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What Really Worries Democrats About Obamacare

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Ignore the media, and the liberal spin.  There is one simple political reality:  Democrats across the board are extremely worried about the Affordable Care Act, and its effect on the 2014 elections.

I have quite a few connections to staffers and other behind-the-scenes people in the Democrat Party.  Talking to them, there is a consensus: they are in trouble.

Some of them fully believe that Barack Obama, Kathleen Sebelius and the rest of the President’s administration can right the ship, and some make the Obamacare system functional enough to please the public.

Most, however, don’t believe anything of the sort.

There is a reason for this:  for all the bluster and hot air about the Obamacare website debacle, that is the least of the worries for liberal supporters of the health insurance reform plan.  In fact, the failure of the website may actually be hiding some of the more pernicious aspects to the health care law.

So here is a timeline of the largest hurdles  the supporters of Obamacare face over the next twelve months:

 

November through December 2013

The enrollment numbers for the first month were terrible, and that is unlikely to dramatically change any time soon.  Initial numbers stated the total enrollment nationwide for October was a meager 50,000 or so.  That is less than 1/10th of 1% of the total necessary to keep the system sustainable.

Obamacare defenders will try to spin that the tens of thousands added on to the Medicaid system as a sign of success, but even people not familiar with the ACA understand it is easy to give away free stuff; It is another thing entirely to get Americans to pay their hard-earned money into the system, when that system may not provide them any great benefit in the near term.

The website functionality is going to be an ongoing challenge as well. President Obama and HHS Secretary Kathleen Sebelius both promised that the website would be working by the end of November.  That now appears to be another ‘incorrect promise’ and frankly, most IT experts I talk to would be surprised if the system is up and running before February.

Website Security will be an issue as this process continues as well. Consumer Reports and others already warned Americans that they should wait until major fixes in the security loopholes were corrected. On 11/19/13, there was testimony that the website places user data at “critical risk” despite recent government assurances it is safe to use.   Several security experts have predicted a large-scale breach in security. Imagine millions of Social Security numbers, credit card numbers, along with IRS tax data and health data being breached.

Amazingly, the entire ACA Payment system also has to be built, after three years.  There is no system at present to transfer funds from the Federal government to the states or to insurers.  And even more shocking? On November 18th, the head of the IT for the ACA admitted that at least 30% of the ENTIRE IT INFRASTRUCTURE still needed to be constructed.

To compound matters, the system also has a nonfunctional subsidy calculator.  What does this mean?  Right now, they are only estimating individuals expected subsidies.  However, if the estimate is incorrect and over estimates your subsidy, you could be liable for hundreds or thousands of dollars more in premiums next year.  This would be problematic in the best of situations.

To compound this problem, the administration is trying to shunt customers to private insurance websites, as a ‘work around’ for  the broken Federal exchange.  The problem is, it is technically against the law for purchases outside of the exchanges to receive federal subsidies.  What happens if a legal entanglement results in those subsidies to be ultimately rejected?  Customers could be in for a real disaster if they agree to purchase insurance, only to find they are not eligible for subsidies.

 

January through June 2014

The first problem is one I have already written about:  Obama will have to break his promise that If you like your doctor, you can keep your doctor.  This promise could never have held true in the market that Obamacare creates, because as predicted, many of the policies purposefully eliminate expensive and elite institutions.

I personally have been booted off of several health care plans because of a cancer center I work at.  I know many doctors stating similar experiences at elite institutions such as Memorial Sloan-Kettering Cancer Center, Mayo Clinic, Cleveland Clinic, and other prestigious institutions. The most famous case was a cancer patient in California who wrote an editorial in the Wall Street Journal, and who could no longer see her oncologists and other treating physicians, because the California exchange had no policies that would include all of her physicians.

The next major debacle will be the surprise of high deductible payments. The majority of the policies being sold are the cheaper ones on the exchanges; the so-called Bronze and Silver plans.  The average yearly deductible, after paying your premium for these policies, is around $5,000.  There is a high degree of variability, but on average these are high deductible plans.  What will happen the first time there is a sick child, and a $5,000 deductible stands between that poor family and a life saving procedure?

One interesting twist will be the use of Obamacare Navigators.  This was a program the administration started to ‘guide’ customers through the process.  Sounds great.  Except for one problem:  many of the Navigators were not appropriately screened, and there has already been a fair amount of fraud in this group of government workers. Undercover videos of Navigators telling customers to defraud the government have already surfaced, and I am sure you will see dozens of those as time goes on.

 

July through September 2014

This is actually when the rubber meets the road.  By this point, no matter how incompetent the administration’s IT experts are, virtually everyone that wants to have insurance should have insurance.  The website problems, even if they still persist, should no longer be relevant.

The first question that will arise is how many people chose to pay the penalty?  For many of the lowest income persons, a penalty of $95 was all that was required to opt out; with the high expense of many plans, a fair number of people will choose this option.

