October 28th, 2013

More ruminations on Obama’s Big Lie: you can keep it

Let me say first that anyone who believed Obama was telling the truth when he promised “If you like your health care plan, you can keep your health care plan” was naive.

And that’s an understatement. Not just naive; gullible.

Or perhaps just plain stupid.

Why did he say it? To sooth the public, calm the waters of protest, and make Obamacare acceptable. That it didn’t really work—that Obamacare has remained unpopular from before its passage to the present—doesn’t mean he wasn’t trying to make it sound more pleasing and less disruptive to people’s lives.

Perhaps he thought that once Obamacare actually was implemented people would like it better, especially the ones receiving subsidies. That’s potentially a large portion of the American public and a large redistribution of wealth. Perhaps he thought that, as more older policies were canceled or changed, and more and more people came on the exchanges and many received subsidies as well, it would sweeten the deal. Or perhaps his goal all the time was to create a demand for single payer, and to do that he had to break a few health insurance policy omelets without warning the public it was about to happen.

One thing we do know is that his promise was a lie, as in “a statement the speaker knows to be false while uttering it.” NBC News, of all people, is reporting that:

President Obama repeatedly assured Americans that after the Affordable Care Act became law, people who liked their health insurance would be able to keep it. But millions of Americans are getting or are about to get cancellation letters for their health insurance under Obamacare, say experts, and the Obama administration has known that for at least three years.

Four sources deeply involved in the Affordable Care Act tell NBC NEWS that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a “cancellation” letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience “sticker shock.”

None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.

Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”

That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.

Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”

“This says that when they made the promise, they knew half the people in this market outright couldn’t keep what they had and then they wrote the rules so that others couldn’t make it either,” said Robert Laszewski, of Health Policy and Strategy Associates, a consultant who works for health industry firms.

I doubt this would come as a surprise to any reader of this blog—or to anyone who hasn’t just dropped down from planet Xenon. Did it come as a surprise to NBC News?

Anyway, Jay Carney has an answer—it’s just not an answer to the question asked:

Today, White House spokesman Jay Carney was asked about the president’s promise that consumers would be able to keep their health care. “What the president said and what everybody said all along is that there are going to be changes brought about by the Affordable Care Act to create minimum standards of coverage, minimum services that every insurance plan has to provide,” Carney said. “So it’s true that there are existing healthcare plans on the individual market that don’t meet those minimum standards and therefore do not qualify for the Affordable Care Act.”

So, you didn’t really hear the promise you thought you heard. And of course, we did the bait and switch For Your Own Good.

[NOTE: By the way, I first noticed this propensity of Obama’s in June of 2008, in regard to campaign financing. He broke an oft-repeated promise, blamed the Republicans, and got away with it.

It also might be time to revisit this, from November of 2009:

Cons, like Obama, are ordinarily out to deceive people as to their true purposes. But it’s an error to think they come across as sleazy. The most effective ones are unusually likeable and charming, even as they pull off their scams. This likeability is not a tangential characteristic of con artists, either; it is a central one.

“Con,” after all, is short for “confidence.” The con artist works by gaining the victim’s confidence and trust. The successful con artist is so very likeable, in fact, that he seems especially credible, and people who might otherwise be wary and cynical drop their guard around him. They don’t examine him too closely, so great is their desire to believe.

Contradictions are waved away. Acts that would arouse suspicion if they were committed by someone else are excused. Important omissions go unnoticed. Inconsistencies are rationalized. Shady company is defended or ignored. Sound familiar?]

73 Responses to “More ruminations on Obama’s Big Lie: you can keep it”

  1. Mitsu Says:

    After looking into this a bit, I concede you’re correct, Neo — the grandfathering provision is narrower than I thought it was. I still don’t believe your constant suspicion that Obama “knew” this was the case just because buried in an HHS document there was an estimate of how many grandfathered plans would get cancelled. This is clearly a flaw in the regulations written by HHS, and something I oppose. The regulations should have been written in such a way as to allow the majority of grandfathered plans to stay in place.

    Furthermore, that would have been politically much more palatable for the Obama Administration.

  2. neo-neocon Says:

    Mitsu:

    My suspicion? Try: “NBC’s conclusion.”

    Ah Mitsu, if only Stalin knew.

  3. JuliB Says:

    It was a design feature, not a bug, not an unknown.

    If it were true, then President Sergeant Schultz is the most incompetent president ever.

  4. Mitsu Says:

    It’s clearly a bug, whoever knew what when. I don’t see a political upside or a policy upside. The health of the exchanges won’t live or die on the basis of how many grandfathered plans there are, so it was excessive to write the regs so tightly. Half of the grandfathered plans remain in place, regardless.

    I have been reading that one problem is that some consumers don’t know there are still many insurance plans being sold outside of the exchanges. You only need to use the exchanges if you want a subsidy. But if you don’t qualify for a subsidy, you can shop with a regular insurance agent and I’ve been reading some people are managing to get lower rates on those plans.

  5. neo-neocon Says:

    Mitsu:

    Of course some people are getting lower rates on those plans.

    Only thing is—those would tend to be the people the exchanges need the most to avoid a death spiral. They would be the young and healthy.

    They would also be the people with more income, who would have had to pay full freight on the exchanges.

