Coverage Of The Success of Obamacare And Debunking Republican Lies

Obamacare Winning

Reading liberal versus conservative columnists give entirely different views of the Affordable Care Act. Liberals have been writing about its success while conservatives continue to spread misinformation. Here’s a few examples of liberal views on the topic (which are the fact-based articles):

Tim Dickenson of Rolling Stone (source for the above graphic) writes that Obamacare is working. Instead of the fake conservative horror stories, he linked to stories which show how the Affordable Care Act is helping people. He described the successes, and pointed out that “Republican Party sabotage has also impeded enrollment.” Rather than back away  from calling a lie a lie as many journalists will, Dickenson directly addressed Republican lies as lies as he debunked them:

GOP LIE No. 1: THE NUMBERS DON’T MEAN ANYTHING
Over the course of the open-enrollment period, Republicans labored to argue that Obamacare did far less good than advertised because an estimated 4.7 million Americans received letters in the fall warning that their current policies could not be renewed, as they failed to comply with new coverage requirements. They point to these “cancellations” to argue that few of the folks being counted as ACA enrollees previously lacked insurance.

There are three glaring flaws to this argument. First: Many if not most of those whose plans were canceled were automatically transferred into similar policies that complied with the new law. One of the nation’s largest for-profit insurers told House investigators that it had issued fewer than 2,000 outright cancellations.

Second: Through executive orders, Obama gave roughly half of those who received a letter – 2.35 million – the chance to stay in their existing coverage. CBO estimates suggest that just 1.5 million actually continued in their grandfathered plans, as many could find cheaper and/or better coverage on a subsidized exchange or qualify for Medicaid. It’s telling that the Michigan leukemia patient featured in Koch-funded ads intended to convey the horror of these cancellations has found a compliant poicy on the exchange that still covers her oncologist and cut her monthly premium in half.

Giving the Republican argument every benefit of the doubt, this would leave a potential pool of about 3 million people who changed, rather than gained, insurance. This leads to the third flaw in the argument: Obamacare sign-ups were always going to include millions of people who already had insurance. In its latest estimate, the CBO showed just two-thirds (4 million of 6 million) of exchange enrollments coming from people who were previously uncovered. And the limited hard data available from the states suggests the CBO is closer to the mark than the GOP: In New York, nearly 60 percent of buyers were previously uninsured. In Kentucky, it’s even higher: 75 percent.

GOP LIE No. 2: THEY HAVEN’T PAID THEIR PREMIUMS YET
GOP critics point out that the administration hasn’t tracked how many enrollees are actually paying their insurance bills. The complaint about transparency is fair, but the concern is misplaced. Figures from state exchanges and insurers themselves show that between 80 and 95 percent of enrollees are paying their bills.

GOP LIE No. 3: OBAMACARE WILL COLLAPSE UNDER ITS OWN WEIGHT
One legitimate concern as Obamacare ramped up was that it could enter a “death spiral.” This would happen if the number of older, sicker people on the exchanges far outnumbered the young and the healthy. Premiums would spike, year over year, with each increase driving more healthy folks out of the pool – making the exchange unsustainable. While reaching 7 million enrollees is a huge win politically, it doesn’t ensure Obamacare’s viability as an insurance program. “I do think there’s too much focus on the overall number,” Karen Ignagni, a top insurance-industry lobbyist, told reporters. What matters far more, she said, is the insurance pools’ “distribution of healthy to unhealthy.”

The administration wanted 18- to 34-year-olds to make up nearly 40 percent of enrollees. By March, however, only 25 percent of the mix was under 35. That sounds dire. Yet even pools with just 25 percent of younger people would not create a tailspin, forcing premiums to rise by just 2.4 percent, according to the Kaiser Family Foundation.

Additionally, the convoluted structure of Obamacare eliminates systemic risk. Even the 27 states that relied entirely on the federal exchange will end up with state-specific insurance pools. What this means is that if a death spiral were to develop in, say, Ohio, that failure would not pull down neighboring states. What’s more, safeguards within the ACA mean states don’t have to get the mix right in Year One. For the first three years, ACA has shock absorbers to prevent premium spikes in states with problematic pools. Over that same period, the penalties for not buying insurance step up – which should drive younger, healthier people into the market, balancing the risk profile. We lack hard data to get a clear picture of all state pools. But private insurers are sending optimistic signals to investors that all is well. Case in point: Insurance giant WellPoint just raised its earnings forecast.

GOP LIE No. 4: “OBAMACARE IS THE NUMBER-ONE JOB KILLER IN AMERICA”
That’s what Texas Sen. Ted Cruz told a Tea Party convention in Dallas last summer. Since then, the GOP has been making two ACA-connected job-loss claims, both demonstrably false. First, they twisted a February CBO report to claim that Obamacare will cause 2.5 million Americans to lose their jobs. What the CBO actually found is that Americans will be able to work a little less thanks to lower health-care costs, voluntarily scaling back work hours between 1.5 and 2 percent through 2024, or the output of 2.5 million full-time workers. The other GOP lie is that Obamacare is causing employers – who will be responsible for insuring employees who work more than 30 hours a week – to either scale back the hours of full-time employees or hire only part-time workers. This, too, is hogwash. While the share of part-time employment remains historically high, it has actually been in decline since 2010, when Obama­care became law.

I have discussed many of the above points, with links to the evidence, in previous posts on health care reform.

I was also happy to see that he concluded with the same opinion I have expressed that Democrats must take the offensive on health care:

House Republicans have learned the hard way that even nibbling around the edges of Obamacare can backfire. In February, the GOP pushed a bill to tweak the mandate that businesses offer health care to all employees working more than 30 hours. Switching to the GOP’s preferred 40-hour standard, it turns out, would add $74 billion to the deficit by 2024 and cause nearly 1 million Americans to lose coverage. That’s the kind of move that would play right into Democratic hands. Says Greenberg, “Democrats do very well when they hit back at Republicans on what people lose.”

