The sweeping health overhaul law turns 2 years old this Friday. And as it heads toward a constitutional showdown at the Supreme Court next week, the debate over the measure remains almost as heated as the day President Obama signed it into law.
In fact, public opinion about the law remains divided along partisan lines to almost exactly the same extent it was when the law was signed on March 23, 2010, according to the latest monthly tracking poll from the Kaiser Family Foundation.
Democrats mostly like the measure. Republicans mostly hate it.
Michael Cannon, an opponent of the law who works for the libertarian Cato Institute, says he's not a bit surprised that its popularity hasn't grown as many Democrats predicted it would.
"Even if this law was written exactly as its supporters would have liked, you still can't put lipstick on this pig," he says. "The law just takes too much from too many people to be popular with the American public."
Opponents of the law say the main reason for that is the so-called individual mandate, which requires most Americans to have health insurance or pay a fine starting in 2014.
"There was something fundamentally different about trying to jam the individual mandate down the throats of the American people," says Tom Miller, another opponent of the law from the conservative American Enterprise Institute. "Even people who had insurance, who were buying it — it just didn't resonate with their core gut instincts and larger values and history."
But supporters say the reason the law hasn't won more love is considerably more complicated.
Princeton sociology professor and health care watcher Paul Starr says part of the problem that so much of the law hasn't taken effect yet. "They're only really going to become aware of the specifics of the legislation as we get close to the point where there's enrollment in health plans and where people actually see how the health insurance exchanges actually work and how the subsidies work," he says.
And there's another big factor in the the lack of support — a lot of people who might like the law misunderstand what it actually requires.
For example, in a March 2011 poll, Kaiser (like most other groups polling on the subject) found that two-thirds of respondents said they opposed the individual mandate. But when it was explained that simply having employer-provided insurance would satisfy that requirement and that most employers were expected to continue to provide such coverage, opposition dropped to 35 percent.
"Probably 95 percent of the voting public either meet the individual requirement or are exempt from it," says Chris Jennings, a former health aide to President Bill Clinton and a supporter of the new law. "Why aren't these messages coming through better than they obviously are?"
It probably doesn't help that the Obama administration has been spending more effort trying to put the law into effect than working to dispel some of the myths about it.
"I don't think that was our primary job," says Nancy-Ann DeParle, White House deputy chief of staff and one of the key administration architects of the health law. "I really think our primary job was making sure that the changes that are happening to our insurance system were implemented in a careful, deliberate, transparent fashion."
DeParle blames the misperceptions — particularly about the pivotal individual mandate — on the law's many political opponents. She says, "The fact is for the vast majority of Americans they'll just check a box that says, 'Yes, I have insurance. '"
But the administration's lack of messaging, not to mention the political polarization around the law, has frustrated some of the law's other supporters.
"What messaging?" asks John Rother, who runs the nonpartisan National Coalition on Health Care. "I think the problem with something that's this controversial is it's always much easier to criticize it is than to defend it. And given that, I think the advocates for the legislation have been missing in action."
Princeton's Starr says there's another reason that opponents of the measure outnumber supporters. The entire structure of the law — preserving a private insurance system with an individual insurance requirement — was originally aRepublican idea. "The president and Democrats adopted that approach in the hope of getting moderate support," Starr says.
Yet Republicans have unanimously turned against it. And they're not the only ones.
"Many liberals were never enthusiastic about it to begin with," says Starr. And that shows up in the polls. "Many of the people who are unfavorable are actually unfavorable from the left and are unhappy about the law, because it isn't a single-payer national health insurance plan."
That may be yet another reason why President Obama spends a lot more of his time on the campaign trail these days talking to his Democratic supporters about things other than healthcare.
Healthcare for All/Single Payer -
I live in a state that has refused to accept Medicaid Expansion funds. The latest reports are proof that Texas, the largest state opting out, will cut off its nose to spite its face: we could collect $100 billion in federal funds over the next 10 years if we agreed to expand Medicaid eligibility. While hospitals in other states will see a drop in uncompensated care, Texas hospitals will continue to provide $5.5 billion annually to the uninsured.