  6. Otiose Says:

    I can’t claim any inside access to Obama’s thinking but given his leftist worldview and my experience over the years talking to such types, I’m sure he doesn’t see himself as a confidence man i.e. a thief. More likely he sees the current health plans along with the current distribution of wealth and income as gotten by unjust means or undeserved good fortune at the expense of the many without health insurance/wealth/income and the Obamacare provisions which are removing grandfathered status and raising costs of so many are simply steps to right past wrongs. He probably sees these steps as unpopular but necessary to bring a wider justice to more people. If that brings short (and long) term pain to a great many now it all evens out as many now deprived will get their fair share.

    Also there is the matter of his mental handicap regarding basic budget issues. I remember reading in passing someone saying that during discussions on the Obamacare plan the fact that the economics are problematic at best and he refused to discuss it waiving off the whole thing saying it’s just right wing politics or something like that.

    The irony of it all. I remember the criticism of Bush II was that he was incurious and doesn’t read real books etc. It turns out that Bush actually does have an open mind (compared to Obama at least). Obama is remarkably incurious in fact about the world and blind to aspects that don’t fit his worldview.

    “Though liberals do a great deal of talking about hearing other points of view, it sometimes shocks them to learn that there are other points of view.” William F. Buckley, Jr

    And his neglect to know anything of substance about his major legislation is a small piece in a larger pattern.

    He seems to have taken no active interest in the almost trillion dollar stimulus back in 2008/9. It’s not even Keynesian so much as corrupt due to his failure to get in involved?

    The IRS/NSA/….

  7. Mrs Whatsit Says:

    If Obama didn’t know that the grandfathering regs were being written so tightly, Mitsu, then who did decide to write them that way? And whoever it was — starting way back in 2010 when that first regulatory reference unearthed by NBC appeared — why didn’t he or she say something to The Boss to clue him in and stop him from making one misstatement after another to the American people, or else rewrite the regs to make them correspond with what the President purportedly wanted them to do? And, if Obama didn’t know before, why — now that he does know — isn’t he having the regs rewritten to be consistent with his promises? Why hasn’t he fired whoever it was in his administration who bamboozled him this way?

    It certainly is a puzzlement.

  8. Steve Says:

    Dan: CBS Reports a Obamacare increase from $54 to $595 a month…

    http://commoncts.blogspot.com/2013/10/obamacare-update-obamacare-resulting-in.html

  9. Geoffrey Britain Says:

    “The people never give up their liberties but under some delusion.” Edmund Burke

    Of all possible forms of delusion, self-delusion is the greatest. Mitsu and other liberals are living proof of this dictum.

    “I’m sure he doesn’t see himself as a confidence man i.e. a thief.” Otiose

    Perhaps but I think not. I’ve long been convinced that he’s fully aware of his lies (to lie; to knowingly tell an untruth) he simply rationalizes the means as justified by the end.

    I do think he tells himself that this is all for the greater good and that the evil capitalist rich must be opposed by any means necessary.

    It’s certain that he’s a leftist and so “the dialectic of the left” fully applies; “When I am the weaker, I ask you for (mercy and forgiveness) because that is your principle; but when I am the stronger, I show no mercy, because that is my principle.”

  10. Geoffrey Britain Says:

    A lyric from Simon & Garfunkel’s “The Boxer” applies to the Mitsu’s of the world, “Still the man hears what he wants to hear / And disregards the rest”

    Churchill opined that the mass of humanity share Mitsu’s ‘blinders’, “Most people, sometime in their lives, stumble across the truth. Most jump up, brush themselves off, and hurry on about their business as if nothing had happened.”

    And wise old Ben Franklin knew of the Mitsu’s too, “You cannot reason a man out of a position he has not reasoned himself into.”

  11. Mitsu Says:

    Who knows. What concerns me is policy — I think this might have been a much better issue for Republicans to run on, in terms of modifying the ACA, than things like getting rid of employer subsidies for DC staffers (which is a truly loopy notion both in terms of fairness and in terms of politics — why should Hill staffers be the only employees in the country not allowed to get employer contributions towards their health insurance)? I’d support a bill that expanded the definition of plans that could be covered under the grandfathering clause.

  12. Mrs Whatsit Says:

    Quick, quick, when all alse fails, blame the Republicans!

  13. momo Says:


    I’d support a bill that expanded the definition of plans that could be covered under the grandfathering clause.

    The problem is by the time any such bill gets passed the damage will have been done. The idea is to burn down the current system (which is what is happening, and is why it was so so so important for nothing to delay the ACA implementation).

    Once the current system is destroyed, The Left can go back and say “Wow this New System doesn’t work, how about we try single-payer instead?”

    The ACA is part 1 of a 2-punch combo. The first part moves your opponent out of their stance. Then you deliver the KO blow (single payer)

  14. Mitsu Says:

    >the damage will have been done

    Depends on how fast it gets passed. It could get passed this month, in time to rescind some of those cancellation notices.

  15. Ymarsakar Says:

    So it’s true that there are existing healthcare plans on the individual market that don’t meet those minimum standards and therefore do not qualify for the Affordable Care Act.

    This is almost word for word the same thing Democrats have said in defense of their Leader.

    It’s like they Obey the Part on a hive instinct almost.

  16. parker Says:

    I’m of the let it all burn mind of late. Elections have to have consequences, and it does not matter if you voted without thought of consequences. Unintended consequences are par for the course when you’re spending someone else’s money to pay for BHO kicking his heels up on the back 9.

