Still a Big Biden Deal

The ACA turns five today, and it is still a big Biden deal.  The uninsurance rate has cratered, the growth rate of medical costs are now down to the level of general economic growth, and quality in the system is improving as Medicare has successfully begun to attach penalties for being ineffective.  These are all BBDs.

Right now, HHS estimates roughly 16.4 million more people have health insurance today than they did on on 3/23/2010.  This is an undercount as it neglects trend changes.  Before PPACA was signed, the trend was for more people to become uninsured every year.  If PPACa was not passed, we’re probably looking at 18 to 20 million more people without health insurance in that counterfactual universe compared to ours.

Is PPACA perfect? Hell no.  Is it a whole lot better than the pre-exisiting condition?  Hell yes.  Is it vastly superior to the Republican alternative of nothing but high income tax credits and race to the bottom deregulation, hell yes.

So our job is to understand why PPACA matters, defend it from the neo-feudalists and reactionaries, and figure out how to make it better.  But is still is a  Big Biden Deal.

126 replies
  1. 1
    Baud says:

    From prior thread

    The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions.

    Vox has an article about how Dems have list the PR battle on Obamacare. So there’s that.

  2. 2
    Wag says:

    This.

    One thousand times, this.

  3. 3
    JPL says:

    I just happen to have my BFD t-shirt on!

  4. 4
    Matt McIrvin says:

    @Baud: Obamacare is giving the poors diabetes!!!!

    I’ve had to defend the ACA from at least one liberal who insists that Obama should never have pushed it in the first place, gives it as an example of his egotistical arrogance, and says a better health-care deal would have come along in “a few years” from some other administration. They point to King v. Burwell as the crack of doom and imagine that this somehow wouldn’t have happened if it had been done later.

    I want to know when “a few years” is. For one thing, without the ACA, health-care spending would have continued to explode an a greater rate, probably causing an “entitlements crisis” over Medicare/Medicaid before the next time they could have gotten health-care reform done.

  5. 5
    Lurking Canadian says:

    Wow, what a colossal failure! No wonder the people are clamouring for Paul Ryan (R-Galt’s Gulch) to save them from the scourge!

  6. 6
    Baud says:

    @Matt McIrvin:

    Balloon Juice aside, there are too many shitty liberals for us to collectively be successful in politics.

  7. 7
    Snarki, child of Loki says:

    @Matt McIrvin: Well, the alternative has always been “The NRA Plan”:

    Just keep on without coverage until you get that terminal diagnosis, then load up on ammo and insanely powerful firearms and use a bunch of GOPers to pave your way on a short sprint into Valhalla.

  8. 8
    Iowa Old Lady says:

    @Matt McIrvin: Anyone who says “wait a few years” must have had health insurance already.

  9. 9
    Germy Shoemangler says:

    @Matt McIrvin: I just want the health plan that Paul Ryan and Ted Cruz enjoys.

  10. 10
    Germy Shoemangler says:

    @Iowa Old Lady: Yes, because if they stub their toe kicking the can down the road, they can afford to have it looked at.

  11. 11
    thehalfrican says:

    b-b-but……no public option means its evil, right?

  12. 12
  13. 13
    blueskies says:

    Did anyone catch that article in the Atlanta Journal-Constitution over the weekend that tried to paint the Arkansas solution as somehow being a “private” plan? As near as I can tell, they expanded Medicaid, a GOVERNMENT program, but layered in private insurance companies. It’s still Obamacare, but less efficient and more expensive. But hey, at least they are doing better than all the other southern states.

    BTW, that article was a real piece of work. The author could just not get herself to call a duck a duck. It seems to me that if the program exists because of Obamacare, was written in as one of many options of Obamacare, THEN IT IS OBAMACARE.

    This is how Republicans will claim victory on healthcare insurance reform, btw.

  14. 14
    ThresherK says:

    @Matt McIrvin: Isn’t that Coca-Cola’s job?

  15. 15
    Richard Mayhew says:

    @blueskies: Arkansas is truly odd in how they did their Medicaid expansion.

    In most states, Medicaid is managed in one of two ways.

    1) State run where the state pays the claims itself (or hires a subcontractor to do it) and the state bears the full risk of things going pear shaped.

    2) Medicaid Managed Care MCOS where the state pays private companies a head charge and tells the companies to take care of the Medicaid population. Most states do this now as the private companies bear some of the risk of things going pear shaped/Solvadi being introduced.

    Both models count on provider payment rates to be significantly below Medicare payment rates to make the books balance.

    Arkansas went from #1 to #2 when they expanded Medicaid for their Legacy/Traditional Medicaid population. BUT for their expansion population, they went to Door #3, and gave everyone a voucher to shop on the Exchange. There the providers are getting paid above Medicare rates.

    Most of the excess money is not sticking with the insurers, it is passing through the insurers and going to the providers.

  16. 16
    Richard Mayhew says:

    of course

  17. 17
    Cervantes says:

    @Matt McIrvin, paraphrasing:

    Obama should never have pushed it in the first place, gives it as an example of his egotistical arrogance, and says a better health-care deal would have come along in “a few years” from some other administration.

    Curious to know what this person did to advance the cause between, say, 1993 and 2010.

  18. 18
    OzarkHillbilly says:

    @Matt McIrvin:

    I want to know when “a few years” is.

    My napkin math says 17 years.

  19. 19
    blueskies says:

    @Richard Mayhew: Thanks for the explanation. Maybe the AJC should keep you on retainer to ‘splain this to them. I certainly didn’t divine it from their article.

  20. 20
    OzarkHillbilly says:

    @Cervantes: Drats! Beat me to it.

  21. 21
    blueskies says:

    @blueskies: Actually, now that I’ve re-re-read your explanation, it seems like door #3 involves private insurers even less than door #2. Is so?

