Tuesday, November 11, 2014

It's the Stupidity, Stupid

It's that time of the season again for Democrats to defend the kludgey Affordable Care Act against the predations of the corrupt Supreme Court and the nefarious Republicans, who'd rather see one rich plutocrat thrive than have millions of regular folks enter for a chance to barely survive in the for-profit health insurance sweepstakes.

The latest round in Good Cop-Bad Cop kabuki involves the Supremes gratuitously deciding to take up a case involving the confusing state exchanges. One lower federal court recently decided that resident-consumers of states embracing the federal exchange should get the tax subsidies, while another lower court has decided the opposite. The highest court in The Homeland will now decide what the crafters of the law actually "intended."

So, just when I thought I'd seen the last of them, emails are again arriving, urging me to "click here" and "have the president's back" on his signature legislative achievement(s). These petitions obviously come attached to an appeal for money in order for the Democrats to "fight back" against the GOP Death Panel for the rights of a couple million people to both like their Obamacare and keep their Obamacare. This whole Supreme Court brouhaha is all over a stupid "typo,"* they shrill.

Of course, the ginned up hysteria is just more much ado about nothing. The Supreme Court "spared" the law once before, punishing only the poor re state Medicaid expansion, so they will likely do so again. After all, the law gifts the predatory insurance and pharmaceutical industries with profits beyond their wildest imaginings. No way will this money spigot be turned off to satisfy a cadre of phony libertarian Obama-haters.  

It's the latest manufactured crisis, designed to keep us on one side or the other instead of noticing that the two teams are both part of the same corrupt league, and that the game is fixed. It's also a very lucrative manufactured crisis, acting as a magnet for partisan fundraising and armies of K Street lobbyists bearing gifts of cash they don't even bother to hide any more. Bribery is legal now.

Luckily, a few intrepid truth-seekers have dug up a year-old video in which one of the original architects of the law is caught admitting that it was deliberately designed to be a complete confusing mess. Its opacity was built right in. Otherwise, it never could have passed.

Jonathan Gruber, an MIT economist, was paid $400,000 to help the Obama administration rely on "the stupidity of the American voter" by writing the bill in such a "tortured way" as to deliberately disguise the fact that there was a tax involved in the individual mandate. (Psst... the dummies in the Heartland can't be told that the healthy will pay for the sick, because socialism.) The White House, according to this expert, was more interested in Congressional Budget Office scoring being politically beneficial to them, rather than the law itself being beneficial to the health of the lucky few recipients of insurance.

As constitutional lawyer Jonathan Turley writes,
What is fascinating is that Gruber is open about what has long been hidden in this Administration: the lack of transparency as a tactical political vehicle. The ACA was pushed through by a muscle vote on a handful of votes while the Administration made claims that he later had to admit were misleading at best, such as the President’s repeated assurance that citizens could keep your current insurance policy if you liked it. Gruber also admits that the Administration crafted the law to avoid it being supported by a tax despite Chief Justice John Roberts’ later decision that it was a tax. Gruber says that, while he would have preferred to be honest and open, such considerations had to be set aside in the interests of passing the law — even by less than honest means.
Meanwhile, the Obama administration is now (whoever could have predicted?) predicting fewer new enrollees than previously estimated. Their best case scenario is that by the end of 2015, a grand total of 9-10 million people will have been signed up. From the Washington Post:
HHS officials also said Monday that of the 8 million people who bought health plans by this past spring for the first year of coverage under the law, 7.1 million remained in them as of mid-October. Of those who left, some had stopped paying their monthly insurance premiums, and 112,000 were immigrants dropped by the government because they had not proved that they were eligible.The administration’s enrollment expectations appeared five days before the start of the second sign-up period through the federal insurance exchange being used in about three dozen states and through separate state-run exchanges. The figures also emerged as the health-care law — enacted in 2010 as a crowning domestic achievement of Obama’s presidency — is facing new political and legal peril.
As much as I despise the Republicans and the five reactionary justices of the Supreme Court, the Obama administration has to be considered equally culpable in this manufactured mess. As much as I would hate for the millions of people now benefiting under expanded Medicaid to be kicked off, or even for those partially subsidized enrollees to be deprived of their Bronze Plans (stories abound of $10,000 deductibles charged to workers who barely make ends meet as it is)  it's hard to defend the indefensible.

 Will these continued failures and challenges to the torture that is Obamacare nudge us closer to Single Payer health coverage? After all, despite the GOP's hollow "victory," most voters do favor progressive initiatives, including health care. Any improvements will likely come at the local level, because Big Money has full control in Washington.

