Richard Kirsch: How Many Lives Does the Health Care Reform Cat Have Left?

[ProSense]

How Many Lives Does the Health Care Reform Cat Have Left?

by Richard Kirsch

In the first of a series of excerpts from his new book, Fighting for Our Health, Roosevelt Institute Senior Fellow Richard Kirsch explains how Scott Brown’s upset victory threw the fate of health care reform into doubt.

<...>

First up is the U.S. Supreme Court, which will hold three days of hearings on various aspects of the constitutionality of the Affordable Care Act at the end of March. Sometime before July 4 we will learn whether the law — in whole or in part — survives that challenge.

The next potentially lethal threat to the health care law will be the presidential and congressional elections. If a Republican wins the presidency, he’ll be obligated to try to kill the health care law. Even if President Obama wins reelection, an unfavorable Supreme Court decision may force new legislative action, throwing major parts of the law into doubt.

None of this should be surprising. Despite the odds, the legislation that became the Patient Protection and Affordable Care Act survived a grueling gauntlet of stolid Republican opposition, maddened tea partiers and right-wing Democrats, and tens of millions of health insurance dollars funneled through the U.S. Chamber of Commerce. It’s already been through at least nine lives.

My new book, Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States, recounts one way that the law beat the odds: for the first time in the long-failed history of attempts to make health care a public right, there was a well-organized and funded grassroots campaign behind the effort. And at crucial times when the law was hearing its death knells, our grassroots campaign helped it rise to its feet. My book begins with the most unlikely of those mortal moments: the election of a Republican to Ted Kennedy’s seat in the Senate.

- more -

http://www.newdeal20.org/2012/01/30/how-many-lives-does-the-health-care-reform-cat-have-left-70568/

Flashback: Richard Kirsch on the passage of health care reform
http://www.democraticunderground.com/1002200857

[zipplewrath]

1. That lie again

The supporters of HCR keep telling this lie:

My new book, Fighting for Our Health: The Epic Battle to Make Health Care a Right in the United States, recounts one way that the law beat the odds: for the first time in the long-failed history of attempts to make health care a public right,...

It accomplished no such thing. It did nothing to establish health CARE as a "right". Quite the opposite, it clearly outlined exactly who the government has no obligation to help in obtaining health INSURANCE. It established the purchase of health INSURANCE for a range of people, including some employers, and some individuals, as a requirement (mandate). There is no guarantee at all that people recieve health CARE. It creates the opportunity for people to receive some health care, but not as an obligation. People have no more of a "right" to health care than before this bill was passed.

[ProSense]

2. That

It accomplished no such thing. It did nothing to establish health CARE as a "right". Quite the opposite, it clearly outlined exactly who the government has no obligation to help in obtaining health INSURANCE. It established the purchase of health INSURANCE for a range of people, including some employers, and some individuals, as a requirement (mandate). There is no guarantee at all that people recieve health CARE. It creates the opportunity for people to receive some health care, but not as an obligation. People have no more of a "right" to health care than before this bill was passed.

...spin again. The law banned deny/dropping coverage because of a pre-existing condition. And when a law ensures that people who are uninsured and unemployed have access to coverage, expands Medicaid and increases the number of insured to more than 95 percent that qualifies.

[zipplewrath]

3. Which has nothing to do with CARE

It's all about insurance. Nothing improve the status of health care as a right. If you can't afford health care, they can still deny you health care. It can still ruin you. Even before HCR, people WITH insurance couldn't afford the health care when they got sick. So now they've forced people to buy health insurance, but they still may not be able to afford the underlying health care.

They established buying insurance as an obligation, and did nothing to establish health CARE as a right. If they had, they wouldn't have had to outline who is exempt from actually purchasing insurance, because the government has no intention of helping them get it.

[ProSense]

4. Because

Which has nothing to do with CARE

It's all about insurance. Nothing improve the status of health care as a right. If you can't afford health care, they can still deny you health care. It can still ruin you. Even before HCR, people WITH insurance couldn't afford the health care when they got sick. So now they've forced people to buy health insurance, but they still may not be able to afford the underlying health care.

They established buying insurance as an obligation, and did nothing to establish health CARE as a right. If they had, they wouldn't have had to outline who is exempt from actually purchasing insurance, because the government has no intention of helping them get it.

...not a single person with health corverage now gets "CARE," right?

You know, dismissing the fact that the law increases the number of people with coverage is about as stupid an argument as one can make.

It requires conflating affordability with care. For the millions who will get coverage via expanding the Medicaid rolls, it's a ridiculous argument.

For those who will get hardship waivers, it's a stupid argument. For those who will be covered, despite unemployment and lack of income, it's an absurd argument.

