Support for HCR Increasing, Particularly Among Dems

Greg Sargent has the details:

[T]he internals of the new CNN poll contain a striking finding: Support for the Senate bill is up among Democratic voters. What's more, Obama's support has increased among liberals.

The poll finds that support overall for the Senate health care bill has jumped six points, to 42%, since early December. That's a sizable jump, though overall 56% oppose it.

But here's the interesting part: The poll also found that approval of the Senate bill has jumped 10 points among Dems in the same time period -- a time period during which the Medicare buy-in was dropped. That's a faster rise than overall. What's more, it has jumped by the same number among young voters -- who are presumably more liberal.

On top of that, the poll also says that Obama's overall approval among liberals has gone up, to 81%.

This isn't a perfect bill. But it's also not a bad bill, either. And the American public, particularly Democrats, appear to be warming to the proposal. To a large extent this coalescing of support is tied to the procedural success of the bill; as the bill moves closer to becoming a law, and thus a procedural success, more are jumping on the bandwagon. That said, as the public sees that the legislation nearly through the Senate expands healthcare coverage for 31 million Americans while greatly reducing the deficit, it's understandable that more would come around to supporting the bill.

Tags: 111th Congress, healthcare reform (all tags)



Re: Support for HCR Increasing, Particularly Among

Where is the other polling data the subject from the last few week?

by bruh3 2009-12-21 12:02PM | 0 recs
What a crappy poll question

Most people will read "some" and believe it equates to "minority"

Look under this bill 15 million more people will be covered under Medicaid compared to the baseline and 26 million will be in the exchange and most of those eligible for the subsidy. This is offset some by 4 million less getting employer coverage and five million less getting coverage through the non-group (i.e. individual) market.

If you have a family income of $66,000 plus and no employer coverage you are required to purchase insurance. Big effing deal, if you are letting your kids hang out without insurance because you don't want to pay 8% of your income, a figure that is generally less than you would pay today for family insurance in the non-group market you should be investigated for child abuse.

This question takes a tiny minority of the population and suggest that they are a huge part of the equation.

This whole "makes you criminals" crap is straight out of Rep. Dave Camps office (literally). That some progressives with a single minded insistance on singly payer are deploying this right wing talking point is frankly despicable. Nobody is going to get thrown in jail for refusing to pay a $750 fine, instead Rep. Camp deliberately solicited a letter from the JCT asking about the range of possible penalties under CURRENT law for violating this section of the tax code. In 2008 there were 693,000 violations of which more than 692,000 were settled by civil penalties which generally were a percentage of the fine, while there were about 759 misdeameanor and felony prosecutions with 666 (I shit you not) convictions which I suspect were mostly from people money laundering and lying on their taxes (this is after all how they took down Capone).

If you tell the Big Lie enough times people believe it. That doesn't mean that "voters get it". Huge majorities believed Saddam had WMDs. That didn't make them miraculously appear.

Jim Dean may not understand he is just repeating wing-nut talking points but the use of 'criminals' is pure crap. If you don't pay all of your taxes the IRS charges you a fine. That doesn't mean you are going to be herded into FEMA concentration camps. Sheesh.

by Bruce Webb 2009-12-22 02:18AM | 0 recs
Re: heres a more scary poll

The plan certainly provides that 30 million additional Americans receive insurance. There is certainly plenty of evidence that many Americans chose to remain uninsured despite there being affordable coverage available.

With requirements that all plans provide for basic coverage (as provided for in the bill) it is likely that nearly 30 million Americans are going to be insured who currently are not.

by lojasmo 2009-12-22 03:54PM | 0 recs
Somewhat significant development:

If Jacob Hacker endorsed the Senate health bill, then do liberals really have a leg to stand on anymore?

Hacker, after all, is the creator of the idea of a "public option." The Yale professor wrote on Jonathan Cohn's The Treatment blog on The New Republic's Web site -- under the headline, "Why I still believe in this bill" -- while "it would be tempting" to say the bill should be killed "it would be wrong."

He lists several reasons:
(1) "opportunities for serious health reform have come only rarely and fleetingly;"
(2) "Many Americans will be gravely hurt by the delay;"
(3) Obama, "the most progressive president of my generation ... will be handed a crippling loss;" and
(4) Democrats "will be branded as unable to govern." 009/12/21/2157902.aspx

by fogiv 2009-12-21 12:04PM | 0 recs
Re: Somewhat significant development:

How is this related to polling?

by bruh3 2009-12-21 12:07PM | 0 recs
Re: Somewhat significant development:

It's not.  How are you related to Barry Manilow?

by fogiv 2009-12-21 12:09PM | 0 recs
Re: Somewhat significant development:

Next time you may actually want to relate  your talking points to diary so as to not be so obviously shilling. At least the diarist only left out polls, you choose to not discuss them at all.

by bruh3 2009-12-21 12:15PM | 0 recs
What bothers you so much about this diary?

And what do old polls have to do with anything?

by NoFortunateSon 2009-12-21 12:32PM | 0 recs
Re: What bothers you so much about this diary?

