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ACA Agonistes
Obamacare Up, Obamacare Down
Photo courtesy Shutterstock.

Photo courtesy Shutterstock.

Where does public opinion stand on the Affordable Care Act now that the front-end of the website is functioning better? It depends on which poll you use. Five new polls have come out in the past few days, and they paint different pictures of how the law is being received. A Pew Research Center/USA Today poll and a New York Times/CBS News poll both tended to paint a modestly positive picture. They found that public support for the ACA is about what it was in September and October (still not very high); that Obama’s job approval ratings are up, possibly to where they were before the rollout disaster; that respondents were also more likely to think the law will have positive effects than in previous polls; that despite Obama breaking his “like it, keep it” promise, most Americans still trust Obama more than GOP leaders on healthcare.

Other the other hand, a Quinnipiac University poll found that Obama’s approval numbers are continuing to drop, while a Marist College/McClatchy poll claimed that more Americans than ever disapprove of Obama’s job performance. A Wall Street Journal/NBC News poll also reported an all-time high in disapproval of Obama’s performance, and found that disapproval of the President was highest among the uninsured. The number of uninsured opposed to the ACA has climbed, according to this poll, from 34 percent in September to around 50 percent today.

The discrepancies between these polls suggest that it’s too early to accurately predict the political fate of the ACA’s most contested provisions, or how they will affect the rest of Obama’s second term. But one lesson can safely be drawn from them: Americans are skeptical of parts of Obamacare but determined not to return to the pre-ACA situation. Any future health-care reform is going to have navigate those two realities.

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  • Corlyss

    “most Americans still trust Obama more than GOP leaders on healthcare”

    It’s that propaganda thing again. If anything, that figure is a tribute to the doggedness with which the media continues to report that Republicans have nothing to offer on health care. It ought to point the Republicans in the direction they should be going, i.e., settling on one plan, one voice. Alas, it is the ‘tupid party and therefore unlikely to take advantage of the moment.

    • ljgude

      Yes, they are missing an opportunity. But I don’t think America is ready for what has to be done which is a reform of our existing socialized medicine systems: To wit, Medicare, Medicaid, and the requirement for public hospitals to treat the indigent with the government picking up the tab in complex and expensive ways. Example from Medicare. I need a CPAP machine and the masks cost over $500 through Medicare with a $50 co-pay. Amazon price: $75. Specialist CPAP suppliers $125. Medicare mandated windfall profit $375 to someone who puts it in a box and ships it exactly like Amazon. Just an example I am familiar with. People still think they are going to be better off, but I don’t think so because the whole system – both insurance based and public is too expensive. Double the OECD average for no better health outcomes. Trying to achieve the goals of socialized medicine by forcing insurance to cover everyone does not make any business or social sense. That is why most countries have a universal public system supplemented by an optional private insurance system that allows choice of doctor and faster access to non urgent surgery. Hilarycare, if I remember correctly, was an extension of Medicare. That is the right end of the stick. The only other country that tries to do it with insurance alone is the second most expensive healthcare system in the world – Switzerland @ 11% of GDP to our 16% which the ACA caps at 17.5% by 2027. The Republican opportunities have only just begun.

      • Corlyss

        “Medicare, Medicaid, and the requirement for public hospitals to treat the indigent with the government picking up the tab in complex and expensive ways. ”

        I certainly agree that the payment/price fixing arrangements employed by Medicare and Medicaid need critical reform, but they aren’t likely to get it because in fact Democrats DO use public money to buy votes. I want to know where is it writ that Government owes its population unending access to medical care without concern for cost and the implications thereof. People don’t realize that all these programs of state-sponsored health care are post-WW2 measures to stop the spread of Communism and prevent the revival of fascism. Well, they accomplished their goals at horrific future costs to the nations dumb enough not to have built in expiration dates (that would be all of them). Now the monster is too big to deal with if a politician expects to be re-elected. Remember the quip by one of the European central bankers after one of their crisis meetings in 2008: “We know what needs to be done. We just don’t know how we’re going to get re-elected if we do it.” What he was talking about was the reduction, if not zeroing out, of entitlements programs. More than a decade ago, people worried about America’s fiscal future and the fate of its world leadership role announced that within a couple of decades America would be an eldercare facility with a military. That’s almost the way it is now, with something like 60% of the budget going to entitlement programs and no prospect except further growth in entitlements because the public is woefully ignorant about the state of affairs and the import of the decisions they as voters have made for the last 60 years. ANY reform that contemplates the Government primary role is to pay people taxpayer money to prevent them from living with the consequences of their poor decision-making, and that included their poor choices for politicians and policy makers, is a prescription for disaster and eventual revolution. IOW in the words of the immortal R.A. Lafferty, “That way lies rump of skunk and madness.”

        • Andrew Allison

          “I want to know where is it writ that Government owes its population
          unending access to medical care without concern for cost and the
          implications thereof.” It isn’t. There’s no question that the State cannot provide that, hence the complaints about single-payer systems. It’ a safety net, not a blanket.

          • Corlyss

            I think in policy-makers’ minds, there’s no real difference between the concepts in the real world. There may be in the rhetorical world, but as long as politicians keep voting to keep giving money away and not to reform the system, I just don’t see a distinction. Even this new budget deal that we conservatives are supposed to be smart about and grateful for really achieves little except more spending. Democrats have to be flushed out of Congress altogether, along with their RINO fellow travelers, before serious progress could be made. Even then, I expect there to be a repeat of the 1996 revolt among the newer members of the Republican caucus if they see the slightest dip in their popularity. Honestly, I don’t know how to go about attacking the problem and keeping the majority long enough to succeed. Not with the electorate and the media we have now.

