Why is it so?

I cam across this post in my morning Google reader perusal:

A ballot measure that StateImpact Ohio (a creation of local public media and NPR) describes as “a referendum on a constitutional amendment…aimed at keeping the national health care reform law from taking [e]ffect” won in all 88 counties in Ohio. In 81 of the counties, it won by a margin of at least 20 percentage points. Statewide, it won by 32 points (66 to 34 percent).

Ohio is a northern swing State not a so-called “Red State” so you’d have to regard this vote as a significant measure of the apparent unpopularity of Obamacare.  I can’t help asking why?  I’m not au fait with the details of Obamacare, but in general terms I thought it was not all that dissimilar (at least in philosophy) to Australia’s Medicare system i.e. universal health care cover.  Why then the almost diametrically opposed outcomes in terms of public support?  Australia’s Medicare system was so popular after introduction that the Coalition was forced to reverse its initial opposition to it and has promised ever since to retain it.

Are Americans so radically different from Australians?  Or is Obamacare a radically different or badly flawed initiative?  I simply don’t know enough about it to have an opinion, so I’m rather hoping some more erudite Troppo readers can advise.

BTW Despite rumblings and an application before the US Supreme Court, it doesn’t look very likely that Obamacare will be held unconstitutional.

About Ken Parish

Ken Parish is a legal academic, with research areas in public law (constitutional and administrative law), civil procedure and teaching & learning theory and practice. He has been a legal academic for almost 20 years. Before that he ran a legal practice in Darwin for 15 years and was a Member of the NT Legislative Assembly for almost 4 years in the early 1990s.
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whyisitso
whyisitso
10 years ago

Why Is It So?

Indeed, that’s what I keep asking in my comments, but no sensible answers are forthcoming. For instance why is it so that Homer keeps coming back with inanities? And why is it so that if we all know that K B Keynes is his pseudonym why doesn’t he simply comment as Homer Paxton?

Are Americans so radically different from Australians?

Yes I would have thought it was obvious – they are, as a nation, in favour generally of free enterprise, small government and self reliance, whereas we Australians are generally much more comfortable with governments telling us what to do.

Darryl rosin
Darryl rosin
10 years ago

“Are Americans so radically different from Australians?”

There’s a libertarian streak that runs through mainstream American thought that’s almost entirely absent in Australia.

d

Yobbo
Yobbo
10 years ago

Health care in general is a lot more expensive in the US. If I had to guess, it’s because Obamacare is hideously expensive compared to Medicare.

conrad
conrad
10 years ago

“Are Americans so radically different from Australians?”

An alternative way to look at this question might be to try and guess what Australians would do if we had the equivalent of the American health care system, as well as some rather well to do people saying how bad changing it to Medicare would be (cf. the mining tax). I doubt Australians would vote for the change. The fact that people here might think that semi-socialized medicine is not so bad is perhaps because we’ve had it for a long time, and it’s comparatively cheap and works pretty well (of course, one can always find an essentially infinite number of things it doesn’t do, but that’s not a fair comparison). We can also compare it to other systems that don’t work as well (like the US) to convince ourselves how good it really is, but I don’t think Americans do such cross-cultural comparisons to nearly the extent that we do.

Yobbo
Yobbo
10 years ago

BTW any chance of making comment subscriptions opt-in rather than opt-out? I never remember to unclick it and once you do it once you click it you are stuck with email spam forever.

whyisitso
whyisitso
10 years ago

Yobbo, I agree. In fact I got in slightly before you asking for this

Dan
Dan
10 years ago

Conrad@4 – my experience is that most Americans assume they have the best of all possible health systems already and can’t imagine how good the rest of the first world has it.

KB Keynes
KB Keynes
10 years ago

Obamacare is essentially telling people they have to get private health insurance if they do not have it now.

Thus whyisitso’s comments are nonsensical.

US health costs have always been higher than elsewhere.

Medicare is government owned so Yobbo is advocating that Health should be in the public sector.

Ken, it is probably the case most yanks really have no idea after all over 70% thought that invading Iraq was all about 11/9.

