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Posted at 1:13 PM ET, 12/27/2010

Liberal obtuseness on ObamaCare

By Jennifer Rubin

Jill Lawrence writing in Politics Daily personifies liberal cluelessness on the subject of ObamaCare:

The biggest mystery of 2010 may be Democrats' failure to explain and sell their landmark health law, and the public's sustained resistance to it despite the popularity of many of its components. Polls show strong support, for instance, for requirements that insurance companies sell policies to people with existing medical conditions and let parents keep children on their policies until they turn 26. Republicans are determined to repeal the whole law or at least block funding for various parts of it. The battles ahead give Democrats another chance to explain what they did and why, this time in their outside voices.

A mystery? Well, yes, the left can't fathom why people would be disenchanted with a bill that requires them to buy insurance whether they like it or not, that constitutes another weighty entitlement program, that is now acknowledged not to bend the cost curve downward and that is already causing employers to dump or change their employees' health-care coverage. But for those of us remotely in touch with the public zeitgeist, it's no mystery at all.

Moreover, the contention that the Democrats' problem is a communication one is a persistent fable that underscores just how sheltered the ObamaCare spinners remain from public antipathy toward a program that, among other things, is going to slash Medicare Advantage and impose a raft of mandates on new business. Obama graced us with hundreds of speeches and press conferences, and even a health-care forum. The more the voters heard the less they liked.

If ObamaCare's defenders are right, Democrats should welcome a series of probing and informative hearings by the new Congress. Let's find out, as soon-to-be former Speaker (ooh, that was fun typing "former") Nancy Pelosi put it, what's in there. If Lawrence is right, the voters will love what they hear. But somehow I'm thinking that won't be the case.

By Jennifer Rubin  | December 27, 2010; 1:13 PM ET
Categories:  Obamacare  
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Comments

GOOD JOB WITH HIRING THIS WIGNUT. AT LEAST NOW YOU WILL HAVE TO ADMIT THAT YOU HAVE SOLD YOUR SOUL TO THE WINGNUTS, AND NO LONGER CARE IF YOUR SO CALLED WRITERS ARE ONLY SNARKY IDIOTS

Posted by: marse1 | December 27, 2010 1:36 PM | Report abuse

Eliminating the Federal subsidies to Medicare Advantage plans should be one of the few elements of PPACA that fiscal conservatives keep. The failure to reform Medicare Part D (and instead adding the unfunded filling of the donut hole) and permanently fix physician reimbursement formulas are two priorities for PACCA reform, assuming the whole sausage can not be remade.

If the GOP has any sense, they will push for a national, borderless, health insurance market with portability, without all of the Federally mandated coverage requirements, and Medicaid funds as block grants to the states instead of yet another unfunded mandate.

McCain had the right direction for health insurance reform in 2008.

J-Ru is losing her capacity for independent thought and analysis on domestic issues since moving to WaPo. Perhaps due to over-exposure to Sargent's Plum Line?

Spouting worn out talking points is as counter-productive from conservatives as from liberals.

Posted by: K2K2 | December 27, 2010 1:59 PM | Report abuse

@marse1 | December 27, 2010 1:36 PM

You forgot the obligatory trail of exclamation points. If not for your ALL CAPS, it wouldn't be obvious how upset you are.

Posted by: HenriLeGrand | December 27, 2010 2:39 PM | Report abuse

K2K2 makes some very good points.

I wouldn't elminate Federal Subsidies to Medicare Advantage at all. Instead I would mandate a reform in the way that the "system" works.

As it is currently constituted, the HMO's decide to offer plans in a given area based on their assessment of the probability that they can provide the mandated care for less than the per capita amount offered by CMS.

That per capita amount is called Area Average Per Capital Cost. It is an actuarily derived number that is supposed to represent the amount Medicare pays for care. Clearly the HMO's can provide the same level care, and in most cases better care, for far less.

So ratchet down the AAPCC but keep the program in place. We'd save plenty of money, the Insurance companies would still be profitable and the seniors would retain a very popular Medicare option.

the national market idea is decent, but I struggle with in on Federalism grounds. To me the real issue with insurance is confronting the long term costs of chronic illness.

