FYI, gjohnsit has another fine essay out today, focusing on Obamacare. Originally I wanted to leave these words as a comment in that essay, but quickly realized that it would have been far, far too long, and so I decided to write my own "essay" instead. This piece is a collection of certain of my prior comments on TOP; I hope readers will find them useful. For those who are refugees from TOP, let me preface this essay with the fact that I tried to educate Brainwrap about HRC and Obamacare over on TOP, but in the end he chose to never shift in his support for HRC. Most of the comments below were addressed to Brainwrap.

http://www.dailykos.com/comments/1472738/59108032

Brainwrap, I've been following you for a while, but I disagree with you on this one. I actually left an employer because of healthcare reasons — after working several decades for the company they decided that they would no longer subsidize future retiree insurance. At that point I learned the hard way about the realities of private insurance before ACA. Basically, they owned the bat and the ball, and if you didn’t want to play the game their way you had no choice but to go home. During that time I learned that health insurance companies are basically heartless corporations that just want to make $$$, they LITERALLY don’t care whether people live or die. And they had discovered that they made the most money by doing their best to limit enrollment only to healthy people who don’t really “need” insurance because they basically are not sick. They were essentially doing their best to limit healthcare to only the people who did not need care. Because if you are sick, and you do need care, that was/is EXPENSE that ate/eats into their profits. The b*stards were doing stuff called “rescinding coverage” — i.e. RETROACTIVELY CANCELLING insurance when the insured (even for many years) became critically sick with something like cancer. At that point, they would scan the application that had been made years and years before, and if the applicant left off any prior condition on their app, as trivial as toe fungus, they would cry FRAUD, and leave the poor newly diagnosed cancer patient in a horrible, horrible state. I’ve had to fill out several of those d*mn applications, trying to remember every single friggin illness everyone in the family has had for the past ten years was not a trivial task, and anyone who never had the “pleasure” of filling one of those d*mn things out should keep that in mind. Two takeaways for me were: 1) my prior employer, a large corporation, basically took a morally questionable action in the name of increasing their own profits, and 2) the health insurance companies, other large corporations, were doing morally repugnant things in the name of increasing their own profits, including withholding care to dying people and critically ill infants. Large corporations have the personalities of psychopaths, did you know that? Their power over out country increases every day. Also during this time I grew to become an incredible fan of Wendell Potter. Do you know him? You must, he was like a God during the ACA process — Bill Moyers did a fab interview, Wendell Potter on Profits Before Patients. Anyhow, he wrote a very interesting article early last year: Elimination of ‘Public Option’ Threw Consumers to the Insurance Wolves When he was running for president, Obama regularly talked about the need for a public option. That was one reason why many health care reform advocates supported him instead of Hillary Clinton. He kept insisting on a public option for months after he was elected. He said on July 18, 2009, “Any plan I sign must include an insurance exchange—a one-stop-shopping marketplace where you can compare the benefits, costs and track records of a variety of plans, including a public option to increase competition and keep insurance companies honest…” Soon after that, though, he began to waffle. It became clear to me as well as public option supporters in Congress that industry lobbyists had gotten to him [...] Knowing the industry as I did, I told the committee that if Congress failed to create a public option to compete with private insurers, “the bill it sends to the President might as well be called “The Insurance Industry Profit Protection and Enhancement Act.” Pelosi insisted that Congress had no intention of doing that. The public option was the key mechanism that would keep insurance prices low. We are in an incredibly lousy place right now, as we are legally required to buy a product that is exempt from the Sherman Anti-Trust Act. And the insurance prices are starting to rise as a result. Fixing the medical loss ratio to 80%/85% was a good thing, but the insurance companies are playing games to redefine the meaning of “healthcare” so that they can put non-healthcare expenses into that category to further increase their profits. Medicare has a ratio of about 95% according to Potter. For the insurance companies, it’s like shooting fish in a barrel, and we are the fish. We are the fish. We need a politician who is willing to fight the powerful insurance industry so that us lowly common people aren’t eaten alive. I now think of banks and insurance companies almost like vampires, they want to keep us just barely enough alive so they can feed off of us and suck as much as they can out. I seriously doubt that HRC is that person, she is more into political expediency these days. And so I think you are gravely mistaken casting your vote based primarily on your wonky analysis of the healthcare programs that have been put forward. Promises are made during elections — for things like the public option, remember? — but they those promises get forgotten once the office holder gains power. Many of us thought that the public option got pulled off the table far too early, remember? Good negotiators know that you start your bidding at a price that is much more than you want, so that during the negotiation you can “move to the middle” and end up at a price that you still like. It occurred to me that by asking for Single Payer at this point in the process, Sanders might very well be “starting with a very high price” in order to be in a better negotiating position. The logical, logical path forward to single payer is to simply offer a Public Option to the ACA. This very well might be Sanders short-term goal, for the many reasons that you mention. Any idiots who want to buy their expensive insurance from “private insurance compainies” can continue to do so, but others like me will choose the public option. And over time, more traffic will go to the public option and less to private insurance, and voila, single payer becomes a much more logical goal to all concerned (except the vampires). Bill Clinton signed NAFTA with promises of “it will increase good-paying American jobs”, and he signed the bill that kill Glass-Steagall (which the banking industry had been seeking for decades, at least) and low and behold the stock market cratered enormously a few short years later. I don’t trust that Hillary Clinton will always have the best interests of the 99% in mind. I respectfully urge you to reconsider your position.

