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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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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Paul Krugman Leaving Princeton To Be Closer To Zabar’s

Paul Krugman is leaving Princeton next year to join the faculty of the Graduate Center, City University of New York and be near Zabar’s. I don’t blame him. If I was nearer to retirement I might consider moving back towards Ann Arbor to be closer to the academic atmosphere of the University of Michigan Zingerman’s.

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Fake Right Wing Claims Of Losers Under The Affordable Care Act

Last week I looked at the right wing’s inability to present losers under Obamacare. There certainly are some losers in a major overhaul of the healthcare system, however they just don’t help the Republicans with their line of attack. The losers, i.e. people paying more in premiums, are affluent Americans who don’t qualify for subsidies but, as I pointed out in the previous post, we still receive significant improvements in coverage to offset higher premiums which we can afford to pay. The types of people the Republicans portray as losers to gain sympathy for their argument have repeatedly been shown to not be losers under Obamacare once the facts are revealed. Anybody with serious medical problems such as cancer is far better off since the Affordable Care Act was passed, regardless of how the Republicans try to twist the facts.

Paul Krugman revisited this issue today, comparing the false claims of losers under the Affordable Care Act to the right wing claims of non-wealthy people being losers under the “death tax.” Krugman wrote:

I’m not sure whether conservatives realize yet that their Plan A on health reform — wait for Obamacare’s inevitable collapse, and reap the political rewards — isn’t working. But it isn’t. Enrollments have recovered strongly from the law’s disastrous start-up; in California, which had a working website from the beginning, enrollment has already exceeded first-year projections. The mix of people signed up so far is older than planners had hoped, but not enough so to cause big premium hikes, let alone the often-predicted “death spiral.”

And conservatives don’t really have a Plan B — in their world, nobody even dares mention the possibility that health reform might actually prove workable. Still, you can already see some on the right groping toward a new strategy, one that relies on highlighting examples of the terrible harm Obamacare does. There’s only one problem: they haven’t managed to come up with any real examples. Consider several recent ventures on the right:

■ In the official G.O.P. response to the State of the Union address, Representative Cathy McMorris Rodgers alluded to the case of “Bette in Spokane,” who supposedly lost her good health insurance coverage and was forced to pay nearly $700 more a month in premiums. Local reporters located the real Bette, and found that the story was completely misleading: her original policy provided very little protection, and she could get a much better plan for much less than the claimed cost.

■ In Louisiana, the AstroTurf (fake grass-roots) group Americans for Prosperity — the group appears to be largely financed and controlled by the Koch brothers and other wealthy donors — has been running ads targeting Senator Mary Landrieu. In these ads, we see what appear to be ordinary Louisiana residents receiving notices telling them that their insurance policies have been canceled because of Obamacare. But the people in the ads are, in fact, paid actors, and the scenes they play aren’t re-enactments of real events — they’re “emblematic,” says a spokesman for the group.

■ In Michigan, Americans for Prosperity is running an ad that does feature a real person. But is she telling a real story? In the ad, Julia Boonstra, who is suffering from leukemia, declares that her insurance has been canceled, that the new policy will have unaffordable out-of-pocket costs, and that “If I do not receive my medication, I will die.” But Glenn Kessler of The Washington Post tried to check the facts, and learned that thanks to lower premiums she will almost surely save nearly as much if not more than she will be paying in higher out-of-pocket costs. A spokesman for Americans for Prosperity responded to questions about the numbers with bluster and double-talk — this is about “a real person suffering from blood cancer, not some neat and tidy White House PowerPoint.”

Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?

The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.

No, what the right wants are struggling average Americans, preferably women, facing financial devastation from health reform. So those are the tales they’re telling, even though they haven’t been able to come up with any real examples.

Even the healthy young people are able to buy catastrophic insurance policies which, once subsidies are considered, will often cost less then their current minimalist plans.