It's important because it distracts from discussion of the facts.  Polling data is the end-all be-all regarding this issue...unless it isn't.

by lojasmo 2009-12-22 04:08PM | 0 recs
Re: Somewhat significant development:

I made no attempt to directly relate Hacker's endorsement to this set of polling data.  You're the undisputed Strawman Ass-Kickin' Champion of the World.  No contest Dude, you're truly the best.  (1) Ready, (2) fire, (3) aim.

Sorry if it offends your deeply entrenched position (aspects of which I agree with BTW), but this struck me as a significant development because Hacker's is a strong voice on the issue of HCR that joins a seemingly growing swell of support for passage.  The poll Singer is discussing here may indicate that public opinion with regard to this bill isn't as nasty as we'd previously thought.  More expert opinion such as Hacker's may help soothe some disaffected progressives.  That's all I'm saying.

by fogiv 2009-12-21 12:35PM | 0 recs
Re: Somewhat significant development:

It does however support the idea that there is a growing consensus among progressive policy wonks and democratic voters that passing the bill is preferable to killing it.  I know that you disagree and think many of your arguments about the deficits of the bill are well taken.  But for those of us who rely on a range of policy analysts to grasp the technical intricacies of this legislation, Packer's position is relevant indeed.  We cannot all be independent experts.  I have read your analyses and those of professional analysts.  I think the Packer piece and the CNN poll suggests that the drive among legislators and analysts to shore up support for the bill might be having an effect.  Of course, it's only one poll.  We'll see if policy pieces and statements by legislators in coming days affect subsequent polls.

by Strummerson 2009-12-21 12:20PM | 0 recs

Hacker, not Packer of course.  Read a review of the latter's new collection of work from the New Yorker over the past decade last night.

by Strummerson 2009-12-21 12:22PM | 0 recs
Informed vs uninformed voter

"How is this related to polling?"

Easy. Some part of those polled, and given the way disinformation has been coming from both left and right probably a large fraction if not majority is profoundly underinformed on this issue.

A poll is fundamentally a measure of what people believe to be the truth and not of the truth itself. If you have evidence that a high information voter previously opposed to a particular proposal has flipped and now supports it it provides some indication that the bolll result while still statistically valid shows some probable disconnect between reality and public opinion.

The poll is what it is but its significance for policy is discounted, particularly when as here the poll question itself has language weighted in a way that moves the response. This question assumes matters that should be in dispute and is very close to a push poll. That is why Hacker matters.

by Bruce Webb 2009-12-22 02:28AM | 0 recs
the problem with Hacker's assessment

is that he assumes the bill's insurance regulations will be properly enforced, which they won't be.

I agree with him that if the bill goes down that is not great political news for Democrats, but I think Obama knows he needs something to pass, so he would go for something more limited via reconciliation, with fewer corporate giveaways.

Chris Bowers was right: "There is no happy ending to this one."

by desmoinesdem 2009-12-21 01:26PM | 0 recs
Re: the problem with Hacker's assessment

I agree with both you and Bowers that nothing here indicates a happy ending.  The question is which is preferable with regard to what comes next.  Does this bill open more possibility for further reform than killing it?  It's a difficult question.  Right now, I see a preponderance of progressive legislators and policy analysts arguing that passing is preferable with regard to the future.  Accepting their arguments doesn't mean I don't also concur with the critiques of the policy and its political implications that many of them also recognize.  

by Strummerson 2009-12-21 01:34PM | 0 recs
Re: the problem with Hacker's assessment

But what do you think about the bill?  Putting aside who lines up for and against it.  Do you think it's a positive move forward?  And what evidence leads you to that conclusion?

by orestes 2009-12-22 06:19AM | 0 recs
Re: the problem with Hacker's assessment

I think the bill sucks.  I don't think that there is a need to recite all of its problems.  We likely concur on most of them.  In short: mandates without cost controls add up to a massive corporate giveaway that also suggests serious future political liability.  But if I had a vote, I would cast in favor at this point.  My determination is based on an informed supposition about the dynamics.  There seems to be a preponderance of opinion, from both progressive policy folks such as Hacker and Krugman and even Reich (if I recall correctly) and from the leftward side of the legislative spectrum that passing this bill is smarter as a long term strategy than killing it.  Enough of them see more opportunity for further reform emanating from passage than from flushing the thing.  If it seemed more likely to more people involved with the process whose goals I share that we could get further by killing it, I would line up that way.  If only legislators were lining up and progressive wonks were urging a kill I would back a kill.  And if most of those who are critical but still urge passage were arguing that this is the best we can do and this is the end game, I would also want it killed.  But that's not the case.  Krugman, Hacker, Bernie Sanders, Russ Feingold and many others are hardly apologetic for the bill's critical deficiencies, but all are pushing to pass it.  Does any of that qualify as evidence?  No.  Not at all.  But they all credibly opine that it's preferable to pass and try to fix than kill.  The danger is in passing and then taking our eyes off the ball.  And that's a real danger.  So I can't say I am enthusiastic.  But it does seem to be the better course going forward.

by Strummerson 2009-12-22 07:10AM | 0 recs
Re: the problem with Hacker's assessment

I'm not a big proponent of deferring to authorities.  I saw Kuttner on Bill Moyers last Friday and his arguments were so weak that I lost all respect for him.  He was dripping with noblesse oblige.  I think this may be motivating some of the others as well.  I would love to hear a more detailed analysis from Krugman or hear him debate his view.  I respect his opinion, although I heartily disagree with him on this issue.  I do think one can never overestimate the personal motives of the overprivileged. Krugman et al. will feel no real effect from this bill, but they have the privilege of demonstrating concern for the poor (those unwashed 30 million [sic] who will have health insurance).  I have yet to hear a good argument as to how this bill can lead to more progressive reforms in the future.  They all seem to be based on, dare I say it, hope.

by orestes 2009-12-22 09:55AM | 0 recs
Point me to the chrystal ball store

"he assumes the bill's insurance regulations will be properly enforced, which they won't be."

