GOP's "Big Beautiful Bill" Is Causing Millions To Lose Their Health Insurance

The following is part of an article by Reed Abelson and Margot Sanger-Katz in The New York Times:

Millions of Americans appear to be dropping Obamacare coverage in the months since Congress failed to extend the generous subsidies that had become a defining feature of the Affordable Care Act.

Initial sign-ups had already fallen by about 1.2 million people. But insurance companies, state officials and industry analysts are reporting that many more have lost Obamacare coverage now that people are facing long-term higher costs. The federal government has yet to report current enrollment data.

Many insurers and analysts are estimating overall declines of about 20 percent, dropping to around 19 million from the 24 million who were covered under the A.C.A. last year. Other indications suggest there could be even larger potential losses by the end of the year, a deep retrenchment for Obamacare coverage and a reversal of significant gains in the last several years.

The rising cost of health care has shown up as a top concern among Americans in several public opinion polls. Premiums are rising for Americans who get insurance through work, too, as health care costs have been increasing nationwide. Out-of-pocket costs are growing too, as plans with high deductibles have become popular. . . .

One analysis, by Wakely Consulting Group, a firm with access to detailed insurance industry data, estimates that coverage in the marketplaces will drop by as much as 26 percent this year compared with last year’s average enrollment. . . .

The insurers and state officials said early retirees with middle-class incomes, who faced the largest increases in premiums, appeared to be among the hardest hit. In some markets, the cost of insurance for this group rose by $1,000 a month or more.

It's Time To Fix The Health Care System

 Part of a post by Dan Rather:

The American health insurance “system” is a misnomer. It implies that it was intentionally designed. In truth, coverage in the United States entails a messy patchwork of private insurance companies covering 65% of those insured and government-funded insurance (Medicare and Medicaid) covering the other 35%.

Senator Bernie Sanders is a proponent of health care for all provided by the federal government. What we have “is a system not designed to provide health care to all people in a cost-effective way,” Sanders said of the current setup. “It is a system designed to make huge profits for the insurance companies, the drug companies, and many other industries within the system.”

Most of those private insurance companies are publicly traded entities whose primary goal is to make money. And boy, do they.

Last year, UnitedHealthcare, the largest private insurance company in the country, made $16 billion in profit. To boost profits even further a company must reduce costs. The easiest way for insurance companies to do so is to deny coverage. UnitedHealthcare, which has one of the highest denial rates in the industry, turns down about a third of all claims.

Shockingly to me, many health insurance companies — UnitedHealthcare among them — outsource the decision-making of approving or denying coverage to third parties that use AI-generated algorithms to make life-and-death judgements. According to reporting by ProPublica, this hidden cottage industry works by a “denials for dollars” model. The more they deny, the more they get paid.

It is no wonder people are infuriated and some are praising a self-styled vigilante who claimed he was trying to do something about it.

A 2023 Gallup poll found that just 31% of Americans trust the U.S. health csare system. One in 4 report delaying or foregoing medical treatment because of cost. While the Affordable Care Act has improved things, adding 45 million people to the insurance rolls, an estimated 23% of these are still underinsured, meaning they don’t have enough coverage.

Wouldn’t it be great if we had politicians who had the guts to do something about this mess? Health care lobbyists have spent more than $150 million to keep Congress in line.

And now we have Donald Trump and his bevy of billionaires, including the world’s richest man, looking to cut costs. Elon Musk says he may consider Social Security and Medicare as possible places to find savings.

The system can be fixed, but it would take elected officials willing to have the government do more, not less, at least when it comes to health care. Anybody think that sounds like Trump, et al.?

U.S. Wastes Billions Of Healthcare Dollars Every Year

 Americans like to think that the money they spend each year for health insurance goes to actually pay for health care. It doesn't. The truth is that the U.S. spends hundreds of billions of dollars each year that doesn't contribute to the health of any American.

The money goes to pay the overhead for private insurance companies -- profits, executive and employee compensation, stockholder compensation, et cetera. The people receiving this money provide no health care. They simply suck dollars out of the health care system.

No matter what kind of health care system a country has, some money will be spent on overhead (managing the system), but Americans spend far more on overhead than other countries do -- and that is largely why health care costs so much more in the U.S. than in most other countries. For instance, Canada spends only about $1 on this compared to $4 in U.S. for each person.

Consider this excellent article by Melissa Healy of the Los Angeles Times:

In the United States, a legion of administrative health care workers and health insurance employees who play no direct role in providing patient care costs every American man, woman and child an average of $2,497 per year.

Across the border in Canada, where a single-payer system has been in place since 1962, the cost of administering health care is just $551 per person — less than a quarter as much.

That spending mismatch, tallied in a study published this week in the Annals of Internal Medicine, could challenge some assumptions about the relative efficiency of public and private health care programs. It could also become a hot political talking point on the American campaign trail as presidential candidates debate the pros and cons of government-funded universal health insurance.