Cross posted at The Moderate Voice

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White House Postpones Employer Mandate For Medium Sized Employers

Republicans have been trying to blame everything on the Affordable Care Act including long standing health care issues, unemployment, the poor performance of Denver in the Super Bowl, and Justin Beiber’s recent antics. Okay, I’m exaggerating a little, but to blame Obamacare for any of these problems is untrue. I’ve already discussed the false claims from conservatives that the Congressional Budget Office shows that Obamacare will increase unemployment when it will actually do the reverse and decrease unemployment.

Unemployment is a serious problem but the attempts to tie it to the Affordable Care Act do not hold up. In addition to the information released by the Congressional Budget Office, the argument that employers are not hiring due to the mandate to provide insurance coverage also fails to hold up. The argument fails to take into account the subsidies which will help employers provide the coverage, along with the fact that the employer mandate had not been scheduled to start until 2015. The White House has today announced a further delay in the employer mandate until 2016 for employers with 50 to 99 employees. (The mandate does not affect employers with under 50 employees).

Derek Thompson has more on the myth that Obama has been killing jobs or is responsible for an increase in part-time employment.

Paul Krugman looked more at the unemployed, and how the right wing is impervious to evidence regarding government action.

Steve Benen explains once again what the “insurance trap” means and why freeing people from having to keep their current job to maintain their insurance is a feature, not a bug, of Obamacare. Face it, if the conservatives don’t understand this yet, they are (intentionally) never going to understand.

Update: Sarah Kliff has a good rundown of the additional changes announced today including relaxing the requirements for employees covered by large companies. The most important change is probably that volunteers won’t be counted as full-time employees. There had been some speculation that volunteers such as volunteer firefighters would be covered by the  mandate, making it more expensive to use such volunteers. She also makes the valid point that, as the majority of companies offer insurance, the postponement of the employer mandate won’t affect very many people.

The conservative reaction has been to denounce this as a dictatorial action from Obama. If these people are so concerned about potential abuse of Executive power, where were they during the Bush years when Republicans backed the Unitary Executive theory which would greatly expand the power of the President (or during the Busy years, the Vice President)?

Update II: Two more thoughts on the conservative spin:

Strange that they are complaining so much about a delay in the employer mandate when they have been predicting such dire consequences of the mandate.

The reason much of this, right or wrong, is being done by executive order is that the system is broken. We know whose fault that is. Congress has voted, at last count, 47 times to repeal the Affordable Care Act but the Republicans are not willing to work on fine tuning the law as would normally be done after such a huge law was passed.

Cross posted at The Moderate Voice

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Medicaid Is Not The Route To A Single-Payer Plan

Corrente is a far left blog which I generally have little interest in, but there are bound to be times when our interests overlap. Today I must say they are right while Paul Krugman and several other liberal writers/bloggers, who I would generally side with over Corrente, are wrong. Paul Krugman and some other liberal writers have been praising Medicaid expansion as if it is a path towards a single-payer plan. A writer at Corrente counters with a post saying that Paul Krugman is wrong about Medicaid.

The writer describe some of their negative experiences in a Medicaid program and concluded:

This is not the system Krugman imagines. He’s not alone; most Democrats and many people who describe themselves as progressive are celebrating the Medicaid expansion under Obamacare as an extraordinary advance. In terms of coverage, they’re right. In terms of steering the country toward health care equity, they’re wrong. Medicaid patients are too often treated as second-class citizens, and the problem is likely to worsen without the kind of drastic reform I mentioned earlier.

There are at present about 150 million Americans being served by at least a half-dozen single-payer systems. We need to take the most popular of those systems and expand it to provide cradle-to-grave coverage for everyone in the country, and improve it to achieve the health care equity that Americans deserve and that President Obama has described as a basic human right. We need Medicare for all.

Medicaid, as the author acknowledged, varies from state to state and even within different parts of states. Some people will have better or worse experience, but the fact remains that in general Medicaid patients are second-class citizens in the health care system. Access to care does vary, but is far different from the health care experiences of most Americans who have insurance or are covered by Medicare. My office receives quite a few calls each week from both people on Medicaid who do not have physicians and from those who desire to get away from the second-class care they often receive in the clinics which will see them. While better than no coverage, to those who have better coverage Medicaid would represent all the horrors of government run health care which the right has been crying about.