    Boehner needs to marshall his forces and send the senate a bill that requires Obamacare to be funded in full with no exceptions or exemptions. Then, send the house home and refuse to reconvene until the senate and the messiah enforce the law in totality. The law of the land (thank you Roberts) is the law of the land. BHO swore an oath to duly execute the law of the land. He does not get to pick and choose what he will or will not execute. The repubs are wasting a golden opportunity.

  17. Oldflyer Says:

    Mitsu is a classic Obama apologist.

    Sorry, Mitsu. They rushed this through before the public, the press (if they were interested) and the GOP in Congress could even read the bill, much less digest it. Then Obama’s hand picked Sec of HHS made it worse with the implementing regulations which were tacked on sort of in the dead of night.

    Throughout the process he was telling soothing lies to the American people. If he did not know that he was lying he should be impeached for gross negligence and unrecoverable stupidity.

    Now, they say they did not know the details? Now, they say that a little adjustment here and there will fix it? No. That is not true. That is emphatically not true.

    We haven’t even reached the point where the big birds come home to roost. Wait until old folks learn the full extent of cuts to Medicare to partially fund the massive increase in Medicaid rolls. Wait until people go in to the hospital and finds out how big the deductible is on their government dictated policies. Wait until the deficit soars, and the Feds and State governments come looking for big tax increases. Wait until people start learning that there is some bureaucrat looking into their life style and dictating medical treatment based on their compliance with standards for acceptable living. And, of course as Sarah Palin told us, wait until the Bureaucrats start telling folks that their parents and grand parents are going to have to “move on” to make room in the health care world for others.

    I do not accept for one instant absolve Obama, along with the Trolls in his Administration and his Congressional Henchpersons, from blame for this debacle. In the rather unlikely event that they did not actuallly know what they were creating, it was because they lazily turned the process over to those who would benefit most from this monstrosity. No matter, they own it. It was they who crammed the finished product down our throats. I do accept that their implementation is even less competent than they had hoped it might be; on the other hand they, of all people, should know how low their level of competence actually is.

  18. Artfldgr Says:

    Socialized Medicine is the Keystone to the Arch of the Socialist State.

  19. T Says:

    Mitsu,

    “I still don’t believe your constant suspicion that Obama “knew” this was the case . . . . This is clearly a flaw in the regulations written by HHS, and something I oppose.”

    Okay, just for the sake of discussion, let’s assume that NBC is incorrect and Obama didn’t know. The restrictive grandfathering is in the regulations to execute the law, not in the law itself. Further, Obama has shown a propensity to disregard both laws and regulations he does not like (e.g., mandate extensions for corporations) and to issue executive orders to nullify their enforcement. So Obama knows now. So why hasn’t he rushed to halt and nullify the restrictive grandfathering with an executive order so individuals can keep their existing plan?

    There are none more blind than those who choose not to see.

  20. T Says:

    Neo,

    A serious question to one trained in social science: Do you think that Obama is, in the clinical sense, a pathological liar?

  21. Ymarsakar Says:

    He’s a sociopath and/or malignant narcissist.

  22. rickl Says:

    I honestly don’t understand why anybody bothers engaging Mitsu. It’s a complete waste of time.

  23. neo-neocon Says:

    rickl:

    I can explain why I engage him, although I don’t engage him for long and I’ve pretty much reached my limit.

    He is an interesting type, a good example of what I consider a fairly typical type of reasoning/arguing. I think it’s instructive to other people who might be wandering by to see how it works: the moving goalposts, the excuses, the denial, the denial of the denial, and the interminable, pile-driver nature of it. Mitsu is also unfailingly polite rather than abusive. His is a sort of slow water-torture approach to wear the opponent down.

    Is he sincere? Is he a troll? I think he’s a sincere troll, if such a thing be possible.

    His pattern is that he usually comes here for a little while when something special is happening (like in this case I suppose it’s the Obamacare rollout) and leaves fairly quickly after a few days. We’ll see what happens this time.

  24. sdferr Says:

    It’s a complete waste of time.

    It’s worse than that. The end of the aphorism goes: “. . . and the pig likes it.”

  25. neo-neocon Says:

    T:

    I don’t like the term “pathological liar” because it’s too general. I would say Obama is a strategic and very accomplished liar, but he knows what he’s doing. I would say his lies come under this heading.

  26. Mitsu Says:

    I’ve said many times why I come here: it’s because I think, perhaps hopelessly, that rational discourse across the political spectrum may be possible. I don’t like the fact that we, as a nation, have become accustomed, perhaps because of the Internet, only to talking to people we agree with. “Troll” has become the attack word that everyone who agrees in a given Internet ghetto throws at everyone who is on the outside.

    Over on “my side”, of course, I observe this happening to conservatives who occasionally wander over there, and I find it distasteful as well. Of course, “we” think you guys are engaging in distorted thinking, that empirical evidence is on our side, etc. Can we talk? Perhaps not.

    I leave after a few days mostly because I don’t have the time to do this more than a few days at a time.

  27. Cory C Says:

    I have family members who insisted Obamacare would be the best thing. Yep, they received rejection letters and now they’re fuming. I don’t have the heart to tell them we told you so.

    Btw, what happened to the commenter Occam’s Beard? Loved his witty, clever, and wry comments.

  28. Oldflyer Says:

    The link to the NBC story telling that Obama knew that millions would lose their policies at the time that he was assuring us that no one would, now goes to an

    ERROR 404 message.

    It is simply amazing how quickly, and how frequently, stories that criticize Obama just disappear into the abyss.

    If Mitsu is still around; I would point out that although he receives a good deal of flack here, there are also many counter arguments to his assertions. He just seems to ignore those.

