, say, the mass of a proton.

        You have an opinion, and in this cloistered sandbox everyone has close to the same opinion. Prettying that opinion up around the edges with the language of skepticism doesn’t make it anything more.

        1. I am biased toward basic medical care. This bill provides a level of that and eliminates billions of dollars in losses for hospitals a year, which means insurers eat less cost, too. Care is provided to citizens and two gigantic industries eat less cost. Is the benefit of not having a healthier populace and a more solvent healthcare market (again, billions) greater than the value provided by blockading this law (which has stood against repeated sieges)? If so, how is it more valuable?

        2. This particular post is an opinion piece, yes, but I think it’s hilarious when neo-liberals or libertarians think that advocating for capitalism is unbiased or something. All economics are political, however, there are some schools of thought that are more evidence based than others. The Austrian school, that libertarians seem to love, is explicitly anti-empiricist and therefore should be completely disregarded by any skeptic, yes?

          The fact of the matter, universal health care has been shown to be more economically efficient by many economists. If you are unaware of this, then I might suggest looking up journal articles, but we may run into some government shut-down access problems. Since journals aren’t an option at the moment, here are a couple good places to start:


          I don’t think this is a good place to debate or discuss the merits of ACA or universal healthcare so I’m not going to debate here, but really, the accusation that leftists hold their opinions without evidence is really getting tired.

          By the way, I don’t consider the ACA to be a leftist or progressive reform of healthcare. Yes, it’s better than what was before, but nowhere near actual universal healthcare.

        3. You have the real, actual truth huh?

          So far you have spouted an opinion, which you are welcome to, but it does not constitute “the truth”.
          The IRS scrutiny was initiated by a staunch Republican employee and a good amount of those targeted included tea-party in their names (and despite all the astroturf they do consider themselves to be an actual political party) sort of telegraphing their intentions. The White House was not involved, the IRS had been wantonly ignoring this particular rule for years and an employee decided to look into it, that doesn’t mean that it should have been done (I feel that it actually should be extended to all organizations regardless of their political leanings, including churches and unions) but it was not even against the rules and nobody should have resigned in my estimation. The only reason anyone did was because of the overblown fuss kicked up buy the right. If there were orgs using names with democratic party or republican party I would expect them to be scrutinized as well. So “the truth” is not nearly as cut and dried as you would pretend it to be.

          Neither is the “truth” of a profit based healthcare system. In the health system that is envisioned by the Ayn Rand-worshiping, Tea-Party pandering Republicans everyone will be able to freely choose the health insurance they want and the insurance companies would be able to price that coverage to whatever the market would bear, no matter the actual effect on the quality or cost of the resultant health care. If you get sick, or are old, or have a pre-existing condition, or simply can’t afford the prices born by that market it is better you die and stop being a burden anyway, so mission accomplished. The entire thing puts me in mind of Ebeneezer Scrooge at the beginning of A Christmas Carol when he points out that he already pays for workhouses and prisons when asked for charity for the poor.

          I won’t pretend that liberals or Democrats don’t do things to pander or for their own interests, and I wouldn’t say that every conservative or Republican would put profits ahead of people (at least not consciously), but let’s not pretend that you have some overarching “truth” when it comes to politics. Political beliefs are opinions and as such are open to mockery just as much as religious beliefs, and if someone acts in a callous way you will excuse me for believing that they are callous.

          Anyway, I am done talking about this with you, I am not in the mood to hear it My wife was recently told that she needs a hip replacement but that the insurance will not pay for it until she is at least 50 (four years of intense pain for her, I guess), it seems artificial hips are expensive and last around 15 years so the insurance company wants to make sure that when a replacement for the replacement is need she will be Medicare’s problem. So, once again I ask you, how the fuck am I being unskeptical?

          1. Lois Lerner is anything but a staunch Republican. I would suggest you branch out a bit in your news consumption away from the Daily Kos and Huffpo.

            I agree with Trinity that a skeptical blog isn’t the place to argue politics, and that’s part of my point.

