Over at The Atlantic, Megan McArdle takes issue with my contention that a lot of the public's distaste for the "Democrats' health care bill" is based on misinformation:
Now, on one item, the "anti's" are pretty obviously wrong--the program was pretty clearly better for people like me with pre-existing conditions. But all the rest of it is debatable. Obviously, Nate believes that the bill will improve things like out-of-pocket costs and choice of doctor. That's why he supports it. But those aren't scientific facts; they are opinions. [...]Reasonable minds can come to the conclusion that the bill is bad policy, and people are also 100 percent within their rights to believe that the bill might be bad for them for self-interested reasons (if they make greater than $200,000 per year and would be subject to the increase in the payroll tax, for instance.)
[When] I look at the polls, most of the concerns are pretty reasonable. People aren't responding to "lies". They are saying that they do not believe administration claims that this program will reduce the budget deficit without impacting quality of care--a pretty safe bet, to my mind. But even if you disagree, it is not crazy and delusional to believe that government programs often do not deliver what the politicians who enacted them promised. It's a pretty safe reading of history, actually.
With due respect to Megan, however, the debate over health care is not playing out like the one in elite circles of public opinion, in which Ezra Klein and I represent the pro-bill coalition and she and David Brooks the opposition. As this month's tracking survey from the Kaiser Family Foundation makes clear, there are a lot of beliefs the public has about the bill which are objectively wrong.
The following table combines two sets of questions from the Kaiser survey, each of which ask people about the individual components of the bill. One set of questions asks people whether they believe that the bill contains each provision; the other set, which I've tabulated on a net basis, asks them whether they'd be more or less likely to support a bill if it contained such a provision.
What we see is that most individual components of the bill are popular -- in some cases, quite popular. But awareness lags behind. Only 61 percent are aware that the bill bans denials of coverage for pre-existing conditions. Only 42 percent know that it bans lifetime coverage limits. Only 58 percent are aware that it set up insurance exchanges. Just 44 percent know that it closes the Medicare donut hole -- and so on and so forth.
"Awareness", by the way, might be a forgiving term in this context. For the most part in Kaiser's survey, when the respondent doesn't affirm that the bill contains a particular provision, he actually believes that the bills don't include that provision. 29 percent, for instance, say the bill does not contain a provision requiring insurers to cover those with pre-existing conditions; 20 percent think it does not expand subsidies.
How would public opinion change if people were fully informed about the content of the bills? It's hard to say for sure, but on average, the individual components of the bill are favored by a net of +22 points. An NBC poll in August also found that support went from a -6 net to a +10 when people were actually provided with a description of the bill.
Obviously, it's not as though this is going to do much to help the bill's popularity in the immediate term. But in the long term, once people actually see the go bill into effect, their perceptions are liable to improve, in ways that might help the Democratic party. Although there are a few things like the individual mandate which the public obviously does not like, most of the other components of the bill are things they are liable to be quite pleased with and to find quite reasonable.
Lastly, it's much harder to read the opinion polls as a "mandate" against the health care bill when much of that opinion is based on demonstrably false beliefs, some of which have been perpetuated deliberately by opponents. And it's much harder to know how the Democrats ever expect to pass a health care bill or similarly complicated policies like cap-and-trade if they wither in the face of polls that reflect less a disparity of opinion and more a poverty of accurate information.
136 comments
Nate Silver doing what he does best.
For being advantaged by such a "liberal media", as the Republicans constantly carp, the Democrats are embarrassingly bad at disseminating the message they wish to put out.
"For being advantaged by such a "liberal media", as the Republicans constantly carp..."
Yes the Republicans whine about it, but as with most things they whine about, that doesn't mean it exists.
Whilst there's certainly plenty of misinformation around about the bill it isn't fair to claim it's "true" popularity is the sum of the parts described here.
The bill also includes various give aways to win over recalcitrant senators which I can imagine would poll somewhat worse than the bill as a whole.
Also we don't know how the public weights the importance of the various components. They may favour the ban on preexisting conditions but weigh it fairly low compared to their very strong distaste for the individual mandate. Unfortunately the ratings here are still entirely compatible with an unpopular bill.
"No coverage for illegals"
Illegal is an adjective, not a noun. A person cannot be "an illegal." Maybe illegal immigrants? Or better yet, the more neutral "undocumented immigrants."
What do the white spots signify? Some seem to be elements that were removed or speculative elements, but items like taxes on insurers (or did we give those away too?) and the projected cost seem a little more concrete.
White space means they were not polled.
It is much easier to stir up fear than gain acceptance, the Repubs are phenomenal at doing nothing.
My feeling is that the only reason that health care reform slipped in the polls is because voters got bored and tired of hearing it debated day after day.
The average voter doesn’t necessarily care about the minutiae of policy. What they care about is action in a positive direction. If health care had been passed within a month or two of the conversation starting, voters would love it and would see the administration and Congress as heroic.
I simply don’t understand why members of Congress haven’t grasped this most basic fact about the electorate: they care about positive action, not policy minutiae. The longer something drags on, the less people like it. The polls reflect boredom, not frustration with aspects of health care policy.
I don't even think negative press from Republicans was at the core of the issue--though it may have helped in some small way. Mostly, it was a slow grinding down of opinion by time, followed by a massive disappointment in MA.
The proposals are not paid for. The so-called mandate (required for insurers to insure people with preexisting conditions) is a joke. The anti-trust exemption is not being repealed and there is no provision for re-importation of drugs (ie- the Dems have been bought off by special corporate interests). First dollar coverage is designed to drive health costs up. It's hard to find a single thing about the proposals that is good.
Now, start with Wyden-Bennett, and you'll be on the right track. But all of you must be prepared to pay your fair share. If not, you're just a bunch of freeloaders and no better than the people who cry for tax cuts without spending reductions.
While we are on the subject of media fabrication:
If Brown only received 60,000 more votes than McCain, and if, as the media tells us, Obama-voting independents from 2008 changed sides, then how did we end up with this number of votes? Where did McCain's independents go? Surely they didn't sit the election out.
Ah thanks Henry
I wonder how other items that could (should) have been included in a HCR bill would have polled?
1. Tort Reform
2. Cross state Insurance Competition
3. Tax on ELECTIVE Procedures
4. Early buy in to Medicare
5. Data (Internet)surcharge to pay for Electronic Medical Record System.
I see two issues here: first, you can't gauge support by NUMBER of things they prefer. You can ask me if I want this, that, and the other on my cheeseburger, and rack up 20 things I'd love to have there, but if the ONE thing I don't like is the cost, that can easily outweigh everything else.
Second, the NBC poll sees an increase in support as you describe when the health care plan is summarized, but 1) that was in August, and 2) the summary contains none of the standard objections, which like it or not, are a fair part of the debate.
This is kind of what Megan's getting at, Nate: just because a program SAYS it will do something, that doesn't mean it will. We had similar issues during the campaign, where people would say Obama was going to raise taxes, and he would counter with "no, my plan says I won't." But nobody disputes the AIM, necessarily, just the unintended consequences. Unintended consequences make up almost the entirety of opposition to this sort of thing, so pointing out that they're not part of the actual plan is irrelevant, and does nothing to demonstrate misinformation or assuage concerns.
Nate, you make some great points, but this is still a continuation of the same problem--people don't always understand the implications of every provision. Maybe more so than the whole package, but not entirely.
The mandate is unpopular? No shit. But the bill would be a lot less feasible without a mandate.
People like the idea that existing plans will stay the same? Fine, but that is still an impediment to really changing the system.
People like cross-state competition too (which an exchange would ideally allow). But it's rarely exchanged why it's so problematic if there aren't minimum coverage requirements.
Opinions tend to be formed based on the rhetoric surrounding these sub-issues rather than their direct implications.
Tort reform, as Npt noted above, tends to poll quite well. After all we all know there's a lawsuit crisis--I've seen that on the teevee! And nobody likes lawyers! It would be an exceptionally popular but Godawful policy resulting in thousands of deaths and perpetuating a culture of corporate irresponsibility, all for very very marginal cost savings.