http://www.dailykos.com/comments/1473410/59134520

Brainwrap, you wrote: So, what does Hillary Clinton have to say about her plans for healthcare in America, beyond her promise to generally defend and improve the Affordable Care Act? Well, she's posted the following "factsheets", each of which is at least as detailed as Bernie's entire 5-page single payer outline to completely overhaul the entire U.S. healthcare system (I'm only posting the main bullet points; the actual links give far more in-depth discussion of each): How did you come across these magic URLs? They are not on HRC’s Issues/Healthcare page, and that seriously concerns me. www.hillaryclinton.com/… At this point I’m not going to even comment on the contents of these sheets, just say that it they are not prominently visible on the website, if they are merely buried deep in secret URLs, then it makes it difficult to hold her accountable to those promises once she is elected. The second thing I want to say is that you are making many assumptions about implementation aspects of Sanders “plan”, and then finding his plan unacceptable based on those assumptions. The net effect is that you are inventing catastrophes and then judging Sanders plan as being too catastrophic. The original promised cure for private insurance overcharging for health insurance was competition, especially the competition that would come from a Public Option. IMHO, Wendell Potter had it exactly right when he wrote the brilliantly titled piece: Elimination of ‘Public Option’ Threw Consumers to the Insurance Wolves Soon after that, though, [Obama] began to waffle. It became clear to me as well as public option supporters in Congress that industry lobbyists had gotten to him [...] Knowing the industry as I did, I told the committee that if Congress failed to create a public option to compete with private insurers, “the bill it sends to the President might as well be called “The Insurance Industry Profit Protection and Enhancement Act.” The ACA without a Public Option was a wet dream for insurance companies. There is not a viable mechanism to keep costs down without legitimate competition for the profit-driven and literally inhumane insurance companies. We are at the mercy of the insurance companies now. We are at the mercy of the wolves, and so many “Democrats” either don’t see it or don’t care. “Defending ACA” is a laughable goal in it’s present state, which will become increasingly obvious as time goes by. And I rather feel for you if your plan is to continue providing ACA metrics, because you will slowly see that in the numbers and remember the support you unwittingly gave HRC, and thus helped make it happen. A recent NYT article (that an HRC fan helpfully provided to me) contains this: And the big rate increases sought by some health insurance companies for 2016 are less significant than they appear, administration officials maintain, because most people buying insurance through the Affordable Care Act’s public exchanges receive federal subsidies that cover most of the premium. They do not need to worry about the “list prices,” officials said, and if they do, they can switch to less expensive plans. Don’t worry about the prices charged by the insurance companies, because most people buying on the ACA are getting subsidies. Translation: Don’t worry about the prices charged by the insurance companies, because Uncle Sam is picking up the tab. Do you see the scam? Health insurance companies have managed to have laws enacted that make it a crime to not buy their product. They can still overcharge for their product — but those in charge of the ACA says not to worry, don’t worry about list price at all, because if you cannot afford to pay for it than Uncle Sam is going to pick up the tab. What a sweet deal for the health insurance companies — they make large profits, courtesy of the taxpayers. Isn’t this essentially the same kind of sweetheart deal that BIG PHARMA got with Medicare Part D enhancements that contributed greatly to the national debt? Do I need to explain the problems caused by the increased national debt? I’ll limit myself to saying that conservatives are currently using the high national deficit (that was primarily caused by two unfunded wars, unfunded enhancements to Medicare Part D, and the Bush Tax Cuts) as a rallying cry to cut Social Security and Medicare. Clinton is promising all kinds of good things, it sounds like a wish list created from focus groups. But without true competition, the industry that is exempt from the Sherman Anti-Trust Act is essentially going to be gaining tremendous profits that were paid for with the national credit card. And Republicans will yell “Tax and Spend Liberals” and they will absolutely fucking be right. Sanders it telling us he wants to fight for Universal Health Care. The most reasonable short-term compromise would be a Public Option as another choice available from the choices available on the ACA Marketplace. On what basis have you completely ruled this out as a possibility? On what basis have you reached your conclusion that Sanders will completely dismantle the ACA? By denouncing Sanders goals, and not proclaiming support for a Public Option, Hillary is putting her full support behind the “The Insurance Industry Profit Protection and Enhancement Act.” BIG INSURANCE will be happy, and continue to give her big contributions. Please, please think again about the recommendation you are giving so publicly. I sincerely believe you are going to regret it deeply if HRC becomes president.