More important is the ratio of healthy individuals compared to sick ones in the exchanges.  For the exchanges to survive, they require a very high ratio of healthy people buying in, in order to subsidize the rest of the population.  Recent data from Kentucky (supposedly a liberal success story) shows that the ratio of healthy to sick is closer to 1:4 than the close to parity required for financial sustainability.

What happens if this does not occur?  Insurers will enter the oft talked about ‘death spiral’.  They will be required to raise their future premiums in 2015, because the cohort of patients in their insurance pools are less healthy, and thus, more expensive to treat.  The death spiral occurs as young, healthy persons realize that the increased costs of their insurance is not worth it, and opt out…further increasing the ratio of sick persons in the insurance pools, and further increasing costs.  This is the scenario that most scares Obamacare proponents.

The irony of all this is this presumes that the individual mandate  is not delayed.  Right now, the Upton and Landrieu bills sit in Congress, and Obama has announced his executive order to ‘fix’ the problem of policy cancellations.  The more delay of the individual mandate, either by legal methods or presidential signature, the more likely it is that insurers will have costlier insurance pools that will drive up premium costs moving forward.

The next problem is how this huge new population of insured patients will be treated by a system that is already overburdened.  A doctor shortage very well could arise.  Something similar, but to a lesser scale, occurred during Romneycare’s implementation in Massachusetts.  Massachusetts was more prepared than most states, as it has the highest ratio of doctors to patients in the country.  Even then, access to physicians, especially specialists, was restricted substantially.  Now imagine the states with low doctor to patient ratios, and you can imagine the complications that could arise.

That doesn’t even take into consideration that many physicians are likely to opt out to the largest expanding health care insurance program in the country:  Medicaid.  Already in states like New York, about a third of doctors have opted out.  Many physicians, especially those tied to hospitals, cannot opt out.  But this decrease in available primary physicians to handle this huge new number of Medicaid patients (who are among the sickest and poorest patients around) could be a disaster, and there is no short term solution to this problem.

 

October through December 2014

This is where all the real excitement occurs.  Let us assume some how, some way, Democrats have survived the year without any major catastrophes, and are holding their head above water as the midterm elections come.  There are several huge hurdles still remaining. 

The first, and largest by far, will be the kicking in of the employer mandate. Remember that this mandate was supposed to occur this year; however, because of the completely broken and unworkable system, Obama delayed it (outside of legal bounds no less).  But the employer mandate is the crux of the entire system; the majority of Americans get their insurance through their employer, and insuring this mandate is vital to that majority.

The problem arises in the fact that in the same way that millions are losing their private insurance plans today, even a greater number of employees are likely to either lose their plans or see drastic changes next year.  This was predicted by the Department of Health and Human Services as far back as 2010.  Now is when that change kicks in.

Furthermore, millions of small business owners will have to decide whether to pay for insurance, or send their employees into the exchanges; the same exchanges that are so far struggling to handle the volume and load.

For employers that are going to continue their insurance plans, another problem: they will likely get notices from insurance companies that the plans they currently purchased no longer exist.  Sound familiar?  And insurers will, under Federal law, have to do that a minimum of 60 days before cancellation, meaning…the beginning of November, at the very latest.

And, remember the ‘death spiral’ we discussed above?  If insurers face that hurdle, they are likely to raise rates across the board.  Here is the biggest problem of all: for all the talk about these changes affecting only the people on the exchanges, if and when a ‘death spiral’ or anything like it occurs, costs will rise for everyone.  That means increased premiums for businesses, which will likely be passed on directly to employees.  Some employers will also likely choose the easy option, which is shifting their employees to the exchanges.

And all this will be announced just weeks before the election.

 

After all of this, you begin to understand why those that truly understand the steps necessary in the next year to implement the full-scale of the Affordable Care Act are worried.  Right now, we are seeing the tip of the iceberg: gross incompetence in establishing a website for entry into this behemoth government monstrosity.

But once you enter this behemoth, you start to understand that there are numerous interweaving and interconnected cogs that will need to work relatively smoothly, or the system as a whole will flounder.

That doesn’t even tell the political story.  Every week, if not daily, there will be a story about individuals who are being harmed by the ACA.  Those stories will drown out any of the positive stories, because we know that ultimately the media highlights the negative.  As stated above, when a child or young mother is denied life saving treatment because of restrictions placed upon them by Obamacare, who takes the blame?

Liberals are trying to circle the wagons, to keep sustainable political support for the plan, in the hopes that the Obama Administration can fix the problems in short order.  But as you can see above, there is no simple fix.  Many of the ‘problems’ with Obamacare are inherent to the system that Democrats devised.  These were intended results.  How do you fix the plan, when it is the intent of the plan that is the problem in the first place.

So batten down the hatches, America…it is going to be a bumpy ride.

 

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Gettysburg Address Sesquicentennial

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150 years ago, today:

Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate — we can not consecrate — we can not hallow — this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us — that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion — that we here highly resolve that these dead shall not have died in vain — that this nation, under God, shall have a new birth of freedom — and that government of the people, by the people, for the people, shall not perish from the earth.

Abraham Lincoln
November 19, 1863

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Democrats To America: We Lied, But You Should Apologize

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What a hilarious dynamic you now have in the Democrat Party.

