Jan 24 2010

Earth to Dems: It’s the Mandate Stupid.

(11 am. – promoted by ek hornbeck)

Beltway smartguy Nate Silver has posted a chart of results from the latest Kaiser Health tracking poll (PDF).

Nate uses this chart to argue that the lack of support for HCR is due to people not knowing how great it really is.

What we see is that most individual components of the bill are popular — in some cases, quite popular. But awareness lags behind. Only 61 percent are aware that the bill bans denials of coverage for pre-existing conditions. Only 42 percent know that it bans lifetime coverage limits. Only 58 percent are aware that it set up insurance exchanges. Just 44 percent know that it closes the Medicare donut hole — and so on and so forth.

Nate says that the Dems should pass HCR, teabaggers be damned, because once passed, the program’s benefits will become apparent.

Obviously, it’s not as though this is going to do much to help the bill’s popularity in the immediate term. But in the long term, once people actually see the go bill into effect, their perceptions are liable to improve, in ways that might help the Democratic party. Although there are a few things like the individual mandate which the public obviously does not like, most of the other components of the bill are things they are liable to be quite pleased with and to find quite reasonable.

Now, everybody knows Nate’s a smart guy, so one would think he would apply his vaunted statistical sense to make the obvious case that HCR stands a far better chance of being a popular program if the individual mandate is jettisoned.

After all, under Nate’s logic, if the individual mandate is already at minus 40% net favorability  (62% against: 22% for), just wait until the bill passes and everyone not only knows about it, but is forced, under pain of IRS audit, to buy overpriced, underperforming, for-profit health insurance.

But Nate won’t go that far.  Instead of advising Dems to fold on the mandate, he’d rather them take a blind gamble that the popularity of the benefits of HCR will outweigh the unpopularity of the individual mandate – and thus essentially repeat a strategy that has already contributed to the loss of Ted Kennedy’s old Senate seat to a teabagger.

Truly, the establishment Dems’ studied denial of the individual mandate’s political liabilities, even by its most respected analysts, borders on the absurd.



(x-post @ Big O)

68 comments

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  2. Oh, nevermind.  I see that argument has been made ad nauseum in comments at Orange.

  3. Does it not strike you as ODD that we’re debating “health reform laws” that cover the young and the old and the uninsured.

    But that, apparently, insofar as not draining our pocketbooks dry, anyway, middle aged people are in a big ole hole?

    Yeah, fuck all those 25-50 year old low to middle wage and salary earners like me.

    Just because we make most of the true wealth the country uses to keep running, that’s no reason not to exclude us.

  4. Why does this list still have “public option” in it?  The Senate, we hear, is taking that out, and Obama isn’t committed to fight for it, so it’s not gonna be there as far as I know.  

    (It’d be GREAT if it was, but this would seem dishonest as a means of talking about how, um, great the plan is, if the plan is for the public option to not even be there).

    About “Guaranteed Issue” — I assume this means no ban on preexisting conditions .. but isn’t that another thing they’re going to get rid of?

    “No fed funding for abortions”, “No coverage for illegals” .. these are being touted as positives?  So, those provisions that fuck the base and are manifestly unfair are, because they’re popular, good selling points for the plan?

    I mean I realize this is statistics, and this is a bloodless statistician’s argument — but please.  Nate’s saying it would be popular to create huge problems with large numbers of people in this country, and if people just knew that more, they’d support the plan more?  Well, maybe .. but FUCK ME WITH A DONUT!

    Another thing that is just as important to me .. when you tout that “most people don’t understand” or the bill would be popular .. how are people supposed to do that?  When the bill changes every day or every week to take something essential out or add something really nasty in?

    People just don’t understand it well enough?  Could it be because they keep fucking with the bill to make it more right wing and palatable to insurance companies?  How are people supposed to understand a moving target — one that appears headed straight into a nose dive with baked Mother Earth as the target?

  5. My Cobra coverage used up my entire premature pension but in order to save face the industry responded by putting out junk insurance plans.   It is enough to get you into your doctor so he can order tests that are not covered.