FYI, Brainwrap didn't even respond to this comment at all. I think I was becoming an annoying troll at that point, lol.

http://www.dailykos.com/comments/1473410/59155408

RETIII Jan 21 · 10:44:00 PM What is so wrong about the Affordable Care Act that Dems would want to make their next signature fight about overhauling the whole system to single payer? I mean that sincerely — not what are the advantages of single-payer (which I understand) but what is so wrong about the Affordable Care Act? In terms of priorities, why wouldn't we focus for a while on income inequality and wage stagnation outside the area of health insurance? How is it that Democrats consider the overhaul of Obamacare to be such a top and urgent priority? Don’t we now have more pressing problems and priorities (and ideas) following our success with the ACA? Older and Wiser Now Jan 23 · 01:52:30 PM I had a fascinating experience yesterday. I answered that very question in a comment that I made on this very thread: [edited to remove the URL, it points to comment you just read prior to this one] On this thread, my comment was completely ignored. No recs, no response from Brainwrap. I decided to leverage from that comment, and put a very similar comment in another thread, this one here (warning: takes a while to load) http://www.dailykos.com/stories/2016/1/22/1473620/--Some-Experts-Like-Kr... This second comment received 27 recs, and I was asked to turn it into a diary. Which I did: Wendell Potter:"Elimination of ‘Public Option’ Threw Consumers to the Insurance Wolves" The diary received 57 recs, and made the Rec list too. Wendell calls the current ACA “The Insurance Industry Profit Protection and Enhancement Act.” Health insurance companies have managed to have laws enacted that make it a crime to not buy their product. They can still overcharge for their product — but those in charge of the ACA says not to worry, don’t worry about list price at all, because if you cannot afford to pay for it than Uncle Sam is going to pick up the tab. What a sweet deal for the health insurance companies — they make large profits, courtesy of the taxpayers. Do I need to explain the problems caused by the increased national debt? I’ll limit myself to saying that conservatives are currently using the high national deficit (that was primarily caused by two unfunded wars, unfunded enhancements to Medicare Part D, and the Bush Tax Cuts) as a rallying cry to cut Social Security and Medicare. Clinton is promising all kinds of good things, it sounds like a wish list created from focus groups. But without true competition, the industry that is exempt from the Sherman Anti-Trust Act is essentially going to be gaining tremendous profits that were paid for with the national credit card. And Republicans will yell “Tax and Spend Liberals” and they will absolutely fucking be right.