In the past folks with some diseases died early and so this wasn't an issue. Now we can sustain folks with a healthy and productive life for a long time. It ain't cheap though and the market that Obama confronted was driven by experience based rating systems which created a disincentive to enrolling the chronically ill.

I've given this some thought, since I work in the healthcare field and I'm married to a lady with a chronic illness. We need some fair way to ajudicate the existence of these diseases in a person (the disability system is irredeemably broken IMHO) and then perhaps a funded risk pool of some sort.

It is good to see some thought provoking and well written commentary from the "right" on this.

Thanks K2K2

Posted by: skipsailing28 | December 27, 2010 2:43 PM | Report abuse

Skipper/I've given this some thought, since I work in the healthcare field and I'm married to a lady with a chronic illness.

The Rightys/Tea Nuts don't care about your thoughts or your wife,and they certainly don't want to be made to pay for her health care in any manner/plan..If the insurance doesn't cover it,sell your house/assets and go bankrupt,if you need more,ask for charity,if that fails TS,they hope you have funeral insurance;sorry about sugarcoating this,but that's the deal.

Posted by: rcaruth | December 27, 2010 3:45 PM | Report abuse

The hearings will be highly entertaining ... especially when they corner Berwick and ask this academic pediatrician to explain his comments that life saving treatment performed on the elderly should be considered a form of " assault ". This from an elitist bean counter who has zero hands on experience treating critically ill patients. This is the problem when academic governmental theory runs into reality. Luckily we have the ability to illuminate such farcial elements now and none too soon. Paging Dr. Issa ............

Posted by: cunn9305 | December 27, 2010 4:17 PM | Report abuse

As for preexisting conditions, how long would insurance companies survive if they had to accept someone that had never held car insurance, totaled his car and then applied in order to have his car fully replaced by the insurance company? I know how lovely it sounds libbies to offer insurance to those with preexisting conditions but it will put private insurance companies under and the result will eventually be full government health care and rationing as there will be no insurance companies left. Economics 101. And how bout those death panels that were slipped in? Watch for that to be the big news over the next few days. I trust this administration just about as far as I can throw them.

Posted by: thebink | December 27, 2010 4:29 PM | Report abuse

There is something else missing from the list:

For many people, besides Sarah Palin, the notion of the government controlling what measures may and may not be available and admissible in matters life, health, and the abatement of pain is simply an intolerable nightmare.

ObamaCare is about strangulating and controlling first the health care market and ultimately putting everything, including everybody’s lives, under governmental control in the name of achieving *efficiencies.*

Get that? The idea of turning to the government to achieve(!) efficiencies(!!) for our own good(!) pegs the needle of BS meter.

Posted by: nvjma | December 27, 2010 4:34 PM | Report abuse

Perhaps if the government hadn't screwed up pretty much everything to date, and I'm talking both Democrats and Republicans, there would be more faith in their policies. People need to stop the cheerleading for Obama no matter what he does simply because he's Obama and a war has been created between the left and right in this country. An intentional war. Think about these policies that will affect every American and don't just cheer your team. This is about our future.

Posted by: thebink | December 27, 2010 4:47 PM | Report abuse

Hopefully the whole Obamacare mess will soon be repealed.

Posted by: oldno7 | December 27, 2010 5:09 PM | Report abuse

@rcaruth | December 27, 2010 3:45 PM
"I'm married to a lady with a chronic illness ... sorry about sugarcoating this,but that's the deal"
_________

Sorry about your wife's chronic illness, but I disagree with your interpretation of what "the deal" is.

There does exist what is referred to as "catastrophic" medical insurance. It is designed to protect you from the type of financial catastrophe that you seem to think is inevitable unless we have the kind of healthcare insurance you favor.

Posted by: HenriLeGrand | December 27, 2010 5:32 PM | Report abuse

So now a liberal refusal to consider right-wing stupidity is to be labeled "obtuseness"? I thought that the Post could not sink lower than the Will/Krauthammer/Gerson/Theissen Quadpartite Axis of Ignorance, but you are proving me wrong.

Posted by: jerryo2 | December 27, 2010 6:54 PM | Report abuse

The upcoming hearings on the innards of ObamaCare will give the American people the ability to find what exactly is in ObamaCare.

The bureaucrats from HHS including the Secretary KS on down with have explain to the American people what is in this bill ("you have too pass the bill in order too find out what's in the bill") and they will find out why the American people don't like it one bit.

