Good news everybody

The interesting thing to me in this chart besides the final outcome is that the introduction and proliferation of government sponsored insurance after 1980 to 2010 basically was sufficient to replace 1:1 declining employer sponsored coverage and not expand coverage. Legacy Medicaid picked up more responsibility, Medicare picked up more members, CHIP was a brand new program that has covered a lot of kids. But all of those programs were effectively either status quo keepers on a population basis or slowed the rate of uninsurance growth.

There are three major challenges left.

  • Reduce uninsured rate to under 2% (Massachusetts is damn close to that now)
  • Increase the value of the coverage so that it is far more useful to more people
  • Continue to bend the cost curve so that total national healthcare costs grow at or under the rate of nominal economic growth.

 

58 replies
  1. 1
    Baud says:

    All three of those challenges boil down to one: keep the GOP out of power.

  2. 2
    Punchy says:

    What the hell happened between 1980 and 1989? I thought Saint RayGun was Officially The Shizzle on all things everywhere domestically? That graph seems incongruous with Pappa Ronnie’s faux legacy…

  3. 3
    OzarkHillbilly says:

    There are three major challenges left.

    Reduce uninsured rate to under 2% (Massachusetts is damn close to that now)
    Increase the value of the coverage so that it is far more useful to more people
    Continue to bend the cost curve so that total national healthcare costs grow at or under the rate of nominal economic growth.

    Commie.

  4. 4
    OzarkHillbilly says:

    @Punchy: That’s a feature, not a bug. Moochers and losers gotta die.

  5. 5
    Schlemazel Khan says:

    @OzarkHillbilly:
    As Herr Drumpfenstein explained the other day, it is a moral imperative that Social Security be cut. Same goes for healthcare I am sure.

  6. 6
    Baud says:

    @Schlemazel Khan: Trump is now talking about cutting Social Security?

  7. 7
    satby says:

    All I gotta say is ” Thanks, Obama”!

  8. 8
    bemused says:

    Anyone notice that Republicans proposed yet another “new” health care legislation plan last week? The title is a doozy. Pete Sessions and one other R introduced “HR 5284-The World’s Greatest Healthcare Plan of 2016”.

    So what will they name the next dozen healthcare plans.

  9. 9
    Central Planning says:

    @Baud: He said he was lying about supporting it now because he knew that if he said he wanted to cut it, he would never get elected.

    ETA – wow, too many pronouns in there.

  10. 10
    Patricia Kayden says:

    @Baud: Yep!!

    And Thanks Obama!

  11. 11
    Jeffro says:

    Victory lap time,Mr President

  12. 12
    Baud says:

    @Central Planning:

    Thanks. Interesting. I wish there was a real difference in the parties so we’d have an alternative to Trump.

    Maybe in 2020.

  13. 13
    OzarkHillbilly says:

    @Baud: Let’s see, it’s Monday so….. Who the fuck knows?

  14. 14
    Schlemazel Khan says:

    @Baud:
    Yes, just this past week. Here is a link to the story.

    “From a moral standpoint, I believe in it,” Drumpf said of cutting Social Security. “But you also have to get elected. And there’s no way a Republican is going to beat a Democrat when the Republican is saying, ‘We’re going to cut your Social Security’ and the Democrat is saying, ‘We’re going to keep it and give you more.’ ”

  15. 15
    Zinsky says:

    All of this points to something that galls the right-wing and drives them sociopathic – Obama is going to be remembered as a very competent and accomplished president. He inherited an absolute cowpie of an economy from Bush the Simple – all the major banks were insolvent, the three major carmakers were in or near bankruptcy and the Dow had crashed to 8,000. Now, eight years later and our economy is at or near the healthiest in the developed world and Dow is teasing 18,000. Osama bin Laden is dead and al-Qaeda is de-fanged, if it weren’t for ISIS (which is also a Bush legacy), terrorism would be a non-issue. While I have major problems with Obama over drones, wiretapping and other civil rights, he has done a stellar job during very tough times while dealing with the most Negative Nancy Congress in American history!