            I agree with you that I don’t have some overarching “truth” when it comes to politics, but here’s the deal – you don’t either. That’s why they’re beliefs or opinions or value judgements. I believe that I have history and the facts on my side. I believe you are well intentioned but horribly wrong. Where you are unskeptical is that you believe me to be not only wrong but mean and callous. If course nothing could be farther from the truth but it helps you persuade people.

            And your wife should be fine now right? Obamacare is here, the exchanges are up, no pre-existing conditions can be denied. She should be able to take care of that hip.

            And going back to the original subject, this is one of the reasons Obamacare will fail. Young people will choose to pay the fine (or not pay it, there is no enforcement measure to collect it) and not join the exchanges. This is partly for financial reasons but also because when they do get sick, they can instantly get health insurance no matter what their condition. Without the young, healthy populace subsidizing the older, sicker part if the population, the scheme will be unsustainable. What was sold to us as a budget reduction measure will end up costing trillions of dollars while at the same time degrading the health care system in this country.

            So sure…no reason to be skeptical of Obamacare. Please disperse…all is well…

          2. Yeah, mrmisconception. Geez. Everyone’s an unconscionably greedy bastard who would rather have to find an appropriate insurer, wade through filing for insurance, and wait to get the insurance after filing for it after trying to deal with a heap of current medical bills and prognosis information, and insurance pays for past medical consultations and actio–what’s that? Buying into insurance doesn’t pay doctors visits from before you had insurance? While people are far from entirely reasonable, most don’t want to have to fuck with that kind of stuff later? Several millions of people have been signing up or trying to sign up in the last four days rather than waiting for coverage that will take three months to take effect? They aren’t freeloading until January? I’m sure you’re misconstruing the situation. Your name is mrmisconception, after all.

          3. I was not speaking of Lois Lerner but rather the anonymous source cited in the interview transcript released by Congressman Elijah Cummings. I’m sure you would not believe that to be credible, it seems that you are right if you only listen to the sources who agree with you, I think I heard that somewhere recently.

            I never claimed I had the truth, only that I wasn’t being unskecptical. I also never said that you were mean and callous just that the people who are advocating for a market only solution are, you inferred the rest rightly or wrongly. But you were the one that came here to wave the “no true skeptic” bullshit argument around. That is a trend that I do see, any time someone on a skeptical blog disagrees it must be because they are not being skeptical, not that they have a differing point of view, not that they are uninformed, or not that they simply disagree, no no, it’s because they are unskeptical and dare to call themselves skeptics. Gasp! The horror!

            The issues you mention with Obamacare are exactly why I said it didn’t go far enough, everybody should have to enroll without exception, except the for profit insurance companies and health providers couldn’t let that happen. Profits over humanity again.

            I’m glad that you care about my wife’s situation enough to use it as a snide remark. But you see, if the law had been universal there would be no incentive to delay the surgery, but since health insurance is still tied to employers, still partly privatized, and still profit driven costs of the future override decisions of the now and the care of the patient. We could switch insurance but it would be much more expensive because it would not be subsidized by her employer (a benefit she would then be forfeiting) and that wouldn’t even guarantee a different outcome. But then even if the law had been universal, it would have had to have been written in such a way that when implemented the portion that employers pay now as a benefit would have gone to the worker, because I can guarantee that a good portion of businesses would otherwise pocket that as profit.

            You feel you have “the facts” but the truth is you simply have an interpretation of the facts you recognize to fit your narrative. Facts of history can be rather open to interpretation by those writing the history, you can feel free to believe your version of this history that furthers you narrative is “the truth” and I will continue to believe that incompetence and stupidity are far more likely than malice and conspiracy to be the cause of human failings. Deal?

          4. I wasn’t making a snide comment about your wife’s condition, because she is exactly the type of person this law is supposed to help. If it isn’t helping her, then perhaps there is reason to be skeptical of Obamacare (contrary to the intent of this original post).

            And I actually put more stock in an anonymous source than I do in people resigning or pleading the 5th in front of a congressional committee. (That was a snide comment)

            Ezra Klien and I don’t agree on much, but here is what he has to say, “Here’s what everyone agrees on: The Determinations Unit based out of the Cincinnati IRS targeted 501(c)(4) applications that used tea party-related terms for extra scrutiny. Whether the intent was benign, as the IRS swears, or rogue agents were carrying out a political vendetta, the effect was to politicize the IRS’s filtering process. That’s a huge problem.”

