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Bernie’s Healthcare Plan By The Numbers

I keep hearing a couple of things about Bernie’s single payer healthcare plan that I need to address. The Hillary supporting left likes to say that he doesn’t actually have a plan to pay for it. WRONG. The right prefers to proclaim that he’s going to massively raise your taxes to pay for it. Not totally wrong, but not even remotely the whole story.

So I’m going to break this down, so that I never have to hear these bullshit talking points again. So here it is, point by point.

Right now, we pay twenty trillion dollars for healthcare (all of my numbers represent 10 years of spending). That breaks down to about fifteen trillion dollars in premium costs, and another five trillion dollars in copays.

Of that twenty trillion dollars, six trillion is currently guaranteed profits and administrative costs. Remember that the ACA capped these costs at twenty percent. To give you some context here, medicare’s administrative costs are four percent. There are obviously no profits, so four percent is the whole number. That’s four percent for medicare, vs twenty percent for private insurance so that six trillion dollars in costs would all but evaporate.

We pay 3.1 trillion taxpayer dollars out to employers in the form of tax incentives to provide their employees with health insurance. So you’re actually paying for some of that employer subsidized health insurance through your taxes in addition to your monthly premium contributions. That 3.1 trillion dollars evaporates under Bernie’s single payer system.

If you’re keeping track, we’re already at over nine trillion dollars in savings, and we haven’t even gotten to your premium contributions yet.

We’re left with a balance of eleven trillion dollars. That’s where Bernie’s tax plan comes into play. Yes, we will be paying 100% of that eleven trillion dollars through our tax dollars, rather than premium contributions.

Bernie’s plan is to raise your taxes by 8.4% (6.2% if your income is under 28,000) so that’s where the republican talking point is true. But remember that you will no longer be paying those insurance premiums. So ask yourself, are you currently paying more than 8.4% of your income for healthcare? Actually, don’t. I have the numbers. The median single person household spends 21% of their income on health insurance. The median family household spends 23% of their income on health insurance. That’s the part that republicans leave out. You will be saving around 11% – 15% of your total income overall. Bernie also creates new tax brackets. Right now, the highest tax bracket kicks in at an income of $415,000. So we don’t treat anyone who makes $10 million dollars, or $1 billion dollars a year any differently than we do someone making $415,000. That top tax rate is currently 39.6%. What Bernie is proposing is the following:

  • 37 percent on income between $250,000 and $500,000.
  • 43 percent on income between $500,000 and $2 million.
  • 48 percent on income between $2 million and $10 million. (In 2013, only 113,000 households, the top 0.08 percent of taxpayers, had income between $2 million and $10 million.)
  • 52 percent on income above $10 million. (In 2013, only 13,000 households, just 0.01 percent of taxpayers, had income exceeding $10 million.)

I literally copied and pasted those last four lines from Bernie’s official campaign website, so sorry Hillary supporters. Your ambiguity argument, just demonstrates that you didn’t bother to look at Bernie at all. There are several other tax increases he proposes aimed at the filthy rich. You should go to his website and familiarize yourself with that tax plan.

Bernie’s plan saves us five trillion dollars in healthcare costs every decade, according to the critics of his plan. The best estimates have us saving nine trillion dollars every decade.

That’s how he pays for it. It’s not an ambiguous plan, nor is it a plan that is going to hit the middle class and the poor. They come out way ahead under Bernie’s plan. I’m sincerely hoping that at least democrats, stop peddling these falsehoods I’ve been hearing. I know that truth has never gotten in the way of a good republican talking point, but I hope this will end some of the bullshit I’ve been hearing.

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The Inevitability Of Single Payer

I’ve always maintained that a single payer health care system is not only the way to go, but the inevitable endgame for the US. I didn’t love Obamacare, but I saw it as a first step. A first step by the way, that we’ve been trying to make since Nixon was president. Unlike with financial “reform”, when Obama refers to the ACA as “historic”, he would be correct since we historically haven’t made a damned thing happen.

I was incredibly skeptical on where the savings we were being told to expect were going to come from. But they did come, and they came in in bigger numbers than anyone had expected. So I was wrong, and I admitted I was wrong. And then when the rates were announced for 2015, and they stayed completely flat, I was elated to have been wrong.

Republicans were 100% wrong about every single thing they said about Obamacare. Wanna know how you can tell? They haven’t brought it up in a really long time.

On the other side, some liberals can’t take a good day and accept that it’s a good day because Obamacare was a giant giveaway to big pharma and the private insurance companies. I’m talking to you in this post.

Yes it was a giant giveaway but you also had a good day so spare me your analysis about how horrid everything will be tomorrow. When the norm is that you never win and big business always wins, it’s not rational not to celebrate the small victories when you get them. You really have to be a special kind of ideological partisan not to be happy about the savings we’ve seen, regardless of how long they last. The liberals who are so rigid in their ideology, whether it be as advocates for single payer, or as demonizers of Obama for not being a liberal irritate me the most. Obama isn’t remotely liberal enough for me either. That doesn’t mean that I have to demonize every single thing he does and conflate the drone disaster in Pakistan with the brilliant Iran and Cuba deals, in order to make forming an opinion about him easier on myself. That kind of ideological purity is how republicans ended up where they are today.

But back to Obamacare. Of course it’s is going to cave in on itself. Yes, it was a giveaway to private insurance companies, whose business model was fatally flawed. We got a respite on premiums because of the influx of people coming into the system. But corporate greed will eventually prevail. By eventually, I mean in the near future.