  22. 22
    Germy Shoemangler says:

    I saw this headline about Ted Cruz:

    BREAKING: Disturbed Man Tries to Get Into White House

    Twitter has “Ted Cruz Campaign Slogans”

    https://twitter.com/search?q=%23TedCruzCampaignSlogans&src=typd

    “The only thing we have to fear is this list of things you can find on my campaign website”

  23. 23
    Richard Mayhew says:

    @blueskies: Both Door #2 and Door #3 are 100% private insurer involved, the big difference is how much each door costs. Door #2 is cheaper.

  24. 24
    blueskies says:

    @Richard Mayhew: Thanks. So it seems that the BEST a southern state with a Republican governor and legislature is doing is to find a more expensive way to do what others are doing.

    Sounds about right.

    Of course, the other southern states are letting their people die just so they can say that they did their part to kill Obamacare, so Yeah for Arkansas!

  25. 25
    jonas says:

    Richard, what’s your take on how the accessibility issue has played out? One of the few criticisms of the ACA that wasn’t of the form “aaagh soshulized medicine will destroy us all!!1!” variety was that all the insurance in the world does you little good if there aren’t any doctors that take it. This was particularly the case with Medicaid expansion. Medicaid pays providers so little, that few physicians accept it.

  26. 26
    Dupe70 says:

    @Matt McIrvin: I believe Ted Kennedy thought/said the same thing in the early 70s when Nixon offered a deal on universal care. Perhaps the aphorism: “a bird in hand is worth two in the bush” might set them straight. Then again probably not.

  27. 27
    Gene108 says:

    @blueskies:

    A lot of providers do not accept Medicaid, since the rates are below private rates.

    Having private insurance plans may increase the available pool of providers for Medicaid recipients.

  28. 28
    blueskies says:

    @Gene108: Thanks for the additional education. I don’t know much about any of this (pretty obvious, I know). My default is to expect the worst of the Rs and of the AJC reporting, which has been trending more and more conservative for years.

  29. 29
    Zinsky says:

    Obamacare = Romneycare. There is no difference. It’s a Republican idea, so it’s no surprise that it is f*cked up!

  30. 30
    rikyrah says:

    yes, it’s a big deal.

    Happy Birthday, Obamacare!

  31. 31
    Germy Shoemangler says:

    Okay, I misspoke about the health plan Ted Cruz enjoys. I just assumed it was through his government job.

    From the NYTIMES:

    Senator Richard J. Durbin of Illinois, the Senate’s No. 2 Democrat, tried to push Mr. Cruz into admitting that he was on his wife’s blue-chip Goldman health plan — a sign of hypocrisy, he implied. And then Mrs. Cruz’s boss, Goldman’s chief executive, Lloyd C. Blankfein, turned up at the White House to urge against a devastating debt default, one of the issues with which Mr. Cruz had become closely associated.

    “I have to say, honestly, I’m not involved with any of those issues at our firm,” Mrs. Cruz said. And if her husband was evasive about where he got his health coverage, Mrs. Cruz was blunt.

    “Ted is on my health care plan,” said Mrs. Cruz, who has worked in Goldman’s investment management division for eight years.

    Catherine Frazier, a spokeswoman for the senator, confirmed the coverage, which Goldman said was worth at least $20,000 a year. “The senator is on his wife’s plan, which comes at no cost to the taxpayer and reflects a personal decision about what works best for their family,” she said.

  32. 32
    Matt McIrvin says:

    @Germy Shoemangler: Well then! All Americans have to do is marry Goldman Sachs employees.

  33. 33
    Germy Shoemangler says:

    @Matt McIrvin: That reminds me of the Onion headline from a few years ago:

    McCain’s Economic Plan For Nation: ‘Everyone Marry A Beer Heiress’

  34. 34
    Matt McIrvin says:

    @Zinsky: There are differences, but more importantly, “Romneycare” was not a Republican idea; it was drafted by the Democratic-controlled legislature of Massachusetts, who had a veto-proof majority. Romney couldn’t have killed it if he wanted to.

    The ACA is imperfect largely because the majority that passed it included a fair number of centrist Democrats, some from conservative districts, who were constantly threatening to bolt if it went too far toward universal public health insurance. And because the process of passing it was marred by byzantine parliamentary maneuvering to get around the fact that the Republicans had made a 60-vote Senate majority the de facto threshold for passing legislation, through abuse of the filibuster. There’s this bizarre idea that Obama could have gotten anything he really wanted passed in 2009, but it’s not even remotely true.

  35. 35
    WaterGirl says:

    @Germy Shoemangler:

    “The senator is on his wife’s plan, which comes at no cost to the taxpayer and reflects a personal decision about what works best for their family,” she said.

    So Ted Cruz is in favor of the right to choose.

    Better make that “the right for him to choose”, everybody else, not so much.

  36. 36
    Face says:

    Obamacare just stripped Glorious Freedom of diabetics to live without feet or sight. We need SCOTUS to step in and restore every excessively glucose-laden-blood American’s right to die slowly and painfully while forever noshing on cronuts and Coke.

  37. 37
    jayackroyd says:

    And skeptics need to acknowledge that they were wrong. Like me. RIchard’s view that “pretty much anything comprehensive would be so much better than nothing that whatever we could get was a no brainer” has won the day. And credit Obama’s team for getting a lot of innovation and experimentation in under the radar.

  38. 38
    Hal says:

    @Iowa Old Lady:

    Anyone who says “wait a few years” must have had health insurance already.

    100% this.

  39. 39
    Violet says:

    Big fucking deal! I still have my BFD t-shirt. Maybe I should get it out and wear it in honor of this important date.

  40. 40
    EconWatcher says:

    @Matt McIrvin:

    Even with its flaws,it’s amazing that something this good came from that sausage-making factory.

    I know it was a complex piece of legislation to explain to Joe and Mary Sixpack, but I’m still left feeling more might have been done to sell it and bolster its popularity (and perhaps still could be done).

