"Nixon proposed today’s Affordable Care Act: It's easy to forget amidst all of the conservative handwringing that this is the kind of plan GOP has always wanted"
2013-10-29 by Robert Reich [http://www.salon.com/2013/10/29/nixon_proposed_todays_affordable_care_act_partner/]:
House Majority Leader Eric Cantor says Republicans will seek to delay a requirement of the 2010 Affordable Care Act that all Americans obtain health insurance or face a tax penalty. ”With so many unanswered questions and the problems arising around this rollout, it doesn’t make any sense to impose this one percent mandate tax on the American people.”
While Republicans plot new ways to sabotage the Affordable Care Act, it’s easy to forget that for years they’ve been arguing that any comprehensive health insurance system be designed exactly like the one that officially began October 1st, glitches and all.
For as many years Democrats tried to graft healthcare onto Social Security and Medicare, and pay for it through the payroll tax. But Republicans countered that any system must be based on private insurance and paid for with a combination of subsidies for low-income purchasers and a requirement that the younger and healthier sign up.
Not surprisingly, private health insurers cheered on the Republicans while doing whatever they could to block Democrats from creating a public insurance system.
In February 1974, Republican President Richard Nixon proposed, in essence, today’s Affordable Care Act. Under Nixon’s plan all but the smallest employers would provide insurance to their workers or pay a penalty, an expanded Medicaid-type program would insure the poor, and subsidies would be provided to low-income individuals and small employers. Sound familiar?
Private insurers were delighted with the Nixon plan but Democrats preferred a system based on Social Security and Medicare, and the two sides failed to agree.
Thirty years later a Republican governor, Mitt Romney, made Nixon’s plan the law in Massachusetts. Private insurers couldn’t have been happier although many Democrats in the state had hoped for a public system.
When today’s Republicans rage against the individual mandate in the Affordable Care Act, it’s useful to recall this was their idea as well.
In 1989, Stuart M. Butler of the conservative Heritage Foundation came up with a plan that would “mandate all households to obtain adequate insurance.”
Insurance companies loved Butler’s plan so much it found its way into several bills introduced by Republican lawmakers in 1993. Among the supporters were senators Orrin Hatch, R-Utah, and Charles Grassley, R-Iowa (who now oppose the mandate under the Affordable Care Act). Newt Gingrich, who became Speaker of the House in 1995, was also a big proponent.
Romney’s heathcare plan in Massachusetts included the same mandate to purchase private insurance. “We got the idea of an individual mandate from [Newt Gingrich], and [Newt] got it from the Heritage Foundation,” said Romney, who thought the mandate “essential for bringing the health care costs down for everyone and getting everyone the health insurance they need.”
Now that the essential Republican plan for healthcare is being implemented nationally, health insurance companies are jubilant.
Last week, after the giant insurer Wellpoint raised its earnings estimates, CEO Joseph Swedish pointed to “the long-term membership growth opportunity through exchanges.” Other major health plans are equally bullish. “The emergence of public exchanges, private exchanges, Medicaid expansions … have the potential to create new opportunities for us to grow and serve in new ways,” UnitedHealth Group CEO Stephen J. Hemsleyeffused.
So why are today’s Republicans so upset with an Act they designed and their patrons adore? Because it’s the signature achievement of the Obama administration.
There’s a deep irony to all this. Had Democrats stuck to the original Democratic vision and built comprehensive health insurance on Social Security and Medicare, it would have been cheaper, simpler, and more widely accepted by the public. And Republicans would be hollering anyway.
"The Heritage Foundation Designed Obamacare to Preclude Single Payer. Republicans Win Again!"
2013-09-28 from [http://my.firedoglake.com/jbade/2013/09/28/the-heritage-foundation-designed-obamacare-to-preclude-single-payer-republicans-win-again/]:
Obamacare was/is the invention of the hard right.It was born in the Heritage Foundation in the early 1990′s as an alternative to single payer, should the establishment ever be threatened by single payer. the Republicans introduced it as a bill in 1993. Bob Dole ran on Obamacare in 1996 and Mitt enacted it in Mass. in the early 2000′s.
Although Obamcare does offer corporate health coverage for some who have none, it does not lower costs in a meaningful way. and the same bargain you give away any chance of single payer as you write into law, through mandate, corporate control of the health system. The opposite of medicare/caid single payer ect.
Healthcare costs will never go down significantly under Obamacare because their corporate profits are tied to them. Get it.