This meme showed up in one of my social network feeds:

CignaCEOOf course I got to fact checking, not because that salary sounded high to me. I remember the CEO of United Healthcare collecting over 100 million dollars in 2009. But I didn’t want to reshare until I confirmed the information. The information that I found reaffirmed my belief that single payer is the inevitable endpoint for us. David Cordani did in fact make $27.16 million dollars last year. That was a fifty-three percent increase from his 2013 salary of $17.76 million dollars in 2013.

Are you completely disgusted? Well buckle up, we’re just getting started. Cordani’s compensation in 2013 was an increase of forty-two percent from the $12.5 million he was getting paid in 2012.

I took a look at what was happening with our buddy Stephen Hemsley at United over that same period of time. In 2014, his total comp was just over $66 million dollars. That’s way the fuck up from his 2013 compensation of just over $28 million dollars. He was at $34.7 million in 2012. In his defense, the poor bastard did take a huge cut from his totally reasonable salary of $102 million in 2009.

Jay Gellert, who is the CEO of the worst health insurance company in America (Health Net) saw his salary increase from $5.79 million in 2012 to $12.48 million in 2014.

Do you see the pattern here? 2014 was a very good year for these vultures, who aren’t talented enough to make something you actually want to buy (like Steve Jobs was), so they make money on your back (literally). In Q1 2014, nine of the eleven biggest insurance companies in the US saw their stock prices hit a fifty-two week high because of Obamacare. Health insurance stocks outperformed the rest of the stock market in 2014, as did hospitals. The “big five” health insurance companies are feverishly working on whipping up new plans to offer on the exchange next year. That means that 2016 will likely bring us another year of flat or slightly declining premiums.

As I said earlier, I’ll take it. Am I bothered that the vultures are making out like bandits? Of course I am. They’re talentless hacks, paying themselves blood money and patting themselves on the back for a job well done, because President Obama did all the work for them and brought in higher profits. But we all won too, and that almost never happens for us thanks to the way campaign finance laws have devolved. I’ll take it for as long as it lasts.

It definitely won’t last. We can see the scorpion and the frog dynamic unfolding already. Health insurance companies are scorpions and they will always sting. We’re going to end up in a single payer system because when this caves in on itself, there’s nowhere else to go. Unfortunately, there are going to be some painful years between the collapse of Obamacare and the acquiescence from our politicians to a single payer system. I think we’re going to see skyrocketing uninsured rates that parallel the trajectory of skyrocketing premiums. The more unaffordable insurance is, the fewer the people will buy it. And that will bring the private insurance industry back to its failing business model, and it will cause hospitals to hemorrhage money again.

But I’ll take the respite in the meantime, and I will call this law the success that it is. I don’t need to conflate what I’m positive will happen in the near future with what is happening now.

Here’s the best part of Obamacare; President Obama took the republican health care plan away from them and implemented it successfully. Democrats are now officially the experts on improving the health care system. There is no plan left for republicans to put on the table. Single payer is all that’s left. I’ve studied health care systems all around the world. They’re all either single payer or a much more effective version of Obamacare. Switzerland has a 100% private insurance system, just like Obamacare. Of course, their regulations and cost controls are much more “big governmenty” than ours. They regulate the shit out of drug prices, the cost of medical procedures, and even the profit margin their 90+ private health insurance companies can make (I think they can make a 5% profit vs the 20% that Obamacare allows). They also have the second most expensive health insurance system in the world, after ours. A couple of other places have single payer with private insurance available for those who want it to cover extras.

Trust me when I tell you that single payer is the end of the road. It’s either that, or everything collapses for us, for insurance companies, for doctors, and for hospitals.

Make no mistake, Obamacare was a necessary first step to single payer. We were never going to go from the shit show we had, straight into sanity. I do wish he had fought for it a little bit, just to put the term “single payer” in the minds of more Americans who have no idea what that means, even though they know they want it. But my premiums were cut in half so Obamacare goes in the Obama success column.

Yes, that’s right I have columns. It’s much more complicated than just lionizing or demonizing someone, but I use excel so it works for me!

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The Anecdotal Obamacare Story That Matters

If you’re even casually familiar with me, you know that I have almost no use for anecdotal "evidence". Anecdotes are not evidence of anything other than what one person believes they’ve seen at one specific moment in time. Obamacare has brought a glut of anecdotal Obamacare horror stories to my various social media pages. Statistically speaking, every single American who got screwed by this law has ended up finding me on social media. No seriously, the numbers simply don’t support these claims of devastation and woe. One guy claimed that his insurance premiums increased by 250%! Holy shit! Surely Fox News would have found him if this were true, right? I mean, they paraded a bunch of Obamacare "victims" whose stories all turned out to be 100% bullshit. Fox was really in need of a legitimately fucked over insurance consumer. Why didn’t this guy take this opportunity to possibly become a right wing hero a la Cliven Bundy? Why? Because he told me he was in Arizona. I looked up the stats for his state. Turns out that in Arizona, rates went down by ten percent for 2015. Oopsie! I never heard back from him after I shared that data with him. I guess he died at home alone, of a stubbed toe that got infected because he couldn’t afford the one million dollar copay that came with his wretched Obamacare plan. Poor bastard.

And then there was the vet who insisted that the VA was the worst health insurance in the world, and that Obamacare was going to destroy the previously awesome private insurance market. When I pointed out that the VA has always had a higher satisfaction rating than private insurance, he got huffy and played the "I’m a vet and you’re not" card. I let him know that I would be happy to ignore his attempts at acting intellectually superior with actually being intellectually superior if he could find me a single year in which the VA’s approval rating was lower than that of private insurance. He didn’t even bother to do that, instead opting to insist that he knew better because of his first hand experience. I assured him that the curmudgeon contingent was included in those approval ratings. He was unmoved by reason, logic, or anything that might not fit with what he "knew".