This should make for great political theater this coming year..........

Posted by: montpied | December 27, 2010 7:14 PM | Report abuse

Really, how about we all find out what exactly is in the health care bill before it's fully judged. And how about we all try for a little empathy for a change.

Posted by: thebink | December 27, 2010 7:18 PM | Report abuse

I see the confusion for the conservative goobers. They confuse something being made available to something being mandatory.

Gay marriage. If and when it becomes legal, you don't have to marry someone of your sex. You do so only if you want to and the other person consents.

Abortion. If you are pregnant, and want to give birth, please go right ahead. No one is demanding that you abort.

Same with end-of-life counselling. If you are OK leaving it to Jesus how you cope with your death, that's just fine. But in case you want to know your options, consider your survivors in any sense, you may avail of this program.

And another thing: see a doctor for your oral sodomy fetish. Perhaps then you won't see every legislation or executive order as something being rammed/jammed/shoved down your throat.

By a black man.

Posted by: HumanSimpleton | December 27, 2010 7:37 PM | Report abuse

It's a little off topic, but I first want to observe how many leftists are offended by the very notion of someone with Rubin's views even being published in the Post. --it doesn't matter if they have to read her, it's as if an informal blockade had been broached.

Health care seems to be an ideal topic for the Left, since it allows them to present themselves as caring, and the right as uncaring (a distinction which they, further, seem to think answers all questions and objections)--apparently rcaruth has decided to play along with that. You would think that he, who has given some thought to economics, would consider that bankrupting the entire system won't prove very caring to anyone. The first part of the solution has to be encouraging everyone to get catastrophic insurance early in life--perhaps parents would buy it for their newborns, or even when they get pregnant or before; second, reining in the FDA and loosening licensing practices so that the market allows for much wider experimentation in new forms of care; and, third, accepting that with health care, as with everything else, there will be products and services that will be available to the rich first and will gradually afterwards become commonly available. I suspect that third part will be the most difficult for people to accept, but the fact that certain innovative cancer treatments will first be available to millionaires is no different from the way in which telephones, private homes, cars, etc., were first introduced to the American public. There is no other way--if the most expensive modes of health care are unaffordable for individuals, they are not thereby made more affordable by transfering the costs to the government, supported by the taxes of those very same individuals.

Posted by: adam62 | December 27, 2010 7:47 PM | Report abuse

So… anyone who disagrees with you is clueless. The terminology must be chosen to be perjorative (I wonder if you realize that Democrat Party is a specifically chosen insult). Hey, if singing to the choir is your thing, go for it.

BB

Posted by: FairlingtonBlade | December 27, 2010 8:10 PM | Report abuse

There does exist what is referred to as "catastrophic" medical insurance. It is designed to protect you from the type of financial catastrophe that you seem to think is inevitable unless we have the kind of healthcare insurance you favor.
Posted by: HenriLeGrand

There does exist what is referred to as "catastrophic" medical insurance.(Try to buy it with a pre-existing condition,so you better buy it at birth)) It is designed to protect you from the type of financial catastrophe(but it won't) that you seem to think is inevitable(for a % of the population) unless we have (some kind) of healthcare insurance.
Posted by: HenriLeGrand

Posted by: rcaruth | December 27, 2010 9:05 PM | Report abuse

Hey, I confess that I am one of those curious centrist with an independent streak who remains a registered Democrat despite my increasing horror at statist liberalism espoused by Nancy Pelosi and the apologetic foreign policy of the postmodern transnational Obama.

Insurance products are regulated at the state level - one of the reasons why AIG almost took down the economy.

Perhaps the compromise would be to re-create the NOT FOR PROFIT Blue Cross network for what we used to call Major Medical.

As for end of life costs? I really do wish there was a legal pill available for when my savings run out. Long story, but the wonder of American medicine has been a long series of bad mistakes by some of the best doctors in the New York metro area while I still had really excellent insurance coverage.

If the Dems really wanted to deal with health care, they should have started with the way medicine is "practiced", not forcing expansion of insurance coverage through deceptive legislation.

PACCA will not be repealed - the GOP should figure out how to reform it piece by piece. Otherwise the GOP will be looking a lot like a pile of Scrooges.