    I don’t think the Big Dog could have ever got it passed, because he would have triangulated himself into some kind of ridiculous half-measure in a futile attempt to get Olympia Snowe’s vote. (While Obama gets accused of that, I think he just did what he had to do for those needed 60 Senate votes.) But if it had been passed on the Big Dog’s watch, I think he might have been better at getting average people to understand and appreciate it.

  41. 41
    bemused says:

    @Matt McIrvin:

    “Liberals” like your acquaintance make me very tired. I’d like to know just how in the hell he or she imagined anything like ACA could possibly have happened if we had just “waited”.

    Last week I ran into a couple of acquaintances. One woman in her very early 60’s had been through a really rough medical event breaking both her knees badly in Nov. She is just now walking. She talked about the medical expenses and their high deductible. The other woman, 60, piped in “Obamacare” twice. I didn’t bother to engage her knowing she is from an area near me that is a hotbed of uber Republican/Libertarian types. It would have been a total waste of breath.

  42. 42
    boatboy_srq says:

    @Matt McIrvin: Indeed. The GOTea solution is for one spouse to be covered by private (employer-sponsored) health insurance. Oh, you’re not married? That’s too bad: better find find a spouse (and make sure it’s a cisgendered spouse because we don’t hold with that SSM cr#p). Oh, your employer / your spouse’s employer doesn’t offer health insurance? Better find a new employer. Oh, there aren’t jobs where you are? That’s too bad: better move to a better job market. Oh, you can’t afford to relocate? That’s too bad…

  43. 43
    Cervantes says:

    @Dupe70:

    I believe Ted Kennedy thought/said the same thing in the early 70s when Nixon offered a deal on universal care.

    Can you say more about this? What deal are you thinking of?

  44. 44
    Germy Shoemangler says:

    @boatboy_srq: Or in my oldest son’s case (he works for a corporation owned by one of the richest families in this country): “You’re only working thirty-five hours a week, so no health insurance for you.”

    This year he becomes too old to stay on our plan. He will have to shop the marketplace.

  45. 45
    elmo says:

    I’m incredibly sensitive to this issue, because my wife has a number of mysterious and painful neurological issues that would make her 100% uninsurable under the old system. She’s entirely disabled, so before I went to work for BIGCOMPANY that allowed her on my insurance, she was dependent on Medicaid (this was before teh ghey mawwiage). Because we’re a same-sex couple, the PWB didn’t inquire into my finances, which is a good thing because I make too much money. If they had imputed my income to her, and if I hadn’t gone to work for BIGCOMPANY, she would have been uninsurable, untreated, and likely wouldn’t have survived the gallbladder crisis she had in late 2013.

    People who want to take health insurance away from people like my wife are fucking evil. And most of them really do want to take it away from her on two counts: they don’t want us to be married, and then they don’t want her to be able to be insured either by private insurance or Medicaid.

    And I can’t even adequately describe how I feel about people like that – mostly because if I really did say what I feel, it would trip all kinds of law enforcement and NSA filters and John would have to ban me. I hate them.

  46. 46
    Yatsuno says:

    @bemused:

    I’d like to know just how in the hell he or she imagined anything like ACA could possibly have happened if we had just “waited”.

    We had been waiting since Theodore Roosevelt first proposed a national health insurance scheme in 1912. Yes the idea is THAT old in this country. Johnson came closest with Medicare, which was originally supposed to expand to cover everyone but Johnson knew he didn’t have the votes for that. So how much longer do we wait while people DIE?

  47. 47
    Cervantes says:

    @Yatsuno:

    Not only did LBJ not have the votes for it, there was also the small matter of money.

    (Cue Raven …)

  48. 48
  49. 49
    WaterGirl says:

    @Face:

    …while forever noshing on cronuts and Coke

    That’s kind of a jerky thing to say. Have you seen a photo of Shawn? Not everyone who is diabetic is obese or eats badly.

    And until you’re willing to say the same sort of thing about smokers, and all the people who live a sedentary lifestyle, and all the people who don’t drink enough water and end up with kidney failure…I will find your comment offensive.

    Not to mention that good food is not even affordable to many people who are poor.

  50. 50
    bemused says:

    @Yatsuno:

    Exactly. The “let’s just wait” liberals are wimps.

  51. 51
    gogol's wife says:

    @WaterGirl:

    He/she was snarking in the voice of a RWNJ.

  52. 52
    Cervantes says:

    @gogol’s wife:

    Or perhaps trying to.

    In any event, I don’t think I want to know what “cronuts” are.

  53. 53
    WaterGirl says:

    @gogol’s wife: Ah, I didn’t catch that.

    @Cervantes: cronuts are apparently the marriage of donuts and croissants. I can happily say that I have never had one.

    edit: sorry, I didn’t see until after I posted my comment that you didn’t want to know. or maybe that wasn’t meant to be taken literally, either? :-)

  54. 54

    @Matt McIrvin:

    I’ve had to defend the ACA from at least one liberal who insists that Obama should never have pushed it in the first place, gives it as an example of his egotistical arrogance, and says a better health-care deal would have come along in “a few years” from some other administration.

    Because that strategy worked so well for Hillarycare. Every time we put off a real opportunity for universal health care, it took a long time to get another chance, and the offer the next time was worse. Those who fail to learn from history are condemned to repeat it offer really shitty advice on the sincere belief that they know what they’re talking about.

  55. 55
    Cervantes says:

    @WaterGirl:

    Well, since you asked: “I don’t think I want to know” does not actually imply “I don’t know.”

    Anyhow, I do appreciate the intended kindness in your original comment, especially the reminder that “good food is not even affordable to many people who are poor.”

  56. 56
    Violet says:

    @WaterGirl: How’s the next door construction going?

    @Cervantes: So true. “Food deserts” are a real thing in poor areas.