It’s a little difficult to understand why politicians in our state—and others like ours–would reject the opportunity...
Deborah Mitchell | Counter Punch 05 Oct 2014 Hits:500 HCA Articles
Besides our own health-care system, Switzerland's may be the one that gets the most attention in America because of its similarities to the Affordable Care Act's new coverage scheme. So it seems worth noting that 64 percent of Swiss voters rejected a ballot measure on Sunday that would have scrapped its own system in favor of single-payer health care.
If that vote had gone through, it would have replaced more than 60 insurers with a government-run system, something that a fair number of liberals and others would like to see here,...
Jason Millman | The Washington Post 05 Oct 2014 Hits:419 HCA Articles
The Affordable Care Act has made a dent in the glaring lack of health care for many millions of poor people in this, the wealthiest country in the world. But allowing states to op-out of providing Medicaid coverage for the poor, most often people of color, youth and those living in rural areas, means many millions more — in 23 states — have been denied access to essential health care.
This disgraceful loophole in the ACA was raised at the Healthcare-NOW! national strategy conference held in Oakland, Calif., Aug. 22-24. “The...
Sue Davis | Workers World 14 Sep 2014 Hits:598 HCA Articles
A study of hospital administrative costs in eight nations published in the September issue of Health Affairs finds that hospital bureaucracy consumed 25.3 percent of hospital budgets in the U.S. in 2011, far more than in other nations.
Administrative costs were lowest (about 12 percent) in Scotland and Canada, whose single-payer systems fund hospitals through global, lump-sum budgets, much as a fire department is funded in the U.S.
The study is the first analysis of administrative costs across multiple nations with widely varying health systems.
It was carried out by an international team...
Stephanie Woolhandler | Single Payer Action 14 Sep 2014 Hits:955 HCA Articles
Don Berwick is making a vital point about the need for progressives to expand the discussion about healthcare reform.
Democratic and Republican strategists, and the candidates who let campaign consultants frame their range of opinion, are still engaging in picayune debates about the strengths and weaknesses of the Affordable Care Act.
But Berwick, who for seventeen months headed the Medicare and Medicaid programs under President Obama, isn’t getting lost in the political weeds. He’s blazing a trail in the direction of what ultimately must be done—pushing at the constraints of the conversation...
John Nichols | The Nation 14 Sep 2014 Hits:854 HCA Articles
This week, U.S. experts from the Center for Reproductive Rights (CRR) and SisterSong Women of Color Reproductive Justice Collective will testify before the United Nations' Committee to End Racial Discrimination in Geneva, sharing a report that describes the experiences of American women of color and immigrant women who pay with their health and even their lives for the race and gender discrimination that tirelessly persists in our health system.
The meeting is part of the U.N.'s periodic review process that evaluates how signatories to the International Convention on the Elimination of...
Andrea Flynn | The Hill 17 Aug 2014 Hits:508 HCA Articles
Now that the initial shouting and—at times—vitriol from both sides has subsided after Monday’s Supreme Court ruling in the Hobby Lobby case, it’s time to take a sober look at what the ruling says about the future of health care reform in the United States. The majority’s ruling was an imperfect solution to a complicated case involving the reach of religious liberty to exempt organizations from providing certain medical benefits that they find morally objectionable to their employees. The fact that these medical benefits were almost exclusively offered to women...
Fred Rotondaro and Christopher J. Hale | TIME 13 Jul 2014 Hits:1180 HCA Articles
The United States currently spends more per person on health care than any other developed country. Health outcomes in the U.S., however, are among the worst.
Despite weak health spending growth worldwide, a number of countries still had substantial health care budgets as of 2012. Based on data released by the Organization for Economic Co-operation and Development (OECD), the U.S. led the developed world in 2012, spending $8,745 per capita on health care. Turkey, by contrast, spent just $984 per capita, the lowest among developed countries. 24/7 Wall St. reviewed the...