Posted by: K2K2 | December 27, 2010 9:09 PM | Report abuse

"There does exist what is referred to as "catastrophic" medical insurance.(Try to buy it with a pre-existing condition,so you better buy it at birth)) "

Yes, precisely--buying life long catastrophic insurance for newborns must become one of those things parents do automatically prior to the birth of their child. The more people who do, the sooner, and the more free the national market, the easier it will be for everyone to afford such insurance.

Posted by: adam62 | December 27, 2010 9:19 PM | Report abuse

Politically, Obamacare will be the gift that keeps on giving for Republicans. The more the public learns about it and sees its real-world consequences, the more they will hate it. Among its faults are a poorly drafted, unworkable and highly-intrusive regulatory scheme; an unaffordable new entitlement at a time of unavoidable fiscal belt-tightening; and its destruction of the few remaining free market features of the health care system.

The present 54-43 unfavorable/favorable split among voters will probably worsen as more people are adversely affected. The Republicans need to de-fund it as much as possible, fight it in the courts, and make its total repeal the top issue in the next elections. Obama's radical big government agenda and its damage to the economy may be to the Republicans what Hoover and the Great Depression were to a generation or two of Democrats -- a game changer. Disastrous policies can discredit a party for decades.

Posted by: eoniii | December 27, 2010 9:42 PM | Report abuse

Yes, precisely--buying life long catastrophic insurance for newborns must become one of those things parents do automatically prior to the birth of their child. The more people who do, the sooner, and the more free the national market, the easier it will be for everyone to afford such insurance.
Posted by: adam62

Adam,Try to sell this c--p on a commission* basis,and I guarantee that you and your family will not have enough income to survive.
*Insurance is sold that way. The objection that having to pay for this from birth with the perception that a catastrophe is never going to happen to my child,makes this a miserable sales prospect. The only way this would work is if it's mamdatory.

Posted by: rcaruth | December 27, 2010 9:45 PM | Report abuse

"Gay marriage. If and when it becomes legal, you don't have to marry someone of your sex. You do so only if you want to and the other person consents.

Abortion. If you are pregnant, and want to give birth, please go right ahead. No one is demanding that you abort.

Same with end-of-life counselling. If you are OK leaving it to Jesus how you cope with your death, that's just fine. But in case you want to know your options, consider your survivors in any sense, you may avail of this program."

HumanSimpleton, Let me ask you a few questions. Regarding gay marriage, why can't gay couples simply have a ceremony with a priest or JP of their choosing and declare themselves married? Why do they need to have state sanction? There are many reasons a conservative may oppose gay marriage, but the primary one is, in my opinion, that marriage is a cherished institution and to make it more than a man and a woman will "water down" that cherished institution. I bet most conservatives are perfectly fine with civil unions.

Regarding abortion, conservatives view the unborn as helpless humans that are unable to defend themselves, and therefore need someone to defend them. I'm sure you wouldn't support 3 year old children getting killed by adults. Morally speaking, there is little to no difference to many conservatives.

As for end of life counseling, the fear for conservatives is that it's a first step to end of life encouragement. Which in then might lead to legalized euthanasia. And that in turn may lead to societal moral decline and disrespect for life.

The scenarios you posit have more to them than just those immediate scenarios. That is why conservatives oppose these things.

Posted by: RitchieEmmons | December 27, 2010 10:14 PM | Report abuse

RE/ I'm sure you wouldn't support 3 year old children getting killed by adults.

Except for collateral damage in war.

Posted by: rcaruth | December 27, 2010 10:18 PM | Report abuse

RE/Regarding abortion, conservatives view the unborn as helpless humans that are unable to defend themselves, and therefore need someone to defend them

Ritchie,seriously,where a husband takes his wife when she's having serious medical problems with her pregnancy,tells us a lot about that husband. Does he take her to a Jewish Hospital or a Catholic Hospital? He goes to the former if he wants to retain his wife,and try for another child,but if he wants a kid,and maybe a new wife,head for St. Anthony's.

