The American Interest
Analysis by Walter Russell Mead & Staff
Obamacare Fail The ACA Is in a Total PR Free-fall

The ACA was just handed its worst opinion poll numbers yet. The Kaiser Family Foundation’s July poll found that 53 percent of respondents view the law unfavorably, up 8 percentage points since June. As WaPo reports, that’s the highest unfavorable we’ve seen and one of the biggest monthly swings in either direction.

Something else besides the numbers make this anti-ACA spike significant, however. First is the fact that the poll shows this spike occurring just as holdouts are finally beginning to make up their mind about the ACA. The number of respondents who were “without an opinion” on the ACA was 11 percent in July, compared to 16 percent in June. More people are forming an opinion, and increasingly that opinion is negative. Second, there is no obvious cause for this shift:

“Normally, when negatives go up, you can tie it to an event,” said foundation chief executive Drew Altman in an interview. Events like a broken enrollment Web site, or people losing their health plans.

That doesn’t seem to be case here, though. The poll was conducted before a federal appeals courts split on the legality subsidies in the 36 states with federal exchanges, and before House Republicans formally advanced plans to sue President Obama over his failure to enforce the law’s employer coverage mandate. Yet, the poll was conducted after a string of surveys showing that the nation’s uninsured rate has dropped significantly since Obamacare’s coverage expansion took effect this year.

This is almost a worst-case scenario for the ACA. Even with a string of favorable (or an least not unfavorable) news prior to this poll, the public was in the midst of breaking against the ACA. Those who previously had no opinion are being won over to the opposition, and once a choice like that is made it takes a lot to swing someone back over to the other side.

None of this necessarily means that repeal is politically possible. It’s not uncommon for people to be opposed to a law and also oppose scrapping it entirely. But for the law’s supporters and architects, this has to be troubling news.

Published on August 1, 2014 2:44 pm
  • Andrew Allison

    You don’t think all the publicity about restricted networks had anything to do with it?

    • circleglider

      The shift from “no opinion” to “negative opinion” is likely due to more and more people actually experiencing buying and using insurance on the exchanges. It represents the difference between an abstract idea and its real-world implementation.

      Which is really bad news for Obamacare. A plurality likes the idea of Obamacare, but a majority hates the reality

  • FriendlyGoat

    Like the meaningless polls about whether America is on the “right track” or “wrong track”, we don’t know ANYTHING from the latest Kaiser poll unless you identify and measure the reason any particular respondent disapproves the ACA.

    Thanks to right-wing propaganda, most Americans (except those actually purchasing coverage on an exchange) are misinformed about what the law does.

    • Suzyqpie

      Left-wing roorback gets some credit, also, for the 0bamaCare, aka, DemocratCare debris field. When the bureaucracy got done with 0bamaCare, aka, DemocratCare the page count was 10,535. It would be an herculean task for anyone, including the Democrats who passed 0bamaCare, aka, DemocratCare, to be informed.

      • FriendlyGoat

        It’s not hard for any individuals to understand that they can either buy insurance subject to cancellation when they get sick—-the situation before Obamacare—-or they can buy insurance under government rules where rescission is not allowed.

        It’s also not hard for any individuals to understand that tons of people can qualify for monthly governmental premium help averaging $264/mo against policies otherwise costing about $400/mo and up.

        • Suzyqpie

          Democrats – Game Show Government, vote for me I’ll give you cash and prizes!!! The plan is working…. Mid 2010 I bought Wall Street health care stocks, CI, WLP, HUM, UNH, AET, share value has doubled. Which insures that the Rs will never repeal/replace 0bamaCare, aka DemocratCare, very good investment…. 0bamaCare, aka, DemocratCare has created great WS wealth. I am grateful. BTW, Friendly, IRS has now named the fine-mandate-tax ‘Shared Responsibility Payment.’ That has a nice collectivist sound, right Comrade…..

          • FriendlyGoat

            DemocratCare is a more honest slang portrayal of ACA than ObamaCare ever was. I’m kinda surprised your friends let you talk that way. (You’re “off the talking points” with that, you know.)

