Will Obamacare succeed where term limits failed?

[Husar]

What? They're not doing that already?

Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.

Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them.

You're assuming that a majority of customers actually have the nerve and strength of will to use supply and demand tactics to bring about change. This is patently false as shown by the gaming market where people say they do not think a game is worth the money the supplier asks but instead of not getting it, they get it illegally instead since they cannot resist the urge to play it anyway. How many people can't keep their fingers off chocolate or meat or whatnot? If everybody were a purely rational homo oeconomicus who knows everything he needs to know about every product and service they consume, then we wouldn't need market regulation. But the world is not a capitalist utopia, there are markets where the forces work really well and there are markets where they don't work very well due to the nature of the product, the consumer or both.

With healthcare and food you also get additional interests such as children who cannot fully decide for themselves what they consume. You may say children of sloppy parents do not deserve to live or to be healthy anyway but apparently society at large disagrees with that notion.
Society also disagrees with having a large percentage of dumb people who cannot contribute so we introduced mandatory education and a public education system. Letting market forces handle such things has detrimental effects on a society because not everyone always makes the optimal choices or has the desirre/time to put in enough effort to make informed decisions about things.

In my opinion letting the government handle these things through regulations is just a form of centralization and specialization where the people at large outsource the decision making regarding some fundamental things to a small group of people who can make a better informed decision than most.

The system doesn't have to be perfect but there is also no pure and perfect free market, consider that companies using very good marketing and market manipulation can get advantages they should not get on a perfect free market. Intel bribed some electronics stores here so they wouldn't sell any systems with AMD CPUs. Now Intel are so far ahead because they made illegal market manipulations that they have a monopole in the upper mid and high end CPU "market". Now regulation does not stop this since it's illegal and happened anyway but the point remains that regulation is usually there to fix flawed markets that simply do not work properly without it because not everything in the world is perfectly aligned to work on a free market.

[Pannonian]

The American health care system needed some form of intervention. Market forces were not working because the system wasn't designed with those in mind. I am all for something being done to open it up to greater consumer choices with tax incentives to do so. The tax incentives should be present as a recognition that choices made regarding ones own health can be made under duress and that healthcare is a different ballgame than car and home insurance. I'm not looking for home tax deductions, I believe that those are unethical. I want to see lower taxes across the board and and end to most tax write-offs of everything other than health care.

Writing off your home? deleted. renters shouldn't be punished with higher taxes because you own a home. Writing off your education? deleted. Individuals are held back by the system of higher education grants which encourage irresponsible education over local community, commuter and online education. HSA's for everyone, because the money that we spend on most healthcare should be our own and it shouldn't be handicapped by government. Lower taxes for everyone, but cut the cuts.

This article in Bloomberg seems to suggest that High deductible plans are becoming the expected norm. THis would be fine, just as long as we have a way to pay for our co-pays, co-insurance without being taxed and saving our money in an IRA like account. OPEN US THE HSA program to everyone at slightly lower amounts and mandate that employers set them up.

Cor, isn't this pretty much what the NHS is (or was, until they introduced small tariffs for working age people). Healthcare that is free at the point of delivery, so payments are made steadily when one is capable of them, and when the need comes, one doesn't have to choose between that and other necessities. Except we call it a tax, something that our tax package pays for, but Americans, allergic to the idea of taxes, call it a savings fund instead. I guess this just shows that government driven action is the only thing that can make something like this work, whatever language it's dressed up in.

[Ironside]

What? They're not doing that already?

Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.

Look at the explosion of organic food stupidity if you need an example. People are willing to pay 3x as much for a banana because it's "organic", as though other bananas are "inorganic". Therefore, you can't find a grocery store that doesn't stock them.

Is aspartame dangerous or not? No matter your answer, what source did you base this on?

Why are those bananas "organic"? Because they're labeled that way. What does the label stand for? Do you know the exact formulation, or are you information deficient? Are the labeling correct or not? How do you know? And why are you calling it a stupidity? Is it a secret goverment project to sell it? Or is it market manipulation by the companies, earning money on the costumers information deficiency?