Will there be issues, sure, but as a general argument it makes no damn sense.

[zipplewrath]

5. There is no "right" estalished

Whether people get coverage isn't the claim being addressed. There is a claim of establishing health CARE as a right and this bill did nothing towards that goal. Quite the opposite, it moved the other way. It relieved the government from any responsibility towards a class of lower economic individuals to have any coverage, and did nothing to establish a right to CARE. That there 4% or so that now have government assistance to get coverage that didn't have it before, doesn't change the fact that our government recognizes no RIGHT to health care.

Making something more affordable, doesn't make it a right.

[ProSense]

6. If

There is no "right" estalished

Whether people get coverage isn't the claim being addressed. There is a claim of establishing health CARE as a right and this bill did nothing towards that goal. Quite the opposite, it moved the other way. It relieved the government from any responsibility towards a class of lower economic individuals to have any coverage, and did nothing to establish a right to CARE. That there 4% or so that now have government assistance to get coverage that didn't have it before, doesn't change the fact that our government recognizes no RIGHT to health care.

Making something more affordable, doesn't make it a right.

...you intend to argue in circles: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=242023

[zipplewrath]

7. It is interesting behavior

If it was so great, why do folks feel the need to exaggerate, or lie, about what it actually accomplished? It isn't universal, and it does nothing to establish a right.

It speaks to the underlying reality that the adocates feel the need to make such claims. The reality being that for the vast majority of people, it changed little to nothing at all.

[ProSense]

8. What's

It is interesting behavior

If it was so great, why do folks feel the need to exaggerate, or lie, about what it actually accomplished? It isn't universal, and it does nothing to establish a right.

It speaks to the underlying reality that the adocates feel the need to make such claims. The reality being that for the vast majority of people, it changed little to nothing at all.

...interesting is you claiming that undered the law people will be "forced" buy health insurance, but that it "changed little to nothing at all."

Seems the entire purpose is not to point out the flaws in the law, but to dismiss it as "nothing at all."

No need to spin:

[zipplewrath]

9. They will

It really is a small percentage of the total population that will be affected by the mandate. Some 85+% of people already had insurance. HCR only added about 7 -8 % to the number of people covered. The regulations don't directly affect many of the insured, since the regulations were modeled on many of the most popular plans. The exchanges have the best opportunity to affect the greatest number of people. That remains to be seen. But again, that affects the cost of health INSURANCE, not CARE. The primary affect of HCR was to reduce the rate of growth to the feds of the costs.

And again, it did NOTHING to establish health CARE as a right. Health care, much less insurance isn't "universal".

And as you have demonstrated, you just can't get away from that reality.

[ProSense]

10. Actually

It really is a small percentage of the total population that will be affected by the mandate. Some 85+% of people already had insurance. HCR only added about 7 -8 % to the number of people covered.

...95 percent minus 83 percent (the current level) is 12 percent. About 16 to 17 percent of Americans lack insurance.

The regulations don't directly affect many of the insured, since the regulations were modeled on many of the most popular plans.

It affects those who would have been dropped because of a pre-existing condition. The rebate checks from the new MLR rule go to those who have coverage.

Still, keep trying to denigrate the law, but facts are facts.

[zipplewrath]

11. I won't argue single digits

The numbers are basically the same, roughly 4-6% of those eligible now, were eligible before. The numbers that will end up with insurance because of this bill is around 8 - 12%. And you're taking the lowest statistic for the number covered, and comparing to the highest number estimated to ultimately be covered. Nominally, the numbers are more like 85% and 93%.

The vast majority (80+%) will see no change in their coverage or care, and that was by intent. Obama sold this on the basis that most people wouldn't notice.

Those who will recieve rebates, and those that will have coverage for existing conditions is a VERY small percentage of the overall population. And all they will get is coverage, they won't get a guarantee of CARE because the bill did NOTHING to establish health CARE as a right. And quite the opposite, it made insurance and obligation, with the governments duty specifically limited.

I don't dengrate the law, unless you mean accurately reflecting what is does AND DOESNT' do "denegrating". The original author on the other hand vastly overstated what the bill actually does. I guess he's the one that doesn't think to much of what it does, so he has to imbellish it to make it sound worth while at all.

[ProSense]

12. Of

I won't argue single digits

The numbers are basically the same, roughly 4-6% of those eligible now, were eligible before. The numbers that will end up with insurance because of this bill is around 8 - 12%. And you're taking the lowest statistic for the number covered, and comparing to the highest number estimated to ultimately be covered. Nominally, the numbers are more like 85% and 93%.

...course you won't argue, but you'll spin absurd claims.