You know this how? Your infallible sense of Cynic-Dar?

That is the same kind of logic Bush used when he said we shouldn't increase taxes on the ultra-rich, because after all they would just find a way to cheat anyhow

The right wing, the capitalist class, want you to be cynical, want you to believe the game is so-rigged that there is no escape. Because they want to discourage you from even trying to improve things.

Don't fall into the "OMG we are SO fucked" mindset or we won't get anywhere at all.

by Bruce Webb 2009-12-22 02:36AM | 0 recs
Re: Point me to the chrystal ball store

I think that compelling all Americans to purchase private health insurance from the companies who have created a health care crisis in this country and calling it major health care reform makes me cynical.  

by orestes 2009-12-22 06:21AM | 0 recs
Re: Point me to the chrystal ball store

 I can't point you to the crystal ball store, but it might be located next to the free pony store.

by QTG 2009-12-22 06:30AM | 0 recs
Very interesting

My theory has been that depressed poll numbers the past few weeks have been due to legislative fatigue. It's quite an unattractive process; sausage making that is. Now that achievement is within grasp, I hypothesize that poll numbers will bounce back to a more normal level. Arianna and others believe there will be no poll bounce. We'll have to wait just a little longer and see. Thanks for the good news.

by NoFortunateSon 2009-12-21 12:14PM | 0 recs
IMO, the progressive agenda would be better off if there is no rebound. If Democrats don't suffer some loss for throwing the left under the buss, then the left has absolutely no power. Might as well not vote.
by luckymortal 2009-12-21 12:17PM | 0 recs
There's a real question... to who threw who under the bus here.

Did the democrats throw the progressives under the bus?

Or did the progressives, in hysteria, jump?

Make no mistake, having a fractured progressive wing is bad for the party in elections, but my theory has been that progressives cannot handle the mantle of power. Dean got screamed in 2004 because Americans view progressives as hysterical and fringe. They played right into that with the healthcare debate.

For me, the seminal moment was when Bill Clinton came out and big footed Howard Dean, who has now backtracked and urged passage of the bill.

by NoFortunateSon 2009-12-21 12:34PM | 0 recs
Good bill: if you don't mind more dead women

Abortion restrictions always mean more dead (and maimed) women, and no I'm not being hyperbolic.

This bill also rolls back Roe V. Wade, and experts believe it will create a domino effect that will eliminate abortion coverage in all private insurance plans.

And before you argue with me, read the below thread, which backs up what I've summed up. /20/121547/68/1500#c1500

Only Nixon could go to China, and only Dems could betray their female base and roll back Roe v. Wade.

They apparently don't mind throwing us under the bus, and we may return the favor in 2010.

by judybrowni 2009-12-21 12:46PM | 0 recs

the only people who can "roll back" Roe v. Wade are on the Supreme Court.  The abortion restriction is bad but even the worst bill can't rewrite the Constitution.

by JJE 2009-12-21 12:50PM | 0 recs
Re: There's a real question...

Yes, it's the progressives' fault.  For having progressive values.  And from which source do you draw your sage insights?  

by orestes 2009-12-21 01:03PM | 0 recs
Yes, heighten the contradictions.

Has always worked as a strategy for the Left. If you just ignore something I call 'history'.

Revolutionaries make me sick, particularly those revolutionaries who are themselves more often than not comfortably situated.

Back in the day they were called 'parlour pinks', happy to see workers suffer because after all such suffering would just hasten the day of the proletarian revolution.

Except of course where it just served to rally the workers and peasants to reactionary movements. This willingness to sacrifice the interests of 30 million mostly working class Americans in the interest of the "progressive agenda" is the reason why the Left never actually gained the fundamental allegiance of workers. Instead workers made their biggest advances within a structure that had for example union leaders negotiating with the capitalists and the party working through democratic means.

No the process doesn't have the purity of the revolutionary spirit. But it gets shit done in ways that the New Left never even attempted. Over my lifetime (I am 53 next week) I have seen dozens maybe hundreds of demonstrations where the crowd chants: "What do we want? XYZ!! When do we want it? Now!!!!" Somehow it never seems to move the ball down the field.

Rooting for health care to fail is to validate Limbaugh and Beck.  

by Bruce Webb 2009-12-22 02:52AM | 0 recs
Re: Yes, heighten the contradictions.

I suggest you do some research on the progressive movement in this country.  The people who helped start the unions and have helped (and continue to help) workers to unionize are PROGRESSIVES.  People who fought for workplace regulations, child labor laws, etc.- progressives.  

Nice job trying to tar the entire progressive history in this country with one broad brushstroke.  It's the old parlor trick of picking out the worst example and tarring an entire movement with it.  And who's validating Limbaugh and Beck?  