Posted by: rcaruth | December 27, 2010 10:40 PM | Report abuse

rcaruth | December 27, 2010 9:05 PM
"Try to buy it with a pre-existing condition,so you better buy it at birth"
______________

Insurance is available for protection against POTENTIAL risk (less than 100%). Nobody can offer insurance for risk that is 100% CERTAIN. You can't buy life insurance for someone who is already dead. If you want to be insured against the risk of a calamity, you have to buy it before the calamity occurs.

What part of this concept don't you understand? We are not discussing the issues you or any salesman may have selling the concept. We are discussing strategies to manage risk, including transferring some of the risk to another party for a fee.

Nobody is willing to accept your risk for any fee if that risk is 100%. If not everyone is willing to buy insurance, the fee for those who are willing will be higher. Those who don't buy the insurance don't get to transfer their risk to another party and they have to deal with the consequences. This is known as free choice to live your life as you wish to live it.

What part of freedom of choice don't you understand?

Posted by: HenriLeGrand | December 27, 2010 11:37 PM | Report abuse

Obama was only concerned about his place in History with this health-care fiasco. He didn't want to be remembered only as the "token" black president, so he needed this to be enacted so he'd be remembered for something besides the color of his skin. He's had his 15 minutes - Now we need Hillary to step in!

Posted by: kenalexruss | December 27, 2010 11:38 PM | Report abuse

"Adam,Try to sell this c--p on a commission* basis,and I guarantee that you and your family will not have enough income to survive.
*Insurance is sold that way. The objection that having to pay for this from birth with the perception that a catastrophe is never going to happen to my child,makes this a miserable sales prospect. The only way this would work is if it's mamdatory."

People got into the habit of buying life insurance, usually soon after they got married; most of us have gotten into the habit of setting up special savings accounts for retirement, for our children's higher education, and all these things must be done decades before they are needed. The kind of pre-birth catastrophic insurance I am suggesting would be no different--just another sign of a mature society, in which people voluntarily join in various private, mediated forms of reciprocity to manage risk. And if they knew that this would be the only way they could guarantee health care in the case of unexpected costs, a lot more would do it--just as companies that knew they wouldn't get bailed out by the government would be a lot more careful in the risks they took. I don't deny that those who didn't would pose a problem, but I think that would be a "better" problems than the ones we generate now out of our latest attempt to have the government solve the problems caused by the government's previous attempt to solve a problem...

Posted by: adam62 | December 27, 2010 11:53 PM | Report abuse

What part of freedom of choice don't you understand?
Posted by: HenriLeGrand

That it exists at all.

Posted by: rcaruth | December 28, 2010 12:35 AM | Report abuse

Henri/What part of this concept don't you understand? We are not discussing the issues you or any salesman may have selling the concept.

Please do me a favor and give me an example of a sucessful "catastrophic" insurance program that has ever been offered. There may be one,I'm not aware of any.
http://www.google.com/search?hl=en&source=hp&biw=1020&bih=534&q=catastrophic+health+insurance+plans&aq=1&aqi=g10&aql=&oq=catastrophic+health+insurance&gs_rfai=

Posted by: rcaruth | December 28, 2010 12:42 AM | Report abuse


I dont feel like i should be forced to have health insurance, I think everyone would like to have health insurance if they could afford it. If you need affordable health insurance search online "Wise Health Insurance" you dont want to be with out insurance any time.

Posted by: kathrynmuniz | December 28, 2010 1:33 AM | Report abuse

So, Jennifer Rubin must be in favor of single payer, universal health care, which would "bend the cost curve down" and improve health care outcome and cost. Oh, right, deregulating our health care insurance friends will achieve these objectives. Spend a day with me as I navigate HealthKafka to try to get the free market giants to pony up what they promised.

Posted by: newsraptor | December 28, 2010 2:20 AM | Report abuse

There are now folks receiving healthcare in the high risk pools of "Obamacare" & are glad to have it. Will they be consulted too or just left for dead in typical Repub style??

Posted by: carolerae48 | December 28, 2010 4:13 AM | Report abuse

It is true the Obama healthcare bill is terrible. It was thrown together at the insistence of Obama, who contributed nothing. He claims this is a landmark healthcare bill. Unfortunately it does nothing about controlling costs which is the biggest issue in healthcare. In fact the bill has no way to pay for itself.
We cannot afford healthcare, public or private, as we know it. We have to make changes. We have to put healthcare in the budget along with everything else. Healthcare's soaring costs are gobbling up too much of the GNP and destroying our ability to compete in the global market where other countries have variations on a single payer model, and is preventing job creation here in the US.