Progressive contenders for the Democratic nomination, including Sen. Bernie Sanders of Vermont and Sen. Elizabeth Warren of Massachusetts, are calling for a “Medicare for All” system. More centrist candidates, including former Vice President Joe Biden and former South Bend, Ind., Mayor Pete Buttigieg, have questioned the wisdom of turning the government into the nation’s sole health insurer.

It’s been decades since Canada transitioned from a U.S.-style system of private health care insurance to a government-run single-payer system. Canadians today do not gnash their teeth about co-payments or deductibles. They do not struggle to make sense of hospital bills. And they do not fear losing their health care coverage.

To be sure, wait times for specialist care and some diagnostic imaging are often criticized as too long. But a 2007 study by Canada’s health authority and the U.S. Centers for Disease Control and Prevention found the overall health of Americans and Canadians to be roughly similar.

Some Canadians purchase private supplemental insurance, whose cost is regulated. Outpatient medications are not included in the government plan, but aside from that, coverage of “medically necessary services” is assured from cradle to grave.

The cost of administering this system amounts to 17% of Canada’s national expenditures on health.

In the United States, twice as much — 34% — goes to the salaries, marketing budgets and computers of health care administrators in hospitals, nursing homes and private practices. It goes to executive pay packages which, for five major health care insurers, reach close to $20 million or more a year. And it goes to the rising profits demanded by shareholders.

Administering the U.S. network of public and private health care programs costs $812 billion each year. And in 2018, 27.9 million Americans remained uninsured, mostly because they could not afford to enroll in the programs available to them.

“The U.S.-Canada disparity in administration is clearly large and growing,” the study authors wrote. “Discussions of health reform in the United States should consider whether $812 billion devoted annually to health administration is money well spent.”

The new figures are based on an analysis of public documents filed by U.S. insurance companies, hospitals, nursing homes, home-care and hospice agencies, and physicians’ offices. Researchers from Hunter College, Harvard Medical School and the University of Ottawa compared those to administrative costs across the Canadian health care sector, as detailed by the Canadian Institute for Health Information and a trade association that represents Canada’s private insurers.

Compared to 1999, when the researchers last compared U.S. and Canadian health care spending, the costs of administering health care insurance have grown in both countries. But the increase has been much steeper in the United States, where a growing number of public insurance programs have increased their reliance on commercial insurers to manage government programs such as Medicare and Medicaid.

As a result, overhead charges by private insurers surged more than any other category of expenditure, the researchers found.

In U.S. states that have retained full control over their Medicaid programs, the growth of administrative costs was negligible, they reported. (The same was true for Canada’s health insurance program.) But in states that shifted most of their Medicaid recipients into private managed care, administrative costs were twice as high.

America’s Health Insurance Plans, a group representing private health insurance companies, said administrative practices shouldn’t be blamed for escalating the cost of care in the United States.

“Study after study continues to demonstrate the value of innovative solutions brought by the free market,” AHIP said in a statement. “In head-to-head comparisons, the free market continues to be more efficient than government-run systems.”

AHIP cited a recent report by the Medicare Payment Advisory Commission, an independent body that advises Congress. The report showed that Medicare Advantage plans — which are privately administered — deliver benefits at 88% of the cost of traditional Medicare.

Even so, the study authors concluded that if the U.S. health care system could trim its administrative bloat to bring it in line with Canada’s, Americans could save $628 billion a year while getting the same health care.

“The United States is currently wasting at least $600 billion on health care paperwork — money that could be saved by going to a simple ‘Medicare for All’ system,” said senior author Dr. Stephanie Woolhandler, a health policy researcher at Hunter College and longtime advocate of single-payer systems.

That sum would be more than enough to extend coverage to the nation’s uninsured, she said.

Americans Split On Obamacare - Want Public Option Added

The charts above are from the recent Politico / Harvard T.H. Chan School of Public Health Survey -- done between August 31st and September 4th of a random national sample of 1,000 adults, with a margin of error of 3.7 points.

Obamacare (the Affordable Care Act) has been in effect for a couple of years now. Over 20 million Americans now have health insurance that did not have it before, people with pre-existing conditions can't be denied insurance or charged rates they couldn't afford, students up to age 26 can stay under their parents insurance plan, there is no longer a cap on medical care that insurance will pay for, and 80% of insurance premiums must go to pay for medical care. Those are all good things, and a big improvement over the system before Obamacare was passed.

So, what do Americans think of Obamacare? It turns out that the American public is split, with 47% saying it is working well and 47% saying it is not working well -- with 83% of Democrats saying it is working well and 80% of Republicans (and 56% of Independents) saying it is working poorly.

What is wrong? Why isn't there huge support (since Obamacare has been a significant improvement over the old system)? It turns out that many don't think it has gone far enough. It hasn't covered enough people, and it hasn't reduced the cost of medical care.

