Category Archives: Obamacare

Rep. Ellison’s Ultimatum: Single Payer or Government Shutdown

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SatireSaint Paul, Minn. –U.S. Rep. Keith Ellison (D-Minn.)  announced today that he is leading a progressive effort to shut down the federal government until a single payer health insurance system replaces the federal Affordable Care Act (ACA) passed in 2010, further complicating the federal budget impasse.

“The private insurance exchanges used in the ACA were never what progressives wanted, so ‘we the people’ have decided to make a principled stand against them,” said Ellison, Co-Chair of the Congressional Progressive Caucus.  The Caucus has long advocated for a single payer system in which the government would fund and operate a single insurance pool for all Americans, similar to how Medicare has long been structured for older Americans.

Rep. Ellison’s rhetoric was eerily similar to that of his fellow House Republicans, who have pushed for replacing the Affordable Care Act with the status quo system.  Under the current system, 48 million Americans are uninsured and health costs are among the highest in the industrialized world.

Rep. Ellison said his caucus is pushing legislation authored by Rep. John Conyers (D-Mich.) to essentially build on and expand the federal Medicare program.  Under the bill, all Americans would be guaranteed access to health care regardless of an ability to pay or pre-existing health conditions.

Just as Tea Party-backed House conservatives advocated in 2009 for preserving the status quo private health insurance system, House progressives pushed for a single payer approach in 2009. But neither side was able to muster sufficient votes to enact their preferred policy.

Still Ellison points to an Associated Press poll finding that 65% of Americans agree that “the United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.”  Ellison also noted an NPR poll shows that 93 percent of Americans believe that the number of uninsured under the status quo system that the Republicans are fighting to preserve is a “serious problem.”

“When House Republicans finally agree to open up the government again, we’re going to shut it down if they don’t support our single payer approach,” Ellison said.  “House Republicans shut down the government to maintain a status quo insurance system that almost all Americans believe is a serious problem, so progressives can damn sure shut it down over something that two-thirds of Americans support.”

Rep. Ellison said he has offered to compromise with Republicans by offering to delay the implementation of the single payer system by a year.  Ellison has also offered to allow private insurers to sell Medigap-like supplemental health insurance plans.  However, Ellison says Republicans are refusing to even discuss compromise.

In a related development, Sen. Joe Manchin (D-W.Va.) announced that he would move to re-shut down the federal government if House Republican lawmakers didn’t pass his legislation to require background checks on people buying guns at gun shows or online.  A Washington Post/ABC News poll shows that 86% of Americans support such background checks.  Despite this overwhelming public support, Manchin’s bill was rejected by House Republicans in April 2013.  Manchin also demanded a new credenza for his office.

NOTE:  If it is not obvious to you, THIS IS SATIRE.  IT IS NOT A TRUE STORY. Representatives Ellison, Conyers, and Manchin are much too responsible to shutdown the government when they don’t get their way in the democratic process.

This post was featured in Politics in Minnesota’s Best of the Blogs and in MinnPost’s Blog Cabin.

Related post:  Bachmann Vindicated:  Industrialized Nations Continue Rush to Replicate U.S. Health Care System

– Loveland

Learning To Lose With MnSure

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Bunyan_woodpeckerIn case you haven’t heard, Republicans hate health insurance exchanges like MnSure. While the conservative Heritage Foundation developed the approach, conservative leaders like Bob Dole, Newt Gingrich and Orrin Hatch endorsed it, and conservative standard bearer Mitt Romney pioneered it, contemporary conservatives have come to despise it since it was adopted by President Obama.

Conservatives now prefer to allow insurance companies to compete across state lines governed by federal regulations, instead of the current system of state-by-state regulation of insurance products.  But there isn’t sufficient political support to enact the conservatives’ preferred interstate competition approach.

I feel my conservative friends’ pain, because my preferred approach also doesn’t have enough political support to become law, and I also don’t love insurance exchanges like MnSure.  I’d much rather have a single payer system — the system that delivers the best care and value in other industrialized nations — than this competitive private sector exchange model.  However, since there wasn’t sufficient political support for my first choice, my fallback preference was to authorize a “public option”—a Medicare-for-All — competing against private options to test which model is more efficient and effective.

But alas, after a long, fair and considered congressional debate, I lost on both my first and second choices.  Now I and all Americans have to accept the private competitive exchange model that prevailed in the democratic arena.