The importance of this issue can not be overstated because all the austerity both parties forward would be unnecessary if we had single payer system like any other industrialized country. Lowering our healthcare costs to the 11 to 13 percent that these countries pay ,almost brings our national account into balance-that’s how big the healthcare costs are as a piece of the pie. Those costs are now and will continue to be the basis for their “austerity measures”.
These are the same Democracts and Republicans who voted to make it illegal(because it was legal) the re importation of prescription drugs. This precluded the american taxpayer from 100′s of billions in savings, even more 100′s of billions savings for consumers through the re-import of drugs manufactured here and sold to the world at 10 cents on the dollar.Stop and think. Would a group of individuals who would do that EVER try and lower your health costs? You cant be that stupid. Yet this Obamacare scheme, designed by these same people, that turns over the system to a handful of corporations is reasonable. I dont get it.
The only reasonable course of action is to oppose Obamcare, what will when implemented be, the end of any hope of single payer and ending of their stated cause for austerity. I say single payer is worth fighting for. It is the great equalizer. The more rich share your healthcare system, the better it will be. The more separated, the worse your healthcare will be. If they, their kids go to same doctors hospitals as you your kids, you will have good healthcare.
Obamacare separates you from that bond that assures good healthcare. The american people across the political spectrum endorsed a public option in huge numbers over 70%, even republicans. The president isolated the part of the party supporting a public option, a majority of the party and forwarded the the right-wing agenda of handing more and more power to a select few parasitic corporations. Thats worth fighting against.
For those who support Obamacare they should answer the following questions:
1. How have healthcare corporations every made healthcare better ? more efficient? cheaper?
2. How do you reduce costs if their corporate profits are tied to healthcare?
3. Does Obamacare empower the worst actors who are proven failures? is that reasonable?
4. How do you get the money for other social programs under the projections for Obamacare?
"Obamacare website woes: another sign of out-of-control private contractors; The Obama team outsourced Healthcare.gov to big corporations that rang up large bills without delivering what they promised" 2013-10-21 by Moira Herbst from "(London) Guardian" newspaper [http://www.theguardian.com/commentisfree/2013/oct/21/obamacare-website-glitches-cgi-private-contractors]:
The homepage of Healthcare.gov, the online home of the new US health insurance exchange marketplace. Photograph: Healthcare.gov
Whatever the ultimate benefits of Obamacare, it's clear that the rollout of its $400m registration system and website has been a disaster. Healthcare.gov was unusable for millions who visited the site on launch day earlier this month, and the glitches reportedly continue. What went wrong?
Of course, the Obama administration is to blame for the botched rollout, but there are other culprits getting less attention – namely, global tech conglomerate CGI [http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/16/meet-cgi-federal-the-company-behind-the-botched-launch-of-healthcare-gov/], which was responsible for the bulk of the execution, and in general the ability of big corporations to get massive taxpayer-funded contracts without enough accountability [http://www.pogo.org/blog/2013/07/weak-penalties-for-misbehaving-contractors.html].
Government outsourcing to private contractors has exploded in the past few decades. Taxpayers funnel hundreds of billions of dollars a year into the chosen companies' pockets, about $80bn of which goes to tech companies [http://www.pogo.org/our-work/letters/2013/20130415-feds-vs-contractors-cost-comparison.html]. We've reached a stage of knee-jerk outsourcing of everything from intelligence and military work to burger flipping in federal building cafeterias, and it's damaging in multiple levels.
For one thing, farming work out often rips off taxpayers. While the stereotype is that government workers are incompetent, time-wasters drooling over their Texas Instruments keyboards as they amass outsized pensions, studies show that keeping government services in house saves money [http://www.pogo.org/our-work/reports/2011/co-gp-20110913.html]. In fact, contractor billing rates average an astonishing 83% more than what it would cost to do the work in-house. Hiring workers directly also keeps jobs here in the US, while contractors, especially in the IT space, can ship taxpayer-funded work overseas.
Fortunately, then, there are alternatives to outsourcing public functions to big corporations padding their profits at taxpayers' collective expense, and it is time we used them.
To this end the Healthcare.gov experience should serve as a wake-up call to President Obama, who, after all, said early in his first term he wanted to rein in the contractor-industrial complex [http://www.politico.com/news/stories/1209/30858.html], and to the state governments doling out multi-million dollar contracts. The revelation here is that an overdependence on outsourcing isn't just risky in terms of national security, extortionate at wartime, or harmful because it expands the ranks of low-wage workers [http://takingnote.blogs.nytimes.com/2013/09/26/federal-contractors-low-wages/]; it's also messing with our ability to carry out basic government functions at a reasonable cost.