  57. 57
    Amir Khalid says:

    @Cervantes:
    @WaterGirl:
    I tried a cronut once. It was shaped like a regular donut. It felt and tasted like a regular croissant. I assure you, you have missed out on absolutely nothing.

  58. 58
    Cervantes says:

    @Amir Khalid:

    Or on too much.

  59. 59
    The Moar You Know says:

    In any event, I don’t think I want to know what “cronuts” are.

    @Cervantes: Oh yes you do, very much so. Best food item on the planet. Croissant dough fried into a donut. You have not lived until you’ve had one.

    every excessively glucose-laden-blood American’s right to die slowly and painfully while forever noshing on cronuts and Coke.

    @Face: Bring it. If I were to ever have a last meal that’s pretty much what I’d want it to be.

  60. 60
    Cervantes says:

    @The Moar You Know:

    Alas, you will have a last meal. We all do.

  61. 61
    Iowa Old Lady says:

    When I think of how hard it was to pass the ACA, how long it took, how much negotiation had to happen, I can’t believe people say well some person with a magical touch could have gotten something so much better.

    Same thing when the Rs say they’ll just come up with a better plan. Then they produce a wish list. Where’s the legislative language? Where’s the actual work being done? Of course, in their case, they’re just lying. They’ve had 5 years and done nothing.

  62. 62
    boatboy_srq says:

    @bemused: There’s a lot of that running around. It’s difficult to be sympathetic in those circumstances, when people are bound and determined to do anything except sign up for a program that will help them because TABMITWH.

  63. 63

    @bemused:

    “Liberals” like your acquaintance make me very tired. I’d like to know just how in the hell he or she imagined anything like ACA could possibly have happened if we had just “waited”.

    It’s a variant on the old “worse is better” or “wait for the collapse” idea. The theory is that we can’t get a good deal because the situation isn’t completely critical. Only when the whole edifice collapses will we be able to push through the ideal solution. The idea of incremental improvement, or the need for immediate solutions for the people who are suffering today, never occurs to them.

  64. 64
    Punchy says:

    @WaterGirl: please adjust your Snark-O-meter, STAT.

  65. 65
    debbie says:

    @Amir Khalid:

    Ah, but have you enjoyed a $4 piece of toast in a toast-only restaurant?

  66. 66
    Cervantes says:

    @Amir Khalid:

    Off-topic, but from today’s NYT:

    Mourners shrugged off the darker side of Mr. Lee’s tenure, especially the relentless prosecutions of his political opponents. Yeo Siew Siang, 65, a former Singaporean Army colonel who said he remembered pigs roaming in a neighborhood now filled with cafes, addressed the criticism of the stifling of political dissent, saying, “You can’t make an omelet without breaking eggs.”

    François de Charette, take a bow. You, at least, were fighting the Reign of Terror.

  67. 67

    @Iowa Old Lady:

    Of course, in their case, they’re just lying. They’ve had 5 years and done nothing.

    It’s been a lot longer than that. They’ve had just as many decades as the Democrats to propose a plan for what to do about healthcare, but they’ve never done it voluntarily. They had control of both houses of Congress after the 1994 election, but they did nothing about healthcare. They had control of both houses and the presidency under W., and the only thing they came up with was the boondoggle giveaway to the drug companies. The only time they’ve ever talked about universal health care is when the Democrats brought the issue up and they felt a need to offer an alternative.

  68. 68
    Amir Khalid says:

    @Cervantes:
    Singaporeans are a well-trained people.

  69. 69
    SFAW says:

    All you bozos who are crapping on the junior Senator from the fucked-up great state of Texas should stop it! Apparently, he may be rethinking his staunch opposition to Obamacare.

    Don’t believe me? Go visit http://www.TedCruzforAmerica.com , you’ll see he’s changed.

  70. 70
    Elizabelle says:

    Ted Cruz selling his “Freedom through Fascism”. “It is a time for truth. It is a time for liberty. It is a time to reclaim the Constitution….. to reclaim the promise of America…..”

    He promises liberty from Obamacare and that pesky IRS. That Ted!

    He and the conservatives will restore that “shining city on a hill.”

    And that seems to be about the only use Ted and conservatives ever have for cities, and the people found in them.

  71. 71
  72. 72
    SFAW says:

    @Iowa Old Lady:

    They’ve had 5 years and done nothing.

    Well, getting to the bottom of Benghaziii!!!1!!2! takes a lot of time and effort, so cut them a little slack.

  73. 73
    catclub says:

    @Roger Moore:

    It’s a variant on the old “worse is better” or “wait for the collapse” idea. The theory is that we can’t get a good deal because the situation isn’t completely critical.

    Although I agree with you that getting the ACA when we did, was the best we could get, the example of 1932 is tempting. The depression had run 4 years and 1932 was the worst. THEN FDR came in with a huge mandate for dramatic change. If FDR had been elected in 1930, with 1932 still to come, he would probably not have gotten that huge mandate for change.

  74. 74
    dmsilev says:

    Completely OT, but apparently Ted Cruz’s team doesn’t quite fully understand this whole Intertubes thingy. Firstly, TedCruz.com is, shall we say, just a tad off-message. Also, via Vox, there’s this:

    For some reason, the SSL certificate for tedcruz.org lists nigerian-prince.com as another valid address for Cruz’s website.

    Secret liberal mole trying to make Ted Cruz look (more) ridiculous?

  75. 75
    SFAW says:

    @Elizabelle:

    “It is a time for truth, eh?”

    Fixed to reflect the country of his birth. Which reminds me: where’s the RWTM outrage for someone else born outside the US running for Preznit?

  76. 76
    catclub says:

    @Cervantes: Not in the sense of being told beforehand that this is your last meal.

    Similarly for the last time you pick up and carry your toddler. If you were told, you might do it again.

  77. 77
    SFAW says:

    @dmsilev:

    Check out the other one (see my link @69).

    Nigerian prince, eh? I think I’m seeing a link to Rafael NOT being Canadian born, but maybe African-born. Where’s the birth certificate, Rafael? Somebody alert Donald Trump!