These are just a couple of anecdotal examples of why I have no use for anecdotal "evidence" (see what I did there?) Wanna know where I’m going next? Yep, I’m going to share an anecdotal Obamacare story. This is the story of James Webb, a fifty one year old self proclaimed teabagger and veteran. He hates commies and Obama. He does love guns though. He really, really loves guns. He loves to make videos of himself shooting guns. Lots and lots of ‘pew, pew, pew, pew, pew’ videos on his youtube channel. He hates the fact that the gays have ruined The Walking Dead for him. He refers to the Ferguson protestors as the "cesspool of America", who come from "generations and generations, and generations of living off the government". He’s been posting videos on youtube for seven years now so if after reading this, you decide that he was a plant, let me assure you that he isn’t.

Anyway, James posted a video last week that will double the one million views mark he crossed last month (congrats James), in a matter of days. James posted a video explaining why he might vote for Hillary Clinton. See, James retired last year because Obamacare set him free from having to work for health insurance. He’s not interested in losing the awesome and affordable coverage he has. Before I get to the latest video about who he’s going to vote for next year, let’s watch a video he put up seven months ago, explaining how Obamacare allowed him to retire at the age of fifty.

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Notice how he starts off by saying that, "In the Obama administration, the least [sic] you work, the more you get. Now I know it used to be you worked hard, you saved hard and you retired, but not anymore". But as he kept talking he says, "I’ve been pulling that wagon for thirty-one years. It’s my turn to ride in it, and I’m going to ride. I’m going to ride in that wagon, and I deserve it." This is a guy whose right wing programming is at odds with what he’s seen and lived.

To republicans, if you don’t work until you die, you’re lazy. I know I’m skipping ahead but let’s get into some of the replies he got to the video he posted last week. Some republicans weren’t happy with his considering voting his own self interest in 2016. One woman said, "Heaven fucking forbid you have to go back to work. Since when is retiring at age fifty acceptable?…..Get off your fat ass and go back to work…..You are what’s wrong with this country." This is my favorite part of the stupid twat’s email to him, "People who vote based on what’s best for them are fucked up people. You need to be thinking about what’s best for society as a whole and future generations, and our planet, and humanity as a whole." Yeah, she said that to justify voting republican. WOW! That just redefined the parameters of cognitive dissonance. Another guy writes James to call him a troll. He demands that James explain himself and the affliction that justifies his early retirement.

These people aren’t morally outraged that James is retired at the age of fifty. They’re enraged that they can’t. And the reason why they can’t, is because they’ve bought the whole line of right wing bullshit that keeps them slaves to the billionaires who bought their party. They have Stockholm Syndrome and they can’t allow anyone to suffer less than they expect to have to suffer. These are the same dumb dumbs who insist that welfare recipients should be subjected to drug testing. I post statistic after statistic about state after state, where testing welfare recipients has unearthed very little drug use while costing taxpayers a lot of money. I always get replies to those statistics, proclaiming that "if you’re on welfare, you should be drug tested". But I just showed you that doing that wasted a whole bunch of your taxpayer dollars for no good reason at all. But NO! People on welfare must be punished, and reason, logic, and fiscal responsibility are irrelevant! These people are not rational. They’re probably not even hateful by nature. But their struggles make it necessary to punch down at people who they need to be on the rung below them. Because if there’s nobody suffering beneath you, what does that make you in the grand scheme of society?

I always ask myself, as part of deciding where I land on an issue, "who are you advocating for?" If you want to humiliate poor people, even though it’s going to cost you money to do it, who are you advocating for? If you’re insisting that James’ lazy ass need to get a job right now, who are you advocating for? We see James himself do it at the beginning of the video I posted above, when he said that under Obama, people no longer need to work hard. He can’t even hear his own contradiction when he goes on to say that he’s put in thirty-one years of work, and deserves to enjoy his life. Here’s the difference between liberals and conservatives. Conservatives believe that they’re the worthy exception to the rule. Whether it’s taking food stamps, collecting unemployment insurance because of a layoff, or signing up for Obamacare; they earned it but everyone else is a moocher. Liberals believe that everyone who needs help should have it. The exceptions are the teenie, tiny ( I can post dozens of examples) few who abuse the system.  

Here’s a couple of other things about James that I noticed. He went from the military, straight into a government job where he became eligible to retire at the age of fifty. That dreaded big government he and his ilk hate, is who he worked for. And that dreaded government he worked for provided him with the pension that Ronald Reagan and the republican party don’t want anyone to have. That’s why they invented 401k’s. They weren’t funneling enough money to Wall Street, or enough company profits up to the top with pension plans so they concocted 401ks to steal (I urge you to watch that video) more from you. Everything that James has gotten for his hard work, is something that he’s voted against having. He says that he’s voted republican for thirty-two years.