Memo to my Republican friends:  That’s how losing works in a democracy.  You have to accept the outcome of the democratic process, and move on like an adult.

While insurance exchanges like MnSure were far from my preferred option, there are things I like about them.  For the first time, they require products to be directly comparable, so that a lightly informed consumer like me can actually do apples-to-apples shopping, or silver plan-to-silver plan shopping.

That represents a significant improvement that will reshape the marketplace in a somewhat more consumer-friendly way. With private and non-profit insurers required to create directly comparable products, insurers now know that many consumers are going to buy the more affordable apple over the comparatively expensive apple.  That puts consumer demand pressure on insurers to offer the most affordable apple possible, just as airlines have constant demand pressure to offer the most affordable ticket to New York City via online marketplaces like Kayak, Orbitz and Travelocity.

Whether we’re talking about Kayak or MnSure, the widespread availability and use of the Internet makes this kind of comparison shopping possible.  Social media and advertising guru Simon Mainwaring is among those those who have written about how the Internet changes modern marketplaces:

“More than ever before, consumers have the ability to unify their voices and coalesce their buying power to influence corporate behaviors.”

So far, this type of “coalesced buying power” is showing promise.  In Minnesota’s competitive exchange, we are seeing among the lowest premium prices in the nation.  That’s a tribute to Minnesota’s non-profit health insurance companies, the state health care model that Republican Governor Arne Carlson significantly shaped and the exchange model that Republicans developed, supported and pioneered.

In life and in policy making, sometimes we don’t get our first choice, or even our second choice.   Liberals like me certainly didn’t get our first or second choice in the 2010 federal health reform debate.  But that doesn’t mean that some good can’t come from the third choice, if we’re adult enough to give it a chance, instead of working overtime to sabotage it.

So my conservative friends, on the launch day for MnSure, join me in belting out those healing Stephen Stills lyrics:  “If you can’t be with the one you love, honey, love the one you’re with.”

– Loveland

Note:  This post was also featured in Politics in Minnesota’s Best of the Blogs.

Time for Obamacare Supporters To Let Their Light Shine

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insurance_denialObamacare is easy to misunderstand.  It’s complex, confusing and heavily demagogued, and those things all plant seeds of doubt in a lightly informed citizenry.  Given the barrage of lies flying around, it astounds me that a majority either still want to keep it or make it stronger.

But as Senator Ted Cruz and many others can tell you, it is very easy to whip about a third of the population into a fervor over Obamacare.  Listening to Cruz, Boehner and the boys discuss Obamacare, you’d think the End Times are nigh.

One of their favorite tactics is the ritualistic burning of the Obamacare Card.   Though there is no such thing as an Obamacare Card, a conservative group called Freedomworks printed up a batch of faux cards so they could burn them in the public square.

The minority intent on repealing Obamacare has created a good visual with the card burnings.  Now, the majority of Americans who either want to maintain or strengthen Obamacare need to create a memorable counter visual.

I nominate burning insurance rejection documents.  For decades, insurance companies have been denying health coverage for seriously ill Americans, because seriously ill people are expensive and unprofitable to cover.   I’m not blaming insurance companies for doing this, because we have built a system that effectively requires them to deny coverage to those with expensive medical needs.  After all, any insurance company that started covering the most sick, expensive patients would be run out of business, because they wouldn’t be able to compete against competitors who reject the most sick, expensive patients.  Unless all insurance companies are mandated to cover these folks, none will.

Everyone agrees that these denials have tragic consequences for an enormous group of ailing Americans.    According to research by the Commonweath Fund:

An estimated 9 million were turned down or charged a higher price because of a health problem, or had a preexisting condition excluded from their coverage.

The tragedies that stem from such denials are widespread.  Non-treatment.  Under-treatment. Inefficient and ineffective treatment.  Bankruptcies driven by mountains of unpayable medical bills.  Cost-shifting to the rest of us.

No more.  Starting with the insurance policies going on sale  October 1, 2013, Obamacare makes it illegal for any insurance company to ever again deny coverage based on a preexisting condition.  As a result, 9 million of some of the sickest Americans finally will be eligible for coverage, and if you get sick or hurt in the future, so will you.