And you appear to claim to be concerned about the workers.  Well, this bill taxes the health care plans that unionized workers have fought to gain and then maintain.  Yeah, that's real reform for the working class.  Power to the corporations!

by orestes 2009-12-22 06:35AM | 0 recs
Re: who is validating Limbaugh and Beck?

"Rooting for health care to fail is to validate Limbaugh and Beck. "

Validate may imply agreement on rationale, which I agree is too strong. But by reaching the same practical endpoint, you know, the thing that History records, is a very valid point. Not passing a Bill has a lot extremely nasty repercussions, and very little to recommend it. Petulant Progressives (a shrinking subset of Progressives - don't tell me Howard Dean is not a Progressive now that he supports passage!) are selfish (don't make me buy insurance unless it's free!) and shortsighted, and are manic to boot.

by QTG 2009-12-22 06:57AM | 0 recs
I'm hoping...
there will be a push-back, if there's enough time. I just can't see how the left can allow this massive tax raise on working people to fund a give-away to the same industry that has worked against us in this fight. It's like we lost the war and are being forced to pay reparations. This is paving the way for corporate power to fight the progressive movement...
by luckymortal 2009-12-21 12:15PM | 0 recs
Re: I'm hoping...

I like you.

This is a corporate giveaway. We are eroding our own political power to boot. A lose-lose.

by Charles Lemos 2009-12-21 12:19PM | 0 recs
Re: I'm hoping...

I should add that there are merits but I'd grade this bill a C.

The community health centers, I like.

Mind you, fixing our healthcare system is going to more than just a bill. Ultimately it means tackling issues such as sprawl, transportation infrastructure, diet, ending the corn subsidy,our dependence on automobiles, farming practices. The moving parts are plentiful.

by Charles Lemos 2009-12-21 12:25PM | 0 recs
Re: I'm hoping...

Mind you, fixing our healthcare system is going to more than just a bill. Ultimately it means tackling issues such as sprawl, transportation infrastructure, diet, ending the corn subsidy,our dependence on automobiles, farming practices. The moving parts are plentiful.
And oh so heavy some days :(
by NoFortunateSon 2009-12-21 12:36PM | 0 recs
Re: I'm hoping...

That's been part of my problem with the tone of some folks around here.  Really, fixing the way we pay for health care - even if you take it to the logical extreme of single-payer - doesn't really fix the underlying problems.  As David Kessler (author of "The End of Overeating") says, half the healthcare costs we're seeing now could be summarized under the heading of "obesity".  He was the person who spearheaded Clinton's fight against tobacco.  His take on the subject is that laws do nothing to prevent smoking, but changing social norms does everything.

Think about how often you smell cigarette smoke these days.  Several years ago, you could have been sitting in a room with someone and wouldn't necessarily have noticed that they were smoking a cigarette.  Cigarette smoke was everywhere.  Now, you can be several hundred feet from someone and you'd know in an instant if they lit a cigarette.  That's a changing social norm.

The same goes for obesity and our abusive relationship with food and the food industry.  Changing that, changing the norms associated with that, in a good way, will do as much or more than any public option or medicare buy-in.

by the mollusk 2009-12-21 01:04PM | 0 recs
Re: I'm hoping...

C seems about right.  mcjoan has a helpful breakdown of the good and the problematic of this bill up at Kos.  The question, which I've been voicing quite regularly is whether that grade can be improved.  I currently have a student in a rhetoric and composition course who will receive a C+ from me this semester.  But this student had a few significant struggles and I have offered them the opportunity to re-write an essay over the next semester in consultation with me with the possibility of raising it as high as a B+.  If something similar is possible over the next few legislative cycles with this bill, it's certainly worth passing.

by Strummerson 2009-12-21 01:50PM | 0 recs
Re: I'm hoping...

I'm tempted to say C, but then I think HEALTH CARE, and DO NO HARM, and I have to say this bill doesn't pass. Sure, there are a few things I like, but it's starting in such negative territory there's no climbing out. To me, our biggest fight now is against corporate power and it's distorting effects on democracy. And this bill does more than I ever imagined to make that power stronger--intractable, probably. It puts the profits of fat cats before the health of the people. As is, it's a big big problem.

by luckymortal 2009-12-21 02:42PM | 0 recs
Re: I'm hoping...

What's clear is that this is judgment work.  I'm not a hard core policy guy.  I think I can recognize cogent arguments with regard to particulars, but like most progressives, I have to rely to some degree on where the preponderance of informed political and policy analysis is falling.  If this bill is more likely to lead to an intractable black hole of corporate dependence and leave us in the death grip of the insurance industry, why are folks such as Hacker, Krugman, and our only self-avowed socialist Bernie Sanders pushing for its passage?  If they thought that was the likely outcome, would any want to pass it anyway for anyone's political prospects?  Seems unlikely.  They may be wrong, but it seems like more people of good faith and progressive principles are lining up behind the "pass it and keep working on it" option.  That holds a great deal of weight for me and others.  I have my own areas of expertise where I am less dependent upon legislators and analysts.  But the point is to pool our opinions and read one another critically.  Given that, I am hesitantly pulling for its passage and looking forward to what we will need to do to improve both the political and policy implications.

by Strummerson 2009-12-21 02:55PM | 0 recs
Re: I'm hoping...