Wow, this is pretty sad stuff from a "smart" guy like Nate.
In sales, if your prospect has no trust in you, it doesn't mater how many "facts" you present, they won't buy. Would you invest in a company that Bernie Madoff says is a can't miss?
A little off topic but...
I called my representative for the first time ever yesterday and asked if he was prepared to vote for the senate bill. If yes, he gets $100 and my vote forever. If not, a promise to vote for his next challenger. It made me feel better.
@brian
This isn't sales; it's governance. If we left everything to polling, we would never have created Medicare, ended slavery, seceded from Britain, given women the right to vote, etc etc etc.
But I guess those were all "liberal" initiatives anyway, so maybe we would be better off without them, right?
@Brendan
And what did he say?
Jacob,
Please READ the following article http://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html by DAVID LEONHARDT
New York TImes.
The issue is not about liking Lawyers or lawsuits, the issue is about costs. I can't see how you can pay for HRC without addressing Tort reform. The two are linked in any rational real world solution.
Everyone here holds up different countries HC results and systems. Which of those systems operates a Tort system comparable to the US? ...
Its just like sales, and the people are the prospects.
And if they weren't for those things you mentioned, then they wouldn't have been done. Let hope you guys don't resort to killing those that oppose you like in your slavery example.
This survey is also not so telling. Who's to say the pro-HC people aren't the one's that don't undestand the provisions. I'd be more intersested in asking "if you are against HC, what specific provision(s) are you against.
Nice job, Nate, setting the frame and carrying it out.
I will agree with Brian that it's also sales, but so is every policy ever passed by any legislature. The vast majority of people are unaware of the specific contents of any law.
One things the elected representatives are expected to do is to guard the interests of their constituents even when they aren't necessarily well informed. It is impossible to consult them for their literal "opinion" on every element of a bill.
Npt
Interesting article, and truly some valid points. This one stuck out:
"If a new policy could eliminate close to that much waste without causing other problems, it would be a no-brainer."
WITHOUT CAUSING OTHER PROBLEMS
But medical errors cause about 225,000 deaths a year, which has increased in states enacting stringent tort reform laws, with estimates ranging from about 2000-2000 deaths per year due to tort reform.
Beyond that, it just seems manifestly unfair that the courthouse doors should be closed to those who have been seriously injured. Yes, there are costs to civil justice, but there are much larger costs to removing that right.
Now if we enacted common tort reform proposals, I would be as happy as anyone that I could get a $100,000 procedure done for the low low price of $95,000 (in a best case scenario), but it's inherently not worth the risk of being unable to support myself for the rest of my life if the surgeon makes a serious mistake.
*sorry 2000-4000 deaths per year
It does not matter what is popular and what is not.
It only matters what can pass, and what cannot.
The corruption in the United States Senate specifically and the Congress just in general, has just about killed this effort.
Which is exactly what happens when you let Phrma and the Health Insurance Industries write the stinking bills.
The American People seem to know, just intuitively, that is what happened.
And they don't like it.
People would support things like the public option if it came without huge spending hikes, and had absolutely no effect at all to the 80% of Americans who like their health care.
If someone comes up with a bill like this, phone me in from Fairy Land and tell me about it.
The bill's opponents and supporters are equally aware/unaware of this bill. I don't know why Nate insists that higher awareness equals overwhelming support.
Note also that this poll is of all Americans. I would be interested to see a similar poll for likely voters only.
Health care as Paul Krugman suggests should be passed immediately namely the imperfect senate bill. Otherwise, it will be years probably not in my 62 year old life that it will ever be raised again.
There is a real intereting pattern to be observed in the last three Democratic Presidents, both Carter, Clinton, and Obama are very smart even brilliant men. All at the time were very good at getting elected, all ran against washing, and all were very inept rulers. Also all I would call "Eisenhower Republicans" of different stripes. Why is it that the "best" democratic politicians are incapable of passing Democratic Domestic Legislation even as they are often brilliant when it comes to their own elections.
Republican delaying tactics and the dragging of the heels by Max "Mr. Insurance" Baucus in the Finance Committee are what have helped bring this thing down. Republicans rightly guessed that drawing this out would make the Democrats look weak and give the media plenty of time to misinform the public about the contents of the bill. As an added bonus they gained a Senate seat in the interim, and have managed to get every commentator on TV and Radio to say that passing the current bill would be "political suicide" for the House Democrats. Jim Demint was right about Waterloo. I think these Republicans must sleep with a copy of The Prince under their pillows.
Nate,
I hate to say it but you're off on this one. Americans FEAR government controlled anything. They see this bill as one step closer to that. This isn't a misinformation problem. It's a total distrust in government problem. There is no quick fix for this one.
Expand Medicaid is popular? I guess if you don't mention that states need to kick in $$$ and most are already drowning from Medicaid costs---which will lead to state tax hikes.
And my guess is any smart 25 yr old male understands what happens when he's forced to buy insurance and age rating is restricted.
Face it---this thing does almost nothing to cut costs. Just dumps costs on the states and young people and seniors.
Face it...all Dems proposals sound good in the short term. Its no coincidence that they steadily become unpopular as people learn more. Lucky this wasn't jammed thru in August (as the Dems wanted) and we've had 5 months to look under the hood.
My guess is Nate would be dissapointed to know that if people were even more informed....the bill's popularity would be even lower!
Brian,
Did you read Nate's post or the attached poll results? The point is that people don't know what's in the bill. Again, we can debate how effectively these things will work, but it's an issue of people knowing what provisions are contained in the bill, what the bill strives or intends to do. And people don't know, even after "5 months to look under the hood." Please, respond to the actual argument.
Mr. Silver,
I think you missed Megan McArdle's point (one which I made in previous comments): the items you cite are not evidence of misinformation.
"With due respect to Megan, however, the debate over health care is not playing out like the one in elite circles of public opinion..."
But that was part of her point. For example, she writes: "Now, on one item, the "anti's" are pretty obviously wrong--the program was pretty clearly better for people like me with pre-existing conditions."
That is not an item Republicans have not "lied" about. The Republicans have not contested that fact, so attributing it to misinformation is pretty silly.
And as Ms. McArdle says, the other issues are debatable.
The Kaiser survey reveals that most people are not all that informed about what's in the bill. This is unsurprising, given that many people don't follow the news all that much. This illustrates the public's disengagement with government and politics, not the evils of Republican lies.
So on the one hand, you point to favorability of provisions to people with little to no knowledge of the bill as a good thing, but then appear to construe lacking awareness as evidence of Republican lies - or maybe you're amending your original complaint? (your rebuttal to McArdle wasn't clear)
JB-
Had this survey been done in August, would the understand level been higher or lower? Likely lower. Yet the popularity level is lower than in August? So you might guess that if Dems had another 6 months to "educate us", the popularity would drop even further as people learn more. Face it, "getting the facts out" is not helping this thing.
Jacob said...
"No coverage for illegals"
Illegal is an adjective, not a noun. A person cannot be "an illegal." Maybe illegal immigrants? Or better yet, the more neutral "undocumented immigrants."
Illegal is acceptable as a noun due to its common usage.
Also, crime is crime. Should we start calling shoplifting "undocumented purchases" or robberies "undocumented withdrawals"? Stop white washing these people who snuck across the border while my ancestors had to wait in a line for days and get checked for disease.
When presented with facts that prove their position untenable,Republicans will simply move on to another lie upon which they can hang their hat. Facts are something for Democrats to worry about. Conviction be damned,morality be damned even country be damned. The only overiding concern is that Democrats lose.
This makes the case for Deliberative Polling.
From the center for Deliberative Democracy:
"Conventional polls represent the public's surface impressions of sound bites and headlines. The public, subject to what social scientists have called 'rational ignorance,' has little reason to confront trade-offs or invest time and effort in acquiring information or coming to a considered judgment.
