Nate’s “Common Sense” on ObamaCare

Nate Silver has a post purporting to show that it is “common sense” that SCOTUS overturning ObamaCare (Nate calls it the “health care bill,” which it is assuredly not) would not be good for Obama.

He argues his point by pointing to the very same data I did when arguing there are things Obama could do to make a SCOTUS loss work to his advantage. Nate notes that Obama doesn’t need ObamaCare one way or another to enthuse his base. Nate acknowledges that swing voters–the people who will decide the November election–don’t like ObamaCare. And then he notes that these same swing voters in general have a good opinion of SCOTUS. Nate summarizes the “common sense” he derives from this data this way:

However, the argument that the bill being struck down would actually help Mr. Obama seems to have little grounding in the evidence — nor, frankly, in common sense. Among the voters that are most critical to Mr. Obama’s re-election prospects, the Supreme Court is more popular than the health care bill. If the justices declare one of the president’s signature accomplishments to be unconstitutional, it would not be a boon to him.

The people who will decide the election don’t like ObamaCare and so–Nate’s common sense says–if law they don’t like goes away (in part or whole?), they will be less likely to vote for the guy who brought them that law they don’t like that has gone away. “Common sense”!

Let’s unpack the things Nate doesn’t talk about, in addition to his calling a health insurance law a health care bill.

First, he does what ObamaCare boosters tend to do in these discussions, not distinguish between a scenario where just the mandate is thrown out, and one in which the entire law is thrown out (due, largely, to the Administration’s own arguments about severability). Each scenario, it seems, would have different results. If SCOTUS threw out that part of the law people disliked most, it might make everyone–except the insurance companies and those arguing that a mandate is the only way to make this work–happy, particularly if the Administration promised to find a solution that would make the whole thing work (they won’t). Whereas if SCOTUS threw out the whole thing, it would lead people to become aware of the parts of the law people really do like, such as coverage for those with pre-existing conditions and kids under 26, and therefore develop a new appreciation for the law SCOTUS shot down. I think there are potential upsides and downsides for Obama in both those scenarios, but they are two different scenarios, and any “common sense’ ought to acknowledge that.

And then there’s the other assumption: that if SCOTUS threw out ObamaCare Obama would be utterly passive; that reactions to the SCOTUS decision would be entirely unaffected by Obama’s response because (presumably) there wouldn’t be one.

We already know that Obama will respond because he’s doing so already–by attacking the SCOTUS that, as Nate points out, is better liked by the people who will decide November’s election than ObamaCare is (in response, the 5th Circuit has gotten an order of magnitude more petty, threatening to let the whole thing devolve into an intra-branch squabble no one will like). I have already suggested that’s probably the least productive response; if that’s going to be Obama’s response, I agree, losing at SCOTUS will hurt him.

In any case, we know that if ObamaCare is shot down, Obama will respond. The question is whether he will respond in a way that helps his electoral chances or hurts them.

How voters will respond to a SCOTUS defeat is partly contingent on Obama’s actions. He can respond in a way that appeals to those swing voters–perhaps by offering alternatives that address the thing people like least about the law, the mandate–or he can respond in a way that exacerbates precisely the poll numbers Nate points to by doing what he is doing.

I’m not saying a SCOTUS defeat (of the mandate or the entire law) will help or hurt Obama. But I am saying that he can influence that response and–possibly–use a defeat to turn this thorn in his popularity around. I’m increasingly pessimistic he will do so, mind you, but he is not a passive actor in affecting the response.

53 replies
  1. 4jkb4ia says:

    I am cranky because I got up late and I can’t say Kaddish. Of course there was no minyan yesterday because I didn’t count and some people left town. And it doesn’t affect the substance of the post. But I am with Greg Sargent and Jeff Shesol on this one. What Obama said doesn’t count as an attack. What Obama said counts as “I am sure the Supreme Court will see sense”. Given Obama’s record with appointing judges to the lower courts an attack on SCOTUS will appeal only to voters with a certain low information level. EW is also leaving out, because it is obvious, that how Mitt will respond is also a key factor. You want less to attack SCOTUS than to make clear to the low-information voters what President Romney will mean for the court, which they may still respect. And that will depend on what Mitt himself says and does.

    (It’s Opening Day. They had it without my mom, for some unfathomable reason, but I’m still happy. And I have to tackle the oven today.)(And make a shopping list and go to at least the butcher shop. The turkey we’ve got.)

  2. emptywheel says:

    @4jkb4ia: I agree Mitt is a factor, I agree with Nate that in a limited way because of RomneyCare, and I agree that telling low info voters why the Court matters is one possible response for Obama (as I pointed out in my last post on this). It’s nowhere near the best response, which would be to tell voters he will try to find a way to get them health CARE, without having to rely on this jerry-rigged health INSURANCE system which is what voters don’t like about ObamaCare (though of course he can do both).

