That’s what Cass Sunstein concludes after looking at new research:
When people are assured of anonymity, it turns out, a lot more of them will acknowledge that they have had same-sex experiences and that they don’t entirely identify as heterosexual. But it also turns out that when people are assured of anonymity, they will show significantly higher rates of anti-gay sentiment. These results suggest that recent surveys have been understating, at least to some degree, two different things: the current level of same-sex activity and the current level of opposition to gay rights.
Consider one study of 2,500 people involving a standard “best practices” survey and an anonymous “veiled” survey:
In the best practices survey, 11 percent of the population said that they didn’t consider themselves to be heterosexual. In the veiled report, that number jumped to almost 19 percent – an increase of 65 percent.
Did participants believe that discrimination on the basis of sexual orientation should be illegal? In the standard survey, only about 14 percent said no. That number increased to 25 percent in the veiled report.
In best practices, only 16 percent of participants said they would be uncomfortable having a manager at work who was lesbian, gay, bisexual or transgender (LGBT for short). The number jumped to 27 percent in the veiled report.
However, there’s one more reason to think the kids are fine:
The effect of assuring anonymity varied significantly across demographic groups. The veiled survey had no effect on the answers of young people to questions about their sexual orientation, apparently because social norms don’t much discourage young people from revealing the truth.
Start by paying a primary-care physician $80 a month to see each patient, whether he is healthy or sick. That’s what so-called concierge doctors charge, and it would give Medicaid patients what they really need: first-class primary-care physicians to manage their chronic cardiovascular and metabolic conditions. …
Then throw on top of that a $2,500-a-year catastrophic plan to protect the poor against financial ruin. The total annual cost of such a program would be $3,460 per person, 42 percent less than what Obamacare’s Medicaid expansion costs. Heck, you could put the entire country on that kind of plan, along with giving people the opportunity to use health savings accounts to cover the rest.
I think this misses a huge part of care. Physician time shouldn’t be minimized. But this plan would involve a huge deductible for everything else. So how would preventive care get paid for? Things like colonoscopies, mammograms, and laboratory panels aren’t cheap. How would maternity care get paid for? One third of births occur on Medicaid.
Would we expect people below the poverty line to have thousands of dollars to pay for deductibles for this stuff? Cause they won’t have it. A baby will bankrupt them.
“I’ve never said that in my life to her. I would never do that. I’m happily married. I’ve got more than enough to eat at home. Thank you very much,” – Toronto Mayor Rob Ford, in a statement, on allegations he told a staffer he wanted to “eat her pussy.”
Listening closely to the president’s noontime presser, I couldn’t help but be reminded of Ronald Reagan’s famous address to the nation in March 1987. Reagan had been caught in a lie – his declaration that he had never traded arms for hostages in his attempt to reach out to Iran (yes, neocons – he was trying to reach out to Iran!). For months, he languished as investigations revealed that he had indeed done such a thing, and his credibility – long his strong point – was at stake. Here’s the address:
The most famous line – addressing his clear statement to the American people that he “did not trade arms for hostages” – was the following:
My heart and my best intentions still tell me that’s true. But the facts and the evidence tell me it is not.
Today, Obama said something very similar about his statement that “if you like your plan, you can keep it, period.” I love the guy, as I loved Reagan, even though I have not exactly held back when I thought he was screwing things up. And the yawning discrepancy between that unequivocal statement and the “facts and the evidence” of the cancellation of individual market insurance policies these past few weeks was startling, to say the least. Had I misjudged the man? Had he unequivocally peddled a focus-group line that he perfectly well knew was untrue, in order to overcome resistance to healthcare reform? Was he a bullshitter – or something worse, a liar?
As I heard him today, he explained it this way. He says he was focused on the large majority of Americans who get their insurance policies through their employer. And for them, the statement is true, even though, of course, insurance policies are fluid and subject to change. What he ignored was the 5 percent of people in the individual market, whose plans did not meet the standards of the ACA. He said he believed that the grandfather clause would help the majority of those people and that those whose policies could be canceled would see, once the website was up and running, that they now had access to better plans at a similar cost. He also says he believed that the constant churn in the individual market – which cancels or changes policies dramatically and unpredictably all the time – would make cancellations due to the ACA seem like business as usual. He now says he realizes his statement was wrong and irresponsible but that he didn’t fully grasp that at the time, as focused as he was on the 95 percent, and as he believed the grandfather clause would help the rest.
