The real test for Obamacare

By Jonathan Bradley in Sydney, Australia

16 December 2013


The latest news on the implementation of the Affordable Care Act is disappointing, but not suprising:

Enrollment records for close to 15,000 HealthCare.gov shoppers were not initially transmitted to the insurance plans they selected, according to a preliminary federal estimate released Saturday.

While these cases pose a challenge for the Obama administration, officials say they believe the situation is improving. Since early December, fewer than 1 percent of HealthCare.gov enrollments did not make their way to health insurance plans.

The Administration has been focusing its attentions on front-end fixes to the troubled website — making sure it loads and works properly for visitors — but this is an example of the back-end failures the system has been undergoing since its launch. It's all very well for someone to find and select a health insurance plan she would like to buy, but if her details aren't then transferred to the relevant insurer, it's all for nought. Hopefully the improved December figures are a sign that the system is working properly now.

And yet, despite yet another example of the technological goofs that have plagued Obamacare since its launch, stories like this seem rather incidental to the point. While immensely frustrating to the Americans the ACA is supposed to be helping, and concerning for folks who have had their old plans cancelled and are struggling to sign up for a new one before the deadline, none of this is really evidence of the ACA failing as a reform measure.

The problem with the United States health care system is not that it has a lousy website; it's that it doesn't insure enough people. Even if the website worked perfectly, the true test for Obamacare is if it can expand coverage. And the news from places where the technology is working is inspiring — especially considering these aren't places naturally friendly to a Democratic president's major reform. Try Kentucky

The per-capita income in Breathitt is about $15,000, and the rates of diabetes, hypertension and other health problems earned this part of Kentucky the nickname “Coronary Valley.”

Lively, who has been signing people up since the exchanges opened in early October, said one woman cried when she was told she qualified for Medicaid under the new law. She said people have been “pouring in” to her office, an unused exam room in the back of the clinic, where her set-up includes a table, a two-drawer filing cabinet, manila folders, a planner to track her schedule, a notebook to track her numbers and a laptop that connects to the state health-insurance exchange, Kynect.

[...]

[H]er next client [was] a 52-year-old disabled master electrician who said his mother, two brothers and two sisters all died from lung cancer. He had been ignoring a spot on his lung discovered during a visit to the emergency room after he had broken his ribs several years ago ... “All right,” Lively said after a while. “You are covered.”

“I’m covered?” Fletcher said. He slapped the table. He clapped twice.

“Woo-hoo! I can go to the doctor now?” he asked Lively. “I’m serious. I need to go.”

Or South Carolina:

An elbow-injuring fall in March proved nearly as painful financially as physically for Carolyn Gates, who was uninsured and ended up with an $8,000 bill for her emergency room visit.

She felt much better Wednesday after a visit to the S.C. Progressive Network’s Columbia office, where she worked with Navigator Tim Liszewski to sign up on the Health Insurance Marketplace under the Affordable Care Act. While Gates and her husband slowly pay off that emergency room debt, she’ll also be paying a $107-per-month health insurance premium next year.

“As far as I’m concerned, it was the best thing ever,” Gates said. “I told my Bible study about it, and three said they’re going to sign up.”

These are anecdotal reports, sure, but they're also charactaristic of the real health care problems in America and the potential for the Affordable Care Act to fix them. If it expands coverage to many more people like these in Kentucky and South Carolina, it will be a success, regardless of any launch difficulties the website had.


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I don't mean to brag, but...

By Jonathan Bradley in Sydney, Australia

31 January 2012


...we know our stuff here at the US Studies Centre.

This past Saturday, the Sydney Morning Herald asked four people whether politics has "finally moved beyond the personal." The evidence of this purported cultural shift? Newt Gingrich's victory in the South Carolina Republican primary, where he won over a socially conservative electorate despite his multiple marriages and reports that he'd asked an ex-wife for an open relationship.

"Politcians tax us too much, spend our money wastefully and regulate our lives," demagogued "The Libertarian," a.k.a. the Instittute of Public Affairs's James Paterson. "So why do we spend so much time worrying about their personal lives instead of the things that really matter?" Gingrich's success, he posited, was "one piece of evidence that American voters have moved beyond the personal." Voters have moved on, even if the media hasn't.

