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

[dismal]

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.

Has it improved outcomes across the country?

 

[Nice Squirrel]

Yes.

 

[KeepTalking]

...'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.

So, in your view, nothing can ever be called a success unless it is absolutely perfect in every regard?

 

[dismal]

Yes.

I thought we wouldn't know for 20 years.

 

[NobleSavage]

The next two years are gong to be crucial. A majority of the public doesn't like it and the Republicans want to destroy it. Yeah, it was supposed to be a wedge to better things, but there is no real incentive to cut costs. If you are on the bottom and getting subsidies it's a good deal. For everyone else, not so great. If the public doesn't come around in 2 years it's gonna be a failure. I'm cynical so I'm betting on failure.

 

[KeepTalking]

The next two years are gong to be crucial. A majority of the public doesn't like it and the Republicans want to destroy it. Yeah, it was supposed to be a wedge to better things, but there is no real incentive to cut costs. If you are on the bottom and getting subsidies it's a good deal. For everyone else, not so great. If the public doesn't come around in 2 years it's gonna be a failure. I'm cynical so I'm betting on failure.

I'm not on the bottom getting subsidies, and it has turned out to be a good deal for me. I will be saving $50 a month in premiums with my employer provided insurance next year, and cutting my deductible in half. If I ever have to get insurance on my own again, I will not be denied coverage for my pre-existing conditions, which happened last time I was self employed for a few years (in the 90's).

 

[Nice Squirrel]

The next two years are gong to be crucial. A majority of the public doesn't like it and the Republicans want to destroy it. Yeah, it was supposed to be a wedge to better things, but there is no real incentive to cut costs. If you are on the bottom and getting subsidies it's a good deal. For everyone else, not so great. If the public doesn't come around in 2 years it's gonna be a failure. I'm cynical so I'm betting on failure.

I'm not on the bottom getting subsidies, and it has turned out to be a good deal for me. I will be saving $50 a month in premiums with my employer provided insurance next year, and cutting my deductible in half. If I ever have to get insurance on my own again, I will not be denied coverage for my pre-existing conditions, which happened last time I was self employed for a few years (in the 90's).

Yep. My premiums are being cut by $100/mo. My friends can afford and have coverage. It is a good thing.

 

[Togo]

I have a US friend* who couldn't get treated for his condition. He can now. That means he's likely to live longer. I appreciate that that isn't a positive economic benefit you can stick on a graph, but it seems like a good outcome to me.

*I'm friends with his wife, not him.

 

[NobleSavage]

Yeah, I've got a pre-existing condition so it's all good for me. However,

More broadly, Harvard researchers said polling results showed public approval for the law has edged down since it was enacted four years ago, despite millions of previously uninsured Americans receiving coverage as a result of it.

Public support for the law fell to 40 percent in 2014 from 44 percent in 2012 and 42 percent in 2010, while opposition to the measure rose to 51 percent from 45 percent in both 2012 and 2010, according to the review.

http://www.reuters.com/article/2014/10/29/usa-healthcare-survey-idUSL1N0SO1L120141029

 

[KeepTalking]

Yeah, I've got a pre-existing condition so it's all good for me. However,

More broadly, Harvard researchers said polling results showed public approval for the law has edged down since it was enacted four years ago, despite millions of previously uninsured Americans receiving coverage as a result of it.

Public support for the law fell to 40 percent in 2014 from 44 percent in 2012 and 42 percent in 2010, while opposition to the measure rose to 51 percent from 45 percent in both 2012 and 2010, according to the review.

http://www.reuters.com/article/2014/10/29/usa-healthcare-survey-idUSL1N0SO1L120141029

So, it fell from 44% to 40%, with no margin of error for the aggregate, but a 3-5% margin of error for the individual polls, which indicates that the variance is within the margin of error.

The article also notes that the results are mostly divided along partisan lines, so there really is nothing new here. The spreading of misinformation, and pure hatred for anything done by Obama still rules the issue for Conservatives.

 

[maxparrish]

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.

And it seems odd to support expending 200 billion a year on a target that you believe to be arbitrary. Since when, except in public spending, does anyone propose a 200 billion dollar project with an ROI that does not matter - it being "arbitrary"?

 

[maxparrish]

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.

So, in your view, nothing can ever be called a success unless it is absolutely perfect in every regard?

No, in my view, no policy can ever be called mainly, mostly, or entirely a success without a priori benchmark, based on values and goals. Some considerations might be:

1) Did it save, or is it likely to save, the typical family 2500 a year?
2) Did it deliver on "keeping your doctor"?
3) Did it increase or decrease the cost of policies?
4) Did it improve or harm access to primary care doctors and hospitals for typical policy holders?
5) Did it fairly allocate costs through community rating?
6) Who benefited and who was harmed?
7) What was its effect on wage growth?
8) Etc.

Politically, perceived "successful" programs (no matter the reality) don't get reformed or replaced - they become frozen with new vested and rent seeking interests.

 

[ksen]

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.

And it seems odd to support expending 200 billion a year on a target that you believe to be arbitrary. Since when, except in public spending, does anyone propose a 200 billion dollar project with an ROI that does not matter - it being "arbitrary"?

Since when should government care about ROI?