About 54% of the general public (with 75% of Democrats and 52% of Independents) would like to see a public option offered. Only the Republicans oppose that, with 60% opposing a public option. Most believe Americans should be able to opt for a government insurance plan (like Medicare) to get away from the greedy insurance companies who care more for their bottom line than for patient health.

Americans are also unhappy with the cost of health care -- and they should be, since Americans pay more per capita for health care than any other developed nation. The general public, Democrats and Independents mainly place the blame for the cost on drug companies and insurance companies. Once again, Republicans are out-of-step with everyone else, most of them blaming the federal government.

Supreme Court Should Protect Obamacare Subsidies

When our lawmakers wrote the bill that instituted Obamacare (the Affordable Heath Care Act), they put a provision in it to make sure that it was understood that those people going through a state health care exchange qualified for a federal government subsidy to help them purchase insurance. But they evidently didn't make it clear enough that people using either a state exchange or the federal exchange qualified for those subsidies.

The right-wing, which has been searching for a way to destroy Obamacare for several years now, has jumped on this rather poorly written provision of the law -- and they filed suit to keep those using the federal exchange from getting a subsidy. That case is now pending before the U.S. Supreme Court, and if that court decides in favor of the right-wingers who brought the case, up to 8 million people would lose their subsidy (and no longer be able to afford health care insurance).

A new poll has been done, the Washington Post / ABC News Poll, to find out what the public thinks the Supreme Court should do. That survey was done between May 28th and 31st of a random national sample of 1,001 adults, and has a margin of error of 3.5 points. And the public spoke up clearly in defense of the Obamacare subsidies.

The public wants those subsidies to remain intact. This includes 55% of all adults, 65% of Democrats, 57% of Independents, 58% of those living in a state that has a state exchange, and 53% of those living in a state without an exchange. The only group with a majority saying the subsidies should be stopped is Republicans (and 34% of them want the subsidies protected).

Republican officials are beginning to realize they may have shot themselves in the foot on this issue. They could be entering the next election cycle being responsible for something the public is against (the removal of subsidies, which could virtually kill Obamacare), and with 8 million angry voters having lost their health insurance (and looking for someone to blame).

The Supreme Court decision is expected sometime this month, and most pundits believe there is a 50-50 chance they will stop the federal subsidies. The congressional Republicans have been searching for a way out of this mess they created for themselves (with their rabid opposition to Obamacare), but right now, it looks like they are not going to be able to agree on a solution. They are too afraid of looking like they support Obamacare (which could hurt them in next year's primary).

It looks like the states will have to find their own solution -- and fortunately a simple one is available. They could follow the example of Pennsylvania and Delaware. Those two states are creating their own exchange -- sort of. It is a state exchange in name only, since their citizens will continue to use the federal website to buy insurance -- but it would be sufficient to allow their citizens to keep getting the federal subsidy to help them purchase insurance.

Will all the non-exchange states follow this example if the Court rules against the subsidies? I don't know. Some very red states, like Texas, could refuse to take action. It will be interesting to see what the court decides this month, and what Republicans do about that decision (if it kills subsidies). They have definitely put themselves between a rock and a hard place on this issue.

House GOP Wastes No Time In Attacking Obamacare

(This caricature of the GOP elephant is by DonkeyHotey.)

The Republicans told us they would try to destroy the Affordable Care Act (even though they have no replacement for it) if given control over both houses of Congress -- and in the first week of the new 114th Congress, they have started to make good on that promise. It looks like they are trying a different tactic though. Instead of trying to repeal the whole health care law, they are going to attack it in bits and pieces (sort of a "death by a thousand cuts" approach).

This week the House passed a bill to modify the Affordable Care Act (Obamacare). Obamacare required larger employers to provide health insurance for any employee working at least 30 hours (or pay a penalty to the government to help the government finance that insurance). The law intentionally set the limit at 30 hours to make sure all full-time employees would get health insurance. The new House bill would raise that limit to 40 hours.

The House Republicans bragged that their bill would "protect" the insurance for full-time workers, but that is nothing more than an outrageous LIE. The effect of the bill would be to do just the opposite -- take the insurance guarantee away from any employee working less than 40 hours. This means an employer could cut an employee's hours by one hour (limiting him/her to a 39 hour work week) -- and in doing so they would still basically have a full-time employee, but would no loner have to provide health insurance or pay the penalty for not providing it.

This would shift the burden for paying for health insurance from the employer to the taxpayer, who would then have to pay for that employee to either get on Medicaid (if a low-wage worker) or get a government subsidy to buy private insurance. This bill was not passed to help or protect workers or taxpayers (because it hurts both). It is nothing more than a GOP payback to corporations for donating huge sums to help them get elected last November.

Some may think that corporations (and other large employers) won't take advantage of this new bill if it becomes law. If you think that, then you don't understand either capitalists or human nature. I have no doubt that many employers will take advantage of the law by cutting hours to 39, and putting the money that should go toward providing insurance into their own pocket, letting taxpayers foot more of their labor costs.