  16. 16
    WaterGirl says:

    @OzarkHillbilly: I think you meant to say “it’s Monday at 9am, so… Who the fuck knows?” By noon, the answer may be entirely different!

    Sadly, that’s working for Trump because people can believe that it doesn’t matter what he says, he’ll really do (insert whatever matches your beliefs) if elected. God help us.

  17. 17
    NorthLeft12 says:

    Congrats to Obama and the Dems that supported him to make this progress. Hopefully, one day in the not too distant future, you will join the rest of the first world countries, and cover 100% of your citizens, and maybe even 100% of anyone resident in your country.

  18. 18
    Baud says:

    @Schlemazel Khan: That’s great. He really is the golden calf of American politics. Looking forward to seeing how this all turns out.

  19. 19

    Huh–thanks Obama!!

  20. 20
    rikyrah says:

    Mayhew, do you have an approximate % of what the uninsured would be if all the states do the expansion of Medicaid?

  21. 21
    rikyrah says:

    @bemused:
    Yeah. Saw that title. ..
    Sigh..

    Phuck.outta.here

  22. 22
    benw says:

    Thanks, Obama!

    The rate of non-elderly adults in my household losing at Mastermind to a six y.o. however is 100%.

  23. 23
    mental.masala says:

    From my non-wonk perspective I’d throw in two more policy challenges (not sure if they qualify as “major”):
    1) Break down the separation between health insurance and dental insurance. It makes little sense that dental insurance is not part of “normal” health insurance. Unhealthy teeth, gum disease, and other dental afflictions are bad for your overall well being.
    2) Eliminate the disparities between physical health coverage and mental health coverage. I know that progress is being made on this, but understand that much work needs to be done.

  24. 24
    cmorenc says:

    @Baud:

    All three of those challenges boil down to one: keep the GOP out of power.

    …because the fundamental postulate of the GOP perspective is that any health insurance program involving a government program is inherently a disaster that incurs runaway costs and interferes with actual availability of services (all those masses of people waiting in line for months for simple procedures I tells ya)- and any nominal drop in the uninsured rate is hence an illusory benefit, cause the whole system of socialized medicine is sliding downhill to dysfunctional hell in a hand basket. And hence also your purported “statistics” about drop in uninsured are an unsustainable fraudulent illusion, and therefore irrelevant.

  25. 25
    Mai.naem.mobile says:

    Math has a liberal bias,also too Muslin numerals.

  26. 26
    Fake Irishman says:

    @rikyrah:

    Kaiser estimates that expanding Medicaid in states currently without expansion would cover an additional 3.2 million people. So, assuming the US population is about 320 million and the uninsured rate is about 9.5 percent (which is what the whole population uninsured rate is according to the same survey that Kaiser uses above to estimate the percentage of working-age adults who are uninsured.) we can probably say expanded Medicaid would reduce it by an additional percentage point to 8.5 percent (roughly 27 million give or take). Those remaining uninsured would consist of undocumented immigrants, those who can’t afford insurance and have a waiver from the individual responsibility mandate penalty, those who don’t want insurance and pay the penalty, and those who don’t know about the law. (a surprisingly large number, though the percentage of those eligible for CHIP, Medicaid and the Exchanges who actually take advantage of those programs has gone up considerably since the full ACA roll out in 2014 IIRC .)

  27. 27
    VFX Lurker says:

    @Punchy:

    What the hell happened between 1980 and 1989? I thought Saint RayGun was Officially The Shizzle on all things everywhere domestically? That graph seems incongruous with Pappa Ronnie’s faux legacy…

    Me, I’m wondering if it represents the continued decline of union membership under President Reagan. :-(

  28. 28
    JPL says:

    @Baud: On one of the morning news shows, I heard him say that if the ten trillion in tax cuts, (for the wealthy) didn’t pay for themselves, he might have to cut Social Security.

