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Sep
23

Why Obamacare is truly terrifying

The actions of some of Obamacare’s opponents are outrageous, immoral, abhorrent, revolting.  And very revealing.

The latest plunge into the cesspool is courtesy of the Koch Brothers; if you haven’t seen Creepy Uncle Same, don’t. You’ve been warned.

The disgusting ad is the latest in a series of outright lies and complete fabrications perpetrated by Koch and their fellow cesspool-dwellers on the wingnut right.  Amazingly, some of their pundits seem to think this is acceptable behavior, that using a video of Uncle Sam preparing to rape a young woman is funny, appropriate, acceptable.

It is not, absolutely not.

Leave aside the minor matter that the ad is complete bullshit, and the pathological minds that would fund, create, applaud such an ad are pathetically twisted people.

Instead, ask yourself why they’d descend to such depths in an attempt to scare young people away from enrolling in health insurance.

First, it’s just stupid.  Of course everyone should have health insurance.

Second, it goes directly against a fundamental conservative principle – personal responsibility.  If young immortals don’t have insurance – for whatever reason – when they get sick or hurt you and I end up paying for them.  That’s wrong.

Third, if Obamacare/PPACA is so bad, so fundamentally flawed, so bound to fail, why do opponents have to resort to rape scares? After all, it is based on principles laid out by the Heritage Foundation, a central pillar of the conservative movement.

And therein lies the core issue.  I posit the following.

For reasons we’ve discussed here at great length, PPACA won’t “fail”, simply because it fixes the core problem with the current insurance market – Private insurers will not insure people who are likely to have health problems at anything close to affordable rates.  And they shouldn’t. The “solutions” proposed by opponents are just laughable. The basic elements of the GOP’s approach – buying insurance across state lines, tort reform, meaningless tax credits, a paltry high-risk insurance pool – do nothing to address that core problem.

When it does succeed, it will blow a very large hole in what passes for current ultra-conservative theology; government is completely incompetent.

That scares the pants off Koch and their allies, the fear that personal experiences with a government-run program will be generally pretty positive; that things will work pretty well.

Oh, the horrors.

The young woman in Koch’s Creepy ad is a metaphor for the brothers’ own reaction to Obamacare; it is going to work pretty well, people will like it, and they will then become more favorably disposed to more activist public policy.

 


7 thoughts on “Why Obamacare is truly terrifying”

  1. Joe:

    I saw the video this weekend, too, and was a little taken aback; very strange. But rape!? I saw it as “creepy Uncle Sam” taking the place of the Doctor, after she left the room. Agreed, it’s a distasteful ad and I hope it remains an online-only ad and dies a quick death.

    Supporters of the ACA have got to stop falling back on The Heritage Foundation as a retort to current conservative opposition to the ACA. Everyone’s fallible and entitled to evolve their positions. They made a mistake back in 1989.

    “If young immortals don’t have insurance – for whatever reason – when they get sick or hurt you and I end up paying for them.” Thank the government for that. Only the Government has the power to create such an economic model. “The Emergency Medical Treatment and Active Labor Act (EMTALA)[1] is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions.”

    So, the core problem with the current insurance market is, “Private insurers will not insure people who are likely to have health problems at anything close to affordable rates.” And the solution is to have the Government dictate to these private insurers the details of the product(s) they can sell, how much they can sell it for and who they have to see it to? You’ll continue to see the insurers leaving the state exchanges because they refuse to offer their services at the Government’s specifications.

    And therein lies the real, Progressively sought after end-game: single payer. Destroy the private health insurance industry and ride the Government white horse to the rescue with Medicare for all. “The evil insurers have abandoned you, but we’re here to help!” But wait, look around, where did all the doctors go? In this Progressive future, everyone will have “insurance,” but there’s no one left to treat them adequately. Then what? Government-mandated doctors? Where are they going to come from?

    With every attempt at a centralized “solution” come unintended consequences. You’re left playing “Whack-a-Mole,” but that’s OK for the Progressives, because of the public’s goldfish-level memory. Every time they whack a mole, they’re portrayed as fighting for the “little man” and they garner enough votes in the next election to continue the charade ad nauseam.

    1. Allen – welcome back to MCM, and thanks for the thoughtful comment.

      re rape, it certainly meets the definition – a grinning clown face with a speculum and a terrified woman screaming and trying to escape? that is the very definition of rape, a woman forced into a sexual act..

      Re Heritage, I”ve addressed that elsewhere; they’ve become more strident, less thoughtful, and waaay less of a “think” tank over the last few years.

      re EMTALA, don’t thank the “government”, thank the GOP. Recall that they controlled the Senate and the White House in 1986 – when EMTALA became law.

      re “the solution” – the “government” does NOT dictate how much insurers can sell their plans for; while there’s controls around age bands there is no baseline price control; insurers can charge whatever they want. What PPACA does do is level the playing field so the free market can work, so consumers can pick from insurers with the confidence the benefits offered are consistent.

      As to the ills of single payer, I’d suggest the VA and Washington state’s workers’ comp system are excellent examples of how a well-run government payer can deliver excellent results.

      As to the “progressive end game”, I don’t see it as single payer, but given the far better outcomes and much lower costs delivered by many single payer systems, that might not be a bad option.