This horrendous bill must be stopped before it becomes law. Hopefully, that can be done in the Senate with a filibuster. If not, this would be a great opportunity for President Obama to put his veto pen to work.

GOP Still Can't Get A Majority To Oppose Obamacare

The Kaiser Family Foundation has released its latest survey on health care and the Affordable Care Act (Obamacare). The survey was done between December 2nd and 9th of a random national sample of 1,505 adults, and has a margin of error of 3 points. This included 467 Democrats (5 point MOE), 378 Republicans (6 point MOE), and 464 Independents (5 point MOE).

Many of the congressional Republicans want to think that their success in the last election (taking control of both houses of Congress) means the public is now behind their efforts to repeal Obamacare. That is not true. While the Democrats strongly support Obamacare, and the Republicans strongly oppose it, the general public (and Independents) are split on the issue -- with both groups showing a slight favorability for keeping Obamacare intact. And in fact, most people like nearly all of the aspects of the new law.

As in the past, the only aspect of Obamacare that is really disliked by most is the individual mandate -- the requirement to have insurance or pay a penalty. It seems that many people still have not realized that everyone must be on board with the national health insurance program to keep private insurance companies from raising their rates exorbitantly.

I believe most people don't understand that the individual mandate will not affect most Americans at all. Too many have accepted the Republican lies that say this mandate will affect a large number of Americans. That is just not true. If you get your insurance through an employer (as a significant majority of Americans do), or if you are on Medicare or Medicaid, or you already have insurance -- then the individual mandate will  not affect you at all. It is estimated that those affected will be in the low single-digits.

As the charts below show about 64% of Americans are against the individual mandate, only 3% could correctly answer as to exactly what the individual mandate's penalty for 2015. About 72% admitted they had no idea what it was, and another 25% gave an incorrect answer. In other words, most people opposing the individual mandate don't know what the penalty is, and haven't yet realized that it doesn't even apply to them (or to most Americans). The government (and the media) needs to do a much better job of explaining the individual mandate, and to whom it will apply.

In addition to the lies the Republicans have told about the individual mandate, they have also told lies about two other things. They have told Americans that undocumented immigrants can get a government subsidy to buy insurance -- and they have told them that Obamacare created end-of-life death panels to decide who among the elderly should live or die.

Neither of those two things is even remotely true. But as the charts below show, far too many Americans still believe them. About 43% think undocumented immigrants can get a government subsidy, and about 41% think Obamacare created death panels. It is outrageous that congressional Republicans (and other teabaggers) are still telling these lies. And sad that four out of ten Americans are ignorant enough to believe them.

Warren Blasts SCOTUS Decision On Corporate "Religion"

(The caricature above of Sen. Elizabeth Warren is by DonkeyHotey.)

As you probably know by now, the United States Supreme Court has decided that the religious rights of a corporation trumps the right to health care of American women. They decided that Hobby Lobby could exclude birth control from its employee insurance plan because it "offends" the corporation's religious beliefs. Like many other Americans, Senator Elizabeth Warren (D-Massachusetts) thinks this decision is unconscionable and must not stand. Here is what she had to say in her latest e-mail to her supporters:

I was stunned by last week's Hobby Lobby ruling.

Stunned that we live in a world where the Supreme Court of the United States of America would even consider putting the interests of big corporations before the fundamental rights of American women.

Stunned that the Court would establish precedent for one enormous slippery slope on letting employers deny individuals health coverage for any medical treatment.

Today, my Democratic colleagues and I are fighting to do what the Supreme Court failed to do: to protect the basic rights of American women and families.

Led by Senators Patty Murray and Mark Udall, we've just introduced a new bill – the Protect Women's Health from Corporate Interference Act. The bill reverses the Supreme Court's decision by making it clear that employers cannot deny access to any of the health benefits required by the ACA – not immunizations, not blood transfusions, not HIV treatments, and not birth control – while preserving reasonable accommodations for religiously exempt employers.

If we're going to respond to Hobby Lobby, it's got to be through a legislative fix. And if the Republicans won't fight for the women they represent, then we're going to take that fight to them. Let them explain why they think employers should decide what health care a woman can get covered by her insurance .

I cannot believe that in 2014 I have to send you an email about protecting access to birth control. We've got a lot of other big problems in our country to tackle right now.  

Millions of people still haven't recovered from the worst economic downturn since the Great Depression. More and more young people are drowning in student debt. Too many workers are struggling to stay out of poverty on a minimum wage, and millions of others are struggling to save for retirement. Seniors keep getting told they're going to have to get by on less.

But the Republican Party has made it clear: They want to spend their time working to deny women access to birth control and punch as many holes in the Affordable Care Act as they can.

Just look at the facts:

• In 2012, Republicans tried to pass the Blunt Amendment – legislation that would allow employers and insurance companies to deny women's health care services – even birth control – based on any vague moral objection.