  29. 29
    D58826 says:

    Since even a stopped clock is right on occasion – when the GOP say’s IT”S OBAMA’S fault, they will actually be right for once.

  30. 30
    Bess says:

    Richard, how about a graph of uninsured in Massachusetts with a marker for the point at which Romneycare kicked in?

    A diving toward 2% graph….

    A separate graph of the rates for states that got onboard the Obamacare train would be nice as well. Leave out the states run by jerks.

  31. 31
    JPL says:

    Mitch McConnell was on CBS This Morning promoting his new book. He spoke about having polio when he was four, and his mother taking him to Warm Springs, GA for treatment. It was a center set up by FDR. With not even a moments hesitation, he moved on bashing the President’s policies.
    Government for me, but not for thee.

  32. 32
    Miss Bianca says:

    @mental.masala: I’m with you on those two. I had a terrible time after my car accident getting the insurance companies to pay for my dental implants (I lost seven teeth). Actual back-and-forth:

    Insurance Person: We don’t pay for dental.

    Me: But it was a medical accident. If I lost an arm or a leg in an accident, would you pay for a prosthesis?

    IP: Yes – well maybe – it would depend on the prosthesis.

    Me: OK. Well, I lost teeth.

    IP: We don’t do dental.

    Got it paid for eventually, but everything about that experience – from that one to being dunned for medical bills because two different insurance companies were fighting over who *wouldn’t* pay first – soured me on the insurance-driven health care industry in this country. (Present company excepted, Richard).

  33. 33
    JPL says:

    @Bess: I think a map of all states would be interesting. The southern states need to be shamed into taking care of their citizens.

  34. 34
    Baud says:

    @JPL: Seems like a risk worth taking.

  35. 35

    @Zinsky:

    All of this points to something that galls the right-wing and drives them sociopathic – Obama is going to be remembered as a very competent and accomplished president.

    And their decision to tag the PPACA as “Obamacare” has to be the worst thing of all for them. They meant for it to be a way of ensuring a negative association, but instead it’s going to make any attempt to guarantee universal health coverage be associated with Obama. Instead of destroying his legacy, it’s going to guarantee it. Smooth move, Republicans.

  36. 36
    starscream says:

    @Zinsky: I think Obama’s major goal for his last year is to kill al-Baghdadi. He’s been very slowly upping the war against ISIS – in my non-expert opinion he knows they’re on the run and would love one more scalp for his wall.

  37. 37
    Amir Khalid says:

    @Roger Moore:
    Remember what Obama said about the “Obamacare” epithet: “Damn right, I care.”

  38. 38
    Suzanne says:

    @starscream: I can see Obama announcing that he gets al-Baghdadi, like, the day before the election. Or on his last full day in office. With a mic drop. BOOM.

    I’m gonna miss that POTUS. Love me some BHO.

  39. 39
    ThresherK says:

    @JPL: I don’t know if I’d go that far, but it is a good reminder of things nonetheless.

    I’d settle for shaming NPR into getting a clue about why health outcomes happen where they do.

  40. 40
    NorthLeft12 says:

    @Fake Irishman:

    those who don’t want insurance and pay the penalty

    Personally, I think it was always a mistake to call that a penalty. It should be called what it is….a non-refundable deposit by the non-insured against their future use of the health care system which they will not be able to pay for. Some members of this group of rugged individuals will find themselves in over their head with a large, unexpected [though completely predictable] health care cost, and get the public to cover their debt. This nr deposit will help to cover that.

    By calling it a penalty, I think it reinforces the right wing feeling that the uninsured are being punished, instead of being identified as the welchers/pikers/chiselers they are.

  41. 41
    Ella in New Mexico says:

    We’ve looked through four decades of data, and the share of people who are uninsured has never been this low.

    And yet, as far as we’ve come, we still have SO much to do to make the PPACA a less complex, more comprehensive, more affordable program. Can you imagine what we could do with a Democratic Congress AND a Democrat in the White House?