The vast majority (80+%) will see no change in their coverage or care, and that was by intent. Obama sold this on the basis that most people wouldn't notice.

That's also nonsense because the basic coverage is now more in line with what Congress has. People will have more choice, and that will be significant.

[zipplewrath]

15. Most folks had something similar

As I said, these plans were modeled on some of the largest out there. Heck, the auto companies were so much BETTER that they created the "cadillac plan tax", remember that? One of Obama's stated goals was to not take away much of what folks already had. Again, the vast majority will see no changes due to this law. They'll also see virtually no change in their health CARE.

And, the fact you keep avoiding, is that it does NOTHING to establish health CARE as a right, but it does establish buying insurance as an obligation. Something your original post lied about.

[ProSense]

17. You

As I said, these plans were modeled on some of the largest out there. Heck, the auto companies were so much BETTER that they created the "cadillac plan tax", remember that? One of Obama's stated goals was to not take away much of what folks already had. Again, the vast majority will see no changes due to this law. They'll also see virtually no change in their health CARE.

...mean the plans that cost nearly $30,000, with some of them not even providing the best coverage?

The unions supported the final law, remember?

[zipplewrath]

23. After

They supported it AFTER they got the change in to give them time to restructure their plans, because Obama thought they were too good. Their other interest was that it expanded the number of employers that would be required to supply health insurance, so the unions won't have to negotiate for that anymore.

So as I said, and Obama has said, the vast majority of folks haven't noticed any difference in their health insurance, or their health CARE. And it still didn't do ANYTHING for estalishing health care as a right, despite the implications of your OP.

[ScreamingMeemie]

13. Dismissing the fact that hundreds of healthy kids can now no longer get health insurance because

of a giant loophole is as obtuse as one person can get.

Signed, the preexisting condition uninsured mother of a perfectly healthy son who can no longer be insured on his own.

[ProSense]

14. I'm

Dismissing the fact that hundreds of healthy kids can now no longer get health insurance because

of a giant loophole is as obtuse as one person can get.

Signed, the preexisting condition uninsured mother of a perfectly healthy son who can no longer be insured on his own.

...sorry to hear that, but where did I do any such thing?

I don't know your circumstances or the loophole to which your refer, and made no mention of any specific issues. I do know the bill is not perfect, but if your intent was to jump into the thread with to make a case that it's "obtuse" to defend the law, then I disagree.

The law will insure millions and save tens of thousands of lives, that's good enough for me until the something better, the best comes along.

[ScreamingMeemie]

16. By acting as if this law has done something good for the many of us without insurance.

10 years ago my disease was under control because I was compliant. My family was insured. When the COBRA ran out, I was no longer insurable at a cost cheaper than a monthly mortgage payment. My disease is no longer under control and no doctor will treat me without payment up front. My son, a health 13 year old is no longer insurable (accept for major catastrophic coverage, which I pay for because he needs something) under a regular policy, because the major insurance companies refuse to cover any children on their own-to circumvent the legislation. HCR is one of the greatest travesties of an administration that could have done so much.

Obama's administration has done numerous wonderful things...this is not, and never will be, one of them.

[ProSense]

19. It

"By acting as if this law has done something good for the many of us without insurance."

...most definitely has. Again, I cannot speak to your specific circumstance.

[ScreamingMeemie]

21. It definitely has not. Saying it is so does not make it so. It could have done actual

good for the many of us with preexisting conditions.

[ProSense]

22. But

"It could have done actual good for the many of us with preexisting conditions. "

...it did help some: http://www.democraticunderground.com/1002240072

[ScreamingMeemie]

29. It is being lauded as something it is not. It has created worse conditions

for many of us within the 35-55 year age range, with children, whose children need us. Sorry, but it is not something that I look at as an accomplishment. I never will. Taking health insurance away from health kids is not a success story. No matter how it is spun. Sorry I didn't click on your link. If mine is one story (of 5 that I know of in my neighborhood alone) then I imagine that link is too. But, don't worry. I'm apparently not worthy enough for affordable coverage.

[zipplewrath]

18. Something won't

Something won't come along "better" for a long time, and probably it will be the GOP that ends up bringing us single payer. Obama "blew his wad" to make some changes around the margins and save the feds some money. And in the process he established health insurance as a legal obligation for the individual, and codified that the government is not responsible for delivering health CARE. Not to mention that health care not only wasn't established as a right, but in fact it was even more established that it is NOT considered as such by our government.

[ProSense]

20. That's

Something won't

Something won't come along "better" for a long time, and probably it will be the GOP that ends up bringing us single payer. Obama "blew his wad" to make some changes around the margins and save the feds some money. And in the process he established health insurance as a legal obligation for the individual, and codified that the government is not responsible for delivering health CARE. Not to mention that health care not only wasn't established as a right, but in fact it was even more established that it is NOT considered as such by our government.