"A random, representative sample is first polled on the targeted issues. After this baseline poll, members of the sample are invited to gather at a single place for a weekend in order to discuss the issues. Carefully balanced briefing materials are sent to the participants and are also made publicly available. The participants engage in dialogue with competing experts and political leaders based on questions they develop in small group discussions with trained moderators. Parts of the weekend events are broadcast on television, either live or in taped and edited form. After the deliberations, the sample is again asked the original questions. The resulting changes in opinion represent the conclusions the public would reach, if people had opportunity to become more informed and more engaged by the issues.
"Each experiment conducted thus far has gathered a highly representative sample together at a single place. Each time, there were dramatic, statistically significant changes in views. The result is a poll with a human face. The process has the statistical representativeness of a scientific sample but it also has the concreteness and immediacy of a focus group or a discussion group. Taped and edited accounts of the small group discussions provide an opportunity for the public to reframe the issues in terms that connect with ordinary people."
http://cdd.stanford.edu/polls/docs/summary/
In a deliberative poll on health care, those who would be willing to pay more if coverage were greatly expanded went from 44 percent to 42 percent. The importance of malpractice reform went down from 40 percent to 30 percent. Belief in a single payer system went from 51 percent to 58 percent, while disagreement went down from 40 to 37 percent.
Simple facts were corrected. Before the deliberative session, 30 percent knew the number of uninsured, after, 50 percent --although I'm still wondering about that other 50 percent.
http://cdd.stanford.edu/polls/btp/2005/onlinebtp/appendix.html
Obama has faced his poodles, the White House Press corps, not once from July to December last year.
Instead, he makes hundreds of speeches ("look at me").
Well, if people are misinformed then either: 1) he's not hearing questions, 2) he not communicating, not even to the bits of media that adore him. Obama's campaign record is: helped 3 (NJ, VA, MA), lost 3, didn't help one (NY23), won one.
As I've said previously, Ronald Reagan this guy is NOT.
BTW, has anyone worked out the cost of that silly rant against the banks? How much have pension funds lost? How much have people's 401(k)s lost? For a petulant attack on people who funded his campaign. He should front Michael Moore's next film, not run the country.
The reason people may not know what's in the bill is because the Dems don't want people to know what's in the bill. That's the reason for the lack of transparency. The Dems won't discuss it and the liberal media won't report on it.
How long have we been talking about HCR for goodness sake? And the Dems still haven't been able to get the message out? I don't think it's unintentional.
In my post above about deliberative polling that should be "went from 42 percent to 52 percent" about the number of people who would pay more to expand coverage.
"most individual components of the bill are popular -- in some cases, quite popular"
Well, yes. That's the nature of a cost-benefit analysis, isn't it? You can have lots of substantive and tangential benefits, but that big -32 for cost matters a lot, and it doesn't really get outweighted by good feeling about banning gender rating.
Edward Gaffney,
But note Nate's point: "the debate over health care is not playing out like the one in elite circles of public opinion..."
In other words, the people are aren't really equipped to handle a cost-benefit analysis.
But I agree with you.
Hey - look at how popular my sandwich should be! Here are the ingredients...
Bread : +40 Popularity
Cheese : +30 Popularity
Roast Beef : +35 Popularity
Mustard : +18 Popularity
Lettuce : +29
Rat Poison : - 100 Popularity
My poll forgot to ask people who they felt about my recipe being written for me by the Rat Poison For People Lobbying Group - but overall, my sandwich should obviously have more support.
Nate - you're lying with statistic and avoiding the big picture on purpose. You're going to cost Democrats the Senate and House by ignoring the very real problems with this corporate written bill.
It's always that there isn't enough information-- not that people actually disagree with liberal policy.
That's how you people will always characterize it.
You will never admit that people knowingly reject your ideas.
Never.
Gee! What a suprise! Another "The American people are too stupid piece"!
This is what people on the left are reduced to.
I can make the same arguement on tax policy regarding the progressive income tax ,minimum wages increases, and welfare.
The American people are misinformed in those areas in my opinion.
"Undocumented aliens" = illegal aliens, simple as that.
"once people actually see the go bill into effect, their perceptions are liable to improve"
Or not. Maybe what happens is akin to getting nibbled to death by ducks.
When the Food Stamp program was rolled out, proponents claimed it would only help those most needy and that it would max out at 800,000 recipients at a cost of $400 million per year. Today there are 37 million on Food Stamps at a total cost of over $8 billion.
Flash backward: Would the Food Stamp program have been approved if Americans had been told that someday 1 in 8 Americans would be collecting?
That's why many don't trust the Democrats and health care reform.
I want to add the thoughts of economist William Baumol who argues there is a limit to cost saving, and that health care costs will always rise higher than inflation.
In 1966, he proposed the "cost disease" hypothesis by using the Mozart string quintet example. In 1787, it took five musicians to play it. 223 years later, it still takes five, but the musicians are more expensive.
Although some fields, auto manufacturing, can be significantly more productive, health care is more like music--labor intensive with more expensive labor. One surgeon doing a coronary bypass today. One surgeon doing it five years from now, but at a higher salary.
Unless we all move to India, but it's too crowded there already.
These considerations move Baumol to believing not in despair but in the necessity of reform.
“No one has found the way to prevent health care costs from growing, so the bottom line is they will grow,” he said. “That means that the less affluent of our population are going to need help in being provided with adequate medical care.
“But we can afford it, because we are an economy in which innovation and productivity all continue and continue to rise, and provide us the means with which we can afford to provide health care to the people to whom it is denied today.”
http://prescriptions.blogs.nytimes.com/2010/01/17/an-economist-who-sees-no-way-to-slow-rising-costs/?scp=1&sq=baumol&st=cse
Correct me if I am wrong:
1. Most people will be forced to buy insurance, and the IRS will enforce it.
2. The few reforms placed on the industry will be enforced by states but is unfunded.
True or false?
If true, how can anyone, other than a health insurance industry shill, say that is a good thing?
If false, where am I wrong?
Obama and the dems started themselves in a compromised position and just kept on compromising.
This is why you need a right of center guy Nate, this and most of your healthcare coverage is straight up cheer-leading and spin.
JohnDoeAt30Below,
"Flash backward: Would the Food Stamp program have been approved if Americans had been told that someday 1 in 8 Americans would be collecting?"
Nate would have said the same thing about food stamps that he wrote about people's belief that health care quality and cost will suffer:
"these beliefs range from mostly and probably untrue to completely and demonstrably untrue."
@JohnDoeAt30Below
Would the Food Stamp program have been approved if Americans had been told that someday 1 in 8 Americans would be collecting?
My Gods man, if 1 in 8 Americans today need food stamps, it's a damn good thing we've got the program.
Bush really screwed up the economy, but good.
"Reasonable minds can come to the conclusion that the bill is bad policy...With due respect to Megan, however, the debate over health care is not playing out like the one in elite circles of public opinion, in which Ezra Klein and I represent the pro-bill coalition and she and David Brooks the opposition. As this month's tracking survey from the Kaiser Family Foundation makes clear, there are a lot of beliefs the public has about the bill which are objectively wrong."
but why is it relevant for what reason people oppose the bill? you said it yourself: reasonable people can come to the conclusion that the bill is bad policy". whether they dreamed such conclusion or read it in their horoscope or studied it for two semesters at harvard is irrelevant. what matters is whether the conclusion is correct - not how good your justification is.
@Cata -
what matters is whether the conclusion is correct - not how good your justification is.
Are you saying that there is one (and only one) "Correct conclusion"? If so, does it not seem more likely that this one (and only one) "correct conclusion" is more likely to be reached through considering the actual facts as contrasted with believing falsehoods, or being ignorant of the facts?
I'm not certain that there is one (and only one) "correct conclusion", but I am absolutely certain that a discussion in which there is one side calmly presenting fact while the other is screaming scary lies is not an intelligent way to make policy -- and is virtually certain to create bad policy.