          • Andrew Allison

            The American Republic will endure until the day Congress discovers that it can bribe the public with the public’s money. Alexis de Tocqueville. Get over it!

          • Corlyss


    • Andrew Allison

      What, exactly, do the Republicans have to offer on healthcare other than ACA is a crock (which it is) and should be repealed? At the risk of being repetitious, should we provide basic heathcare for every legal resident, or not, and if so, how?

      • Corlyss

        The problem, Andrew, is that there are several plans on offer from different House members, and there’s been other proposals that treat problems piecemeal. That’s why I said they need to settle on one plan to deal with the most pressing problems in health care and all of them get behind it.

        Your second question is easy for me to answer: I do not believe it is the obligation of government to provide basic health care for every legal resident. Hand-holding is NOT the principal job of government. The job of government first and foremost is the protection of the nation’s borders; the financial integrity of the nation; and protecting the nation’s interests wherever they may be. The mandated internal navel-gazing resulting from WW2 and its impoverishment of many former nation-states was an aberration, a moment in time that needs to be moved on from, not ossified into a national government. (I have my own theory that the way in which the welfare state was deployed is evidence that the intent was to so monopolize the treasury that there would be no CAPACITY to make war and therefore Europe would enjoy permanent peace. I don’t really believe in conspiracy theories, so I just say that so many of the EU’s creators believed in the same causes and the same solutions to WW2 that they were not seriously opposed by people asking what the endgame was.) What many European states have done, and America has imitated, is to make government the source of all social impetus and control. Read Samuel Huntington’s Who We Are: you’ll see that as the elites from the west began to cross-pollinate each other, and establish think tanks and foundations to promote their world view, the pace of social welfare state creation and expansion grew enormously.) If government didn’t think of it and do it, it shouldn’t be done. That’s way too much trust in a weak inflexible human institution (government) in an effort to prevent people from suffering ANY bad consequences of their decisions. The answer is not to empower government to do ever more and establish watchdog institutions (always the lagging function). The soviet example is instructive. Libs/Dems/Progs like to dismiss every failure of the statist model like the soviet collapse as an imperfectly realized dream disabled by the short-sighted incapable humans in charge. They never seem to get it that 1) humans are not perfectible; 2) humans will always be there to screw up the implementation so that hustlers take a disproportionate amount of the benefits; and 3) it’s the IDEA itself that’s fatally flaws and we should STOP trying to make the model work.

        • Andrew Allison

          We are basically on the same page. As you point out, the Republicans are incoherent on the subject.
          I wish I shared your certitude as to the role of the State, i.e. “and protecting the nation’s interests wherever they may be.” Where, in other words, do we as a society draw the “social well-being” line. My argument is that any approach which doesn’t address that issue is, perforce, piecemeal. Note that I’m note arguing for single-payer, just that it’s only one way to serve everybody, and that I agree with your closing statement. Always a pleasure.

          • Corlyss

            Just looking for info here.
            You say, “that it’s only one way to serve everybody”
            What was wrong with a market that allowed people to buy what they needed or nothing at all if they didn’t want it? (I want your assessment, so this is not a rhetorical question.)

            That market system served 265 mil people just fine before the Democrats/Liberals/Progressives decided that to serve the remainder, they had to blow up a system that satisfied 86% of those who had insurance thru their employers and 80% of everyone? If you’re concerned about people who can’t get treatment because they didn’t have insurance, I suggest that the vast majority of them made the decision not to buy insurance and should be held accountable for that decision. “Life is not fair.” – Pres. Jimmy Carter. Government can’t make it fair because the only way it can do that is by impoverishing everyone equally. There’s too d*am*n much grasshopperism in the welfare state, i.e., a spurious obligation of the many to pay for the bad judgment of a few. Remember the “moral hazard” that occupied so much speculation about bailing out GM and the banks and AGI, etc.? There’s your moral hazard for you: encouraging people to spend spend spend to keep the economy booming and then running to save them with taxpayer money when they have a catastrophic illness that their meager savings or their minimalist insurance can’t cover, or their poorly managed pension funds go bust. At some point everyone is led to believe they will be saved by the nanny state, and frankly we both know it is impossible for taxpayers to save everyone. There are not perpetual motion machines, not golden geese, no free lunch.

          • Andrew Allison

            Thanks for asking. The issue is that the old system, which only served those who could obtain (pre-existing conditions, etc.) and/or afford insurance, is/was eating up a sixth of the US economy (twice the amount of any other developed country, while producing no better outcomes). To provide healthcare for all, that fraction would have to increase significantly. Where’s the money going to come from?

            We currently have a profit-making middleman (the insurance industry) siphoning of a very significant amount of the premium dollar.

            As every other developed country has figured out, that’s a luxury we can’t afford if (and perhaps even regardless of whether) we decide to provide healthcare for all.
            I agree that anybody who can obtain insurance and doesn’t should take responsibility for the decision. The moral hazard issue is a red herring: the insured are currently paying for the bad decisions made by the other insured as well as the uninsured.
            The same penalties should apply to both.

            I think we have a very simple choice: basic, single-payer, coverage for all with private insurance for those who want more; or a purely private insurance system for those who can afford it. As ACA so clearly demonstrates, pretending that we can have both is nonsensical.

            Again, I’m not arguing for one or the other, but that we as a society need to decide which course to pursue. Regards, Andrew

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