Until recently, Greenberg had been advising Democrats to move beyond Obamacare and turn to bread-and-butter issues like jobs and the minimum wage. “The strongest attack on Republicans,” he says, “is that they’re obsessed with Obamacare instead of critical issues like dealing with the economy.” But his new poll has Greenberg rethinking that counsel. “Until now, this is an issue where the intensity has been on the other side,” he says. But defending Obamacare, he adds, has emerged as “a values argument for our base.” Greenberg now believes Democrats “ought to lean much more strongly” to campaign on the virtues of Obamacare as a means of boosting progressive turnout. “Not apologizing for Obamacare and embracing it actually wins the argument nationally,” he says. “And it produces much more engagement of Democratic voters. That’s a critical thing in off-year elections.”

Eugene Robinson also wrote about the success of Obamacare:

A new report by the nonpartisan Congressional Budget Office estimates that, despite all the problems with the HealthCare.gov Web site launch, 12 million people who previously lacked insurance will obtain coverage this year. By 2017, the year Obama leaves office, the CBO predicts that an additional 14 million uninsured will have managed to get coverage .

Why was the Affordable Care Act so desperately needed? Because without it, 54 million Americans would currently have no health insurance. Within three years, according to the CBO, Obamacare will have slashed the problem nearly in half.

We should do better, and perhaps someday we will. Most industrialized countries have some kind of single-payer system offering truly universal coverage. But if you have to work within the framework of the existing U.S. health-care system — which involves private health insurance companies and fee-for-service care — the Affordable Care Act reforms are a tremendous advance.

Many Republican critics of Obamacare know, but refuse to acknowledge, that the reforms are here to stay. Does the GOP propose to let insurance companies deny coverage because of preexisting conditions, as they could before the ACA? Does the party want to reimpose lifetime caps on the amount an insurer will pay? Tell young adults they can no longer be covered under their parents’ policies?

He concluded by also recommending that Democratic candidates take advantage of the success of Obamacare:

To do well in the fall, Democrats have to infuse their most loyal voters with similar enthusiasm. The success of Obamacare will help. Already, polls are showing upticks in support for embattled Democratic incumbent senators in Louisiana, Arkansas and Alaska. Democrats control their own destiny in November: If they can get their voters to the polls, they’ll win.

In the long run, no matter what happens in the election, I’m more convinced than ever that the Affordable Care Act will be seen as landmark legislation. With minimal immediate impact, the ACA does two tremendously important things.

First, it shifts the incentive structure in the health-care industry in ways that promise to hold down rising costs. And second, it establishes the principle that health care should be considered a right, not a privilege.

Of course it’s not perfect. It’s a thing of beauty anyway. We have liftoff. It’s working.

Paul Krugman described Obamacare as the unknown ideal:

The current state of public opinion on health reform is really peculiar. If you’ve been following the issue at all closely, you know that the Affordable Care Act is one of the great comeback stories of public policy: after a terrible start, it has dramatically exceeded expectations. But hardly anyone seems to know that.

He blamed Fox and Rush Limbaugh for all the misinformation they have spread, the Obama administration for doing a “lackluster job so far in getting the word out,” and “a persistent anti-ACA tilt in news coverage.” He pointed out how factual stories on the success of Obamacare are often buried in the back pages of newspapers.

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Fact Checking Valuable, But Not Always Right

Pinoccio

The Moderate Voice has a post yesterday on the increase in fact-checking in journalism. Fact-checking is preferable to the standard media practice of quoting both sides as if they are equally valid, generally with an implied assumption that the truth is somewhere in the middle. This leads to erroneous reporting when one side is intentionally using misinformation and lying far more than the other. However labeling something fact checking doesn’t necessarily mean it is immune from journalistic problems. Paul Krugman pointed out one problem:

“The people at PolitiFact are terrified of being considered partisan if they acknowledge the clear fact that there’s a lot more lying on one side of the political divide than on the other,” Krugman wrote in 2011.

“So they’ve bent over backwards to appear ‘balanced’ — and in the process made themselves useless and irrelevant.”

As Krugman pointed out, there are fact checkers which label an equal number of statements from Democrats and Republicans as being wrong in order to give the appearance of being impartial. That typically means that outrageous lies from Republicans are called lies but to provide a sense of balance,  statements from Democrats which are generally true but in which there is an exception are also called lies.

The entire idea of calling something true or a lie is often a poor way to handle complex issues which are stated by politicians in brief statements. Sometimes politicians are trying to be truthful, but boiling down a complex issue into a brief statement, or commercial, will result in exceptions where the statement is false. Often it is preferable to look at what is true in what is being said and where it isn’t entirely true and explain the issue rather than just calling it truth or a lie.

While Republicans have been hit far more with big lies on health care, Democrats have been harmed by the problems in how some fact checkers declare something either true or a lie (being a lie if not 100% true in every case). There have been two big examples of this. The first is Democrats saying that the Medicare proposals in the Ryan budget would destroy Medicare. Technically this is untrue as Ryan would replace Medicare with something named Medicare. On the other hand, it is true because the Republican proposals would change Medicare into something fundamentally different with far less protection for seniors. Rather than just calling it a lie, fact checkers would have done more good by explaining why Democrats consider these changes to be destroying Medicare.

The other is the greatly exaggerated “lie of the year” when Obama said people could keep their own doctor under the Affordable Care Act. This was an absurd statement on one level because every year insurance companies and doctors make decisions which can affect this which the government has no  power over. On the other hand, Obama was right in the context where he was speaking, even if worded poorly. Republicans were lying when they claimed that Obamacare would make people join some sort of government run program which would tell them which doctors they can see. The Affordable Care Act actually makes it more likely that people could have insurance which would allow them to keep their doctor than had been the case in the past and does nothing to force people to lose their doctor. People have a better chance of keeping their doctor when protected from losing their insurance. Frequently people are forced to change doctors because of employers changing insurance plans. Employees have a better chance of keeping their own doctor when provided more choice in plans, as under the Affordable Care Act.  Where Obama got it wrong was that the same forces already present which lead to people having to change doctors, while diminished, would still exist. It would be far better to explain this complex issue, where Obama was mostly right, than to just declare it a lie because it is not true one hundred percent of the time.