I bet that Krugman, and those who echo his views, would change their minds very quickly if they had to give up their private physicians and obtain all their care through Medicaid clinics.

The blogger at Corrente is also correct that, while Medicare is not perfect, Medicare for all would be a much better model for a single-payer plan. It is far better than Medicaid, while still keeping costs down.

I must conclude by also pointing out that Medicaid expansion is not without benefits. Having Medicaid is still far better than having no coverage, despite misinterpretations being spread by conservatives regarding studies of Medicaid expansion in Oregon. I previously discussed this topic here. When the Affordable Care Act was being considered in Congress while the Democrats technically had sixty votes, there weren’t sixty votes for either a pubic option or even a Medicare buy-in, due to opposition by Joe Lieberman and Ben Nelson. With limited money to expand health care coverage, and the impossibility of a single-payer system based on Medicare getting through Congress, Medicaid expansion was an understandable compromise to provide some coverage to the working poor. That does not make it a desirable model for moving to a single-payer plan.

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False Objectivity, Media Bias, And The Budget

One area where conservative media bias can be seen is in reporting on the budget. Media reports commonly report measures which cut the deficit as good and those which increase the deficit as bad. This view may or may not be correct, but it is not an objective position. There are counter arguments that, during a time of economic slowdown when interest rates are low and the infrastructure has largely been neglected, the economy would do better in the long run if we did borrow more to stimulate the economy and improve infrastructure. Continued austerity budgets are not necessarily the best policy. Looking at priorities beyond shrinking the deficit might make sense at a time when government spending is dropping at the greatest rate since the demobilization after World War II.

The  Columbia Journalism Review looked at media coverage of government spending, finding that the media often confuses support for what is seen as a centrist view in support of cutting the deficit as objectivity:

Under the norm of objectivity that dominates mainstream political journalism in the United States, reporters are supposed to avoid endorsing competing political viewpoints or proposals. In practice, however, journalists often treat centrist policy priorities—especially on fiscal policy—as value-neutral. That’s wrong. While it’s widely accepted that the federal government faces limits on what it can borrow in the financial markets, there is significant disagreement, including among experts, over the priority that should be given to reducing current deficit and debt levels relative to other possible policy objectives. It is, in other words, a political issue. Reporters often ignore this conflict, treating deficit-cutting as a non-ideological objective while portraying other points of view as partisan or political. That’s why it’s not accepted for reporters to explicitly advocate, say, abortion bans or recognition of gay marriage, but criticism of the president for not advocating entitlement cuts with sufficient fervor can run in a “factcheck” column.

This confusion between centrism and objectivity cropped up again in coverage of the budget deal, which often portrayed the fact that the agreement did little to cut the federal debt as a failing. The Washington Post’s Lori Montgomery, for instance, was implicitly critical, writing that “the deal would do nothing to trim the debt, which is now larger, as a percentage of the economy, than at any point in U.S. history except during World War II.” McClatchy’s David Lightman also suggested that the lack of more aggressive deficit-cutting was a flaw. The bill is “likely to still increase the federal deficit, if only slightly, this year and next,” he wrote, and is “hardly the grand bargain that’s eluded Washington for years, much less a plan to make a serious dent in the government’s $17.2 trillion debt.”

Stories in the Associated Press and Christian Science Monitor opined even more directly about the bill’s supposed merits. The AP’s Charles Babington tried to take a value-neutral perspective by aligning himself with “[p]eople hoping for a government that works better.” These people, he writes, “can’t decide whether to cheer or lament a bipartisan budget bill,” noting that it “should avoid a repeat of this fall’s government shutdown and flirtation with default” but “comes nowhere near the more ambitious efforts to address long-term spending and debt.” He again reiterates later in the article that the deal “does little to dent the nation’s $17 trillion debt.” The CSM’s Mark Trumbull similarly wrote that “Congress can postpone a grand bargain that reforms the tax code and restrains the growth of entitlement spending, and the economy won’t collapse,” but added that “delay isn’t a good thing for the economy.”