            Everyone agrees…except Mrmisconception of course…

            Once again, this time for the cheap seats…I’ll have a political discussion with you all day. I’d welcome that actually. I’d welcome a chance to discuss the morality of the free market, and how collectivists like yourself – who believe you have good intentions – do more harm than good to the very people you intend to help. Let’s have that debate because I think I’d wipe the floor with you.

            But that debate will have little to do with skepticism (except in the area of determining facts, like with the IRS scandal, if you refuse to acknowledge an accepted fact, it’s hard to have a discussion). Political debates are about convincing people to make value judgements similar to yours.

            My main issue with this blog post is it’s mockery of any skepticism of Obamacare and the sycophantic comments that followed. We had to pass the bill to find out what’s in it…and we’re just starting to see the fruits of that now.

            This bill – passed against bi-partisan opposition – will have more of an impact on our daily lives than any bill passed in the last half century…and a “skeptical” blog essentially says “nothing to see here.”

            That is a politically partisan move, and in political discussions it’s hard to be skeptical and politically partisan at the same time. In fact it’s impossible. Skeptics must be ready to change their mind upon receipt of new/better information. Is there any type/amount of information which would make you change your mind on the free market argument for health insurance? Because if there is I’d like to take that shot.

            Just not here.

          5. Your comment about my wife was snide and she is not being helped because the public option was watered down so much, with a truly universal system the incentive to extend her pain would be gone.

            You are here arguing about the tone of an article you feel should be more serious, that’s too bad for you as it’s not your blog and you don’t get to set the tone. Sorry.

            Of course you dismiss the anonymous source, that wouldn’t fit your narrative. You believe that the orders to stop these orgs from getting tax-exempt status came from the White House, this source contradicts that and explains why that scrutiny was very localized. I wish the source would come forward with their name but they would be quickly crucified by the right-wing echo chamber.

            I actually agree with Ezra Klien, it is a problem and the only part I disagree with is the political vendetta part. It is a problem that was triggered by the Citizens United decision. After that awful ruling came down there was an influx of 401(c)(4) requests that overwhelmed the IRS, a good percentage of those new requests had political names (mostly from the right) that indicated that they may violate the rules, a rule that had been reinterpreted (not rewritten) years before. It wasn’t a politically partisan move, it was a decision by an employee that was fed up with a rule-breaking attempt to circumvent democracy. He decided to do something about it, wrong perhaps but not illegal, why has nobody been arrested or even indicted if it was?

            The current iteration of libertarians always feel that they know better than everyone else yet every time their shitty little policies get implemented the wealth concentration increases and the safety net gets thinner, good for them not good for anyone else. I have no interest in having a political debate with you, not only is this the wrong place for that but listening to people justifying their “I’ve got mine, yours is not my concern” outlook makes me want to vomit. And if my humanism comes across as collectivist to you so be it, fuck the rich, they got where they are on the backs of the little people whether they acknowledge that or not so I have little sympathy for those of them that refuse to pay back into the system they used to get the wealth they have.

            Most bills have opposition, so what? This particular bill passed the House and Senate, was signed by the president, was found constitutional by the Supreme Court and is now the law of the land. If its opponents wish to repeal it then they need to actually repeal it rather than hold there breath and call their guesses about what the law will do “facts”.
            If you don’t know how it works try watching I’m Just a Bill.

            As to what will change my mind. Some actual facts that show how this law made health care more expensive, reduced care, or cost the government more money. There are projections, the CBO says it will save billions, The Heritage Foundation says it will cost billions, neither own a working crystal ball to my knowledge.

            So yes, we can mock skepticism of Obamacare because it is denial rather than skepticism. If the law creates a bad outcome then I will be ready to admit I was wrong, four days in I see zero evidence but keep trying.

          6. Mrmisconception – you asked me before how you were being unskeptical. Read through your last comment and see if you can find it.