Cross posted at The Moderate Voice

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Obama Warns Of Threats To Right To Vote

Protect Vote

If one followed politics superficially from the mainstream media, they might come to the incorrect view that we have a two party system in which the two parties differ on some issues but are essentially mirror images of each other. Looking more closely, it becomes apparent that instead we have a centrist party which has been struggling to continue our system of self-government and an extreme right wing party which seeks the destroy the vision of America held by our founding fathers. Among those who have bucked the usual media narrative and have reported on this are Thomas Mann and Norman Ornstein. This pair of centrists who have pointed this out in an essay, Let’s just say it: The Republicans are the problem, and in their book  It’s Even Worse Than It Looks: How the American Constitutional System Collided With the New Politics of Extremism, which clearly laid out the extremism of the current Republican Party. They have explained that the mainstream media missed the big story of the 2012 campaign–the dishonesty and extremism of the Republican Party.

Republicans benefit by rigging the system in their favor as much as possible. Some of this is built in to the structure of our government, such as giving small Republican states the same number of Senators as larger, Democratic states. Gerrymandering, as well as the tendency of Democrats to concentrate more in urban areas, give Republican an advantage in the House, even in elections such as in 2012 when more people voted for Democratic representatives than Republicans. Republicans take advantage of control over large segments of the mainstream media, including Fox which operates essentially as a house propaganda organ, and then “play the refs” by complaining of fictitious liberal media bias. If this isn’t enough, they try to rig election laws to make it harder for Democrats to vote.

While Republicans use their influence over the mainstream media to promote misinformation to further their cause, Democrats have done a poor job of promoting a message or even of exposing what their opponents are doing. I was therefore happy to see that Barack Obama has spoken out against Republican restriction of voting rights.

“The right to vote is threatened today in a way that it has not been since the Voting Rights Act became law nearly five decades ago,” Mr. Obama said in a hotel ballroom filled with cheering supporters, most of them African-American. “Across the country, Republicans have led efforts to pass laws making it harder, not easier, for people to vote.”

Speaking a day after a conference in Texas commemorating the 50th anniversary of the Civil Rights Act, Mr. Obama linked the issue to the movement that helped pave the way for him to become the nation’s first black president.

“America did not stand up and did not march and did not sacrifice to gain the right to vote for themselves and for others only to see it denied to their kids and their grandchildren,” he said.

Republicans in some swing states have advanced new laws that go beyond the voter identification requirements of recent years. Among other things, state lawmakers are pushing measures to limit the time polls are open and to cut back early voting, particularly weekend balloting that makes it easier for lower-income voters to participate. Other measures would eliminate same-day registration, make it more difficult to cast provisional ballots or curb the mailing of absentee ballots.

Over the last 15 months, at least nine states have enacted voting changes making it harder to cast ballots. A federal judge last month upheld laws in Arizona and Kansas requiring proof of citizenship, like a birth certificate or a passport, leading other states to explore following suit.

I hope we see more of this. Warnings about the Republican threat to freedom and democracy should not be limited to a single date commemorating a past event. This should be an important part of the political debate between the parties every day. Hopefully people will then realize that they should be wary of a political party which finds that its success depends upon keeping people from voting.

Cross posted at The Moderate Voice

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Quote of the Day From Bill Maher on Fox

“Absolutely nothing new has happened with the missing plane. It is astounding how they continue to report ‘news’ even though they have zero information, although, it never stopped Fox News.” –Bill Maher

Bonus Quote:

“Fox News, they may be a little biased. We had an earthquake here on Monday and they reported that the Earth’s crust was emboldened by Obama’s weakness.” –Bill Maher

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Good News On Obamacare Enrollment Leading To More Favorable Coverage

Democrats have suffered damage from the Affordable Care Act far more from negative press than actual negative results. Of course they make the problem far worse by running away as opposed to standing up for the successes of the Affordable Care Act. Two stories last fall did the most harm–the failed roll out and news of people receiving cancellation letters. The computer problems were IT issues which have nothing to do with the benefits of the Affordable Care Act as policy. Now that we have some data on enrollment, we know that the initial IT problems did not decrease enrollment at all from initial projections. We also now know that most of the people who received cancellation letters received alternate coverage, frequently from the same company, with better coverage at a lower price.

Bad news tends to lead to more bad news but good news often leads to more good news, and hopefully the Democrats will show the ability to capitalize on it. Republicans who made claims of Obamacare leading to fewer people having coverage or failing to meet projections look as foolish as the Republicans who ignored the polls and projected a Romney victory in 2012. Instead of negative stories, we are seeing stories such as this from Politico: Obamacare critics: Homina, homina, homina:

Back in the fall, conservatives seized on the flubbed Obamacare rollout as proof that President Barack Obama’s brand of liberalism doesn’t work.

Now, the law’s opponents aren’t about to say that critique was wrong — but they’ve lost the best evidence they had.

On Tuesday, Obamacare sign-ups passed 7 million, six months after the launch of a federal website that could barely sign up anybody. There are still a lot of questions about how solid that figure is, but the idea that the law could even come close to the original goal after such a disastrous start would have been laughable even a few weeks ago.

It was also a wake-up call for Republicans and conservatives, and even the occasional liberal, who pushed the argument that the failed website challenges the idea at the heart of Obama’s agenda — that government can still solve big social problems.

Of course Fox and other right wing outlets are still running negative headlines, but otherwise success is leading to the rest of the media being more positive. While conservatives spread false stories of Obamacare nightmares, there are more stories on those who benefit under the Affordable Care Act. The New York Times has pointed out that many people have purchased insurance directly from insurance companies in addition to the over seven million purchasing through the exchanges:

Millions of newly insured people are hiding in plain sight.

They are the people who have bought new health insurance since the start of this year but have chosen for one reason or another to bypass the state and federal exchanges that opened last year under the Affordable Care Act. While the exact number is unknown, some health care experts estimate that it may be in the millions.

Politicians and policy makers have focused on the number of people who signed up through the exchanges — at nearly seven million and counting a day after the March 31 deadline — but they have largely overlooked the group that did not use the exchanges, even though it could have a major impact on the program’s financial success in the years ahead…

All individual health insurance plans offered after Jan. 1 must adhere to several new requirements, regardless of whether they are bought through the marketplaces. Insurers must offer more comprehensive coverage and charge healthy and sick people the same rates. And they can no longer turn people away if they have existing medical conditions.