The civil war I described earlier is between two, diametrically opposed views.  One is the Obama Progressive Idealistic wing: they will push Obamacare, no matter what.  If there is absolute, positive evidence that the program doesn’t work, it wouldn’t alter their belief that their plan must be enacted fully.  Reality matters little to this wing of the party; they simply are fanatical idealogues.

The other cohort is the Pragmatic ‘Do and Say Anything to win elections’ wing of the party.  This was most famously led by Bill Clinton, but now numerous Democrats that are (SURPRISE!) up for re-election next year have joined as well. Mary Landrieu, Kay Hagan, Mark Begich, and moderates such as Joe Manchin belong in this group.  They believe they must placate the angry American electorate first and foremost. What is ironic is this group doesn’t care about the success or failure of the ACA either; they simply want to do enough to get 50.1% of the vote next year.

And in the middle is the rest of America.

Americans feel betrayed.  They never truly supported the Affordable Care Act, but a majority of them trusted Barack Obama enough that they gave him the benefit of the doubt; that, more than anything explains Obama’s re-election.  The benefit of the doubt on the economy, on foreign affairs, and yes…on Obamacare.

That trust is now broken.

Look no further than the recent polling from numerous agencies.  Trust in Obama has collapsed entirely.  On most issues, Republicans are more trusted; remember, this was the party who a few weeks ago was less liked than many venereal diseases.  Obama is doing worse than that.

And what has Obama and Democrats done to respond to Americans discovering they have been lied to?  Basically, they blamed…everyone but themselves.  The list is long.

It was Republicans fault for not working with Democrats; even though the GOP correctly and appropriately predicted the problems that have now occurred.

It was the fault of the media, for not spinning more.

It was the fault of contractors, who failed to do their job, as if government oversight wasn’t the administration’s responsibility.

My favorite? It was the fault of average Americans. Why?  Because they were foolish or stupid to believe the lie in the first place.

If you think I am exaggerating, simply go read some of the ‘elite’ liberal columnists out there. This last excuse actually has become common place among the liberal intelligentsia.

The quandary that liberals are in leaves them between a rock and hard place.  Either they can follow their fanatical ideology, and fight for the Affordable Care Act, even though more and more evidence is coming to light that the plan cannot achieve the major goals set for by Obama himself.  The alternative is to pass something like Landrieu’s Senate plan, allowing people to keep their current health plans; that would blast a hole in the central tenet of Obamacare, which is to redistribute health care dollars from the healthy to the sick.

I actually agree with many liberals:  no amount of running away from Obamacare is going to save Democrats this time. They own this, in totality.  Ultimately, the only thing that would save them would be a competent rollout of the remainder of the system, which at this point seems highly unlikely.

Which means, when the 2014 election rolls around, we can truly see who deserves to be delivering, and receiving, apologies.

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The Early Stages Of A Democrat Civil War

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An interesting dynamic is brewing in Congress among Democrats, and with the White House in the middle, as their circular firing squad on Obamacare continues.

Greg Sargent of the Washington Post as well as other liberals have pointed out that Sen. Mary Landrieu’s Keeping the Affordable Care Act Promise Act , which is a various of Republican Rep. Fred Upton’s Keep Your Health Plan Act, is forcing the hand of Democrats in the House of Representative.

Landrieu’s plan is going to be hard for Red State Democrats to ignore.  Poll numbers on Obamacare are plummeting as the Administration’s incompetence becomes more apparent.  Sen. Kay Hagan’s vanishing lead in North Carolina will only hasten to increase the pressure on these vulnerable Senators.  Furtherm0re, even relatively safe liberals like Jeff Merkley of Oregon have signed on to Landrieu’s plan, showing the political pressure Democrats are under.

For the House, who has always been more steadfast in their support of President Obama, this puts them between a rock and a hard place. Most House Democrats are in safer districts than their Senate counterparts, and thus can afford to hold the line. But how much pressure is too much?

This builds an interesting dynamic of triangulation for the White House.  They need to balance the needs of their liberal allies in the Senate, while still making the political choices palatable to their friends in the House.

But this becomes more difficult by the day.  Again, from Sargent:

A senior Democratic aide tells me opposition to the Upton plan will be increasingly difficult to maintain among House Dems if the administration doesn’t offer a workable fix of its own. The aide adds the need to maintain House Dem opposition has been made more urgent by another problem: Senate Dems (the latest being Dianne Feinstein) supporting their own politically expedient “fixes” that could also undermine the law.

“Now that Feinstein has broken off, that makes it even more important that House Democrats stay together as much as possible — to keep Senate Ds from caving,” the senior Dem aide says. But the aide adds, in a reference to this week’s House action: ”We need an administrative fix that works before the vote.”

This puts all the pressure on Obama; but his choices are slim.  Delaying the individual mandate is actually very bad policy now (I personally oppose the Upton plan for a myriad of reasons). Obama cannot do that and not make the systemic problems worse.  There is no Presidential order that will give people their insurance back to them.  And the other legislative fixes are nonstarters either in the House or Senate.

