Millions Are Uninsured
When People claim “Millions Are Uninsured Under the PPACA,” it is a garbage statement meant to elicit a negative reaction without going into the detail of who is uninsured and why. Repeatedly Charles Gaba, Maggie Mahar, Commonwealth Fund, Urban Institute, Kaiser Foundation, etc. have explained the numbers and the whys of the uninsured, most of which are not the fault on the PPACA.
I see commenters come to AB and outside AB discussing the uninsured. Some being legitimate bloggers claim “millions are uninsured” and some have exaggerated it even more with citing “tens of millions” with their credibility disappearing as they can not recite the make-up of or the reasons for the number as they do not know it or are trying to make a political statement. The latter being worst than the ignorance of the former.
There are reasons for the uninsured as detailed by Kaiser Family Foundation. For example, Republican states which do not allow expansion of Medicaid accounts for 2.6 million, undocumented citizens 5.4 million, those eligible for Employee sponsored insurance 4.5 million, and 3.0 million who could have unsubsidized insurance. Then there are 6.4 million adults and children eligible for Medicaid and another 5.3 million eligible for Premium Subsidies and for some reason have not chosen to be insured. Some states like Michigan do make it difficult to enroll in Medicaid. These are the Kaiser numbers for 2016 and they total ~27 millionfor uninsured and why. A “tens of millions” uninsured is a BS numeric when we start accounting for Republicans blocking Medicaid Expansion in states, undocumented immigrants, ESI available insurance, 6.4 million eligible for Medicaid, and another 5.3 million eligible for subsidies. Other than undocumented citizens and states blocking the Medicaid Expansion, there is access to healthcare insurance in one form or another through the PPACA, much of which exists today due to the PPACA, or Employer Sponsored Insurance. When we account , the number drop as there are those without subsidy who chose not to be insured, others who could be on Medicare or have Premium subsidies, and those who could have Employee Sponsored Insurance.
If I understand your point correctly, millions are uninsured under PPACA, but to acknowledge it is wrong because there are reasons why they are uninsured. Since there are reasons, we shouldn’t acknowledge that they are uninsured.
Do you have any comparison with other developed countries which have what is usually called universal coverage? How many millions lack insurance in those countries that they don’t acknowledge because there are reasons for their lacking coverage?
interesting that your nom de plume does not suggest to you that your reasoning is of the devil. because someone presents a “fact” in a way twisted so as to deceive, you conclude that the rest of us just have to accept the devils framing and go along with the scam.
saying “millions are uninsured” is intended to fool people into thinking it is the fault of obamacare that these poor people now labor under the anxiety and risk of being uninsured, when the facts appear to be that most of the “uninsured” are the result of Republican (the devil) maneuvers to defeat obamacare.
sorry to bring the devil into these enlightened times, but “the evil that men do” is too long to say and “the devil” is a handy metaphor.
Correct, “oh no the PPACA is flawed” when much of the issue is elsewhere and not with the PPACA. The Repubs, other blogging sites, and some commenters have used this repeatedly without explaining the reasons why. Similar to the “oh no” Healthcare Insurance Premiums are going up, Co-ops are going out of business, and insurance companies are leaving the healthcare exchanges when it has nothing to do with the PPACA and the issue is with Repubs (Upton, Kingston, and Sessions) cutting off funding for the Risk Corridor program. Explained below in an earlier post.
There is no comparison with what other countries are doing.
Well, Coberly, I do hope that nothing I write will be an impediment to truth. I really didn’t know that anyone thought that the PPACA is flawless. I don’t know that arguing that it is advances good policy, persuasion of the people in a democracy towards good policy, or honest assessments on our own part. If you think this is the devil, just erase the comment and forget it. We’re just very far apart on how to think about policy and people.
yes we are far apart. i didn’t hear anything in your comment that suggested examining obamacare for flaws
but instead to accept the twisted “truth” of its enemies who don’t give a damn whether it was flawed or not. their only interest is in maximizing the pain suffered by human beings, while possibly helping the very rich make a little more money.
for the record, i had, have, my objections to obamacare. and expressed them here. but we are not dealing with any rational problem-solving discourse.
Well, on flaws, I did suggest looking at policies in other countries which have produced better outcomes than what’s happening with health care policy in the U.S. I thought it was relevant to defining and arguing for good policy. Again, sorry to have raised the devil in your thinking.
From 2010 onward and when Repubs took control of The House, “any” modifications to the PPACA or migration was not going to happen. Universal Healthcare or a migration to Medicare (which is a two tiered system unless you want to pay the 20% of Part B and your drugs out of pocket) for all was not going to happen. The Senator from Aetna killed the Public option with his sixtieth vote in 2010. When the DEMS lost the Senate any changes died with it again. When the DEMS lost the Presidency, we are now on the verge of repeal of the PPACA. In which case do you honestly believe Repubs under Ryan and McConnell are going to give you a government sponsored program?