  29. sdferr Says:

    The link to the NBC story

    It has been re-published at another url, Oldflyer, having gone through a number of gyrations tonight.

  30. Mitsu Says:

    >there are also many counter arguments to his assertions

    I don’t have time to respond to every single thing everyone posts; I try to restrict myself to discussing things where maybe there’s a glimmer of hope of at least some kind of communication, even if there’s not much hope of convincing anyone here of anything. I try to maintain an open mind. But a lot of the differences here are judgement calls — what seems credible or plausible to me and what is credible or plausible to some of you, or Neo, differs quite a bit because I don’t have the dark, conspiratorial idea of Obama that you do. To you, I suppose, that makes me “naive” or in some way unwilling to face the truth, whereas from my perspective you guys are biased, predisposed to see conspiracies when much more run of the mill explanations are possible.

  31. Matt_SE Says:

    @momo

    “Once the current system is destroyed, The Left can go back and say “Wow this New System doesn’t work, how about we try single-payer instead?””

    Like many, I assumed single-payer would come afterwards but that presented a problem: if Obamacare crashes and burns, who is going to cry out for MORE government intervention?
    I think now that single-payer is already in play: 80% or more of applicants are signing up for Medicare/Medicaid. If Obamacare takes a while to implode, there may be many more people signed up for these systems before the end.
    By drawing the process out, it will give enough time for the private insurance industry to go bankrupt under the onslaught of “adverse selection.”
    Medicare/Medicaid have specific eligibility criteria, but when they are the only game left in town those criteria can be relaxed, then done away with altogether. Americans will be over a barrel then…and I have no doubt this administration will be fine letting them suffer without insurance until they “voluntarily” choose Medicare/Medicaid.
    This may be the method by which single-payer is enacted.

  32. Boonton Says:

    I’d only consider this a lie if you can establish those buying individual plans (a minority, most people get their health plan either thru the a gov’t single payer plan Medicare/caid/VA or from employer plans EBI) are unable to buy an equilivant or better plan for the same amount of money or less.

    This is going to be a tough task for you since at the same time you’re describing the exchanges as a huge ‘transfer of wealth’ in the form of subsidies.

  33. physics geek Says:

    You know what’s funny? In a sad, twisted and pathetic way, I mean. The O-Care apologists are now saying that Obamacare isn’t causing people to lose their policies. Rather, it’s the mean, nasty insurance companies doing so. The fact that the insurance companies are cancelling policies to COMPLY WITH FEDERAL LAW (O-care) simply gets ignored.

    What’s sad is that a lot of people will be stupid enough to believe it. The results of the last two presidential elections show that it’s easy to sway an uninformed electorate. As long as the debates don’t interfere with Honey Boo-Boo, that is.

  34. Boonton Says:

    The law doesn’t ban policies that don’t meet the min. standards. If you have a bare bones policy that doesn’t qualify you the only consquence is that you won’t satisfy the mandate (which means $95 or 1% of income).

    If an insurance company discontinues a policy because they don’t think there’s enough customers to justify its fixed costs, I wouldn’t necessary consider that a violation of the promise of ‘you can keep your plan’.

    Statements like ‘you can keep your plan’ or ‘you can keep your doctor’ have to be taken with a grain of salt and read in a reasonable manner since they were addressed to reasonable people in America. If Obama said “you can keep your doctor if you pass X” and your doctor happens to die in a car accident then I don’t think any normal person would claim Obama broke his promise.

    Every year doctors swap around insurance they do and don’t accept and insurance companies change their policies (as well as cancel individuals, esp. individuals who are buying policies on their own in non-community rating states) so since that was the pre-ACA status quo I don’t think it’s reasonable to accept every single change as evidence “Obama lied”. Nor would I accept a market change (i.e. a policy is discontinued because 75% of its customers are expected to leave for an exchange based policy) that might be caused by Obamacare a valid example. Think about this, lots of things may indirectly impact the market for a particular policy. Maybe an increase in employment in a particular region may cause a lot of individual buyers of your favorite plan to switch to EBI causing your plan to be discontinued. In that case even not passing a health law could be claimed to keep you from ‘keeping your plan’.

    I think the only valid cases would be an actual policy made illegal by Obamacare or a case where an actual policy has been made unavailable and all replacements are either higher cost or lower quality.

    Now contrast this with a policy that would clearly violate such a promise. For example, imagine a policy where single payer was instituted and mandated with no option for private pay with all doctors assigned to patients by a central National Health Service. That would clearly be a case where you couldn’t keep your doctor or your plan.

  35. Boonton Says:

    BTW, it’s not like there’s absolutely no market for ‘sub-par’ plans. There are many people who have two insurances using one as a primary and the other as a secondary which ends up paying some or all of their copays and co-insurance costs. (For example, Medigap Insurance) There’s no particular reason why non-exchange worthy plans couldn’t be sold in the market as a product that ‘rides on top’ of either exchange insurance or EBI based insurance.

  36. blert Says:

    Boon…

    You’re engaged in reality displacement of a high order.

    No counter argument can proceed when you’re able to scaffold an alternate reality.

    The concept: living in denial, the first step on the path to acceptance.

    You’ve got a very long row to grovel.

    =====

    Back to facts: nationally essentially no one will have a grandfathered insurance plan by 2015.

    Regulations coming out of HHS are driving this outcome.