"I just can't see how the left can allow this massive tax raise on working people"

I don't see how this kind of over-reaching rhetoric helps any. This bill places a significant burden on people making over around 250% of FPL which is just under the average median household income. And that is exactly the group of Americans most likely to have employer paid coverage. Left out of the subsidies are self-employed people making between $66,000 and $100,000. Left in are most of those people who would describe themselves as "working people"

It is worth noticing that just about everytime somebody reaches for numbers you use what is an outlier. CBO projects 41 million people more on Medicaid or in the Exchange compared to the baseline with around 9 million of those moving from either current employer insurance or the current non-group market for a NET change of 31 million. Of those 41 million how many will actually be WORSE off after than before? 3 million? 5 million? And do those interests outweigh whatever percentage of the 41 million have new or different (and mostly improved) coverage?

Like I implied above 'Parlour Pinks' talk a good revolutionary game but all too often don't have personal skin in the game. A lot of talk about 'Workers' but not necessarily a lot of assistance in the here and now. Under the House Bill HHS was called upon to set up an immediate national High Risk plan for uninsurable individuals starting on Jan 1, 2010. It would have been expensive for me but I could have borrowed the money from family and gotten some needed surgery done under the plan in the three years until subsidies kicked in via the Exchange. And if this bill had met its August deadline I could have been first in line to apply in two weeks, but instead the Senate deferred to President Snowe for five months. And now progressives are blithely prepared to throw me and potentially 50 million people like me under the bus AGAIN just to make an ideological point?

It is not a massive tax on working people, it is a moderate tax on a subset of people making relatively comfortable incomes. A subset that oddly resembles the typical demographic of the left blogosphere: younger, college educated, middle class 'advocates'.

by Bruce Webb 2009-12-22 03:19AM | 0 recs
Re: I'm afraid...

It is not a massive tax on working people, it is a moderate tax on a subset of people making relatively comfortable incomes. A subset that oddly resembles the typical demographic of the left blogosphere: younger, college educated, middle class 'advocates'.

Bruce, that has been nagging at me. Thanks for stating it so clearly. You've moved it from a nagging suspicion to a generally disturbing probability. All it would take now to push it to the level of absolute despair would be the emergence of a doppleganger 'tea-party' comprised of 'younger, college educated, middle class' progressives fighting reform for stupidly selfish yet ultimately suicidal motives...

by QTG 2009-12-22 03:34AM | 0 recs
Re: I'm hoping...

You're rich.  Progressives who are fighting for a better bill for working people are to be excoriated because they will not accept a corporate giveaway that drains the pockets of working people.  

by orestes 2009-12-22 06:40AM | 0 recs

"This isn't a perfect bill. But it's also not a bad bill, either."

You're in for it now!

by The BBQ Chicken Madness 2009-12-21 12:21PM | 0 recs
Re: Uh-Oh...

The beauty of MyDD is that we have a spectrum of opinion. I think it's great that Jonathan steps up to defend the bill. Few other blogs are doing so.

by Charles Lemos 2009-12-21 12:27PM | 0 recs
Re: Support for HCR Increasing

I'd like the explanation of how it gets to 31 million people. What sort of equation is this number built on, any links?  I know its a talking point, and entirely there to to assumptions that the mandate forces people to buy insurance, or they think its now affordable due to the subsidies, but whats the formula here for the number?  

by Jerome Armstrong 2009-12-21 12:50PM | 0 recs
Re: Support for HCR Increasing

The "affordability" argument comes solely from the subsidies. Basically, they are transferring wealth from the middle class to the lower middle class and the poor.  

by bruh3 2009-12-21 01:10PM | 0 recs
And furthermore,

I would like to also know why insuring an extra 31 million people is a good thing.

In the end, the desired metric is better health, not better health care...

by Ravi Verma 2009-12-21 01:34PM | 0 recs
Re: And furthermore,
Well, but it's 31 million extra customers for the party base (Insurance Industry!) I mean, come on! The point of "health care" is wealth creation, right? LOL, at least it'll create jobs. They'll have to hire at least a few new people to summarily deny claims to those 31 million extra customers! Of course, those jobs will probably go to India...
by luckymortal 2009-12-21 01:42PM | 0 recs
Get some facts

$15 million of those $31 million will be on Medicaid which last I heard was dual payer: feds and states. And a big proportion of the rest will be people earning under 250% of FPL whose total premiums and out of pocket costs are much lower than the numbers you see floated which generally apply to that small minority of people making over 400% of FPL

by Bruce Webb 2009-12-22 03:23AM | 0 recs
How do you improve your desired metric

if people don't have health care coverage?

There are a lot of things I could do to improve my current health state starting with life-style changes. And there are others I could do that would help prevent new conditions. But right now my most serious conditions were caused by excessive exposure to sun in 1958 to 1964. Kind of late for me to go back to toddler Bruce and tell him to stay out of the sun or he would be sorry starting in 1980.

I don't have health insurance currently and my condition is neither life-threatening nor is the needed treatment available in an emergency room. And because this condition is known to be caused mostly be sun exposure decades in the past it is clearly pre-existing meaning I am in practical terms not insureable in the individual market.