Like many contractors, CGI got an open-ended deal from the government, and costs have ballooned even as performance has been abysmal. The company – the largest tech company in Canada with subsidiaries around the world – was initially awarded a $93.7m contract, but now the potential total value for CGI's work has reportedly tripled, reaching nearly $292m [http://www.reuters.com/article/2013/10/17/us-usa-healthcare-technology-insight-idUSBRE99G05Q20131017].
Sadly, Healthcare.gov is but one high-profile example of the sweet deals corporations get to do government work—even as they fail to deliver. For other recent examples, one need only look at the botched, taxpayer-funded overhauls of the Massachusetts, Florida and California unemployment systems, courtesy of Deloitte.
In Massachusetts alone, professional services giant Deloitte got $46m to roll out a new electronic system for unemployment claims. The company, whose private-sector whippersnappers were expected to lap the crusty bureaucrats the state employs directly, delivered the project two years late and $6m over budget. On top of that, the system has forced jobless residents to wait weeks to months to collect benefits. One unemployed man who filed a claim for benefits instead received an erroneous bill charging him $45,339 [http://www.bostonglobe.com/business/2013/08/23/man-applies-for-jobless-benefits-gets-bill/OS8ObQw71Zug0eWiIOkEqM/story.html]. A slap in the face of absurd proportions.
Similarly, the rollouts in Florida and California, which each cost about $63m, can only be described as train wrecks: late, over budget and riddled with glitches that delayed payments to the jobless [http://www.bostonglobe.com/business/2013/09/24/troubled-calif-unemployment-computer-system-has-similarity-with-mass-consultant/sLa8QG030NnPzOsjdJNCzO/story.html].
It doesn't have to be this way. We can save money, create good jobs, and get more for each taxpayer dollar by simply by in-sourcing government work. Doing so would mean actually having faith that the government can employ top talent instead of making unfounded assumptions that anyone receiving a government check is a waste of space who can't possibly innovate. Think about it: Why couldn't we, the taxpayers, have just directly hired the finest minds in tech to build Healthcare.gov?
Unfortunately, while Obama promised to focus on insourcing at the start of his presidency, federal workers have instead received multiple kicks in the teeth. There are now 20%, or 676,000, fewer federal workers since the size of that workforce peaked in mid-2010. Recall, too, that Obama froze federal worker pay for two years following the 2010 congressional elections [http://www.nytimes.com/2010/11/30/us/politics/30freeze.html]. Now the sequester – a fancy word for the government cuts that started this year – is causing further damage, and could cost 100,000 more federal jobs within a year [http://www.huffingtonpost.com/2013/09/11/sequestration-costs-jobs_n_3907741.html]. Deep cuts to state and local governments continue at the same time.
If we're not going to insource work – presumably because anti-government types successfully peddle the useless bureaucrat stereotype – we should at least have a better process for picking contractors that benefit from taxpayer largesse to carry out public projects. It may be hard to believe in light of the Healthcare.gov experience, but there are examples of successful government outsourcing arrangements in IT. One key to their success, a Government Accountability Office study pointed out, is consistent communication with, and monitoring of, contractors. Penalties for cost overruns, failing to deliver by agreed-upon deadlines and other forms of mismanagement would help, too.
Of course, we also need a more competitive bidding process, and a more thorough examination of the track record of any company up for a giant government contract.
Putting all of these systems in place takes time and money, which is one reason why direct government hiring is preferable. But regardless of whether we start insourcing or improving oversight or both, one thing is clear: we need to stop blindly throwing taxpayer money at corporations while not holding them accountable.
This is an example of how convoluted “fact-based” journalism can be if done for loyalty to a political party. You may note how the author puts forward the history of Obamacare as deeply rooted in the Republican Party, but dismisses that history as “lies”, despite showing us the facts proving that it’s true!
"Lies the Dems tell themselves"
2013-10-25 by Debra J. Saunders [http://www.sfgate.com/opinion/saunders/article/Lies-the-Dems-tell-themselves-4926880.php]:
During the Obama years, a potent mythology has taken root in Democratic circles. In this narrative, Democrats are victims, martyrs even, while Republicans are wily tricksters.
Last year, there was a hyped-up fable about Senate Minority Leader Mitch McConnell. President Obama told "60 Minutes," "When I first came into office, the head of the Senate Republicans said, "My No. 1 priority is making sure President Obama's a one-term president." Sen. Dianne Feinstein even told the Chronicle Editorial Board she heard McConnell speak to that effect on the Senate's opening day.