So one of two dynamics shape up: one, the Senate passes Landrieu’s bill, and House Democrats are left fighting a losing fight against the Upton bill, in which case they will have to defend voting against this bill to the public.

The second option is that House Democrats fold, and Obama is forced to veto this bill, in which case all the blame falls upon him, after he just promised he would do ‘everything imaginable’ to fix the problem.

Either way, there isn’t any safe harbor for Democrats on this issue.  They are fooling themselves that any of this will  protect them from the wrath of the American voter if the ACA fails as incredibly as events so far have shown. From a political standpoint, I think at this point they would be better served to circle the wagons and defend their progressive policies.  But the panic instinct among politicians is so profound, they must appear like they are doing something productive, even when the target of their attacks are members of their own party, or their own President.

So the Democrat circular firing squad continues.

 

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Obamacare’s Frightening Reality

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Here is a personal story.  My wife has a friend in New York who is in her early 40s and was found to have breast cancer last year.  The woman had metastatic disease, and her condition was considered grim.

This woman then was recommended by both my wife and I to go to Memorial Sloan-Kettering Cancer.  I trained there, and know it is one of the premier cancer centers in the world.

Luckily, this woman had health insurance, which her husband pays for out of pocket, because he runs a personal business.

Now, here is where it gets interesting. First, this woman is a huge Obama supporter. So much so, she campaigned for Obama in 2008 (she went to New Hampshire during the primaries, and stayed in a hotel there for several weeks on her own dime campaigning for the Obama effort).

I spoke to her last night, by coincidence.  And her opinion was shocking.  And it changed because of an Op/Ed from a cancer patient that was published in the Wall Street Journal last week.

The article was written by Edie Littlefield Sundby.  Ms.  Sundby is the victim of stage IV gallbladder cancer, a horrible disease that has a very poor 5 year survival rate.  She had been lucky to have excellent insurance, and had been treated at premier cancer centers at the University of California; Stanford University’s Cancer Institute; and the M.D. Anderson Cancer Center in Houston.  All three are consider top tier cancer institutions.

However, she just found that her insurance has been cancelled because of regulations placed upon it by the Affordable Care Act.  She can still get insurance, but none of the choices available to her would allow her to continue to see all of her physicians, as  her old plan did.

People who have never dealt with cancer treatment would wonder, “Why not change your doctor?”  However, cancer is unlike most things in medicine.  A detailed therapy plan often is only available with certain institutions and doctors, and not everyone provides every therapy.  Moroever, after myself working at Sloan-Kettering, I have seen how these elite institutions provide far better results with stage IV and advanced cancers than many other institutions.

Now, this brings us back to my friend, the Obama supporter.  She is truly worried now.  She is still going to Memorial Sloan-Kettering for treatments, and likely will have to for the rest of her life.  But now, she is unsure if her insurance will be there when she needs it.  She and her husband have expected to get the cancellation letter in the mail, and right now, her search of New York’s health exchange has not given her a solution that would allow her to not only see her local doctor, but to see her physicians at the Cancer Center as well.

This is the reality of the ripple effects of the Affordable Care Act.  And you will continue to hear stories like this, over and over again.  And Democrats will have to defend their choices, now that they have real world consequences.  If the Obama Administration can convince people that they will maintain their same high level of care for a reasonable price, then all these worries go away.

Right now, Americans like my friend are not convinced.

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Thor: The Dark World: Movie Review

thor the dark world poster

Thor: The Dark World is in my mind one of the tougher movies to make in the Marvel Universe.  Heck, I thought it was a minor miracle that Director Kenneth Branagh made a half way decent first Thor film.

There is a reason for this.  First, Thor is a strange character.  He is semi-god, who comes from an alternate reality where Norse gods are real.  Kind of hard to relate to any of that, isn’t it?  Heck, how many of us really remember what the Norse gods stood for anyway?

In the comics, Thor is sometimes portrayed as God-like, but sometimes portrayed as half insane.  Even more confusing.

But Branagh pulled it off the first time; the first film introduced a new generation to Thor’s world, and in an enjoyable manner.  However, repeating a miracle is always a tough chore.  Into that tough task comes ne Director Alan Taylor (Game of Thrones).

Compounding this is the fact that this all comes after the events of the Marvels Avengers movie.  We say a galactic power invade Earth, only to be repelled by the power of Earth’s mightiest heroes. So what greater threat remains?

In this episode, we immediately are faced with another galactic threat: that of Malekith (Christopher Eccleston), leader of the Dark Elves, who wants to destroy the Nine Realms (governed now by King Odin, played by Anthony Hopkins).  A millenia before, Malekith threatened to return the universe to darkness during a convergence of the Nine Realms.  But Bor, Odin’s father, defeated Malekith, and banished all the Dark Elves to eternal slumber.

How Malekith brings back his power and tries to achieve his goals is convoluted, unscientific, and largely mystical.  And this is where I am sure this movie will lose a lot of people  And that is, at its very heart, the problem with Thor as a character.  He is a magical character, not a realistic one, and his entire existence must simply be accepted on faith, as must the rest of his world.  Some people can’t make this leap.