...simply an inaccurate assumption. I do note the desperation in the language though.

In 2014, under the federal health overhaul law, millions of Americans will be able to buy coverage through state-based insurance exchanges. In California, government-run public plans, like the Alameda Alliance for Health, will go head-to-head with private insurance companies to compete for all those new customers, and those who run the county plans believe they can offer a robust network of doctors and hospitals to bargain shoppers looking for low-cost coverage.

http://www.democraticunderground.com/1002197452

Vt. gets $18M for health exchange
http://www.pnhp.org/news/2011/december/vt-gets-18m-for-health-exchanges

[zipplewrath]

25. Exchanges won't affect most folks

The health insurance exchanges won't affect most folks, and they never were intended to. Just ask Obama. You keep wanting to claim bigger changes than are coming.

And Vermont could have achieved the same thing without all this hoopla. They are just working within the existing structure.

[ProSense]

26. Neither

Exchanges won't affect most folks

The health insurance exchanges won't affect most folks, and they never were intended to. Just ask Obama. You keep wanting to claim bigger changes than are coming.

And Vermont could have achieved the same thing without all this hoopla. They are just working within the existing structure.

...would have the public option. The exchanges will mean something for the millions of people who use it.

As for Vermont, they still needed the waiver and a funding mechanism, which the law provides. Those two issues have always been the sticking point.

Facts!

[zipplewrath]

27. Vermont didn't need the HCR to get to this point

That's using a sledge hammer to drive a tack.

HCR reform got passed so this the context under which this is being done.

The public option was the basis for moving to single payer. It was also the mechanism for establishing health CARE as a right. You shouldn't have a mandate without a public option. It was the process of getting the government involved in paying for health CARE that was important. It would give them the direct ability to influence the cost of health CARE. That would have affected EVERYBODY. Instead, we have a system devised to ensure 15% profit for the health INSURANCE industry. We have a system to ensure a customer stream to health insurance companies.

And it did NOTHING to establish health care as a RIGHT, despite your misleading OP.

[ProSense]

28. Vermont

Vermont didn't need the HCR to get to this point

The public option was the basis for moving to single payer. It was also the mechanism for establishing health CARE as a right. You shouldn't have a mandate without a public option. It was the process of getting the government involved in paying for health CARE that was important. It would give them the direct ability to influence the cost of health CARE. That would have affected EVERYBODY. Instead, we have a system devised to ensure 15% profit for the health INSURANCE industry. We have a system to ensure a customer stream to health insurance companies.

...didn't need HCR to pass a law, but the state depends on a federal waiver and funding, that's a fact that you cannot spin away.

Step Forward on Health Care

Vermont on Tuesday was awarded more than $18 million to help implement a new national health care reform law. The federal funds will help the state devise an affordable insurance exchange to make it simpler for consumers to select health insurance policies. Vermont plans to structure its exchange to be converted by 2017 to a public, single-payer health care model that would provide better care at less cost. "At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all, single-payer approach to health care," Sen. Bernie Sanders said.

The insurance exchange would be a first step for state residents to receive federal tax credits and premium subsidies for meaningful health insurance under the federal law. Moreover, the systems established to manage an insurance exchange eventually could be used to help administer a single-payer system.

The state Legislature and Gov. Peter Shumlin earlier this year created a board to design and implement a publicly-funded health care system for the state.

Vermont was one of 13 states to share $220 million awarded today by the U.S. Department of Health and Human Services to design Affordable Insurance Exchanges - one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs. Altogether, 49 states and the District of Columbia have received planning grants.

"Today's announcement will help Vermont begin to build the foundation for truly universal, cost-effective and high quality health care for every man, woman and child in Vermont in the years to come," added Sanders, a member of the Senate health committee and chairman of the Subcommittee on Primary Health and Aging.

http://www.sanders.senate.gov/newsroom/news/?id=20BD0B94-8A65-45D9-938A-B87BBECAC4C2

Vt. gets $18M for health exchange
http://www.pnhp.org/news/2011/december/vt-gets-18m-for-health-exchanges

[zipplewrath]

30. So you're suggesting

That the justification for dumping the public option, instituting a mandate, limiting medicare's ability to negotiate drug prices, and spending 9+ months trying to pass legislation that did nothing to establish health care as a right, but established that purchasing commercial health care is a legal

You really trying to suggest that we couldn't have gotten Vermont 18 Million and a waiver with out it?

[Romulox]

24. HCR did create a new "right"--the "right" for Insurance Multinationals to profit from each and every

one of us.

It didn't create any "right" to receive care though, no.