            Separately, though, if you won the Game-Show Government Game with the health care stocks, why are you griping about a “debris field”? Being in a position to buy those things AND benefit from a capital-gain preference—-when so many other people have neither stocks nor insurance—-is the kind of thing that makes Warren Buffet speak with a tone of gratitude. What is it that causes so many of the other political “conservatives” to be so resentful of a plan designed just to keep some of the poorer people out of medical bankruptcy? For heavens sake, the Federal Reserve has propped up the owners of stock to levels they never even dreamed they would have, and the richer they get—–with government help—-the more they throw out the “Comrade” sh*t at everyone who either has less or speaks for those who have less. It’s pretty sick, really.

        • Suzyqpie

          Hey, Friendly, why do you think that Pres 0bama hasn’t appointed anyone to the IPAB. Those are plumb patronage appointment positions. This little dust-up with Gruber on Halbig shouldn’t be a hindrance. IPAB provides cover for Medicaid, Medicare cuts for WDC Rs & Ds so I speculate that WDC autoecious bureaucrats would be racing to get those positions. I am thinking that Tom Daschle, Chris Dodd, Max Baucus, Eliot Spitzer, Anthony Wienee, are awaiting their IPAB assignment at the WDC trough. Also Eric Cantor recently tossed off the WDC trough….WDC bureaucrats always support other bureaucrats, Rs or Ds, see Chuck Hagel. IPAB positions need to be filled to fuel the campaign funding laundromat.

          • FriendlyGoat

            There is a pretty good discussion of IPAB at http://www.modernhealthcare.com/

            That’s their home page, then use their search box to find “IPAB”—-leads to an article dated 1/24/14.

          • Suzyqpie

            Friendly, get some new advisors, Thanks, 1/24/14, I need 6 month old news? Thanks again. Friendly, did you check out modernhealtcare dot com? Did you? It is a debris field, a total gallimaufry of detritus. PCORI, “With the governments comparative-effectiveness reach range machine finally in full operation critics are beginning to question whether the program still has the capacity to promote significant change.”

        • stanbrown

          It’s not hard for my friends to understand that seeing someone’s premiums go up 50% due to Obamacare because they have to pay for maternity care that they don’t need at age 58 post-hysterectomy really, really sucks.

  • SisyphusRolls

    Some states, California in particular, have had local reporting in that time period on the health insurance increases they can expect for next year. Some California metro areas are going to see up to 88% increases in non-subsidized health insurance pricing! If some of the undecided voters caught those stories on the local news, they’d probably be breaking hard against ACA.

  • Pete

    “Thanks to right-wing propaganda, most Americans (except those actually purchasing coverage on an exchange) are misinformed about what the law does.”

    You got it backwards, Chief. The propaganda — no, make that lies — about health care have been from Obama, the Democrats, and their running dog media sophicants. Who can forget: “If you like your health plan you can keep it. Period.”?

    Now that the truth is dawning on this illegitimate health care reform, the public support — what little of it there ever was — for ObamaCare is drying up and with it the Democrat majority in the Senate.

    • FriendlyGoat

      Actually, “Chief”—–you’re the walking propaganda machine. Your side has never proposed anything whatsoever except (unspecified) “tort reform” and “selling (unspecified) insurance products across state lines” (from the least-regulated state—–neutering the other 49). At least some of us DO understand your shtick—–even if you think we don’t.

      • Pete

        Sorry, Chief, but you can bark at the moon all you want. The fact is that the lies & propaganda of BHO and his media syphocants can’t save this disastrous health care ‘reform’.

        ObamaCare is dying the ugly death it deserves and with it the political careers of many of out of touch liberals in the Senate and House who voted for that monstrosity.

        • FriendlyGoat

          You will have to wait until 2017 to kill the major features of this law and there is not any particular reason to believe you will have either the votes or the presidency, even then.

          You imagine that the American people will support repeal without knowing what comes in as replacement. They won’t.

          • dwick_OR

            Oh… off-topic but here’s a news flash I knew you’d be interested in.

            Apple, progressives/liberals’ favorite pet high-tech company that just happens to be the second most profitable company in the world with $159B in cash reserves, just completed the $3B acquisition of Beats Music/Electronics and immediately layed off ~30% of Beats 700 employees. Imagine that… $159B in the bank and they have the nerve to let 200 employees go! I mean gee whiz… the rounding error in calculating the interest off that $159B would be enough for Apple to keep paying those 200 employees for the rest of their lives AND put all their kids through Harvard! So be sure to add Apple to your list of those greedy insensitive corporations.

          • FriendlyGoat

            Count me as one liberal who does not worship Apple.