• When the Blunt Amendment failed, the Republicans resorted to hostage-taking. Remember last year's government shutdown that nearly tanked our economy? That all started with a GOP threat to get Democrats to change the law so employers could deny coverage for birth control.

When Democrats wouldn't cave and the government shutdown backfired, the Republicans turned to their conservative friends on the United States Supreme Court – five justices who are among the top ten most pro-corporate justices to serve in the last half-century – to do what Congress and the American people would not: give corporations rights to determine women's access to health care coverage.

We cannot stand by while the radical right of our country conducts a full-scale assault on women's rights and basic health care.

Help us fight back against the Hobby Lobby ruling. Sign up now to show your support for the Protect Women's Health from Corporate Interference Act.

This is 2014, not 1914 – and we've had enough.

Thank you for being a part of this,

Elizabeth

Supremes Say Corporate Rights Trumps Women's Rights

In a 5 to 4 vote, the conservatives on the Supreme Court have made a decision that should shame all Americans. They have decided that the religious rights of a corporation are more important than the rights of women who work for that corporation. They ruled that corporations like Hobby Lobby have the right to make sure the insurance they provide for employees doesn't contain anything that would offend the religious beliefs of the corporation's owners -- in this case many kinds of contraception, such as IUD's, the morning after pill, and some types of birth control pills.

The crazy part of this is that the corporation did not have to pay even a penny for that coverage of contraceptives. The insurance companies had taken that expense on themselves (since contraceptive coverage saved them money). But even though they didn't have to pay for that coverage (since their insurance would cost the same with or without contraceptive coverage), the company decided their religious views were offended and demanded that the insurance they provided for employees should not cover contraceptives for women.

I was not really surprised by this decision by the court's right-wingers. The right-wing in America seems determined to keep women as second-class citizens. They deny women the right to control their own bodies, to be paid equally for equal work, and now the right to have contraception covered by their employer-provided health insurance policy. The sad fact is that these same companies who deny contraception coverage are also the companies that pay poverty wages -- so that at least some women will be unable to pay for their own contraception.

The only good thing about this decision is that it doesn't seem to apply to publicly-owned corporations (but only to companies owned by an individual, a family, or a small group). And Hobby Lobby does say there are some forms of contraception they approve of (sponges, some types of pills, etc.) -- but there is nothing in this ruling that would keep them from deciding in the future that no form of contraception meets with their religious approval (or that could be decided by some other company).

This decision also puts health care rights on a slippery slope. If these companies can deny contraception in their policies, can other companies deny other health benefits based on religious beliefs -- like blood transfusions (or in the case of a company owned by a Christian Scientist, any kind of medical care other than prayer)?

This was a very bad court decision, and like the Citizens United decision, needs to be overturned. Courts have made bad decisions in the past (like the infamous Dred Scott decision) that was overturned by a better court. Hopefully this will happen.

Ruth Bader Ginsburg wrote the minority opinion. Here are some excerpts from her opinion:

"The exemption sought by Hobby Lobby and Conestoga would...deny legions of women who do not hold their employers’ beliefs access to contraceptive coverage."

"Religious organizations exist to foster the interests of persons subscribing to the same religious faith. Not so of for-profit corporations. Workers who sustain the operations of those corporations commonly are not drawn from one religious community."

"Any decision to use contraceptives made by a woman covered under Hobby Lobby’s or Conestoga’s plan will not be propelled by the Government, it will be the woman’s autonomous choice, informed by the physician she consults."

"It bears note in this regard that the cost of an IUD is nearly equivalent to a month’s full-time pay for workers earning the minimum wage."

"Would the exemption...extend to employers with religiously grounded objections to blood transfusions (Jehovah’s Witnesses); antidepressants (Scientologists); medications derived from pigs, including anesthesia, intravenous fluids, and pills coated with gelatin (certain Muslims, Jews, and Hindus); and vaccinations[?]...Not much help there for the lower courts bound by today’s decision."

"Approving some religious claims while deeming others unworthy of accommodation could be 'perceived as favoring one religion over another,' the very 'risk the [Constitution's] Establishment Clause was designed to preclude."

"The court, I fear, has ventured into a minefield."

Obamacare Is Working But Single-Payer Would Work Better

The Commonwealth Fund has released its 2014 report on health care. This report compared health care in several different areas for 11 rich developed nations. Sadly, out of those 11 nations, the health care in the United States was rated last, meaning it had the poorest attempt to deliver health care to all citizens of any of those developed nations.

The survey was done before Obamacare had fully been implemented, so some areas will have improved -- like accessibility and equity. Millions more people now have health insurance in the United States thanks to Obamacare, and even more will probably get that insurance in the future. But a flaw in Obamacare allows the states to continue to control the access to health insurance for poor people, and since about half of the states (controlled by Republicans) refuse to expand Medicaid, millions of poor people in the United States continue to go without health insurance and therefore lack access to adequate health care. In Texas alone, this figure is more than 1.5 million people.