So the key question remains: Is this plausible?
I can’t answer that for you. But it was to me, just as it was plausible to me that Reagan basically did not absorb the full consequences of what he was doing in the Iran-Contra affair, and so lied without really meaning to lie. I think that’s what Obama is trying to say as well: he lied without really meaning to lie. In both cases, the two presidents had to come clean at some point in a very messy situation. Many dismissed the Reagan line as hooey, and a further deception. I didn’t and still don’t. But the important fact is that both Reagan and Obama took ultimate responsibility for the de facto deception. “It’s on me,” the president said today. Reagan, of course, couldn’t do much to redress it, except cooperate in investigations. Obama has offered a temporary administrative fix for a year to retroactively make his promise valid, while retaining the core of the ACA.
The other difference? Reagan had a better grasp of theater. His speech was intimate, direct, and his confession not mediated by a journalist or a press conference. Obama – under acute pressure from the Congress – had to act quickly. But in my view, his mea culpa would have been better served by exactly the kind of personal televised address that Reagan made. Americans are ready to forgive presidents who cop to their mistakes. To break through the chatter, Obama should, in my view, have used the Reagan approach – and still can, of course.
But some other context. Obama’s approval ratings have tumbled because of this credibility gap. They have declined, in Gallup’s measurement, from 45 percent approval to 41 percent in a few weeks. What people forget is that Reagan’s slide was much more dramatic. His approval rating collapsed from 63 percent to 47 percent in one month. That’s the biggest collapse in approval for any president since Gallup began polling. And after that, Reagan came back to the historical average approval rating for all presidents, which is where Obama now is as well. That dotted line is the average for all presidents:
Obama now is where Reagan was – but sooner in his second term. But Obama, unlike Reagan, can still do something tangible to improve his position: he can make the ACA work and he should soon begin to make a much more aggressive, positive case for the reform. He has an administrative task right now. But he must soon also engage in a critical political task: to get off the defensive and onto the offensive; to make the case for the good things the ACA can do, and is doing; to remind people of the radical uncertainty of the past, and to demand that the Republicans offer more than just cynical, partisan spitballs to address the unfair, unjust and grotesquely inefficient mess that the ACA was designed to reform. That was the gist of his presser today. It needs to become a stump-speech. He needs to get out of his White House administrative mode as soon as he gets a grip on the reform, and launch a campaign mode against a return to the wild west of the past in healthcare and to expose the Republicans as cynical, opportunist critics who refuse to offer any alternative and any constructive reform.
But soon he needs to channel the core argument of this presser into a face-to-face talk with Americans. He needs to be as crisp and candid as Reagan was:
“I screwed up. I’m sorry. I didn’t think it was a lie, but it was. And I’ve changed the law to address the false promise. Now let’s make this reform work.”
“If you can’t take some joy, some modicum of relief and mirth, in the unprecedentedly spectacular beclowning of the president, his administration, its enablers, and, to no small degree, liberalism itself, then you need to ask yourself why you’re following politics in the first place. Because, frankly, this has been one of the most enjoyable political moments of my lifetime. I wake up in the morning and rush to find my just-delivered newspaper with a joyful expectation of worsening news so intense, I feel like Morgan Freeman should be narrating my trek to the front lawn,” – Jonah Goldberg.
A YouGov poll finds that “that a majority of all Americans (59%) support requiring health insurance companies to cover inpatient mental health services”:
J.D. Tuccille examines the price-tag on Obamacare’s mental health coverage requirements:
The costs that mandates add to health coverage are no mystery. [T]he Council for Affordable Health Insurance estimates that, while each individual mandate might elevate costs by only a small amount, in aggregate “mandated benefits currently increase the cost of basic health coverage from slightly less than 10 percent to more than 50 percent, depending on the state, specific legislative language, and type of health insurance policy.”