Furthermore, as a standalone movie, this is a terrible piece of moviemaking. If you haven’t seen Thor, or the Avengers, you might as well not even show up for this installment.  They are all interconnected, and the value is significantly diminished if you aren’t totally invested in the entire Marvel Universe.

That doesn’t mean that this is a terrible movie.  In fact, if you like Thor as a character, I think you will thoroughly enjoy this movie.  The best scenes are between Thor (Chris Hemsworth) and his recently imprisoned brother Loki (Tom Hiddleston).  Much of the movie is about how Thor and Loki must find a way to trust one another again in order to save their world.  Loki is the most entertaining character in the movie by far, and dominates every scene he is in. Only the scenes with between Thor and his female platonic companion Sif (Jaimie Alexander) can compare.

On the other hand, Malekith is a bore as a bad guy.  Natalie Portman is a non-essential part of the scenery, and you wonder at points why Thor would bother with such a lame mortal.

The battle scenes are brutal and more interesting, as we see the true force and power of Asgardians and their enemies, and Thor wielding Mjolnir.  Asgard itself gets much more time on screen, which true fans will love.

Overall, this is a mediocre film. If you are a fan of the Marvel Universe, especially of Thor and Loki, you will definitely enjoy it.  If you are not a major fan, you would be best served skipping this until some later date.

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What Christie/McAulliffe Victories Mean

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So, the media will talk a lot about the national significance of these two races, because there is not much else to talk about. This is a repeating event every four years, because there is nothing else to do between the Presidential and midterm elections.

So what can we really learn from these results?

1.  Off year elections don’t mean much.

Historically, these elections mean little to nothing.  You can take a lot of meaning into Christie and McDonnell winning four years ago, right before the Tea Party swept the 2010 elections, but there were many local issues that drove both candidates to victory that were far more important than national trends at the time.

I am sure many liberal bloggers will put a lot of weight into McAuliffe’s victory, and give credence to the argument that the shutdown helped him win, or the Obamacare debacle didn’t hurt him, or some other wacky theory.  But the reality is, McAuliffe ran a better campaign, that was better funded. It was as simple as that.

But, at least it gives the media and bloggers such as myself something to talk about.

2.  Chris Christie starts his Presidential run tonight.

This is among the worst kept political secrets in America, along with the fact that Hillary Clinton is running for the big job.  Christie sees an opening, as do other moderates.  Their view is the GOP has been losing elections because it has moved too far to the right, and that we need a strong moderate leader to take the helm.

Of course, forget the fact that the last two nominees of the GOP are the milquetoast Mitt Romney and the ‘Maverick’ John McCain. I think that claim is dubious.  For me, however, there are more important political trends that Christie’s re-election points to.

First of all, Obama, Democrats and Republicans are making the stench of the beltway toxic to the American voter.  Christie, as the consummate outsider, can use that. He is fat, gruff, at time boorish but glaringly and painfully honest…everything that Barack Obama is not.  2014 and 2016 are likely to be election cycles where being an outsider is a boon, and Christie plays that role quite well.  Just wait and watch Hillary try to run away from her State Department and Obama roots as well.

Second, Obama’s gross incompetence is going to make Americans look for a true manager, and that to me means an obvious solution:  Governors.  Christie may not be the guy, but my guess right now is that a Republican governor from somewhere is going to win the GOP nomination.  Christie believes he is that guy; I am not so sure.

But let us not discount Christie’s achievement.  As Sean Trende pointed out in his piece today, Christie is likely the most conservative statewide elected politician in New Jersey in more than half a century. Christie has run a moderately conservative fiscal plan with a few socially conservative leanings in a far blue state…and is going to win running away. That is pretty unique in the GOP in the last generation.  I may not be the biggest Christie fan, but the achievement is remarkable nonetheless.

3.  The Virginia result is even less important.

Some liberals will say that this is because the GOP lost.  Actually, I have been predicting a loss here for six months, and have said since August that this will be a 5 point victory.

The count is not over, but it appears the race will be far closer than that.

Some well-known liberal bloggers were calling for a double-digit victory not two weeks ago.  So who is more delusional?

The problem with taking any large arching ramification from the Virginia is simple:  there were too many confounding factors.  First, Gov. Bob McDonnell got caught in a horrible corruption scandal, one nobody expected.  Even though Ken Cuccinelli was no ally of the Governors, and continued to try to distance himself, that stench never went away.

Second came the shutdown.  I am not sure how much effect it really had ultimately (I actually think as of election day most people have already forgotten it; exit polls will tell us more), but it certainly halted any effort Cuccinelli made to close the gap in early October.

Now, compound that with a relatively strong third-party candidacy from Robert Sarvis, with many Republicans defecting to the third-party, and I am not sure what to make of the entire mess.