It is all well and good to appeal to better health, but that doesn't pay the surgical bills. People who don't have insurance or consider themselves immortal seem to have no idea what it is like to be middle aged and uninsured and so totally reliant on charity care should you get sick or injured or perhaps worse having a chronic condition that really needs some medical monitoring you just can't afford.

by Bruce Webb 2009-12-22 04:44AM | 0 recs
Re: How do you improve your desired metric

First, my sympathies for your personal condition.  I realize that a cold reading of numbers does not alter someone's personal condition.

But going back to the substance of your comment, let us assume that there is some correlation between health (which is what we desire) and health care, and furthermore, there is some correlation between healthcare and health insurance.  But, what exactly is this correlation ?  If we spend $1 on health insurance, does it result in any additional health metric (such as life expectancy).

I would submit that the answer, for the specific case of US society today, is no !  I have documented the evidence in my diary, here .

And I would be very interested if you have any evidence to the contrary.  All the discussions I have seen have amounted to "we will spend X and cover Y", with nary a word on the health metrics.

by Ravi Verma 2009-12-22 11:12AM | 0 recs
Re: Support for HCR Increasing

You can read the CBO score. I've linked to it above.

by Jonathan Singer 2009-12-21 01:53PM | 0 recs
Re: Support for HCR Increasing

Again, the same CBO that recently said that a medical loss ratio of 90 percent equals government take over health care? That CBO?

by bruh3 2009-12-21 01:58PM | 0 recs
Re: Support for HCR Increasing

I am getting really, really tired of this argument that because the CBO made one bizarre decision, they now have no credibility on anything and should basically be considered the equivalent of the Heritage Foundation.

It reminds me of arguing with wingnuts, frankly.  You can never ever cite to any authority for any proposition they disagree with, because it's always like "that guy was involved it the 1973 petunia scandal, how could you believe anything he says?" The old saying "false in one thing, false in all things" isn't actually true.

by Steve M 2009-12-21 04:20PM | 0 recs
Re: Support for HCR Increasing

Well, I am sorry you feel that way. but what I am getting tired of is the attitude that facts do not matter with regard to how we should assess what is being said. I provide a link below that discuss how difficult is for the CBO to make any clear determinations regarding their numbers under this sort of circumstances. My view is if it were just that mistake I would let it go, but after the question was asked- I did a  little research, and it took me few minutes to realize that indeed the CBO is not particularly able to assess new situations. I don't consider your concern more important than accuracy. What reminds me of arguing with wingnuts is where no facts matters. Just how you feel. if you can back that feeling up with some links of your own including analysis, then I will care. That's the least you can do when you respond to someone complaining about them questioning the accuracy of numbers. I didn't know we base our views on just wanting to believe them.

by bruh3 2009-12-21 05:35PM | 0 recs
Re: Support for HCR Increasing

I think if you want to attack a particular calculation by the CBO, you should explain why that calculation should be disregarded.  Blanket arguments that the we should automatically ignore the CBO because they said one thing that was BS aren't persuasive.

by Steve M 2009-12-21 06:35PM | 0 recs
All your facts are FROM CBO

or just pulled out of thin air.

I wasn't happy with that 90% decision, it seemed totally arbitrary. And in the end it didn't stick after the Senate agreed to 85/80. But mostly all of the numbers that people have been using come from the CBO scoring.

Where are you actually getting your alternative facts? PNHP? Kip Sullivan? State your fact and its authority and then we can talk.

by Bruce Webb 2009-12-22 03:29AM | 0 recs
Re: Support for HCR Increasing

Here's that information.  If and until you can provide similar, I am really not interested in this sort of one sided exchange on  here anymore. It is a waste of my day:

No evidence. When legislation creates new kinds of health models, or even expands a local model to a national one, the CBO often has little or no evidence for its projections. With health legislation, as opposed to, say, building new bombers, the CBO must try to determine costs for both the system and how changes would affect human behavior. When Congress proposed a "doughnut hole" in Medicare benefits coverage, something no commercial policy had ever used, the CBO had to guess how the system would react. It overestimated the cost by about 35 percent, according to some estimates. In the current reform debate, there's disagreement between the CBO and the White House's Office of Management and Budget over how many billions can be saved by tweaking Medicare benefits, with the CBO coming in on the low end of the spectrum. Who's right? The safe bet is that no one knows"

You ask a very good question.

by bruh3 on Mon Dec 21, 2009 at 07:19:06 PM EST
[ Parent | Reply to This ]

Re: Support for HCR Increasing (none / 0)

Link /archive/2009/10/08/why-the-cbo-s-estima tes-shouldn-t-count-for-much.aspx

by bruh3 2009-12-21 05:37PM | 0 recs
Your link didn't work

But Googles up just fine. /archive/2009/10/08/why-the-cbo-s-estima tes-shouldn-t-count-for-much.aspx

The article makes three points. And my response.

1) "Built in skepticism" CBO doesn't do dynamic scoring, instead focusing on direct impacts to the federal budget.

Me: that's their job. Once you get outside that you open the doors to supply side magic thinking showing that tax cuts don't actually cut revenues, because productivity increases rides in on a magic pony and saves the day.