It makes little difference to insurers how the new customers arrive at their door: What matters most is that they get there. Insurers must bring in enough new customers, including a significant number of healthy ones, to offset the higher costs of complying with the law.

Aaron Billger, a spokesman for Highmark, an insurer that offers plans in Delaware, Pennsylvania and West Virginia, said about 30 percent of the approximately 133,000 members that Highmark had enrolled as of mid-March had signed up outside the marketplaces. The large insurer WellPoint, which has said it expects to enroll about one million customers nationwide in new plans, has reported that about 20 percent of its sign-ups have occurred off the exchanges.

Some people are saving money by purchasing insurance from co-ops which are being set up in some states thanks to the Affordable Care Act as an alternative to the large insurance companies. It is too soon to tell whether they will really lower costs, but they do sound like a promising alternative:

The names of the big health insurance companies are familiar – Blue Cross, Aetna, United Healthcare. But what about CoOportunity Health, or Health Republic Insurance of New York?  These are among 23 new health insurance companies that started under the Affordable Care Act.  They’re all nonprofit, member-owned cooperatives, and the aim is to create more competition and drive prices down…

“In some states, co-ops are dominating the marketplace, with 80 percent of the enrollees going to the co-op,” he says.

That’s in Maine. Morrison says most co-ops are very happy with their enrollment numbers. Their rates are often the lowest available through an exchange.

“The co-op states have 8.4 percent lower premiums on average than the non-co-op states, across the marketplace,” says Morrison. “So co-ops are creating that competition. They’re keeping rates down in the states they’re operating in.”

The Los Angeles Times told the story of a cancer patient who benefited from Obamacare:

Robertson wrote a passionate account of his cancer and posted it on the White House website to illustrate how important insurance is even for younger people. Noting that he had paid just 1% of the $900,000 cost for five surgeries, radiation and chemo, he wrote, “Without that, I would have bankrupted my family just to stay alive.”

And without Obamacare’s guarantee that he could buy affordable insurance despite his preexisting medical condition, he wrote, “there’s no telling what life would have been like for us moving forward.”

A major benefit of the Affordable Care Act is to enable people to obtain coverage on the individual market who had difficulty obtaining coverage in the past, when most coverage outside of government programs came from large businesses. There have already been stories on some of the winnersPolitico reported on how Obamacare has helped self-employed artists and actors:

Abromaitis is among the hundreds of thousands of artists, musicians, dancers, actors and filmmakers around the country who especially stand to gain under Obamacare, either through the plans and premium subsidies available on its new insurance exchanges or from the plans employers must start offering.Typically a well-educated but lower-earning demographic — whose members are self-employed more often than not — these Americans have frequently struggled to buy insurance on their own. Some were able to afford union plans, but others paid for costly coverage on the individual market or went without it despite the risk.

A survey last year by The Actors Fund found that 43 percent of individuals working in the visual and performing arts lacked coverage, more than double the national uninsured rate. More than a third of those who had coverage said they got it on the individual market, compared with the 6 percent of Americans generally who turn there for health insurance.

Many are now flocking to Obamacare’s federal- and state-run exchanges, hoping for a way to get covered without breaking the bank. They’re finding both good and bad: more affordable plans but sometimes narrow provider networks and high deductibles.

The narrow provider networks and high deductibles did come as a surprise to some but this has actually been a characteristic of insurance sold through the individual market for a long time. When I purchased new coverage (directly from the insurance company, bypassing healthcare.gov), there was a choice of policies with more restrictive networks with a lower premium, along with choices without restrictive networks but with a higher premium. Most people who wind up in plans with the most restrictive network did so out of a choice to save money. The choices I saw were no different from the choices offered prior to the Affordable Care Act. The difference was that the coverage was far more comprehensive, had new limits on out of pocket expenses, and could never be canceled due to medical problems.

There is far  more good news this week on the Affordable Care Act. Hopefully the Democrats will finally stop being scared of negative and false attacks from Republicans and go on the offensive and develop a new message to take political advantage of the law they passed.

Cross posted at The Moderate Voice

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No, Your Insurance Premiums Are Not Going To Skyrocket

Journalists report what they hear but often lack the background knowledge to really evaluate the information. This is especially true in health care, where journalists typically do not understand the complexity of the field. This creates great opportunities for those who want to play the ref, such as insurance companies talking about the Affordable Care Act. This is seen in a story at The Hill today claiming Obamacare premiums will skyrocket.

We have seen many other predictions of terrible things happening and they universally have failed to occur. Even the IT problems with the opening of the exchanges were quickly fixed. This falls into the same category, but of course conservative bloggers who prefer articles which reinforce their biases over facts have spent the day repeating it. When conservatives gloat over such claims, keep in mind that they are partially responsible for any future rate increases by putting out a misinformation campaign designed to dissuade people from signing up–including campaigns outright saying not to sign up.

It is always best to avoid panic with articles such as this. When predictions are made it would be best to simply wait until later in the year to see what happens, but obviously that doesn’t fit in with life in the blogosphere. At least wait a few hours as more information comes in. After the story began to spread, Ed Kilgore responded with a good take on this:

I’m sure many of you saw a certain headline from The Hill today: “O-Care premiums to skyrocket.” At first I thought the source was The Drudge Report.

If you actually read the accompanying article by Elise Vieback, the rather alarming assertion is mostly a collection of blind quotes from “health industry officials.” Yes, one former Cigna executive went on the record to say his “gut” tells him premiums could go up, which is of course very convincing. Otherwise the closest Vieback gets to attribution is an “insurance official who hails from a populous swing state.”

In an updated version of the article, Vieback does quote by name two experts—who deny the whole premise of her story.

And the “premiums to skyrocket” claim directly contradicts a variety of on-the-record assessments by health insurance executives—e.g., Aetna CEO Mark Bertolini, Wellpoint president Joe Swedish, and Cigna CEO David Cordani—that the Obamacare premium structure is working out relatively well. And the most reliable independent study, from the Kaiser Family Foundation, concluded that the much-feared “death spiral” of premiums that Vieback seems to be predicting as a reality for much of the country is very unlikely to occur.

Particularly in its revised form, Vieback’s piece has a number of “to be sure” qualifiers that undermine the headline. But it’s the headline that will get big coverage today—to be sure—maybe on Drudge Report itself. And it’s pretty clear which political constituency is driving the “story.”