            That aside, thanks for pointing out another excellent example of tax cuts not creating jobs. You laugh at me because you think I’m too naive to know that acquisitions result in job cuts. BUT, your side is constantly advertising to low-information voters that tax cuts WILL create jobs—-when they don’t.
            My side may be fodder for your fun-making, but your side is a pack of liars—nothing for you to be proud of.

  • ljgude

    Back to basics chilluns. The US was spending 16% of GDP on healthcare BEFORE the ACA, which caps spending to 17.5% of GDP by 2017. The OECD average for healthcare spending is around 10% of those countries GDP. The key error of the ACA is that it tries to use the insurance system to accomplish reform, which unsurprisingly, appears to be increasing costs. America is a wealthy country but I don’t think it can afford to pay nearly double for healthcare indefinitely. And no, America doesn’t get what it pays for – it has about the same health outcomes – in many cases slightly worse – than other first world countries. I don’t think it is either desirable or even possible to go back to what the US had before, but the ACA has not even demonstrated it can be implemented as written, never mind being financially sustainable. I don’t know what will ‘happen’, but given the current ingredients something will have to give. My guess at this point is that Hillary will win in 2016 as the person who can fix it and even though I am a Republican I would say that her original 1992 proposal to extend Medicare downward in age would be one way to phase in universal coverage while retaining some control over costs. I doubt the ability of American bureaucracy to control costs as do health bureaucracies in those OECD countries that routinely deliver cost effective healthcare. I am a US citizen long resident in Australia and I know from personal experience that the Australian system has handled my my serious health problems just fine. The Australian system covers everybody based on a ‘Medicare Levy’ that nearly everyone pays in addition to their income tax. If additional coverage is desired private insurance can be purchased which gives greater access to optional procedures. The insurance industry has to compete with the public system to provide added benefit, not just sit there and raise rates based on being forced to provide more coverage. All in all a sane and balanced system that costs about half as much for the same health outcomes.

    • FriendlyGoat

      Thanks for sharing some balanced sense into this site—a place which is mostly inhabited by people who choose to remain clueless as to why American health care is double-priced.

      • ljgude

        Dear FriendlyGoat. Methinks your comment is a friendly, but trollish ideological barb directed at my fellow conservatives who are here precisely because they don’t see the world through the lens of liberal-progressive ideology. And I would like to take this opportunity to personally thank out host, WRM, for providing a site where, those of us born into the Eastern Intellectual Establishment, can take refuge from the eternal verities of the New York Times.

    • Andrew Allison

      Thank you for demonstrating that the US heathcare system borders on third-world standards and that the principle reason is universal private health insurance.

      • ljgude

        I sense sarcasm – rightly or not – but to answer straight: No the US system does NOT border on third world standards. As I said its health outcomes are very near, but not quite at the top. The problem is the way we finance it and the ACA appears to be making it worse by going with an entirely insurance based system with very limited and uneven competition. (The Republicans rightly raise that issue.) Not coincidentally, Switzerland is the only other first world system based on insurance alone and it is the second most expensive system at 11% of their GDP – 5% less than where the US went into healthcare ‘reform’. Bitter Pill by Stephen Brill is the best explanation of our cost problem. http://livingwithmcl.com/BitterPill.pdf The comparative healthcare data with the OECD countries is here:http://pgpf.org/Chart-Archive/0006_health-care-oecd
        I think the answer lies in having both a private and a pubic system that compete with each other. Here in Australia if the public system waiting lists get too long, people buy private insurance. If the insurance premiums get to high they drop the insurance and rely on the public system.

        • Andrew Allison

          You sense correctly. However, as the link which you provide illustrates, the US spends twice as much per capita on healthcare as the average OECD country. As illustrated by http://www.oecd.org/els/health-systems/Health-at-a-Glance-2013.pdf, outcomes and other indicators are BELOW the OECD average by every measure except cancer mortality.
          We are in violent agreement that the answer is the mixed public/private insurance to be found in most OECD countries. Unhappily, the visceral distaste for what is misleadingly referred to as socialized medicine seems likely to prevent widespread public insurance. FWIW, while statistics are hard to come by, it looks as though the taxpayer is picking up about 80% of the average ACA premium. As Suziqpie points out below, the big winners have been the insurance companies.