Ashley C. Allen | USA Today 13 Jul 2014 Hits:556 HCA Articles
The venomous politics dogging the Affordable Care Act and the flawed rollouts of its new health insurance marketplaces have too often overshadowed health reform’s noble goal: ensuring that more Americans have access to vital, potentially lifesaving medical coverage.
But on Wednesday, a groundbreaking analysis released by University of Minnesota researchers offered a powerful reminder of why it’s important to keep the big picture in mind as the challenges of implementing the landmark 2010 law continue. Even though this state struggled with the balky MNsure website, historic gains were made in extending...
Editorial Board | Star Tribune 15 Jun 2014 Hits:675 HCA Articles
Oregonians can take a critical step toward comprehensive health care for everyone in the state. That first step is the HB 3260 study of health care financing options.
In 2013, the Oregon House Health Care Committee unanimously approved the study, the legislative passed the measure with bipartisan support, and the governor signed it into law.
Why is this HB 3260 study critical?
The study authorizes the Oregon Health Authority (OHA) to study four options to finance comprehensive, universal health care in Oregon. When the study is complete, the OHA will submit its report...
Samuel Metz, MD 14 May 2014 Hits:587 HCA Articles
Twenty years ago this week, Rwanda's genocide began. Over the course of 100 days, more than 1 million people would be murdered, and after the violence ended, the country—including its health care system—was left in ruins. Cholera outbreaks were rampant, HIV was widespread and people no longer trusted the few doctors who remained in the country because of their ties (suspected or legitimate) to the genocidal regime, the Atlantic reports.
In just two decades, however, according to a new study published in The Lancet, Rwanda has gone from one of the world's most health care-deprived countries to a stand-out example...
Rachel Nuwer | Smithsonianmag.com 11 Apr 2014 Hits:729 HCA Articles
When the giant kapok and nawa trees that tower over the Queen's Medical Center in downtown Honolulu were planted more than a century ago, Hawaii faced a health crisis.
Many on the islands, including the queen who founded the hospital in 1859, feared that native Hawaiians, devastated by smallpox, measles and other illnesses brought by foreigners, were in danger of dying off completely.
Today, the people who walk under these trees are some of the healthiest in America.
Hawaiians live longer than their counterparts on the mainland. They die less frequently from common...
Noam Levey | Los Angeles Times 11 Apr 2014 Hits:616 HCA Articles
Sovaldi, a new hepatitis C treatment, can cure up to 90 percent of patients within three months. There's just one problem: The drug costs $1,000 a day. That price tag has thrown the biotechnology world into turmoil, as lawmakers and insurance companies complain that Sovaldi's maker is trying to milk desperate patients.
Doctors are understandably finding it hard to pass over a drug that is so effective. As a result, Sovaldi's manufacturer, Gilead Sciences (GILD), is raking in the dough, while its shares have soared 53 percent over the last year....
Kim Peterson | CBS News 11 Apr 2014 Hits:663 HCA Articles
Canadians don’t drop dead or delay care due to the lack of health insurance. However in America, thousands will continue to face death according to Harvard researchers. About 25 million people will still not have insurance under Obamacare. Those that do, have seen their rates rise and contrary to the promise that “you can keep your existing plans” bullshit, working people with existing coverage and the poor will see rates not only increase, but will continue to pay a greater share of their income for health care than the wealthy...
Steven Maiken | Daily Sundial 16 Feb 2014 Hits:1091 HCA Articles
Lawmakers have begun looking at how to finance a single-payer health care system that Gov. Peter Shumlin hopes will be his crowning achievement.
Shumlin, a second-term Democrat, wants to launch a universal, publicly financed health care system known as Green Mountain Care in 2017. He has repeatedly told lawmakers that the financing plan to support the system, which his administration has estimated will cost $1.6 billion in its first year, will be revealed next January.
But Sen. Peter Galbraith, a Democrat from Windham County, says the governor’s date is too late. He’s...
Staff | Times Argus 20 Jan 2014 Hits:651 HCA Articles
A government-run health care system in Maine would provide universal coverage to residents, cut down on administrative costs and free businesses from the complexities of providing insurance for their employees, supporters of a single-payer model said Thursday.