I further discussed the reasons why the conservative death spiral scenario is not realistic last month, including quoting from the Kaiser report mentioned by Kilgore.

We also have to keep in mind the fact that double digit increases annually were common in the past in the individual market so there might be increases which are not out of line with past events. I once even had to change policies because of a tremendous jump in rates. I was able to find alternative coverage, but that is not true of everyone who lost their coverage in the days before the Affordable Care Act.

The insurance companies also do have a legitimate concern here, even if they are playing the refs with scare stories. They have to make predictions a year ahead of time as to what their costs will be to set premium rates. It was understandable that Obama gave into political pressures and made changes in the Affordable Care Act, but this also does make it harder for insurance companies to predict future costs. Allowing people to keep their old junk policies longer does adversely affect their calculations. The changes made will probably result in higher rates for legitimate reasons–but most likely much, much smaller than this article makes it sound.

Update: Even though it is posted at The Hill, it looks like this article might be considered just another piece of unsubstantiated garbage from the right wing noise machine. Elise Viebeck, writer of the article, did an internship at the right wing National Review.

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Nate Silver Opens FiveThirtyEight With Questions Raised About Data Journalism

Nate Silver’s new site, FiveThirtyEight.com, opened this week and I must say I have been underwhelmed. Certainly check it out yourself and come to your own conclusion, but so far I hardly see the posts there as adding anything of value to online sources than we had in the past. I think this is largely because Nate Silver’s numbers driven type of analysis applies far better to sports coverage and polling than it does to many of the other topics which the new site attempts to cover.

Certainly other areas also involve analysis driven by numbers. If one is to run a web site based upon claims of superior analysis of the numbers, it is also important that the numbers be well established as correct. Think Progress has raised questions about FiveThirtyEight’s science writer on climate change. This also shows that it is important to read analysis which does more than just present numbers. As I learned back in college statistics, statistics is the science which shows that the average human has one testicle and one breast.

I don’t intend to downplay the value of Nate Silver’s polling analysis, but it was hardly unique in predicting the elections. Yes, he did far better than the many Republicans who predicted Romney victories based upon opinions rather than fact, but he was not the only one. Besides watching Nate Silver’s site, I also watched a couple sites which took an aggregate of polling results to show who was leading. This provided essentially the same results. It was also easy to predict based upon past results and limited knowledge of the states which states were tending in a different direction.

Nate Silver described his vision for his site here. I certainly appreciate the use of data to substantiate opinions, but so far the posts there have not really provided terribly meaningful data in other areas. Perhaps it will improve over time, but he would have been smarter to have a really major article telling us something we don’t know based upon the numbers to initiate the new site. First impressions are important.

Needless to say, his criticism of opinion articles hasn’t been accepted very well by some opinion writers. Paul Krugman hardly ignores facts and figures but has somehow been cast as the opposing model to Nate Silver’s. Krugman responded to Silver’s criticism of opinion writers:

Nate’s manifesto proclaims his intention to be a fox, who knows many things, rather than a hedgehog, who knows just one big thing; i.e., a pundit who repeats the same assertions in every column. I’m fine with that.

But you can’t be an effective fox just by letting the data speak for itself — because it never does. You use data to inform your analysis, you let it tell you that your pet hypothesis is wrong, but data are never a substitute for hard thinking. If you think the data are speaking for themselves, what you’re really doing is implicit theorizing, which is a really bad idea (because you can’t test your assumptions if you don’t even know what you’re assuming.)

Leon Wieseltier discussed the importance of opinion writers, concluding:

Since an open society stands or falls on the quality of its citizens’ opinions, the refinement of their opinions, and more generally of the process of opinion-formation, is a primary activity of its intellectuals and its journalists. In such an enterprise, the insistence upon a solid evidentiary foundation for judgments—the combating of ignorance, which is another spectacular influence of the new technology—is obviously important. Just as obviously, this evidentiary foundation may include quantitative measurements; but only if such measurements are appropriate to the particular subject about which a particular judgment is being made. The assumption that it is appropriate to all subjects and all judgments—this auctoritas ex numero—is not at all obvious. Many of the issues that we debate are not issues of fact but issues of value. There is no numerical answer to the question of whether men should be allowed to marry men, and the question of whether the government should help the weak, and the question of whether we should intervene against genocide. And so the intimidation by quantification practiced by Silver and the other data mullahs must be resisted. Up with the facts! Down with the cult of facts!

An opinion with a justification may be described as a belief. The justification that transforms an opinion into a belief may in some instances be empirical, but in many instances, in the morally and philosophically significant instances, it will not be empirical, it will be rational, achieved in the establishment of the truth of concepts or ideas by the methods of argument and the interpretation of experience. A certain kind of journalistic commentary, when it is done rightly, is a popular version of the same project, an application of thoughtfully (and sometimes wittily) held principles to public affairs, and is therefore an essential service to a free society. The intellectual predispositions that Silver ridicules as “priors” are nothing more than beliefs. What is so sinister about beliefs? He should be a little more wary of scorning them, even in degraded form: without beliefs we are nothing but data, himself included, and we deserve to be considered not only from the standpoint of our manipulability. I am sorry that he finds George Will and Paul Krugman repetitious, but should they revise their beliefs so as not to bore him? Repetition is one of the essential instruments of persuasion, and persuasion is one of the essential activities of a democracy. I do not expect Silver to relinquish his positivism—a prior if ever there was one—because I find it tedious.

Silver proclaimed in the interview that “we’re not trying to do advocacy here. We’re trying to just do analysis. We’re not trying to sway public opinion on anything except trying to make them more numerate.” His distinction between analysis and advocacy is a little innocent. (Like the insistence of the man who went from the Times to ESPN that he is an “outsider.”) Is numeracy really what American public discourse most urgently lacks? And why would one boast of having no interest in the great disputations about injustice and inequality? Neutrality is an evasion of responsibility, unless everything is like sports. Like Ezra Klein, whom he admires, Nate Silver had made a success out of an escape into diffidence. What is it about conviction that frightens these people?