            “I have no interest in having a debate…”

            “Makes me want to vomit…”

            You are so deeply entrenched in your political worldview that the mere presence of a contrasting argument makes you ill. Think about that…

            I’ll spare the wonky details, but I’m proposing a testable hypothesis: Obamacare will increase health insurance costs dramatically (we can debate what that means, I’ll define it as 50-75%), it will decrease the overall health of the populace (as measured by a variety of statistics we could choose up front), it will not reduce the deficit (relatively easy to measure), and will ultimately (within 5-10 years) be either repealed or significantly altered.

            If my hypothesis proves correct, will you concede that you are wrong?

            I have little doubt I’ll win handily, and would even put money on it.

          7. “Obamacare will increase health insurance costs dramatically (we can debate what that means, I’ll define it as 50-75%),”

            This is actually a somewhat interesting assertion. See, prior to this bill, insurance cost was coupled to what they wanted to charge you to have it, while pushing for less and less coverage, and a higher percentage of the cut from what you gave them. The bill explicitly says that they *must* spend a high percentage of it, much more than they currently are required to in many case (they actually argued, successfully, that it was somehow unfair to have to pay out 75% of the cost of the procedure, and thus, they should be allowed to make you pay 35% of it. What that translated to in terms of how much of your money, from what you gave them to be insured actually got spent on medical is uncertain, but it varied, and in some case was so bad that you got almost nothing, compared to what was spent to have it.

            So, what does decoupling the amount they *must* spend from their own internal decision making process, as to how much to spend on literally *everything*, including political bribes, they waste you money on, and instead mandating that the majority be spent on health care do? Well.. this is interesting, because it means that they either have to approve more procedures, instead of denying them, because they don’t want to cover it, or they have to cut you a check for the difference, they can’t just “keep” the remains, if its never used, otherwise, they wouldn’t be spending a “set percentage” of your money on providing care. They might get by with using some of it, as part of a pool of money, to approve things someone else might not have otherwise gotten, but it still has to be spent on “actual care”, not dumped into someone’s wallet.

            Now, this is a problem, for the rising costs theory – How do you justify, unless the health industries costs are what go up, raising the cost of the insurance, if the company doing so ***doesn’t get to keep the excess***? Sure, they can charge you more, but then.. they have to spend it. They can’t just pocket it. So, rationally, their is no way to increase the cost, unless its “in step” with what they actually need to spend, to cover your medical bills. Anything they don’t spend, they can’t keep, so their is no longer and incentive to hike up the costs, to try to squeeze more money out of you. Doing so won’t get them any more money.

            This is in contrast with the “100% free market” solution, which we have had, where they could charge what ever the hell they could get you to pay, pocket half of it, deny you procedures, there was no incentive to prevent doctors padding their bills, except that it meant they where robbing the pockets of the insurance companies, who where only annoyed because it meant that they couldn’t keep as large a percentage as they stole from your pocket in the first place, **and** there was no explicit requirement for either a) what they spent it on, or how much of it, or b) what, including funneling their “savings” into bonus checks of the CEO, they could use any “unused” money for, since, without an explicit requirement that they have to spend it on your health care, they could come up with paperwork to make it disappear any way they wanted, and them claim it was lost in the “costs” of doing business.

            So, yeah.. Not sure how coupling what percentage of your money “must be” used for health care to the actual cost of that care, instead of leaving it entirely up to the companies to just make up what ever excuse they like for how the money inexplicably vanished into a mass of red tape, would “cause a rise in insurance costs”. What would be the incentive for them to jack up the price? They don’t, unlike pre-Affordable Care Act, get to keep it if they don’t use it for what you intended in the first place.

            That said, they have spent every waking moment, prior to it going into effect, trying to squeeze as much as they can get by with out of people, in a bid to scam as much out of us as they can, before they can’t get by with it any more. Its almost like.. a panicked attempt to grab everything they can, while they can.

          8. Those are some interesting predictions there Nostradamus, but let me ask you, did the Bush tax cuts create jobs? Did the bailout of GM get paid back? Did the stimulus actually hurt the economy?

            I ask because the same sources you are using to make these backward predictions also predicted all of these things, incorrectly. This is the reason I don’t like “debating” libertarians, they make assertions that are backed up only by the think-tanks that push their same agenda, then when the failures of said policies are pointed out in becomes all tu quoque arguments and selfish justifications.