          • ljgude

            Yes, I was a bit surprised at the apparent sarcasm because I usually find myself in strong agreement with your comments. I have gotten about half way through the OECD health report and agree that the US is getting poor outcomes overall and in particular for the money it spends. While I think these stats show poor performance relative to developed countries, I would still disagree that the US has fallen to third world status – there are very few third world countries in these stats. Still the US is repeatedly in the lower cohort of the developed world – and I readily concede that really is a problem. I am both a US and a Australian citizen and can choose to live in either country. The difference in the healthcare systems is a major factor in my choice to live in Australia. On the other hand the best single overview of health stats I have ever encountered is Han Rosling’s TED 2008 talk which gives a clearer overview of where the US falls in the entire spectrum of healthcare plus it shows how things have changed globally since about 1960. http://www.ted.com/talks/hans_rosling_shows_the_best_stats_you_ve_ever_seen
            On the money side I was amused that US doctor remuneration was apparently missing. Again I recommend Brill’s article Bitter Pill to understand where the money goes. I would agree that the ACA has given the insurance companies a chance to improve their profitability, but the disruption to the providers has created lots of opportunity for increasing prices too. I have seen the figure 17% of GDP quoted already here on the American Interest. I think the bottom line is that the ACA makes some marginal gains in coverage at the expense of people with existing coverage with overall price increases distributed among those already charging double what it costs elsewhere.

          • Andrew Allison

            I do recognized that US healthcare is not Third World [/grin]. It is, however, ridiculously overpriced for what it delivers and it’s my belief that private insurance is a very significant contributor to the problem. The Brill article is typical of many such horror stories, but illustrates the primary reason that the prices are so high, namely that the pricing is entirely fictitious for insured patients (e.g. $24 reimbursement for a Medicare X-ray). In addition, hospitals are required to provide emergency care to the uninsured and, I suspect, have little luck in collecting from patients who are un- or under-insured (hence the demand for payment in advance). The rational response is to charge uninsured patients as much as the market will bear to make up for it. I’m not defending this, simply pointing it out. WRT ACA, the bottom line is an enormous transfer of taxpayer funds to insurance companies. Here’s a real life example: My wife quit her job this year and lost her employer-provided health insurance. She’s very healthy and we balked at paying $550/mo for insurance paying 60% after a $4K deductible. Come January 1, she’ll qualify for ACA and pay $18/month, the taxpayer picking up the other 97%! This is completely crazy.

          • ljgude

            Good, we are on the same page. Thanks for the example which is, I agree, completely crazy, but seems consistent with what we have been hearing. That is, the ACA forces expensive high deductible insurance on those who can pay, and makes insurance for the poor very inexpensive. It will be interesting to see the deductible levels etc. on that $18 policy – I bet they are pretty high too. It looks to me like the insurance companies which are quasi monopolies have just adjusted the premiums and the deductibles to fit the profile mandated by the ACA to a level that keeps them profitable and a whole heap more. Hence the 17% of GDP figure being quoted elsewhere by WRM. By contrast in Australia I am 71 and pay $2000 a year to have my choice of doctor and stay in a private hospital. I have had about 8 heart procedures in the last year and a half (it worked in the end) and have spent almost nothing out of pocket. That is partly because the surgeon chooses to not charge people on a pension – roughly like US Social Security – an out of pocket payment. The bills added up to well over $100,000 paid by insurance. They even sent a rep in to see me in hospital to see if I was happy with the service! I am aware I would come under Medicare in the US (I pay the part B premium $1200 hundred a year just in case), but have no intention of exposing myself to the tender mercies of the US system if I can help it. I think a solution for the US would be to phase in Medicare by dropping the eligibility age slowly and making it possible for people who wanted a better level of care to buy private insurance on a model similar to the Australian or other hybrid system. That way you don’t trap everyone in a single payer hell and you really cover the people who can’t afford insurance. So for example the young man who has a terrible motorcycle accident and little or no insurance just has to concentrate on getting better – not debt. Same with the really poor. Then the insurance companies have to compete against the public system and the hospitals have to stop charging irrational amounts for their services. And, boy, they wouldn’t like that! A personal example of how out of line Medicare is currently. My sister and I both suffer from Sleep Apnea. My sister in the US gets her CPAP masks through Medicare @ $50 out of pocket for a new one every three months. Medicare pays some supplier over $500 for the mask. I use the same mask which is quite expensive here in Australia – like $3-400. I order the mask from Amazon or a CPAP supply house in the US for $70-$120 and my sister sends it on to me. So someone is skinning Medicare for about $400 dollars a mask and the taxpayers are also paying for some bureaucrat to license the approved seller to steal the $400. I’d like to be in that business and would happily pay a healthy honorarium to the bureaucrat involved to ensure I can make my next Lexus payment.