While it is true that "reasonable people can come to the conclusion that the bill is bad policy", it is also true that reasonable people can come to the conclusion that the bill is good policy, and the only sensible approach would have been to have a national discussion on the actual policy proposals being made.
@beavis
Correct me if I am wrong:
Okay. You're wrong. Consider yourself corrected.
It is fascinating to read the comments on this thread from people who are opposed to Health Care Reform. Universally, they are defending willful ignorance and disinformation -- "It doesn't matter why people oppose this bill, I believe it's a bad bill, and I'm right, dammit! Even if I (and the other people who oppose it) don't really have a clue as to what I'm talking about! And how dare you provide solid evidence that people don't actually know what's in the bill? Are you saying we're stoopid?"
It's also interesting that many of the same people who are living by public opinion polls as regards, say, the President's popularity -- or even as regards the popularity of HCR! -- are so apparently enraged by a poll which reveals how much people actually know about the health care bill.
"My mind is made up -- stop confusing me with actual facts as opposed to the disinformation I have already absorbed."
Nate:
1) The key finding is that folks by a large margin do not want to pay $871 billion for Obamacare. Support for Obamacare is likely to crater entirely if Kaiser used the correct price tag of $2.3 TRILLION over the first ten years when all the benefits are in place starting in 2016.
2) Obamacare is not being offered ala carte, thus should not be polled that way.
3) If this is a test polling for breaking up Obamacare into parts, each part should be followed by its price and any major tradeoffs.
4) Apart from the overall price tag, there are several other errors / lies being polled.
a) All current private insurance will be outlawed within year and will be modified to meet the new set of mandates. NO ONE can keep their present insurance once it expires.
b) It is a complete lie that Obamavcare will reduce the deficit. These CBO findings only cover the first decade with benefits given for only five years and assume that Congress will actually cut Medciare by 10%. There is no reason to believe that Congress will cut medicare, thus deficit spending on Obamacare will be slightly less than 2 TRILLION over the first decade of full operations.
c) Illegal aliens will be covered under Obamacare because there is no provision to ascertain citizenship status.
d) Only the House bill bars subsidy for abortion. The Senate bill does not do so effectively.
If I had to guess, Kaiser is simply doing preliminary polling for breaking up Obamacare.
shrinkers,
"It is fascinating to read the comments on this thread from people who are opposed to Health Care Reform. Universally, they are defending willful ignorance and disinformation..."
As someone opposed to the Democrats' current vision of health care reform, I've not defended willful ignorance at all. I don't think there is much willful ignorance. People just don't pay much attention to what happens in government. And there is always disinformation in politics. In the current debate it is coming from both sides (eg it is going to lower costs, hahaha).
Nate has not shown that people's general ignorance has much to do with disinformation. I think if people were fully informed, the approval ratings for the Democrats' health reform would be much lower.
Bart claims the Health Care Reform proposals will cost about $2 trillion over 10 years. That's about $200 billion per year, or about 30% of the military budget.
Assuming Bart's numbers are right, that sounds pretty cheap to me. I'd be willing to pay 1/3 as much to keep Americans healthy as I am spending in preparing to kill people.
So let's point out while we're at it that during that same 10 year period, we'll be spending about 6 TRILLION DOLLARS on the military, and see if people are okay with that price tag -- especially given that this is far more (about twice as much) as the rest of the world combined.
@BdP
c) Illegal aliens will be covered under Obamacare because there is no provision to ascertain citizenship status.
Under your argument here, we are already paying for "illegal aliens" whenever they show up in a hospital for treatment and don't pay cash. If this bothers you, encourage your representative to pass separate legislation to deal with it.
You are not giving an argument that applies to the proposed HCR. You are giving an argument for additional reform.
The proposed HCR also doesn't fix the pothole in the street outside my house. That fact is a relevant as is your absurd objection here.
On the topic of not covering illegal aliens -- we want to be absolutely certain that illegal aliens don't get health care. That way, they can get sick and spread diseases to full-blooded American kids, which is always a good thing.
shrinkers:
100% of the population benefits from national defense. About 5% of the population (maybe) might benefit from Obamacare by gaining insurance. The vast majority of long term uninsured are young and healthy or illegal aliens. The first group will not buy insurance under this plan and the second group should not be subsidized under this plan.
shrinkers said...
BD: Illegal aliens will be covered under Obamacare because there is no provision to ascertain citizenship status.
Under your argument here, we are already paying for "illegal aliens" whenever they show up in a hospital for treatment and don't pay cash.
Full insurance will subsidize far more care and create far more expense. This should be part of the polling if it is to be honest.
"I'm not certain that there is one (and only one) "correct conclusion", but I am absolutely certain that a discussion in which there is one side calmly presenting fact while the other is screaming scary lies is not an intelligent way to make policy -- and is virtually certain to create bad policy."
but that is not what is going on. as nate himself said, there are people calmly presenting arguments on the other side as well. and it is far from obvious that pro-reform side is consistently well-informed and cold-headed.
given time-constraints, a rational person might decide to accept conclusions of whatever group of "calm, reasonable" people he previously found to be reliable. this is what politicians from both sides do, and it then trickles down to those less interested. most of the so-called lies are crude versions of legitimate arguments.
in fact, obama himself never showed significant ability to articulate arguments of any complexity regarding healthcare. he merely parrots back what experts he trusts tell him is the case. and i don't blame him for that. but to say that he is so much above misinformed masses has no foundation in reality.
Only the House bill bars subsidy for abortion. The Senate bill does not do so effectively.
It is already illegal to use federal funds for abortions. There is no need to repeat this fact in every law passed by Congress.
All current private insurance will be outlawed within year and will be modified to meet the new set of mandates. NO ONE can keep their present insurance once it expires.
Yes, new policies will not be able to refuse coverage for pre-existing conditions. They will not be able to have lifetime maximum on coverage. They will not be able to drop you when you get sick or injured. You are right, if you want to get screwed you have to go somewhere else.
What you appear to be objecting to is that insurance policies will have to include the provisions that everyone wants them to include.
It is notable that all your various attacks on HCR are dishonest, disingenuous, or or are simple spin.
Cata,
Very well said. I hope Nate takes special note of this point you made: "it is far from obvious that pro-reform side is consistently well-informed and cold-headed."
As Nate said: "With due respect to Megan, however, the debate over health care is not playing out like the one in elite circles of public opinion, in which Ezra Klein and I represent the pro-bill coalition and she and David Brooks the opposition."
shrinkers,
"It is already illegal to use federal funds for abortions. There is no need to repeat this fact in every law passed by Congress."
On its face, this logic makes sense. But in practice, it's not so simple.
Senator Boxer (D) told McClatchy News Service that the limitation on abortion in the Senate bill is 'only an ‘accounting procedure’ that will do nothing to restrict [abortion] coverage.'
Is this disinformation? Or is she right, that it's only an "accounting procedure" that essentially launders money so that that the federal money isn't directly spent on abortion?
brian said...
This survey is also not so telling. Who's to say the pro-HC people aren't the one's that don't undestand the provisions. I'd be more intersested in asking "if you are against HC, what specific provision(s) are you against
Actually the gave the answers borken done by repub, dem and independent and also by age...read it, its interesting...
And there is similar arguement on the lack of majority support of HCR, a decent chunk of the non-support comes from people on the left that want single payer, or the jettisoned Public Option.
@Bart DePalma
A repub congress and repub pres - W - passed an extremely expensive Medicare Part D, vey expensive because it sent Parma stocks to Pluto, and they didn't figure how to fund with unpopular but necessary if you are going to spend - taxes, instead they just passed the costs onto our grnachildred, in a relativley good economic time, when the came into office with a surplus in the annual budget, the Repubs used massive deficit spending to pay for very cost inefficient benefit that still did not cover senior meds all year...I didn't hear anyone nagging about how that would poll if they put a cost to it. Repubs jsut pandered to their base, seniors and big businesses and racked up huge debt to make both happy...they didn't give a rats ass what people thought about the cost. And what if we had polled what the cost to the budget and tax cut for the rich during war time and how much our debt would increase for this tax, did anyone poll that?