And by the way, that finish line at age sixty-five wouldn’t exist at all, were it not for democrats. Republicans never wanted, and still don’t want you to have medicare or social security. They also don’t want for you to earn a living wage in exchange for working hard. Is anyone under the impression that cleaning office buildings is work for lazy people? Are they too lazy to work and too lazy to bootstrap themselves into college with that $7.25 an hour they wouldn’t even be earning if republicans had their way? Their whole fucking system is designed to keep you a lifelong wage slave. The only way you get anything in republican paradise, is to be born into it. If you’re not born into a family that can send you to college, you’re literally shit out of luck. You’re worse than shit out of luck, because they will treat you like a lazy piece of crap for not being able to get yourself to college on the crap wages they insist you should earn. I showed you in a post last week, that if you’re born poor in America, 70% of you will stay poor. Republicans like it that way. And poor republicans have been programmed to like it that way. That’s why they avail themselves of the opportunity to shit on someone else, every time they get a chance.

This post is already longer than I intended, so I’m going to wrap it up soon. The reason why James’ anecdotal Obamacare story matters, is because it runs contrary to his ideology. What he realized isn’t what he expected to realize. That just makes him more credible. Here’s the video where he talks about his struggle with his 2016 vote;

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And here’s a follow up he posted yesterday; 

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Notice how the second video lacked explanation? I wonder if that’s because it’s just an inexplicable decision? I believe that James will ultimately vote his own self interest because once the thinking starts, the programming really can’t reassert itself. I don’t know who the nominees are going to be, but I’m pretty sure that James won’t be voting republican.

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Sheriff Richard Mack

I don’t normally post about the situations of individual people because I just don’t find those stories very useful in understanding the big picture. I’ve always maintained that anecdotal stories are not evidence of anything other than what someone perceives they saw at a specific moment in time. More often than not, they’re completely fabricated bullshit, created to advance a narrative that can’t be advanced by using facts. That’s why I always insist on data.

I imagine that by now you intuit a story of an individual that I’m going to share with you in order to advance a narrative. You would be correct. There will, however be no hypocrisy on my part if you stick with me.

So there’s a retired sheriff in Arizona who has fallen on hard times. He and his wife both suffered some major medical issues within weeks of each other. At this point, you should be thinking, "Good thing they’re in Arizona, where the medicaid expansion component of Obamacare was embraced by the governor, resulting in a 4% drop in the rate of uninsured because affordable coverage is now available to Arizonans." Yes, being in a state that took the medicare expansion would be a good thing, if you weren’t opposed to Obamacare, and didn’t get yourself any insurance.

Here’s what the hero of my little story had to say about Obamacare;

The States can stop every bit of it! That’s right, the individual States can stop "Obamacare" and all other forms of out-of-control federal government mandates and "big brother" tactics. If Arizona, Hawaii, New Hamshire, Texas, etc. want nothing to do with National Healthcare as proposed by Barack Obama or Congress, then all they have to do is say "No!"

So now he’s a massive pile of medical debt that’s growing, and a long road to recovery ahead of him but thank god he didn’t let big brother force him into taking responsibility for himself!  So what do you do when you’re an irresponsible man in his 50s or 60s who didn’t think that insurance was a thing that you might need? Panhandle on the internet, of course! He set up a Go Fund Me page to beg people to donate to his irresponsible ass so that he can pay those medical bills he didn’t have to incur. He’s raised a little over 16k in almost five weeks. I’m pretty sure he’s nowhere near raising what he needs to pay for just his heart surgery, let alone the hospital stay and ongoing care that he needs.

We’ve seen this movie before with Ron Paul’s freedom loving campaign manager, Kent Snyder who was in exactly the same situation. He also tried to panhandle his medical bills away, subsequently leaving his mother with $400,000 in medical bills to deal with. So it seems like the panhandling thing doesn’t really work as well as insurance does.

This jackass former sheriff, like Ron Paul’s campaign manager has a higher profile than most people, and can therefore raise more money than the average middle aged couple can. The jackass sheriff is an oath keeper so he’s got a community of racist vigilantes he can tap, and an active member of the ammosexual community so he also has those whackadoodles to hit up. And all of that community activism probably hasn’t raised enough money to pay for just the medications that were administered to him in the hospital. To be fair, I don’t know that for sure, but I’m making an educated guess based on medical bills I’ve seen posted online.

So either his kids, who clearly won’t be going to college will be paying his and his wife’s medical bills for their entire lives, or everyone else in Arizona will be paying them. But yay FREEDOM! No jackbooted government thug told him he had to do the responsible thing by getting the affordable insurance they made available to him, and that’s what’s important here!

I did a quick search for plans in Arizona. I looked in Phoenix, which should be the highest priced area in the state. I put in a household income of $80,000 for a family of four (that would be 30k above the median household income, but I’m trying to get the highest premiums I can). I was trying to put in an income that didn’t qualify for a subsidy but apparently an income of 80k for a family of four still gets you a premium subsidy of $146.05 per month so we’re going to go with that. The cheapest plan is a bronze level HMO which costs $541 per month after the subsidy. So that’s $6,492 in annual premiums. This plan has a $10,000 annual deductible, with an annual out of pocket maximum of $13,200 (the maximum allowable by Obamacare). So had the jackass sheriff gotten himself some insurance, he and his wife would have been on the hook for a total of $19,692 for her medical issue and his heart surgery.

That’s enough about this irresponsible asshole. Let’s get back to what’s really important: me. I promised you that I wasn’t going to be a hypocrite by sharing the type of anecdotal story I always reject from others. This story demonstrates the foundation for how and why Obamacare works for all of us, and is therefore not anecdotal. It’s one of the actual data points used in the mathematical analysis upon which Obamacare is based.

The subsidies that some claim they’re paying for would total $1,753.00 per year for jackass sheriff. The lowest estimate I’ve ever seen for the premium surcharge on everyone with insurance, to cover the uninsured is about $400 per year, for an individual or $1,000 per year for a family. The smaller the number of uninsured becomes, the smaller that hidden tax placed on those with insurance gets. That’s where the savings are coming from, and that’s how it’s possible for you not to be paying for anyone else’s insurance coverage. Those surcharges cost more than the subsidies do.