            Keep on believing you are right, in 5-10 years when Obamacare is highly popular (and the rest of your predictions are laughably backward) and there is a push to expand it try to remember this time and maybe, just maybe be humble enough to admit to yourself that you were wrong.

          9. Kagehi – we’re already starting to see premiums rise for many/most families. Avik Roy is doing some of the best work on this. And as younger people opt out of the exchanges premiums will rise even more – remember having younger, healthier people in the exchanges is the only way this scheme works as they are subsidizing the older, sicker part of the population.

            One more point – “This is in contrast with the “100% free market” solution, which we have had.” I would argue that we have not had the 100% free market solution. Before Obamacare the health insurance industry was one of the most heavily regulated – but at the state level. We’ve not yet seen how a free market could improve health care. I doubt we will even after Obamacare fails.

          10. Mrmisconception – one more in the being unskeptical column…I offer a testable hypothesis and you give me the grown-up version of “I’m rubber and you’re glue!”

            I want to spend a second on your GM question though because it directly relates to the health care debate.

            Which is the party of big business? Dirty nasty Republicans right? Not so much. Businesses get big by beating their competition in the free market, they stay big by keeping upstart competitors from entering that market through increasing barriers to entry (government regulation). Take a look at which political party Apple employees – the biggest brand on the planet – donate for example (hint, it’s not the GOP).

            The health insurance industry, like GM, has struck a Faustian bargain with the Democratic Party. They depend upon Democrats for their livelihood now and must pander to them for an ever increasing slice of the pie.

            In health care/insurance, as I said before, everything is now political. No upstart can come in with a fresh idea and revolutionalize the health care marketplace. And no Democratic politician will ever propose such an idea (unless it’s single payer, which I believe was the goal from the outset).

            So you can rail about the 1% I suppose, but I would venture a guess that many (most) of them consistently vote for the candidate with a (D) behind their name.

          11. A testable hypothesis huh? You mean the one that would take 5-10 years to test and that would be forgotten by you and everyone else by then? No, you did not offer a testable hypothesis, what you did was offer a prediction on par with those offered at the beginning of every year by every psychic. Pathetic really.

            GM is part of the health insurance industry? Really? No, they are a large client thanks to there being no universal healthcare AND the legacy costs of that healthcare is a big part of why they couldn’t compete on a level play-field (because it is not level), how is a company that has to provide health insurance supposed to compete with those that do not? My father worked for the auto industry and I think you would be very surprised how Republican the blue-collar workforce is, often to their own detriment as those same same Republicans tend to be hostile to worker’s issues. But god, guns, and gays dontcha know.

            I find it hilarious that you responded to my post, in which I pointed out how libertarians only site libertarian sources, right after you sited a libertarian source to kagehi to prove that premiums have risen without the slightest but of irony. Just stop, you’re embarrassing yourself.

          12. “I find it hilarious that you responded to my post, in which I pointed out how libertarians only site libertarian sources, right after you sited a libertarian source to kagehi to prove that premiums have risen without the slightest but of irony. Just stop, you’re embarrassing yourself.”

            I actually wouldn’t be surprised if they had. But, here is the thing – they didn’t go up because costs did. They went up “because” Obamacare was going to be passed. Look at it this way, if it fails, or gets repealed, they get to keep their higher rates. If it stays, then they suddenly have to spend a large chunk of money they are taking in “on” health care for people, but they will base all of their arguments about how much that is, and what the true costs of the care are, on all of the hikes they tacked on, just before the law went into place. And, then, they can get by with not changing it, for as long as it takes for people they are robbing blind to actually scrape together enough money to sue them, assuming they don’t manage to get state/federal laws passed, preventing anyone from suing them at all (depending on the state, such a clause is either legal, or null and void, but since placing the clause in the contract **is** legal, most people don’t realize, when they see it, that it may not be enforceable, so, many people have no idea that they ***can*** sue over it. Neat trick, huh?)