Stephen Hill
Stephen Hill
10 years ago

The referendum in Ohio was only about one portion of the Affordable Health Care Act – the individual mandate that requires every citizen to obtain health insurance. Some people who voted against the mandate on this would be supporters of a single-payer model similar to the health system we have here in Australia.

The Affordable Health Care (ironically very much modelled on Bob Dole’s alternate health-care plan to the one advocated by Clinton in the 90s) does make significant changes – in that there is much tougher regulation against the health insurance industry so they cannot exclude people with pre-existing conditions, allowing people up to 25 to get health care on their parent’s plan and having the state provide health insurance for those in the lower-income brackets. However, those above this threshold are mandated to take out health insurance or suffer a fine (although from what I hear the fine is small – similar to the sanction someone gets for not voting). The referendum therefore focused on the least popular aspect of Obama’s health-care plan.

It must also be mentioned that at the same time another referendum was also a rebuff to the GOP – with 61% of voters repealing Governor John Kasich’s plan to strip public workers of their right to collectively bargain.

Brad
Brad
10 years ago

Huge cultural differences. Generalisation: Americans hate the state butting into anything; Australians call on government to fix anything that might be slightly broken (or not broken).

Australia has had a fairly profound policy convergence in the past few decades, bringing the two major parties together on a lot of issues (like public health cover). The influence of pure ideology has weakened here.

America has had no such shift. In fact, you could possibly argue that the two main sides of politics are diverging further and further: the Democrats are fairly well in the middle, while the Republicans are moving further and further right (esp. with the advent of the tea party).

They’re understandable differences if you look at the early histories of each nation.

America is also a lot bigger. People expect more from their states than we do. We prefer national approaches to things.

AlanJae
AlanJae
10 years ago
Sancho
Sancho
10 years ago

Michael Moore’s Sicko documents the way Republicans explicitly and carefully associated federal health care with communism, so medicare = red menace is part of the American psyche, but I think Dan at #7 nailed the main reason.

Americans are proud of their system the way that every empire is. It would require unbearable self-doubt to believe that their health setup isn’t the best possible, let alone the unthinkable heresy of taking tips from Europe.

And as KB Keynes points out, it’s not a federal healthcare scheme, but a requirement for all Americans to buy health insurance, so it’s actually a plan to herd people into the arms of one of the richest industries in the US. Hardly the “socialeezum!” the detractors claim.

SJ
SJ
10 years ago

My money would be on this explanation in comments at CT:

There was no effort put into Issue 3 because it was both worded in a deeply confusing way and pointless (it’s clearly unconstitutional.) So I wouldn’t read much into that one at all. Issue 2 was where the action was.

Nicholas Gruen
Admin
Nicholas Gruen(@nicholas-gruen)
10 years ago

I certainly recall the Libs trying to block medicare – so it’s easy to believe that medicare might not have got up except for the ALP’s perseverance – that is it may not have been much of an electoral winner perhaps a liability but when they managed to luck it into office it got implemented and then became an entitlement. But being voted against by all 81 counties seems pretty amazing.

Shows you how dangerous socialism can be. I guess they just didn’t want death panels. You don’t want to wake up perfectly healthy one day and find out that Obama is going to turn your life support off. Hayek warned of this kind of thing in the Road to Serfdom. Death panels don’t seem too bad here, but that’s because they’ve become an entitlement. It starts out innocently enough – for instance with container deposit legislation. But pretty soon you’ve got death panels, as we have found out.

Creeping socialism.

Peter Patton
Peter Patton
10 years ago

“Are Americans so radically different from Australians?”

Before I answer, this question is a satirical wind-up, right?

Mel
Mel
10 years ago

Ken,

I think the American public is even more easily manipulated by right-wing voodoo ideas than we are here. I recall watching some doco or current affairs report on Obamacare in which hysterical middle aged and elderly white Americans really did think that Obama is going to subject them to death panels.

As an aside, a lack of health insurance kills about 45,000 Americans per year according to a Harvard Medical School study. But of course, scientists were involved in the study and we all know scientists are lying socialists who like death panels because it will let them harvest human organs for secret global warming experiments. As Nick notes, the ever prescient Von Hayek warned about this. Or maybe it was Michael Crichton who warned us. Same difference, I suppose.

ps. I agree with the above dissenters on the notifications opt in thingie.