With all that, the GOP candidate likely is going to lose by less than 4 points.  Of the few lessons we can learn from the race, one is this:  the polls should be ignored by the GOP when races are close.  McAuliffe outspent Cuccinelli 3:1, and in the late stages of this election, that could have driven up Democrat votes in D.C. and Richmond, and stifled conservative votes in those regions.  This was a winnable race.

Furthermore, the exit polls are very worrisome for Democrats.  Blame for the sequester?  46% Obama, 47% Republicans for Congress, according to VA exits. Obamacare was upside down, 46% to 53%.  The real terrible story for the GOP was single women, which they lost by…40 points.

4.  Cuccinelli is ideally a poor candidate for modern Virginia.

Virginia is a blue state.  That is the first reality.  Second, it is a major urban population, with the suburbs of Washington, D.C..  Thus, Virginia should be considered more along the lines of Pennsylvania than North Carolina.

As such, Cuccinelli is a poor candidate.  Assuredly, he made his name opposing Obamacare in the courts, but he was almost as well-known for his very strong beliefs in criminalizing certain societal acts, such as homosexual sex and his defense of sodomy laws in unique situations, turned off a large swathe of conservatives.  I know this as a fact, as many of my Virginia friends, those that would vote for Tea Party candidates like Rand Paul and Ted Cruz, absolutely refused to consider Cuccinelli.

The GOP must learn that it can stay a socially conservative party; but pushing legislation to dictate the actions behind closed doors of consenting adults simply is a non-starter, even among many (if not most) social conservatives.  Conservatives are largely moving toward become libertarian on these social issues.

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Overall, it was a mixed bag.  I think Democrats can take heart that they retook the Virginia Governorship, but by a much slimmer margin than the polls and conventional wisdom imagined.

For the GOP, they need to learn a couple of lessons.  First, ignore conventional wisdom.  Conventional wisdom stated this race could not be won, that Cuccinelli was done after the shutdown, and the race was a blowout.  All three  suppositions were false.  Cuccinelli’s clear negatives were on social issues, where the GOP needs to hone their msessage; nothing wrong with social conservatism, but it is not the primary issue voters are concerned with.

The shutdown was not the negative that the mainstream media wanted us to believe, three short weeks ago; that effect has already dissipated.  In fact, one can argue (and I admit is is arguable both ways) that Obamacare had more effect on this race ultimately than the shutdown did.  I am sure liberal and conservative commentators will be arguing that for months.

However, a big night clearly for Chris Christie, as he is going to be the clear frontrunneer for the GOP nomination, until a true conservative alternative can come and show they deserve it more.

 

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Ender’s Game: Movie Review

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Ender’s Game, the novel by Orson Scott Card, is considered one of the pinnacles of science fiction over the last half century.  It presented a universe in which the human race was out of ideas to save itself, and looked at the only alternative left to it:  its children.

We enter an era in which the previous generation of humanity had to face its greatest threat:  an invasion of frightening, insectoid like creatures who could neither be defeated nor negotiated with.  Humanity’s survival form that alien incursion was more by luck and circumstance than skill and technology.  In response, the Earth’s military minds prepare for the next Alien invasion by forming the elite Battle School.

The protagonist is Andrew (Ender)Wiggin (Asa Butterfield of Hugo fame), a child of a brilliant family of children, who is closely analyzed and followed by the elite military minds of the world, who scour the Earth for potential candidates for their prestigious Battle School.  His older brother Peter is just as much a genius as Ender, but has an uncontrollable violent streak.  His sister Valentine (played by Abigail Breslin) is the person whom Ender loves the most in the world; and the reason he loves her (for her pure emotional attachment) was a reason she was not considered an ideal candidate.

However, Ender is the ideal candidate:  a genius who is emotionally attached enough to fight for his family and humanity, while vicious and violent enough to destroy his enemies should the need arise.

Thus enters Colonel Hyrum Graff (Harrison Ford) and Major Gwen Anderson (Viola Davis), who run the school. Graff was integral in identifying and choosing Ender for the school.  He enters him into the Battle School, where much of the action of the movie takes place.

Underlying all this is the fact that the training of these killers is being done with children.  The adults are forming a military force that focuses on young, agile minds, and turns them into tactical killers.

Ender’s rise to the top of the class is painful, emotional, and angst ridden, which is quite the point.  Much of it is orchestrated, as the children are played like puppets, one against the other.  By the time Ender meets his hero Mazer Rackham (Ben Kingsley), he is already a leader waiting to take command.

The end scenes of the movie are critical in later enjoying the rest of the plot.  The critical moments of the movie put Ender to the ultimate test. And this is no classical war movie with children with a clear happy ending.

Overall, the best performance here was by Harrison Ford.  I cannot recall the last time I enjoyed his acting as much.  Asa Butterfield is shaky at the beginning, but is solid in the rest of the movie.

Overall, I think this is a solid adaptation of one of my favorite science fiction novels.  Well worth the wait.

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Obamacare Rollout: What We Know, 1 Month Later

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So, as November 1st arrives, we were supposed to get a good feel if the rollout of the Affordable Care Act was going as planned, trajectory of insurance purchasers, relative cost comparions, etc.

We really have none of the above.