  78. 78
    WaterGirl says:

    @Cervantes: Eat every meal as if it’s your last?

  79. 79
    Cervantes says:

    @dmsilev:

    Not so secret. It’s just a different Ted Cruz, a lawyer in Arizona who has owned tedcruz.com for a number of years. He is a Democrat and seems … unlikely to make an endorsement today.

  80. 80
    EconWatcher says:

    @Amir Khalid:

    Lee Kuan Yew is talked about a lot in Moscow as a model. But while Putin has certainly been able to imitate Lee’s authoriarianism (and then some), he doesn’t seem to have tried to replicate any of his more progressive tendencies….

  81. 81
    Tripod says:

    @jayackroyd:

    I appreciate the mea culpa. The rest of the netroots collectively shat the bed, and are still pretending that didn’t get noticed.

    Kudos to Tim F for posting links and spreading the word at Balloon Juice to contact congressional members while the rest of the netroots had thrown in the towel, or were blathering moronically on about killing the bill.

  82. 82
    Cervantes says:

    @WaterGirl:

    Good advice — for people over a certain age!

    (That is to say, I would not encumber kids with it.)

  83. 83
    SFAW says:

    @Roger Moore:

    Only when the whole edifice collapses will we be able to push through the ideal solution.

    Saint Ralph the Pure tried pushing that as a rationalization of Bush’s “victory.” He said things would get so bad, that a new wave of Liberalism would result, lasting for umpteen years.

    Prescient as always, Ralphie-boy.

  84. 84
    Cervantes says:

    @jayackroyd:

    And skeptics need to acknowledge that they were wrong. Like me.

    Yes, thank you.

  85. 85
    Cervantes says:

    @catclub:

    Sure, I agree.

  86. 86
    Matt McIrvin says:

    @catclub: And we got the New Deal, but we came disturbingly close to either a fascist or a Communist revolution. More likely the former, seems to me. It was the coming thing. Strongmen riding on a white horse are always appealing, and a lot of the powers that be in the US were fond of Hitler and may have appreciated someone taking him as a model.

  87. 87
    Brachiator says:

    @EconWatcher:

    I know it was a complex piece of legislation to explain to Joe and Mary Sixpack

    We are beyond this need to explain thing now. There are people who have health insurance who did not have it before, people who are getting medical care who did not seek treatment before. People don’t ask for an explanation of legislation when the thing itself, healthcare exists.

    If the Democrats have a brain, they can easily defend this. “You can go to the doctor now. The Republicans would take that away from you.” I have no idea why Democrats never made it clear that the Republicans have never had a plan to improve health care, but simply claimed that faith in Free Market Jesus would heal the sick and raise the dead.

    A more subtle issue is the fact that Republicans also deeply detest and want to repeal the ACA because it provides any reproductive services at all. The Dems need to hit this hard, especially with women.

    The Democrats’ vulnerable spot is the possibility of rising premiums, lack of actual access to doctors, and increased penalties on those who chose not to get health insurance.

    Meanwhile, progressives or whoever who continue to wail about “single payer” are like members of the Flat Earth Society. Cranks that no one cares about.

  88. 88
    EconWatcher says:

    @Matt McIrvin:

    There’s a decent argument that fascism originated in the US, rather than Europe, with the Ku Klux Klan. And we effectively had fascist control in a number of U.S. states (such as Indiana, where the Klan controlled state government for a while, as well as of course points farther south).

    It’s interesting to compare the rise of the Klan in the US with the rise of Nazism in Germany (prompted by humiliating defeat in war, combination street gang/political party, conflating communism with racial tolerance, etc. etc.)

  89. 89
    Matt McIrvin says:

    @Roger Moore: The big question is, if/when King v. Burwell starts an insurance death spiral in the states without their own exchanges, does the ACA get blamed or do the Republicans/SCOTUS? Obviously both forms of blame are going to happen, we know what Fox News is going to say, but which story gets traction at voting time in 2016?

    The leading line I hear from the right now seems to be that the law was always incoherent because liberals are too incompetent to pass a law that makes any sense (never mind the endless drama of Joe Lieberman, Olympia Snowe and Susan Collins, or the malevolent clown show that was Republican Congressional obstructionism even in 2009), so the Supreme Court has no choice but to slap it down, and Republicans have no choice but to toss out the whole unworkable mess in favor of whatever nothing they imagine being able to pass. So if you lose your Obamacare, it’s the fault of some Democrats who are now the minority party in Congress; better not put them back in charge. It’s a story that has potential to appeal to good-government process wonks and both-sides-do-it centrists.

  90. 90
    SFAW says:

    @Brachiator:

    A more subtle issue is the fact that Republicans also deeply detest and want to repeal the ACA because it provides any reproductive services at all. The Dems need to hit this hard, especially with women.

    Will that really have an effect on voting patterns? Maybe I haven’t been paying close-enough attention, but it seems like this point gets (relatively) ignored by too many women, because the Rethugs always find a scary hot-button issue to scream about, and the noise overwhelms the pro-choice choice, except for those women who wouldn’t vote Rethug anyway.

    Meanwhile, progressives or whoever who continue to wail about “single payer” are like members of the Flat Earth Society. Cranks that no one cares about.

    Am I correct in assuming that you’re commenting on the wailing, not on the idea that single-payer would be highly beneficial for almost everyone who needs healthcare?

  91. 91
    gelfling545 says:

    @Matt McIrvin: Why would it be less “egotistical & arrogant” from some other administration or in a few years? Ohhhhh…that’s why.

  92. 92
    jayackroyd says:

    @Tripod: We ARE a reality based community, aren’t we?

  93. 93
    WaterGirl says:

    @Violet: Well, it’s certainly been up and down multiple times and I’ve been up for less than 3 hours!