The same pattern often crops up in the sourcing for budget stories. I’ve questioned the media’s insistence on “he said,” “she said” reporting about matters of fact, but there’s no reason to think that centrist deficit hawks have a monopoly on wisdom about the nation’s federal budget priorities. So why are the claims of groups like the Concord Coalition or the Committee for a Responsible Federal Budget presented in articles like Montgomery’s and Lightman’s as neutral, non-ideological perspectives that don’t need to be balanced with offsetting quotes from other points of view? The same deference is rarely given either to conservatives who want more aggressive cuts in the size of government or liberals who would give greater priority to public spending.

The root of these problems is the philosophy of “objective” journalism itself, which forces reporters to try to draw lines between opinion and fact that often blur in real life. But even if reporters aren’t willing to rethink objectivity, they should try to understand why prioritizing deficit reduction over other competing values is a kind of ideology of its own.

Evaluating a policy based upon what is thought to be centrist is especially hazardous in the current political climate where both parties have moved towards the right on economic issues in recent years, with the Republicans taking an especially radical position. As a consequence, what is now thought as centrist in this country would be to the right in much of the world.

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SciFi Weekend: Doctor Who, Star Trek, Batman, Star Wars, JK Rowling, SHIELD, Sleepy Hollow, Utopia, Breaking Bad

Doctor Who

The BBC has released the above poster for the 50th anniversary episode of Doctor Who, to be named The Day of The Doctor. It will be the second from last episode staring Matt Smith, also staring David Tennant and John Hurt.

Steven Moffat discussed filming the final episode with Matt Smith at the TV Choice Awards, where Doctor Who won for Best Drama Series. David Tennant won the Best Actor award for his role on Broadchurch. Miranda Hart of Call the Midwife won for Best Actress. (Jessica Raine,who plays Jennie Lee on Call the Midwife, played Emma Grayling in the Doctor Who episode Hide and has a role in the upcoming movie on the development of the series, An Adventure In Space And Time.)

Peter Davison

Peter Davison will be appearing in the 50th Anniversary episode of Doctor Who. While he has confirmed the appearance, he states he is unable to give any specifics. My suspicion is that he has a cameo role in the special but does not reprise his role as the Doctor unless the story can give a plausible explanation for showing a former version of the Doctor who has also aged. Pictures appeared on line of Tom Baker in his scarf starting rumors that he would also appear but it turns out it was to film a skit for another show.

startrek-lensflare-spock-tsrimg

In follow-up of the controversy I mentioned last week, TrekMovie.com has posted another opinion arguing that Star Trek is Not  Broken. Those who are not happy with how J.J. Abrams is handling Star Trek might be happy to hear that he will not be directing the next Star Trek movie now that he will be busy with Star Wars. I fear that this won’t change many of the problems cited by fans but at least it might mean less lens flare.

There has been even more controversy over the choice of Ben Afflect to play Batman in the Man of Steel sequel. The CEO of Warner Brothers defended the choice, describing this Batman as “kind of tired and weary and seasoned and been doing it for a while.”

Besides the upcoming Star Wars trilogy, Disney is going to take advantage of buying the rights by putting out additional movies. Variety reports that they will be origin movies. There will be a lot of Star Wars as “one ‘Star Wars’ trilogy film or ‘origin story film’ would also appear on the release schedule each year, starting with the seventh installment in the ‘Star Wars’ saga that J.J. Abrams will direct and Disney releases in 2015.”

Warner Brothers is returning to a recent major source of income for the studio. J.K. Rowling is going to write a new movie series taking place in the Harry Potter universe. After recently reading The Cuckoo’s Calling, I think she does have a better future in writing such movies then detective novels, although the two aren’t mutually exclusive. It’s not that I didn’t like the book, but I read several far more entertaining novels over the summer, and there are plenty of similar mystery series already out there.

