How Obamacare Actually Paves the Way Toward Single Payer

[DonViejo]

BY NOAM SCHEIBER

Last week the liberal documentary-maker Michael Moore prompted indigestion across the progressive wonk community by pronouncing Obamacare “awful.” In a New York Times op-ed, he bemoaned the way the president’s law preserved the health insurance industry rather than replacing it with a Medicare-for-all style single-payer system. The good news, Moore conceded, is that the previously uninsured (and often previously uninsurable) can get finally get coverage. The bad news is that their coverage will often be lousy and pose an enormous financial burden. He ended by calling for activists to lean on state politicians in an effort to beef the law up.

I happen to agree with Moore’s basic sentiment. For-profit health insurance is on some level morally offensive—at least when it’s practiced the way we Americans practice capitalism. With a few tantalizing but mostly unrepresentative exceptions, the longstanding aim of health insurers has been to weed out sick people, and to weasel out of paying for treatment if they somehow get insurance, so that the companies could boost their share price, lavish income on their executives, and plow money into annoyingly saccharine TV ads. To its everlasting credit, Obamacare genuinely tries to whip the insurers into shape—making it illegal to deny coverage to sick people, or to withdraw coverage when healthy people get sick, among other much-needed reforms. But you still have to be skeptical of middlemen who historically spent a mere 60 cents of every dollar individual policy-holders sent them on, you know, health care.1

And yet I’m still much more sympathetic to Obamacare than Moore. He thinks it’s awful. I consider it a deceptively sneaky way to get the health care system both of us really want.

How? Allow me a brief digression: In 1991, Congress created the National Breast and Cervical Cancer Early Detection Program, which funded screenings for women who earn up to 250 percent of the poverty level. What Congress didn’t do is provide money to pay for treatment if the tests came back positive. The policy seemed sadistically cruel: Suddenly thousands of women would discover they had a life-threatening illness while realizing they could do nothing about it. Both Moore and I would have surely denounced the law. But it soon proved to be a shrewd, if unintentional, opening move. “Almost from the moment it was implemented, there was pressure to take the next step,” says Harold Pollack, a professor of social policy at the University of Chicago. “They constructed a sympathetic and organized constituency … with an actionable grievance.” Congress approved the money for treatment in 2000.

more
http://www.newrepublic.com/article/116105/obamacare-will-lead-single-payer-michael-moore

[Laelth]

1. k&r for Noam Scheiber. n/t

-Laelth

[BlueCaliDem]

2. K&R for the PPACA and its "State Innovation & Medicaid Waivers" clause

that will provide necessary funding and pave the way for single-payer - the very waiver Vermont has applied for in order to implement single-payer in their State starting 2017, and what California OneCare will undoubtedly use to finally implement single-payer for us.

[spin]

3. This may be true but the ACA might cause our party to lose seats in the Senate and the House ...

in the midterm elections and possibly put a Republican in the White House in 2016.

The roll out of the ACA was a total fiasco and that may be a generous appraisal. While the web page is no indication on the quality of heath care that the ACA will offer, the fact that it was not ready for prime time leads me to wonder if the ACA was well crafted. Time will tell and six months from now we will be better able to judge the advantages and disadvantages that the ACA has.

Many low income families are qualified for and have signed up for Medicaid through the ACA. Unfortunately many excellent doctors, including mine, refuse Medicaid patients. Those doctors who do accept Medicaid patients may be totally overwhelmed by the influx of new patients and the results could be long wait times for a doctor visit that may be short in duration as the doctor has a long line waiting to see him in his waiting room.

Obama did promise that you could keep your own doctor under "ObamaCare" which will likely prove false for many people who signed up for the plan. I am not willing to call his statements lies but the misrepresentation has hurt his credibility with many Americans.

I sincerely hope that all the predictions about how horrible ObamaCare will be will prove to be false.

My son in law was laid off six months ago and went on COBRA continuation health coverage at $600 a month until he found a job. I did some quick research when the ACA website was up and found that he might only have to pay somewhere around $300 a month for a good plan. He wasn't all that impressed and told me, "My policy at work cost me just $40 a month before I was laid off." Of course he may get some government aid to reduce the cost of the plan depending on how much money he makes at his new job which doesn't offer health insurance.

On the other hand his mother and step father who are in their 60s and have a number of health issues, were extremely pleased when they signed of for the ACA as they discovered they would save a bundle of money on their insurance.

I am retired and on Medicare with a supplemental insurance policy. Medicare has been sometimes described as a form of single payer care. To say that I am happy with Medicare would be an understatement. I had an operation earlier this year that required an overnight stay in cardiac intensive care. The total cost for everything was $00.00 and that includes all doctor office visits and the rather involved nuclear stress tests and x-rays before the operation.

Prior to the ACA we had the most expensive and far from the best heath care system in the developed world. I wish that we would have looked at the best of the other health care systems and developed an even better system but this was probably politically impossible. In my opinion the ACA is indeed a good first step. I just hope our party didn't shoot itself in the foot by passing it.