This freedom loving asshole is going to foist a couple of hundreds of thousands of dollars worth of medical bills on every single insured person in the country. The good news for Moochy McFreedom is that he can still get insurance to cover future bills, since he can’t be denied insurance for his preexisting insurance. Thanks to Obamacare, even being an irresponsible dumbass won’t prevent you from obtaining health coverage.

I don’t know if this asshole has reflected on the error of his ways or not, but I wanted to share his story to serve as both a cautionary tale, but also to let you know that Obamacare is the best way we have at this point, to insure that you’re not paying for anyone else’s health insurance. Well, anyone other than Sheriff Richard Mack and his family of freedom loving deadbeats.  

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How A Lie Becomes A Sycophant’s Truth

Another GOP lie about Obamacare is about to be debunked on the record. Last week, house republicans released a "report" claiming that the percentage of people enrolled in an insurance plan through the ACA who actually paid was only 67%. This was 100% bullshit when at the time it was released. From the report;

Data provided to the committee by every insurance provider in the health care law’s Federally Facilitated Marketplace (FFM) shows that, as of April 15, 2014, only 67 percent of individuals and families that had selected a health plan in the federally facilitated marketplace had paid their first month’s premium and therefore completed the enrollment process. 

This would be total bullshit. They received no such data from any of the private insurance companies. Wanna know how I know? Because three giant insurance companies are going to testify at a congressional hearing today. Wellpoint says that 90% of their enrollees have paid their first months premium on time. Aetna reports that their payment rate is "low to mid-80 percent range". Health Care Service Corp., who runs Blue Cross Blue Shield plans in five states said that number is at least 83 percent.   

We’ve known that the percentage of people who paid their premiums was around 85% for about a month and a half now. We know this because the federal government and all of the states who run their own exchanges have reported roughly the same percentage. But republicans still claimed that no one had paid for their insurance, knowing that is was a lie, and that the lie would be exposed in one short week. But that’s okay, cause all they need to do now, is to stop talking about it, and let the lie just hang there for the midterms just like they’re doing with Benghazi.

This is how a lie becomes every sycophant’s truth;

  • repeat it in perpetuity
  • repeat the lie with impunity
  • ignore the truth completely

The republican lie machine will just keep repeating that there was a cover up in Benghazi, all the while ignoring the bipartisan senate intelligence committee’s report. They don’t care about the truth, and won’t ever acknowledge it when it comes out. Saxby freaking Chambliss, Tom Coburn, and Marco Rubio who are on that senate intelligence committee couldn’t even suggest that there was a fucking cover up. Yes, they blamed the State Department; "the Americans serving in Libya were vulnerable; the State Department knew they were vulnerable; and no one in the Administration really did anything about it". But they couldn’t come up with a cover up.

That’s not going to stop congressional republicans. There’s a midterm coming up, after all. So they’re going to keep telling you that Obamacare was a failure and caused four Americans to die in Libya, or some other total bullshit for the next six months because they know that the truth is irrelevant as long as they have a battalion of dedicated sycophants to parrot their crap. Truth be damned.     

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If You Like Your Health Insurance Plan, You Can Keep It

I’ve called this a lie with an asterisk in the past, and I still refer to it as a lie with an asterisk. Strictly speaking, it wasn’t a lie. It was a rosy statement designed to reassure and sell a plan, while leaving out a bunch of information that would have sounded like the last 20 seconds of a 30 second pharmaceutical ad. You know, the part that warns that increased suicidal thoughts and anal leakage are some of the fabulous side-effects that you can look forward to if you ask your doctor about this drug. Here’s what the absolute truth would have sounded like;

If you like your plan, you can keep it*

*except for the 17% of you in the single subscriber market that get a cancellation letter every year, because your insurance company chooses not to offer your plan anymore since they’ve found a new way to screw you

*and the additional 1% of you in the single subscriber market that will receive a cancellation letter this year, because your crap plan doesn’t meet the new federal minimum requirements for health insurance

*and those of you in the employer provided market whose plans change every year because your employer needs to find a new way to tamp down the rising costs

That wouldn’t have sounded as good, and would have been much wordier than "If you like your health insurance plan, you can keep it", but it would have been more accurate.

Every time someone would crow about the huge number of cancellation letters that people were getting because of Obamacare, I would ask, "how many more cancellation letters went out this year, versus prior years?" I wasn’t asking the question to be cute, or clever. I asked the question because without that information, there’s no point there. So if 10 million cancellation letters went out last December, the logical question that any critical thinker would ask themselves, is how many cancellation letters went out in previous years? Without that information, 10 million is a meaningless piece of data. Since I never ask a question I don’t know the answer to, I had already done the legwork of hunting this information down. The answer was that we didn’t know. Those numbers lie with each individual insurance company, and they never release those numbers. They historically don’t release those numbers, and they certainly didn’t release those numbers for last December. So even though I didn’t know the answer to my question, I knew two things; the answer was unknowable and the numbers that were being thrown out for last December were completely fabricated. I didn’t know the answer to my question, but I did know that the "information" being thrown around was meaningless, and that the point that was supposed to be made with that information wasn’t made. 