    And I’ll repeat that whatever Obama did–I do think it was an attack–it is unlikely to change Anthony Kennedy’s mind from where it already has and it does put Obama in an antagonistic position from where Nate has shown voters actually are. In other words, attack or no, it was one of the least productive things Obama could have done.

  3. justbetty says:

    He probably won’t take your good advice now any more than he did when he pushed Congress into passing this garbage. How sad that such a golden opportunity to fix a mess was missed- presumably because he didn’t want to be disruptive. How do you fix anything without disrupting the status quo? And these are the smart people, we’re told.

  4. SpanishInquisition says:

    “How voters will respond to a SCOTUS defeat is partly contingent on Obama’s actions. He can respond in a way that appeals to those swing voters–perhaps by offering alternatives that address the thing people like least about the law, the mandate–or he can respond in a way that exacerbates precisely the poll numbers Nate points to by doing what he is doing.”

    I think Obama will do whatever the corps want him to do. He wouldn’t have gotten himself into the Obamacare mandate mess if he hadn’t been bought, he wouldn’t have done of the SCOTUS mandate severability argument that he did if he wasn’t bought and he’s going to keep staying bought in response to SCOTUS.

  5. jerryy says:

    @emptywheel: Hey, hey, I had nothing to do with rigging the insurance system! :^)

    Nate has really had some odd blinders on throughout the health insurance debacle. When you and he were debating it waaay back when, he had a habit of not responding to critiques raised against his notions. I distinctly recall him saying that middle class folks could afford the insurance if everybody did not go on vacation. He disappeared from the chats after it was pointed out that not going on vacations would sink the economies of many states (this was later demonstrtated by the BP oil disaster in the Gulf of Mexico).

    Besides the obvious mistake of if sense were common, people including him would have it, he seems to be making the usual mistake of not getting out away from the data set and looking at what the data represents instead of imparting judgements on what the analyst wants the data to represent (this is a very hard thing to do).

  6. emptywheel says:

    @jerryy: Right. “Common sense” says that the underlying problem here comes when wonks treat health insurance as health care. Actual people spending huge chunks of their income for what would work out to be the world’s most expensive yearly checkup know better.

  7. quixote says:

    justbetty, assuming the motivation was a desire for non-disruption seems too kind. All the evidence points to a desire to help Big Pharma and Insurance. The “single payer is off the table” meme before any bargaining had even started. The backroom deal with Big Pharma to stop cost controls. Dropping even the measly public option. Not using his filibuster-proof majority when he had it. Not telling Congress to use reconciliation to muscle through anything worthwhile. And so on.

    And then, as far as I’m concerned, the most telling bit of all, back when he was a state Senator in Illinois, and he had this to say on the right way to gut Illinois’ attempt at State-assisted health care:

    “We radically changed [the health care bill] in response to concerns that were raised by the insurance industry.” (Obama, 2004/05/19)

  8. klynn says:


    “Actual people spending huge chunks of their income for what would work out to be the world’s most expensive yearly checkup know better.”

    Your clarity makes me smile. May I put your quote on a t-shirt?

  9. Tom Allen says:

    @klynn: Why not tattoo it on my butt? THAT would be a statement. Plus I’d get like a million likes on YouTube. :-P

    And you probably think I’m joking.

  10. Bay State Librul says:

    I sort of like Nate Silver because he’s a numbers guy.
    I like stats and odds.

    Here is my five cents:

    The worst possible scenario would be that the Supreme Court strikes down the mandate, but keeps the other jagged parts.

    The odds are running about 37% that June will bring the end of ACA as we know it.

    My advice to Obama would be hit the Repubs on the women issues. Polls have indicated that this is a game changer. Women are independent and swing voters. Hit hard on that message.

    As a secondary position….. very gently hit on the Republican’s solution to health care (whatever the fuck it is).

    Emphasize that the Court has ruled and we will abide by the results.

    The Repubicans are very keen on messaging and talking points. We will lose if we comment on Judicial Activism (even though I believe they are dickheads).

  11. SpanishInquisition says:

    @Bay State Librul: “I don’t have such a mandate because I don’t think the problem is that people don’t want health insurance, it’s that they can’t afford it. So, I focus more on lowering costs. This is a modest difference. But, it’s one that she’s tried to elevate, arguing that because I don’t force people to buy health care that I’m not insuring everybody. Well, if things were that easy, I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t.”
    If President Obama had carried out what Candidate Obama said, we wouldn’t be in the position that we are now. Instead of doing the Dorgan amendment, public option, drug price negotiation, etc…Obama did the very thing he said was ridiculous since you can’t solve homelessness with a mandate.

