Ambinder: Obamacare survived August

Marc Ambinder thinks the wingnuts have thrown their best punch at Obamacare, and it’s still standing.

After August, under the worst case scenario, there is majority support for the following major changes to health care: real (albeit limited) competition in the insurance industry (even absent a public plan). A cap on what a person pays for catastrophic illnesses. An end to insurance company recision policies. Guaranteed issue. A basic benefit package. Significant subsidies to help people who earn as much as $64,000 a year pay for health insurance. Better cost and coverage incentives. And lots more. Say what you will about these reforms — maybe they’re incremental — but they’re a foundation for center-left policy in the future.
After August, conservatives have exhausted their repertoire of arguments and many of their demagogic tricks. Public support for significant health care reform as something worth doing remains high. Support for Obama’s plan remains unchanged — didn’t grow, certainly, but didn’t decline. Support among Democrats remains at 90%. Obama’s message tomorrow night will be one that dovetails with what the American people believe: it’s important to get health care reform done.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact:

6 thoughts on “Ambinder: Obamacare survived August”

  1. Obama has many political skills, but I do not think he has mastered the art of telling the people what they do not want to hear. In one domain, that of the “war on terror,” he has not told us how bad the situation really is, nor what kinds of escalation he may be forced to contemplate. We do not want to hear.

    In the domain of health care, he has to deal with the fact that the majority of the people are satisfied with their health care plans. This is highly attributable to another fact: the majority of the people have never been really, really sick, and therefore have not discovered what large gaps there are in their health care plans. If they ever did get seriously ill, their satisfaction with their plans might change dramatically. People do not want to hear him say: the reason you are so satisfied is due to your good fortune so far, not to the soundness of your insurance policies. That would be upsetting to hear, and he will not utter it. “You may feel secure now, but you are skating on thin ice.” Imagine the response if he said anything like that!

    Maybe some contributor to the reality-based community can offer some examples of political leaders who managed to tell the people what they wanted not to have to think about. Fear mongering for personal political gain is commonplace, but I am seeking another kind of phenomenon: not when an imaginary danger (missile gaps, predatory gays, Muslims, etc) is magnified, but when an underappreciated pitfall is pointed out just where most people felt that there was solid ground beneath their feet.

    If Obama could find and model himself after one of these acts of statesmanship, that could turn the tide. Any suggestions?

  2. All this is moot if congress-critters like Mike Ross, Ben Nelson and Max Baucus decide to use the August circus as an excuse for doing what they wanted to do all along. I'm not saying we can't have meaningful reform without a public option. I think we can, but it then very much depends on the details. The Dems (specifically Reid) are too feckless to go the reconciliation route, and going for 60 votes in the Senate will virtually guarantee that the bill is toothless.

    As for Ed's point above, candidate Obama had actually displayed an admirable tendency to tell audiences what they didn't want to hear. But yes, President Obama has certainly been more expedient.

  3. I tire of the idea that people "don't want to hear the facts". I've also heard the argument people don't want to "see the things I've seen", or "I've done the dirty things for you so you don't have to". Everybody would just love to see what bad things have been done, what dirty work has been done in their name. People would love to see the things "you've" seen. Folks would truly enjoy knowing "the facts" if they could know what the facts are.

    I'm satisfied with my healthplan, with some serious reservations. I pay $180 per quarter for what amounts to virtually unlimited healthcare. Theoretically. The company I retired from pays $3,200 p/month per family member for my healthcare. My primary healthcare is our company's health and welfare trust fund. My secondary is Pacificare. My wife's primary healthcare is Pacificare and her secondary is the trust fund. The $180 per quarter we pay each is for the health and welfare trust fund.

    We arranged it this way, my wife and I, so we'd have the maximum health insurance we'd need. But the insurance companies are more clever than us. Once they became aware their were two of them, each claims the other must pay first. Once the other pays first then the second in line will pay. That way, they can delay payment for medical services until the we ourselves must pay. After all, we're the people who will be charged when all other options fail. It appears our two insurance companies are doing their best to make sure that happens. This is despite the letter we have from them stating Pacificare will pay first, the majority of the charges, and the trust fund will pay the balance.

    Pacificare required my wife have a colonoscopy because of her age and because her older brother had colon cancer, something that comes out on the medical form. It's been two years since she's had the colonoscopy and the doctor that performed it has yet to be paid by either Pacificare or the trust fund.

    We are receiving dunning letters from the doctor who performed the colonoscopy, performed as required by Pacificare, a doctor approved by Pacificare, and who has had payment refused by Pacificare. The trust fund rightfully refuses to pay first as per the letter we received.

    The doctor is rightfully angry, we are rightfully angry, and our primary physician is rightfully angry. The colonoscopy doctor recommended and required by Pacificare, who performed the operation (or service) at Pacificare's behest should be paid by Pacificare. It's $130.00. What's the beef?

    Since Pacificare has a beef and won't provide an explanation I'd like to fire them. If the public option is passed I will drop Pacificare and go for it in a New York second. Without hesitation.

    There are a number of other reasons I'd drop Pacificare. It should be noted the only reason I have them is they're the only option I have.

  4. Of course Obamacare survived August. If anything passes AT ALL, it's going to be called "Obamacare", and declared a victory. "Obamacare" is too content-free to be defeated.

  5. I fear that Brett is right. Usually, I'd worry more about asteroids bringing the dinosaurs back to earth, because that's more plausible.

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