Seriously, you call the organic food costumers (aka parts of the electorate) falling for something stupid, while asking in the paragraph above why the electorate can't force the change. The electorate gave you Obama vs Romney. And was almost split in half. Combined might, combined ingenuity (the electorate has the power to pick someone else that what the parties offers) indeed.

Your basic assumption are that the companies aren't players. In fact, they are the strongest players there is. Because they've got financial might and vested interest. Only the combined might of the public may beat them. But none informed the public that they should fund independent research and make sure that it's not influenced by the companies. Has American companies lied about the dangers of their products in the past? Oh yes indeed, many times.

But since you and everyone else is homo omnieconomicus, that won't ever be a problem would it?

[Xiahou]

Is it a secret goverment project to sell it? Or is it market manipulation by the companies, earning money on the costumers information deficiency?

It's businesses giving consumers what they want.

Seriously, you call the organic food costumers (aka parts of the electorate) falling for something stupid, while asking in the paragraph above why the electorate can't force the change.

And?

Your basic assumption are that the companies aren't players.

What on earth gave you that idea?

But none informed the public that they should fund independent research and make sure that it's not influenced by the companies. Has American companies lied about the dangers of their products in the past? Oh yes indeed, many times.

And has the government lied or been wrong about the dangers of products in the past?

The naive paternalistic view of government that you and Husar exhibit is amusing.

[Husar]

The naive paternalistic view of government that you and Husar exhibit is amusing.

While your darwinian model is much less so.

At least you can laugh about my model while in your model more people end up miserable and/or die while you sit there calling them dumb and saying they deserve it for not being expert biologists and expert chemists.
Your model of personal responsibility is something only an intellectual who is divorced from the reality of the working classes can suggest. It's incredibly cold and narcissistic borne out of the belief that nothing could happen to you in such a world since you are apparently well-informed about everything. What would happen to others is apparently none of your concern then.

The problem with that is that a majority of humanity disagrees with it and decided to build society in a different way that we call more humane. Your attempts to change this are quite amusing.

[Ironside]

It's businesses giving consumers what they want.

Marketing consists of three parts. The first is to show the world that you exist, the second to increase the number of people wanting your product. The third is to make them willing to pay the price you given (in particular about exclusiveness of a product). The second and third is all about manipulation.

And?

If the people behave like that without "teh guverment keeping dah man down", then why do you expect them to behave differently? To paraphrase. "This would work perfectly if people stopped acting like people." I do remember seeing this about another political system.

What on earth gave you that idea?

Your insistance that "what the consumer wants, the market provides", without acknowledging that the consumers are far from a monolithic mass, and under manipulation from the market. You also ignore that the consumers already got the powers of boycott ("but the electorate itself can't force the change?"), probably because it's too weak. And with your "new, improved" system, that's the only power.

And has the government lied or been wrong about the dangers of products in the past?

The naive paternalistic view of government that you and Husar exhibit is amusing.

A goverment doesn't have any economic reasons for lying about it. A corrupt goverment does, putting it in a similar spot as the companies already bribing them. Remove the goverment and your starting place would be the companies. Or in the best case, underfunded independant research.

My point with the aspartame question is the one of a reliable source. You can choose to be ignorant and ignore it, you can choose to do a basic read up on it, or you can dedicate at least months and probably years of studies to get a full understanding of it.
For most people, it'll be the basic read up. It's a staggering number of sites claiming that a waste product of aspartame is toxic. Bonus point is even the goverment and the producer agrees with that, but says it's a trace amount of a toxic waste we already get naturally in higher amounts. And thus we come to my point:

To be able to do a basic research, the thing 99,9% of the population shouldn't need to surpass, you'll need to be able to easily recognize the reliable sources. You have 3 basic options, the goverment, independant research and the companies. The problem with independant research is thier source of money. Without a stable, reliable source, large conditioned donations would dominate (and you can see how the mild ones look like already). And creating a stable, reliable source is pretty much taxing things already. Easier to keep it within the goverment and have the watchers monitoring that, than developing new systems that looks exactly alike.

[HoreTore]

Don't you find it odd that you think a democratically elected government can force companies to behave on the electorate's behalf, but the electorate itself can't force the change? If a majority of people want ingredients on food labeling, they vote for representatives that will enact the regulation. But, if a majority of people want ingredients on food labeling, can't they accomplish the same thing by buying from suppliers that do so? If it's important, it'll drive sales. If it drives sales, all suppliers will be doing it in short order.

Ah, the sweet-sweet smell of blue-eyed market optimism.... It's so cute!


The simple answer to why consumer power doesn't work, is that it simply doesn't work. If you want real change, history has shown that it must be forced from a position of power. And power is what the state has, while the power of the consumer is an over-hyped nothing.

[HoreTore]

The consumer's relative lack of power in America is only because of years and years of concerted efforts by deregulation lobbies though.

"Consumer power" never existed and never will, since it rests on a deeply flawed premise; an incredibly simplistic model of human behaviour completely detached from actual reality.

The free market is excellent at giving us cheap crap. If we want anything resembling quality products, we need the regulations only state power can enforce.

[HoreTore]

Right. In America that power shifts back and forth. These days we live in a golden age for big business and consumer abuse.

Could you please be more specific as to when that period where businesses obeyed the wishes of the consumers was?

[HoreTore]

Well, taxes on the rich and the minimum wage (adjusted for inflation) were both higher in the 50s and early 60s.

Both examples of state power enforcing regulations, so that pretty much confirms my point, doesn't it?

[HoreTore]

Your over-agressive socialist rhetoric makes it hard to recognize when someone is supporting your point, I guess.

This is why I love you.

[Husar]

Get a room!

[HoreTore]

Get a room!

I have a room. What I need is an airplane ticket for GC and a bucket of lube. Wanna chip in?

Since you're German, you're bound to have some extra lube lying around...

[Lemur]

I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans.

The insurance companies argue that it's simply capitalism at work. [...] By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.

TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace's Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren't necessarily able to stop them.

It's not yet clear how widespread this practice became in the months leading up to the marketplace's opening -- or how many Americans will end up paying more than they should be for health coverage. But misleading letters have been sent out in at least four states across the country, and one offending carrier, Humana, is a company with a national reach. [...]

The most troubling part of the Humana case is that the company was pushing customers into a Humana insurance plan that was more expensive than the plan Humana was selling on the Obamacare marketplace, without the financial help available under Obamcare.

[a completely inoffensive name]

The power of the consumer is to consume heavily.

It's not a power, it's a weakness, an urge in today's society, and it's why companies can do whatever they want unless government says otherwise.

[ICantSpellDawg]

I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans.

The insurance companies argue that it's simply capitalism at work. [...] By warning customers that their health insurance plans are being canceled as a result of Obamacare and urging them to secure new insurance plans before the Obamacare launched on Oct. 1, these insurers put their customers at risk of enrolling in plans that were not as good or as affordable as what they could buy on the marketplaces.

TPM has confirmed two specific examples where companies contacted their customers prior to the marketplace's Oct. 1 opening and pushed them to renew their health coverage at a higher price than they would pay through the marketplace. State regulators identified the schemes, but they weren't necessarily able to stop them.

It's not yet clear how widespread this practice became in the months leading up to the marketplace's opening -- or how many Americans will end up paying more than they should be for health coverage. But misleading letters have been sent out in at least four states across the country, and one offending carrier, Humana, is a company with a national reach. [...]

The most troubling part of the Humana case is that the company was pushing customers into a Humana insurance plan that was more expensive than the plan Humana was selling on the Obamacare marketplace, without the financial help available under Obamcare.

Traditionally, State Insurance Departments were developed to stop insurance companies from jacking rates without rational cause. Now that insurance policies are commodities that must be purchased by law, they aren't worried about losing business, and the 1000 pages of cost increases has given them Carte Blanche to spike rates without SID oversight. Hey, If the government was handing out money to private business, I'd raise my prices too.

The reality is this: the new requirements will increase claims payouts. Individuals will not sign up until the last possible minute in the event that they are ever able to. Claim costs will increase immediately, premiums will trickle in. Large numbers won't offset the loss ratio for some time. State and Federal insurance commissioners are to give the insurance industry time and leniency to pad their numbers and ensure that they are solvent, hence the large spikes in cost. Costs which will never go down, only slow in growth as people enter the market.