  12. 4jkb4ia says:

    I read Nate’s post now. Nate did confuse the mandate and the bill and having just the mandate struck down is a different set of issues. But he is talking to people who are talking about having the whole thing struck down. Then the common sense here is that a) a president is hurt by having his signature accomplishment struck down and b) Obama was seen to work harder for this and care more about this than anything else in his presidency, was convinced by others that the mandate would work, and it was struck down. You have two themes here–government overreach and being deluded by sitting in that chair. Those hurt and Romney has been hitting them.

    (I am really pleased that I cannot see how I would have addressed He Who Must Not Be Named any differently here. And I respect EW– that’s not the issue–she knows that. Maybe.)

  13. emptywheel says:

    @klynn: Absolutely. I just wish I had figured that one out during the actual debate. We’re asking people to pay $8400 a year for a checkup and some limits on but not guarantees against medical bankruptcy. All in the name of moral hazard.

  14. emptywheel says:

    @Bay State Librul: In your scenario, SCOTUS frees ObamaCare of the parts that people hate, keeps in place the best parts (Medcare delivery issues and Medicaid expansion and coverage for all and extended coverage for kids and MLR and so on), and provides a real impetus to find a real solution, otherwise the insurers go BK (they claim).

    That puts actual people in a stronger position than they were in in 2009, when Obama sold them out.

    How is that a bad thing? If they don’t find a solution, the good bits remain, and just half of the half of the uninsured who would get insurance coverage don’t. It’s far better than the status quo, shows that we can fix our problems by fixing Medicare (and then making it accessible to all), and doesn’t force people barely making ends meet to bail out insurers.

    How is that a bad thing?

  15. bmaz says:

    @4jkb4ia: Yeah, I am squarely with Marcy here. Whether you call it an “attack”, “criticism”, or simply pointed lobbying for the outcome he appears to desperately want, that is merely a matter of semantics. Whatever the term, he is poking the SCOTUS bear, and I guarantee you the very Justices he likely needs to get his law upheld, Kennedy and Roberts (Thomas, Scalia and Alito are lost causes) are, especially Roberts, the ones most likely to be peeved at the attempt. It serves to both delegitimize the Court in general and piss off the votes there Obama so desperately needs. It is patently stupid, even if entirely predictable, of Obama.

  16. emptywheel says:

    @bmaz:In related news, Jay Carney is walking Obama’s comments back.

    Too late to undo the damage with SCOTUS, son enough to undo the damage with the 5th, maybe. But hopefully soon enough for him to figure out it’s a losing strategy going forward, regardless of what happens at SCOTUS.

  17. emptywheel says:

    @emptywheel: And in related related news, Mitch McConnell’s gonna beat up on Obama for his comments in an upcoming speech.

    I guess Carney’s not gonna be able to unring this bell. Oops. Forced error, Obama.

  18. SpanishInquisition says:

    @emptywheel: Yes, everyone should be thrilled that they did what Candidate Obama claimed he wanted when he asked people to vote for him.

  19. joanneleon says:

    Nuance. I think a lot of people, not just Nate, are ignoring the nuance of the arguments about how this plays out politically, depending on which scenario happens and how Obama responds. There are a lot of people out there who want everything boiled down into a talking point. That being said, I don’t think Nate is usually one of them, though I tended to disagree with him fairly often when I still read him, especially when he gets too far away from things that involve numbers.

    So Nate did it too this time, boiled the whole thing down into a strawman argument then wrote something the admin would want to hear. Pretty useless for everyone involved.

    Didn’t you take him on during the healthcare reform (cough) bill negotiation? I seem to remember a time when he put out an argument with some nonsensical numbers. After the health care reform debate was over, I stopped reading Nate except for a few occasions.

    And I would just like to take this opportunity to mention again how incredibly stupid it was to delay the implementation of this bill, and how it was exponentially more stupid to take Medicare for All off the table. It changed my view of the D party forever, that whole freaking mess.

  20. Bay State Librul says:


    I was assuming that the “the whole kit and caboodle” is struck down.
    Then, if Obama is not careful, he could lose the election.
    The Republicans will shove it up his arse,and the swing/independent
    voters will go for Romney. Unless, of course, Romney fails to embrace
    the women issues, or Kramer’s stock market explodes.

    You are betting that the mandate goes, and the rest remains, and Obama is re-elected.

    Very dicey, and why I think it is “bad karma”
    Too many things could go wrong.

    We need the mandate to stay, it meets the Commerce Clause, and the
    Supreme Court needs to look beyond partisan politics (the odds of that
    happening are 37%). I’m hoping for the 37 Percent Solution.