2) "The ten year estimate". CBO generally does not attempt to make estimates in the out years because of the substantial uncertainty involved.

Me: makes sense to me, nobody in 1997 was predicting a deep recession starting in Sept 2007, for that matter nobody was predicting the sharp dropoff in productivity in Q3 2005. And from 1993 to 1996 the outlook for Social Security was steadily deteriorating only to turn around enough by 1999 that Dean Baker and Mark Weisbrot were able to publish a book "Social Security: the Phony Crisis". CBO's recent decision to bend to the demands of Senate Republicans to score the Stimulus Package over twenty years blew up in Republican faces when HCR started showing huge improvements in the Budget in the out-years. We probably should have left well enough alone.

3) "No evidence".

Me: CBO can only work with what it has got. Congress demands a score, CBO does what they can to comply. Unless someone out there has a better crystal ball I don't see what the objection is.

I read this article as claiming that the public shouldn't have blind faith in CBO numbers and that maybe individual Senators or Congressmen shouldn't either, but for better or worse the rules require Congress to consult CBO when they are scoring whether or not spending violates previously set budget rules and ensures that everyone is working off the same scoresheet.

CBO tends to be conservative on this. For example the Peterson-Pew Budget Reform Commission issued a document named 'Red Ink Rising' that got every past CBO Director to sign off on Peter G Peterson's entitlements reform commission. -rising and every OMB Director but one. So yes it is frustrating but you have to work with the tools you have.

by Bruce Webb 2009-12-22 03:53AM | 0 recs
Re: Your link didn't work

Let me sum up your response to me as I read it: Yes, the CBO's numbers are guess work at best because of various reasons, but it is the best we have. In saying that, you ignore political pressure to produce the guess work they produce.

The politicians and the press are portraying these numbers as the gospel for a reason, including the diarist who ignores all comments except those by Jerome pointing the lack of accuracy out to him. Steve M indignantly responds that I am a wingnut for daring to question the CBO. That reason has little to do with what you describe here as the "best we can figure out." if that were true, that would be their frame. Because it is not, this is just spin.

by bruh3 2009-12-22 11:12AM | 0 recs
Re: Your link didn't work

I didn't say you were a wingnut for questioning the CBO.  Try to argue more honestly.

by Steve M 2009-12-22 04:54PM | 0 recs
Re: Support for HCR Increasing

Does it matter if the CBO made its bizarre analysis on this same issue?  Would you consider that its prior assessment on this issue (HCR) may reasonably lead to the conclusion that it is either ill-informed on this issue (and thus incapable of making reliable predictions) or has a bias with regard to this issue?  It's not necessarily an all-or-nothing proposition.

by orestes 2009-12-22 06:45AM | 0 recs
Re: Support for HCR Increasing

No, see I am a wingnut so that's not possible to question the CBO like that.  A wingnut questions. A fact based person accepts. Up is down. Black is white. Left is right.  

by bruh3 2009-12-22 11:16AM | 0 recs
Re: Support for HCR Increasing

Or, if you don't want to click through, here's the CBO score (again, a large .pdf):

By 2019, CBO and JCT estimate, the number of nonelderly people who are uninsured would be reduced by about 31 million, leaving about 23 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants). Under the legislation, the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent. Approximately 26 million people would purchase their own coverage through the new insurance exchanges, and there would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law. Relative to currently projected levels, the number of people purchasing individual coverage outside the exchanges would decline by about 5 million. Under the legislation, certain employers could allow all of their workers to choose among the plans available in the exchanges, but those enrollees would not be eligible to receive subsidies via the exchanges (and thus are shown in Table 4 as enrollees in employment-based coverage rather than as exchange enrollees). Approximately 5 million people would obtain coverage in that way in 2019, bringing the total number of people enrolled in exchange plans to about 30 million in that year.

The number of people obtaining coverage through their employer would be about 4 million lower in 2019 under the legislation, CBO and JCT estimate. The net change in employment-based coverage is the result of several flows, which can be illustrated using the estimates for 2019:  

* About 6 million people would be covered by an employment-based plan under the proposal who would not be covered by one under current law (largely because the mandate for individuals to be insured would increase workers' demand for coverage through their employers).  

* Between 8 million and 9 million other people who would be covered by an employment-based plan under current law would not have an offer of such coverage under the proposal. Firms that would choose not to offer coverage as a result of the proposal would tend to be smaller employers and employers that predominantly employ lower-wage workers--people who would be eligible for subsidies through the exchanges--although some workers who would not have employment-based coverage because of the proposal would not be eligible for such subsidies. Whether those changes in coverage would represent the dropping of existing coverage or a lack of new offers of coverage is difficult to determine.