    I made myself wait to call my contact, Jeff, at the city until 8:30 (though I wanted to call at 8!) He said he thought they would be able to do it but that he was going to check with “Bev”. But he didn’t think they could be stopped from pouring the concrete AND he thought they could probably legally park there. Even though last year he said they couldn’t, and he confirmed that they couldn’t when we talked last week.

    He said he’s try to catch Bev before she left for a day of inspections. I asked if Bev could knock on my door when she was out to inspect. He said yes.

    Just now (90 minutes after talking to Jeff) Bev called me. She said they were supposed to have all the forms ready for her to inspect this morning and that she had come by at 7:30 and then again a few minutes ago. The contractors aren’t here but it’s was sprinkling a bit this morning and there’s a good chance of rain for today, so maybe that’s it.

    Anyway Bev talked to her boss and he said no, they cannot pour there. So she left a message with the contractor telling them they had not said anything to her about the work on the side yard when she was out last week and that no, you cannot pour there. So don’t do any further work on the side area unless it’s to restore it to its former state.

    BUT apparently there are different codes and the guy who can resolve the question once and for all is out sick today. But Bev said her boss told her no, so that’s what’s she’s sticking with for now.

    I also told Bev that on Sunday I had asked the contractor (and my neighbor) politely to please not doing anything that “can’t be undone” until this can be resolved with the city. I also told her they flat out said no, they would not wait.

    And I told her how the contractor had told me he is very tight with the inspectors and that they would let him do whatever he wanted to do. I don’t think she was very pleased to hear that.

    So I don’t think anything will happen today, but what will happen tomorrow is probably a crap shoot. But for not it’s a victory that they aren’t pouring today.

    On Sunday when he said “no, we won’t wait”, the contractor said there was no way they could do the driveway and the side jobs separately. So my guess is that they’ll either go ahead with the driveway and not do the side or the whole thing is going to have to wait.

    As I type, I can hear my neighbor loudly talking outside the house and he doesn’t sound happy, which could mean something. But it might not mean anything because he is always very loud.

    Fun times.

  94. 94
    catclub says:

    @EconWatcher:

    There’s a decent argument that fascism originated in the US, rather than Europe, with the Ku Klux Klan.

    An interesting comparison is the Sunni officers of the defeated Baath party in Iraq as similar to the ex-CSA officers Klan rebellion in the US.

  95. 95
    Hob says:

    @Cervantes: The fact that Nixon at one point supported a somewhat ACA-like bill, while Kennedy was pushing for a single-payer bill, has become in some people’s minds the story of a “deal” that Nixon offered and Kennedy haughtily rejected. (Hilariously, in one version of this story– favored by an acquaintance of mine who had an impressive collection of “Nixon was a liberal compared to Obama” rants, all of which were based on incredibly wrong history he vaguely remembered reading somewhere– it was Nixon who bravely proposed single-payer, only to be shot down by Kennedy.) Anyway, a couple years later Nixon and Kennedy had more or less converged on a bill that was closer to Nixon’s original proposal, but legislative squabbling and then Watergate got in the way. So I guess you could argue that if Kennedy (and Democrats in general) had gotten behind Nixon’s bill a couple years earlier, there would’ve been a better chance of passing something– but that’d be the kind of “deal” where you do exactly what the other guy wants and he uses none of your ideas in return.

  96. 96
    Violet says:

    @WaterGirl: Oh my goodness. Well, hang in there. Sounds like you’ve got a good handle on it and have the right people on it now. Telling the inspector that the contractor told you he was tight with the inspectors and could get them to do what he wanted….hahahahahahaha! Good move! I bet she didn’t like hearing that one bit. Hilarious.

  97. 97
    raven says:

    The Scene of the Crime
    A reporter’s journey to My Lai and the secrets of the past.

    BY SEYMOUR M. HERSH

    A couple of months later, at the height of widespread campus protests against the war—protests that included the killing of four students by National Guardsmen in Ohio—I went to Macalester College, in St. Paul, Minnesota, to give a speech against the war. Hubert Humphrey, who had been Lyndon Johnson’s loyal Vice-President, was now a professor of political science at the college. He had lost to Nixon, in the 1968 election, partly because he could not separate himself from L.B.J.’s Vietnam policy. After my speech, Humphrey asked to talk to me. “I’ve no problem with you, Mr. Hersh,” he said. “You were doing your job and you did it well. But, as for those kids who march around saying, ‘Hey, hey, L.B.J., how many kids did you kill today?’ ” Humphrey’s fleshy, round face reddened, and his voice grew louder with every phrase. “I say, ‘Fuck ’em, fuck ’em, fuck ’em.’ ”

    And fuck your fat ass and your boss.

  98. 98
    raven says:

    Declassified documents from McNamara’s years in the Pentagon reveal that McNamara repeatedly expressed skepticism about the war in his private reports to President Johnson. But he never articulated any doubt or pessimism in public. Craig McNamara told me that on his deathbed his father “said he felt that God had abandoned him.” The tragedy was not only his.

  99. 99
    WaterGirl says:

    @Violet: Actually, I think it’s better than that, or I am luckier than that. Because Bev is not the regular person, the regular guy is on vacation. I have a sneaking suspicion that the contractor may be tight with the regular guy, and maybe the regular guy would let him do whatever he wanted.

    But now it’s too late, Bev is involved, and her boss has weighed in. So they may get to do what they want in the end, but the good old boy situation may not be as likely to prevail even after the regular guy returns – since there has already been sunshine on this little situation.

    It is pouring rain right now and the neighbor is out there laying plastic over all the dirt. So one way or another, nothing will happen today.

  100. 100
    Ruckus says:

    @Cervantes:
    Sure, everyone has a last meal, but how many get to know it’s the last one ahead of time? That’s a lot smaller number.

  101. 101
    WereBear says:

    @WaterGirl: Good for you and stick with it. We had a problem with such “neighbors” on my in-law’s property. She got wimpy and now the illegal thing they did is still there, interfering with everyone’s access.