            When it comes to some things, the government itself fails to see, or step in, to deal with those that violate the basic principles of a law, relying, instead, on the courts, yet, the courts only act “if” someone presents a case to them, If people have no idea they can do so, or are encouraged to believe they can’t, or otherwise don’t believe they have an option to redress the situation, then.. you can get by with a lot of shit, before someone finally steps in, gives you a slap on the wrist, then, maybe, fines you some tiny fraction of what was literally stolen out of everyone’s pockets. And, if the company is clever enough, they can take a page out of the NSA’s playbook, and argue (sometimes successfully, which thankfully the NSA wasn’t when they tried to push certain laws through), that it should be legal to do what you are already doing (and, in the case of insurance companies, keep all the resulting money).

            In any case, I have no problem, at all, with the idea that they might have hiked rates ***before*** the law passed, for three reasons: 1) To promote the idea that it would cause even more hikes, 2) encourage repeal, and 3) make as much money as they can get by with, in the short term, in case their other gambits don’t succeed. And, when you follow the money… well, its hard to argue that this isn’t precisely what is being attempted.

        4. {META: something is going horribly wrong with blockquote, which isn’t working right, at least in firefox for me, and.. the login is taking bloody forever to actually do so…}

          “I will tell you up front that I am biased and will argue the free market case”

          Yeah.. I don’t mind someone arguing the case, but they need to explain, when they do, why the existing “free market” with minimal regulations, few controls over costs, never mind who it paying them, and how, etc., didn’t create some great paradise, instead of an increasing mess, which included arguments by insurance companies that making us pay 25%, at one point, of even “minor” bills was “too much”, and convincing legislators to actually up that to 35%. Given that the new version makes it 15%, its not terribly surprised insurance companies are pissed.

          However, other shady dealing from the “free market” in this – Doctors “choosing” to charge people 10 times what someone else does, for the same procedure, then padding the bill as well. This same doctor, in the case of the one I know of, mysteriously closed up shop, without telling his own employees, sent out numerous bills direct to his customers, instead of running it through insurance, threatening anyone that tells him they won’t pay, and.. set up shop in another state. Got to be something in there that is illegal, but.. given this guy charged the most of any doctor in the area, one wonders if he also had a lawyer “look over” his plans, in order to try to find loopholes that make it legal. But, the one that really gets me, and its way more recent, and may not turn out well for the doctor..

          The one that really gets me was decades ago. At the time there was only one company in the country that collected information on costs, to find averages, and thus provide insurance companies with details on what those where, then setting pay outs from that. One of said insurance companies **bought it up**, and then started telling it to under-estimate (which in effect meant that the vast majority of procedures, in all places, would be higher than the average cost, and the “customer” would be paying out of pocket the difference between the covered cost, and the actual one. The got sued, and the courts gave them a slap on the hand, then ordered them to provide money to open an “alternative” company to do the same thing. Note: They didn’t declare it a sufficient conflict of interest to require they divest themselves of the company, nor did they (or could they have) set regulations in place, to prevent them continuing to make things up, cheat on the estimates, or otherwise not lie about what the average costs really where, and thus, how much the sick person would need to pay out of pocket. As far as I know, they still own the company, and still sell “its” results to other insurance companies, who decide to use their bullshit numbers, instead of the ones from other, hopefully, more accurate sources.

          But, then there is this series of articles. from a someone “in” the health care industry:


          Don’t remember all the details of all the articles, but the first one goes into an interesting mess with drug manufacturing. Basically, once a drug is no longer “high profit”, even if its a “critical” medication, its sold off to a small number of much smaller companies, which a) don’t have as many resources, b) have fewer sites, and c) are more likely to have errors and other issues, which result in recalls, and shortages. This leads to certain groups “betting” on those shortages, and, say.. store-housing critical heart medications, which when the shortage hit, they can then “over charge” for, sometimes on massive scales. This, in turn, leads to the people who give a damn, like doctors, and hospitals, basically, “spreading out the pain”, by overcharging you and 500 other people, for your aspirin, in order to pay for the fact that someone else just got charged $50 for a $5 pill, which they will die without. And, its going on pretty much daily, with everyone, possibly even including the ones near death, being overcharged for a dozen things, to pay for a dozen others, which someone else can’t afford, except, they might have, if the damn thing cost what it was supposed to in the first place.