I have many recent posts on health care reform. Yes, many parts of the issue can be quantified. I could concentrate on the number of people who were without coverage because of preexisting conditions and the number who lost coverage due to being dropped when ill. Numbers are also important when looking at Republican horror stories and the truth about how much money people are really saving under the Affordable Care Act. These are important parts of the story, but not the full story. We also must consider explanations as to how the health care system works and opinions as to how it should. The same is true in many other areas. Facts and numbers are important, but so are analysis, opinions and values.

Update:

This is an argument where neither side is entirely right or wrong. There is even a counter argument to Wieseltier’s assertion that, “There is no numerical answer to the question of whether men should be allowed to marry men.” Steve M wrote:

But there is very much a “numerical answer to the question of whether men should be allowed to marry men” — or at least the opponents of gay marriage strongly suggest that there is. Those opponents argue that gay marriage harms society — specifically, they say that children suffer harm from not having two opposite-sex parents. How do we know this is nonsense? We can look at the lives of children raised by gay couples and compare their well-being to that of children raised by married heterosexuals. If gay marriage were harming the children of gay couples, we’d know it, but it isn’t. And it’s good that we have studies showing a lack of harm, because if we were high-mided and Wieseltierian and chose to remain above the tawdry collection of data on this subject, the anti-gay right would generate all sorts of anti-gay-marriage data and drive the debate with it. (Perhaps Wieseltier needs to be reminded of the preposterous statistics about gay people’s health that have been circulating online and elsewhere for several decades — “the lifespan of a homosexual is on average 24 years shorter than that of a heterosexual” and all that.)

While I agree with Steve regarding the numbers involved, the fact remains that any discussion of gay marriage does also involve values–in this case the values of individual choice and separation of church and state in opposition of conservative values on this issue.

The debate between Krugman and Silver is one where neither side is entirely right or wrong and the differences between the sides are exaggerated when this turns into a blog debate. I don’t think that either Paul Krugman objects to presenting the numbers or that Nate Silver really thinks that everything comes down to the numbers.

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Putin Goes To War

As is often the case, David Remnick provides excellent coverage of the events of the last few days in Ukraine. He shows not only what is going on in the Ukraine, but what good journalism should be. On Putin:

Vladimir Putin, the Russian President and autocrat, had a plan for the winter of 2014: to reassert his country’s power a generation after the collapse of the Soviet Union. He thought that he would achieve this by building an Olympic wonderland on the Black Sea for fifty-one billion dollars and putting on a dazzling television show. It turns out that he will finish the season in a more ruthless fashion, by invading a peninsula on the Black Sea and putting on quite a different show—a demonstration war that could splinter a sovereign country and turn very bloody, very quickly.

There’s more background information than is found in the typical article which concentrates more on up to the minute news than analysis, and then a return to Putin’s motives:

In a recent Letter from Sochi, I tried to describe Putin’s motivations: his resentment of Western triumphalism and American power, after 1991; his paranoia that Washington is somehow behind every event in the world that he finds threatening, including the recent events in Kiev; his confidence that the U.S. and Europe are nonetheless weak, unlikely to respond to his swagger because they need his help in Syria and Iran; his increasingly vivid nationalist-conservative ideology, which relies, not least, on the elevation of the Russian Orthodox Church, which had been so brutally suppressed during most of the Soviet period, as a quasi-state religion supplying the government with its moral force.

And this is how the war is likely to go:

I spoke with Georgy Kasianov, the head of the Academy of Science’s department of contemporary Ukrainian history and politics, in Kiev. “It’s a war,” he said. “The Russian troops are quite openly out on the streets [in Crimea], capturing public buildings and military outposts. And it’s likely all a part of a larger plan for other places: Odessa, Nikolayev, Kherson. And they’ll use the same technique. Some Russian-speaking citizens will appear, put up a Russian flag, and make appeals that they want help and referendums, and so on.” This is already happening in Donetsk and Kharkov.

“They are doing this like it is a commonplace,” Kasianov went on. “I can’t speak for four million people, but clearly everyone in Kiev is against this. But the Ukrainian leadership is absolutely helpless. The Army is not ready for this. And, after the violence in Kiev, the special forces are disoriented.”

In conclusion (but read Remnick’s full article first):

Putin’s reaction exceeded our worst expectations. These next days and weeks in Ukraine are bound to be frightening, and worse. There is not only the threat of widening Russian military force. The new Ukrainian leadership is worse than weak. It is unstable. It faces the burden of legitimacy. Yanukovych was spectacularly corrupt, and he opened fire on his own people. He was also elected to his office and brought low by an uprising, not the ballot; he made that point on Friday, in a press conference in Rostov on Don, in Russia, saying that he had never really been deposed. Ukraine has already experienced revolutionary disappointment. The Orange Revolution, in 2004, failed to establish stable democratic institutions and economic justice. This is one reason that Yulia Tymoshenko, the former Prime Minister, newly released from prison, is not likely the future of Ukraine. How can Ukraine possibly move quickly to national elections, as it must to resolve the issue of legitimacy, while another country has troops on its territory?

Vladimir Ryzhkov, a liberal Russian politician who no longer holds office, said that the events were not only dangerous for Ukraine but ominous for Russia and the man behind them. “It’s quite likely that this will be fatal for the regime and catastrophic for Russia,” he told Slon.ru. “It just looks as if they have taken leave of their senses.”

There are, of course, other views worth reading.  Peter Baker explains why it will not be easy to make Russia pay, despite the rants from Republican politicians such as Marco Rubio who seek to find political advantage in the current international crisis.

Mr. Putin has already demonstrated that the cost to Moscow’s international reputation would not stop him. Having just hosted the Winter Olympics in Sochi, he must have realized he was all but throwing away seven years and $50 billion of effort to polish Russia’s image. He evidently calculated that any diplomatic damage did not outweigh what he sees as a threat to Russia’s historic interest in Ukraine, which was ruled by Moscow until the breakup of the Soviet Union in 1991.

Mr. Putin may stop short of outright annexation of Crimea, the largely Russian-speaking peninsula where Moscow still has a major military base, but instead justify a long-term troop presence by saying the troops are there to defend the local population from the new pro-Western government in Kiev. Following a tested Russian playbook, he could create a de facto enclave loyal to Moscow much like the republics of South Ossetia and Abkhazia that broke away from Georgia. On the other hand, the White House worries that the crisis could escalate and that all of Russian-speaking eastern Ukraine may try to split off.