Comment got no recs and no reply.

http://www.dailykos.com/comments/1474843/59183282

wd7179 Jan 25 · 09:43:37 AM This one tells the real story about single payer...by the way tell us how many countries have single payer. http://acasignups.net/16/01/20/healthcare-i-have-side-hillary Re “that one” — [snip, repeat of stuff already listed above] FYI, If you don’t know who Wendell Potter is, you really need to fix that. The most excellent place to start I think is here: a Bill Moyer’s interview conducted in 2009 called “Wendell Potter on Profits Before Patients.” His support made a huge difference in getting the ACA passed, he testified before Congress several times I believe.

Managed to get a response from brainwrap on that one, lol. He was mostly pissed that I called him out for not responding (I do have some empathy for him there), here is part of it:

Regarding Wendell Potter: Yeah, I know Wendell. HE CALLED ME a year and a half ago (unexpectedly) to discuss the ACA, open enrollment and my work with reporting the data. We spoke for a good hour plus about a great many things. He and I are even part of the same stable of freelance healthcare/ACA writers over at healthinsurance.org from time to time. So please, spare me the “Gaba didn’t reply to me, therefore he’s turned into a corporate/Hillary shill” stuff. I never thought I’d be hearing this sort of crap about myself from the dKos community. I guess I’m “Part of the Establishment” these days as well, just like Planned Parenthood, Human Rights, Paul Krugman, Ezra Klein, etc etc etc...

I responded with this:

Brainwrap, perhaps you don’t realize it but you are more of public figure now. People who admire you are using your endorsement and saying “Brainwrap says, Brainwrap says” in the same manner that they say “Krugman says, Krugman says”. They don’t necessarily understand the details of what you are saying, but they become self-righteous in their belief that because such a respected figure endorses it, they must be right. Which is exactly what wd7179 did right here. Your endorsement is a big fucking deal. Yes, indeed, you have the right to not respond to any post. But I have rights too. So no, I’m not going to “spare you”. You still have the right to not respond, but I have the right to point out your silence regarding my concerns. ACA as it stands is the “The Insurance Industry Profit Protection and Enhancement Act.” That is a huge problem that threatens Social Security and Medicare, and I plan to bring that to the attention of as many people that I can. I respect you a great deal, and I’m sorry that we are standing on opposite ends of the spectrum on this.

There is more dialog, perhaps it gets wonky ... if you want to see it, you'll have to go to TOP, I'm afraid.

Then a diary by greywolfe359 was putblished:

Hillary's Fastest Flip-Flop Ever: We Know We Can Have Universal Health Care We Can Never, Ever Have