Here is one ray of hope: student members of the notoriously arch-conservative  American Medical Association have just passed a resolution in support of state legislation supporting true universal health care:
Although the resolution applies only to the student section of the AMA, supporters say it sends a signal to the larger organization that many physicians-in-training think the most recent round of national health reform didn’t go far enough.
“Last Friday’s vote is yet further evidence that physicians – and in this case physicians-in-training – are increasingly angry about private insurance companies that meddle in doctor-patient relationship, deny access to care, balk at payment, and afflict providers and patients alike with costly and unnecessary red tape,” said Bradley Zehr, a second-year medical student at Boston University School of Medicine who helped write the resolution.“Med students want to practice medicine and to help people get better, not to be part of a corporate enterprise that puts financial gain over our patients’ well-being,” Zehr said. “They see the millions of people who will remain uninsured or underinsured under the Affordable Care Act. That’s why physician opinion is shifting toward a nonprofit, publicly financed, Medicare-for-All-type system that would cover everyone while also controlling costs.”
The Obama administration may have relied on the alleged stupidity of the American voter when it rammed through its corporation-friendly kludge. What they very stupidly haven't relied upon is the basic humanity and unacknowledged intelligence of the American voter, and the political power of the health care community  Americans are discovering that "voting" for representatives instead of policies is neither sufficient nor particularly effective in the runaway oligarchy that masquerades as a democracy.


* Contributor Pearl Volkov's comment on the Paul Krugman column (linked above) really zings it:

The complications of Obamacare go beyond a so called typo which could have
been deliberate in case someone is cleaning up as a result. The huge
thousands of pages of the original health care bill was never completely
read by voting Congresspeople by their own admission and left lots of
loopholes for misunderstanding, misstatements, misrepresentation,
misinformation and misconduct. Reports of the financial activities of the
numerous insurance companies handling medical claims are not only impossible to make sense out of but I firmly believe deliberately made complicated andconfusing to cover up the allocations of great sums of money to them from patients who have no choices and have no information how their coverage is allocated.

By covering some comparatively minor loopholes for people, you are so happyand busy rejoicing for these coverages that the miserly help which gives spotty coverage or none to many citizens is never mentioned.
If you are going to write columns of anger about the attempt to destroy
Obamacare whether for the right or wrong reasons, at least do your homework.

There are several progressive/liberal websites which keep accurate reports
on this issue and prove how the financial set up of Obamacare provides belowstandard quality of actual medical care for subscribers in comparison to the fees collected.


Pearl said...

Karen: More and more comments in the NYTimes from readers about the inadequate health care coverage in the country are appearing (like responses to Krugman's recent article about the wonders of Obamacare).
It will take time but it will become more and more apparent as to what is really going on and hopefully will organize people to fight back.
Your column says it all. It is a national disgrace and the deliberate confusion created seems to be found in many other issues that remain unresolved.

Karen Garcia said...


I didn't comment on Krugman's latest because I wasn't familiar enough with the legalese and details to respond intelligently. I've done my research since, though, and was pretty shocked to come across what I consider to be the smoking gun of the Gruber video. Of course, it is mainly being aired in the right-wing blogosphere, because it does reflect badly upon Obama. And he needs all the protection racket he can get.

I agree that more people are seeing the light but the political cult of personality is hard addiction to overcome, apparently. At least the critics of the Dems aren't getting as badly lambasted for disloyalty and non-adherence to Lesser Evilism, post Meh-terms. Reality can occasionally be a powerful, albeit fleeting, antidote.

Denis Neville said...

The purpose of government is the looting of the governed.

“Like the Obama campaign itself, the public option was never more than a brand. It was a container designed to fit our hopes and dreams just well enough and just long enough to close the deal, an empty wrapper, with little or no candy inside.”

“It's not even about delivering health care, it's about bailing out health insurance companies. The legislation will force millions of Americans to buy skimpy private insurance, often with hundreds of dollars a month of their own money under penalty of law. Billions more in government subsidies will be added to the giveaway to help purchase health insurance policies for the bottom half or more of the insurance market.

Republicans will have a series of easy targets to rail against - forced health insurance payments continuing to bankrupt people, lazy and undeserving blacks, and browns and poor whose health insurance is paid for by their hard-working salt-of-the-earth neighbors, and so on. The empty wrapper works fine for them.

Private insurance companies will be written into the law and the system in a systemic way that will be extremely difficult to undo, and drug company profits are guaranteed. It works fine for them.

The rest of us will be left with an empty wrapper at best. Or maybe with nothing at all.”

“Medicare … really IS single payer, and therefore was never on the table. That would be too much like real candy, when our betters never intended to serve us more than the wrapper.”

“No. Wait. Give us the wrapper too.” – Bruce Dixon,


Obama, his main advisers, the Democratic leaders in Congress, and the remainder of the Vichy Left in Washington were and are deeply embedded in the tar-pit of neoliberal doctrine. They never miss an opportunity to out-Republican the Republicans in their willingness to sacrifice the last remnants of the New Deal.