And since these states continue to refuse to define health care as a right (instead viewing it as a product for sale to those with the money to buy it), there is little hope that all states will expand Medicaid in the near future. But even if they did, there would still be some Americans (a few million) left without health insurance. That's because Obamacare was designed to help people get health insurance, but did not make it a requirement for all people to be covered with adequate insurance.

There is another problem with health care in the United States. It is just too expensive -- and this is a problem that Obamacare won't, and probably can't fix. Note in the chart above that the United States spend much more than the other developed nations on health care (on a per capita basis) -- and it does that in spite of the fact that millions of Americans are not offered or given access to the health care system.

Now one might be tempted to say that the cost is so high in the United States because those who do receive health care in the United States get better care than in those other countries. That is just American exceptionalism, and is not true. According to the Commonwealth Fund report, the United States doesn't finish first in any aspect of health care among these developed nations. Health care is so expensive in the United States because it is treated as a profit-making business (on all levels) rather than a right of citizens -- and government doesn't do anything to control the costs (as it does in those other countries).

There is a simple way to reduce the cost of health care significantly in the United States. We could adopt a single-payer health care system (where all citizens would be covered with government health insurance, sort of like a Medicare for all system). Even if we left doctors and hospitals as profit-making businesses, which is the most likely scenario for single-payer in the United States, health care costs could be significantly reduced.

The costs would be reduced for several reasons. First, the profit-making private insurance companies would be taken out of the equation. Second, government insurance has a lot lower overhead cost than private insurance. Third, government could negotiate with doctors and hospitals to control the costs. And fourth, overhead costs for doctors and hospitals would be reduced since they would have to deal with hundreds of different insurance companies (all with their own policies and regulations).

Obamacare has improved the health care situation in the United States, but it falls far short of fixing the broken system. A single-payer system would cover ALL citizens with health insurance, give them access to adequate health care, and lower the cost for that health care. All citizens have a right to decent health care -- and a single-payer system is the best way to accomplish that.

Republican Officials Think It's OK For Poor Mothers To Die

The Republicans like to say the Affordable Care Act (Obamacare) wasn't necessary, because the United States has the best medical system in the world. And on one level that is true. We have great doctors (and lots of them), great hospitals, and the best medical technology available anywhere in the world. And if you're rich (or have good health insurance), you can take advantage of that great medical care.

The problem is that the great medical care is not available to all the citizens of this country. Millions of citizens don't have the money, and can't afford the insurance, to be able to get adequate access to decent medical care -- especially preventive care (that could find serious illnesses early enough to fix them). Although it's far from perfect, Obamacare was created to help address this problem. It mandated quality insurance from private companies, gave subsidies to many to help them buy that insurance, and provided Medicaid coverage for those too poor to buy private insurance.

This should have provided even the poorest Americans with basic health insurance coverage. But it didn't -- and the reason it didn't is because the Republicans killed the expansion of Medicaid in about half of our states. I have already posted about how this purely political move by the GOP is going to cost thousands of American lives each year (the lowest estimate being about 7,000 unnecessary deaths, and the highest estimate being slightly more than 17,000 unnecessary deaths).

Now we learn that these unnecessary deaths will even involve mothers giving birth. A new report  by The Lancet (a British medical journal) shows that the United States, the richest nation in the world, pages far behind all other developed nations in the maternal mortality rate (MMR). In fact, it even ranks behind many developing nations -- ranking 60th out of 180 nations (see the above map from the report). Other developed nations have a maternal mortality rate of less than 10 deaths per 100,000 births (with Iceland having the lowest rate at 2.4). By comparison, the MMR in the United States is 18.5 deaths per 100,000 births. Here is how The National Memo sums up this report:

For much of the last decade, maternal mortality rates (MMRs) have declined globally. But in the United States, they have consistently increased and are now at one of the highest points in the last 25 years. If conservatives have their way with social and economic policy, it’s unlikely the U.S. will make significant strides to improve the health of mothers in the near future.

According to a report released last week in the The Lancet, the U.S. now ranks 60th out of 180 countries for maternal deaths. China is number 57. Only seven other countries experienced an increase in MMR over the past 10 years. They include Greece, Afghanistan, and South Sudan. The report estimates that for every 100,000 births, 18.5 mothers die in the U.S. By comparison, 13.5 women die in Iran, 6.1 in the United Kingdom, and only 2.4 in Iceland.

It is no coincidence that the U.S. MMR has increased as poverty rates have steadily climbed. In 2010, Amnesty International released a report that showed women living in the lowest-income areas were twice as likely to suffer a maternal death. States with high rates of poverty were found to have MMRs 77 percent higher than states with fewer residents living below the federal poverty level. Women of color have poverty rates more than double those of white women, and black women are 3-4 times as likely to die from pregnancy-related causes. . .

Expanding Medicaid would save women’s lives. A 2010 study conducted in New York City showed that the MMR for women with no insurance was approximately four times higher than for insured women, and that the rate for women insured by Medicaid was comparable to that of women with private insurance.