"The Feminist," Kate Gleeson pointed out, not unreasonably, that the public is more forgiving of the male and heterosexual Gingrich's indiscretions than they might be of a woman or gay man. "The Former Politician" Cheryl Kernot used the forum to urge legislators to restrict free speech by enhancing privacy laws, and and applauded one of Gingrich's self-serving attacks on the media.

Fortunately, "The Academic" — also known as the USSC's David Smith — was on hand to straighten things out:

The triumph of Newt Gingrich in South Carolina reminds us that the politics of the personal is as strategic as any other politics.

Moral outrage is not a natural phenomenon that occurs automatically in response to revelations about politicians' personal lives. It is a political weapon to be exploited or neutralised by those who best understand how to use it. No one understands better than Gingrich how outrage works in South Carolina.

America's "Red" states (conservative, Republican-voting) have higher average rates of divorce and birth out of wedlock than the supposedly more permissive "Blue" states. While conservatives insist on strict moral rules, they know they live in a morally complicated world. Everybody knows and loves people who have "fallen" at least once. Gingrich wants to appear as someone who has sinned and repented, and deserves the forgiveness everyone sometimes needs.

Moreover, he has successfully turned himself into a victim. When CNN's John King opened a debate with a question about Marianne Gingrich's claims that Newt had asked for an open marriage, he called the accusations "tawdry" and expressed outrage that the "elite media" would try to protect Barack Obama by attacking a leading Republican this way. This earned him a standing ovation; he had masterfully implied that an attack on him by his ex-wife was an attack on all conservatives by the vindictive liberal media. During the Obama presidency, Republicans have found no emotion more satisfying than victimhood.

Quite. Gingrich is a benefactor of circumstance and cultural affinity. Let us not forget that personal indiscretions recently claimed the careers of Demcoratic Congressmen Anthony Weiner and Mark Sanford, a Republican and the former governor of South Carolina. (Sanford, you may recall, went missing in the middle of 2009 when he was supposed to be hiking the Appalachian Trail. It turns out he had skipped off to Argentina to have an affair. Until then, he was expected to be competitive in this year's presidential primaries.)

After the jump, the rest of David's response.

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If conservative Christians understand that moral rules are difficult to follow and transgressions must sometimes be forgiven, they have less tolerance for people who want to overturn the rules. This may make Gingrich a more acceptable candidate than Mitt Romney, who has a spotless family life but signed gay marriage into law as governor of Massachusetts. Brad Atkins, the leader of South Carolina's 700,000 Southern Baptists, has also claimed "Romney's Mormonism will be more of a concern than Gingrich's infidelity'', because Christians can forgive infidelity but Mormonism is a continuing affront to Christianity.

"The personal" is a lot more than sex. Gingrich's well-known past infidelities may have lost the power to hurt him, but that does not mean "character" has ceased to be an issue. Testimony from former colleagues could hurt him more than testimony from ex-wives. Grandiosity might be less forgivable than infidelity.

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The end of the road for Gingrich?

By Luke Freedman in Sydney, Australia

30 January 2012


A

Five days ago Newt Gingrich held a 10 point lead in Florida and looked poised to carry his momentum from South Carolina down into the Sunshine State. Alas, five days is a lifetime when it comes to campaigns. Over the last several days, Mitt Romney has surged back ahead and now is the clear favourite to win the January 31 Florida primary.

This is obviously bad news for Gingrich, but it’s especially damaging given the campaign schedule. The four upcoming states (Nevada, Maine, Colorado, and Minnesota) were all carried by Romney in the 2008 Republican primary. If Gingrich stalls in Florida, it will be exceptionally difficult to regain momentum.

