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Obamacare - How do you determine if it is a policy success or failure?

maxparrish

Veteran Member
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SF Bay Area
Basic Beliefs
Libertarian-Conservative, Agnostic.
Over the past year I've noted that there has been a lot of claims of failure or success that are dependent upon moral assumptions that are taken as a given. As such, there is no explicit basis of what constitutes "the good or bad" or a utilitarian measure of PPACA's success or failure. There is no agreed upon measurement for balancing effects (even when the effects are undisputed). It seems to me that no conversation can advance without a mutual acknowledgement of core values, some tool of measurement, and a good dose of honesty about the good and the bad results of any legislation.

Therefore, here is what leave me unsatisfied:

1) Suppose, as the few studies done and economic theory indicates, ACA lowers wage growth significantly or somewhat below what would otherwise have occurred. How do we know that this is good or bad? If, in the year 2019, wages were significantly or somewhat below what they otherwise would have been how do we know if, on balance, this "bad" is off-set by more insured as a "good"?

2) Suppose, as the few studies done and economic theory indicates, ACA lowers employment significantly or somewhat below what would otherwise have occurred. How do we know that this is good or bad? If, in the year 2019, employment was significantly below what they otherwise would have been how do we know if, on balance, this "bad" is off-set by more insured as a "good"?

3) Is the issue more insurance policies or improved overall health?

4) If, on average, the same insurance coverage costs an average of 21 percent more than it otherwise would under the prior actuarial system, how does one 'offset' or balance it against the goal of more insured poor and working class? What if it were 10 or 30 percent? How about 50 percent or 75 percent or 200 percent?

5) How does one offset the narrowed provider networks and higher premiums and deductibles for everyone who does not have employer insurance with the "good" of some more people with some kind of insurance policy?

6) What are the principled values, and are they absolute? I ask because:

a) It seems like some argue with the implicit assumption that if ACA helps even a few poor or saves a handful of lives, then any downside to others in cost, quality, is justified.

b) It also seems that some argue that no matter WHO is targeted to pay for ACA, the losers are always morally wrong. For example, even if those who bare the burden for all those with pre-existing conditions or subsidize 'unaffordability' are substantially the other members of the 5 percent of independent policy holders, they must 'grin and bare it' for others good.

c) How much can the young, or childless, male or older female be 'targeted' to pay for the others? How is this justified and what are the limits?

7) Finally, how are you going to get a better system IF you keeping telling us that ACA is "a success"?
 
If Obama supports it = Failure
It it is the exact same one from Republicans = Total success!
 
Some function of better health outcomes over dollars spent.
 
I think the disappearance of the free clinics is a very good indication of the success of Obamacare. The need went away because the sick were now able to get insurance.
 
I think it is folly to judge any large change in society over a short period of time.
 
Finally, how are you going to get a better system IF you keeping telling us that ACA is "a success"?


I think people are forgetting that "Obamacare" is not nor was it ever intended to be the be-all and end-all of health care reform. It is like the first seat belts in cars. Good idea. Manufacturers hated it, but a good idea.


Then came shoulder belts. Seat belts in the back seats.


Airbags.


Right now the cheapest Chevy compact you can buy is arguably safer than the sturdiest Volvo from a couple decades ago.



The Affordable Care Act is like the first seat belts.
 
Finally, how are you going to get a better system IF you keeping telling us that ACA is "a success"?


I think people are forgetting that "Obamacare" is not nor was it ever intended to be the be-all and end-all of health care reform. It is like the first seat belts in cars. Good idea. Manufacturers hated it, but a good idea.


Then came shoulder belts. Seat belts in the back seats.


Airbags.


Right now the cheapest Chevy compact you can buy is arguably safer than the sturdiest Volvo from a couple decades ago.



The Affordable Care Act is like the first seat belts.

Or the first Social Security, the first MediCare...
 
I think people are forgetting that "Obamacare" is not nor was it ever intended to be the be-all and end-all of health care reform. It is like the first seat belts in cars. Good idea. Manufacturers hated it, but a good idea.


Then came shoulder belts. Seat belts in the back seats.


Airbags.


Right now the cheapest Chevy compact you can buy is arguably safer than the sturdiest Volvo from a couple decades ago.



The Affordable Care Act is like the first seat belts.

Or the first Social Security, the first MediCare...
Ardent conservatives would like to scrap them as well, so they are obviously failures.
 
Ardent conservatives would like to scrap them as well, so they are obviously failures.

Exactly. They want to scrap all social spending.
And the sad reality is that those social services and policies initiated under FDR have been a tremendous success. The cry-baby conservatives who want to shitcan them have benefitted from them but they're too ideologically stupid to admit it.
 