“This great neoliberal transformation in the political economy of American health care wasn’t the result of the vagaries of nature or the unique cultural proclivities of Americans: it was part and a parcel of a much larger corporate-driven transformation, which, over these same years, has drastically exacerbated inequality while simultaneously fraying the substance of American civic democracy.


Neoliberalism (aka neoconservativism) is a viral, toxic doctrine that could easily end up crashing the world’s cultures that even Nazi Germany couldn’t do.

Valerie Long Tweedie said...

Thanks for this, Karen.

I won't claim to know the ins and outs of ObamaCare but I do know this, the only people I know who can afford it are two friends who have retired from the computer industry as millionaires at fifty. Thanks to NO negotiating with insurance companies by our government for a giant group discount, as would be reasonable with this kind of negotiation, only those who have a fair chunk of change can manage the monthly rates. Of course, these friends have money to spare so they take coverage with five and ten thousand dollar deductibles.

Meanwhile, friends who have lost their jobs or have jobs that don't provide insurance as a perk, are going without, hoping they will get lucky and stay healthy.

It is all so wrong. Yet by making it all so confusing, those pulling the strings keep many, many people in a state of psycho emotional paralysis. So they do nothing, not really understanding how to negotiate the system or simply not being able to afford it, hoping, hoping that they don't have a bad fall or get an infection or worse, get a terrible disease or illness.

Zee said...

BRAVO, Pearl!

Well said!

Zee said...

This article includes some of Jonathan Gruber's past pronouncements about the [Not So] Affordable Care Act, including one wonderful quote which may just push the Supreme Court to sink the [NS]ACA:


"I think what’s important to remember politically about this, is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits. But your citizens still pay the taxes that support this bill. So you’re essentially saying to your citizens, you’re going to pay all the taxes to help all the other states in the country. I hope that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these Exchanges, and that they’ll do it. But you know, once again, the politics can get ugly around this." (My bold emphasis.)

So it seems clear that, in the mind of one of ObamaCare's chief architects, states refusing to set up their own insurance exchanges and deferring to the federal government to do so, wouldn't be entitled to health insurance subsidies.

So why should the Supremes conclude that the current wording represents a "typo," rather than the clear intention of Congress to exclude from subsidies those residing in states who refused to set up their own subsidies?

I must say that it's pretty funny--to me, at least--that one of the chief architects of ObamaCare may just have provided the Supreme Court with all the ammunition necessary to put it out of our misery.

stranger in a strange land said...

Remember the raft of shit Whole Foods founder John Mackey caught when, in an interview with NPR, he had the temerity to utter the word "fascism" in reference to the Affordable Care Act?

"Technically speaking, it’s more like fascism. Socialism is where the government owns the means of production. In fascism, the government doesn't own the means of production, but they do control it, and that’s what's happening with our healthcare programs and these reforms."

Amid the uproar he attempted to walk-back his nomenclature:

"Well, I think that was a bad choice of words on my part ... that word has an association with of course dictatorships in the 20th century like Germany and Spain, and Italy. What I know is that we no longer have free enterprise capitalism in health care, it's not a system any longer where people are able to innovate, it's not based on voluntary exchange. The government is directing it. So we need a new word for it. I don't know what the right word is."

Perhaps "Inverted totalitarianism" is a more appropriate term?

(h/t Fred D.)

Denis Neville said...

"It is certain that ignorance, allied with power, is the most ferocious enemy justice can have." - James Baldwin

Jonathan Gruber’s easy-to-understand comic book “Health Care Reform: What It Is, Why It's Necessary, How It Works,” so “stupid” Americans could understand the Affordable Care Act (aka ObamaCare) in a Sesame Street way:


Prominent among the book’s comic characters was its author, Jonathan Gruber, who makes no bones about his enthusiasm for the ACA.

“It feels truly Orwellian that progressives are applauding the forced purchase of private health insurance — one of the most hated industries in the United States — while the right is opposing a model that originated from their political leaders. The Affordable Care Act (ACA) is a step farther on the path to total privatization of our health care system, not towards the health care system that most Americans support: single payer Medicare for all.” - Margaret Flowers,

“Political language is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.” – George Orwell

Jonathan Gruber’s "the stupidity of the American voter" and Rahm Emmanuel calling left wing activists "Fucking Retards," “Sorry you didn't get a pony” …

The 2014 Democratic Party debacle was a direct result of the Lame Duck and his fellow traveler Dimocrats being corrupt corporate shills who lie and use bait-and-switch tactics in order to deceive and sell the public out.

Stupid American voters? These neo-liberal clowns will never win by trying to be more like Republicans.

Valerie Long Tweedie said...

Spot on, Pearl! Thanks for writing it so much more eloquently than I ever could!