And, as the support dries up, so do the campaign contributions. Money is always important in the primary, but in the earlier, smaller states like Iowa and New Hampshire, a candidate can somewhat compensate for a lack of resources by campaigning aggressively across the state, and holding face to face meetings with voters. However, as the campaign drags on, this becomes an increasingly difficult task. The number of days between each state primary shrinks, and a number of states begin holding their elections on the same day. A candidate simply doesn’t have the time to personally visit all the counties in each state. Under these circumstances, having the resources to blanket the airwaves with advertisements is an enormous advantage.

Of course, if we’ve learned one thing during the campaign, it’s not to count out Gingrich. Every time he’s been left for dead, he’s managed to rise from the ashes in a blaze of populist rhetoric. And the creation of Super PACs means that Gingrich can potentially rely on advertising campaigns financed by wealthy individuals, even if his own direct campaign contributions begin to dry up.

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Still, given the unfavourable upcoming primary schedule and increasingly harsh attacks from other Republicans, Gingrich is facing an uphill battle going forward. South Carolina was critical for Gingrich, but it was also essential for him to build from that performance by winning Florida as well. Now, he needs to find a way to recapture momentum — and hold on to it for more than a week — if he wants to stop the Republican primary from becoming a Romney blowout.

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More meaningless stats, stat!

By Jonathan Bradley in Sydney, Australia

22 January 2012


I daresay we'll hear it said a lot over the next few days: No Republican has won his party's nomination without winning South Carolina since 1980. In fact, here's a New York Times report on Saturday's South Carolina contest, won resoundingly by Newt Gingrich, saying exactly that:

And after being so confident just 10 days ago, the Romney campaign is now fighting not only the perception that Mr. Romney cannot consolidate broad support among conservative voters, but also at least one troubling fact: No Republican has gone on to win the party’s nomination without winning South Carolina since before 1980.

Meaningless statistic is meaningless! We're talking about five races in which an incumbent Republican president was not running — hardly a decisive precedent. (Make it six if you consider Pat Buchanan's challenge against President George H.W. Bush in 1992 to have actually stood a chance.) And remember a week ago, when Mitt Romney was thought to have won Iowa and been all but a sure thing for the nomination, how commentators were fond of saying that, in the modern primary era, no Republican challenger had won both Iowa and New Hampshire? It was as if the eight votes by which Romney had been thought to have won by actually indicated some exceptional electoral strength that proved his competitiveness.

South Carolina's track record in picking winners is aptly explained by Jamelle Bouie at The American Prospect:

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After defecting from the Democratic Party over civil rights, Senator Strom Thurmond argued that the state’s whites should direct their political activities toward amassing as much influence as possible in the national GOP. “That notion, that you wanted to have maximum influence on what the national Republicans believed, tended to produce a kind of caution in supporting an insurgent nominee for president,” says Lacy Ford Jr., a historian of the South and Southern politics at the University of South Carolina. “A lot of people outside of South Carolina thought that Bob Dole would be vulnerable in 1996 to such a candidate, but that wasn’t the case at all—he took out Pat Buchanan decisively by beating him in South Carolina.”

 This year, however, says Bouie, South Carolina Republicans were looking to buck the trend and follow their political instincts to a hard right conservative:

[Tea Party Republicans] see this contest as an opportunity for finding a more ideological nominee. “I go to a lot of party meetings and party functions, and it seems like voters are looking for people who match up with their values first and can win last,” says Edward Cousar, second vice chair to the state GOP and head of the Black Republican PAC, a group devoted to supporting Afri-can American candidates in South Carolina and across the country. Karen Floyd, a former state Republican Party chair, agrees. “I think the grassroots effort is crucial in the state of South Carolina, and I think some consultants can help deliver that, but really, it’s all about message. Most people are looking for the person who is most authentic and can help us get out of the situation we’re in.”

Gingrich had been assidiously courting such voters all week, and his efforts bore fruit today. But not too much has changed. Gingrich is still a severely flawed candidate, and though his rival Mitt Romney might have had a truly awful week, Romney is still better organised, better funded, and, with Florida, Michigan, and Nevada set to vote in coming weeks, looking at a more friendly electoral calendar. South Carolina might well have lengthened the GOP race today, but Romney is still the favourite, and Gingrich is still as non-viable as ever.

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