But now I have a pretty good idea of what the answer is. Health Affairs just released a very well sourced report wherein they took a very close look at the individual insurance marketplace and came up with historical data on insurance cancellations. Here’s what they found out; historically, only 17% of those in the individual health insurance marketplace stay on the individual marketplace for more than two years. Why? Because most people get single subscriber plans only when they don’t have access to a public or employer based plan. In other words, people turn to the single subscriber insurance marketplace temporarily while they’re in the gap between full time employment. What percentage of single subscribers actually got cancellation letters in December? 18.6%, or 2.6 million people. Nowhere near that 10 million number that the noncritical thinkers loved to throw around.

So what happens for those 2.6 million people? From the report:

While our sample size of those with non-group health insurance who report that their plan was cancelled due to ACA compliance is small (N=123), we estimate that over half of this population is likely to be eligible for coverage assistance, mostly through Marketplace subsidies. Consistent with these findings, other work by Urban Institute researchers estimated that slightly more than half of adults with pre-reform, nongroup coverage would be eligible for Marketplace subsidies or Medicaid.

So over half of those people will either qualify for free coverage through medicaid, or get subsidies under the medicaid expansion. In other words, over 1.3 million of those people will be better off this year, than they were last year. That leaves us with about a million people who are maybe getting screwed by Obamacare. Why do I say maybe? Because we don’t know what their premiums were, versus what their premiums look like on the exchange. But a bigger problem than we not knowing the premium differences, is that most of them don’t know. From the Urban Institute Study:

Yet making the best enrollment choice may be difficult for consumers. HRMS findings show that many people are not aware of the new state Marketplaces, few know whether their state is expanding Medicaid, and many lack the confidence to enroll, make choices, and pay their premiums.

In other words, the disinformation campaign is working. People don’t know their options, and are very likely paying more than they need to. I personally have found this to be true while helping some of my Facebook and G+ followers with their quest to find health insurance. Granted, I have two advantages in that I’ve been following the ACA and changes to the ACA very closely, and I’m an HR professional with nearly fifteen years of experience in designing corporate insurance plans.

Health insurance is complicated and annoying on a good day when you’re not being fed a bunch of crap about how you’re fucked, and there’s nothing you can do about it. It’s exponentially worse when you’re being used as a pawn in a political chess board to take down a president. The health insurance doomsday crowd is going well beyond not giving a flying fuck about you; they’re actively encouraging you to screw yourself so that they can be right about something they’re completely wrong about. It’s needless and sad, and you should spend as much time as you have to spend to root out the information you need to protect your own self interest.         

 

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We Won’t Be Calling It Obamacare By Next Summer

According to a Bloomberg article this morning, 100,000 people purchased insurance on the federal exchanges in November alone. That’s nearly 4x more than the nearly 27,000 who bought insurance on the federal exchanges in October.

127,000 enrollments nationwide may sound low, but it’s actually very promising for a number of reasons. First off, if you look at when people actually bought health insurance in Massachusetts when they rolled out their own Obamacare, you’ll realize that the lion’s share of enrollments will happen just before the deadline to buy. There’s no empirical reason to believe that the same thing won’t happen nationally.

Secondly, those 127,000 people represent enrollment in just the states who have governors that refused to help their constituents get affordable insurance. That number does not include people in NY, CA, KY, or the other twenty-three states who took the medicaid expansion and set up their own exchanges. California alone has enrolled 80,000 people, and Kentucky has enrolled about 50,000 people so that 127,000 federal enrollment number is already smaller than those of just two states who embraced the ACA. The number of people who have been able to purchase insurance as a result of the ACA is much higher than we’re currently aware of.

Thirdly, you need to look at the trend. A four time multiplier on the number of enrollments from one month to the next is much more telling than the overall number. This is especially true since we’re still four months away from the deadline to buy insurance.

But there is one factor that is more relevant to the success of the ACA than overall enrollment numbers; how many people under the age of 30 are signing up? We don’t yet know what that number is on the federal exchange. I don’t believe we’re going to know that number until March or April. But we do know what is happening in Kentucky. 41% of the people that bought insurance in Kentucky are under 31 years old. That’s a huge percentage that I never saw coming. I suspect (I don’t have the data on any other state yet) that the percentages will be similar in all of the states that elected to take the medicaid expansion, since Kentucky doesn’t have a substantively younger population than any of the other states. I also suspect that the national percentage of under 31s will be lower, absent the medicaid expansion. For the under 30 population in the expansion states, coverage is well under $100 a month. It will be around, or a little bit higher than $100 for those same people who live in states where their governors are trying to undermine Obamacare. It’s reasonable to expect that higher costs will equal lower enrollments. I would be shocked if that 41% were cut in half in the more expensive states. But if we assume that nationally, the under 30 percentage is 20%, we will definitely get the 2.9 million enrollments that we need to keep the current premium levels.

In other words, this reform is most assuredly going to work. None of the early indicators suggest otherwise to me. I must say that I’m pleasantly surprised at how well this is going. I was very skeptical was passed, but I’m always happy to be proven wrong by evidence

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It’s The Contractors, Stupid

Now that the government is open again, republicans are finally getting their opportunity to talk about something other than their cravenness and incompetence; the failure that is healthcare.gov. To be clear, the failure is limited to the website and in no way, shape or form extends to the ACA at large.

Let’s not kid ourselves, the launch of healthcare.gov was a monumental disaster. As an aside, the issues aren’t all emanating from just the federal site. Most of the state run sites were also poorly coded. We don’t have one giant federal failure, we have one giant federal failure and twenty some odd state failures.