I'd be willing to live by all the holier than thou rules Repubs come up with Dems if they would not be such hypocrites and not live by those rules when they are in power. Next time Repubs want a tax cut for rich or sellout to a big business, lets explain to people how it will cost our grandchilden in debt and interest costs
Oh yes, fact based arguments...Tra la la
Gay marriage (a much simpler concept to defend than HCR)
has to be defended constantly against the lies, and just plain fantasy of the opposition.
And that's not to change the subject, but just to point out what one is up against.
GAY marriage will destroy your hetero marriage. Yes, really, it will...they say so. I know a gay couple who got married, and whamo, two regular marriages were destroyed.
@Jacob,
Sorry, away from computer today.
My rep is Adam Schiff. I called the local Pasadena, CA office, the girl who answered was evasive even when I pressed. I took from her response that he was not ready to vote for the Senate bill. "He supports HCR". He HAD voted for the house bill. Or maybe she was just being careful. She took my e-mail and address.
As of now, I will vote for his competitor.
Sometimes I wish I were a Republican just so I could use the same emotional arguments for everything.
"Blargh, Obamacare, Russians, death panels, blargh, Obamacare, 861 billion dollars, blargh, taxes..."
If I were Obama, I would invite John "say it ain't no" Boehner or any GOP-nominated spokesman to a public one-on-one debate on health care. That would be pretty awesome.
God bless ya, Nate Silver. You nailed it again. I'm a mom in despair of the last week, but seeing you speak such truth makes me feel a glimmer (just) of hope.
kankan:
You are correct that no one (apart from myself and some libertarian types) seemed to care about the cost of creating another Medicare entitlement when the original intergenerational ponzi scheme was die to go broke in a little over a decade.
The GOP was busy practicing the oxymoron of "big government conservatism" and the Dems never care what anything costs so long as you can expand government.
Well, folks are awake now in the era of $1.4 Trillion Dem deficits and we are sort of concerned that transforming these into $2 Trillion deficits might just put the US on the same course as Peronist Argentina.
I recently returned from an extended stay in England. This is just my opinion, of course, but I think that if Americans actually understood just how well the British health care system worked, we would have huge crowds in the streets demanding something similar in this country.
Perhaps this is just one more bit of evidence that the press/public media really is dominated by the Republican/right wing.
@Joe
Senator Boxer (D) told McClatchy News Service that the limitation on abortion in the Senate bill is 'only an ‘accounting procedure’ that will do nothing to restrict [abortion] coverage.'
Observe, Joe: abortion coverage is legal, that is, there is nothing that prevents a consumer from buying an insurance policy that covers abortions. Nor should there be anything that prevents this.
On a separate topic, no federal funds are used to pay for abortions. A consumer my pay for an abortion, or may purchase an additional rider that will cover abortions.
Is this hard to understand? No federal money may pay for an abortion. That is against the law. (It's a stupid law, but it is the law.) And the health care reform suggestions do not alter that.
@Bart DePalma
... the Dems never care what anything costs so long as you can expand government.
Typical Republican disinformation. The last time the federal budget was balanced was under a Democratic president, who balanced the budget by insisting anything new be paid for by revenue enhancements or spending cuts elsewhere. Clinton created the largest Federal surpluses in history. Two years after he left office, a conservative Republican president with a conservative Republican congress created the biggest federal deficits in world history.
The Democrats are the party of fiscal responsibility. Republicans are the party of spend spend spend spend and drive the country bankrupt and drive the economy of the whole world off a cliff -- and then lie lie lie about it, as you are doing now.
Does your conscience never bother you about the disinformation you and the other Republicans insist on spreading? Or are you truly as selfish as you pretend, and you imply do not care about the effect of these untruths upon the rest of humanity?
Well, folks are awake now in the era of $1.4 Trillion Dem deficits and we are sort of concerned that transforming these into $2 Trillion deficits might just put the US on the same course as Peronist Argentina.
Bush left a $1.7 trillion deficit in his last year, which Obama reduced to $1.4 trillion. Does your conscience never bother you at all?
And invoking Argentina -- we've reached reductio ad Hitlerim, and you hereby lose the debate.
Combs-
I agree with you on the debates. I would be happy to debate this issue for 6 more months until everyone understands everything. Lets setup the HC channel on CSPAN for 24hr debates.
Unfortunaely, the Dems did not scrutinize Med PartD like Repubs are on Obamacare. The opposing party has an important role to "keep 'em honest". The Repubs just do that role much better than Dems.
I doubt you can find 10% of Repubs that think Part D was a good idea.
I love how Dems rip on Bush for Part D and that he dumped a new entitlement with no way to pay for it. Of course, regular Medicare is essentially the same thing-except 10 times bigger-yet Dems adore Medicare.
You never hear how LBJ just dumped a big program on us and how now 45 yrs later we're drowning in its cost. Thanks LBJ!
@brian
I love how Dems rip on Bush for Part D and that he dumped a new entitlement with no way to pay for it. Of course, regular Medicare is essentially the same thing-except 10 times bigger-yet Dems adore Medicare.
Actually, everyone loves Medicare. I really hope Republicans run on a platform to repeal Medicare. They'll have about 3 people in the country voting for them.
The difference between Medicare itself and Bush's "Part D" is that Medicare actually has a mechanism to pay for it. "Part D" doesn't. (Republicans think you don't ever have to actually pay for anything. Cheney said, "Reagan proved deficits don't matter.") The reason the rest of Medicare has some financial difficulties on the horizon is that Republicans have been doing their best to de-fund it ever since it was enacted.
Love it when Republicans create financial problems then rip on the programs they have crippled on the grounds that those programs supposedly have financial problems. Similar to the way Reagan started drowning the country in debt, and then Republicans complain about the federal debt.
Republicans are lying hypocrites, all of them.
Thanks Shrinkers for your unbiased view. You love Medicare becuase a Dem prez proposed it, you hate Part D because a Repub proposed it.
At least some of us are consistent in hating programs that dumps a huge enititlement whose costs invariably skrockets onto future generations. LBJ did the same thing as Bush, pandered to seniors so they would get an immediate "goody" inspite of never paying a dime in taxes.
Noone loves Medicare. I guarantee if FoxNews was around in 1965, it'd never been enacted.
Obamacare is not being offered ala carte, thus should not be polled that way
Well, to those of us who are genuinely curious about whether passage of ObamaCare is likely to help or hurt Democrats in the midterms, it makes sense to ask about individual components, because not all people will be impacted by all the bill's provisions, and, moreover, the bill's provisions will be implemented over time.
But sure, if you're opposed to this expansion of social insurance, and you're not genuinely interested in its impact on the midterms -- but rather your goal is to scare Democrats into not passing it -- then spinning public opinion in a maximally negative fashion makes a lot of sense.
Most people will be forced to buy insurance, and the IRS will enforce it. 2. The few reforms placed on the industry will be enforced by states but is unfunded.
True or false?
False. Most people will continue to voluntarily participate in the insurance programs that currently cover them. I doubt the number of adults affected by the mandate exceeds seven or eight percent of the population, and it's certainly possible many of them (given the fact that they'll receive subsidies) will welcome the chance to have coverage -- so "forced" is probably overstating it. And in any event, such a percentage of the population is clearly very far from "most." I'm not exactly sure what your second question is, but the "reforms' being forced on the industry (community rating, guaranteed issue) will in essence be "funded" by tens of billions of dollars in new premiums revenue from the new customers they'll be signing up.
LBJ did the same thing as Bush, pandered to seniors so they would get an immediate "goody" inspite of never paying a dime in taxes.
Brian: What the hell are you talking about? The last time I checked "seniors" were not exempt from federal income taxation, and the vast majority of them have paid substantial taxes over the course of their working lives.
People like you -- who would begrudge an old person medical care, or the dignity of being kept out of poverty -- should be shunned by society in the same manner as that practiced by the indigenous people of the Arctic.
