Posts tagged Affordable Health Care Act

A future with high deductibles for everyone

The RAND Health Insurance Experiment demonstrated that health care use was reduced by 30 percent in patients with cost sharing as compared to first dollar coverage, supposedly without resulting in harm (though low-income people were harmed). But that study was limited to healthy workers and their young healthy families during a few healthy years of their lives. It does not apply to the relatively unhealthy 20 percent of people who use 80 percent of our health care dollars – care that is not influenced by deductibles. Reducing spending by 30 percent on healthy people who use very little care – perhaps an office visit or two – is not going to reduce our national health expenditures significantly.

Many other nations have first dollar coverage with no deductibles, yet spend far less than we do, and with no evidence of significant overuse of medical services. There are far more effective and much more patient-friendly methods of controlling spending than the use of deductibles and other cost sharing, as these nations have demonstrated.

The Affordable Care Act is not providing us the framework that would ensure affordable care for everyone. Trying to modify the Act to make it work better won’t help because the financing infrastructure is so fundamentally flawed that legislative tweaking cannot repair it. Though getting rid of deductibles would be an improvement, it wouldn’t reduce our high costs, but would merely shift them, making insurance premiums even less affordable.


A Good Day For Progressive Politics
  • Arizona’s anti-immigrant legislator and author of SB1070 Russell Pierce was recalled today
  • Ohio voters overturned the anti-worker and anti-union bill that was passed through the legislature
  • and Mississippi voters defeated a bill that would have defined human life as beginning at fertilization was .

Not So Fast: Issue 3 did pass in Ohio. Some are making faulty analogies between the Affordable Health Care act and President Obama’s popularity. If we’re going to be honest about the AHCA, it has a lot of problems, it’s another one of those better than nothing kinds of legislature.

We’d have to get really deep in to the weeds with some honest pollsters in Ohio to read the tea leaves on this vote. I don’t know of any and if I did, I doubt that I’d be able to afford them to tell us if Issue 3 was a referendum on the politician or the legislation that he’s been identified with.

URGENT: Sign letter of protest over IOM’s skimpy health plan prescription

A recent Quote of the Day message expressed alarm at the fact that the Institute of Medicine is recommending a grossly inadequate, skimpy, spartan standard for the package of benefits to be offered by health plans in the state insurance exchanges being established under the Affordable Care Act….

Following is a letter asking the Obama administration to reject this recommendation. Though only selected names will be used in publicizing this letter, we encourage everyone who concurs with the views expressed to sign it, using this link

Do we have to accept $15, 000 premiums and higher deductibles?

Yesterday’s (quoted) message was on framing, demonstrating how the right has taken control of our cognitive processes by superimposing the moral worldview of individual responsibility, while bypassing logic. As proof, much of the bashing of single payer advocates is coming from the left. Even though liberals understand fully the logic of single payer, they are absorbed in the process of making the Affordable Care Act work. We’ve shown that it cannot ever accomplish the goals of universal coverage and affordability, yet they insist that this right-wing consumer/market approach will get us there through incremental steps, though incrementalism hasn’t achieved our ultimate goals in over a half century of trying.

Today I received an email message that went out to another list, sent by one of the most intelligent, dedicated, progressive individuals in the health care reform movement. The title of the message was, “Don McCanne is wrong Re: [hc4ac] US Last In Mortality Amenable to Health Care.” She wrote, “The vote on the ACA has occurred; opposing it on a daily basis does not get us closer to universal coverage or price controls or to single payer; nor does intoning single payer on a daily basis.”

So abandoning single payer and tweaking a model designed by the conservative Heritage Foundation will get us there? We certainly screwed up the framing on this one!

I find it refreshing to find political activists, particularly those who are interested in making life better for people in demonstrably proven ways (i.e. most left of center) admit mistakes. The sooner that tactics and programs are recognized to be deficient, the sooner better programs and tactics can be devised to win