  37. Lizzy Says:

    I agree with others that Obama knew that he was lying, but chose to do so because that’s what he does to get what he wants. I’m already skeptical of him, but it seemed quite obvious during his Obamacare campaigning that he was just making it up as he went along. This is a habit, not an anomaly (seriously, every time he says “Let me be clear…” or “As I’ve said before…” you can safely bet that a lie will follow). He knows that the press will cover for him when/if he is caught in a lie or messes up (Benghazi, etc.), so there’s minimal risk involved.

    He also is just not a policy wonk/details guy, which is why he handed off the work of crafting the bill the Reid, Pelosi and others in his administration (instead of staying involved). He’s not a negotiator, so he prefers to campaign, where he can say what he wants unchallenged to receptive crowds.

  38. JuliB Says:

    Matt_SE – IIRC hasn’t Medicare been cut (as in a real cut, not just a made up cut)?

  39. Lizzy Says:

    NBC reposted their story because of a “glitch”, with the newer version edited to no longer include info about Obama knowing that millions would lose their health plans. This site has the before & after versions: http://preview.tinyurl.com/opffc9x

  40. Ymarsakar Says:

    When the Left points a gun at people’s head and tells them, buy this or else, I’m not too sure where their loyalists get off talking about “rational” anything.

  41. Matt_SE Says:

    @JuliB

    $716 Billion was cut from Medicare Advantage. It is the most free-market part of Medicare and was supposed to be working well with high customer satisfaction.

    *From Wikipedia*: “Not only do most Medicare Advantage plans significantly reduce the out-of-pocket cost of health care to just a few thousand dollars annually, compared to tens of thousands of dollars an extended hospital stay could cost under Original Medicare, they also offer greatly expanded benefit packages, including dental, hearing, podiatry, chiropractic, acupuncture, and vision coverage, as well as health club memberships and other services which are also not covered by Medicare, such as transportation to and from clinic appointments.”

    These savings happened because Advantage uses HMOs (the savings went to the expanded coverage). This was an improvement over regular Medicare because the government was reimbursing HMOs instead of patients, with limits on the subsidies HMOs could receive. The HMOs had an incentive to keep costs down. Under regular Medicare, patients had no incentive to keep costs down since they didn’t see it as “their” money paying the doctors.
    Admittedly, HMOs will restrict access to only approved doctors and hospitals but the truth is that most patients don’t need the “world’s best” doctor for most illnesses.

    I would guess that Obama cut such a popular, efficient system because Obamacare can’t match the service offered by the free (-er) market…and we can’t have Obama looking bad, can we?

  42. Matt_SE Says:

    Oh, also: if the Dems want to get to single-payer then the private insurance market MUST BE DESTROYED. Medicare Advantage assumes the private market exists and uses it.
    …which is why Medicare Advantage itself must be destroyed.

  43. Ymarsakar Says:

    We got two examples of Obama’s care defenders right here and right now.

    Imagine that they represent 99% of the bureaucrats that will decide what you will get and when.

    You want to deal with them when your lives are in their hands?

  44. blert Says:

    JuliB…

    To the tune of $500,000,000,000 over a ten year period.

    That’s the quoted figure.

    As ever, if the impossible quotation force is ever pinned down, the Secretary will deny any knowledge of facts.

    ========

    0bamacare clips the young by brutal premiums…

    0bamacare clips the elderly by defunding Medicare…

    Which is to be squared up by the Death Panels — terminating end of life expenditures in a pro active manner.

    The gusher of funding will then be redirected, via HHS regs, into sustaining the Emergency Rooms of America — and all of the illegal immigrants receiving care via that mechanism.

    Indeed, the HHS will compel hospitals to provide much more extensive care to the indigent than heretofore. It won’t be enough to patch them up and send them back out. Instead, HHS will insist that EVERY indigent passing through the ER receive a full body work-up so as to prevent further health difficulties. That’s what the rationale will be.

    BTW, the insurance industry is just throwing darts inre pricing. They know that the maladministration is CERTAIN to expand the scope of coverage, ex post facto, via HHS regulations. This has all of the players shooting high, for the consequence of optimism is bankruptcy.

    It’s getting late in the day, but no one has been appointed to the Death Panels.

  45. John Dunne Says:

    At this point I just can’t say whether Obama knew how the ACA’s grandfathering would affect people in the individual market. If he did know, I’m also unsure whether it’d be better characterized as a politician’s massaging the truth or a despicable lie. Frankly, a person’s answer to those questions probably has more to do with how they think of Obama and Obamacare generally than with the specifics of this revelation.

    From a policy perspective, what do people here say to the idea that, presumably, federal/state exchanges will allow people whose policies are cancelled to pick up better, cheaper policies?

  46. John Dunne Says:

    “if the Dems want to get to single-payer then the private insurance market MUST BE DESTROYED.”

    I don’t get this. Isn’t the simpler scenario that the ACA is a muddled compromise between political actors with very different opinions, rather than that it’s an elaborate plot to destroy non-government healthcare options?

  47. Ymarsakar Says:

    America’s political foundation was premised on the fact that people who are free to collect the resources they need for life, will leave each other alone and avoid war/conflict if they can be assured that nobody else is going to try to take their stuff and their ability to support themselves.

    Even the Pilgrims tried out Leftist central planning socialism and almost starved as a result.

    Elizabeth Warren speaks of the social compact, where you didn’t create any jobs when you open a business. Society did, by protecting you and giving you the authorization to work.

    Their social compact reads essentially, “if you can work, we’ll make you work. If you are a higher disadvantaged class, we will redistribute the goods of the slaves to you”.

