The Affordable Care Act, Part II

NYT: 5 Obamacare myths (July 2012)

1. Myth: It's a jobkiller
2. Myth: it's a fed takeover of health insurance
3. Myth: the unfettered marketplace is a better solution
4. Myth: leave it to the states; they'll fix it
5. Myth: it's loser: run against it, run from it; don't run on it

Issues of Cost and the Affordable Care Act
(lots of other stuff, at this post)
Why we need "Obamacare":
http://andrewsullivan.thedailybeast.com/2012/06/what-the-wapo-wont-run.html

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Cost/Affordable Care Act

• Kevin Drum - Mother Jones - Why Health Care Costs Keep Growing (8/2012) http://bit.ly/OIhVFh
• a big part of the blame on all the shiny new technology that we're so eager to use (and use and use and use), and the most recent estimate also lays a lot of the blame on rising incomes (as incomes go up, we actively want to spend a bigger share of our income on healthcare).
• David Pakman Show - Woman Who Sued Over Obamacare Now in Bankruptcy w/ Medical Bills (7/2012)  - http://bit.ly/LZrwK8
• RT @thinkprogress: Santorum claims Obamacare will cost 2x what Obama projected. Actually, it will cost less than Obama projected. http://thkpr.gs/xhCQNH #facts (3/17/2012)
• Santorum hammers Obama with dubious claim on healthcare bill cost - latimes.com (3/17/2012)

TWO GREAT VIDEOS to remind you about what is at stake with Health Care Reform -- recommended viewing!

More info after the flip...
Tne Doctor Shortage

• Curing the Physician Shortage: Systemic Change to Breed the Doctors We Need - Ben Gallagher - The Atlantic (8/13/2012) http://bit.ly/QuUMEi

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After The Supreme Court Decsion

• Greg Sargent's immediate post-decision round-up of reactions, and critiques of the Right's responses: http://wapo.st/LH95tC 
• Wendell Potter, "After Ruling, Health Insurers Now Back on Team GOP," Leanforward/MSNBC (June 2012) http://bit.ly/LEKsYj
• Four Reasons Why The Court's Decision to Uphold Obamacare is Good News for the Economy, Think Progress, June 2012 http://bit.ly/OGfkhf
• Can We Now Start Talking About The Law? | The New Republic - (6/28/2012) http://goo.gl/IBI3k
• 10 Things You Get Now That Obamacare Survived | Mother Jones - (6/2012) http://goo.gl/IkkUb

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"Obamacare" Now

• Who really has to purchase health insurance under the individual mandate? | Insure Me Kevin - (HINT: NOT VERY MANY; ok the answer is 7%) (APril 2012) http://goo.gl/mv9BH
• "Private health care costs will be reduced, according to CBO estimates. Private health insurance premiums grew by just 3.5% in 2010, compared with 8.4% per year on average between 2000 and 2005." Insurance News - ACA Coverage Provisions Estimated to Cost $1.1T http://bit.ly/yT0JaW (3/2012)
• A Spoonful of Sugar: On the Affordable Care Act | The Nation (1/25/2012) 
•  Nobody with a sense of history...could doubt how sensible and brave was the president’s effort to drive the Patient Protection and Affordable Care Act of 2010 through Congress. Nobody with a feel for the present moment should doubt how imminent is the threat to the act, how urgent it is for progressive Democrats to rally around Obama—and without all the condescending qualifications that “independents,” who flock away from allegedly weak or incompetent leaders, interpret as contempt. 
• Good News! Obamacare Will Cost Less than Projected | Mother Jones (3/8/2012) http://bit.ly/yWc8vj -- you end up with net cost reduction of $161 billion over ten years.
• Why Romneycare Is Working In Four Graphs | ThinkProgress (1/26/2012)
  • Study: Romneycare is making Massachusetts healthier - The Washington Post (3/2012) http://wapo.st/zoFdfa 
• I am ObamaCare | Given Eyes To See (10/20/2011) 
• Former Sen. Bob Bennett: Individual Mandate Was The 'Conservative Approach' To Health Policy 20 Years Ago | ThinkProgress (7/27/2011) http://bit.ly/zxxrhA

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"We have the best health care in the world"