      1. Perhaps I missed the woman screaming and trying to escape. The version I saw faded out as Uncle Sam stood up and flexed the speculum. Regardless, there is no defense of the ad and it simply detracts from the real debate/discussion at hand.

        The Heritage Foundation, or any other “think tank” should be taken for what it is: a self-serving collection of individuals producing opinions that cater to those that support the organization. I can’t defend them either and they’re not really germane to the discussion; simply chaff.

        To use your analogy, in 1986, the GOP WAS the Government. It doesn’t matter the party in charge. My statement was about the fact that the Government, regardless of party control, is the only entity that can create the economic model we have today; one set of market participants paying for the another set of market participants (who cannot pay themselves).

        While there may be no overt “baseline” price control for the amount an insurer can offer a policy, there is an indirect enforcement of price control: regulated MLR. Agree with it or disagree with it, but it’s price control mechanism.

        I’m all for leveling the playing field and allowing consumers to compare options and pick the option that best suits them. But for the Government(s), IT WOULD ALREADY BE LEVEL. It’s the Government that warped it and that’s my point on this topic. Only the Govenrment has the force to enforce such a perversion of a free market. The Goverment needs to step out of the way and let the market work. Want to cover kids until they’re 45? Go ahead, market a policy. Want to cover people with pre-existing conditions without a waiting period? Go ahead, market a policy. Want to cover people comprehensively with a low deductible for less than $100 a month? Go ahead, market a policy. Want to sell the same policy in ME, FL, CA, and WA? Go ahead, market a policy. Let people make choices and market products voluntarily, without force.

        All Progressive roads lead to single payer. Sounds like a great idea, but at what cost? You can have:

        1) An affordable health care delivery system
        2) A convenient, responsive health care delivery system
        3) A high quality health care delivery system, staffed with the best and brightest, practicing cutting edge treatments

        At most, you get to pick 2. Often, however, you’re left with 1 or, tragically none.

        1. Allen – thanks again for the comment.

          One thing is missing from your description; no insurer would sell insurance to someone with a pre-existing condition and/or high likelihood they’d develop an expensive condition. Thus the “free market” would not solve this issue, which is the core of the current insurance disaster.

          The government has to force insurers to do this and/or come up with a high risk pool; as soon as they do this you have government regulation.

  2. Isn’t it strange that the very people who scream “FREEDOM”, want to give women ultrasound probes, deny them right to choose to have an abortion based on their decision and that of their doctors, family members, etc., and now they want to scare young women into opting out of the ACA by showing Uncle Sam as a weird OB/GYN?

    As for single payer, when you consider that we have one health care system for veterans of the military (war service or not), the spouses and family members of active duty military personnel, members of Congress and the bureaucracy, the elderly, the poor and children, then pooling the budgets for all of these programs, plus taking a little (a billion here, a billion there, now you’re talking real money) from the defense budget (the part that goes to the merchants of death, not to the defense of the nation and the paychecks of our service persons), you might be able to fashion a single payer system that covers everyone and is paid for out of revenue the government already spends on health care, so taxes don’t have to be raised.

    Every other industrialized, Western nation has some form of single payer system that has lower costs and better outcomes than ours. We are the only nation that clings to 18th century ideas that health care is not a right, but an “entitlement” that somehow forces the provider of a service to have their labor power owned by the person who is “entitled” to that service, without compensation to the provider.

    That is not what anyone is proposing, both the supporters of ACA and supporters of single payer. Only the followers of the Heritage Foundation, the Koch Brothers, the Tea Party/Libertarian Party wackos believe that. Doctors will not work for free under ACA or single payer, they will just have to treat more people and get paid accordingly.

    but this whole thing about the Repugnants wanting to defund or delay or outright repeal the ACA, reminds me of that commercial from the late 60’s or early 70’s whose tag line was “try it, you’ll like it”. The Repugnants should wait until people try it, then if they don’t like it, it can be changed, but you are right, people will try it, they will like it, and the Repugnants will be unable to do anything about it.

  3. American exceptionalism combined with plain ignorance and lack of global insight have created a fertile field for fear-mongering.

    I am a physician, person deeply involved in utilization, patient, and the person responsible for making the buy decision for the 140 or so people in my company.

    Check out my recent blog entry:

    http://mcntalk.com/2013/09/03/when-theres-no-incentive-to-control-costs-a-personal-anecdote/

    This was my wife’s encounter with a racoon. The ridiculous way in which I never saw a bill and had to ask for it, and when I did, noted that it was upcoded, and had other clear errors speaks loudly – as does the initial charge along with the adjusted one. The system is in entire disarray.

    Obama made a politically necessary decision to keep the basis system intact, and rely upon individual premiums and buyers. My understanding is that those many systems that have equal or better outcomes, and a third less or so in costs rely upon tax based payments to private providers.

    Why should it be the job of an employer to provide health care for employees? And what is so magic about turning 65 that Medicare suddenly becomes acceptable? How about starting Medicare at birth? Ask patients and doctors in places like Canada, Australia, Germany and so many other places if they really envy our system.

    Interesting by the way that those foes of insurance reform largely remain silent on Medicare and are not suggesting it be dismantled. Consistency would demand otherwise.

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Joe Paduda is the principal of Health Strategy Associates

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