Thanks Shrinkers for your unbiased view. You love Medicare becuase a Dem prez proposed it, you hate Part D because a Repub proposed it
No. Shrinkers gave a reason for his/her opinion about Medicare Part D: it was enacted by the Republican Congress and signed by George W. Bush with literally no funding mechanism in place whatsoever, save an IOU to future generations. It's a classic, even iconic, example of the destructive, nihilistic, cynical and utterly unserious Republican style of governance. Check that -- they are serious about political power -- I'll give them that.
@brian
Thanks Shrinkers for your unbiased view. You love Medicare becuase a Dem prez proposed it, you hate Part D because a Repub proposed it.
I see you didn't actually read the post of mine that you are pretending to respond to, but instead substituted something out of your own imagination (which is typical behavior for conservatives).
Noone loves Medicare. I guarantee if FoxNews was around in 1965, it'd never been enacted.
Wait. Fox News runs the government? I know they're the propaganda arm of the Republican party, but no one actually elected Fox News to anything, you know.
shrinkers,
"Observe, Joe: abortion coverage is legal, that is, there is nothing that prevents a consumer from buying an insurance policy that covers abortions. Nor should there be anything that prevents this."
Well of course, I never denied that. The issue I was addressing was whether federal funds will be used to fund abortions. Boxer suggested that is the case.
"On a separate topic, no federal funds are used to pay for abortions. A consumer my pay for an abortion, or may purchase an additional rider that will cover abortions."
That is not a separate topic. That is the topic I was addressing. Which raises the questions I posed in the same post:
Is Boxer's statement disinformation? Or is she right, that it's only an "accounting procedure" that does indirectly spend federal money on abortion?
"Is this hard to understand? No federal money may pay for an abortion. That is against the law."
Well, apparently it's hard for Boxer to understand, since she think the language in the bill is not a ban but rather an "accounting procedure."
Yo 99-
If I'm 64 yrs old and I'm planning to stop working in a year you tell me I can start getting free HC in a year that will largely be paid for by everyone thats working---thats a pander imo.
Yeah, I hate old people and I'm a racist too. And I love rape just like Scott Brown.
No, Joe, you are twisting Ms. Boxer's words, as well you know. It is in violation of Federal law -- the Hyde Amendment -- for Federal funds to be used to fund an abortion. Since HCR does not repeal Hyde, it will remain illegal for Federal funds to be used to finance abortions.
Ms Boxer said that it will remain possible for customers to obtain insurance to cover abortions. At no point did she imply that HCR will allow Federal funds to be used for abortions. It's a stupid argument you're making, simply inventing an issue where none exists. You're repeating empty rightwing talking points / intentional disinformation. It makes you look stupid.
brian, please please please suggest to Republicans that they should run on a platform to repeal Social Security and Medicare. Please. It's a great idea. The populist tsunami will love it. It's a sure winner. Please do this, I'm begging you.
I will Shrinkers.
I'd like people's opinion on this:
1) If you could go back in time to 1965 and Medicare was being discussed as a new program, would you advocate its passage?
You're thinking much to small, brian. I bet we could both predict how a poll here would come out. More important would be for Republican congressional candidates to oppose Social Security and Medicare in public. Medicaid, too. All those socialist programs. You need to kill them, and you need to tell your representatives about your eagerness to have these programs repealed.
I said--I will! We need big ideas. Frankly, I've been dissapointed in all I hear is tort reform from Repubs. If thats all they've got, I think a 3rd party (tea party) is going to emerge. No more compassionate conservatism!
@juvanya:
Illegal is acceptable as a noun due to its common usage.
Agreed.
Also, crime is crime. Should we start calling shoplifting "undocumented purchases" or robberies "undocumented withdrawals"? Stop white washing these people who snuck across the border while my ancestors had to wait in a line for days and get checked for disease.
You are right. All who break the law should be called "illegals." That includes, of course, those who ever drive faster than the speed limit, or who don't always come to a complete stop at a stop sign.
From my observation of people's driving habits, pretty nearly every American is an "illegal," who is therefore unworthy of receiving health insurance. ¡Die, Illegal Scum!
BD... the Dems never care what anything costs so long as you can expand government.
shrinkers said...Typical Republican disinformation. The last time the federal budget was balanced was under a Democratic president, who balanced the budget by insisting anything new be paid for by revenue enhancements or spending cuts elsewhere.
You are confusing the Clinton Administration of $200 billion deficits (not counting Hillarycare) as far as the eye can see fame with the Gingrich balanced budget plan, which Clinton vetoed twice before signing in 1997.
The Democrats are the party of fiscal responsibility.
LMMFAO!
Congress and not the President enacts taxes and spending. The only Congress in my lifetime to enact actual spending cuts and a balanced budget was the GOP Gingrich congress. Every single major increase in the deficit for the past century was enacted by a Dem Congress except for the Bush "big government conservatism" oxymoron. This is why the GOP was kicked out in 2006 and 2008, not so the Dems could match 8 years of Bush deficits in one year.
@Bart
I agree that we should reduce the deficit by cutting defense spending.
It would be nice if people started reading more things...we all clamor for accountability from the comfort of some electronic device. It's kind of sad if you ask me.
I understand that people fear change; but really are things going all that well now?
My personal belief is that I'm not that scared to live as a free being, I'm not really afraid of the unknown "dangers" that lurk in this world, it is the known dangers and our apathy towards one another as beings not deserving of fundamental ideas such as life, liberty and the pursuit of happiness that keeps me up at night.
Nate, you appear to be ignoring the glaringly obvious - that mandates in are wildly unpopular, and their presence in both the House and Senate bills might have something to do with the public's distaste for the Democratic approach to HCR. Of course, the unpopularity of mandates may be at least partly based on the fact that Obama campaigned prominently against them.
It seems obvious that, especially if we're not going to give people the option of buying into a PO, the politically smart thing to do would be to jettison mandates.
@Maikeru
It seems obvious that, especially if we're not going to give people the option of buying into a PO, the politically smart thing to do would be to jettison mandates.
The problem, of course, is that the point of mandates is to bring more people into the system so that there is a way to pay for people with pre-existing conditions.
The best solution is simply to get rid of the minimum age for Medicare. That can be done in reconciliation. Since the Republicants will kill any bill that is subject to a cloture vote, they may be forcing us into this alternative.
There is also talk of lowering the number of votes needed for cloture to 55, thus preserving the filibuster but helping to prevent the unconscionable and unethical abuses of the Republicants.
You can't get rid of the mandates without the government option. Its one or the other.
Btw, I see where the Dems are trying to change the filibuster rules. Nice. Change the rules when they don't work out for you. Just like their dabbling with the electoral college and the Mass. Senate appointment process.
I make considerably less than the supposed $200k "self interest" threshhold, but the Senate proposal would raise my federal taxes by more than $750.
Today, I can put $5000 into a pre-tax medical flexible spending account, and with a family of five and two kids in braces, we easily spend that $5000 after insurance.
The Senate bill would limit healthcare FSAs to $2500, in effect raising my taxable income by $2500.
I notice that tax increase on ordinary people isn't part of the poll.
I like the idea of health care reform, but I also liked Obama's promise that it wouldn't raise taxes on anyone making less than $250,000.
combs said...@Bart - I agree that we should reduce the deficit by cutting defense spending.
EVERYTHING including DoD spending should be on the table.
Between this current spending insanity, the imminent insolvency of Medicare in less than a decade and the rapidly approaching insolvency of Social Security, we are in very real danger of the insolvency of the national government.
Government spending needs to be cut to where it was in 2000 plus inflation or we are in serious trouble.
@Bart
How do we go about reducing Medicare costs? The only way I see to do that is through real reform of the current system.
The Dems should have absorbed all the ideas of the GOP into the bill. Some of those ideas were good (tort reform), and even the ones that probably wouldn't cut costs dramatically (buying across state lines), are not worth arguing over.