    • TMC on January 24, 2010 at 16:09
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    While the bill may ban denial of coverage, it creates a “pool” that may well cost the insured more in premiums, co-pays and minimums. The bill does NOT prevent the DENIAL OF TREATMENT. Re: ERISA 514a

    ERISA Section 514 preempts all state laws that relate to any employee benefit plan, with certain, enumerated exceptions. The most important exceptions – i.e. state laws that survive despite the fact that they may relate to an employee benefit plan – are state insurance, banking, or securities laws, generally applicable criminal laws, and domestic relations orders that meet ERISA’s qualification requirements.

    A major limitation is placed on the insurance exception, known as the “deemer clause”, which essentially provides that state insurance law cannot operate on employer self-funded benefit plans. The Supreme Court has created another limitation on the insurance exception, in which even a law regulating insurance will be pre-empted if it purports to add a remedy to a participant or beneficiary in an employee benefit plan that ERISA did not explicitly provide.[1]

    The result is that the only remedy available to a covered person who has been denied benefits or dropped from coverage altogether is to seek an order from a federal judge (no jury trial is permitted) directing the Plan (in actuality the insurance company that underwrites and administers it) to pay for “medically necessary” care. If a person dies before the case can be heard, however, the claim dies with him or her, since ERISA provides no remedy for injury or wrongful death caused by the withholding of care.

    Even if benefits are improperly denied, the insurance company cannot be sued for any resulting injury or wrongful death, regardless of whether it acted in bad faith in denying benefits. Insurers operating ERISA plans enjoy several immunities not available to other types of insurance companies. ERISA preempts all conflicting state laws, including state statutes prohibiting unfair claims practices and causes of action arising under state common law for insurance bad faith.[3] There is no right to a jury trial in ERISA benefits actions.[4] Although Americans normally take for granted the right to testify on their behalf, plaintiffs have no right to present live testimony in ERISA bench trials, in which the judge simply reads through the documents which formed the record originally before the ERISA plan administrator and performs de novo review.[5] Finally, punitive damages are not allowed in actions for ERISA benefits.[6]

    Many persons included among the some 47 million people presently without health care coverage in the United States are former ERISA “subscribers”, insurance terminology for Plan beneficiaries, who have been denied benefits-usually on the ground that the prescribed care is not medically necessary or is “experimental”-or dropped from coverage, often because they have lost their jobs due to the very illness for which care was denied.

    Many consumer and health care advocates have called for a “restoration of the freedom of contract enforcement,” to the 75% of Americans insured under these work place group plans-in effect, a repeal of the ERISA pre-emption. Permitting these insured persons access to customary state remedies (98% of all civil disputes are resolved in state courts) would, they contend, result in a substantial reduction in arbitrary denial of care benefits, simultaneously alleviating a major burden on state Medicaid systems and clogged federal court dockets.

    This bill is a ruse. Those who are supporting it without a public option do not have all the information.

    • Xanthe on January 24, 2010 at 17:41
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    this morning on ABC roundtable with Cokie, Sam Donaldson, the guy from Politico and Mr. Will:  The American people want the President to embrace the opposition on healthcare.  He must open his arms (with appropriate gestures by Cokie) and tell the Republicans he was wrong – he will turn from the bill and/or healthcare and now concentrate on jobs – but be careful here because the market may go down again if he was serious about what he recently said to the banks.  

    You can see the whole thing on their website – save for Sam Donaldson – they were all…serious, yes serious.  This is what comes from groveling to Republicans who are not interested in comity.  So to these highly paid people, it’s not the healthcare bill or what’s in it or polls – it’s that the President hasn’t embraced the opposition.

    Also at the end – another cry for “entitlement” restructure.  

    • Big Tex on January 24, 2010 at 18:12
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    how Nate Silver’s opinion has become as important as it apparently is to some people. The guy’s good at crunching poll numbers and baseball stats, but I have yet to see any evidence that his opinion is of any more value than anyone else’s beyond that. When I hear people over at the Big Orange Monster saying that Nate Silver supports passing the Senate bill, as if that’s supposed to end debate, I cringe a little.

    But yeah, it seems obvious that the answer is to jettison mandates. I’d say that the same should be done for the excise tax, which I think would be a lot less popular if more people knew about it.

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