The website debacle has basically brought the entire process to a standstill.  People either were unable to purchase insurance, or were so turned off that they didn’t bother.

So what we don’t know, and the data lacking therein, far outnumbers the things that we demonstrably do know.

So, to get past the political spin, what data is there? What, if any, conclusions (partial or otherwise) can we make?  What do we know, for certain?

1.  The Website has issues; major issues. 

The website problem is not a simple fix.  Testimony this week on Capitol Hill clearly demonstrated that.  The officials from the Department of Health and Human Services, as well as contractors paid to build the web platform, didn’t agree on much, but they did agree on that.

A repeated promise was made in hearings however:  that the website would be operational by November 30th.  That is a dubious promise.  If the problems that exist in the website are as reported, it is not simply fixing a few lines of code that will make everything all right. There are major isuses, not only with the code but the basic structure of the system, the transfer of data from the web platform to-and-from major databases, and communication with the insurers themselves.

It will take a Herculean effort to truly make the system operational by the end of November.

Furthermore, the tech surge that President Obama largely seems to be rhetoric, as the majority of those chosen to run the new effort are long term Beltway insiders.  If anything should give you pause, that should.

2.  Medicaid enrollees are far outnumbering purchasers of insurers. 

This may be the most worrisome part of what has happened over the last month, even more than the website issues.  Fundamentally, the entire premise of the ACA rests on the balance of having new people buy insurance on the markets, to partially ‘subsidize’ those millions being added to the Medicaid rolls.

As a Washington Post article today noted, on many of these exchanges, Medicaid enrolles are ounumbering purchasers 9:1. That is a death knell for the system if it continues.  As the CBO reported from the beginning, we need closer to a 1:1 ratio (the CBO says the ratio of Medicaid enrollees:insurance purchasers should be approximately 9.1:7.9, to be precise) to maintain fiscal sustainability.

However, we simply don’t know if this is a short term blip or a long term trend.  This could all be a result of the poor website functionality, which then had a ripple effect in the marketplace.  Or it could honestly be that purchasers don’t like what they see, and may choose option B, the Obamacare tax penalty…which would be fiscally disastrous for the system.  That would be the leading edge toward the ‘death spiral’ that the Administration and insurance industry fears so much.

3.  The Administration has come catch up to do to make their enrollment targets for 2014. 

To maintain the system, they need a minimal number of paying customers in the Exchanges, as described above.  The number the CBO has stated is approximately 7 million by the target date (which, after the White House pushed it back, is now the end of March).

They had expected to sign up about 500,000 people by the end of October.  That number will be missed by a large margin.  Secretary of HHS Kathleen Sebelius refused to release the numbers, but most estimates state that the number of policies actually sold will be far less than 100,000

That number is not going to significantly improve in the month of November, because the website is still largely nonfuctional. Then comes the busy month of December, with the intrusion of the holidays.

My guess (and it is only a guess) is that they may not meet their goal for October 31 of 500k purchasers even as of January 1, 2014.

If that holds true, or even if they do better than expected and get up to 1 million person mark, that means that they will have to sign up 6 million persons in three months time.  That is a huge hill to climb.

4.  Liberals blaming Republicans for this mess don’t really have many facts backing up the claim.

Liberals to this day are blaming the ‘intransigence of Republicans’ for the failures in the system.  However, this has been simply disproven:  go to a number of states that have Democrat Governors and legislatures, that have been implementing Obamacare from the beginning, and see if they are doing better.

For the most part, they are not.  Take Oregon, who as of earlier this week, had not had any purchasers of insurance through their exchanges, though they have had tens of thousands of enrollees in Medicaid.  California, New York and others are not much better.

This is largely not a political problem at this point, but a problem of managerial competence or lack thereof.

5.  We have anecdotal evidence of people paying more for insurance after losing their insurance.

This is ONLY anecdotal evidence at this point; and that makes it very hard to really analyze.

Definitely millions of people are losing their current insurance because of the ACA and associated retgulations that are term limiting those insurance plans.  Democrats can blame the insurers, but that is a lie:  the full responsibilty of that process lies with the ACA.  The vast majority of these plans would still exist today if not for the ACA; it is as simple as that.

As for increased health care premiums, we won’t know for a long time if that is a systemic problem, or an isolated one.  Democrats claim those cases are the exception, Republicans claim they are the rule.  The truth is neither side has enough data to make such absolute claims.  And that data will take a long time in coming.  It may take months, but more likely years to know if the ACA is bending the cost curve up, down, or has no effect.  I have my suspicions, but there are only that:  suspicions.

6.  Conservatives should not rejoice; the plan can still be saved.

I know, this is a shocking statement coming from me, considering I have been so pessimistic about the system as a whole.  But the truth is, if there were competent managers in charge of this, this rollout could have gone much better.

The website debacle has a snowball effect, to be sure. We don’t know how many people, but certainly hundreds of thousands of people if not more would have gone on to the exchanges and, most likely with the help of subsidies, purchased insurance if they were allowed to.

Incompetence prevented that.