This is inexcusable. There is no justifiable reason why the United States, the richest nation with the best doctors and technology, should rank 60th in the maternal mortality rate. We should rank first -- because we have the money, the knowledge, and the technology to save most of these lives. What we don't have is the political will among Republican officials in power to solve the problem.

There are a couple of reasons for this hard-hearted view by GOP officials. First, they don't consider health care to be a right of all humans. For them it is just another product to sell for a profit, and if a person can't afford it that's just too bad. Second, they are afraid if health care is offered to the poor then their rich benefactors might have to pay a little more in taxes -- and they have chosen to see poor people die instead of taxing rich people a little more.

The truly sad part is that we have a health care reform in place (Obamacare) that would significantly reduce the maternal mortality rate in the United States. Just expanding Medicaid to the poor mothers in all 50 states would accomplish that. Aren't lives (even the lives of the poor) more important than politics? If you answer yes to that question, then it should be a moral imperative to vote against the Republican Party in the coming election -- and if you answer no, then I have to question both your humanity and morality.  

Obamacare Insurance Sales Creeping Close To 8 Million

When the Affordable Care Act (Obamacare) was passed, the Congressional Budget Office (CBO) predicted that about 7 million private insurance policies would be purchased by the end of March of this year. But after the program got off to a weak start last October (due to computer problems), the CBO revised their estimate down to 6 million -- and the Republicans predicted that the 6 million figure would not even be reached.

Both the Republicans and the CBO were wrong -- by a significant amount. It now looks like the figure for the end of March was about 7.21 million purchases. And since the program deadline was extended for those who had trouble getting access to the exchanges, another 570,000 policies have been purchased. That brings the current total to about 7.78 million -- and it is not inconceivable that the final total will reach 8 million.

And that doesn't even count the millions who are now on their parents' policies or the millions who have qualified for Medicaid. Obamacare didn't solve all the problems facing of our health care system, but any honest person will have to admit it has been a huge success.

Obamacare Signups Are Still Growing

It seems that the failure of the Affordable Care Act (Obamacare) was nothing but a futile wish of right-wing Republicans -- a wish that has turned into a brutal nightmare for them. The number of private insurance purchases, originally predicted to be 7,000,000 by the Congressional Budget Office, has easily cruised by that figure. It currently rests at 7,588,454 and it is still growing (adding nearly 400,000 since the end of March).

And that is just a portion of the millions of new people who now have insurance coverage thanks to Obamacare. That total is well above 22.7 million people.

The Republicans are still talking about repealing Obamacare, but that is just to keep their teabagger base happy. They have to know it would be political suicide to take health insurance away from over 22.7 million people.

Over 22 Million New People Have Insurance Thru A.C.A.

The numbers of people who now have insurance coverage through the various aspects of the Affordable Care Act (Obamacare) just keeps climbing. The latest total (through Medicaid/CHIP, private insurance purchases, and those under 26 now covered by their parents' insurance) is over 22.2 million people. And the numbers continue to grow.

Last week, the Republicans in the House of Representatives voted for the 52nd time to repeal Obamacare, but that was just to keep their teabagger base happy (since most of them still face a party primary). There is no way they want to actually take insurance coverage away from more than 22 million people, which is what their repeal would do. And by 2017, the earliest a repeal could happen (since the president would veto any repeal before then), there will be a lot more than 22 million people that a repeal would hurt.

The Republicans know Obamacare is here to stay. They just don't want to admit it yet (because that would anger their teabagger base). And there is some evidence that they know it. Last week, they joined Democrats in passing some small changes to Obamacare. If they really thought it was so bad it could not succeed, or they could actually repeal it -- then why would they be voting with Democrats to improve it? Two reasons -- they know the program is  here to stay, and the business community asked for the small improvement to Obamacare.

But they made the small improvement to Obamacare without any fanfare -- holding no debate on the bill, and passing it on a voice vote (so no member would have to go on record as voting for it). Even though most of them have quietly accepted that Obamacare is here to stay, they know their teabagger base has not. The window for repeal has closed, and the Republicans are now just playing political games.

Media Still Won't Report The Truth About Obamacare

For quite a while now the main story the media wants to report is that American oppose the Affordable Care Act (Obamacare) -- leaving the impression that a majority of Americans would like to see Obamacare repealed. Several polls have shown this is just not true, and hasn't been true for quite a while now -- but the media doesn't seem to be interested in delving below the surface to see the real story.

The latest example of this superficial (and deceptive) reporting comes from a news organization that usually does a better job than most in reporting the truth -- National Public Radio (NPR). NPR commissioned Greenberg-Quinlan-Rosner to do a poll, and some of the questions in that poll were about Obamacare. The chart above shows what NPR reported about the poll -- that 51% of the public opposed Obamacare and 47% supported it.

That reporting is disingenuous at best, and borders on being an outright lie. It leaves the listener with the impression that a majority want to see Obamacare go away (be repealed) -- and that is NOT what the poll actually said. It makes me wonder whether NPR actually read their own poll, or whether they no longer care about getting a story right.