          • Andrew Allison

            Just a couple of comments. ACA doesn’t make insurance for the poor very inexpensive. In fact, it makes insurance for everybody unecesarily expensive by requiring broad coverage regardless of pre-existing conditions, and forces the taxpayer to pay most of the premium for the poor. This doesn’t change the cost, just who pays what. By the same token, that $18 premium is for exactly the same coverage as the $550 premium. Medicare is rife with abuses, and since the solution is obvious (buy from Amazon) it’s pretty clear that the bureaucrats running the program are complicit. ‘Twas ever thus, and indeed seems to be the same in Oz judging by the local price for your mask.

          • ljgude

            Right you are the insurance is still expensive, and interesting that the terms are the same on your two plans. Pretty bad terms, which I assume is why not being really able to keep an existing plan caused and will continue to cause political blowback. I would add my own comment that pre existing conditions are a natural consequence of insurance based systems, but don’t play an important role in socialized systems. From the medical point of view you have to treat the patients as you find them, not on the basis of when they developed a condition and when they bought insurance. That is one critical reason why I think the hybrid private/public approach is best. Yes, the cost is shifted, but it gives people with serious chronic conditions a chance to have a life even if poor and I’m good with paying into a well managed system that does that at a reasonable percentage of GDP. The CPAP situation in Australia is different and in fact is a weakness of the Australian medical system – neither our public system nor the private insurance system pays much of anything for CPAP supplies. At the same time many things in Australia cost a lot more particularly specialized equipment that has to be imported in small quantities. When I moved here in ’76 most things cost way more – from cars to fridges, but not food. CPAP equipment does not require a prescription here so it is not protected in the way it is under US Medicare – it is an entirely private market. As an indication that CPAP suppliers are not sitting pretty I noticed recently that a CPAP supply store here had gone out of business. I have my own way of importing it cheaply from overseas and I expect that Australian have found other ways of buying it direct, like they have Cameras and cellphones. A lot of cozy high markup retail businesses in Australia have had to face Australians being able to import stuff under $1000 from overseas tax free. So in the US a fix of the ACA would need a drastic reform of Medicare and relegation of the Insurance system to providing optional insurance over and above a reformed Medicare. Unfortunately I think to accomplish that would require sending most of the Congresscritters, insurance executives, hospital administrators and medical bureaucrats to the countryside for re education.

          • Andrew Allison

            I apparently didn’t make myself clear. There are not two plans: it’s the very same plan with the taxpayer picking up 97% of the premium. This, of course, is one of the herd of elephants in the ACA room: the incentive to lie about AGI to obtain the subsidy is overwhelming. A cross-check of claimed versus actual AGI for subsidy recipients would probably show about the same rate of lying (close to 50%) as the so-called “liars loans” that contributed so much to the financial bubble.
            I’ve been thinking about pre-exiting conditions myself. The problem is that if insurance is voluntary and cannot exclude them, there’s no incentive to obtain insurance until you really need it. A alternative to public health insurance (because that is anathema to so many in the US) is differential rates, i.e., if you apply for insurance and have a pre-existing condition, you pay a higher (means-tested in the same way ACA does) premium. I suspect that the cost to the taxpayer would be significantly less than making everybody pay.
            Political issues aside, reform of the prices which Medicare pays for supplies would be trivially easy to implement. The model already exists in Medicaid, where in order to be included in the approved drug formulary, supplies are required to provide rebates. This should, of course, be extended to Medicare (run by the same agency!) and extended to include supplies.
            I couldn’t agree more about the need for re-education of Congresscritters. We need term limits and mandatory retirement: enough already with octogenarian so-called “representatives” who’ve been in office for most of their lives and represent nobody but themselves. Regards.

          • ljgude

            Got it that they are the same plan. I would point out that Americans are quite used to government medicine through Medicare and Medicaid. My sense from reading various blogs since the ACA came in is that they fear being limited to a single government run plan. Single payer in two words. I agree that pre existing conditions would motivate people to get insurance till they needed it. That is why I prefer those people by and large use a public system, that treats them on an as needed basis. I think that is less expensive in a efficiently run public system than through insurance, but not through Medicare as it now runs. Anyhow we could go on and on. I’ll be on the lookout for AI columns on the ACA as it develops including your comments. It will be interesting to see what kind of fixes the two parties will propose for 2016.