The post is about the Uninsured and not what we could go to as could is not going to happen and we are now attempting to preserve what we have. Too many of you insist the PPACA caused the uninsured when it didn’t, the politics of the government has forestalled further developments from the beginning.
AFAIK, all the other industrialized nations on the planet have some form of single payer. They manage to deliver healthcare at about half the per capita cost and with as good or better outcomes. Based on other countries, it seems to me that single payer would be good policy.
And you believe they are all 100% single payer?
You AB folks are smart, but still suffering from an American language flaw in discussing health care. I hate to have to bring it up again, but “Insured” does not mean “has access to health care as and when needed.”
As soon as the commercial element comes into your system, the middleman (i.e. the insurance company) has a strong motivation to function like a lobster trap — money comes in and as little as possible goes out again. And because it involves a crucial service, US patients become de facto hostages to the system.
In Canada, people get treated as needed. “Canada’s universal health-care system” http://www.cic.gc.ca/english/newcomers/after-health.asp
Even refugees. (“Frostbitten refugee will lose fingers, toe after 7-hour trek to cross U.S.-Canada border” http://bit.ly/2iiRM39 ) The last government, who were voted out with a scoop shovel last year, tried prohibiting this, to the fury of Canadian voters and doctors alike.
And, our system is cheaper. Like, $7,500 per US resident, versus $3,900 per Canadian resident.
(OECD chart from 2008: http://bit.ly/2ioRpcb)
Americans don’t need insurance. They need care. If the nation was smart, the headline would read “350 Million Uninsured.”
How many other countries have Universal/single payer healthcare? You appear to have forgotten the battle to get what we have today as well as the unwillingness for Congress to allow Medicare to negotiate Pharma. This post was meant to explain the uninsured numbers and not to dream about what could have been if Congress was so inspired to grant it.
I already know what Canada, England the two – tired systems in much of Europe provide and for what cost. Many of the commenters here and elsewhere do not though. Good post on Risk Corridors below and how the RePubs sabotaged the PPACA, premiums, Co-ops, and insurance companies.
Not sure what your point is. AFAIK, they all have single payer. If your point is that it is possible in at least some of these countries to obtain medical services outside of the single payer system, that may be true. But it is beside the point. The ACA is not, for anyone, single payer. Medicare is. We need Medicare for all.
Let me explain again, the post was about the uninsured, why they were uninsured, and it is not the fault of the PPACA. If your point is to blow up the PPACA because it does not cover every person in the US, what will you accomplish when there is nothing in the wings to replace it since 2010 due to political interests who opposed it and wished nothing better than to go backwards. Your pronouncements and those who critiqued the PPACA created an environment in which Repubs thrived in since 2010.
Most European countries do not have single payer as many in the US would like to think. Jabbering about Single Payer now is just silly when it appears we may not be able to keep the PPACA which will send millions back to an uninsured status. Medicare is not single payer either and you will still have a two tiered system unless you wish to pay 20% of Part B and all of your drugs. Even then Part A is limited in what it costs. You still need insurance.
Look I have been writing on this since 2008, I did the editing for Maggie Mahar, read the initial PPACA bill, sent note around to a select few on AB, and have been the messenger on this. Arguing about this is silly when we may end up with nothing again. To give you an idea on the treachery being practiced by Repubs, go read my post on Risk Corridors.
I am apt to invoke the devil because of my literary education, not my religious one (which is none). I certainly don’t believe in the devil, or the picture of the devil, the way most people seem to.
If you want to compare health care in US with that in the civilized world, be my guest. but if you are going to propose ignoring the lies of the liars without examining to see if they have not, by chance, distorted the truth, i am likely to misjudge your motives.
The post said that stating that under PPACA “millions are uninsured” shows either ignorance or efforts to make a political statement. Since millions are in fact uninsured, I don’t think it’s ignorance. I do think that “millions are uninsured” is or should be a political statement, in a way that say, “millions don’t like broccoli” isn’t. I don’t see where the lie is. I don’t see where the distortion is.
I guess I wandered into an argument that I didn’t know was going on. Your point (and correct me if I’m lying or distorting), that you really never made explicit in the post but have clarified in comments is that the PPACA does not include millions, but it was the best that the good guys could do, as proven by the reasons for the exclusions. And so, everyone should just be quiet about better health care policy. We disagree here. As evil and mendacious as you may think me, I am appalled by the argument that we should not criticize a system that leaves millions of our fellows without access to health care.