As a conservative, I also agree on defense spending cuts. Why don't liberals go after defense spending like conservatives go after social spending? I can't beleive chasing a bunch of poor Muslims thru Afganistan can be that expensive.
So, lay out the cuts and take it to the American people. As I've said, there are no sacred cows. We are going bankrupt.
"@beavis
Correct me if I am wrong:
Okay. You're wrong. Consider yourself corrected."
Funny, you can't tell me where I am wrong.
Must be because I am right and you are a shit head industry shill.
For the record, I am 100% behind single payer, so do not try to lump me in with the retards like Brian, Bart, Ass Rider, etc.
False. Most people will continue to voluntarily participate in the insurance programs that currently cover them. I doubt the number of adults affected by the mandate exceeds seven or eight percent of the population, and it's certainly possible many of them (given the fact that they'll receive subsidies) will welcome the chance to have coverage -- so "forced" is probably overstating it. And in any event, such a percentage of the population is clearly very far from "most." I'm not exactly sure what your second question is, but the "reforms' being forced on the industry (community rating, guaranteed issue) will in essence be "funded" by tens of billions of dollars in new premiums revenue from the new customers they'll be signing up.
You say false and then you prove it is true.
The mandate, with exceptions says that people have to purchase from corporations or the IRS can fine you.
It doesn't matter if there are subsidies, it is still taxpayer money going to basically unregulated companies.
Which leads to the second part:
The current bill does lock down the insurance industry with new regulations, however, the states are charged with enforcing the new laws and are given no resources to do so.
Not even the biggest states can afford lawsuits against these huge companies.
What that means is that we are being forced to give money to companies that will see little, if any enforcement of the new regulations.
In other words, this bill bends every American over and allows the health insurance industry to fuck everyone dry.
You say false and then you prove it is true.
I have no idea what you're talking about. The original claim I was responding to was that "most" Americans would be "forced" to buy insurance.
I was simply countering that this is self-evidently false, because "most" Americans (indeed the vast majority) voluntarily participate in employer or government sponsored plans under the status quo. Why would that change under ObamaCare?
Try again.
however, the states are charged with enforcing the new laws and are given no resources to do so. Not even the biggest states can afford lawsuits against these huge companies.
What an absurd and strange claim. You're saying that states -- those entities with GDP measuring in the hundreds of billions -- can afford a lawsuit against a large firm? That would be news, I'm pretty sure, to every single one of the country's fifty attorneys general. Moreover, if it's such a problem, I don't see why citizens can't petition the government to enact legislation providing for federal assistance in this area.
Lack of legal resources isn't an impediment to anything in that country called the United States of America.
...can afford a lawsuit against a large firm?
That should read "can't afford a lawsuit..."
@combs
Some of those ideas were good (tort reform),
Actually, this is a terrible idea. Texas has enacted tort deform, and it has not lowered costs -- not insurance rates, not health care costs, not doctors' fees,and not the price of malpractice insurance. All it does is prevent juries from making the monetary awards that victims deserve. And it allows big corporations outside of the medical profession to engage in still more questionable practices, aware that there is no real cost to them.
It is a terrible idea, and it accomplishes nothing useful for the people. It is a giveaway to the powers that be. No populist with even half a brain could support such a monstrous concept.
@shrinkers
If the only thing tort reform brings is enough GOP support to get a bill passed, then it is worth it.
BTW, I'm not a tea bagger populist. I'm a realist.
That is an interesting idea, combs. If any Republicans would vote for HCR with this one provision added, you may have a point. However, I suspect Republicans are going to continue to vote in union against everything anyway, so there seems to be no practical reason for adding something that does positive harm in order to court votes that won't materialize -- especially since adding something like that will be screams from the left of how the Dems are "caving in" once more.
I'm a practical sort. So I would, in a practical sense, agree with you -- if this is all it would take to get an otherwise truly Progressive bill passed, I'd say, yes, by all means. But I doubt it would make any difference.
@shrinkers
Glad you agree in some sense. That was the point I was trying to get across in the message you replied to above.
Here's how I see it. The Dems could have made the bill contain all the "good" parts that the public likes (getting rid of pre-existing conditions, etc), accept what few GOP ideas are out there, and ditch the public option. Leave it up to the insurance companies to figure out how to lower costs or force them out of business. One way or another it would open the door for a public option down the road, but by that time, it would be the *people* asking for it, not the politicians. Give 'em what they want now, and what they need later.
Ah, I see what you're getting at. Again, if it would have gotten a bill passed -- especially since poison pills like this can be stripped out later -- yes, it may have been worth it.
Of course, we're now far past that time. I doubt that Republicans will even pretend to be willing to vote for any form of HCR at this point, and adding (or removing) provisions in an effort to court them would be unlikely to have any good effect. Perhaps it could be used for advertising purposes -- "Look! We included their ideas, and they still voted against it!" -- but I suspect that would piss off more hard left folks than the number of moderates it would impress (hard-right people are probably beyond reach).
Why not poll about the national plan vs. the plan they already have?
@Brian Miller
Why not poll about the national plan vs. the plan they already have?
That would be a useless question, for two reasons: 1) people don't have to make that decision, since under the recommended national plan they'd be able to keep the insurance they now have, and 2) it would held to spread the false notion that people would have to give up the plans they have if the proposed HCR bills are enacted.
Now, if the proposed plans offered something like a public option that would be available to everyone who wanted it -- something like, perhaps, universal Medicare available as an option that everyone could take advantage if if they wanted to -- then it might make sense to ask if people would "prefer" that choice to the plan they have now (which, in most cases, isn't a choice at all, but is something that their employer negotiates and the employees have no real say in).
Lastly, it's much harder to read the opinion polls as a "mandate" against the health care bill when much of that opinion is based on demonstrably false beliefs, some of which have been perpetuated deliberately by opponents.
Massachusetts voters have been living with a system similar to the Senate bill, better in fact. All they need do to imagine most of the consequences is to look at what's happening in their own states. In that context, this statement is absurd.
It's also absurd to line up comparatively minor features of the bill and proclaim that with so many approved, the Senate bill must be popular. Something like the individual mandate can cancel out all the other desirable features for someone who is affected by it.
I also note, again, that no one is discussing the fact that there is no provision for enforcement of any of the insurance regulations in the Senate bill. That makes any discussion of how popular those provision might be pointless, because without credible enforcement most aren't really there.
combs said...@Bart: How do we go about reducing Medicare costs? The only way I see to do that is through real reform of the current system.
According to the government, Medicare has a roughly 14% fraud rate. Thus, there are two options to curb costs:
1) Give Medicare recipients the option to opt out of Medicare and receive vouchers to buy private insurance which does a far better job policing fraud, or
2) Ration care or reduce compensation as happened in the Gingrich balanced budget plan.
Shrinkers,
Have you no conscience or are you simply being willfully ignorant:
In March 2008, then Sen. Obama voted in favor of the 2009 budget with $3.1 trillion in federal outlays along with a projected $400 billion deficit. The 51-44 vote that morning was strongly along party lines with only two Republicans saying "Yes."
When the final conference report was presented to the House on June 5, not one Republican voted for it.
This means the 2009 budget was almost exclusively approved by Democrats, with "Yeas" coming from Obama, his Vice President Joe Biden, and his Secretary of State Hillary Clinton.
In October 2008, Obama, Biden, and Clinton voted in favor of the $700 billion Troubled Assets Relief Program designed to prevent teetering financial institutions from completely destroying the economy.
In February, 2009, a $787 billion stimulus bill was passed with just three Republican votes, and later signed by Obama.
Weeks later, Congress approved and Obama signed $410 billion of additional spending.
Add it all up, and Obama approved every penny spent in fiscal 2009 either via his votes in the Senate or his signature as President.
ANd only in the most feversh of lib dreams does tort reform mean that patients who have been wronged won't be able to sue. It will simply mean that every medical error won't turn into some lawyer trying to hit the lottery with every medical mistake.