Mental health parity—which “ensures that health plans features like co-pays, deductibles and visit limits are generally not more restrictive for mental health/substance abuse disorders benefits than they are for medical/surgical benefits” in HHS terms—is among the more expensive mandates, raising costs by five to 10 percent (PDF), all by itself.
Relatedly, Reihan digs up this quote from Harold Pollock from 2011:
Progressive supporters of health reform disagree about how expansive the essential health benefit (EHB) should really be. An overly restrictive design will leave important therapies uncovered, as happens every day across America. Yet a package designed with too little emphasis on cost (either because too many marginal services are covered, or because prices grow too fast) would be disastrous. This will prove too costly, and thus unsustainable as a platform for near-universal coverage.
David Corn advises the Clintons to pray for Obamacare’s success:
Hillarycare ended up a political failure and set back the cause of health care reform for nearly two decades. It’s not an episode that Hillary Clinton would want discussed during a 2016 presidential campaign. If Obamacare thrives, there will be no reason to look back to Hillarycare and drag these charts out of the dustbin of history. But should the Affordable Care Act falter or collapse, a question will loom: What would Hillary do about health care? Her past record would be raked over and that would likely not boost her presidential prospects. Having screwed up in the early 1990s, could she argue that she would do a better job in reforming the health care system than Obama?
It would be best for a Clinton 2016 campaign for health care to be off the table—with no need to revisit all this inconvenient ancient history. That means she and Bill should be hoping that the implementation of Obamacare proceeds well—and they should do all they can to encourage that. So Bill Clinton ought to coordinate (closely) with the White House on what stuff he should be explaining. It’s not only the president’s political fortunes that are tied to Obamacare.
Domenech is amazed that Obama’s healthcare advantage has disappeared:
President Obama’s signature domestic policy may have accomplished something previously unthinkable: taking an issue where one party had a dominant hold on public opinion, and reversing it in favor of the opposing party. If the latest poll numbers and enrollment figures are to be believed, we could be witnessing a political achievement unequaled in modern political history: the complete demolition of one party’s long-term dominance on an issue area – the Democrats’ ownership of the health care issue – in the space of a few months.
Clearly, the failed rollout of the president’s health-care plan is causing the public to lose faith in him. But let’s remember that congressional Republicans forced the government to shut down, and that it was still shut less than a month ago. Yet today, Americans have more confidence in Republicans’ ability to govern than they do in Obama’s. This is plainly a lesser-of-two-evils situation. But it’s pretty remarkable nonetheless: Republicans haven’t just survived the shutdown, they’ve prospered—at least relative to Obama.
He’s going to allow the renewal of plans cancelled due to the ACA. The president is scheduled to speak any minute now Update: The speech has concluded but you can still watch it using the video below:
One key matter to watch with the President’s proposal is how many cancellations it will actually prevent. Even if insurers are allowed to offer renewals, they may not always choose to do so, either because of the logistical challenges associated with un-cancelling health plans just 47 days before the start of the new year, or because the Affordable Care Act changes the insurance market in ways that make certain old plans unprofitable for insurers.
State insurance commissioners would also have to cooperate in the renewals, for example by approving premiums for 2014. That would be difficult on the tight timeline.
Before Obama’s announcement, Chait worried about short-term fixes causing long-term damage:
Undermining Obamacare in order to placate angry individual-insurance holders makes no sense even on narrow political terms. People losing individual insurance they like are angry right now, but they’re a tiny minority of the market, and their anger will fade over time as the exchanges come online. Higher premiums would affect far more people, and their impact would be felt much closer to the midterm elections. Imagine it’s next year, insurers are pulling out of the exchanges, rates are rising, all because of a law Congress hastily passed the year before — is that a better situation?
President Obama’s signature domestic policy may have accomplished something previously unthinkable: taking an issue where one party had a dominant hold on public opinion, and reversing it in favor of the opposing party. If the latest poll numbers and enrollment figures are to be believed, we could be witnessing a political achievement unequaled in modern political history: the complete demolition of one party’s long-term dominance on an issue area – the Democrats’ ownership of the health care issue – in the space of a few months.
The Dish 