WaPo: "Suddenly, Obamacare Is More Unpopular Than Ever"

[Brittain33]

I'm a little surprised.  It made sense to oppose it while it was being written, and even up through 2012 when we had a chance of electing a president and congress who would reverse it, but we're stuck with it now.  Maybe folks are still hoping to undo it in the next congress with a new president.  I just don't think it's possible because it has become too entrenched and too lobby-worthy over the past two years.  Big Pharma CEOs love the benefit to their industry and medical insurers have a captive new audience.  We might be able to tweak it, I really think we're stuck with it.  Might as well learn, if not to like it, at least be "neutral/don't know/don't care" about it.  

Also, it's provided meaningful health insurance and coverage to upwards of 10 million Americans, and more in the future.

Most people benefiting directly from it are part of a minority with little political power--the poor, the underemployed, those under 26--and the striking benefits to them will not reach enough people to make up a majority in an opinion poll.

[Brittain33]

it's not remotely Socialist or Communist

Agreed.  It's rather the opposite, in fact:  it will funnel trillions of dollars over the coming decade from the people to a few large corporations.  In large part, this is because it focuses on medical insurance, rather than on the underlying causes of medical costs.  Our premium has increased over the past few years, but only slightly and I'm not certain of the relation of the PPACA to those increases.  Still, it is clear that medical costs are not decreasing.  Nor are they projected to decrease.  Estimates are all over the place but it is clear that the percent of GDP in "health care" costs will continue to increase for the foreseeable future.  Some of this is due to an aging population.  Some is due to factors already in place before the PPACA.  Some of it is do to the PPACA itself.

Cost projections for Medicare have been repeatedly lowered since the PPACA became law and as the growth in Medicare spending has dropped. It's been remarkable good news from an area of federal spending which has previously only provided bad news.

[Brittain33]

I any case my quibble is more fundamental. Where is the flexibility of commercial insurance websites? On those I can easily add options on to a required base policy to meet my individual needs, trading cost for benefit. The healthcare runs more like a cable company where I'm stuck with bundled services that either leave me short or overcharge me for a bunch of channels I don't want. But cable has to deal with independent content providers, and those contracts often drive the bundling. Health insurance typically comes from a single provider, so like other commercial insurance products there's no reason to bundle beyond the required base level services that appear in the bronze plan.

On the contrary, insurance companies often provide different levels of service at different prices. I've had 3 options from Cigna offered by my company recently similar to the distinctions the federal government offered. Usually the distinction is not services that are bundled with, but the breadth of network and how co-pays and deductibles are handled to have the user assume more or less risk. This is what the federal guidelines do for PPACA healthcare.

I can not begin to imagine how Fox News and the WSJ would have tackled it if the Obamacare sites offered only a single option to customers at one price. We would have seen footage of people lining up for potatoes in Communist-era streets in the USSR.

[Brittain33]

What are some of the features that a Gold plan has that a Silver doesn't, or a Silver vs. a Bronze? I really thought it was just about access to a broader network of doctors and lower copays and deductibles. Do you know of any examples?

I recall your mentioning some months ago how women in that age group were not pleased to be paying for contraceptive coverage because they didn't need it, but that I believe is common to all levels.

[Brittain33]