The Republicans need to replace Obama's bill with a better one which will control costs while covering everyone.

The public needs to realize that we either control our healthcare costs, or the bond market will.

Posted by: jsands2 | December 28, 2010 7:23 AM | Report abuse

1. The cost of Medicare has risen at a much slower rate in the last 20 years than the cost of private health insurance. In fact if private insurance had risen at the same rate as Medicare, our premiums would be a THIRD lower.

2. All other industrialized countries have some form of universal government run health care. They get better care as measured by all 16 of the bottom line public health statistics, and they do it at half the cost per person. If our system were as efficient, we would save about $1.3 TRILLION each year.

3. Why can't hetero couples simply have a ceremony with a priest or JP of their choosing and declare themselves married?

Posted by: lensch | December 28, 2010 7:35 AM | Report abuse

Posted by: lensch

Even if all three of your points are true,and they likely are,Jennifer and her kool aid buddies donh't care about the accuracy of your three points. They are all about principle,and their ethics prohibit the distribution of their own hard earned money to be spent on some other persons health.
I share with FDR,the opinion that Healthcare is a Right,based on the idea that the Life part of Life,Liberty,Pursuit Happiness is hollow without access to Healthcare as a Right.

Posted by: rcaruth | December 28, 2010 9:52 AM | Report abuse

"RE/ I'm sure you wouldn't support 3 year old children getting killed by adults.

Except for collateral damage in war.

Posted by: rcaruth | December 27, 2010 10:18 PM"

You got me there rcaruth. Preferably I'd like to see anyone aged 1-10 killed as collateral damage in a war, but if 3 yr olds are the best I can get, I suppose I'll just have to settle.

"Ritchie,seriously,where a husband takes his wife when she's having serious medical problems with her pregnancy,tells us a lot about that husband. Does he take her to a Jewish Hospital or a Catholic Hospital? He goes to the former if he wants to retain his wife,and try for another child,but if he wants a kid,and maybe a new wife,head for St. Anthony's.

Posted by: rcaruth | December 27, 2010 10:40 PM"

This is a non-sequitur. Why are you talking about the traits of particular husbands here? If a woman is going to get an abortion, she doesn't need her husband to take her to the clinic/hospital. She can go on her own, have some other family member or friend take her, or call an ambulance if it's that serious.

And before you cement your view that I'm some knuckle dragging neocon who opposes abortion in every conceivable situation, I will let you know that I'm pro-choice.

Posted by: RitchieEmmons | December 28, 2010 10:13 AM | Report abuse

This is a non-sequitur. Why are you talking about the traits of particular husbands here? If a woman is going to get an abortion, she doesn't need her husband to take her to the clinic/hospital. She can go on her own, have some other family member or friend take her, or call an ambulance if it's that serious.
And before you cement your view that I'm some knuckle dragging neocon who opposes abortion in every conceivable situation, I will let you know that I'm pro-choice.
Posted by: RitchieEmmons

Easy RE,it was late,just joking around with an ancient adversary from Contentions days. Good to see your name. RCAR

Posted by: rcaruth | December 28, 2010 10:18 AM | Report abuse

You too RCAR.

Posted by: RitchieEmmons | December 28, 2010 10:28 AM | Report abuse

@rcaruth | December 28, 2010 12:35 AM

You have a chronic illness, too:

http://www.youtube.com/watch?v=0gxKStPXyn8

Unfortunately, yours can't be fixed.

Posted by: HenriLeGrand | December 28, 2010 11:45 AM | Report abuse

Actually Jen, the fact that public opinion hasn't really budged since ObamaCare was enacted illustrates the disengagement of the electorate and the difficulty in repealing the thing. You rightly point out just some items in the fairly steady stream of revelations which have and will continue to thoroughly eviscerate most of the premises and arguments of the bill's supporters and ti validate virtually all the premises of the its critics and yet it retains stubborn support and we have many reason to doubt the existence of the needed Republican resolve to pursue repeal (which will in any case require the election of a new POTUS and at least 10 R Senators in the next cycle.

Posted by: cavalier4 | December 28, 2010 10:55 PM | Report abuse

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