Yes, the site was overwhelmed with traffic. But there were telltale error messages that are indicative of bad coding. There were sql errors, query errors, and javascript errors. These errors would not have been the result of overwhelming traffic. For those of you who don’t know much about software development (I’m not an expert, but I’m reasonably knowledgeable), the query errors and the sql errors indicate that there are issues with the back end and with the database. In other words, the bad coding goes all the way to the core. The javascript errors tell me the front end is also fucked up. These back end issues typically can’t be resolved in a few days, especially if the site isn’t taken completely offline while the code is reviewed. In other words, keeping the site live will prolong the repairs. Additionally, it’s much more difficult to find the errors in someone else’s code so fixing the problems is really challenging.

There doesn’t seem to have been much quality assurance testing done prior to launch. I literally can’t imagine that even a canned piece of QA software, didn’t pick up those query errors.

In discussing this disaster, everyone is missing the heart of the problem, which is the way in which government contracts are awarded. Our government doesn’t award contracts to a company that has a proven track record of successfully completing the type of task they’re being contracted to complete. Our government awards government contracts to companies that have a proven track record of securing government contracts. This ineptitude is often compounded by the practice of either awarding a contract to a crony, the biggest lobbyist, or someone’s nephew. The job almost never goes to the company most qualified to deliver the best result.

That’s what happened here. This is a case of an incompetent company getting a contract to do develop the ACA website. I haven’t been able to find out any details on who the contractor was, or the means by which this contract was awarded. I know there’s at least one journalist working on this, but the media is once again asleep at the wheel. We should be having a national conversation about the menace that are inept government contractors, and how they continue to be awarded for their incompetence with more government contracts. But thanks to the media, we’re once again missing the opportunity to have an important conversation.

Don’t get me wrong, I’m not absolving the administration from their responsibility in all of this. It is well within their power to award government contracts in a more effective way. They simply did nothing to fix the fucked up way in which we dole out federal tax dollars to contractors.

The Obama administration definitely failed here. But let me just say that it takes a special kind of stupid to conclude that the ACA is a failure on the basis of bad software coding. Making that conclusion really does take the kind of  simpleton that is beyond my comprehension.

That said, this situation isn’t a catastrophe since everyone has until March 31, 2014 to get health insurance before the $95 fine (you read that correctly, the fine is $95 or 1% of your annual salary) for not signing up is imposed. . The fact that they launched the site so far ahead of the deadline is a good thing. It’s inconceivable to me that these issues won’t be resolved before the December 14, 2013 deadline to sign up for coverage that is effective on January 1, 2014.

As we’re listening to the hyperbolic doomsdayers, let’s apply a little perspective to this situation. This fuck up didn’t kill anybody, unlike when KBR electrocuted  at least eighteen of our soldiers in Iraq. Personally, I would be delighted if delaying someone’s ability to find out how much money they were going to save on health insurance was the worst thing that an incompetent or greedy government contractor ever did.

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What About The Children?

Pew Research put out a report a couple of days ago that (you should have seen this coming, since it’s “research”) has some right wingers in a tizzy. The research, called Breadwinner Moms finds that women are now the primary or sole breadwinner in 40% of American households. I wasn’t even remotely shocked when I read this report because I fucking live in America. I have plenty of friends who earn more money than their husbands, or who are single moms. I do not live in a 1960s bubble where Mad Men is a reflection of the times, rather than a look back to days of old where the Fox News family seem to live.

Watch Lou Dobbs, Juan Williams, and Erick Erickson lose their shit over modernity;

 

[youtube]http://youtu.be/kORINpVUEtE[/youtube]

 

Let’s go through the batshit crazy in this video point by point.

Juan Williams (the “liberal”) makes the point that men have been harder hit by the recession than women. Why is that, Juan? Could it be that professions like construction work, coal mining, and other industries that are male dominated have taken the biggest beating in the past twenty years? Then he refers to “something going terribly wrong in American society, and it’s hurting our children”. Why, Juan? Why are the children affected by which parent the breadwinner is?

And then Lou Dobbs gratuitously mentions the number of abortions that have taken place since Roe v Wade, as if those children having been born would have resulted in fewer female breadwinners? What the fuck?

And then we get to the grand poobah of douchebaggery Erick Erickson, who absurdly claims that people who are fine with female breadwinners are “anti-science” because nature shows us that males are born to dominate. Hey asshat, have you ever heard the term “queen bee”? I won’t go through the list of species in which females dominate because you can Google that for yourselves, and because that’s not my point. My point is that it doesn’t get any more anti-science than making bogus claims about nature, just to bolster more bogus views. He goes on to ramble about “complementary” relationships between men and women, assuming that men and women can only complement each other as long as the male is dominant. Wow! How much Xanax does your wife have to take, just to get our of bed every day? Erickson then goes on to twist some of the data in the report. He claims that “3/4 of the people surveyed recognize that having moms as the primary breadwinner is bad for kids and bad for marriage”. What the report actually says is that 74% of adults say the increasing number of women working has made it harder for parents to raise children, and that 50% say that it has made marriages harder to succeed. I will get to Erickson’s monumental douchebaggery later. For now, I want to finish unpacking this video.

Juan Williams jumps in to add, “…it is tearing up minority communities even worse than white communities in this country”. I’m sorry, Juan I’m not getting your point here. Are you blaming minority women for being more careless with their families than white women? Do you think that maybe minority women need to work more because of the increased unemployment rate among minorities? Could that be the cause?