Advocates of a single-payer system have long been trying to implement the model in Maine with little success, but said they are hopeful that the steps Vermont officials have recently made to spearhead the effort there can help make it a reality in Maine.
"Our current health care system is complicated, is inefficient, unfair and...
Associated Press | Maine Sun Journal 20 Jan 2014 Hits:609 HCA Articles
As the rollout of Obamacare clunks forward, activists who opposed the law from the beginning say it is time to seize the moment, to tear down the current health-care edifice and start anew, especially now as frustration with the law’s implementation is reaching a peak.
These are not Tea Party activists but advocates for a single-payer health-care system who say some of the problems with the launch of the Affordable Care Act—in addition to built-in problems with the law itself—have made the American public more receptive than ever to a Medicare-for-all...
David Freedlander | Daily Beast 10 Dec 2013 Hits:2606 HCA Articles
The Affordable Care Act continues to plow ahead, despite Republican attempts to fight it at every turn. What is unfolding in front of us is nothing short of spectacular. The problems with healthcare.gov are slowly being resolved which is helping more and more people sign up for affordable healthcare, many for the first time in their life. The law provides so much more than that, including standards for even the lowest level plans, protections for young adults 26 and younger, and the elimination of pre-existing plans. Of course, you will...
Salvatore Aversa | Truth Out 08 Dec 2013 Hits:2047 HCA Articles
Former CMS administrator Don Berwick is running for Governor in Massachusetts. He has an uphill battle in the ever growing primary for the Democratic nominee. Yet his controversial tenure in DC, his pursuit of the Corner Office in the state that birthed RomneyCare (a state that is home to some of the best medical research institutions in the world), and his devoted following on the left — all grant extra weight to his comments on healthcare.
Berwick’s campaign released his platform on healthcare for the Bay State last week. Even with little detail,...
Josh Archambault | Forbes 08 Dec 2013 Hits:842 HCA Articles
It's no secret that the rollout for Healthcare.gov has been somewhat of a bumpy road. Technical glitches have caused delays for folks looking to obtain insurance, and frustrated those working hard to provide coverage options for all Americans for the first time in this nation's history. While the kinks get repaired, much of the criticism has been beyond comprehension. Is it okay to highlight website problems? Yes. Is it okay to push the president to get these tech issues resolved quickly? Absolutely. But when did having website problems become the...
Rev. Al Sharpton | Huffington Post 18 Nov 2013 Hits:811 HCA Articles
In my recent column in The Hill titled Obama's health care Katrina I took President Obama to task -- proudly -- for spending years telling Americans they would keep their insurance policies when he knew millions of Americans could not. I called for a solution to help these people and I called on progressives including myself to lead the fight to help them. And now, even more, it is time to do what really needs to be done and fight like hell for a public option, for Medicare for all,...
Brent Budowsky | Huffington Post 17 Nov 2013 Hits:1277 HCA Articles
Whenever scandal arises in Washington, D.C., the fight between the two parties typically ends up being a competition to identify a concise message in the chaos—or, as scientists might say, a signal in all the noise. This week confirms that truism, as glitches plagued the new Obamacare website and as insurance companies cancelled policies for many customers on the individual market.
Amid the subsequent noise of congressional debate and cable TV outrage, Republicans argued that the signal is about government—more specifically, they claim the controversies validate their age-old assertions that government...
David Sirota TruthDig 17 Nov 2013 Hits:1255 HCA Articles
WASHINGTON — Defying a veto threat from President Obama, the House on Friday approved legislation that would allow health insurance companies to renew individual insurance policies and sell similar policies to new customers next year even if the coverage does not provide all the benefits and consumer protections required by the new health care law.
The vote was 261 to 157, with 39 Democrats bucking their party leadership to vote in favor of the bill.
The legislation would go further than the fix announced on Thursday by Mr. Obama,...