* In addition, between 1 million and 2 million people who could be covered by their employer's plan (or a plan offered to a family member) would instead obtain coverage in the exchanges, either because the employer's offer would be deemed unaffordable and they would therefore be eligible to receive subsidies in the exchanges, or because the "firewall" for those with an offer of employer coverage would be imperfectly enforced. (Those people are counted as enrollees in the

by Jonathan Singer 2009-12-21 01:59PM | 0 recs
Re: Support for HCR Increasing

Yea, I was looking for something more concrete than just listening to the "estimates" of the numbers. What is the basis if the estimates is the question?  Faith seems like the answer.

by Jerome Armstrong 2009-12-21 02:12PM | 0 recs
Re: Support for HCR Increasing

"No evidence. When legislation creates new kinds of health models, or even expands a local model to a national one, the CBO often has little or no evidence for its projections. With health legislation, as opposed to, say, building new bombers, the CBO must try to determine costs for both the system and how changes would affect human behavior. When Congress proposed a "doughnut hole" in Medicare benefits coverage, something no commercial policy had ever used, the CBO had to guess how the system would react. It overestimated the cost by about 35 percent, according to some estimates. In the current reform debate, there's disagreement between the CBO and the White House's Office of Management and Budget over how many billions can be saved by tweaking Medicare benefits, with the CBO coming in on the low end of the spectrum. Who's right? The safe bet is that no one knows"

You ask a very good question.

by bruh3 2009-12-21 02:19PM | 0 recs
Re: Support for HCR Increasing

Link /archive/2009/10/08/why-the-cbo-s-estima tes-shouldn-t-count-for-much.aspx

by bruh3 2009-12-21 02:19PM | 0 recs
Re: Support for HCR Increasing

Not sure that CBO estimates are based on faith. I think they use concrete numbers and complex mathematics.

by Jonathan Singer 2009-12-21 02:25PM | 0 recs
Re: Support for HCR Increasing

And politics doesn't come in to play at all...

Looks to me like they're making a value judgment that a whole lot of people like me, and people who have "Cadillac plans" even if those Cadillacs are 1988 clunkers, can REALLY afford private health insurance but we really just hate sick people.

by luckymortal 2009-12-21 02:50PM | 0 recs
CBO Methodology

CBO by and large doesn't reveal their methodology. This doesn't just apply to Health Care but also to such things as the Social Security estimates and their various Mid-Year Budget Reviews.

Which is frustrating, but there it is. The Social Security Trustees don't reveal their methodology either, at least in detail, but a lot more of the work product that goes into their estimates are available.

Uncertainty is kind of baked into the cake of economic projections.

Probably the best you can do is to track the CBO Director's Blog which in turn gives a description of their letters and reports and usually the tables and then links to the longer text in PDF.

For example we have this:
Measuring the Effect of Reform Proposals and the Federal Budgetary Commitment to Health Care
which in turn links to a letter to Baucus laying out some of the methodology. But they only go so far and generally every report and letter comes with a disclaimer with some combination of 'preliminary' or 'substantial uncertainty' in  the test

by Bruce Webb 2009-12-22 04:04AM | 0 recs
Re: Support for HCR Increasing

Absolute worst thing about this watered-down, no, purified bill, is that date. 2019! Passing this bill will defuse any effort toward change for at least 10 years. But you better believe, people are going to be looking at their premiums next fall, and if they aren't lower, guess who gets the blame...

by luckymortal 2009-12-21 02:45PM | 0 recs
2009 plus ten years gives you 2019.

That is just the end of the CBO Ten year Baseline

If you look at Table 4 you will see the following reductions in uninsured compared to the baseline:

2014: 51-15 = 36 million remaining uninsured

  1. 51-23 = 28 million
  2. 52-29 = 22 million
  3. 53-30 = 22 million
  4. 53-30 = 23 million
  5. 54-31 = 23 million

(some rounding involved).

Don't get fooled with 'by 2019', almost all of the change in coverage will be accomplished by 2016 with all non-elderly (including undocumented) topping out at 92% covered and all legal non-elderly at 94% covered.

by Bruce Webb 2009-12-22 04:30AM | 0 recs
I still haven't heard why the MLR

being 90% made it government spending.

RE:medicaid - how is this effected by state budget crises? How much are states required to spend?

We already know there are people who are eligible for both chip and medicaid who don't enroll - how are they counted?

by bay of arizona 2009-12-21 03:33PM | 0 recs
State spending varies

Depending on how generous they are now. And federal subsidies in some cases phase out to some degree.

People who don't enroll in Medicaid or SCHIPS even though eligible make up a substantial fraction of the 23 million or so residents left uninsured. There are provisions in the bill that encourage out-reach by the states but since increased medicaid enrollment hits their own bottom lines sometimes they are less than eager.

Which is an argument for single payer Medicaid. Adding 15 million people to Medicaid, including singe adults is huge. But like the rest of the bill doesn't make for a perfect system. Then again this category was never in the mix before, Currently if you are a single adult you have to find some way to qualify for SSI or Social Security DI to get basic medical care and work counts against you. Now if you are working and make under 133% or 150% of FPL (depending on the bill) you qualify for Medicaid no matter what your family composition, if over that threshold qualify for subsidies that call for premiums starting at 1.5% of income and rise to 8%. And BTW in every version I have examined mental health and substance abuse are fully covered on a parity basis, there are a lot of homeless people who maybe wouldn't be if they had access to health coverage for either or all too often both.

by Bruce Webb 2009-12-22 04:16AM | 0 recs
Re: I still haven't heard why the MLR

THere is no good answer regarding the MLR other than they are captured by the desire to pass the bill. At this point, they are not really making substantive arguments. The blogs are as captured by the desire to maintain their power and influence as DC is. DOn't take what you read here seriously.

by bruh3 2009-12-22 11:18AM | 0 recs


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