    They think we’ll tolerate it. They think we’ll just gladly sign right up and say, “Yes, Massa, whatever you say Massa”.

    This is Slavery 2.0. The Democrats Never Gave up on the concept of slavery.

    They think they can take whatever food, resources, and wealth the lower classes produce and we will Do Nothing About it.

    They think Americans will just bow down like North Koreans and take the scraps off the table, and eat like dogs at the bowl they designate for us.

    They think their use of force is justified and that no one else is justified in using force except by their authorization.

    They think they will be safe, as they press their boot on the throats of children, insult and crush the heads of the parents, and laugh about it as they have a drink of wine at their private mansions on Gold Plated privatized healthcare while the peons starve.

    This is their “social compact” with America, aka Slavery 2.0.

    Those that don’t like it, know what to do about it.

  48. Matt_SE Says:

    Correction to my post at 11:14:

    *From Wikipedia:” Medicare Advantage is offered by commercial insurance companies and HMO and PPO corporations, who receive compensation from the federal government, but do not process claims through the CMS. [Centers for Medicare and Medicaid Services]”

    So the government reimburses private insurance companies, who reimburse healthcare providers. HMOs apparently are a conglomeration of both the provider and insurer aspects in one company.
    Either one of these routes assumes the existence of a private insurer.

    It seems to me that all the puzzle-pieces are now falling into place:
    1) Gut Medicare Advantage, leaving only the original single-payer Medicare.
    2) Include provisions in Obamacare that increase adverse selection, like letting people up to 26 years old stay on their parents’ insurance.
    3) Implement Obamacare in a slow-rollout fashion, giving adverse selection enough time to kill off the private insurance market through adverse selection. (If true, the website “glitches” may have been planned to draw out the process)
    4) Once all private insurance has been eliminated, get rid of the restrictions on eligibility for Medicare/Medicaid.

    Passing single-payer as it’s own system would obviously be impossible right now. It would be much easier to eliminate all other private options, leaving only Medicare/Medicaid standing.

    Of course, I could be wrong.

  49. kit Says:

    obama knew. It was part of his plan. His goal always was and always has been to inflict pain on Americans.
    The more pain, the more his little withered heart beats happily.

  50. Boonton Says:

    blert

    Back to facts: nationally essentially no one will have a grandfathered insurance plan by 2015.

    Well if you want to play legalism I’ll one up you. All health insurance plans, like your auto insurance, run on a yearly basis. Whatever health insurance you had in 2012 or 2011 was based on a policy that ended when the year ended, period. Obamacare then could have banned all private insurance and fulfilled the statement ‘you can keep your coverage’ if the law had waited a year to implement that plan, when all current plans would have expired. I grew up with a sister so I’ve had plenty of practice playing the nitpicking game if you really want to go there.

    I’m working with a more reasonable definition of ‘keep your plan’.

    Matt_SE

    $716 Billion was cut from Medicare Advantage. It is the most free-market part of Medicare and was supposed to be working well with high customer satisfaction.

    1. $716B? The entire Medicare budget in 2010 was $560B.

    2. ‘Most free-market part’?! If it’s so free market then wouldn’t it be people using their own money to buy plans? You are essentially telling us reducing a single payer type system is attacking the free market! May the Ghost of Ayn Rand haunt your dreams for the rest of your life!

  51. John Dunne Says:

    Also, do we know that what’s happening is actually cancellation, rather than just the adjustment of policies that don’t meet ACA standards?

  52. John Dunne Says:

    Sorry for all the posts! But I wanted to clarify my last question: isn’t rollover of this kind kinda normal? I.e. wasn’t the misrepresentation about the degree, rather than kind, of change that would occur in the individual market?

  53. Mitsu Says:

    Boonton, I’m going to disagree with you. The intent of the grandfathering clause I think is clearly being violated, and the promise isn’t being kept. If only 10% of grandfathered policies were going away, that would be one thing, but 50%? Kind of a lot.

    The reason they made the regs is obvious to me now that I’ve thought about it: they wanted to prevent insurers from circumventing the new regulations by just “modifying” grandfathered plans forever, preventing the ACA from ever fully going into effect. This might starve the exchanges. But I think they went too far with it; politically it’s a negative and they could have just at least modified the regs to allow for a more gradual transition.

  54. Matt_SE Says:

    @John Dunne

    The free (-er) market will always outperform government-provided healthcare by MILES, so in order to get single-payer the private insurance market and HMOs must actually be destroyed…this was not hyperbole on my part. The difference can be seen in how Medicare compares to Medicare Advantage, let alone the lower rates of the private insurance market as compared to Obamacare exchange rates.

    As to the motivation and Occam’s Razor…who knows? I’m not a mind-reader.
    And while it’s tempting to assume the simplest answer is true, this also has the danger of being intellectually lazy.
    For example, most people take the Syria thing at face-value…as a struggle between a dictator trying to hold onto power and insurgents trying to establish an Islamic state. They assume Russia is just supporting a client.
    However, I’ve heard that gulf oil states were planning a pipeline through Syria to Europe. That would endanger Russia’s stranglehold on supplying energy to Europe. So maybe their support is more self-interest than not.
    Which goes to demonstrate that the simplest answers are not always the correct ones.

  55. Ymarsakar Says:

    A lot of people on the net don’t want free markets. They want to be told what to buy and where to buy it.

    Guess what kind of mentality that is.