In my view, the feminist movement wasn’t about putting women in the workforce. It was about giving women the same options that men have. Unfortunately, right after the feminist movement got some serious traction, those options immediately became limited. Why? Because somewhere in the 80s, families could no longer make it on a single income. I believe that lots of women were forced to work because their husband’s salary was not sufficient to support the family, which is why Erick Erickson is a giant douchebag.

You can’t light your hair on fire over the increasing presence of women in the workforce, while supporting policies that bring wages down. You can’t be for busting unions and for stay-at-home moms. You can’t support Paul Ryan’s bill to eliminate overtime pay and expect those worker’s families to make it on a single income. In short, you can’t support GOP wage suppression policies while demanding that women stay home and raise the kids.

So apparently Erickson got enough shit for his comments, that he had to write a post to clarify his comments so that he would sound less misogynistic. Here’s what he said;

Prior to having kids, Christy and I both worked. Once we had our first child and I was making a full time go of RedState, Christy had to work if we were to have insurance. Frankly, we could not make ends meet on my salary alone and, even after the cost of day care, had to have the remainder of Christy’s salary to help make ends meet. We still struggled.

Hold on Erick, did you just make a case for health insurance reform? And did you just say that you lived my point about families not being able to make ends meet on a single income? I will never understand people who go through the difficulty of a situation and continue to advocate against remedies to those difficulties. This man is an asshole, who goes through life learning nothing. He goes on to say;

At one point I had to contemplate being a single dad, but thank God I did not have to be. When we made the decision that Christy would stay home with the kids…

I’m sorry, did you just liken your wife going to work every day with single fatherhood? Are you fucking kidding me with this shit?

And then he goes on to say;

What should be insulting to single moms is for society to tell them they can do it all and, in fact, will subsidize their doing it all. I know a number of wonderful, nurturing single mothers. They do as best they can. Most of them have wonderful children. But not one of them prefers to be a single mother.

Then why the fuck are they doing it, Erick? Could it be that financial pressures are a big factor in marriages falling apart? Do you think that Boeing opening a plant in South Carolina (a nonunion state) and paying those airline mechanics half of what they pay the union workers in Washington may be putting some pressure on the families? Asshole!

You can’t make a career out of beating up on workers and then beat them up for the consequences of those policies. Something has to give here. You can either have a society that implements the tools necessary for a single breadwinner household or you can embrace the effects of not doing so, but you can’t do both because that just makes you a bloviating asshole.

 

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Blinded By Your Own Douchiness

I’m talking about John Schnatter (even his name is douchy), CEO of Papa John’s (barely) Pizza, as well as Darden Restaurants Inc (who own Red Lobster, Olive Garden, and Longhorn Steak House) who have all said that they will be cutting their workers’ hours so that they don’t have to offer them health coverage, as mandated by ObamaCare.

Let me tell you the number of ways this is douchy. The most obvious, is that this is a PR nightmare. I believe that most Americans are good people, who want the people that prepare their food to be able to live a life that includes health insurance. I don’t believe that (with the exception of ideologues) most of us have a problem paying a few cents, or even a few dollars more for restaurant meals if that means providing health coverage to the employees that prepare and serve those meals. How do I know this? Because since 2008, restaurant patrons in San Francisco have been paying an extra 4% on each meal they consume, so that the restaurant workers in San Francisco have universal coverage. This 4% charge hasn’t made it any easier for me to get a table at The Slanted Door when I’m in town, so I’m guessing that San Franciscans aren’t eating at home because that 4% is overly burdensome. 

It’s also douchy because these announcements are clearly politically motivated. The announcements didn’t have to be made. They could have quietly implemented the WalMart model of two part time employees, rather than one full time employee in order to avoid providing any benefits at all. No, they want to make a last ditch effort to scare people into believing that ObamaCare is a bad thing.

But the douchiest part of this, is that it demonstrates how bad these people are at business. Remember what I told you about San Francisco and the added charge for health insurance? Well, a lot of restaurants in San Francisco have turned these surcharges into a profit center. They’re pocketing some, if not all of the money. Wayfair Tavern in downtown San Francisco collected almost $64,000 from it’s customers in 2010. They spent a little over $6,000 of it on health insurance for their employees. I’m not going to go into how they did this, since it’s not relevant to this post. You can click on the link in this paragraph to get more information on it. My point is that John Schnatter, who claims that providing insurance for his employees will cost consumers fifteen cents more per shitty pizza. If he weren’t so blinded by his own douchiness, he would have realized that quietly raising the prices by fifty cents for each inedible pie, would have increased his profits. This would have enabled him to buy another obnoxious castle, while treating his employees to doctor visits. It would have been a win/win, but he douchebagged himself into a lose/lose.

When people don’t have insurance, and can’t get full time hours, they leave as soon as they can so you create a fast-spinning revolving door of employees. As an HR professional, I can tell you that it costs significantly less to keep an employee happy than it does to replace them. In the high tech arena, the cost of replacing an employee can range between 60 – 200% of that employees annual salary. I’m positive these percentages are much lower in fast food, but I’m also positive that it’s cheaper to garner some loyalty and slow the spinning of that revolving door. You have to pay to add an employee to your payroll system, and then you have to pay to remove them. You have to pay someone to perpetually interview new employees, and you have to pay someone else to process the new hire and termination paperwork.

This whole thing is douchy, and it’s bad business. So I say boycott, boycott, boycott! And to the idiots who say that this will cause layoffs, don’t you think I thought of that? You can take your business to Little Caesars, who have no plans to fuck their employees because they never wanted to treat them humanely in the first place.  An increase in business at Little Caesars means more hiring of employees who will get the benefits they need. Laid off Papa John’s employees can get a better job down the street.


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