  42. 42
    Baud says:

    @Ella in New Mexico:

    Can you imagine what we could do with a Democratic Congress AND a Democrat in the White House?

    If 1994 and 2010 are any guide, we could constantly complain about how the progress being made isn’t good enough and then allow the GOP to win midterm elections in a landslide.

  43. 43
    JPL says:

    @NorthLeft12: When republicans realize they have to keep the mandate, they will call it the freedom deposit.

  44. 44
    Kathleen says:

    @ThresherK: But that might hurt Republicans’ feelings.

  45. 45
    Mai.naem.mobile says:

    @Suzanne: yeah,but Trumpy would have gone to Syria and found Al Baghdadi alive all by hisself, flown him back on Trump One with Melanoma giving Al Baghdadi a pole dance to insult Al Baghdadi,had a worldwide pay per view limb cutting and beheading of Al Baghdadi with all proceeds(wink,wink)going to pay off half the US debt. An Oscar winning movie to follow with product tie ins and licensing agreements would pay off the other half of the debt. So you see Trump would have done better the Kenyan Muslin Usurper

  46. 46
    bemused says:

    @rikyrah:

    Sessions must be taking notes on Trumpisms….the greatest, the best, most fantastic….

  47. 47

    @Ella in New Mexico:

    Can you imagine what we could do with a Democratic Congress AND a Democrat in the White House?

    We could patch a lot of problems with Obamacare. We could rewrite the VRA do undo the damage from Shelby County. We could write campaign finance reform that would pass muster with the Supreme Court because we’d have a liberal majority for a change. I just hope people are writing those bills now so they’ll be ready to pass without excessive delay if/when we get there.

  48. 48
    Baud says:

    @Roger Moore: Also, climate change and immigration reform.

  49. 49
    Baud says:

    I don’t get to recommend GOS often, but here is a very nice historical survey of superdelegate influence in the Democratic primary.

  50. 50
    StringOnASick says:

    I sure hope the dems sieze on Trump’s “we’ll have cut social security” and trumpet that high and low. The time to start screamy about that, especially since he’s now on tape saying it, is NOW.

  51. 51
    I'mNotSureWhoIWantToBeYet says:

    @Roger Moore: And automatic voter registration and multi-day voting standards (via various carrots and sticks); and non-partisan redistricting (via various carrots and sticks); and EFCA/Card Check and making sure VW doesn’t kill unionizing efforts at its Tennessee plant; etc.

    Cheers,
    Scott.

  52. 52
    AnotherBruce says:

    Breaking news a woman threw a package over the fence at the white house. Hazmat teams are there and the woman was arrested.

  53. 53
    Miss Bianca says:

    @Baud: Nice article. I forgot that Jesse Jackson won Michigan in the primaries in 1988! He was the first Democratic candidate that I ever felt really excited to vote for – the first candidate rally I ever went to, as well.

  54. 54
    🚸 Martin says:

    @Punchy: Two recessions – one in each of Reagan’s terms. Unemployment spiked each time, and people lost their employer insurance. That was also a period of rapid transition from union to non-union jobs, in part due to Reagan’s policies but also due to interest rates and access to capital.

  55. 55
    🚸 Martin says:

    @Baud: This.

  56. 56

    @Punchy:

    What the hell happened between 1980 and 1989? I thought Saint RayGun was Officially The Shizzle on all things everywhere domestically? That graph seems incongruous with Pappa Ronnie’s faux legacy…

    Merger mania and the rise of the corporation as an entitled entity with no other responsibility other than its shareholders.

    I spent pretty much the entire decade of the 90s jumping from contract IT position to contract IT position without ever being offered health insurance or high enough pay rate to afford it.

  57. 57

    @I’mNotSureWhoIWantToBeYet:

    and EFCA/Card Check

    Repeal Taft-Hartley!

  58. 58
    The Gray Adder says:

    @Baud: THIS. The GOP is sitting ready with a whole box of spanners to throw into the works just as soon as one of their people can get the access panel open. Because Obama.

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