• * “We have the best health care in the world,” “There is no crisis”, “People can get ER care”, etc.... There is a health insurance crisis in America, fiscally and morally 
• Hundreds Wait for Free Health Care in LA, CBS Evening News (4/27/2010) 
• Brock started Remote Area Medical 25 years ago, getting American doctors to volunteer and bring modern medicine to the Third World. Bock said "64 percent of everything we do is here in America."
• US Health Care Gets a Boost from Charity, 60 Minutes (6/14/2010) http://cbsn.ws/MJobub
• Hundreds Line Up for Free Dental Care in Oakland, The Bay Citizen (3/22/2012) http://bit.ly/MJnJfr
• Free Medical Clinics in Oakland, Sacramento, SFGate (3/20/2012) http://bit.ly/MJnNeW
• Spending More Doesn't Make Us Healthier - NYTimes.com  The United States is actually doing worse than a number of countries, like France and Germany, that spend considerably less. (10/27/2011)
• The Cost of Doing Nothing on Health Care - NYTimes.com (2/27/2010)
• Third World Scene With an American Setting : Rural Medical Camp Tackles Health Care Gaps (truthout, Howard Berkes/NPR; 7/27/2009)
• Ticket to treatment - Foreign countries offer Americans a growing menu of sophisticated and relatively cheap medical care - Los Angeles Times (11/2/2008)  
• Study links 45,000 U.S. deaths to lack of insurance | Reuters (9/17/2009)  

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 Why does Health Care Cost So Much?
Essential reading/listening/watching:

• Philip Boffey, The Money Traps in U.S. Health Care - NYTimes.com(1/22/2012) 



from "The Money Traps in US Health Care"  (1/22/2012)

• Americans continue to spend more on health care than patients anywhere else. In 2009, we spent $7,960 per person, twice as much as France, which is known for providing very good health services. And for all that spending, we get very mixed results — some superb, some average, some inferior — compared with other advanced nations. Why this is true isn’t easily answered.
• Gawande, 1/2011: "The Hot Spotters": treating the most expensive patients can lower costs over all (NewYorker)
• Huffpo op-ed/discussion of Hotspotters
• Atul Gawande, "The Cost Conundrum: What a Tx Town Can teach us about healthcare", New Yorker, 1/6/09
• Atul Gawande interviewed re: Health Care Costs, Fresh Air, 1/2011
• Bill Moyers Investigations/Interviews on Health Care
• Discussion w/ Wendell Potter re: Insurance Profits vs. Patients (July 2009)
• Money, Politics and Health (Jul 2009)
• Analysis of Public Option, Single Payer, other reform options (July 2009)
• Rising Premiums? Not because of Reform (accounts for only 1-2% of cost increases) NPR, 10/2010)
• Millionaire Insurance CEOs: Who says Government should work more like private sector? (2011)

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Selling Insurance Across State Lines: The Race to the Bottom

• Doctors for America explains what's missing from GOP discussions of "selling insurance across state lines" (January 2011)
• Ezra Klein also breaks it down, February 2010 
• Kaiser Health News stakes out the debate "on both sides", Feb 2009
• 2005, CBO report: "selling across state lines" would only reduce cost by 5%

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Without You I'm Nothing: The Individual Mandate is the part that makes it work

• MIT economist/MA system architect: w/o Insurance Mandate, it doesn't work (22011-NPR blog) 
• Economist, Jan 27 2011: "More of the Tasty bits Please": all part but mandate are popular. If that's repealed--predicts a move toward single payer type system.

Medicare and "Obamacare"

• See this post for full explainer/links about the debate about what Obamacare does to Medicare--and what Romney/Ryan would do differently (hint: they'd keep the savings, then give tax cuts to rich people): Medicare: It's Socialism and It Works 
• Ezra Klein - Mitt Romney’s bogus attack on the Affordable Care Act (6/29/2012) http://wapo.st/RFpqij  - 

Romney, Healthcare, Romneycare: 

• Mitt Romney's VP Paul Ryan hates on 'Romneycare' highlight reel - POLITICO.com (8/2012) http://politi.co/NyWzI4

Can we talk about Single Payer Yet?
For Medicare, with all its flaws, works better than private insurance. It has less bureaucracy and, hence, lower administrative costs than private insurers. It has been more successful in controlling costs. While Medicare expenses per beneficiary have soared over the past 40 years, they’ve risen significantly less than private insurance premiums. And since Medicare-type systems in other advanced countries have much lower costs than the uniquely privatized U.S. system, there’s good reason to believe that Medicare reform can do a lot to control costs in the future.
In that case, you may ask, why didn’t the 2010 health care reform simply extend Medicare to cover everyone? The answer, of course, is political realism. Most health reformers I know would have supported Medicare for all if they had considered it politically feasible. But given the power of the insurance lobby and the knee-jerk opposition of many politicians to any expansion of government, they settled for what they thought they could actually get: near-universal coverage through a system of regulation and subsidies.
It is, however, one thing to accept a second-best system insuring those who currently lack coverage. Throwing millions of Americans off Medicare and pushing them into the arms of private insurers is another story.
--Krugman, 2011