          1. {META: yeah, blockquotes have been borked in Firefox for some time – I haven’t tried Chrome or IE, but apparently it’s fine with those?}

    3. It is true that the US could and should do a lot more to protect the privacy of its citizens. But to use that as an argument against universal health care makes you a joke in the eyes of the world, because we all know that it just ain’t so!

      As for the reasons the US is the only superpower. we all know it was because you stayed out of WW2 as long as possible then let the Russians do most of the fighting, all the while being out of range of heavy bombers. None of which applies today.

      If the current antics of the pinheads in Washington is any guide I think the US has thrown away any right to world leadership and I for one welcome our new Chinese overlords. At least they use logic and reason.

    4. Its kind of odd. I was under the impression, maybe quite incorrect that:

      1. The parts of the bill that are extend, what little it did, government services, where already “under government control”.

      and 2. One of the biggest damn complaints in the bill that did pass is that it relies on the same insurance companies that already have done everything they can to screw us out of actual coverage, even to the point of actually, sometimes, paying out vastly less than the 85% they will be required to now spend on actual health care, to “compete with each other” to provide cheaper care, **instead of** including a government program that you can opt into, instead. And, of course, this is even as they same assholes fighting against it already screwed the program that “should have” become a universal option, a few years back, so that they couldn’t negotiate **at all** for lower costs than what everyone else is forced to pay, by a system that stacks the deck, cheats to make more money from medications, etc. Hell, I wouldn’t put it past certain “segments” of the industry pulling something like the oil companies, “We need to shut down all refineries for repairs at the same time, which.. coincidentally will raise the price of gas…”, but, that would just be cynical…

      Personally, I consider the affordable care bill, without a government option, how ever screwed up the government can be, to be a bit like negotiating with a group of foxes, over which one will eat the least number of your chickens (while the raccoon is busy stealing your eggs, and blaming it on the chickens, for all being “too lazy” to lay more of them).

    5. Why we’re turning our back on the latter for 1/7th of our economy is beyond me. The results are predictable – the quality of health care in this country will fall.

      Yep, I’m pretty sure my country is in ruins because of socialised healthcare. Oh wait, it isn’t.
      Has it ever occured to you that a profit based healthcare system is there to generate, primary and the foremost, profit?
      What is your solution for those millions of Americans for whom the curent system is broken, who can’t get coverage and are in debt becasue of medical bills? Or should they just die because of natural selection?

    6. “The USA became the worlds sole superpower because of two things, democracy and capitalism. Why we’re turning our back on the latter for 1/7th of our economy is beyond me.”

      Capitalism and democracy are inherently in tension; they have diametrically opposed goals and methods to obtain those goals. Equality before the law is a requirement for capitalism, and equality before the law implies (but does not require) democracy. The Soviet Union became a superpower without either capitalism or (real) democracy, and could have easily survived without either if Hitler had not invaded the USSR during WWII (for reals, that was the heart of the downfall of the USSR).

      I’m also baffled as to why you apparently think 1/7th of our economy is pocket change and nothing about which we should worry. If the economy were to contract by 14%, we would be approaching the Great Depression in terms of misery, but you think that’s NBD?

  8. I sometimes wonder if some of these people read Terry Pratchett and actually think that Ank-Morpork’s interpretation of what “insewerance” means is actually the correct version. After all, it can’t be anything other than, you know, another way for lazy people to con companies, and the government, out of money they don’t deserve, by like.. pretending to be sick, and shit, right?

  9. The phrase “young invincibles” really ticks me off. I had insurance and it was a stupid decision. Basically I stopped taking meds I really should have stayed on just to blow my money on lottery tickets. Lottery tickets that never pay off, because even if I did get the kind of sick they pay for I can’t afford the deductible, I can’t afford whatever percent of the covered expenses I’d have to pay, and I strongly suspect that my insurance would run out pretty quickly. Bankrupt is bankrupt.

    Ever since I lost my insurance, I’ve paid a fraction of what I was paying before for medical services. I lost my doctor at the same time, so I can’t be sure I would have gotten the same deal from my old doctor but I’m paying half what I was per visit with insurance and the moment I told the people at the pharmacy I didn’t have insurance they gave me a discount card that just slashed the price of my meds.

