Good. The more people realize early on how badly Obamacare is going to screw them, the sooner we can dump the Big Health extortion racket and replace it with Improved Medicare For All. I had thought it might take a good ten years for the electorate to realize it had been conned, but with 30 million left completely uninsured, projected mass downgrading to bronze-level coverage, and unions losing their special treatment, maybe not…

“Dr. Robertson says tornadoes hit where people haven’t been paying enough….”

Did you mean to write “praying” enough? Because … no, strike that. “Paying” actually makes more sense.

I interpreted “wankerous” as shorthand for “wankerously hypocritical.”

Does anyone really think Obama or the Senate’s pseudo-Democrats want to give up their best excuse for “not being able” to walk their “nominal constituent” talk? They had the untrammeled ability to amend or repeal the filibuster five months ago and two years before that. What’s different now? Except that to change a Senate Rule in mid-Congress, they theoretically have to find it unconstitutional? (Which it is, but still, that’s one more excuse for not being able to repeal it.)

Of course, a “public option” wouldn’t have reduced our system’s >$400B a year in excess administrative costs, and without monopsonistically negotiated uniform price schedules applicable to all providers and all insurance plans, it wouldn’t have reduced the excess hundreds of billions a year we pay in inflated charges due to price-gouging. But yeah, it might have put some additional pressure on private insurance companies to keep their markups lower than the maximum 17.6% and 25% that the ACA allows. (Those figures are for large-group and small-group policies, respectively. The ACA’s 15% and 20% maximum medical loss ratios translate to 17.6% and 25% caps on markups on expenditures for care and “quality improvement.”)

National single-payer, aka Improved Medicare For All, is by far the cheapest, fairest, and best solution to our health-care problems. Technically, its implementation would be far simpler and cheaper than the ACA’s. But I’ve come to accept that, given our corrupt, inverted-fascistic media and government, national single-payer is probably not going to be feasible until our health-care problems become catastrophically bad and widespread. I’m guessing they will probably have to be at least as bad as the Great Depression and the Dust Bowl combined.

In the meantime, the for-profit health sector will continue to extract around a trillion dollars a year in excess costs from us, bankrupting almost as many patients as before. And it cost them less than a penny on the dollar in advertising, PR, lobbying, and political bribes to keep this racket going! Enjoy!

Oh! I almost forgot: the CBO has just released a revised projection of the number of people left completely uninsured by the ACA from the get-go. It’s 31 million, up from 30 million a couple of months ago. (My “pragmatic” Democratic congressman is still going around touting the imaginary talking-point number of 20 million.) Supposedly, the ACA will extend coverage to around 25 million previously uninsured (5 million of those only transiently uninsured), bringing our aggregate costs up from 18% of GDP to over 20%. Meanwhile, countries with single-payer (or most of its key elements) are spending less than 13% of GDP, covering literally everyone, and mostly getting better medical outcomes. Again, enjoy!

Call me a cynic, but given this administration’s contempt for the Bill of Rights in its relentless pursuit of leakers and whistleblowers, I’m having a hard time believing they stopped at subpoenaing phone records. I mean, all phone conversations have been intercepted, recorded, and stored for some time now, right? But we are supposed to believe that Obama and Holder refrained from ordering a team of loyal flunkies to listen to them because it would violate the 1st and 4th Amendments? I might be willing to entertain the notion that they were afraid of the blowback from illegally wiretapping a target as high-profile as AP, should it ever come to light, but not that it was never considered. Seriously, these guys make Hoover’s and Nixon’s abuses look amateurish and quaint.

Don’t get me wrong. The Democratic Party hasn’t represented the working class since LBJ and I’m through with it. I voted for Jill Stein in the last election (and a bona fide socialist in my state legislatives), and not one penny of mine is ever again going to find its way, directly or indirectly, into the coffers of the DNC, the DCCC, the DSCC, or my state Democratic Party until the Democrats represent the bottom 90%. I just see Biden as somewhat less of a Reaganite than Obama in social insurance, labor, the environment, public transit, and the like. I would happily see Obama impeached and convicted and have Biden take his place, but that doesn’t mean Biden (or Hillary) would get my support in 2016. They wouldn’t.

Why wait until 2016? Obama has implemented a Republican/Blue Dog/New Democrat agenda since day one, and now he wants to cut Social Security, Medicare, and Medicaid. That should be the last straw for at least a significant minority of congressional Democrats. I say we call on them to impeach Obama’s ass.* At a minimum, it would put Republicans in the uncomfortable position of defending their most consistently reliable ally in government. Seriously, would you rather slog through the next two and a half years under the guy who never met a position he wouldn’t pre-emptively surrender, compromise, or sell out, or President Joe?

*The requisite “high crimes and misdemeanors” can be whatever Congress says they are, the only “judicial review” being in the court of public opinion.