          • Andrew Allison

            My sense is that the major barrier to reform is the perception, fostered by the private insurance industry, that single-payer necessarily means single-provider. Even without the recent VA debacle, there was never a possibility of the latter coming into being. Unhappily, the government has probably destroyed any chance of implementing the obvious solution to the insurance issue by reducing Medicare reimbursement rates for services (as opposed to supplies!) to the point that providers are balking. Thus, not just the private insurance companies but heathcare providers are utterly opposed to extending it.
            Thank you for the opportunity to discuss the health insurance issue at length.

          • ljgude

            I think that you are onto something with the distinction between single payer and single provider. Yet, I believe I had to sign something in the Medicare Part B process that said I had to rely exclusively on Medicare. I forget the details but I have assumed that is what was meant by single payer, but I also know that MediGap insurance is readily available. So what the term really means stumps me. But single provider is the problem of socialized medicine – which, apparently, is exactly the problem with the VA. However, US Policy wonks of the liberal persuasion seem to get starry eyed when they use it because, I get the impression, they see it as the only way to impose rational costs on the providers. And those on the right see it as a way to impose an abusive monopoly. When I use the term single payer with my doctor friends in Australia they just look confused. However when you take the FUD away I think all national health schemes are single provider in that they give you no choice of doctor or hospital – you take what the system provides. In my experience that works well in emergencies, but less well in terms of conditions where you want to have some control over the choice of both the doctor and also access to the kind of treatment that is right for you. The latter area is where the private health insurance system here in Australia has really paid off for me personally. My Australian insurer HBF is a non-profit ‘co-op’ that distributes its premiums to its members – like myself. Blue Cross was that way back in the day. What I think has been lost sight of is that medicine is not the same as any other business and that the straight for profit business model creates a different set of problems than the single provider model as we see the insurance companies and providers scramble for the empty chairs created by the ACA. Ironically, I visited the mayo Clinic in Phoenix a couple of years ago with a relative who was having treatment and found a part of the answer in an exhibit which documented Dr. Mayo’s development of a rural practice into a medical institution that needs dip its colors to no other. The central message of the exhibit was this motto: “A private institution dedicated to the public good.”

          • Andrew Allison

            As you point out, the fatal flaw of single-provider is lack of choice (and hence, competition, incentive to excel, etc.). Many national so-called “single-payer” systems are not, in fact,single-payer; and many are, like Medicare, not single-provider (http://www.theguardian.com/healthcare-network/2011/may/11/european-healthcare-services-belgium-france-germany-sweden).
            There’s no requirement that one receive care from a Medicare practitioner, but in practice, it costs much less to do so because, as with the hospitals, the practitioners try to make up on the private swings what they lose on the public roundabout. Medigap, like Medicare Parts C & D, is private insurance which covers things like copayments, coinsurance, and deductibles which Medicare doesn’t.
            It will probably hardly surprise you to learn that CMS (the agency which runs Medicare and Medicaid) has had the insurance piece of the ACA exchanges fiasco in place for years — you can go to Medicare.gov and compare the costs and benefits of all the private policies available in your State for any CMS program! Just one more example of the lunacy of ACA, which is run by a different agency (HRSA).

          • ljgude

            Thanks for the Medicare clarification. The old chestnut ‘swings and roundabouts’ points at one of the key flaws in the existing US system – the decoupling of pricing from the particular services delivered. The uninsured middle class person is overcharged relative to the insured person and so pays part of the homeless person’s bill, and the government picks up the rest with a lot of overcharging going on at every opportunity. So the ACA came into a chaotic healthcare market and as far as I can see has introduced more chaos. Seeing how the ACA and Obama took a big PR hit because of the website failure, I am only further astonished that some of the failed infrastructure apparently already exited in the CMS system. Looks like a Humpty Dumpty class failure to me.

    • stanbrown

      lies, lies, and BS statistics

  • Rick Johnson

    Socialised medicine has been a disaster wherever and whenever it has been introduced. Unfortunately, once it gets it talons into the voting public, it is very hard to get rid of it.