This Obamacare-mandated change is revolutionary for those who have been rejected in the past, and for any of us who could be denied in the future, which is all of us.  It is a vastly under-appreciated aspect of Obamacare.

bonfire_celebrationSo to celebrate this momentous occasion, let’s burn some insurance company rejection documents.  Since there are 9 million lives impacted, let’s burn 9 million denial documents. Just as fake Obamacare Cards needed to be produced for theatrical effect, symbolic rejection documents would have to be recreated.  (Most people don’t save their rejection letters to put into their baby books.)

Imagine what that blaze would represent.  Coverage denial for victims of all types of cancer, diabetes, hepatitis C, multiple sclerosis, schizophrenia, quadriplegia, Parkinson’s disease, AIDS/HIV and countless other ailments?  Up in smoke.  Coverage denial for patients in desperate need of doctor-recommended medications?  Burn, baby, burn.

Think about it.  Never again will any of your desperately ill family members, friends, co-workers and neighbors receive a coverage rejection letter again.  The banning of pre-existing condition denials is now a reality, thanks to Obamacare.  Let’s tell that story.  Let’s create that visual.  Let’s have that celebration.  Supporters of Obamacare should quit cowering in the shadows of the Obamacare Card burnings, and let that light shine brightly.

– Loveland

Note:  This post was featured as a “best of the best” in MinnPost’s Blog Cabin.

South Dakota Guv’s Fiscal Race-to-the Bottom Not A Selling Point for Minnesotans With Dakota Roots

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Dear South Dakota Governor Dennis Daugaard:

I’ve been pondering your recent “Dakota Roots” visits to Minnesota’s Mall of America to recruit South Dakota expatriates to return to their native state to strengthen South Dakota’s economy.    As the Star Tribune explains:

Dakota Roots was first launched under Daugaard’s predecessor (Republican Governor Mike Rounds) to address the state’s vexing problem. South Dakota needs more workers to take full advantage of its low unemployment rate (4.3 percent) and 10,000 unfilled jobs statewide, according to the governor’s staff.

As the name suggests, Dakota Roots is designed to lure people who perhaps grew up in South Dakota and had moved away, or went to college there, or had parents or grandparents from the state.

As a native South Dakotan living in the Twin Cities, I’ve been giving your pitch some thought.  There’s a lot of what you are selling that is attractive to me.  I have treasured family and friends in South Dakota.  I miss the expansive prairie skies framing breathtakingly beautiful fields of sunflowers or bison.  I love many of the changes that have happened since I left Sioux Falls about 30 years ago, such as the Washington Pavillion, Parker’s Bistro, Josiah’s Coffee, Spezia, Zanbroz and the rejuvenated Falls Park.  I admire the populist spirit of South Dakotans, and the pride they have in a place and culture that too few Americans have taken the time to understand and appreciate. Continue reading →

How In the World Did Minnesota GOPers Screw Up Their Golden Opportunity?

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I have a prediction, though not a particularly prescient one.  Minnesota Republicans will say they lost the election because of bad candidates.  Mitt Romney, Kurt Bills, and the Tea Party-supported freshmen legislators were all just bad candidates, they will say.

“Victory has a thousand fathers, and defeat is an orphan,” as John F. Kennedy observed, and in the coming days a lot of Republican candidates will be orphaned.

But for their own good, Republican leaders need to objectively ponder this question:  Bad candidates, or bad policies? Continue reading →

Michele Bachmann and the Anatomy of a Laugh

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“The fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses.

They laughed at Columbus, they laughed at Fulton, the laughed at the Wright Brothers.

But they also laughed at Bozo the Clown.”

– Carl Sagan

 

The Unofficial Backgrounder For Getting To Know Tim Pawlenty

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For the national news media scurrying to cover Minnesota Governor Tim Pawlenty’s impending Vice Presidential nomination by Mitt Romney, here are a few facts that may not be included in the Romney for President news release:

The “Fees”.  Like any obedient GOP presidential aspirant, Tim Pawlenty HATES him some taxes.  He will stress this fact dozens of times per speech.  But the less publicized aspect of our former governor is that he actually loves him some “fees.”  GOP former Minnesota Governor Arne Carlson points out that Pawlenty actually passed the largest tax increases in Minnesota history.  But national reporters should not listen to people like Arne Carlson.  Fees are revenue collected from citizens by government so the government can provide services, and national reporters should understand that is completely different from a “tax.”  Reporters covering Pawlenty will need to take a crash course on how to speak Pawlentese. Continue reading →

For 30th Time, Bachman and the Gang Misread Obamacare Public Opinion

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When it comes to Obamacare, Minnesota Congressman Michele Bachman could not be more certain that she has public opinion behind her.  For instance, in her latest broadside, she signed a letter to all 50 Governors urging them to avoiding implementing Obamacare insurance exchanges to help Americans obtain affordable coverage, Bachman cited an oft repeated myth:

I urge all Governors to let Congress finish the job the American people sent us to do, to fully repeal Obamacare and replace it with common-sense free market solutions.