Finding powerful levers to influence Mr. Putin’s decision-making will be a challenge for Mr. Obama and the European allies. Mr. Obama has seen repeatedly that warnings often do not discourage autocratic rulers from taking violent action, as when Syria crossed the president’s “red line” by using chemical weapons in its civil war.

Russia is an even tougher country to pressure, too formidable even in the post-Soviet age to rattle with stern lectures or shows of military force, and too rich in resources to squeeze economically in the short term. With a veto on the United Nations Security Council, it need not worry about the world body. And as the primary source of natural gas to much of Europe, it holds a trump card over many American allies.

The longer-term options might be more painful, but they require trade-offs as well. The administration could impose the same sort of banking sanctions that have choked Iran’s economy. And yet Europe, with its more substantial economic ties, could be reluctant to go along, and Mr. Obama may be leery of pulling the trigger on such a potent financial weapon, especially when he needs Russian cooperation on Syria and Iran.

“What can we do?” asked Fiona Hill, a Brookings Institution scholar who was the government’s top intelligence officer on Russia during the Georgia war when Mr. Putin deflected Western agitation. “We’ll talk about sanctions. We’ll talk about red lines. We’ll basically drive ourselves into a frenzy. And he’ll stand back and just watch it. He just knows that none of the rest of us want a war.”

Baker also compared Obama’s options to those which George Bush had when Russia went to war with Georgia in 2008. Bush eventually learned that he was wrong about his initial sense of Putin’s soul from looking into his eyes. If anyone still has any doubts, it is clear that Putin’s soul is that of an autocrat and KGB killer.

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Good News On The Affordable Care Act

With all the poor reporting on the Congressional Budget Office report last week, I was disappointed to see that at times this extended to NRP, even if primarily by more conservative-leaning commentators discussing the report. Therefore I was happy to hear a report on Morning Edition today in which Steve Inskeep and Renee Montagne immediately started out by setting the record straight:

RENEE MONTAGNE, HOST:

It’s MORNING EDITION from NPR News. I’m Renee Montagne.

STEVE INSKEEP, HOST:

And I’m Steve Inskeep.

Let’s look for the truth behind some much discussed news about the Affordable Care Act. Congressional forecasters said last week that the law may cause fewer people to work full-time jobs.

MONTAGNE: Critics distorted that finding, saying the law was eliminating jobs. In truth, forecasters were mainly saying that people would leave full-time jobs that they had been keeping for the health benefits. ObamaCare makes it possible for more people to buy insurance outside their jobs in the private market.

Among the many errors I heard over the past week was John Prideaux on the Friday News Roundup on the Diane Rehm show both misunderstand that it is a benefit of the Affordable Care Act that people are freed from the “insurance trap” and fail to recognize that this was a goal from the start. He incorrectly stated that this benefit is “certainly not the one that people, you know, stated when they were backing the Affordable Care.” Allowing people the opportunity to leave their current job was promoted by backers of the Affordable Care Act from the beginning. Currently many people are prevented from retiring in their early 60′s in order to keep medical care. Often a spouse will work in a job the couple does not need primarily for the insurance coverage. Being free to leave a job without losing insurance coverage will also enable people to leave larger companies and to work at small companies or start their own business, strengthening the economy. This will even free up jobs to help reduce the unemployment rate.

The bulk of the report from Scott Horsley was on the unusual situation in this country for health insurance to be tied to one’s job, and how the Affordable Care Act will help change this. They also pointed out how the exchanges are working better:

HORSLEY: In other words, what Gruber calls the crumbling building of workplace health insurance may take a long time to come down. In the meantime, a new building – the insurance market set up by the Affordable Care Act – is slowly taking shape and looking a little less rickety than it did early on. As of last month, more than three million people had moved in.

Mother Jones also summarized the good news which came out yesterday on increased enrollment in the Affordable Care Act:

More Americans enrolled in Obamacare plans in January than expected, according to data released Wednesday by the Obama administration. The Department of Health and Human Services (HHS) had expected to sign up 1,059,900 people last month. Instead, about 1.14 million people purchased health plans through the federal and state health insurance exchanges.

This is the first time since the uninsured started buying insurance on the exchanges in October that the administration has beaten a monthly enrollment goal…

There was also a slight uptick in the number of young adults signing up for coverage in January. A quarter of the Americans who have enrolled so far are young people, who tend to be healthier, and who the Obama administration needs to hold down insurance costs. That’s below the 40 percent target, but the trend is moving in the right direction.

The percentage of Americans who are uninsured hit a five-year low this month, according to a Gallup poll released Wednesday. Sixteen percent of adults do not have health insurance, the lowest uninsured rate since 2009.

Despite all the negative news from those who dwell on early glitches and process issues, the Affordable Care Act is turning out to be a tremendous success.

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The Past Week In Conservative Stupidity

Over a year ago Bobby Jindal warned that Republicans “must stop being the stupid party.” They have not been doing particularly well at following his advice. To extrapolate this to the conservative movement, this week provided two more examples of what can only be labeled as stupidity dominating conservative conversation–the intentional misinterpretation of the Congressional Budget Office report on the Affordable Care Act and reaction to Olympic coverage from Russia.

This is not to say that all conservatives believe these things or are stupid. However, the prevalence of stupidity does seem to have increased tremendously in the conservative movement and Republican Party in recent years. Even ignoring the easy targets such as Sarah Palin and Michele Bachmann, the caliber of conservative discourse generally seen today is far different from what came from past conservatives such as William F. Buckely, Jr., who also fought to keep the Birchers and other predecessors of today’s Tea Party out of the GOP. Barry Goldwater might have many views which liberals find objectionable, but he also warned about what would happen if the religious right took control of the Republican Party. Even Ronald Reagan was not so foolish as to oppose any tax increase or to prevent increases in the debt ceiling to allow the Unites States to honor its debts.