    Let them move somewhere else if they have to have certain things.

  102. 102
    Violet says:

    @WaterGirl: That is even better! Nothing like a little sunshine on a den of corruption to make the cockroaches flee.

  103. 103
    Brachiator says:

    @SFAW:

    Will that really have an effect on voting patterns?

    I’m not sure yet. The Democrats have been astoundingly ineffective in crafting what should be easy, simple replies to the Republicans. It amazes me, for example, that the Democrats never seemed able to echo and reinforce Obama’s challenges to the GOP. And some of the early signs indicate that Hillary will take the path of stupidity, and possible defeat, by running as the return of Bill and Hillary, and disavow any connection to the Obama administration.

    Am I correct in assuming that you’re commenting on the wailing, not on the idea that single-payer would be highly beneficial for almost everyone who needs healthcare?

    I don’t know that single payer is the best option, and it is definitely not the case that every advanced nation with universal health care funds it solely through single payer plans. And just having single payer does not address how you deal with issues of access to doctors and hospitals, hospital and drug costs, fraud and so on.

  104. 104
    muddy says:

    @WaterGirl:

    It is pouring rain

    Looks like the gods are on your side!

  105. 105
    Cervantes says:

    @Hob:

    The fact that Nixon at one point supported a somewhat ACA-like bill, while Kennedy was pushing for a single-payer bill, has become in some people’s minds the story of a “deal” that Nixon offered and Kennedy haughtily rejected. (Hilariously, in one version of this story– favored by an acquaintance of mine who had an impressive collection of “Nixon was a liberal compared to Obama” rants, all of which were based on incredibly wrong history he vaguely remembered reading somewhere– it was Nixon who bravely proposed single-payer, only to be shot down by Kennedy.)

    Right, but let’s see what (other thing) Dupe70 may have had in mind.

    Anyway, a couple years later Nixon and Kennedy had more or less converged on a bill that was closer to Nixon’s original proposal, but legislative squabbling and then Watergate got in the way. So I guess you could argue that if Kennedy (and Democrats in general) had gotten behind Nixon’s bill a couple years earlier, there would’ve been a better chance of passing something– but that’d be the kind of “deal” where you do exactly what the other guy wants and he uses none of your ideas in return.

    As I recall it, some limited legislation was passed, some of it by the simple expedient of giving Nixon all the credit for what Kennedy, and Javits, and others, had come up with.

  106. 106
    sherifffruitfly says:

    And the kill the bill progressives who preferred nothing.

  107. 107
    Joel Hanes says:

    Forbes has published today a Sally Pipes article on Obamacare

    According to Pipes, it has failed to live up to any of the promises made by its supporters.

    You will be unsurprised that Pipes scores the promise
    “Obamacare will slow the growth of health care costs”
    as FALSE, because costs have not fallen in absolute terms.
    This is so transparently dishonest that I’m surprised that the Forbes editors didn’t ask her to make the trickery more obscure.

  108. 108
    Cervantes says:

    @Joel Hanes:

    But the editors have been allowing Ms. Pipes to lie about health care policy on their pages for years. Why should they have stopped yesterday?

    What took me by surprise is that they allowed her (stupidly) to quote Obama’s promise accurately (“slow the growth of healthcare costs”) when they could so easily have had him “promising” to reduce costs, give every first-born girl-child a glittery unicorn, and pave all the streets with gold.

  109. 109
    WaterGirl says:

    @muddy: Hoping so!

    This is the guy whose license plate said KKK for years after he moved in, until they came up for renewal, I think. I don’t trust him at all, so I plan to go out with my dogs for awhile instead of just letting them out in the yard, and for a long while after that I will check out the windows to make sure the gates haven’t someone “accidentally” come unlatched.

  110. 110
    Davis X. Machina says:

    @Cervantes: The go-to guy on the “Obamacare is just HeritageCare” and “Nixon put universal coverage on the table, and Kennedy stiffed him’ canards is Scott Lemieux at Lawyers, Guns and Money.

  111. 111
    SFAW says:

    @Brachiator:

    and disavow any connection to the Obama administration.

    In light of the CNN/ORC poll results released over the weekend, she might not be wrong. [Caveats: only heard the breathless CNN reporting of it, did not look at the poll to see if it was one of those “If you had a choice between a pony, and President Osama’s capitulating to Iraq on nukes, which would you prefer?” situations.]

    I don’t know that single payer is the best option,

    It may not be, but I’d venture that it’s probably somewhat better than what we currently have. But that’s pure speculation on my part, and, in the Balloon Juice tradition, backed up with close-tozero research.

  112. 112
    muddy says:

    @WaterGirl: Ugh. I feel you. Had a psycho family across the street for years, they left last summer. There is one more loony a few houses down who supposedly is getting foreclosed on and will be gone in June. I look forward to it, after that the rest of the street is nice. I do most of my work at home and it’s really draining to have to think about unpleasantness every time you look out your window.

  113. 113
    SFAW says:

    @Cervantes:

    But the editors have been allowing Ms. Pipes to lie about health care policy on their pages for years. Why should they have stopped yesterday?

    Good point. They keep hoping that they can demonstrate to Betsy McCaughey’s satisfaction that she’d fit right in there, but she’s apparently still playing hard-to-get.

  114. 114
    Violet says:

    @WaterGirl: Can you afford to get a security camera system? They’re wireless now and you can monitor from your smartphone. They sell them at places like Best Buy now and they’re not expensive. You don’t even have to check it all the time but having the camera pointed at the periphery of your property might deter some things. Just a thought.

    These neighbors sound like assholes. Wouldn’t put it past them to hurt your poor dogs to hurt you. :(

  115. 115
    Kerry Reid says:

    SELL-OUT! PRIMARY HIM!!!!