It does help some people, otherwise even Obama supporters would be against it.

Some people are helped by it. Others are hurt by it. To determine if it is a success, you have to decide if the help outweighs the harm.
 
7) Finally, how are you going to get a better system IF you keeping telling us that ACA is "a success"?

Seriously, Max? Are you capable of independent thought that is not prepared for you by your conservative overlords?

'Success' does not mean, 'could not be better'. I could pull a C- on a course, and it is considered a success, as I would get full credit for the course, it does not mean that I should not work harder, and try to get an A+ on my next class.
 
Most of the replies on the OP circumlocuted the questions raised, decamping onto cliched rants about conservative attitudes. Some were a case of projecting (If Obama supports it = Failure) and others were expressions of the quasi religious faith that any new expenditure on "good intentions" has to be progress because...well, it just is.

Of those more interested than just a retelling of the book of Genesis on social welfare (In the beginning the welfare society was without form and void, then God (FDR) created SSI, and SSI begat Medicare, and Medicare begat Obamacare...etc.), lets consider a few more interesting points:

I think people are forgetting that "Obamacare" is not nor was it ever intended to be the be-all and end-all of health care reform. It is like the first seat belts in cars. Good idea. Manufacturers hated it, but a good idea. Then came shoulder belts. Seat belts in the back seats. Airbags.
Its a step forward:...

But how does one know "its a step forward" in a non-chronological sense? Would it have been a 'step-forward' if seat belts or air bags had originally cost $7,000 per car? Would it be a step forward if to save 20,000 extra lives a year it had been necessary to pass seat belt laws that required capital punishment for a few hundred violators per year? (a purely utilitarian consideration of lives saved to those forfeited would suggest "yes")?

And the sad reality is that those social services and policies initiated under FDR have been a tremendous success. The cry-baby conservatives who want to shitcan them have benefitted from them but they're too ideologically stupid to admit it.
A circumlocution of the question: how do you measure 'success' and how would that look different from failure?

Three posters did offer a beginning point: Dismal suggested it must be "some function of better health outcomes over dollars spent", LP thought that the disappearance of the free health clinics is a very good indication of success, LD suggested that whatever the measure, you can't measure it over a short period of time.

Finally, some objected to the observation that by defending Obamacare as a success they are acting as "conservatives", blocking real reform.

Keeptalking said:
...'Success' does not mean, 'could not be better'. I could pull a C- on a course, and it is considered a success, as I would get full credit for the course, it does not mean that I should not work harder, and try to get an A+ on my next class.

But if you paid for special tutoring program was promised to raise your likely D+ grade to an A+, and all you got was a C- would you then defend the Prep course as a "success"? I think not, I bet you'd ask for your money back.

But if you kept yelling to everyone what a success this prep course was, do you think that would inspire real reform? Of course not.
 
Success in government programs is measured over decades, not months.

The US system does not turn on a dime.

If a government option is added to the program in the future then the system could possibly turn towards universal heath insurance.

Any system that moves us closer to universal health insurance is a success.
 
4 New Studies Show Obamacare Is Working Incredibly Well

1. Increasing access to the uninsured.

2. Reducing overall health-care costs.

3. Hospital errors.

4. Insurance competition.

So despite lockstep republican opposition the ACA has been successful in the 4 areas above.

Now, is that enough for Max to rethink his position that the ACA is not a total failure? Probably not but short of the ghost of Ronald Reagan coming back and saying it's working nothing will.
 
4 New Studies Show Obamacare Is Working Incredibly Well

1. Increasing access to the uninsured.

2. Reducing overall health-care costs.

3. Hospital errors.

4. Insurance competition.

So despite lockstep republican opposition the ACA has been successful in the 4 areas above.

Now, is that enough for Max to rethink his position that the ACA is not a total failure? Probably not but short of the ghost of Ronald Reagan coming back and saying it's working nothing will.

I started to worry until I scanned the article and wondered who would write this nonsense...then I saw it was Chiat. Nuff said.
 
Our health insurance premiums have been increasing much faster than they did this year. This year the increase will be 4 percent (for 2015). To me that's proof that Obamacare is working to reduce costs. And our insurer still has millions to piss away on advertising and junkmail activity.
 
But if you paid for special tutoring program was promised to raise your likely D+ grade to an A+, and all you got was a C- would you then defend the Prep course as a "success"? I think not, I bet you'd ask for your money back.

But if you kept yelling to everyone what a success this prep course was, do you think that would inspire real reform? Of course not.

It seems odd to condemn a program that has improved outcomes across the country as a failure because it didn't hit an arbitrary target.
 
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