Thing is, the quote in question first appeared nearly two years later - in an October 2010 interview with the National Journal's Major Garrett.
The latest iteration of Democrats-on-the-Cross works like this: Obamacare hasn't delivered the big savings promised by the president - $2,500 annually for the average family - because Democrats ditched the single-payer model to mollify Republicans. In the Los Angeles Times, Harvard Professor Jane Mansbridge writes, "The Democratic Party reluctantly adopted Romneycare, aka Obamacare, to get Republican approval." What's more, House Republicans "coerced the Democrats into adopting a Republican health insurance plan."
A reader e-mails me, "The Republicans who hate Obama would not permit the creation of a decent single payer plan which would allow private insurance carriers to participate on a competitive uniform benefit program." Another insists, "We wanted single payer! The GOP did not - that was the compromise, and it was one of many from this president."
Really? The Affordable Care Act did not win a single Republican vote on the House or Senate floor. If Senate Majority Leader Harry Reid and then House Speaker Nancy Pelosi abandoned single-payer to win GOP votes, they are the most incompetent negotiators in history.
Former Sen. Olympia Snowe, R-Maine, voted for the Obama stimulus package and a measure to end "don't ask, don't tell." In her book, "Fighting for Common Ground: How We Can Fix the Stalemate in Congress," Snowe recalls how 40 House Republicans voted with 249 Democrats to expand the State Children's Health Insurance Program, only to watch Democrats unveil a stimulus package with no GOP input a week later.
There was little spirit of bipartisanship when Pelosi crowed, "Yes, we wrote the bill. Yes, we won the election."
When Sen. Max Baucus, D-Mont., rolled out his draft legislation in 2009, he didn't have a single Republican at his side. When the Senate Finance Committee voted on two Democratic public-option proposals, to allow government plans to compete with private insurers, Sen. Orrin Hatch, R-Utah, denounced the public option as "a Trojan horse for a single-payer system." Be it noted that centrist Democrats joined Republicans to defeat both measures.
In "The Audacity of Hope," Obama laid out a plan for universal coverage that allowed private carriers like Blue Cross and Aetna to compete with new state pools. Still, he didn't stick his neck out to push for Democrats' public-option proposals.
In a 2003 speech, Obama, a second-term state senator, called himself "a proponent of a single-payer universal health care program." Politifact, however, couldn't find a similar blank-check statement. The fact-checking organization observes that as Obama became a more well-known national figure, he "has spoken favorably of single-payer in concept, but always adding qualifiers."
Snowe voted for the Democrats' health bill to get it out of committee, but it never won her support on the floor. You see, Snowe foresaw Obamacare's big problem. As she wrote (my italics), "Not one single member in Congress - Republican or Democrat - could answer whether the newly created health insurance plans would be affordable, yet we hurtled headlong toward a final vote on a monumental bill affecting every American."
In a savvier Republicans-ruined-Obamacare argument, Washington Post wonkblogger Ezra Klein contends that the Democratic part of Obamacare - Medicaid, which is single-payer - works. But: "The part of Obamacare that's troubled is the part Democrats lifted from Republican policymakers. It's the part that tries to integrate private insurance companies with government systems in order to create a universal insurance system that's subsidized by the state but run by private companies."
Get it: If Obamacare fails, it's because Obamacare is a Republican plan.
Now, I won't deny that two decades ago some conservative think-tank swell came up with the term "individual mandate" - which allowed other wonks to try to pin the tail on the elephant.
But if liberals have to fish for a 1989 Heritage Foundation policy paper that had no Republican support in 2008, 2009 or 2012 to establish Republican paternity for the Affordable Care Act, that tells you one thing: They think Obamacare won't work.
'I cannot even stand to look at you' -
Last Sunday Sen. Dick Durbin, D-Ill., put a post on Facebook: "Many Republicans searching for something to say in defense of the disastrous shutdown strategy will say President Obama just doesn't try hard enough to communicate with Republicans. But in a 'negotiation' meeting with the president, one GOP House leader told the president: 'I cannot even stand to look at you.' "
Durbin didn't name the culprit. When a reporter asked White House press secretary Jay Carney about the allegation, he responded, "I looked into this and spoke with somebody that was in that meeting, and it did not happen."
The Chicago Tribune called Durbin's post a "smear" and editorialized that Durbin "shouldn't play by birthers' rules."
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