“…the job the American people sent us to do, to fully repeal Obamacare and replace it…” Whether they are spinning or they actually believe that, they are wrong.  This notion that a majority of the American people want the Affordable Care Act repealed or weakened is demonstrably false.

A June 2012 Kaiser Permanente poll is the last latest to show that a majority (53%) either wants to “keep the law as is” (25%) or “expand the law” (28%).

At the same time, only 38% of Americans support what the Republicans propose.  The Kaiser poll finds that 18% of Americans said Congress should “repeal the law and replace it with a Republican-sponsored alternative,” and 20% said Congress “repeal the law and not replace it.”

So, yes, a majority doesn’t support the law as is, because so many Americans, myself included, would have liked the law to have been stronger…if there had been congressional will to do so.  But it simply is not true that a majority of Americans want to do what the Republicans propose to do to the Affordable Care Act — real it or repeal and replace it.

And so today, for the 30th time, Michele Bachman, John Kline, Erik Paulsen, and Chip Cravaack will vote to repeal the Affordable Care Act.  And for the 30th time, they will be dead wrong about the will of the American people.

– Loveland

 

Note:  This post was also featured as part of the “Best of the Blogs” feature in Politics in Minnesota’s Morning Report.

Minnesota Health System Needs Obamacare Too

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On a weekly basis, Garrison Keillor reminds Minnesotans that we are above average.  But we didn’t need him to tell us that.  We’re a pretty innately smug bunch when it comes to our state.  Call it “Minnesota Exceptionalism.”

We’re especially smug about our health care system.  Therefore, some of us were not all that sure we needed Obamacare’s private health insurance mandate, which is presently the only politically feasible way of improving health insurance coverage and banning pre-existing condition restrictions.

But we do.

It is true that Minnesota is better off than the rest of the nation. Nine percent of Minnesotans lack health insurance coverage, and that’s much better than the nation as a whole, where 16% are uninsured.

We can rest assured that we aren’t suffering nearly as much as many other states, such as Texas (27% uninsured), Mississippi (24% uninsured), Louisiana (22% uninsured), Nevada (22% uninsured), and Oklahoma (22% uninsured). These GOP strongholds are suffering more at the hand of the GOP’s shameless health reform stonewalling than we are.

But let’s not delude our exceptional selves.  Minnesota needs the private insurance mandate too.   After all, using the same kind of health insurance mandate the Supreme Court just upheld, Massachusets has a much better record than Minnesota.  Under ArneCare in Minnesota, we have 9% uninsured, which is better than average.   But under ObamneyCare in Massachusetts, they have only 5% uninsured.

Moreover, we self-congratulatory Minnesotans should never forget that in the shadows of Minnesota’s overall 9% uninsured rate are pockets of much deeper health care despair. For instance, more than a quarter (27%) of low income adult Minnesotans are uninsured. That’s a little bit of Texas in our midst.

No, 9% is not good enough. That’s 463,100 of our Minnesota friends, neighbors, and coworkers who are just one metastasized cell or black ice sheet away from a mountain of medical bills, and the bankruptcy that so often goes with it.

That’s 463,100 Minnesotans delaying medical care until medical care becomes much more expensive, and often much less effective.

That’s 463,100 Minnesotans who obviously don’t stop getting hurt or ill, and therefore are forced to shift their enormous medical expenses to the rest of us, which in turn forces more of us to drop our own coverage.

That’s 463,100 Minnesotans — the population of Rochester, Duluth, St. Cloud, Eagan, Plymouth, Lino Lakes, Willmar and Ramsey, combined.

That can’t be ignored.  Minnesota needs the insurance mandate, and the rest of Obamacare too.  So thank you Heritage Foundation, Newt Gingrich, Don Nickles, Mitt Romney and, now, John Roberts for giving it to us.

– Loveland

Note:  This post also was featured as a “best of the best” on Minnpost’s Blog Cabin feature.