Grant Gustin of Glee will play The Flash on Arrow, and potentially on a spinoff show.

marvels-agents-of-shield-shield

Cult Box has a spoiler-free review of Agents of S.H.I.E.L.D. Gawker reports that some of the scripts were not very good and Joss Whedon had to rewrite them. The web site for the series is now on line.

The Detroit News reviews another new genre show, Sleepy Hollow. More on the show at TV Line.

ABC is working on an alternate reality series which sounds interesting. The show, entitled The Thirteen, takes place in an alternative present day in which the colonies did not win independence from England and are still fighting the English for independence.

Paul Krugman and John Amato both recommend Orphan Black, which I certainly agree with.

utopia

Utopia writer Dennis Kelly has discussed conspiracy theories, over population, and the second season of the series:

There’s going to be a second series of Utopia isn’t there?

There is. It’s currently being written. It’s being filmed in two months [speaking on the 22nd of August]. I’ve got two months before the first block. You film it in two blocks so episodes one, two and three, and then four, five and six. Marc Munden who directed one, two and three, and really set up the look for Utopia – and that’s what people talk about a lot when they talk about Utopia – he’s a brilliant director, more like a filmmaker than a TV director really, and he’s fantastic to work with. He’s come back and he’s going to do the first block again. He has a much more involved role in the whole series, which is great.

Can you give us any ideas about what series two might contain?

We’ve got a very odd first episode, which people are either going to really like or really say ‘what the fuck did you do that for?’ and I’ve got no idea what the reaction’s going to be. Some of the characters are coming back, you’ll definitely see Arby again, and Jessica. There’s a lot of people dead unfortunately and a lot of people will die [laughs].

Do you have a finite end for Utopia in mind?

I think I do, I think so, yeah. Not necessarily a good one. [Laughs].

Luc Besson is interested in doing another movie in the world of The Fifth Element.

Trailer for Last Days on Mars posted here.

The cast of Dexter teased the finale.

Joking Bad, Jimmy Fallon’s parody of Breaking Bad, can be viewed above. The series ends this month. A spinoff is being considered based upon Saul Goodman before he became Walt’s lawyer. The Hollywood Reporter lists Saul’s top moments.

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Drinking Scandal And The State of the Union

It is a sad commentary on the state of political discourse in this country that so many people are far more concerned about Marco Rubio drinking water than the competing arguments made during and after the State of the Union Address. We saw a thoughtful look at our current problems from Barack Obama and then Marco Rubio responding with the usual Republican bromides and straw man attacks, showing that the current Republicans have nothing to say about the real world, and no capacity for coming up with meaningful solutions to our problems.

I was sure happy it was Barack Obama on my television screen last night as opposed to Mitt Romney. Rubio’s speech showed how if Mitt Romney had been elected, the entire State of the Union Address would have been full of the same types of lies, distortions and irrational arguments that we heard from Rubio in the Republican response.

Obama had already debunked the gist of the Republican response with lines such as these: “Most Americans – Democrats, Republicans, and Independents – understand that we can’t just cut our way to prosperity,” and “deficit reduction alone is not an economic plan. A growing economy that creates good, middle-class jobs – that must be the North Star that guides our efforts.”

Rubio’s throat became dry and he took a sip of water. Big deal. I object more to seeing him fall back on perpetuating the same false narratives about Democrats which Republicans have been relying upon for years to avoid read debate over the issues. Criticize him for trying to pass of a plan which would destroy Medicare as a means to save him. Criticize him, as Paul Krugman has, for his simplistic and untrue explanation for the economic crisis, and ignoring the Republican Party’s role in crashing the economy and obstructing attempts at recovery. Compared to this, drinking water is trivial, even though it will probably be the lead skit on Saturday Night Live this weekend. This is what Rubio will be remembered for, regardless of the significance. It would have been cooler, even if unacceptable, if he had reached for a beer instead. It would have been a far better speech if he had presented some actual ideas.

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