Where the rubber meets the road is getting people who will not receive a significant subsidy to purchase on the exchanges.  Now, this is really the hard part for Democrats.  So far, from what little I have seen, the insurance plans on the exchanges are more expensive and provide less financial coverage than many plans that were available prior to the ACA.

Democrats will counter that these plans provide ‘more’ coverage.  There is some truth to that, but much of that coverage is not really beneficial to the majority of consumers.  Furthermore, remember that the primary demographic that they must convince to open their pocketbooks and purchase insurance, instead of paying the penalty, is the young, healthy American.  How many of these people are thinking about ‘better’ coverage when they don’t use the coverage they have today?  Are they going to be willing to pay $100-$200 more a month for something they don’t use?

We simply don’t know the answer to that.

Overall, it has clearly been a rough month for supporters of Obamacare, as nothing seemingly has gone right in their rollout.  Can the system be saved? Yes, but it will take not only a Herculean task on the IT side, but a lot of selling by President Obama and the White House, along with a lot of luck, to convince people to do what is not in their short term interest (i.e. purchasing more expensive health insurance) while promising dubious long term benefits.

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Obamacare’s Debacle Denialists: The Sebelius Hearing Version

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I have, both here and on social media, talked a lot about the denial the left is suffering from when confronting the realities of the train wreck that the Obamacare implementation has become.

Today’s hearing with Health and Human Service Secretary Kathleen Sebelius was a perfect example.

As the person in charge of this implementation, you would presume that she would have the most up-to-date information on the program.  That she would be able to quickly and promptly answer where in the process the repair of the exchange website we are.  And, that she could tell us what the legal standard for the law is.

You would be wrong on all counts.

To put it succinctly, Sebelius’s testimony also turned into a train wreck.

But let us give her credit.  Sebelius started the day by taking full responsibility for the website’s failures.  Good, right?  The only problem is, she spent the rest of the day trying to convince the hearing members that it wasn’t her fault, but everyone else’s.  She primarily blamed the contractors for not telling her the truth that there were problems with the site; that is, of course, now documented to be false.  They have documented that they were not provided the access or authority to test the site fully, and that authority only resides at HHS.

But it gets worse.  When questioned about the websites security measures, she could not confirm that it was ever tested for security leaks.  Again, to the contractors credit, they documented that they sent a memo to Sec. Sebelius in the end of September stating this fact…and yet HHS did little or nothing to insure the security of millions of Americans’ data.

Sebelius then made what I thought was going to be the most remarkably stupid comment of the day (but wasn’t) when she claimed…wait for it…that the website has never crashed.   She claimed,  “It is functional, but at a very slow speed and very low reliability.”  But as the graphic at the top of this post shows, the site was not functional during her testimony.  You would think she would have checked before going out there and made this ludicrous statement.

As if things couldn’t get worse, Sebelius was then asked why she didn’t go to the Washington, D.C. exchange to get her own insurance.  She claimed that because she is a Federal employee it would be illegal for her to do so.  The problem?  That is completely and factually incorrect, as the graphic from the HHS site shows:

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 In other words, the HHS Secretary doesn’t know that the law she is trying to implement would allow her to join the D.C. exchange, as her own HHS website clearly shows. You cannot make this level of incompetence up.

After all that, you wouldn’t think that Ms. Sebelius could worsen this debacle; you would, of course, be wrong. During the exchange asking her about the legality of her joining the D.C. exchange, her hot mic caught this little tidbit:

Rep. Billy Long (R-Mo.) asked her to answer, “yes or no,” whether she’d be willing to drop her federal employee health coverage and buy insurance in the exchanges if she could.

“If you can, will you?” he said.

Sebelius claimed that she thought it would be illegal for her to use the exchanges — but that’s not actually true.

Then Rep. Henry Waxman (D-Calif.) made a unanimous consent request so he could ask a question out of turn. Sebelius turned to a colleague and said, “Don’t do this to me.” Those words were caught on her microphone.

Well, frankly, who could blame her?  I don’t want Obamacare to do this to any of us.

But the line of the hearing still hasn’t been mentioned.

Rep. Greg Harper (R-Miss.) asked Sebelius repeatedly whether President Barack Obama was responsible for the troubled rollout of the health-care law that has left HealthCare.gov, the website where consumers are supposed to purchase insurance, largely dysfunctional.

Sebelius repeated that she and the Department of Health and Human Services were ultimately responsible. This led to a back-and-forth between the two, in which Harper tried to pry the answer he wanted out of her before his time for questioning expired.

“While I think it’s great that you’re a team player and you’re taking responsibility, it is the President’s ultimate responsibility, correct?” he said.

“Well, you’re clearly, uh, whatever,” Sebelius said. “Yes. He is the President. He is responsible for government programs.”

Let me give you a little hint folks: if you are testifying in front of Congress, the body representing the American people, don’t ever respond to a question with the term “Whatever”.

The entire hearing was a debacle, and did nothing to support the claim of the left that the Obamacare implementation is in competent hands.  If anything, it gave more support to the argument that the Obamacare debacle denialist brigade is still in charge.

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