Happy Birthday to Tahmoh Penikett, 38.
And for some good stuff:
1. James Fallows on presidents and leaks. Exactly right. As I said last week: don't worry about leaks; listen to them.
2. Wonderful piece from Sarah Kliff looking at the rollout of Medicare.
3. Brendan Nyhan has advice for reporters on covering scandal. Good.
4. Ed Kilgore dissents in part from my take on Harry Reid.
5. Philip Klein on what might happen to the ACA.
6. And Elizabeth Drew on Nixon. I don't agree with everything she says, but it's still a good quick summary of what Watergate was from someone who remembers it well.
Monday, May 20, 2013
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6 is odd.
ReplyDelete"2. Obamacare is an epic disaster and it gets fully repealed
Under this scenario, the law unravels. The cost controls do not work, proving especially troublesome for smaller regional hospitals. They either start closing, stop accepting Medicare or cut services. This effectively reduces the benefits seniors can get out of Medicare, and they, along with industry lobbyists, pressure Congress into undoing the cuts that are one of the primary offsets to the law’s trillions in new spending. On top of this, new taxes kick in – mandate penalties, the insurance premium tax, the medical device tax, pharmaceutical tax, etc. – and businesses struggle to adjust to a raft of new regulations. The exchanges are swamped with technical problems and poorly administered, making it difficult for individuals to sign up. Not many insurers participate in the exchanges, meaning they don’t offer sufficient choices to promote competition. New regulatory requirements drive up the price of premiums, so young and healthy Americans decide they’d rather pay a penalty than invest in costly insurance.
Much of this is slated to happen or already happening, so it's odd to write of it as "under this scenario."
I will disagree with Klein as well, although for a different reason than backyardfoundry. He seems to have left out the most likely scenario of all, which is (DRUM ROLL)
ReplyDelete5. Nothing much happens as far as most people are concerned, things muddle along with little consensus or momentum on anything.
I suspect over the next twenty-four months or so things are going to be pretty much an indecisive mess. There will be horror stories about the exchanges, but people happy with their new insurance. There will be stories about bureaucratic snafus, but also continued drift of costs downward. There will be battles over Medicaid but not much change for people on Medicare. Evidence as to health effects will be inconclusive, although medical bankruptcies will decline. Overall, most people will have a vague sense that it has all been much ado about nothing as far as they are concerned, and not much firm opinion beyond that. Pollsters will be able to get just about any response, positive or negative, they want by wording questions in various ways, but there will probably still be a soft majority who don't like the bureaucracy involved in Obamacare, or the mandate, and a somewhat firmer majority who do like guaranteed issue and the idea of the exchanges and the medicaid expansion.
And the overall political outcome of all that will be ... not much. Nothing about it will sway conservatives to like Democrats, nothing that goes wrong will sway liberals to like Republicans. The middle will swing this way and that depending on how questions are asked but almost certainly won't be casting votes on health care policy.
Of course success may actually be overwhelming. On the other hand, disaster may be clear and undeniable. If either of those things happen, things will change. But we will just have to wait and see.
What's really scary is to read the comments following Elizabeth Drew's piece...the dominant moitf is that Obama is *worse* than Nixon.
ReplyDeleteCurious, your take on the approval rating thing. Approval rating should dip a bit, right? Unless the surveyed people are in a "Wait and See" mode, which doesn't seem very American like to me. This would certainly help the partisan polling argument.
ReplyDeleteNyhan:
ReplyDelete"It's much easier to pontificate about the "narrative" or engage in armchair punditry about scandal response tactics (Obama needs new staff!) than to do the hard work of reporting, but that hard work remains the most important function of journalism."
http://spectator.org/archives/2013/05/20/obama-and-the-irs-the-smoking
The Spectator finds a pretty open correlation: Obama met with the leader of the union that serves IRS employees. The day after that, according to the TDIG:
"April 1-2, 2010: The new Acting Manager, Technical Unit, suggested the need for a Sensitive Case Report on the Tea Party cases. The Determinations Unit Program Manager Agreed."
Tenuous, but could lead to hilarity!
Anastasios,
ReplyDeleteI agree that your model is more likely than my preferred model of EPIC FAIL!
I just disagree with how the author laid out the post. People may think that the section I quoted is all worst-case-for-Obama-scenario when it's in the bill or already happening:
"new taxes kick in – mandate penalties, the insurance premium tax, the medical device tax, pharmaceutical tax, etc. – and businesses struggle to adjust to a raft of new regulations. The exchanges are swamped with technical problems and poorly administered, making it difficult for individuals to sign up. Not many insurers participate in the exchanges, meaning they don’t offer sufficient choices to promote competition."
The taxes are in the bill so will happen. Many states are resisting the exchanges. The USG is doing a poor job of figuring out the contradictions of its own exchange. Companies are already facing difficult choices because Obamacare put them on the hook for some silly reason. Young people will be forced to subsidize older people and will have big incentives to accept the penalties instead.