Tag Archives: Obamacare

From Vimy to Gibraltar, Obamacare to Russia: Journalism Matters at F&O

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New on F&O this weekend:  Sunday April 9 marked the 100th anniversary of the WWI battle of Vimy Ridge — said to have marked Canada’s passage from colony to country status. Read our report with photo-essay by Reuters, France, Canada leaders mark centenary of Vimy Ridge WWI battle. In Commentary Tom Regan notes that for Canada and the United States, the battle and World War I have very different meanings.  Read Regan’s column,“War to End All Wars” fading from history, here.

Jonathan Manthorpe this week considers Gibraltar — “The Rock” Caught In A Hard Place — in a new column about the territory in British hands since 1713, and is now emerging as an issue in negotiations with Brussels to leave the European Union. Read more about Gibraltar.  Manthorpe’s previous column, Beijing brings order to its colonial “Savage Reservations,” contends that Beijing is reaching back into the excesses of Maoist Stalinism and forward into the high-tech social control of Aldus Huxley’s “Brave New World” to try to contain the restive natives of its colonial outposts, Tibet and Xinjiang, setting the stage for grief for Hong Kong. Click here for the column on China, or here for the list of all of Manthorpe’s F&O works.

Americans turn Canadian about health care, writes Penney Kome in a new piece about how U.S.  public opinion is forcing Republicans to think “expansion,” not “repeal,” of the Affordable Care Act. Read the column, or find Kome’s complete  F&O OVER EASY columns here.

Jim McNiven has been pondering the fuss made by America over Russia, and asks this week, Why Does America’s President Bother with Russia? That column is here, or find all of McNiven’s THOUGHTLINES columns for F&O here.

Noteworthy items elsewhere on the web:

“Why do so many in the news media love a show of force?” asks Margaret Sullivan in the Washington Post.
Good question. The answer is probably found in audience ratings and social media shares– and so, as with everything in the world of commerce, with citizen’s demands.

First Draft News produced a well-received “Field Guide to Fake News,” launched this month at the International Journalism Festival in Perugia, Italy. The Columbia Journalism Review reports.
Stories about America’s political meltdown have become a flood. As mentioned earlier, these diverse, authoritative and credible news sites are worth following for breaking news: Reuters, the New York TimesPolitico,Washington PostBBC, The GuardianAl Jazeera, France24Financial Times, and The Economist.

Last but not least, here are some of our other recent stories, in case you missed them:

Trump Staffers’ Financial Disclosures /ARIANA TOBIN & DEREK KRAVITZ, ProPublica

Trump and Russia: “There is a smell of treason in the air”/TOM REGAN    Column

Beijing brings order to its colonial “Savage Reservations”/JONATHAN MANTHORPE  Column

European leaders renew fraying Union’s vows/ALASTAIR MACDONALD & JAN STRUPCZEWSKI  Report

Lights go out around the world for 10th Earth Hour/REUTERS   Slideshow

Fukushima still in hell/PENNEY KOME    Column

McGill University mangles academic freedom/TOM REGAN   Column

America’s Republican Quandary/ JIM McNIVEN   Column

Sri Lanka’s slow shuffle to lasting peace/JONATHAN MANTHORPE  Column

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Note: this post was updated April 9 to include our report on the Vimy Ridge event in France.

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Americans turn Canadian about health care

After six years with Obamacare, public opinion forces Republicans to think “expansion,” not “repeal.” 

PENNEY KOME: OVER EASY
April, 2017

American attitudes towards universal healthcare insurance have long baffled the rest of the world. Only in the US is serious illness a ticket to bankruptcy and the food bank.  How is this conducive to healing?

The Republican party has always insisted that Americans would rather die free than depend on socialist medical care. One result is that the American infant mortality rate is a “national disgrace,” according to the Washington Post. And Americans seemed okay with that – until lately (1).

Many presidents have attempted to introduce a universal state-run healthcare system similar to Canada’s or Europe’s.  Bill Clinton won the 1992 election after campaigning heavily on health care, HRC, Hillary Rodham Clinton, introduced a national health care plan in 1993, when she was very popular First Lady. Her policy ran into trouble immediately.

 

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US conservatives, libertarians, health insurance and pharmaceutical industries furiously rejected anything that smacked of universal health care, saying patients would be stigmatized by having public rather than private insurance. They also launched vicious personal attacks on HRC that destroyed the proposal and permanently damaged her reputation.(2)

President Barack Obama campaigned on health care reform in the 2008 campaign and managed to pass the Affordable Care Act (ACA) during the two-year window (2008-2010) when the Democrats held the White House, a majority in the House of Representatives, and a Supermajority in the Senate. The ACA expanded Medicare and expecially Medicaid, the existing public health insurance programs. (3.)

Since the president signed the ACA into law in August 2010, House Republicans have voted more than 60 times to repeal it, knowing the president would veto the Bill, even if the Senate passed it.  (4.)

Part of President #45’s 2016 election triumph was the GOP’s opportunity to introduce yet another Bill to repeal the ACA (“Obamacare”), in full expectation that the majority Republican Congress would whisk the Bill through promptly.  Wrong! How mortified they must feel that the Speaker of the House had to withdraw the (empty) repeal-and-replace motion for lack of supporting votes!

Remember the old bumper sticker, “My karma ran over my dogma”? Between 2010 and 2016, US public opinion on healthcare changed dramatically. As with affirmative action programs, once people actually had to live and work with an “other,” they found the situation more congenial and less threatening than they ever expected.

While the greatly expanded Medicaid included 20 million more people, the catch is that each state has to sign on to the program and design its own system. Thirty-two states joined Medicaid, each with its own version and requirements.

As the New York Times editorialized, “….Medicaid now provides medical care to four out of 10 American children. It covers the costs of nearly half of all births in the United States. It pays for the care for two-thirds of people in nursing homes. And it provides for 10 million children and adults with physical or mental disabilities…

“The program is so woven into the nation’s fabric that in 2015, almost two thirds of Americans in a poll by the Kaiser Family Foundation said they were either covered by Medicaid or had a family member or friend who was….” (5)

Those people, and their loved ones, resisted the Bill. They contacted their Republican Congressional reps to protest this was not why they voted them in. Their vocal opposition forced their  representatives to back away from #45’s ill-conceived plan.

More than resistance, what the Republicans encountered is a parade marching in the other direction. Pew Research found that by February 2017, a majority of Americans (54%) supported Obamacare. In 2010, only 40% approved of the Act, and 44% disapproved of it. Ten percentage points is a lot of growth in seven years. (6.)

Medicaid has won over participating state governments, several of which moved quickly to expand their Medicaid programs just as soon as it was clear Trumpcare had failed.  Kansas and Missouri moved to expand; recalcitrant Governors in Virginia, North Carolina, and Georgia have indicated interest in joining Medicaid to get health coverage for their poor people.

The NYT notes that, “The A.C.A. offered a tempting deal to states that agreed to expand Medicaid eligibility to everyone with incomes up to 138 percent of the poverty level — $16,400 for a single person — mostly low-wage workers like cooks, hairdressers and cashiers.

“The federal government would initially pay 100 percent of the costs of covering their medical care, and never less than 90 percent under the terms of the law. Over the past three years, 31 states and the District of Columbia took the deal….”

Remember, many states are facing the twin opioid and suicide epidemics now wracking the US. Disability rates are at an all-time high, although people may turn to disability when faced with lifetime limits on welfare eligibility.  There’s evidence that cash-short state governments are encouraging welfare recipients to apply for federal disability funds instead.

States that sign Medicaid agreements for convenience or out of desperation, soon find they are saving money and producing goodwill among voters.  Patients bring home healthy babies; they take their children to the doctor. They visit family members in long-term care.  People with disabilities rely on Medicaid for adaptive equipment and physiotherapy. And oddly enough, they don’t seem to worry about any social stigma at all.

In short, just as Canadians have come to love our Charter of Rights as much as Americans love their Bill of Rights, now it seems that Americans have come to embrace health care for all the way that Canadians do (and most of the rest of the world.) As Joni Mitchell sang, “You don’t know what you’ve got” until somebody tries to take it away.

Copyright Penney Kome 2017

Contact:  komeca AT yahoo.com

Notes:

  1. https://www.washingtonpost.com/news/wonk/wp/2014/09/29/our-infant-mortality-rate-is-a-national-embarrassment/
  2. https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993
  3. https://www.reference.com/history/did-obamacare-pass-congress-8fb44b73f7bcdcb6
  4. http://www.reuters.com/article/us-usa-obamacare-idUSKBN14X1SK
  5. https://www.nytimes.com/2017/03/27/health/medicaid-obamacare.html
  6. http://www.pewresearch.org/fact-tank/2017/02/23/support-for-2010-health-care-law-reaches-new-high/

Read more F&O columns by Penney Kome here

Return to F&O’s Contents

Penney KomePenney Kome is co-editor of Peace: A Dream Unfolding (Sierra Club Books 1986), with a foreward by the Nobel-winning presidents of International Physicians for Prevention of Nuclear War.

Read her bio on Facts and Opinions.

Contact:  komeca AT yahoo.com

 

 

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Facts and Opinions is a boutique journal, of reporting and analysis in words and images, without borders. Independent, non-partisan and employee-owned, F&O is funded by you, our readers. We are ad-free and spam-free, and we do not solicit donations from partisan organizations. Please visit our Subscribe page or use the PayPal button below to chip in at least .27 for one story or $1 for a day site pass. Tell others about us, and follow us on Facebook and Twitter.

 

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America’s Obamacare is here to stay

America's Obamacare is here to stay. The Canadian experience shows why. -- Tom Regan

America’s Obamacare is here to stay. The Canadian experience shows why. — Tom Regan

TOM REGAN: SUMMONING ORENDA  
June, 2015 

Back in the early- to mid-60s, my dad was a press secretary/information officer for then-Canadian Prime Minister Lester Pearson. During those years, he was intensely involved in two major political issues: the search for a new Canadian flag, and the adoption of universal health care.

I won’t bore you with the details, but the fight for universal health care in Canada was every bit as noisy, brutal and political as is the current battle in the United States over Obamacare. For instance, one group Pearson and his party had to face, which Obama never had to deal with, were the doctors. They were adamantly opposed to universal health care. 

In the end, after a long battle, universal health care became a reality in Canada, and for one main reason, I believe, and which I heard my dad say time and again: once people get it, they won’t want to give it up.

That is exactly the reason that, after this week’s strongly worded 6-3 decision by the US Supreme Court in favor of the subsidies offered by Obamacare, the Patient Protection and Affordable Care Act (its official name) is here is to stay, regardless of all the sturm und drang that can be expected from GOP presidential candidates and conservatives.

The subsides are the key. While these subsidies cost the government billions, they also result in billions more in savings in long term health care costs. The success of this aspect of the ACA is already beginning to show.

You can see it in the polls. While the ACA remains supposedly unpopular with the American public, with support hovering only in the upper 30s, when the same group of people are asked about the subsidies, a resounding 59% of them want them to stay in place. There are two reasons for this: one, the number of people opposed to Obamacare includes a number who don’t think the ACA went far enough and want a more Canadian-like system. And second, as my dad noted, once they get it, they won’t want to give it up.

This notion of not wanting to give it up actually has a strong basis in psychology. The great Nobel Prize-winning psychologist/economist Daniel Kahnemann writes about it at length in his great book, “Thinking, Fast and Slow.”

It works this way. Suppose you give someone a door prize at a party, say a new iPhone. At the end of the party, as the lucky winner is leaving, you make this offer to her: you’ll give her $300 for the phone, which is about $50 more than its worth. In most cases, when offered this kind of transaction, people won’t make the trade, because they hate the idea of losing something they already have. It’s known as loss aversion, and studies by Kahneman and his partner, the late Amos Tversky, suggest that losses are about twice as powerful psychologically as are gains.

And here’s why that’s a problem for conservatives who still want to replace Obamacare with their own plan. First, they’ll politically never be able to take away the subsidies completely, because voters would be furious. But loss aversion research shows that even if the GOP came up with a similar plan that offer similar benefits, people are not likely to go for it because they hate giving up what they already have.

With the Supreme Court upholding the ACA, that gives at least another year and a half for people to sign up for government-subsidized health care, and if any branch of the government is in Democratic hands after 2016, that means at least two more years after that.

While there are other law suits trying to make their way through the legal system, they are too late now. If the conservatives had won this week, they would still have had a difficult time, but it would have been possible to undo the ACA. Now, it’s impossible.

Like my dad said, once they get it, they won’t want to give it up. Obamacare is here to stay. Conservatives will just have to read it and weep.

 

Copyright Tom Regan 2015 

Contact Tom Regan:  motnager@gmail.com

References and further reading:

History Museum’s history of health care in Canada provides a great outline of the battles: http://www.historymuseum.ca/cmc/exhibitions/hist/medicare/medic01e.shtml

An explanation of Loss Aversion
: https://en.wikipedia.org/wiki/Loss_aversion

 

Tom Regan Tom Regan has worked for the Canadian Broadcasting Corporation and with the National Film Board in Canada, and in the United States for the Christian Science Monitor, Boston Globe, and National Public Radio A former executive director of the Online News Association, he was a Nieman fellow at Harvard in 1991-92.

 

 

 

 

 

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Facts and Opinions is an online journal of select and first-rate reporting and analysis, in words and images: a boutique for select journalism, without borders. Independent, non-partisan and employee-owned, F&O performs journalism for citizens, funded entirely by readers. We do not carry advertising or solicit donations from foundations or causes. Help sustain us with a donation (below), by telling others about us, or purchasing a $1 day pass or subscription, from $2.95/month to $19.95/year. To receive F&O’s free blog emails fill in the form on the FRONTLINES page. 

 

 

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Canada’s health care takes a hit

Canadians tend to smugness about the country’s health care, but new research suggests private insurers rake in billions more than they pay in benefits. And a study published today, which examined 20 years of records, revealed that Canadians pay far more for less benefits from private insurance than do Americans.

The Canadian public model stars often in battles over so-called “Obamacare” health care in America’s right-left culture war. Canada’s system is lauded at home and cited constantly in the United States as a better model — although World Health Organization research shows that neither system ranks among the world’s least-costly and most-effective.

But when it comes to private insurance — which covers 60 per cent of Canadians for prescription drugs and dental and eye care —  researchers say Canadians pay more than Americans, and Canadian regulations lag those of the United States. For example in 2011, states the analysis in the Canadian Medical Association Journal, Canadians paid $6.8 billion more in premiums than they received in benefits.

The study contends:

  • Private insurance companies play a substantial role in financing particular health care services in Canada, such as prescription drugs.
  • The percentage of private health insurance premiums paid out as benefits has decreased markedly over the past 20 years, leading to a gap between premiums collected and benefits paid of $6.8 billion in 2011.
  • Governments across Canada should regulate the private health insurance industry more effectively to provide greater transparency and better value for Canadians.

“Although most health care in Canada is paid for by the public, private health insurance plays a major supporting role,” said researchers at the universities of British Columbia and Toronto. In 2010, for example, private insurance expenditures were 11.7 per cent of total health care spending, placing Canada second among nations in the Organisation for Economic Co-operation and Development in terms of per capita private health insurance expenditures.

“Small businesses and individual entrepreneurs are the hardest hit – they end up paying far more for private health coverage,” said study lead author Michael Law of the University of British Columbia, in a press release. “It’s essentially an extra health tax on one of our main economic drivers.”

Early reaction from the private health insurance industry protested that the study does not account for all factors, and one organization told CBC the study is “misleading.

The study is available online at the CMAJ site (for journal subscribers, or for a fee of $25 per article). A press release from the University of British Columbia provides a summary.

— Deborah Jones

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