  56. Ymarsakar Says:

    Occam’s Razor predicts that if a simpler theory explains the reality and evidence, there is no need to make work producing a more complicated alternative theory.

    In this case, incompetence and “I didn’t do that” excuses are not enough, thus the complexity level must rocket towards “evil” not away from evil intent.

  57. Lizzy Says:

    Neo, you’ve probably already seen it, but Jonah Goldberg rants about the liberal policy wonks who are now conceding that yes, they all knew that what Obama was promising was, er, “narrowly untrue”:

    “For starters, Obama’s statements were not ”narrowly untrue.” They were broadly, knowingly and entirely untrue. He repeated them over and over again, often straight into the camera. It’s nice that Greg Sargent concedes now that the president “could have been clearer.” But “could have been clearer” implies that he was a little clear about how this would work and just didn’t clarify enough. The truth is the complete opposite. He wasn’t even deliberately unclear. He was clearly dishonest. Obama was stridently deceitful. Seriously, watch this video compilation of Obama’s repeated and vociferous statements about “keeping your plan” and tell me he was just failing to be sufficiently clear that millions of people wouldn’t be able to keep their plans:”

    video at the link:http://preview.tinyurl.com/kvkfomx

  58. Mitsu Says:

    >The freer market will always outperform

    That’s just not true. Our particular market system has produced the most expensive health care system in the world by a large factor; we spend nearly double what the average industrialized nation spends. Yet our health care outcomes are on average just middling. Yes there are problems with wait times in many countries with universal health care, but not in all of them; and out wait times are actually quite poor. As for doctor choice, most HMOs and insurance plans have restricted choice; in France which is single payer you can go to ANY doctor. The market is not a panacea; it doesn’t always result in better service at a lower price. In health care it’s certainly not the case.

    Health care costs were going up at double the rate of inflation for decades. Do nothing and they would have eaten our economy and blown up Medicaid.

  59. Matt_SE Says:

    @ Boonton

    1. $716B? The entire Medicare budget in 2010 was $560B.
    $716 Billion over the 2013–2022 period. This was a “D.C. cut” in that it was a reduction of the projected growth. Still, since the population is aging you would expect demand to grow…so a cut to future growth is probably a real cut.

    2. ‘Most free-market part’?! If it’s so free market then wouldn’t it be people using their own money to buy plans?
    It is the “most free-market part” in a relative sense…as in, “compared to original Medicare” which is ZERO PERCENT free-market. The third-party payment system was already a bastardization of the free-market system and was the cause of much of the dysfunction, but that’s an argument for another time.

  60. John Dunne Says:

    “In this case, incompetence and “I didn’t do that” excuses are not enough, thus the complexity level must rocket towards “evil” not away from evil intent.”

    First, you seem to not even consider the idea that there are reasonable grounds on which to disagree about the degree to which Obamacare is a disaster, much less whether it even is a disaster at all.

    Second, there are a hundred other directions that the “complexity level” could rocket toward other than Obama being an evil mastermind.

  61. Matt_SE Says:

    @Mitsu

    Here, let me fix that statement for you:
    The freer market will almost always outperform

    As with most leftists, when presented with evidence you don’t wish to acknowledge, you start parsing phrases.

    As to costs, wait-times and metrics of health outcomes vis-a-vis other countries…I can neither prove nor disprove a counter-factual. It is a counter-factual because of the third-party payment system which distorts the market and does not represent the “free market” very well.
    I can only opine that if we had a system more free-market than third-party payer, it would be cheaper and more efficient.

  62. Mitsu Says:

    >if we had a system

    Libertarians always say:if only we had a TRULY free market… to explain nearly every market problem. All I can say is, the idea that markets are a panacea is based on an oversimplified view — you’re comparing markets to a command economy. Yes, a command economy is typically really, really inefficient. But there’s no reason to jump from that correct observation to the idea that completely unregulated markets are the solution for everything, they are always maximally efficient, etc.

    Health care is not like other commodity markets. Most of the time, you don’t need it at all — you can go years without it. Then, suddenly, you REALLY NEED IT, and often it’s an emergency, and particularly in an emergency you’re not going to be shopping around for the best price, checking reviews on Amazon, you’re going to go to the nearest hospital, etc. It’s just not a market with ordinary incentives and so forth. The reason health care costs are skyrocketing is because people perceive the need for health care as extremely pressing when they do need it, and this heavily distorts the market because people are willing to pay much more for it than other things they can live without.

  63. Boonton Says:

    Matt_SE

    1. Ahhh so the horrible $716B cut is over a nearly ten year period. Life will go on and, it seems, if these free market plans are so great individuals other than taxpayers will be happy to pay for them. All that need be done is the Advantage plan be repositioned as a combo Medicare Advantage plan with a Medigap plan whose premium is whatever the cut was. Since customer service, OOP expenses and so on are so great I’m sure seniors would be happy to pay for such superior coverage themselves instead of asking taxpayers to do it.

    2. “It is the “most free-market part” in a relative sense…as in, “compared to original Medicare” which is ZERO PERCENT free-market. ” Well the exchanges where people use a combination of their own money and taxpayer money to shop for plans offered by private companies would be even more free market in your ‘relative sense’ as opposed to a market where people shop for a plan with other people’s money…in fact don’t even see prices!

  64. Ymarsakar Says:

    Most of the US’s healthcare costs are due to medical degree investments and the amount of resources the political elites allocate to themselves via their Congressional privatized healthcares. Also Democrats skimming off the top and redistributing money from medical supplies and equipment to their cronyies constitute at least 10% of the consumer price in all things.