 

[maxparrish]

And it seems odd to support expending 200 billion a year on a target that you believe to be arbitrary. Since when, except in public spending, does anyone propose a 200 billion dollar project with an ROI that does not matter - it being "arbitrary"?

Since when should government care about ROI?

Since when does anyone propose that a 200 billion dollar expenditure should have no targeted return in benefits? Apparently the inability to set a meaningful expectation for the money spent is not a concern to some.

 

[bilby]

And it seems odd to support expending 200 billion a year on a target that you believe to be arbitrary. Since when, except in public spending, does anyone propose a 200 billion dollar project with an ROI that does not matter - it being "arbitrary"?

Since when should government care about ROI?

Since the 1980s, when they all went crazy and lost the plot.

The purpose of government is to do the things that private enterprise can't or won't do, but that are needed nonetheless. Like treat the injuries and illnesses of poor people, for example.

But a bunch of morons who could see how private enterprise can lead to some good outcomes despite the amorality of the actors therein, decided that this meant that amoral actors in government could be forced to generate good outcomes by simply emulating private enterprise. This tarball of logical fallacies is still insanely popular.

It's like noticing how bats can navigate despite being blind, and concluding that the best way to avoid getting lost while driving a car is therefore to wear a blindfold - only stupider and more dangerous.

 

[KeepTalking]

Politically, perceived "successful" programs (no matter the reality) don't get reformed or replaced - they become frozen with new vested and rent seeking interests.

Medicare has been a politically perceived successful program, are you contending that it has never been reformed?

 

[Nice Squirrel]

So, in your view, nothing can ever be called a success unless it is absolutely perfect in every regard?

No, in my view, no policy can ever be called mainly, mostly, or entirely a success without a priori benchmark, based on values and goals. Some considerations might be:

1) Did it save, or is it likely to save, the typical family 2500 a year?
2) Did it deliver on "keeping your doctor"?
3) Did it increase or decrease the cost of policies?
4) Did it improve or harm access to primary care doctors and hospitals for typical policy holders?
5) Did it fairly allocate costs through community rating?
6) Who benefited and who was harmed?
7) What was its effect on wage growth?
8) Etc.

Politically, perceived "successful" programs (no matter the reality) don't get reformed or replaced - they become frozen with new vested and rent seeking interests.

Good, I'm glad these aren't arbitrary. They are close, but a little bit off. Let's try these instead:

1) Did it save, or is it likely to save, the typical family $2,500,000 a year?
2) Did it deliver on "keeping your doctor the insurance company dictates you have"?
3) Did it increase or decrease the cost of policies (because rates have never in the history of the planet went up)?
4) Did it improve or harm access to primary care doctors and hospitals for typical policy holders that dislike Obamacare but not anyone who was uninsured before because they are lazy moochers?
5) Did it fairly allocate costs through community rating, and by fairly we "it failed"?
6) Who benefited and who was harmed minus those who did not have coverage?
7) What was its effect on global warming?
8) Did teenage pregnancy rates go up?
9) Are Mexicans stealing our jobs?

 

[Loren Pechtel]

Yeah, I've got a pre-existing condition so it's all good for me. However,

More broadly, Harvard researchers said polling results showed public approval for the law has edged down since it was enacted four years ago, despite millions of previously uninsured Americans receiving coverage as a result of it.

Public support for the law fell to 40 percent in 2014 from 44 percent in 2012 and 42 percent in 2010, while opposition to the measure rose to 51 percent from 45 percent in both 2012 and 2010, according to the review.

http://www.reuters.com/article/2014/10/29/usa-healthcare-survey-idUSL1N0SO1L120141029

Public opinion has gone down because of relentless GOP harping about it. When you ask people about the individual aspects of it the only one that isn't favorable is the requirement to buy insurance.

 

[Loren Pechtel]

1) Did it save, or is it likely to save, the typical family 2500 a year?

I have no baseline on this.

2) Did it deliver on "keeping your doctor"?

You often can't keep your doctor on an insurance change anyway. I don't see anything that is more of an issue with the ACA.

3) Did it increase or decrease the cost of policies?

The policies now are competitive with the time-adjusted numbers I priced for individual coverage when my employer collapsed. The prices are well above the cost of shitty "insurance" that never should have been allowed to be on the market in the first place.

4) Did it improve or harm access to primary care doctors and hospitals for typical policy holders?

I don't see a change here.

5) Did it fairly allocate costs through community rating?

Yes.

6) Who benefited and who was harmed?

Benefit: A major benefit for those of us with preexisting conditions. There's also a benefit to those who would develop conditions in the future.

Harmed: It costs money. Since that's mostly going to pay for needed health care I don't see a big harm.

7) What was its effect on wage growth?

I doubt there's a measurable effect here.

Politically, perceived "successful" programs (no matter the reality) don't get reformed or replaced - they become frozen with new vested and rent seeking interests.

Some reasonable answer to the uninsurable was needed--something other than the teabagger go-off-and-die approach. Competition and deregulation do nothing to help these people. Some form of shall-issue policy is the only answer.

 

[Nice Squirrel]

http://www.msnbc.com/rachel-maddow-show/away-gruber-theatrics-aca-keeps-succeeding

MSNBC's Analysis: