I’ve written enough about this over the years so that if you are curious of the underpinnings of ACA, the “Affordable Care Act”, you can use our search bar. On a desktop or laptop it is off to the right, and on phones and tablets, you must scroll down below comments and other stuff.
The essential feature of Obamacare was Obama himself, sold to us as a juris doctor, highly educated, charismatic, and kind. His most important trait was that he was half black, which released the virtue-signaling passions of liberals to vote and support him as some sort of demigod who could do no wrong, The One. Obamacare in any other form – McCaincare, Trumpcare, Bidencare, would have been dead in the water. Obama’s being a black man triggered release of the largest tax increase in history, and some of the largest subsidies ever given the private sector.
An essential leadup to ACA was the refusal of insurance companies to cover “preexisting conditions,” leading to tens of thousands of deaths each year, not to mention bankruptcies. True enough, “iatrogenic” (physician-caused) illnesses and deaths are the third largest cause of fatalities after heart and cancer in this country, but let’s set that aside and presume for sake of argument that doctors do only good and vital work without killing people.
It is easy to see in retrospect that the preexisting condition gambit was a strategy put in place to create a need for reform, a crisis! Single payer, which works in most places it is used (the Ontario province of Canada perhaps an exception), was logical, so the strategy was to have Senator Max Baucus take it off the table at the outset, refusing to even allow debate. The entirety of the debate thereafter was scripted, the bill written long in advance by a committee headed by Liz Fowler, an insurance executive at Wellpoint. The committee’s bill, now called Obamacare, was in place long before the bill was introduced and debated. It passed as introduced, unchanged by the staged debate.
Enough of that, ancient history now, Obama settled in his millionaire’s beach house in harm’s way of rising oceans. I came across a statistic that shocked even my cynic’s brain: the proportion of non-elderly Americans with preexisting conditions who got health insurance because of Obamacare, according to the Department of Health and Human Services: 2.7%.
Supporters of ACA claimed that 100 million Americans had preexisting conditions. In its broadest definition, it is 133 million, having at least one. (There’s that damned 33.) Only 2.7% of those people gained insurance after ACA. Three percent of people with preexisting conditions were covered prior to ACA, four percent after.
Obamacare was said to be “transformational,” but it was not. It didn’t cure or fix anything. We still have the worst health care system in the developed world, and easily the most expensive. What changed was out-of-pocket expenses for those who did have insurance – they skyrocketed. And for those who could not afford private sector insurance, a massive subsidy was given to health insurers, wherein government pays the outrageous premiums on their behalf.
The source of my information is Dominic Pino, the Thomas L. Rhodes Journalism Fellow at National Review Institute. National Review has easily become my favorite magazine, even as I skip every paragraph using the words “Biden” or “Trump”.
I am fortunate that I am on Medicare (not Medicare Advantage, another insurance industry subsidy). I recently learned via another source that a privilege I get from Medicare, where they knock down doctors’ and hospitals’ charges before paying (allowing me to pay 20% of a much reduced bill), is that private insurance companies engage in the same practice, following Medicare’s lead. I knew they quibbled and nickel-and-dimed people, but did not know they followed Medicare’s lead in knocking down costs. Doctors and hospitals, of course, jack up their charges to soften the blow of the markdown. It’s all a game.
Piece of Mindful 
Mark, good work but I have a question about this whole obamacare. As we know they like to signal what they intend to do to get YOU to be the one whose bad idea it was in the first place. And the bad idea is the government in charge of your health, and repository of your medical history. I’m going to take a flyer and say the whole concept of “pre-existing” conditions is a pre-text to charge people more who might be perfectly fine, but the system sees as something to exploit. For example, never say you are a “smoker” on any questionnaire. 10 years ago when starting a job i checked that box, because i was in the process of quitting cigarettes, never having more than a few a day. And that was a big mistake that cut my life insurance (thankfully never needed!) in half, etc. So now the government has to know everything about your health history, which is going to now be accessible to insurance companies, gun permit applications, job applications (even if it’s not legal), by fiat and government dictat. Just more shiite for the man to screw with us.
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Having had surgery for torn tendons, an inguinal hernia, and Dupuytren’s Contraction, all medical ailments that surgeons can correct, I filled out many, many forms. Since I do not partake in physical examinations, I have no knowledge of anything that might, in their eyes, be wrong with me. I can happily check the “No” box, top to bottom. Beyond that, I have no problem lying to them, as my (self-serving) definition of a lie is to withhold information from someone who has a right to that information. So when they ask if I drink and how much, my answer is “zero”. There is no “MYOB” box to check.
[A better answer to the how much do you drink question, and I don’t recall who used the line first, is “Just the right amount.”]
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I lie to them. Seems a simple strategy.
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I’m finding many people do not pay their bill from the hospital. It gets sent to a collection agency where the amount becomes negotiable, or substantially reduced. Same with certain court fees, people do not pay their speeding or dui tickets or other violations so then it goes to a collection agency for reduced amount.
I’m shocked the Biden admin didn’t bring back the ACA with the penalty on the tax forms for those that didn’t have it. One thing Trump admin did correct and got it voided.
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“An essential leadup to ACA was the refusal of insurance companies to cover “preexisting conditions,” leading to tens of thousands of deaths each year, not to mention bankruptcies. True enough, “iatrogenic” (physician-caused) illnesses and deaths are the third largest cause of fatalities after heart and cancer in this country, but let’s set that aside and presume for sake of argument that doctors do only good and vital work without killing people.”
However, if we don’t set that aside for argument’s sake… the case could be made that there’s much more risk from having insurance, and being tempted to use it, than not. Just in terms of playing the odds. I’m a broken record bringing up Jennifer Daniels (podcast – Healing with Dr. Daniels on SoundCloud) but she covers virtually every condition, and gives the official stats on the “standard of care” treatments. In almost all cases, your odds are actually better if you do nothing, or try other things, than if you follow the standard of care.
Which also throws a wrench in the iatrogenic numbers. That seems like quite an admission of fault, yet (probably) massively downplays the doctor induced harm. It refers just to actual “errors” – deviations from standard of care. Meanwhile, deaths that occur when the standard is followed, are classified as a result of some condition, rather than due to a pharmaceutical or other intervention.
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Those thoughts wafted through my head as I wrote what I wrote. I am glad you added this comment.
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Just for one shocking example.. why are “suicides” so high among diabetics? Well, using insulin is extremely risky and (maybe only for Type 2, not sure) statistically more risky than untreated diabetes. If one takes too much insulin and drops blood sugar too low, the EMTs who show up assign the resulting death to suicide. (Which must completely wreck the stats on suicide as well, incidentally..!)
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I speculate without knowing that diabetes can be arrested, even “cured” by adoption of a low-carbohydrate diet, giving up cookies and donuts and ice cream and sweetened sodas, French fries, and the hardest of all, pizza. In fact, I recall reading words to that effect in Gary Taubes’ Good Calories Bad Calories.
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Yes, at least for Type 2. Besides Taubes, I’ve seen at least one book from the Nineties maybe, by a doctor making that case. He claimed to have successfully treated many diabetics with low carb. I also have a friend, early 50s, whose A1C showed him to be pre-diabetic, and he successfully uses low carb to control it and avoid becoming diabetic or going on insulin. But it’s not easy to do long term, he misses things he can’t eat.
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The nice thing about low-carb is general absence of hunger. Once I got on it, it became part of my makeup and I do not miss the things once craved. Except pizza. I do have pizza maybe four times a year.
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I read Taubes, his Good Calories, Bad Calories was even part of what led me into “fakeology,” since he made such a strong case for the corruption and failings in nutrition science. But I haven’t really applied his views – at least not currently. I’ve dabbled in it, but I think I need to find a more balanced approach, probably closer to what you’re doing. You still have some grains and starches, don’t you? I currently have too much of a “sweet tooth,” and could also be more selective about grains and starches.
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I pretty much stay away from grains and starches, occasional lapses when we are out (I don’t diet in public or when at friends as it is off-putting). Oroweat and others have come up with breads that is mostly made of fiber, and it is great! I can eat bread again! They make pizza dough out of cauliflower, yuk! They make low-carb flours out of almonds and stuff, but it just doesn’t work for me. We’ll go to Ted’s Montana Grill today, and I will have a burger and French fries, and I will savor every moment. That’s once every two weeks.
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Interesting, thanks! Something to consider, might try it at least as an experiment.
I meant to ask as well, as far as appetite- I understand you don’t have annoying between-meal hunger, but I assume you have some degree of appetite at meal times? It’s not like one is never hungry whatsoever, correct? Anyway, sorry for all the questions.. Hope you and your wife enjoy Ted’s steakhouse!
(Which btw always reminds me of the hilarious Phil Hendrie radio comedy bits about “Ted’s of Beverly hills” – if you’re not familiar, I highly recommend – as a fan of Conan and other comics as you are, I’m fairly certain you’d get a huge kick out of Phil hendrie. Truly over the years, he’s in my top 5 as far as comedy that could regularly put me in tears. If course I was much younger then but still.)
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Thanks for the Hendrie tip!
I really don’t get hungry often, but when I sit down to eat and the food is OK, then I enjoy eating it. What I do not get are the shakes or hunger pangs.
Ted’s Montana Grill is a national chain but with very few outlets. It’s specialty is bison, you might guess, as Turner owns the Flying D Ranch south of Bozeman, and raises bison there. (He allows the wolves to hunt there too.) He’s also the largest landowner in New Mexico, so when we traveled that state several years back, we expected to see TMGs everywhere. Not one in the entire state! His very first TMG still stands in Bozeman, and when we lived there, Jane Fonda would happen by, since she and he were married and they have a beautiful ranch house on Flying D.
We did not begin to dine at TMG until we got to Colorado. Now it’s our place of choice, always a good experience. (We were just last week in Portland, and ate out twice at Cheesecake Factory … meh.
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Something else I wanted to mention on this section –
” I recently learned via another source that a privilege I get from Medicare, where they knock down doctors’ and hospitals’ charges before paying (allowing me to pay 20% of a much reduced bill), is that private insurance companies engage in the same practice, following Medicare’s lead. I knew they quibbled and nickel-and-dimed people, but did not know they followed Medicare’s lead in knocking down costs. Doctors and hospitals, of course, jack up their charges to soften the blow of the markdown. It’s all a game.”
Again from Daniels (and I’ve seen a similar take in an obscure muckraking book from a doctor who also had high level positions in healthcare), at some point in the Eighties the traditional, healthy antagonism between hospitals and insurance changed. They may still quibble over some marginal details, I don’t know exactly, but essentially it was written into law that the insurance companies are guaranteed a certain percent of profit. I have trouble articulating it, but the gist of it is they have a mutually beneficial, collusive relationship. Each year, health care costs rise, because they both benefit from this rising cost. Each year, the insurance companies look at their past payouts, and project forward, adding on the percent of profit they’re legally guaranteed. I may not be explaining this exactly right, I’d have to relisten and take notes.. but maybe this gives the general idea of how it works. They have no incentive to fight with hospitals over rising costs – they just mark their premiums up accordingly. By monopoly/ oligopoly power, people have to pay.. or else the government via ACA I guess.
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If by chance you go to the emergency room without insurance, or have a hospital stay, it is guaranteed bankruptcy. At one point, probably now too, the most common cause of bankruptcies was medical bills.
I think of their posted charges, say $12,000 for knee surgery, as funny money. In the end it will be closer to $3,000. That’s the real cost, and to me, seems reasonable. I used to carry supplemental insurance for my Medicare, with a deductible of $2,800. I had hernia surgery, and then Dupuytren’s, and decided to get it all done at once, and so added torn tendons, so that the deductible would be used up. That never happened. The markdowns were so severe that my out-of-pocket did not approach $2,800.
Medico, the company that supplies the insurance, in all the years I carried it, never paid out a penny. I finally got smart and dropped them, since I was essentially self-insured anyway.
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I love “Peyronies disease”. A.K.A. bent wiener syndrome. First time I saw an ad for that I thought it was a parody.
Peyronie disease – Symptoms and causes – Mayo Clinic
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Anything medical markup starts at 70%.
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Breaking news, the moon landing has been admitted as fake by Hollywood. Jesus H. Christ if anyone believes it from now on they need to be put in a mental institution, especially with all the ridiculous landings like Indias space invaders/Mason lander.
Fly Me to the Moon (2024) – IMDb
Marketing maven Kelly Jones wreaks havoc on launch director Cole Davis’s already difficult task. When the White House deems the mission too important to fail, Jones is directed to stage a fake moon landing as back-up.
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