Even a casual reading of that poll will show that the majority actually wants Obamacare stay in effect (with 47% approving of it as it is and another 7% wanting it to go even further, for a total of 54%), while only 44% oppose it because they think it went to far. That's a 10 point gap in favor of keeping Obamacare. To lump the 7% who think Obamacare didn't go far enough with the 44% who think it went too far is to mislead the public about what the real situation is on Obamacare. That 7% (which I am in) doesn't want Obamacare repealed -- they want to make it much stronger.

I'm very disappointed in the poor job of reporting that NPR did on this story. They used to hold themselves to a higher standard than others. They should be ashamed of themselves, since they have lowered themselves to the Fox News standard.

While I'm on the subject of Obamacare, here are the latest numbers:

The Greenberg-Quinlan-Rosner Poll was done between March 19th and 23rd of 1790 nationwide voters, and has a margin of error of 3.18 points.

Private Insurance Sales Top 7 Million Under Obamacare

I said yesterday in a post that I thought the chances were good that private insurance purchases through the state and federal exchanges established by the Affordable Care Act (Obamacare) would top 7 million. Now it looks like that rather easy prediction to make has officially come true. President Obama announced yesterday that sales had topped 7 million -- and Charles Gaba (who has kept a running total of Obamacare signups at his website ACASignups.net) puts the total at about 7,080,180 (with some states still to report).

The Congressional Budget Office (CBO) had originally estimated that 7 million policies would be sold by March 31st, but after the slow start in October and November they revised their estimate down to 6 million. It turns out that revision wasn't necessary. Consumers flooded the market in March, buying nearly 3.8 million policies in that month alone. Now as the numbers trickle in from the state exchanges, and those who had difficulty with access getting a couple of weeks extension, the question is no longer whether Obamacare will reach its goal but by how much will they surpass that goal.

The Republicans are still saying they want to repeal Obamacare, and that they program will fail -- but the new numbers make those statements sound rather hollow. Obamacare has given more than 20 million Americans health insurance that they couldn't have gotten otherwise, and those numbers will continue to grow. In fact, the only thing keeping most Americans from being able to have quality health insurance is the Republican refusal to expand Medicaid in 25 states (where millions of the poor are still denied health insurance coverage).

Obamacare is not perfect, and I hope we can improve it soon (or go all the way to a single-payer system covering everyone). But it has been a success in getting coverage for millions of Americans, and it will not be repealed. But don't expect any Republican to admit that. They didn't think the huge number of Americans without access to health care was a problem to begin with.

Newest Numbers Verify The Huge Success Of Obamacare

The Republicans have done their best to try and make sure the Affordable Care Act (Obamacare) is a failure. They have lied about the program, pronounced it to be an unworkable failure, urged citizens not to comply with it, and voted to repeal it numerous times. But their efforts to obstruct the program and prevent it from being successful have been for naught, because the latest numbers show that Obamacare is a huge success.

When Obamacare became law, the Congressional Budget Office predicted about 7 million Americans would purchase private insurance through the program by the first cut-off date (March 31st). After the program got off to a very slow start, due to computer glitches and consumer reticence, the CBO adjusted its sales estimate down to 6 million. It now looks like that adjustment was necessary.

As of March 28th, there had been more than 6.622 million purchases of private insurance policies through the state and federal health exchanges. It is still very possible that the 7 million mark could be reached by the end of March, and if not, it will be easily achieved early in April (since the deadline has been extended for those who have had trouble accessing the exchanges). And if you add in the number of new people who have purchased insurance without going through the state or federal exchanges (but still get the same prices and benefits), the number of private insurance purchases has already topped 7 million.

And that is just a portion of the new people now covered with insurance thanks to Obamacare. When you add in the young people under 26 who have been added to their parents' policies (3.101 million) and the new Medicaid and CHIPS sign-ups (10.429 million), you'll find that the number of new people with health insurance in the United States is about 20.152 million. That's not everyone in this country that needs health insurance, but it is a significant achievement (and is expected to grow in the future as more people realize that Obamacare is a better deal than what we had before).

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But while Obamacare has been successful, the Republican efforts to stop it have been shameful -- and nothing is more shameful than the 25 states where Republicans have prevented Medicaid from being expanded. This refusal to expand Medicaid is preventing millions from getting the insurance they need to access preventative care -- and that inability to get preventative care in those 25 states is going to kill thousands of people (somewhere between 7,114 and 17,106 every year).

One of the favorite lies of the Republicans is that Obamacare created "death panels" to make end of life decisions for the elderly in this country. That is not true at all, but that doesn't mean there are death panels -- the death panels composed of Republicans in the 25 states that refuse to expand Medicaid. It is not the elderly that is victimized by these GOP death panels, but the poor. Here is a state-by-state breakdown of the number of people that will be killed each year by these GOP death panels.