JC
JC
10 years ago

Ohio is a northern swing State not a so-called “Red State” so you’d have to regard this vote as a significant measure of the apparent unpopularity of Obamacare.

Actually Ohio is a critical battleground state that can at times determine presidential elections and seem to mostly go with the winner.

I can’t help asking why? I’m not au fait with the details of Obamacare, but in general terms I thought it was not all that dissimilar (at least in philosophy) to Australia’s Medicare system i.e. universal health care cover.

It’s very different. It’s a hodge podge of very complex, badly put together laws at state and federal levels (mandates) and practices, mixed with private and public and other nonsense.

The history of medical insurance in the US is interesting as it was initially a way of paying employees during the war to get around wage controls and stayed on as a practice. Most large employers offer health insurance as part of employment paid by the firm over salary or wages. It is not paid like here…a levy out of income by the insured. I didn’t know for most of the time I lived in the US how much the firm was paying to cover family and myself, as I didn’t give a toss. No one really does except the firm.

Why then the almost diametrically opposed outcomes in terms of public support?

Because it’s mandating a whole host of demands on employers even against some that don’t offer insurance and raising costs. There have been 100’s exemptions so far from Obamacare to avoid these new costs and a few went to friends of Nancy Pelosi…. a restaurant owner in San Francisco for instance.

Australia’s Medicare system was so popular after introduction that the Coalition was forced to reverse its initial opposition to it and has promised ever since to retain it.

Yes, but we also have larger co-pays than they do, both through (US) medicare and private plans. Also the concept of private and public hospitals is blurred there unlike here. So you will be treated in any hospital if say you are retired and entitled to US Medicare at basically the same cost. This obviously applies to people on private medical insurance.

They also don’t have a concept of going to a GP first and then being referred to a specialist. You can of course go to a GP type or a specialist and will be refunded almost all the visit. It’s a hugely costly system.

To give you an idea how expensive it is, I would suffer allergies every spring. However I required a doctor’s prescription for Clarityne(?) whereas it’s over the counter here. I don’t know if it has gone off prescription there yet, but a box of clarityne would end up costing 130 bucks. It would be say at the time 100 bucks for the docs visit and 35 bucks for the box of pills with insurance would take the entire cost! The money has to come from somewhere)

Are Americans so radically different from Australians? Or is Obamacare a radically different or badly flawed initiative? I simply don’t know enough about it to have an opinion, so I’m rather hoping some more erudite Troppo readers can

It’s different. It’s actually the best medical care system in the world. It over tests, the docs are generally first rate and very careful and the facilities are fabulous. However no one gives a shit about the costs.

The US has a medical insurance problem, not a healthcare problem per se.

The Docs are also worried about lawsuits so their med indemnity insurance is huge. Docs have a vested interested to change as much as they like. The insurance companies don’t really care, as all they do is actuarially figure out their costs and then simply add a margin for their profit. The patients also don’t really care because they aren’t paying much in co-payment. So the firms cop a great deal of the costs and a contributing reason why wages at the bottom have not gone up over the last 20 years. Medical insurance rates keep going up at a much higher rate of inflation.

Docs use the private insurance schedule fees to screw the government as some of the associations often threaten not to take US Medicare patients if the government doesn’t come to the table.

Obamacare essentially added to this badly put together system and makes firms pay or people are forced to buy insurance when they may not want to. He didn’t change it much, he simply added to it and also added more costs.

SimonC
SimonC
10 years ago

I’m not worried about death panels per se. But it’s no coincidence that every time a nanny state government finds some vice it wants to ban or tax (see smoking/drinking/drugs) one of the prominent arguments is always the cost to the healthcare system. Ultimately, almost any enjoyable activity can come under government review based on that criteria. Creeping socialism indeed.

conrad
conrad
10 years ago

I always love this term “creeping socialism” — it’s like a derogatory term that people try and pin on each other that is only actually dergatory in a small number of places. In the happy democracy of France, many people are proud to call themselves socialists (they don’t need the word creeping), and they have an even better healthcare system than here, which the non-socialists seem fairly happy about also.

