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

[fromderinside]

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.

Where did you find this stuff? I even looked at Tea Party literature spouting about the dangers of Death Panels and I couldn't find such odd criteria as you chose.

 

[Togo]

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.

The money is spent on the program, not a target you appear to have made up. Trying to claim that your target is my opinion is inaccurate - please do not attempt such again.

 

[T.G.G. Moogly]

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.

What is the ROI on 2000 feet of the nearest paved road to you?

 

[ZiprHead]

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

Long before anyone ever heard of Barack Obama, I had a doctor whom I really liked. My employer changed our insurance carrier and this doctor wasn't in their plan. I had to switch. This doctor even offered to treat me for free to keep me, he was really that nice of a guy. I still couldn't do it because if I ever needed hospitalization or testing he ordered, it would not be covered by my insurance.

 

[maxparrish]

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?

Your none to clever babbling about Mexicans and 2.5 million a year savings for a typical family is not germane to evaluating the promises made by ACA supporters, nor the fairness and efficacy of ACA. The program was sold as a benefit and solution to many problems, without acknowledgement of any side effects. The list I provided is among those benchmarks that are warranted for measuring "success" or "failure".

 

[maxparrish]

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.

What is the ROI on 2000 feet of the nearest paved road to you?

An excellent question, one that should be measured by cost-benefit analysis. It may well be that paving is a waste of resources.

 

[maxparrish]

Nice chart of unsupported claims from talking point articles of faith for left-wingers. Perhaps I should quote Rush Limbaugh's talking points as "evidence" too!

 

[ksen]

you already have been

 

[Togo]

The list I provided is among those benchmarks that are warranted for measuring "success" or "failure".

Warranted how? You've not given a reason.

 

[fromderinside]

What is the ROI on 2000 feet of the nearest paved road to you?

An excellent question, one that should be measured by cost-benefit analysis. It may well be that paving is a waste of resources.

Curry county Comprehensive plan. http://www.oregon.gov/LCD/OCMP/docs/Public_Notice/CurryCounty_CompPlan_EPs.pdf

Take a look at your county's plans and projects. In them you'll find details about justification and worth that'll make you humble about what government actually does to justify and coordinate such as transportation systems. I included a top level plan for Curry county, a 2000 sq mi area with only 23000 residents. The top level document includes a 30 page summary( pgs 234 to 263) of our transportation system. This segment catalogs all types of roads, for instance, according to county, state, and national use and condition standards; condition standards are detailed documents gathered from a number of studies that specify use and condition that are required to provide adequate transportation for their use which are based on such as road use effects studies; road use effects studies are civil engineering studies of road use based on weather, vehicles employed on the roads, populations, incomes, and materials available and used.

I don't want to put too fine point on it, but, suggesting such as cost benefits analyses aren't routinely performed is just plain ignorant. We know what the cost benefits are for paving, what paving, and what frequency of paving, for most every condition and type of road in the US.

Try to keep up.

BTW the health plan for each state, county, and town, are just as detailed and comprehensive. If you want to play, I have to reveal, my wife is a member of the Curry county health district board which covers just one part of the Curry county health plan. I'll be well armed.

 

[NobleSavage]

This is coming from a libertarian website, but I wonder if it's becoming more or less prevalent.

 

[Medicine Man]

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.

It appears The Marketplace already ha$ come-up....​

...With That Mea$urement!!
January 21, 2015

*​

"UnitedHealth Group Inc. reported a better-than-expected 5.8% increase in earnings for its December quarter, as the health-care company continued to benefit from revenue growth in premiums outpacing medical costs.

Shares of UnitedHealth rose 1.3% in premarket trading to $107.01, which would represent a new all-time high for the stock.

UnitedHealth, like its fellow health insurers, has sought to contain costs related to medical care, particularly as expensive, high-profile treatments for hepatitis C and cancer enter the market. Meanwhile, the company has benefited from growth in its government-sponsored plans as well as its health-services arm.

Overall, for the period ended Dec. 31, UnitedHealth posted earnings of $1.51 billion, or $1.55 a share, up from $1.43 billion, or $1.41 a share, a year earlier. Revenue improved 7.4% to $33.43 billion.

Analysts had projected a per-share profit of $1.50 and revenue of $33.1 billion."

I'm this Country's anti-capitali$t$ will have some serious objections to such an unfortunate-outcome!!!​

 

[Medicine Man]

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.

​

 

[maxparrish]

This is coming from a libertarian website, but I wonder if it's becoming more or less prevalent.

I have often wanted to spend time with local providers and try to unwind the price-cost mysteries of the health care system. The example from Oklahoma is one of them.

I lived in Oklahoma for 10 years in the 1980s, and have visited inlaws over the years (but the last time being 11 years ago). Being rooted in FDR populism for the "common man", the state still had (has) many arcane attitudes towards foreign land ownership, branch banking (almost none permitted at the time), booze (dry at the time), and "evil" insurance companies. In the mid 1990s the insurance commissioner had put so many ownership and price- policy mandates that almost all the health insurers left the state. Civil servants suddenly saw their options dwindle to blue-cross...period.

But I also noticed, in my visits, an explosion in 'shopping strip' clinics - cash-credit card only. I never saw this in California (still don't), but I was stunned ... primary care and vision clinics were nearly as common as convenience stores. At one point I had to take my wife to one of the clinics during a very and frightening severe asthma attack. After a day hospitalization, lots of meds, breathing treatments, etc. they released her. The bill was 300 dollars - not bad.

Many lessons here, but as usual ignored by the social welfare crowd.

 

[Nice Squirrel]

Psst Max: The 1980s ended over 25 years ago.

 

[maxparrish]

Psst Max: The 1980s ended over 25 years ago.

And the 1990s ended 15 years ago, and apparently, per the video, the trend I discovered has continued until today. But thank you for your contribution.

 

[untermensche]

Many lessons here, but as usual ignored by the social welfare crowd.

Please enlighten me.

What lesson are those horrible people who care about social welfare missing?

Because you must know that most social welfare people advocate a single payer system, not the current system with Obamacare, which is just a bandaid on a gaping chest wound.

 

[Jason Harvestdancer]

Here's a lesson for the social welfare crowd.

You can't eat good intentions. Ultimately it is results that count, and not all the good intentions and not all the caring in the world will produce one bite of food nor one bandaid for one injury unless someone actually does something no matter the intentions of the doer.

 

[untermensche]

Here's a lesson for the social welfare crowd.

You can't eat good intentions. Ultimately it is results that count, and not all the good intentions and not all the caring in the world will produce one bite of food nor one bandaid for one injury unless someone actually does something no matter the intentions of the doer.

Millions have been eating good intentions for a long time.

Food stamps began in 1939.

 

[Togo]

Here's a lesson for the social welfare crowd.

You can't eat good intentions. Ultimately it is results that count, and not all the good intentions and not all the caring in the world will produce one bite of food nor one bandaid for one injury unless someone actually does something no matter the intentions of the doer.

So.. we should go with UHC because it has the best outcomes for the least money?