Friday, October 25, 2013

Cruising the Web

This is fun. Watch Charles Krauthammer on The Daily Show. It is a nice to hear an intelligent discussion of ideology and politics. Krauthammer is out with a new book, Things That Matter. Read Timothy Carney's review of the book and biographical notes on Krauthammer.

Megan McArdle has a typically perceptive post explaining why some of the proposed solutions for the mess with Obamacare are just not going to work. For example,
6. Delaying the individual mandate: As with the last nonsolution solution, this solves a problem for individuals but destabilizes the insurance market as a whole. If it’s a tedious pain to buy insurance, the only thing standing between us and a death spiral is the fairly hefty penalty that folks who don’t buy it may have to pay. Delaying the individual mandate makes the problems created by the malfunctioning exchanges worse -- which, I reiterate, will ultimately mean more uninsured people, not fewer. This is a terrible idea, which is being seized upon by the administration and Republicans not because it makes any sense, but because it is politically expedient. It is the responsibility of policy analysts and informed voters to stop them before they irreparably damage the market for individual insurance.

7. Extending the open enrollment period: This idea has a number of big problems. For starters, it’s probably not legal. Also, it’s useless without extending the individual mandate: Who wants to find out that they’re liable for both insurance premiums and the penalty for being uninsured? But it would also be very, very bad for the insurance market.

I pointed out a while back that one conservative talking point -- that people can just wait until they get sick, and then buy insurance -- is incorrect. It’s incorrect because we have an open enrollment period: If you get sick in April, you have to wait until next January to get insured again. Oh, you can game it a bit (if you move to a different state, for example, you become eligible to buy insurance outside the open enrollment period). Even so, this provides a pretty powerful incentive to get insured and stay insured: After all, how many people can easily switch states?

But if the open enrollment period is extended, then suddenly it makes total sense to wait, especially if the individual mandate also gets delayed. And who’s most likely to wait? Say it with me: young, healthy people who rarely go to the doctor -- exactly the people we need to get into the system immediately to keep it financially stable.
Jonah Goldberg explains why Obamacare can't survive if the individual mandate is delayed.
That’s because insurance companies cannot survive Obamacare without the individual mandate. Under the law, they must offer insurance to anyone who needs it — often at an artificially low price at that. The only way they can make a profit is if the government upholds its promise to get millions of young, healthy people to sign up for more expensive insurance than they need. Take away the mandate — i.e., the penalty — and you make that virtually impossible. If the government tells insurance companies they still have to provide insurance to bad risks, it will be like the government telling Apple it has to sell iPhones at a loss. The insurance companies will sue. And as Dan McLaughlin of The Federalist notes, their lawyers will invoke the Obama administration’s arguments before the Supreme Court that the mandate was inseparable from the “must-issue” requirements under the law.

But even if, somehow, the insurance companies can be compensated for their losses on that front, the fact remains that the only people willing to put up with the North Korean–level customer service are people understandably desperate for health insurance. Those people aren’t likely to be young and healthy.

So, sure, the website is just one small part of Obamacare. But your jugular is only one small part of your anatomy, too.
Charles C. W. Cooke refutes liberals' attempts to find blame elsewhere for the failure of HealthCare.gov, particularly Republicans.
That notwithstanding, my opinion on this matter has absolutely no bearing on the outcome — and to pretend that it does is extremely na├»ve. I am not possessed of any magical power with which I might prevent the law from working, any more than I am able to stare at an airplane and will it to crash into the ground. I did not award a no-bid contract to a failed Canadian IT firm, nor ensure that the system wasn’t tested until four days before it launched, nor allow it to be “built using ten-year-old technology.” Nor, for that matter, did Republicans. Unless you believe that the role of Congress is merely to “support” the president in all that he does, the fact that more than half of the voting public and one of the country’s two political parties have been critical should not be held against them.

Salon’s Irin Carmon complained sadly this week that “the federal exchanges [are] being burdened by so many more people than expected because for political reasons, a lot of governors refused to set up their own exchanges.” This line is not just askew, it is deeply presumptuous. While the idea that the system is failing because of excess demand has been widely debunked, Carmon is correct to note that a majority of governors declined to set up exchanges, and that they did so for “political reasons.” But, one might ask, “So what?” Texas is a state in a federal nation, and the law that the president signed allows the states to decide how to respond to what is, ultimately, a federal initiative.

To believe that the states have in some way “nullified” or “sabotaged” the law by choosing not to do the lifting themselves is to believe that the states are merely regional departments of the federal government and that their electing whether or not to expand Medicaid or set up health-care exchanges is illegitimate. In this case, “political reasons” means doing what the people in their states wanted them to do.
Oh, darn. Obamacare isn't lowering medical costs in rural areas.

Ed Morrissey writes for CNN about how Obamacare has sped along the death spiral of this administration's credibility.
Instead, the emerging "death spiral" crisis is one of the credibility for the White House and the idea that big government-program interventions work better than the private sector those interventions seek to reform.
The Department of Health and Human Services had 42 months and $400 million to create an operational Web portal that connects Americans who now are required by law to buy coverage from insurers, while connecting to the IRS to qualify people for federal subsidies in the exchanges.

For the last several months, HHS and the White House assured everyone that the system development was on track for an October 1 launch. Democrats fought a pitched battle against Republicans over the last month to keep the GOP from forcing a delay of the rollout.

Now, suddenly, the idea of a delay has moved from the ramblings of "anarchists," as Harry Reid described Obamacare opponents, to mainstream Democratic thought. Sen. Richard Blumenthal, a Democrat from deep-blue Connecticut, told a panel on MSNBC on Thursday that the mandate needs to be delayed, depending on "how soon these glitches are going to be solved." That will depend, Blumenthal said, on "leveling with the American people."

That honesty has been in short supply. More than two weeks into the crisis, HHS Secretary Kathleen Sebelius told CNN's Sanjay Gupta that President Barack Obama had no inkling of the failure until he read about it in the papers, which follows a pattern of denials at the White House. Sebelius also implied that the failure took her by surprise too, even though the ACA was her agency's highest priority over the last 42 months, and the system failed a light-load test days before the launch.

Sebelius must have also missed the August report from the HHS Inspector General pointing out major flaws in the system and its testing, even though Reuters managed to notice it.

CBS is reporting on what is becoming a typical story for people who used to buy their own insurance and now are finding out what Obamacare has done to their formerly affordable plans.
Her insurer, Kaiser Permanente, is terminating policies for 160,000 people in California and presenting them with new plans that comply with the healthcare law.

"Before I had a plan that I had a $1,500 deductible," she said. "I paid $199 dollars a month. The most similar plan that I would have available to me would be $278 a month. My deductible would be $6,500 dollars, and all of my care after that point would only be covered 70 percent."
But, but President Obama promised us that if we liked our insurance plans, we could keep them. I guess Obama thought he could fool everyone that he had the power to suspend the mathematical reality of how insurance works.
Gerry Kominski, director of public health policy at UCLA said: "About half of the 14 million people who buy insurance on their own are not going to be able to keep the policies that they had previously."

He says higher premiums help insurers pay for new requirements including accepting patients with pre-existing conditions and providing preventative care like check-ups and vaccines.

Michelle Malkin details how Obamacare's mandates on electronics medical records is messing up medical care with the typical unintended consequences that permeate the entire law.
nstead of concentrating on care, doctors face exhausting regulatory battles over the definition of “meaningful use” of technology, skyrocketing costs, and unwarranted Big Brother intrusions on the practice of medicine.

As I reported last year, Obamacare’s top-down, tax-subsidized, job-killing, privacy-undermining electronic record-sharing scheme has been a big fat bust. More than $4 billion in “incentives” has been doled out to force doctors and hospitals to convert and upgrade by 2015.

But favored EMR vendors, including Obama bundler Judy Faulkner’s Epic Systems, have undermined rather than enhanced interoperability. Oversight remains lax. And after hyping the alleged benefits for nearly a decade, the RAND Corporation finally fessed up that its cost-savings predictions of $81 billion a year — used repeatedly to support the Obama EMR mandate — were (like every other Obamacare promise) vastly overstated.
The top-down regulations are interfering with doctors' real tasks of interacting with patients.

Norm Ornstein points to President Obama's lack of administrative expertise and how that permeates his entire administration.

What a surprise. When given a choice, teachers don't like to be forced to pay dues into teacher unions.

Victor Davis Hanson warns us about deceptively named laws such as...The Affordable Care Act.

This is not a joke:
Speaker John Boehner (R-Ohio) said the attendance of Roger Daltrey — the founder and lead singer of the band — will ensure that the ceremony honoring Churchill, the former British prime minister, will receive the “first-class” treatment it deserves.
Yes, because nothing says respect

2 comments:

Neo said...

Norn Ornstein, who has been around DC forever, has this wonderful snippet (at National Journal) …

Go back, first, to Max Baucus’s famous and widely distorted and misused “train wreck” comment in a hearing to Health and Human Services Secretary Kathleen Sebelius in April 2013. Contrary to Ted Cruz and countless other Republicans, Baucus did not call Obamacare a train wreck—he was referring directly to its implementation through the website. He said, “I understand you’ve hired a contractor. I’m just worried that that’s going to be money down the drain because contractors like to make moneymore than they like to do anything else. That’s their job. They’ve got to worry about their shareholders and whatnot.

...

If Sebelius, the president, the leaders at the Centers for Medicare and Medicaid Services, and other White House officials were unaware before that hearing about the implementation problems, they could not be unaware afterward. And, as we are now hearing, the stark internal warnings from tech experts of deep-seated problems in the programs came months ago and went unheeded.

Pat Patterson said...

SCOTUS ruled that the individual mandate passed Constitutional muster but didn't say it would work.