The idea that the bill was called the "affordable health care act" was a sham. It is affordable for no one. Has anyone signed up yet?

[ICantSpellDawg]

What a joke. 1000 pages of law creating an environment for massive companies to exploit will create a backlash? This is what regulation is! This is the outcome of attempting to stack the deck - the deck gets stacked! What are you going to do? not buy the product??!!! What a laugh.

What do you think regulation is? Magical salve for problems? if the new Health care law isnt regulation, I wonder what is, 2000 pages?!!!! unbelievable that you can suggest that de-regulation is responsible for this.

[ICantSpellDawg]

My healthcare proposals benefit the working members of society. Working members of society will like them more and more. The elderly and those who don't work will like the idea of the pay based on ability, use based on need. If fully socialized medicine comes to be it will be a coup for the elderly and entrenched interests.

I really don't care personally, 12 years ago I was told that I would likely die or get a liver transplant in 10 years time, so I'm on borrowed time. By the time universal health coverage comes around, if I still am, I'll just sit back playing Battlefield 8 or Rome IV total war, living off my welfare that you guys worked so hard to provide me.

[Xiahou]

Could you please be more specific as to when that period where businesses obeyed the wishes of the consumers was?

Gee, I can't think of anything.....

Spoiler Alert, click show to read: 

I am shocked, shocked that healthcare insurers are using the changes to lie to their customers and try to force them into more expensive plans.

Wait til Donna finds out she can't keep her doctor either.

[Seamus Fermanagh]

So far, the only thing that is a known in the whole issue is that the website access to sign up is malfed.

Are some peoples' prices going to go up -- yes. Is it because they are going to have to acquire truly comprehensive coverage that conforms to ACA standards (hence the difference) or because the whole plan is going to be far more expensive than originally forecast so as to offset the cost of subsidies for coverage? Are the number of people facing increases significant? So far, we have a lot of anecdotal data but no hard numbers.

Same numbers question with the "gonna lose your doctor" bit. Well reported anecdotal evidence or statistically significant problem? Plus, how do you keep your doctor if the doctor retires? It is not as though changing your doctor is a guaranteed horror story. The anecdotes of people losing their doctor make Obama look bad because he made a sweeping statement, but so what?

[Xiahou]

The WaPo Fact Checker weighs in on Democrat efforts to blame the insurance companies for plan cancellations. Their assessment? 3 Pinocchios.

Blaming the insurance companies can only go so far. First of all, the administration wrote the rules that set the conditions under which plans lose their grandfathered status. But more important, the law has an effective date so far in the past that it virtually guaranteed that the vast majority of people currently in the individual market would end up with a notice saying they needed to buy insurance on the Obamacare exchanges.

-----

Are some peoples' prices going to go up -- yes. Is it because they are going to have to acquire truly comprehensive coverage that conforms to ACA standards (hence the difference) or because the whole plan is going to be far more expensive than originally forecast so as to offset the cost of subsidies for coverage? Are the number of people facing increases significant? So far, we have a lot of anecdotal data but no hard numbers.

From Forbes:

[Xiahou]

So the ACA allows insurance companies to continue screwing people, as opposed to insurance companies contradicting the law.

If by "screwing people", you main raise rates to stay in business, then I completely agree.

The ACA creates incentives for the most sickly, and therefore costly to sign up. It also severly limits what the insurance companies' can charge these people. Necessarily, the premiums for everyone else must go up to cover the increased costs that they're taking on. Frankly, with the way the rollout has gone thus far, many insurers are probably underestimating their costs. If things continue, I expect a new round of sticker shock for exchange users next year as rates continue to jump.

[Seamus Fermanagh]

From Forbes:

Thanks, Xman. First thing resembling collated data I have seen on this. Ohio and Colorado both seem to be "winners" here. I wonder if that will have electoral implications.

[Xiahou]

As you point out, the problem is that its a business. It can't be a business if we are to have healthcare as a Right! Now if our options are back to the bad old days or onward to socialized medicine, its onward no contest.

