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Paul Krugman suggests in his New York Times column today that continuing the expansion of Medicaid is the answer to the outlandish cost of health care in the United States. He’s wrong. Medicaid is a lifeline for the impoverished, but the program would have to be reformed to the point that it would no longer be recognizable as Medicaid to be satisfactory for most Americans.
The reason Krugman likes Medicaid is the program’s success at controlling costs. He says that of all the health care delivery systems in the country, Medicaid is the one most like those in Europe, which have much lower costs than ours. If that’s true, it’s only because most of the rest of our fragmented system is completely fucked up.
Among the primary aims of European systems is health care equity — providing everybody with the same access to high-quality health care regardless of income or station. Medicaid does not come close to doing that. Krugman says that care from Medicaid providers is good and that lack of access is greatly exaggerated. In my experience the former is sometimes true and the latter, never.
Continue reading Paul Krugman is wrong about Medicaid
I know that there are millions of Americans who are content with their health care coverage — they like their plan and, most importantly, they value their relationship with their doctor. They trust you. And that means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. (Applause.) If you like your health care plan, you’ll be able to keep your health care plan, period. (Applause.) No one will take it away, no matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works.”
— Barack Obama
I’ve seen a number of Obamacare supporters arguing that the President’s promises about keeping plans and doctors carried a silent qualifier to the effect of “if they’re compliant with the new regimen.” Somewhat less frequent but still common are remarks to the effect that people whose plans have been cancelled should have known better, or that they’re stupid to want to keep their crappy plans. Probably they should have known (although Obama supporters who are ordinarily incensed with people who don’t take the President at his word are now incensed with people who did). Maybe they are stupid. Regardless, we wouldn’t be having this discussion if the President hadn’t lied — and it was a lie — repeatedly. Supporters of the legislation thought that the illusion of choice was critical to the success of the effort. The promises were an epic bait-and-switch, rivalled only by the disappearance of the vaunted “public option.”
In the excerpt from Obama’s 2009 address to the American Medical Association, the line about keeping one’s health care plan, period, is, I suppose naturally, subordinate to the line about keeping one’s doctor, period. Can you spot the silent qualifier in that clause? Yeah, me neither. And with the furor over the cancelled plans on temporary hiatus, awaiting the verdict on the state of the federal exchange in nine days and the verdict of insurers and regulators on extending the plans, the problem of losing one’s doctor is about to take center stage.
Continue reading I drink because I’m worried, people; I don’t drink because I’m dry
“I think we probably underestimated the complexities of building out a website that needed to work the way it should,” [President Obama] told the annual meeting of the Wall Street Journal CEO Council.
The [security] experts said the site needed to be completely rebuilt to run more efficiently, making it easier to protect. They said HealthCare.gov runs on 500 million lines of code, or 25 times the size of Facebook, one of the world’s busiest sites.
One of the most important repairs remaining deals with the information pages that the system provides to insurers about coverage applicants. These so-called “834s” have been riddled with erroneous information and, despite weeks of repairs, they continue to spit out incorrect data.
The enrollment, to give you a general sense of what’s happening, for a health plan that might have to sign-up 100,000 people in order to get their share of the 7 million Obama administration’s national enrollment objective, has grown from perhaps 10-15 enrollments a day a few weeks ago to 40-50 a day now … Backroom error rates being committed by Healthcare.gov, when enrollment data are transmitted to the health plans, are still far too high to transition to high volume processing without serious customer service issues.
The last quote is from an insurance industry insider, so take that into account in whatever fashion you think appropriate. I was too lazy to google the security experts cited in the bit about that aspect of the site, but 500 million lines of code? Holy crap. Can that be true?
Continue reading I don’t find this stuff amusing anymore
Or something like that.
After greasing the skids for Wall Street’s economic vandalism as head of the New York Federal Reserve Bank and then opening the national vaults to banksters and brokers as US treasury chief, Timothy Geithner is making his Wall Street employment official. The man who once boasted of “foaming the runway” for banks with the frothy remnants of liquefied former homeowners has accepted a job supervising the mailroom at private-equity giant Warburg Pincus, where he hopes to work his way to the top after gaining experience in the industry while avoiding charges of cashing in on his government service.
Continue reading JPMorgan Chase goes for the (comedy) gold; crushed by guilt, former New York Fed chief and treasury secretary Tim Geithner retreats to a monastery
Referring, obviously, to congressional Democrats who wish to further reduce food stamp benefits and to cast a Nixon spell on the NSA, rendering all its predations lawful. The latter would be Senator Dianne Feinstein (D-NSA), who is expressing her outrage over the eavesdropping on allies by writing legislation that fully legitimates spying on citizens, and the former a host of other Democrats whose starting point in the negotiations about the SNAP program (food stamps) is a $4 billion cut on top of the $5 billion lost as the stimulus ends.
Continue reading Lickspittles, Poltroons and Slubberdegullions
The Obama administration has sprung a gusher. This is pretty remarkable. In the space of three days, we have learned (so far) that
The National Security Agency has been collecting complete call records on Verizon users (and probably all the other telcom customers as well) for perhaps seven years; The National Security Agency is . . . → Read More: Somebody is seriously pissed off about the Obama administration’s iteration of the national security state
Then-Senator and presidential candidate Barack Obama disappointed some of his liberal supporters when he voted in 2008 to immunize our country’s giant telecommunications firms from any consequences of cooperating with the Bush administration’s illegal warrantless wiretapping scheme. Now, he’s nominating a champion of that scheme to head the FBI.
James Comey, who served as . . . → Read More: James Comey, Obama’s candidate to head the FBI, approved illegal warrantless wiretapping and torture. Forward!
It’s an open secret, but still a secret, that the selection process isn’t entirely random. It’s random within the group from among whom the selections are made, but the group itself is selected.
People ask if selecting isn’t difficult, even traumatic, but it isn’t. Many of the selected are happy to be chosen, oohrah-ing . . . → Read More: Memorial day