Only a couple of weeks until Obamacare’s official launch. (Official name: the Patient Protection and Affordable Care Act, aka ACA.) On October 1 the new insurance exchanges will be open for business, selling health insurance coverage, even to people who haven’t been able to get insurance in the past. The law is expected to make health insurance available to 31 million people who don’t have it or can’t get it now (although at Wonkblog Sarah Kliff says millions will still not be covered, many because they don’t know they’re eligible.)
Buying insurance is mandatory except for people with existing insurance through their jobs or already covered by government plans like Medicare and Medicaid. Mandatory participation is essential because getting healthy people into the pool is the way to make the new system work. (Also, every now and again a healthy person turns unhealthy, sometimes very suddenly. No healthy person believes this, but nevertheless it’s true.) The word mandatory has of course mightily irritated many. Nobody likes mandatory. Mandatory rankles.
There are government subsidies to help with insurance premiums based on income up to $40,000. It appears, to widespread wonderment and even considerable denial, that the cost of coverage will be reasonable for most people, below the government’s original forecast. Aaron Carroll described the good news at the Incidental Economist and also at the JAMA Forum.
Nonprofit co-ops to compete with insurance companies
And here’s an intriguing bit of Obamacare financial news that I’ve not seen heretofore. The ACA sets up nonprofit insurance co-ops to compete with commercial insurers like Aetna and Blue Cross. Jay Hancock reports at Kaiser Health News.
The possibilities are extraordinary, but risky too. Says Sarah Kliff at Wonkblog, “The Consumer Operated and Oriented Plans, or Co-Ops, are a small part of the health care law that could have big implications for its success. Nonprofits in 24 states have received over $2 billion in federal loans to essentially start new health insurance products from scratch. And the health care observers I talk to think that these plans have the potential to upend the health insurance market — or end up as the next Solyndra.”
Obamacare resources for writers
At Reporting on Health, veteran reporter Trudy Lieberman explores how healthcare journalists and other reporters can tackle this immense topic and provide illumination for confused readers. Rob Waters describes the Obamacare enrollment campaign; it is trying, the hed says, “To Break Through Information Fog.” Which gives you some idea of the size of the task. At Covering Health, the blog at the Association of Health Care Journalists, Joanne Kenen also shares a few resources that can help writers with ACA coverage.
The fog does not affect only ordinary citizens. At Kaiser Health News’s Capsules, Mary Agnes Carey describes the American Medical Association’s efforts to bring ACA enlightenment to medical professionals–and encourage docs to help their patients sign up. (Historical aside about organization transmogrification: the AMA fought the legislation setting up Medicare tooth and nail. There’s nothing like massive income to soften the process of being co-opted.) She also notes that the AMA is lobbying against some Obamacare provisions, such as efforts to set up an outside agency focused on cost control for Medicare. Of course.
The AMA site is not particularly extensive, but it does link to helpful material that is informative about the ACA and how to sign up for insurance (some of which is actually from the government, not the AMA.)
Here’s my short list of superb writerly resources on Obamacare:
- Kaiser Health News.
- Sarah Kliff’s pieces at Wonkblog.
- Association of Health Care Journalists’ section on health reform.
- Health Affairs, both blog and journal. The September journal issue is about the ACA but not, alas, open access.
Cutting off your nose to spite your face: A textbook case
The most important thing about Obamacare in the short term is a potential immediate impact that has nothing to do with health care. It is perilously close to causing the US government to close on the day those insurance exchanges open–and/or to begin defaulting on the country’s debt a couple weeks later. This because some Congressional Republicans are refusing to vote for funding those things unless Obama defunds Obamacare. Which is not gonna happen.
The debt ceiling thing, it is widely forecast, would precipitate global economic catastrophe, which is why at Wonkblog Ezra Klein is hoping for a government shutdown as an alternative. But is very afraid the Republicans will instead choose Door B just because it is a lot scarier and will hurt everybody. Even them. They say it’s the principle of the thing.
Climate change = violence = war in and on Syria?
You’ve heard the forecast that climate change, global warming in particular, will lead to more violence in the world. Although there’s plenty of reason to be skeptical, as Knight Science Journalism Tracker Paul Raeburn explains.
But now comes the hypothesis that warming is a factor in a very specific example of violence that has embroiled much of the world and has the US on the verge of attacking yet another Middle Eastern country: the Syrian civil war.
At Wonkblog, Brad Plumer interviews Francesco Femia and Caitlin Werrell of the think tank Center for Climate and Security, who have been studying climatic effects on the Syrian conflict. Femia says, “We can’t say climate change caused the civil war. But we can say that there were some very harsh climatic conditions that led to instability.”
Plumer points out that a lot of studies claim that climate and environmental stresses are a factor in human conflict, but it hasn’t been possible to define the exact role of these stresses. Femia’s response: “. . . you need 20 years of PhD candidates doing research into the area and trying to isolate the various variables at play.”
Ah, yes, the solution familiar to us all: We need more research!
To be fair, they’re probably correct. But still.
Water, water everywhere
Michelle Obama is at the head of a media blast that has just launched Drink Up, a campaign to get people to drink more water. A weird campaign.
At Atlantic Health, James Hamblin wants to know why. He doesn’t get much of an answer, but manages to be amusing about it. Amusing even while serious, pointing out that there is no official scientific recommendation for the proper amount of water to drink–and that the Drink Up campaign has blown a perfect opportunity to argue for water as a replacement for soda and other detrimental fluids.
More water, water everywhere. Even in Kenya!
This is a very big deal. At Gizmodo, Casey Chan reports, with entirely justified amazement, on the find of a big previously unknown aquifer in the driest of drylands. Drink Up!
How to argue with research you don’t like
Another valuable tool for those who write about science, or even just think about science: While you’re at Wonkblog reading up on Obamacare, commit to memory Dylan Matthews’s flow chart of verbal ploys for poking holes in pretty much any piece of research.