Robert Pear and Ashley Parker 15 Nov 2013 Hits:714 HCA Articles
Holding signs demanding “Expand Medicaid Now,” about 60 people, including state legislators, medical professionals, clergy and health advocates gathered Thursday in Charlotte to ask the state’s Republican leaders to reverse their position and accept expansion of Medicaid benefits for the poor.
“Today I am making a 911 call to Gov. (Pat) McCrory and the North Carolina General Assembly,” said state Rep. Carla Cunningham, a Mecklenburg County Democrat.
She and fellow Democratic state Rep. Beverly Earle have asked McCrory to convene a special legislative session to reconsider the earlier decision to reject Medicaid...
Karen Garloch | Charlotte Observer 01 Nov 2013 Hits:696 HCA Articles
As states open insurance marketplaces amid uncertainty about whether they're a solution for health care, Vermont is eyeing a bigger goal, one that more fully embraces a government-funded model.
The state has a planned 2017 launch of the nation's first universal health care system, a sort of modified Medicare-for-all that has long been a dream for many liberals.
The plan is especially ambitious in the current atmosphere surrounding health care in the United States. Republicans in Congress balk at the federal health overhaul years after it was signed into law. States are...
Dave Gram | The Huffington Post 27 Oct 2013 Hits:763 HCA Articles
PORTLAND, Maine — A Maine nurses group on Monday said President Barack Obama’s signature healthcare law, which is criticized by conservatives as overreaching, doesn’t go far enough toward universal health coverage.
The Maine State Nurses Association held Monday afternoon health screenings and an evening “town hall” event at the First Parish Church on Congress Street in Portland to advocate for the expansion of the federal Medicare program to cover all Americans, regardless of age.
The organization is planning to hold a second wave of screenings and another town hall event Tuesday afternoon...
Seth Koenig | Bangor Daily News 15 Oct 2013 Hits:860 HCA Articles
Did you happen to see Jimmy Kimmel’s interesting skit last week, where he asked people on the street whether they preferred “Obamacare” or the “Affordable Care Act”? Far too many people chose the “Affordable Care Act” over “Obamacare” without realizing that they are one and the same law.
Even worse, several of Kimmel’s interviewees rejected “Obamacare” after having already endorsed major pieces of it! Some of this cluelessness is no doubt because of propaganda. Some of it is no doubt because of partisan dislike of the president. But we must not...
Rev. Jesse Jackson | Chicago Sun Times 08 Oct 2013 Hits:878 HCA Articles
Despite critics slamming "Obamacare" – the first major U.S. health-care reform passed in nearly 50 years – as "Canadian-style" health insurance, critics note that major differences between the two systems persist.
McGill University Professor of Political Science Antonia Maioni said the U.S. Patient Protection and Affordable Care Act, which went into effect earlier this week, is "not even close" to the Canadian system.
"Obamacare keeps in place the basic principle of health care in the United States which is: if you want to get access to care you need to buy insurance coverage," she told...
CTVNews.ca Staff 06 Oct 2013 Hits:970 HCA Articles
A sweeping national effort to extend health coverage to millions of Americans will leave out two-thirds of the poor blacks and single mothers and more than half of the low-wage workers who do not have insurance, the very kinds of people that the program was intended to help, according to an analysis of census data by The New York Times.
(Claretha Briscoe, left, of Hollandale, Miss., with family. She earns too much to qualify for Medicaid but not enough to get subsidies on the new health exchange./James Patterson for The New...
Sabrina Tavernise and Robert Gebeloff | The New York Times 03 Oct 2013 Hits:975 HCA Articles
Donna Smith: “The fact remains that we all have bodies and we all will someday get sick or hurt; all of us will need some level of health care.”
Through all the rhetoric, the misinformation, the lack of information, the cheering and the nay-saying, and the threats and realities of government shutdowns that surrounds the Affordable Care Act (ACA), one thing remains certain: individuals will begin enrolling for health insurance at state exchanges starting on October 1, 2013. Whatever else people may think the ACA is or isn’t, it remains this country’s...
Joanne Boyer | Wisdom Voices 02 Oct 2013 Hits:951 HCA Articles
Dr. Bill HonigmanCalifornia
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