Brainwrap Feb 02 · 06:21:38 AM Recommended for the truth that the premise of the diary is false. However, it’s actually the other way around: Bernie’s plan may be Universal...but Universal does NOT HAVE TO BE SINGLE PAYER. Brainwrap how on earth can you say that the premise of the diary is false? The premise of the diary is that Hillary Flip-Flopped, which is absolutely true. 1) There is no reference on her campaign website to universal health care or to a public option. None. Zero. Zilch. 2) As the diarist noted, “Just a few days ago, she told us “we are never, ever” going to have universal health care in this country.” "I want you to understand why I am fighting so hard for the Affordable Care Act," she said at Grand View University after hearing from a woman who spoke about her daughter receiving cancer treatment thanks to the health care law. "I don't want it repealed, I don't want us to be thrown back into a terrible, terrible national debate. I don't want us to end up in gridlock. People can't wait!" She added, "People who have health emergencies can't wait for us to have a theoretical debate about some better idea that will never, ever come to pass. Clinton is giving a false impression that Sanders wants to take away any good things that the ACA has accomplished and leave people without healthcare. while we wait and argue about universal health care. This is dirty, shitty politics to beat an opponent who actually has the courage to stand up for universal health care and fighting the outrageous greed of the healthcare industry. When Chelsea told this same shit, the Sanders team issued a clarification statement, where he said positive things about the ACA. Yes, the ACA has mechanisms to achieve universal health care. The fucking question is how will those mechanisms be used? You don’t have any proof that Hillary is going to use the ACA, you just back her because you know she “could” use it. Meanwhile, when Sanders puts forth proposals to actually do such a thing, YOU DON”T GIVE HIM CREDIT and he has to endure attacks from the Clinton machine. When Chelsea spread her bullshit about how Bernie wanted to dismantle the ACA, the Sanders campaign put out a statement which isn’t so interesting, but something inside of it is: WASHINGTON – Arianna Jones, a spokeswoman for Bernie Sanders, issued the following statement on Tuesday in response to Chelsea Clinton’s attack on Sanders’ health care plan: “It is time for the United States to join the rest of the industrialized world and provide health care as a right to every man, woman and child. A Medicare-for-all plan will save the average middle-class family $5,000 a year. Further, the Clinton campaign is wrong. Our plan will be implemented in every state in the Union regardless of who is governor.” Click here for the truth about Bernie Sanders’ plan to create universal health care. Do you see that bit about the Clinton campaign being wrong? They attacked him over the possibility of using the ACA at a state level because of the negative impact of Republican governors. Please explain to me why they were right to attack him and say that Sanders plan would leave healthcare in the hands of governors.



The link in the statement gives you a fact sheet, which only says POSITIVE things about the ACA: Ultimately, this bill mirrors the legislative methodology of the health exchanges set up by the Affordable Care Act, as opposed to the Affordable Care Act’s Medicaid expansion provisions, which were invalidated by the Supreme Court. While GOP governors were able to refuse the Medicaid expansion, if they refused to implement a state health exchange, their citizens would merely be able to enroll in health care through the federal exchange. Through the Affordable Care Act, 13 states implemented state-based marketplaces; four others implemented state-based marketplaces, yet let the federal government do the IT-work by having their citizens use the federal healthcare.gov; 7 instituted state-partnership marketplaces that administer consumer assistance on the state level while allowing the federal government to handle the rest; and the remaining 27 states yielded all marketplace functions to the federal government. As a result, as of June 30, 2015, 7.2 million Americans in 37 states had enrolled in health coverage through the federal exchange, despite their states not implementing a state-based exchange. I am convinced that one of the first steps that Sanders would take on the road to single payer would be to give us the Public Option on the ACA. Hillary is making it very clear she is not going to work to give us a public option. Yes, there is a lever in the ACA that can be used to get us closer to universal than we are today. The question is, how will the next president use that lever? Give me your evidence, not your hopes and fantasies, that Hillary will actually pull that lever to push for universal, because not only do I not see it, I see the Clintons beating up Sanders for even discussing that possibility. Hillary has neither a plan nor even the will to achieve universal health care. Your words simply astound me. Please write a diary and show all of us both 1) Hillary’s plan to achieve universal health care without putting our country in great debt to the insurance companies, and 2) why it will be successful, especially why it is a better plan than what Bernie is advocating. If you are right and I am wrong, I would be THRILLED. Thank you.

Got 1 rec with this one, but no reply from Brainwrap. That's usually what happens when your opponent is stumped and cannot give you an answer: you just get silence. Do they change their views because of the facts that you've shared? No, of course not. And now Brainwrap is even more in for Hill than ever before.

Brainwrap is a busy, busy guy, which affects his ability to respond to comments. At the same time, he has discovered he has a certain amount of "power of the pulpit" now, and so IMHO he needs to be accountable for how he has chosen to use it. He never provided responses to address my questions and concerns. I tried to educate him, but he did not listen. At this point, I am writing this diary to have a reference of my experiences and opinions regarding the ACA all in one place. I'm hoping that some others in the community may find it to be useful.