    I’m probably going to try out health insurance through the exchanges, but I’m probably going to go to a different pharmacy to confirm that they’re actually paying something on my meds before I even think of telling my pharmacy or my doctor about it.

    1. And.. This is why they wanted to add in a government option. Single payer doesn’t exactly solve much, really. The core problem is that, for something like insurance, or, banking, for that matter, or a cell phone, or any other “intermediary” type business, the end goal of the company is to make as much money as they possibly can, while providing the least actual service possible. There are only two ways to counter that – an alternative service, which doesn’t have stock holders, and isn’t incentivized by making as much money as possible from it, or… masses of confusing regulations, which try to force them to provide services, and force pricing, which they would rather charge individually for, and at as much as they can manage from the public, before the percentage that can still afford it drop “below” what they can make by raising the cost. I.e., when losing a few more customers, by raising the cost, will lose you the same amount of money as you would if you had more customers, but didn’t charge them as much. This is, unfortunately, a real concept of economics. Even if you *could* price insurance cheaply enough, and doctors could provide services at the resulting costs, so as to cover 100% of everyone in the country, it would be impossible to rake in huge ass bonus, or keep raking in 10-50 times the amount of money that your lowest paid employee did. No, we can’t have that, so we can’t lower the costs, or provide more coverage, unless…. someone “forces” us to do so, or, worse, something comes along to “compete” with us, which doesn’t have how much it lines its own pockets from doing so as it primary incentive. Either one of those things will ruin your day, but the second one is, if anything, worse, because you can’t find loopholes in it, you just have to figure out how the hell to provide the services anyway, to compete, and.. there are only so many employees you can stab in the back, and turn into minimum wage workers, without benefits, before the only people left to cut wages from is the board of directors, management, and stock options.

      That none of those things ***had to be*** cut, if they hadn’t decided to screw everyone, including their own employees, over in the first place… is something so apposed to the thinking of the people involved that it has become a cliche. And, because of that, the cliche response from them is always, “Well, if we didn’t *have* minimum wage laws, or people telling is we *had to* provide certain services,or insisting that we actually offer them to everyone, instead of just the one we believe deserve them… the problem would fix itself. ‘Free Market!'” Someone, the reality that such a market must, inevitably, without someone keeping an eye on bad players, reduce itself to lords, serfs, and slaves, just doesn’t compute for some people (though, almost always those that are in the “lord” category, or think that they can prove themselves in some manner, and one day become a high class servant, or a page, or if really lucky, be knighted and given some scrap of land, so they are not longer a serf). Its bloody idiocy. The moment certain things, like water, food, shelter, and/or access to the witch doctor, became a commodity you had to trade for, it was inevitable that some people wouldn’t be able to pay for those “basic necessities”. They should never have been made a commodity, right along side with asking the village tanner how much he wanted in trade for a new coat, made from the unusual pelt he was in the middle of working. Basic needs should never be a commodity ***unless*** there exists the means to meet them, which involves “deciding I want a bigger house”, being the “goal”, not just ***a house at all***. You should have to strive for a mansion, not an one room apartment. To strive for the best of all options for a medical problem, not “the bare minimum needed to solve your problem”. To strive for a 5 star dinner, not barely enough to eat. To strive for an expensive bottle of wine, not a single bloody bottle of drinkable water. But.. try to explain this to some ass who has loads of money, possibly inherited, and gets offended when the bottle of water you hand them has the wrong brand name on it, or wasn’t made in Milan…

  10. “Without the young, healthy populace subsidizing the older, sicker part if the population, the scheme will be unsustainable”

    Um….who do you think has the most money in this situation? Young people are poor. They are just beginning their careers and just barely able to afford a small coffe at Starbucks, let alone subsidize the entire aging population. Perhaps the poor should help raise money for the rich? Also, it should be noted that the one trotting out the “it’s all political” rhetoric is you sir. Sorry, I’m just too bogged down in the whirlwind of factual information you have presented here. Perhaps us liberal humanists are just too jaded and preoccupied with our compassion and concern for those less lucky to see the real problems.

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