I'll never understand how you can think a service is a right. For a service to be provided, people have to provide it. What happens to your right if not enough people are willing to provide? Do we force them to provide your rights? It smacks of Orwellian-ism.

[Lemur]

I'll never understand how you can think a service is a right.

Meh, casting healthcare as a "right" is a distraction.

Markets are great, but they aren't great at everything. I see absolutely no real-world evidence that healthcare can function well as a market-driven enterprise. No other industrialized nation is trying to control/enact it as such, and there might be a reason. Most other nations also frown on privatized military, privatized police, privatized roads, etc.

The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland.

[ICantSpellDawg]

Meh, casting healthcare as a "right" is a distraction.

Markets are great, but they aren't great at everything. I see absolutely no real-world evidence that healthcare can function well as a market-driven enterprise. No other industrialized nation is trying to control/enact it as such, and there might be a reason. Most other nations also frown on privatized military, privatized police, privatized roads, etc.

The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland.

I am effectively convinced of your argument at this point, with caveats:

Most things fail to function well as government driven enterprises. It is a peculiar situation, where many things work well in a market-driven setting, but health care has flopped.

Personally, I believe that duress-based services do not follow market forces and should be treated differently. We should aim to harness the benefits of market forces with the security of government intervention ONLY for health care. The ACA can be adjusted to help do this. It is going to be difficult and it won't be done if we act purely as impediments to it, or if we eliminate even the harshest critics.

Our system was broken before the President touched it. It is now shattered - BUT, like the London Fire of 1666, maybe it is just what we needed to start fixing it and building something world leading again.

[Xiahou]

The closest to a market-based healthcare system in an industrialized nation (besides us, with our Reagan-enacted jackalope crony-capitalist/socialist hybrid) would be ... wait for it ... Switzerland.

Swiss citizens buy insurance for themselves; there are no employer-sponsored or government-run insurance programs. Hence, insurance prices are transparent to the beneficiary.

Boom. Right there is the answer. Ever since FDR-era wage controls (that forced employers to add insurance coverage to their compensation packages since they couldn't raise wages), our insurance system has been spiraling out of control. Any serious healthcare reform has to break the attachment of work and insurance.

The best insurance I ever had was when I was out of work and forced to get private insurance. I asked if I could keep it when I got my next job- but they were legally unable to offer it to someone who had insurance offered to them at work. That's moronic.

As I read it, the Swiss system is basically Obamacare, had it been written by people who were reasonably intelligent... instead of by Democrats.

[Lemur]

As I read it, the Swiss system is basically Obamacare, had it been written by people who were reasonably intelligent... instead of by Democrats.

You might want to read up a little more on Swisscare ... which begat HeritageCare ... which begat RomneyCare ... which begat ... eh, you know where this leads.

The most productive thing for Republicans, going forward, would be to look at the obvious problems in Obamacare, and reach back to the solutions already tested and applied in SwissCare (and already obstructed by Republicans in congress), declare that they are geniuses and have a fix, and move forward.

Hell, if it salves their egos, they can even tell everyone that this is what they meant by "repeal and replace." Whatever. Go nuts. But maybe, you know, work together to make something better. All of that touchy-feely let's-actually-try-to-govern stuff.

[Seamus Fermanagh]

You might want to read up a little more on Swisscare ... which begat HeritageCare ... which begat RomneyCare ... which begat ... eh, you know where this leads..

So, it is akin to labeling the latest scandal "urinatinginthewindgate" or whatever "gate" is being lobbed about. Gads but our public lexicon is thin.

[HopAlongBunny]

I am curious.
In Canada, under "socialized" medicine I just got discharged from the hospital.
I ended up going to emergency from a clinic I stopped in at due to nausea and a continued lack of appetite.
The doctor called me in to discuss test results=>I walked in the door and was handed a letter=>you are a sick man, get to emergency.
Turns out, my kidneys shut down at some point,...I had no idea.
So 6 days in the hospital; much blood, electrolytes, heart medicine, oxygen, food, bed rest and a raft of specialists.
Out of pocket costs so far = $0.00; that will change when I fill my prescriptions => what would be my experience in the USA?

I am also slated to be fitted with a fistula and will be undergoing a regime of home dialysis; machine and materials provided by the state.