In the aggregate, the ACA is going to bleed us even drier than we were being bled before (notwithstanding the fact that it’s probably going to bleed somewhat fewer of us, the ACA poster children, to death, at least in its early years). That wasn’t a Democratic Party talking point, but it was certainly the primary goal of the Big Health lobbyists who wrote the bill.

The solution to extortionate medical pricing is called monopsonistic (“single buyer”) bargaining. Basically, a government agency (or a consortium of insurers) periodically meets with providers and negotiates a uniform schedule of prices and fees for every medical product and service. Every other First World country’s health-care system engages in monopsonistic bargaining and price-setting, in one form or another; every other First World country has significantly lower (and more uniform) medical prices than we do; and almost every other First World country gets better average medical outcomes than we do, in part because a significantly higher percentage of their citizens can afford to get all of the care they need. While single-payer (Improved Medicare For All) is the simplest, fairest, and cheapest way to implement monopsonistic bargaining, you can have have it without single-payer — multi-payer Switzerland does — and Obamacare is utterly indefensible without it.

In response to elisemattu @ 26:

Commercial media was completely in the pocket of Big Health during the Obama health-care reform debate. During the Clinton effort in 1992, Big Pharma was spending less than $300 million a year on direct-to-consumer prescription-drug advertising and you couldn’t turn on a TV without seeing a report about Americans going to Canada or Mexico for affordable drugs. By 2009, Big Pharma was spending $5.5 billion a year on DTC ads, and we saw not one peep about the fact that US drug prices are around twice as high as everywhere else. I’ve no idea how much DTC money Cancer Treatment Centers of America was dumping on the radio and TV networks, but it must have been substantial, judging from the volume of ads. And of course, at the time NBC Universal was 100% owned by General Electric, a major manufacturer of MRI machines and other medical devices. (GE Healthcare yielded GE roughly the same revenues and profits as NBC Universal did back then.) I wouldn’t have expected any NBC news outlets to advertise the fact that American hospitals are charged twice as much as Canadian and European hospitals for identical GE machines, or that Japanese MRI machines are far cheaper, to the point that safe (non-radiating) MRI scans in Japan are less expensive than dangerous (ionizing-radiating) X-rays are in the US. It’s quite a propaganda coup to keep most Americans completely in the dark about decades of proven health-care solutions beyond our borders, but Big Health and our subservient corporate media pulled it off.

“The American people live [in] a democratic system and that is why they are held responsible for their policies.”

So I guess Awlaki bought the big lie, too. America: a de facto plutocracy successfully masquerading as a democracy thanks to the most effective propaganda machine on the planet. Even our enemies believe the fiction!

You know what I like best about the Affordable Care Act? When Bernie Sanders finally capitulated and signed on (along with the rest of the Congressional Progressive Caucus), he did so in exchange for a measly “extra” $1 billion a year for 10 years for community health clinics. (And with the sequester, the clinics aren’t getting it.) To put this in perspective, just one state, California, has already spent over $1 billion trying to set up its Obamacare exchange. I guess a billion a year for community clinics is a better consolation prize than the President’s signing pen, but given that single-payer has the potential to save up to $1 *trillion* a year while providing excellent coverage and outcomes to *everyone*, it’s not something I would go around bragging about.

This is what you get in a country where most of the news media are owned by conglomerates and funded by corporate advertising — including billions annually from the for-profit health sector — and where election campaigns and politicians are funded by by those same corporations and the super-rich. Obama and the 2008 crop of congressional Democrats — including, sad to say, every last member of the Congressional Progressive Caucus — delivered a for-profit health sector protection racket that Bob Dole, Newt Gingrich, and the 1994 crop of Republicans could only dream of foisting on the country twenty years ago. It’s no accident that health insurance and pharma stocks went up when the Affordable Care Act passed and went up again when the Supreme Court upheld it: its primary purpose from the start was to protect the interests of Big Insurance, Big Pharma, and Big Device.

Without major revision — which for-profit health interests now have more money than ever to fight — the ACA protection racket will collapse within 10-20 years because of its complete lack of cost controls, but in the meantime Big Health will continue hoovering around an extra trillion dollars a year out of our collective pockets in price-gouging and skimming (compared to the percentage of GDP spent on health care by the very best, most universal, and most expensive of our peer countries). But I expect that at that point, our pathetic mainstream “news” media, in their role as outsourced public relations flacks for their owners and advertisers, will dutifully sell us yet another cock-and-bull story totally devoid of real-world support … and the majority of the American public will buy it.

Want decent health care at a fair cost? Move to a different country. I don’t think we’re going to see it in the US in my lifetime — and probably not in most of yours. HR676, “Improved and Expanded Medicare For All” is sitting in committee, ready to go, but at this point I expect it’s just window-dressing to raise contributions for the CPC.