Honestly, the fanatasies of doctors, free from fear of losing everything they have worked their lives to build, engage in malpractice daily, killing patients left and right.
You guys really are unbelieveable.
Which is why your progressive "revolution" is done in just over a year.
I think the real question is why can't they simply go at it one thing at a time? Why did they need to try and cram everything under the sun, and then have to bribe their own senators to vote for it? Too focused on doing something "historic"? In too much of a hurry to get soemthing/anything passed?
Lump something like the pre-existing conditions provision in with tort reform. Boom. One down.
And what I meant to say above was, if Doctors were free from the threat that every malpractice case was potential career-ender, they wouldn't just cavalierly go from being careful to being devil-may-care. We don't work that way. We do what we do BECAUSE we care. There are far easier ways to make money. It is an avocation, a calling. Unfortunately, or mistakes carry severe consequences and we realize that. So when the left conjures up the legions of uncompensated injured that will result because docs and hospitals won't have the threat of million-dollar judgements hanging over their heads, it is just that ephemeral images with no base in reality.
Plus, I am telling you, tort reform would bring a shitload of consevratives and most doctors to the table. Because, Obamas white coat phto op notwithstanding, the majority of doctors, who have a really good idea about the quality of American medical care and a deep and painful understanding of health care finanacing, are unified in their opposition to this bill. less than 15% of pysicians belong to the AMA and view the groups blanket ndorsement of the bill as an insult.
Put Tort reform on the table, sincerely, and people just might join you there.
Persist in your hubris, with your deficits and your votebuying, and god help you come November.
Lehman,
It doesn't make sense to pass HCR one piece at a time. For example, if we pass the pre-existing conditions ban by itself, then no one in the country will need to buy health insurance. They just wait until they get sick, and then buy insurance, which will cause premiums to skyrocket. Most single provisions do not work on their own for similar reasons.
As far as tort reform, please be more specific. What changes do your forsee, because as it is, less than 15% of malpractice or negligence lead to lawsuits, and most suits result in no payout. "CONCLUSIONS. Medical-malpractice litigation infrequently compensates patients injured by medical negligence and rarely identifies, and holds providers accountable for, substandard care." http://www.ncbi.nlm.nih.gov/pubmed/2057025
Furthermore, "jury awards, settlements and administrative costs — which, by definition, are similar to the combined cost of insurance [for medical malpractice] — add up to less than $10 billion a year. This equals less than one-half of a percentage point of medical spending." http://www.nytimes.com/2009/09/23/business/economy/23leonhardt.html?_r=1
For Megan, the border between fact and opinion is fairly porous.
I used to read her, until I realized you can't trust the opinion of someone who claims to have experience in business and economics but gets the basics wrong whenever making specific statements.
I like 9 of the 27 measures, or 33%. This does not make me 33% likely to favor this bill. The logic of this post is flawed. For instance, I like that 31 million will be insured, and would tell a pollster I favored this; however, if the poster does not go further, he will not realize that I do not like how this bill goes about enacting this.
Lehman asserted:
In March 2008, then Sen. Obama voted in favor of the 2009 budget with $3.1 trillion in federal outlays along with a projected $400 billion deficit. The 51-44 vote that morning was strongly along party lines with only two Republicans saying "Yes."
When the final conference report was presented to the House on June 5, not one Republican voted for it.
This means the 2009 budget was almost exclusively approved by Democrats...
Thank you Lehman, for reminding us that as soon as the Republican Party ceased being in control all of the organs of the federal government (that is once they lost the House, though still controlling the Senate, and the Legislative and Judicial Branches - including the Supreme Court) they immediately became the "Party of No" and the Republicans in Congress thereafter refused to take part - or responsibility - in governance.
Strange, I didn't see any of the following:
* Nebraska gets a sweetheart deal that no other state got.
* Unions used cronyism to become exempt from the cadillac health plan tax.
* The bill does next to nothing to scale back medical costs, meaning that we should expect medical prices to double within the next decade or two. (Which means increased burden on the federal government, employers, and/or individuals. This also means wages will continue to stay flat like they did last decade.)
* Taxes are increased on various other areas, like medical equipment and elective cosmetic procedures.
* The bill is "budget neutral" because costs have been offloaded to states. States must shoulder a much bigger portion of Medicaid, because of increased Medicaid guidelines. This has led many to speculate states may just bail out of Medicaid altogether (except Nebraska, of course).
* The bill also became "budget neutral" by splitting off a second bill which has unfunded payments for Medicaid doctors, to the tune of around $250 billion. It's easy to make your current bill "budget neutral" when you split off a major chunk of the costs into an unfunded second bill.
* The bill is only a 10 year fix. It is not sustainable, and will leave us with fewer options 10 years from now than what we have today.
But hey, lets ignore all these problems of "unsustainability", "cronyism", "bigger burdens", and "exponentially increasing costs". They're not important to discuss.
While it's nice to ask people about the literal contents of the bill, I think it is the reverberations of certain clauses that are points of contention. It's nice to ask about illegal immigrants not getting coverage, but with the blockage of enforcement or the existence of a Supreme Court ruling that would make that enforcement hairy (California's Prop 187 from the late 90s), awareness of the clause in the bill is the least relevant part of the discussion.
Heck, almost all of the most popular parts of the bill, and all of the ones with sub-zero popularity, were on Republican plans that were voted down cleanly by Democrats in November.
If they simply wanted this stuff passed, and the bullet points of the bill were all they truly cared about, it would have been voted in already.
It's the trickle-down reverberations that remain contentious, and your analysis, while somewhat interesting, looks at simply surface content.
Do we want a lower deficit? Sure. Has it been proven that it will lower the deficit? Not clearly.
Aye, there's the rub...
For the comment about not caring about minutae, I must disagree.
It is that there is SO MUCH minutae without room for reversal that makes the bill so unfavorable.
Many of these elements can be passed immediately in smaller groups of one or two elements (without gifts for Nebraska or unions). That allows time for concrete market reactions to take place: Is "X" lowering cost like we thought? Should we tweak it and introduce another element? Should we give it more time to allow to correct to our new law? If we introduce this segment separately, can we make it effective immediately?
The way this bill goes, it is going to be tough to fix the things that don't work. And the fact that these elements HAVE been introduced in smaller, porkless, chunks, but resoundly defeated along party lines tells us that the goal may be something different.
This information does go to show there is a gap between what people like and what people realize is in the bill. even with that said, I think what this really shows based on the strong positives and strong awareness, with the very strong negatives is that one of the real problems is that we like many aspects and aware of them but are unwilling to pay for it. The killer is the high cost not lies.
American's just want something for nothing as usual.
Maybe we should give the American public a little more credit. The extreme analyzing of every bit of minutia related to the opinon polls listed above seems extreme to me. I think Obama, Reid, Pelosi et al have gotten their message out loud and clear only the American public don't believe that it could actually lower the deficit and improve health care for most Americans. They also see the big picture of how this bill is much bigger than just health care. It will fundamentally alter the entire American economy forever.
Hey you need to think up more positive guestions to average into your total to get the average up. Great going! Yet another mis-use of math to prove a point. Sheesh why didn't anyone catch this?
Much of the disconnect between the claimed content of the bills and the public's reaction to them is the very credibility gap Obama noted.
It is not so much that people object to many of the provisions, but that they DO NOT BELIEVE claims that the bills will be administered as advertised.
To be blunt, they think the Democrats are lying.
Imagine you have asked someone whether they would prefer a certain policy and they say yes. That only means they should support your bill if they believe you when you claim that policy is in there.
When they see you bribing senators and unions to buy votes with their tax dollars, they assume you are lying, and they oppose the bill.
Obama appears to be becoming the next Jimmy Carter. Smart man but just can't work with the Congress and Senate. Can't get things done. I hope somebody starts compromising soon.
The reason the Democrats have such a hard time raising awareness of their message is that the message itself , well basically sucks. More government, less liberties, more government, less freedome, and so on. Yes, the American people are sheep, however, even sheep wake up on the way to slaughter.
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