    Mitsu would prefer a centralized planning system, where all the profits go into Democrat pockets. That’s not exactly a free market moderate zone.

  65. Matt_SE Says:

    @Mitsu

    Straw-man argument: “…completely unregulated markets…”
    Nobody who’s serious thinks healthcare can be completely unregulated. But it would be nice to try patient-paid healthcare, or at least the old system with reforms like the ability to get insurance across state lines before we declare “the market has failed.”

    “Health care is not like other commodity markets. Most of the time, you don’t need it at all — you can go years without it. Then, suddenly, you REALLY NEED IT…”
    Not really. There’s all sorts of low-level coverage that goes on all the time; sprains, headaches, chest colds, vaccinations, etc.
    I used to work in an urgent care clinic near a university town. It was funny that whenever it was a big game day, the number of people coming in dramatically decreased. This tells me that for low-level care, healthcare is elective.
    Now, catastrophic healthcare is another matter but by volume I think it only represents a small fraction of all healthcare transactions.

    Because of catastrophic health problems (and the inability of most patients to refuse care in those circumstances) healthcare will never be a perfect free market. But we can get a lot closer than we’ve previously been.

  66. Boonton Says:

    Most of the US’s healthcare costs are due to medical degree investments and the amount of resources the political elites allocate to themselves via their Congressional privatized healthcares.

    yea right, in Germany for example you can become a doctor by spending one week of concentrated reading about medicine on wikipedia. And political elites? Even if every congressperson got his own personal doctor, nurse and specialist to follow him around 24-7 it would represent only a trivial fraction of America’s production of health services.

  67. Matt_SE Says:

    @Boonton

    1. (Simplified example): Government taxes you $500, skims off $100 for itself and gives you $400 in “healthcare.” In a government-subsidized system, the hospital charges you $400 for your procedure.
    In a free(-er) market system, the hospital charges you $200, but you pay OOP.
    Now, if you’re getting healthcare without government involvement there’s little reason to be paying for services-NOT-rendered.
    If the government taxes you anyway, the total cost of the procedure is $700 to you ($500 tax plus $200 procedure). If not, the cost is $200. Even in a government-subsidized system the cost is $500 to you.

    So yes, as long as people aren’t paying the government for services-not-rendered, people will be happy to pay for them because they come out economically much better that way.

    I think this is a fair representation of the issues at hand, because the free market is lower-cost than most systems with government involvement.

    2. You are comparing apples to oranges here. Introducing partial-patient-payment into a system that used to be single-payer would be an improvement, all else equal. But because Obamacare mandates all sorts of coverage that wasn’t required before (contraception for 80-year-olds, for example), the nature of the coverage itself has changed and become much more expensive.
    Now if this increase is offset by the gains from patient choice, then it’s still better but that leads to another point:
    Obamacare applies to all people, not just the people that used to be under Medicare. The others used to use the free(-er) market, so not only are they having to purchase the type of “comprehensive” coverage required by the ACA (which is more expensive, per se) but they are also going to be hit by the cost of reduced competativeness…a double-whammy.

  68. Matt_SE Says:

    @Boonton

    “yea right, in Germany for example you can become a doctor by spending one week of concentrated reading about medicine on wikipedia”
    I doubt that’s true, but if it is then I won’t be going to any German hospitals.

  69. Matt_SE Says:

    Bob Beckel on “The Five” tonight basically just endorsed the scheme I outlined at 11:41 above.
    - He trashed the insurance industry (check)
    - He called for turning Medicare into the default single-payer (check)

    He didn’t need to endorse points one-through-three, as they were either already accomplished or in the process.

  70. Don Says:

    Our particular market system has produced the most expensive health care system in the world by a large factor; we spend nearly double what the average industrialized nation spends. Yet our health care outcomes are on average just middling.

    False. Our health outcomes are some of the best in the world–hence why Canadian socialist politicians come to America for cancer care.

    The left lies about it, of course. Usually based upon life expectancy or infant mortality stats which simply don’t apply.

    You will note that the US life expectancy is the highest if you factor out homicide and auto accident deaths. The reason the US figures look bad is due to demographics. Note, this doesn’t just impact life expectancy stats, but also healthcare costs.

  71. Don Says:

    The reason health care costs are skyrocketing is because people perceive the need for health care as extremely pressing when they do need it, and this heavily distorts the market because people are willing to pay much more for it than other things they can live without.

    There are several reasonsfor high healthcare costs in the US, but the primary cause is that our system has mostly eliminated price competition at point of service. This is due to using third party payment systems. The customer simply doesn’t care what the real cost is. And, those who are paying represent a third party (additional cost), and in an attempt to keep costs low leverage requirements that further causes additional costs (managed care).

  72. Matt_SE Says:

    @Don

    Also, I understand that the US is one of only a few (like, two-to-four) countries that count all births if the baby just makes it out.
    The vast majority of the world’s countries don’t count babies unless they are “viable”…meaning surviving a certain period of time after birth.
    Because we treat all births with dignity and respect, even the premature ones, our infant mortality stats are higher.

    …but then, the rest of the world is left-leaning, so that’s no surprise.

  73. Ymarsakar Says:

    Europe doesn’t count partial birth abortions as being infant fatalities. Why would they.

    And I didn’t know Boonton was an Obamacan in Germany. That’s something we’ll take note of come the next civil war.

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