  116. 116
    WaterGirl says:

    @Violet: Not a bad idea, I may have to think about the camera if they are really ugly about this. On the other hand, they may prevail and then they’ll be so happy they “won” that that might just be the end of it, except for their regular jerkiness.

    Lets just say these neighbors are not on my list of people I aspire to be like.

  117. 117
    Violet says:

    @WaterGirl: You might research the security cameras so you’ll know your options. They sound awful. I hope you prevail!

  118. 118
    Brachiator says:

    @SFAW:

    In light of the CNN/ORC poll results released over the weekend, she might not be wrong.

    Early polls mean nothing. I remember when the early polls going into 2008 told us that it was going to be Hillary vs Rudy.

  119. 119
    Turgidson says:

    @catclub:

    This is what my liberaler than thou acquaintances still refuse to acknowledge. The timing of Obama’s election wasn’t the same as FDR’s. By the time FDR took office, the country had been suffering for over three full years. Unemployment was what, 25%? It was a cataclysm without end. Unfettered capitalism was completely discredited and the country was fucking desperate. FDR had as free a hand as any president ever (only post-JFK-death LBJ comes close) to enact reform.

    When Obama took office, the country was rattled and scared, but the crisis was still taking shape and there weren’t soup lines or Hoovervilles all over the place. To some degree, the Democrats were prisoners to their forebears’ successes. From the FDIC to food stamps, to Social Security to Medicare and Medicaid, the New Deal and Great Society prevented the bottom from falling out completely for millions of people. And thus, the country was not as desperate for wholesale liberal reform as I think some Obama supporters assumed it would be. There was a short-lived appetite for the government to fix the economy. Then it got drowned out by “zomg the deficit” mendacity and flimflam.

    I still hear my extremely liberal brother say Obama squandered a historic opportunity to really remake America into an egalitarian wonderland. But there was never the political will or running space for that. FFS, we had Joe f’ing Lieberman threatening to filibuster his own goddamn idea of a Medicare buy-in when the ACA was being built. That was what a handful of dipshits in his own party were doing, to say nothing of the almost-seditious obstruction the GOP was undertaking. Obama did a pretty good job with the opportunity he actually had, while he had it. He and the Democrats have done a bad job marketing their achievements to the electorate (not entirely their fault, given the Village media’s belief that it’s not their job to call out GOP bullshit but rather to elevate it, but still), which hastened the window of opportunity slamming shut in 2010.

  120. 120
    Turgidson says:

    @Brachiator:

    Hillary has publicly supported Obama’s warming towards Cuba and the immigration executive order, so I don’t think it’s clear that she’s going to run away from Obama wholesale. She’ll undoubtedly make clear that she doesn’t want to be seen as Obama’s 3rd term, but I think she’ll tout the progress made during his term where she can and should. But Bill has taken some undeserved shots at Obama at times, so we’ll see. It’ll also be interesting to see whether any major Obama campaign hands get brought on board, and at what positions. If someone like Messina or LaBolt or Bird gets a top position, that might signal that she’s planning to at least partially run on Obama’s achievements.

    To their credit so far, it seems like the Obama circle is fine with her running however she wants as long as she wins. They even expect her to run to Obama’s right on Israel now that the administration is talking seriously about (symbolically) hitting Bibi in the nose with the newspaper. They know his legacy will only get stronger if she succeeds him and protects his achievements from GOP sabotage.

  121. 121
    Cervantes says:

    @Turgidson:

    This is what my liberaler than thou acquaintances still refuse to acknowledge. The timing of Obama’s election wasn’t the same as FDR’s. By the time FDR took office, the country had been suffering for over three full years. Unemployment was what, 25%? It was a cataclysm without end. Unfettered capitalism was completely discredited and the country was fucking desperate. FDR had as free a hand as any president ever (only post-JFK-death LBJ comes close) to enact reform.

    So would you say this is an argument for “heightening the contradictions”?

  122. 122
    Brachiator says:

    @Turgidson:

    Hillary has publicly supported Obama’s warming towards Cuba and the immigration executive order, so I don’t think it’s clear that she’s going to run away from Obama wholesale. She’ll undoubtedly make clear that she doesn’t want to be seen as Obama’s 3rd term, but I think she’ll tout the progress made during his term where she can and should.

    Great points. It will be interesting to see what path Hillary takes.

    I’m not sure that I see the value of her running to Obama’s right on Israel, but we’ll see how this works out as well.

  123. 123
    Dupe70 says:

    @Cervantes: See this link. It’s short on details but it looks like both Nixon and Kennedy backed out but if Kennedy had pursued many more Americans would have been better off for the past 40 or so years: http://www.washingtonpost.com/.....03919.html

  124. 124
    Bokonon says:

    @Brachiator:

    A more subtle issue is the fact that Republicans also deeply detest and want to repeal the ACA because it provides any reproductive services at all. The Dems need to hit this hard, especially with women.

    We tried that here in Colorado during the last election cycle. It didn’t work.

    What we got was an electorate that more or less responded “NAH-NAH-NAH, not listening!” And they went out and elected hard-core right wingers at both the state and federal levels. While making fun of Senator Mark Udall as “Mark Uterus” for bringing it up over and over. The state’s paper of record even chastised Udall for being such a bore about it … and endorsed his right-wing rival for his promises to “heal gridlock” and work against partisan divisions. A rival who was one of the co-sponsors of the federal “Life Begins at Conception Act” no less.

    It was really loathsome.

  125. 125
    Brachiator says:

    @Bokonon:

    We tried that here in Colorado during the last election cycle. It didn’t work.

    An excellent cautionary tale; but this may play better in a national election. Still, the reaction in Colorado sounds disgusting.

  126. 126
    Cervantes says:

    @Dupe70:

    See this link. It’s short on details but it looks like both Nixon and Kennedy backed out but if Kennedy had pursued many more Americans would have been better off for the past 40 or so years:

    OK, thanks. Is the above what you meant by your original comment? (Thanks again.)

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