But then, I’m just a silly rube.
not any sillier than most. but you don’t seem to be getting the point and making yourself sound sillier by evading it.
Most are silly? You few, you happy few, you band of smarter-than-most brothers!
Nihil: what, quoting from That Hideous Strength now?
One thing the Internet has sadly taught us is how many people build their worldview from twigs or straw, bound together with sentence fragments and glued in place with gall, bile and, choler.
Having said that, we all have our silly and choleric moments, and must thank inertia and our quotidian duties that they are not more often revealed.
Noni: Henry V, Shakespeare
Um… a quibble. You use the phrase “undocumented citizens” twice in the post. I would venture to say there are very, very few undocumented citizens more than a week old. I believe you are referring to immigrants who happen to be undocumented, or rather, they have documents which suggest they are citizens of other countries and no documents indicating they are in this one legally.
Thanks, nihil. And of course that’s where Lewis got his reference ( unless Shakespeare nicked it from some Greek or Roman writer, which is always a possibility with good old Will.)
Interestingly, Lewis used the phrase to criticize it — to encourage the “happy few” warriors in THS to remember that in all times, in all worlds, there are warriors fighting the same battles, in the same perceived isolation, and that it would do their humility well to remember it. We happy few are legion.
Noni: And although the 1944 Laurence Olivier film portrayed Henry as a great military hero (Britain was fighting WWII after all), in fact, the play is far more ambivalent, giving scenes and speeches that present Henry as a manipulative war criminal. The filmed production I’ve seen that includes all this is the Tom Hiddleston version in BBC’s The Hollow Crown. After Henry’s threats to the town of Harfleur (Surrender or I won’t be able to keep my soldiers from raping your virgins and skewering your infants on pikes — babies on bayonets has been the war crime par excellence for centuries), the whole “we’ll be heroes” rings a bit unpleasant. I read This Hideous Strength decades ago so I don’t remember it very well, but C.S. Lewis did know his 16th and early 17th c. literature inside and out, and would have picked up on the moral ambiguities.
i include myself among the silly on most issues,
but you appear to want to win the sillier than thou contest.
you consider yourself “informed” because you know there are millions of uninsured. but you don’t consider yourself uninformed because you don’t know the reasons why they are uninsured. nor do you care to know that “millions of uninsured” is a right wing propaganda meme to discredit obamacare.
you appear to think that you can do better than obamacare without actually knowing why it is “failing”. that is beyond ignorance, it is a definition obstinate silliness.
glad you brushed up your Shakespeare. not sure I understand the relevance to your pique about we happy few. it is probably a mistake to think that everyone who thinks he knows more than you about something is a fool.
you know, either he does or he doesn’t. but why do you think you know more than he does? happy few, or do you get it straight from god’s mouth to your ear?
As I have already stated, we are too far apart in the way we think for us to have a useful conversation on the issues. I give up on trying to get you to address the issue of how to improve our policies without simply relying on personal abuse, which is the point of every one of your comments. I am the devil who accepts facts presented in a way that is intended to deceive, and I go along with the scam. This is, as you put in quotation marks, “truth”, from enemies whose state of mind and intentions you believe you know, and you know that they are evil. You say, I am ignoring the lies of liars, and participate in distorting the truth. Who these people are, I don’t really know, except that run75441 says that they’re bloggers and commenters. Although I have a point that I think you’re evading, you accuse me of evading your point, and inevitably, have to add the personal insult — I’m making myself sillier by not agreeing with yours. I am operating in pique at people who know more than me. (Actually, by that point I was operating in laughter. My god, can the guy write a single comment without resorting to insult?)
Personally attacking and attempting to demean anyone who disagrees with you or sees issues in a different context is not a good thing. They are not necessarily stupid or evil. I believe that if we are to have good humane policy, we must be able to understand and communicate with respect.
I do not appear to be helping towards that goal here. Good luck with your efforts.
do you ever consider that you might be projecting the “insults.” i admit to not being very diplomatic, but if I express my opinion that something is wrong with yours, my purpose is not to insult but to make my own opinion as clear as i can.
you were the one who called yourself silly… admittedly because you thought i was calling you silly. but i hadn’t up to that point. i merely pointed out that your theory about ignoring the causes of “millions of uninsured” left the playground in the possession of the liars. that this means you were abetting the liars does not mean that i was calling you a iiar. far from it. you have managed to convince me that you were only being silly.
i have no objection to your laughing at me. sometimes i do it myself.
“I believe you are referring to immigrants who happen to be undocumented….”
How did that “happen,” Mike?