• Can we all get a little bit more knowledgeable about Obamacare?

    When the bill was about to become a law, a lot of talking points were established. But it’s now three and a half years later, and I’d like to ask if we could stop with some of them. If I have to hear one more person brag about the fact that, “No one has read the law,” I’m going to scream. This line of attack was awesome when it first appeared. Even though the whole process took, like, forever, there were some who felt that the actual law’s text was too long for a good review before voting. So be it. It also didn’t help that Speaker Pelosi said, “We have to pass the bill so you can find out what is in it, away from the fog of controversy.” Of course, no one ever references that last parenthetical. But that’s irrelevant. It’s been 1258 days since March 10, 2010. That’s plenty of time to read the text. Especially if you’re a politician, and it’s your job to be knowledgeable about the law. I’m baffled by lawmakers’ pride in their know-nothingness.

    While we’re at it, can we stop with the 2700 pages thing, too? Here’s a link to the law, and it’s 906 pages. The If you go to healthcare.gov, and click on their version of the law, you’ll find a version that is 974 pages. What’s the difference? It contains parts of the “Health Care and Education Reconciliation Act of 2010.” I don’t know what 2700 pages was. Maybe they formatted it in a crazy way. Maybe it was the bill, and included lots of stuff that got eliminated. I don’t know. But it’s not right, and it would be nice to see it go away.

    But just pointing out that it’s complex (as mismeasured by its length, or that nobody read it) is about the least helpful thing one can do. Fine, it’s complex. I agree. How about proposing some sensible alternatives that actually address the policy issues? You get bonus points if your alternative recognizes that we need to fix access, quality, as well as cost. Yes, Americans do care about more than just cost.

    Forty repeal votes aren’t alternatives. Shutting down the government isn’t an alternative. Whining about how it was passed three years ago isn’t an alternative. Trying to keep people from buying insurance isn’t an alternative. Denying Medicaid isn’t an alternative. Ripping out the individual mandate isn’t an alternative.

    And making up stuff about the law and pretending that no one knows what it does aren’t alternatives, either. I really look forward to the day when I see a real debate going on about health care reform outside the blogosphere.


    • Why read the law when, as everyone knows, it will be uploaded directly into our brains through the microchips that the law requires be implanted in our necks?

    • Yet most don’t complain about a Defense Appropriation Bill that is even longer. Wonder how many read that whole thing?

    • I would charge everyone fully community-rated premiums.
      That way, those who have chronic diseases will be paying discounted premiums off of the experience rated premium design.
      Without providing discounts for those who have to have continuous claims, we are making an unfortunate situation much too intoelrable, financially.
      Don Levit

    • Bravo. About a week after the Bill was passed, I read it. It took a few evenings, and some extra coffee.

      And now I LOVE being able to respond to the Know-Nothings who chide me about the ACA and who believe malignant secrets are tucked into the fine print: “Hey — I read the bill. Lots of people have read it. Why haven’t you?”

      By the way, these 900-odd pages in the HR version are “federal” pages, with wide margins; 3 or 4 of those federal pages would fit on a regular book page. So, reading the Bill is about as challenging as, say, finishing your weekly college reading assignment for Sociology. Takes a bit of effort, but do-able.

      The “2700-page version” was apparently the original Senate version, where the margins were even wider than in the HR version, and the font was the size of teleprompter lettering.

    • Trivial fix: employers who fail to offer acceptable health insurance should be fined based on total uninsured FTE / year. So if you’ve got 50 employees working 20hr/wk all year, you get fined for 25 full time equivalents. 100 employees, 20hrs/wk, for 6 months? That’s 25fte, too.

      Cutting people’s hours no longer helps, nor hurts, the associated penalty costs.

      Gee, wonder why the representatives whining about 30 hrs not really being full time don’t suggest something like this? Oh, yeah.

    • “Maybe they formatted it in a crazy way. ”

      they did indeed. the practice is to format bills for mark up (as opposed to printing the final laws) with lots of white space. this version of hr3200 is 2454 pages, for instance: http://www.gpo.gov/fdsys/pkg/BILLS-111hr3200rh/pdf/BILLS-111hr3200rh.pdf

      “How about proposing some sensible alternatives that actually address the policy issues?”

      ok! http://www.pnhp.org/sites/default/files/HR_676_2013.pdf

    • Well, outlining a sensible alternative is easy. First, because healthcare is a local activity, a sensible alternative would embrace federalism. Respect for freedom and self-government would call for regulation of local activities on no higher than the state level. Even the Europeans don’t go so far as to place hundreds of millions of people under the thumb of a central authority.

      Second, a sensible alternative would also embrace markets and competition. History proves that market-based economies are superior to centrally directed and controlled economies. Embracing competition would mean enforcing the antitrust laws in the various healthcare markets (hospital, physician, insurer, drugs, etc.). Direct government regulation would be appropriate only in those markets determined to be natural monopolies.

      Third, it appears there are more hospitals and doctors per capita in European countries than in the U.S., so we may have a relative shortage of providers here, resulting in higher prices than necessary. An important feature of a sensible alternative would include steps to increase the number of hospitals and physicians.

      So we have a start: an alternative that revolves around the concepts of decentralization and competition. This would go a long way to creating healthcare markets that benefit consumers in the form of lower prices and improved quality. That’s what competition does and healthcare would be no exception.

      But Obamacare supporters steadfastly refuse to acknowledge the truth about decentralization and competition. Liberals are competition deniers and their denials are sure to result in relative stagnation and decline for almost 20% of the U.S. economy.

      • A true model of competition cannot exist in healthcare. One very important control/driver does not exist. Consumers can never vote with their dollars by NOT buying the product, health insurance.

        And then there is a question of companies not held to basic free market principles. For example, Medicare with its huge market share cannot negotiate prices. Kinda kooky in a “free market.”

        Not sure where you are going with the “liberal” thing. Critical thinking takes us right into gray zones where few absolutes exist. No?