A Little ACA Truth

My enthusiasm for the ACA is mitigated by its complexity and especially by the fact that it leaves private insurers at the center of American healthcare finance, allowing them to continue to suck profits out of the system, pocketing money meant to care for people. (In my state, where insurers have been raising premium costs like right arms at at teabagger rally, while claiming skyrocketing expenses as the reason, it's been recently reported that they have billions in cash on hand.) Still, given the benefits to average people, it's amazing -- or would be, in a world where lies are rejected and truth is valued -- that so many people have been deceived into thinking otherwise.

It's obvious that if Rs get their way after the election, and that if they'd gotten it three years ago, we will not and would not have had any meaningful reform. Given the enormity of the problem, the manifold failings of our current system, the undeniable trajectory of unsustainability on which we find ourselves, and notwithstanding the enormous pressure from obvious interest groups to maintain the status quo, it's a remarkable accomplishment of Congressional Democrats and President Obama that such an effort was made at all, and that, given the opposing political forces, they succeeding in doing something. If imperfect, the ACA represents an actual effort by politicians to do what actually needs doing, sticking out their necks and legislating, despite the difficulty and the potential backlash from a well-oiled propaganda network of RWS™ and faux news. And the unanimous obstructionism of the Republican party.

I assume Republican active disinterest in health care reform stems largely from the idea that they have theirs and don't care about yours; not to mention palms greased by insurers. You'd think the contrast would be a no-brainer to thoughtful people.

But you'd be wrong, wouldn't you?

Wrong Again

The disastrous consequences of the ACA, predicted by the RWS™, insurers, and the Congressional Rs who take their instructions from them, have, so far anyway, failed to materialize.

One of the most significant savings envisioned in the new health- care law - limiting payments to the private health plans that cover 11 million older Americans under Medicare - is, so far, bringing little of the turbulence that the insurance industry and many Republicans predicted.

The law, which sets in motion the broadest changes to the U.S. health-care system in decades, will hold down the amount of money the government gives to Medicare Advantage plans, which are available to patients who prefer a managed-care version of the program. The savings is forecast to amount to $145 billion by the end of the decade.

Whether the payment changes are warranted was a contentious subplot in the protracted debate over the legislation. Democrats argued successfully that the private plans were being overpaid and could withstand the changes. Republicans warned that such plans would raise prices, lower benefits or cause defections from the program, stranding the elderly people who rely on them.

Early clues to the actual effects have now materialized, as elderly Americans may sign up for a health plan for 2011 during an enrollment period through the end of the year, and the warnings of swift, serious damage to the program are not borne out. Fewer health plans are available for the coming year, but the decrease is largely for reasons unrelated to the new law. Premiums have not jumped substantially, and benefits have not tended to erode.

I've expressed disappointment in the law for the extent to which it leaves insurers in the middle of the transactions between providers and patients; and I've been skeptical of the predicted savings said to be the result of the legislation. But the usual right-wing suspects, while proposing nothing substantial (and ignoring that the law pretty much mirrors proposals made by Republicans and instituted by the mittster), provided nothing but scare tactics (like the above) and lies (like "death panels").

I can't see far enough to know the true costs or impacts of the act. But it's a pretty safe prediction that even people as pig-headed as teabaggers will eventually have the data in front of them to show, once again, that they were lied to and manipulated by the Foxobeckian screamers. What they might do with the data, of course, is another thing entirely.

Non-Fiction