Pedro
Pedro
10 years ago

So conrad, the secret to political success is not bread and circuses, it’s bandages and bike races?

One of the weird things about the obamacare debate was the oldies worried about threats to their medicare. I guess that more than anything shows how stupid people get about their entitlements. Remember the horror here when Brian Howe wanted a $1.00 co-payment for the GP visit.

I think we kind of already do have death-panels, just not quite so personally particular. How many times a year is some poor sick person on the 6.30 shows because the govt won’t pay for this or that medicine or operation that would save their live of something?

Patrick
Patrick
10 years ago

France is happy??????

Someone should tell them!!

I think the real problem is that Obama could sell the average lefty tertiary graduate their own mother but couldn’t sell anyone else free beer.

KB Keynes
KB Keynes
10 years ago

Was there this much criticism when Romney introduced his health care plan in Massachusetts? Obama’s proposals are very similar.

The ‘right’ in the US simply move along with the politics thus we see john Taylor criticising plans he advocated when he was in Treasury.

It is called hypocrisy.

Jackie Johnson
Jackie Johnson
10 years ago

The real problem was that Obamacare was a bait and switch. People look at it on this side of the world through the eyes of an argument between single-payer systems, and private-public systems of various types. They don’t look at the detail of what Obamacare was always about.

Dan
Dan
10 years ago

Conrad: last Friday one of my bands played a gig with a band from NZ called Creeping. While the drummer looked like he was from the cast of American History X, we really hit it off and saw eye-to-eye on politics. He’s a Creeping socialist.

Pedro
Pedro
10 years ago

Would that be national socialist?

Sancho
Sancho
10 years ago

Was there this much criticism when Romney introduced his health care plan in Massachusetts? Obama’s proposals are very similar.

It’s starting to emerge now that the Christian right is terrified of having a Mormon in charge, which to them is worse than a Muslim.

Romney’s plan was formulated – and received – as a market-friendly method of delivering healthcare to the population, but when Obama proposed something almost identical, it became communism.

KB Keynes
KB Keynes
10 years ago

Obamacare has distinct Heritage Foundation origins.

Dan
Dan
10 years ago

Pedro@24: not at all! (Yes, I was surprised too.)

KB Keynes
KB Keynes
10 years ago

Pedro,

That was a nazsti thing to say!!

KB Keynes
KB Keynes
10 years ago

that was not germane to the topic Ken.

goering goering gone

Dan
Dan
10 years ago

Oh FFS. I did laugh but part of my soul has gone missing.

Sancho
Sancho
10 years ago

Can we stop Rohming around the subject?

KB Keynes
KB Keynes
10 years ago

just don’t bring your speer.

Sancho
Sancho
10 years ago

That would just be a hessle.

KB Keynes
KB Keynes
10 years ago

I have to go and play with my keitel whilst eating my nuremburger

Sancho
Sancho
10 years ago

Luftwaffles for me.

Alphonse
Alphonse
10 years ago

Because it’s Romney/Heritage Foundation-style lipstick on a pig? Because it makes no immediate change to the fact that US health care is twice as costly as the OECD average with poorer outcomes than the OECD average? Because it is barely comparable to the Australian or any other OECD system?

Dan
Dan
10 years ago

I wonder what proportion of Ohio voters are aware of those performance indicators?

Stephen Hill
Stephen Hill
10 years ago

Ken, there is a new CNN poll that has 52% of Americans supporting mandatory health insurance

According to the poll, 52% of Americans favor mandatory health insurance, up from 44% in June. The survey indicates that 47% oppose the health insurance mandate, down from 54% in early summer.

“The health insurance mandate has gained most support since June among older Americans and among lower-income Americans,” says CNN Polling Director Keating Holland. “A majority of independents opposed the measure in June, but 52 percent of them now favor it.”

The poll was conducted for CNN by ORC International Poll from November 11-13, with 1,036 adult Americans questioned by telephone. The survey’s overall sampling error is plus or minus three percentage points.

http://politicalticker.blogs.cnn.com/2011/11/14/cnn-poll-support-rises-for-health-insurance-mandate/