It is understandable that some conservatives might have been misled by the initial headlines on the report from the non-partisan Congressional Budget Office. Many journalists, overly influenced by conservative arguments and lacking adequate understanding of health care policy, initially were inaccurate in their coverage. Once the report was more fully evaluated, it was clear that the CBO report actually showed that there is no evidence of an increase in unemployment due to the Affordable Care Act as Republicans had been predicting would occur.  Instead the portions of the report on employment showed that Obamacare was projected to be successful in one of its goals--saving people from the “insurance trap.”

Until the Affordable Care Act came into effect many people continued in jobs they did not want because they would be unable to obtain health insurance if they left their current job. Under the Affordable Care Act, health insurance is no longer tied to employment. Now people are free to retire at an earlier age if they desire, instead of waiting until age 65 when they qualify for Medicare. They are also free to leave large corporations to work for small businesses, or perhaps even start a business of their own. The Robert Wood Johnson Foundation wrote about projections for an increase in entrepreneurship and self-employment last May. The CBO report confirms that they were correct. This can help boost the economy.

While an initial mistake regarding this might have been unintentional, there has subsequently been many corrections. Glenn Kessler of The Washington Post,  corrected errors in reporting in writing, “No, CBO did not say Obamacare will kill 2 million jobs”.  Kessler concluded with saying, “we award Three Pinocchios to anyone who deliberately gets this wrong.” Factcheck.org also corrected the misconceptions.

As some people leave jobs they no longer want or need, their jobs can open up for others. In testimony before the House Budget Committee, CBO Director Douglas Elmendorf confirmed that the CBO report suggests the Affordable Care Act will reduce unemployment. Even Paul Ryan corrected fellow Republicans on this point. Besides reducing unemployment, the CBO report showed that, while Republicans had been demanding an end to the risk corridors in order to agree to an increase in the debt limit, the risk corridors actually wind up saving the government eight billion dollars. The CBO projects a deficit of $514 billion in 2014, representing three percent of the Gross Domestic Product. This is down from 2009 when deficit was at 10.1 percent of GDP, and more in line with the average size of the deficit compared to GDP over the past forty years.

Conservatives are rarely willing to give up on their criticism of the Affordable Care Act even when contradicted by the facts. They continue to repeat fallacious arguments about death panels or their false claim that Obamacare constitutes a government takeover of health care. Finding that those who received cancellation notices from insurance companies generally received better coverage at a lower price under the Affordable Care Act did not end their claims of people supposedly losing their insurance under Obamacare.

Conservatives remain unwilling to give up the argument about people leaving their jobs, spinning it to suggest that the Affordable Care Act encourages people to be lazy parasites on society instead of working, ignoring the actual types of people this is likely to affect. Conservatives have been presenting “horror stories” of people allegedly harmed by the Affordable Care Act which typically turn out to be untrue once the details are examined. Finally we are seeing newspaper reports emphasizing the positive aspect of freeing people from the “insurance trap.”

While conservative columnists such as Ross Douthat fear that Obamacare will lead to a “strong work disincentive while looking at a population of childless, able-bodied, mostly working-class adults,” these are not the type of people I am seeing as benefiting by freedom from the “insurance trap.” If the health care debate is turning into one of anecdotal cases, I’m thinking of an affluent friend who, because of health history, cannot obtain insurance on the individual market so his wife has been working full time in a job purely for the health insurance, even though they have no need for the income beyond the benefits. I have a patient who was left without insurance when her husband retired in his early sixties and then struggled to pay her medical bills. As of January she finally has comprehensive coverage she can afford. These are the types of people who are benefiting from the supposed disincentive to work under Obamacare.

In theory there is a risk that “able-bodied, mostly working-class adults” might have less incentive to work, but I hardly think that providing affordable health care is enough to do this on a widespread level. Far more able-bodied adults are not working because jobs are not available. Besides making more jobs available, the Affordable Care Act can help relieve this problem in another way. In addition to freeing people to retire in their early sixties or leave jobs held solely for the insurance, people will be able to start small businesses without losing health insurance. In Republican-speak, this should also be beneficial to the economy due to making more “job creators.” The Robert Wood Johnson Foundation wrote about projections for an increase in entrepreneurship and self-employment last May. The CBO report confirms that they were correct, and to a greater degree than previously projected.

Conservatives were wrong about this argument, and now appear stupid, and dishonest, when they continue to repeat the same mistakes. I spent more space on this first example than intended, but in retrospect this is an important point which deserves repeated explanations as long as conservatives are claiming that this positive aspect of the Affordable Care Act is somehow undesirable.

The second example is bizarre outrage from the right wing over the video below which comes from NBC’s coverage of the Olympic games:

Their objection is to this line: “The empire that ascended to affirm a colossal footprint; the revolution that birthed one of modern history’s pivotal experiments.”

This is being spun by right wing bloggers as praise for Communism, including by FoxMarco Rubio, along with other conservatives commenting, does not appear to understand what pivotal means. The word refers to points which are critical or vitally important. The Russian Revolution was a pivotal point in their history, along with the history of the world. Similarly, Hitler’s rise to power was a pivotal moment. Both 9/11 and Katrina were pivotal moments during the Bush years.  The computer problems during the first month of the exchanges has unfortunately become a pivotal moment for the Obama administration. The word pivotal says nothing about whether the events were good or bad.

This was one line in a video narrated by Peter Dinklage as introduction to NBC’s sports coverage of the Olympics. If this was a political documentary we would expect information on the horrors of communism. This is unnecessary, and probably out of place, in sports coverage, especially if they desire to be polite and avoid criticism of the host country over a political system which has been overthrown (even if the current regime is repeating many of the same mistakes as under Communism).

I suspect this is outrage is partially motivated by the desire of conservatives to falsely paint liberals as socialists or Communists, such as with the absurd claims that a moderate such as Barack Obama is a socialist. To the conservative mind, the mainstream media represents liberals, especially when they fail to differentiate the evening commentary shows on MSNBC from the rest of NBC. There are rare examples, such as the absurd argument I noted a couple of weeks ago at Salon to nationalize the news media, but putting aside such outliers, there no meaningful interest in Marxist-style socialism or Communism on the left. In contrast, I would think that today’s Republicans would love modern Russia. Between its homophobia and substitution of a plutocracy for a working market economy, Russia has become an example of the end-result of the Republican platform.

Cross posted at The Moderate Voice

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