    You are banking that the mandate goes, and the rest stays.
    If that happens, Obama can ignite the base and he is re-elected.

    Then, how do they fix the cost explosion since without the mandate,
    the insurance companies will go bonkers.

    In Massachusetts, the Mandate is a CRITICAL part of the equation.

  21. Bay State Librul says:


    Didn’t you just prove that this is a partisan court.
    According to your previous statements, you believe the Justices will do the right thing based on case law.
    If Roberts is pissed, it shouldn’t effect his vote.

  22. bmaz says:

    @Bay State Librul: There is NOT, in my opinion, a “right thing based on caselaw”. I do not believe the extant cases – the four most commonly discussed are Raich, Wickard, Lopez and Morrison, although there are certainly other cases as well – necessarily clearly address the mandate as constructed. And the existing cases will not address the mandate until SCOTUS says they do.

  23. lefty665 says:

    @Bay State Librul:
    “In Massachusetts, the Mandate is a CRITICAL part of the equation.”

    You bet your ass it is. And, it can be a killer for the 15% or so of Massachusetts citizens who cannot afford health care after they have paid for the $%^&*()_ insurance. Where do you get the money for deductibles and copays when you’ve spent your disposable income on insurance premiums? Don’t pay the rent? Don’t buy food for the kids?

    “Then, if Obama is not careful, he could lose the election.”

    Only if he and his “brain trust” continue to panic. He had it right a month ago. Campaign from the Rose Garden, look presidential, call on Faux and ridicule the dingbats. An aging population of boomers and women are not going to go for Mittens, Paul Ryan, Santorum et al on privatizing Medicare and further gutting women’s rights.

  24. spanishinquisition says:

    @Bay State Librul: For the sake of argument let’s say the court agree it fits within the Commerce Clause, you still don’t NEED the mandate as Candidate Obama elucidated. I live in California and California has offered coverage for pre-existing conditions since way before ACA, but there was never an insurance mandate here to purchase. Acting like the mandate is clearly Constitutional and that in any event it is the only possible solution are both incorrect.

  25. lefty665 says:

    “…how incredibly stupid it was to delay the implementation of this bill, and how it was exponentially more stupid to take Medicare for All off the table. It changed my view of the D party forever, that whole freaking mess.”

    Amen. That’s why after a decade in the trenches some of us have resigned from the D’s. We could no longer stomach defending the indefensible, got fed up with being leaned on to support right wing blue cur morons (ain’t it so emptywheel?), and not rock the boat.

    Further, and to librul’s comment about igniting the base, what ignited some of us was being constantly demeaned and discounted as “left wingers” by the folks we busted our butts to help elect (we turned VA blue in ’08 for the first time since LBJ). Most of what seems to be left at the local and state level are lemmings, hacks and kool-aide drinkers. That’s not a base, that’s a morass. The blather and outrage that there was only one possible ACA outcome seems to confirm that.

    There’s a few good folks hanging in, so there’s some hope for the party. It sure ain’t going to come from more retread Repub ideas like privatization mandates and grand compromises to dismember what’s left of the New Deal.

  26. emptywheel says:

    @Bay State Librul: No, I’m not assuming anything–except that if Obama keeps choosing the stupidest option (beating up SCOTUS to defend his hated mandate) it will make his reelection chances smaller.

    My point is whatever SCOTUS does, O has means of turning this to his political advantage. The chances that he won’t get elected bc legislation that most people don’t like was shot down are small. Unless he decides to defend the mandate after it gets struck down, in which case it COULD hurt his chances.

    Though I, like Nate, think that ObamaCare probably won’t have a huge impact on the election.

  27. emptywheel says:

    @Bay State Librul: The mandate doesn’t fix the cost explosion–as MA’s having to cut coverage shows. Nor does the asinine Cadillac tax (as people’s continued loss of employer coverage shows).

    So keeping the mandate for something it won’t do is … not smart politics.

  28. Bay State Librul says:


    I disagree. It’s the linchpin. As I said earlier, cost reductions take
    time. We are not talking overnight solutions.
    If the Act is overturned, we are back to square one, we all lose.
    The Republicans will take it to the Bank….
    It will be ugly…

  29. Bay State Librul says:


    It’s too bad you feel that way, Lefty.
    Imagine if we had McCain….
    It looks like Forgiving Obama, is as remote as Forgiving Buckner.

  30. lefty665 says:

    @Bay State Librul:

    “cost reductions take time”

    You keep repeating this mantra like it’s supposed to banish demons, but do not offer anything that’s measurable. I trust you have some hard data to back up your assertion. Please share.

    Everything, right up to and including O’s fantasy miniscule “bending the curve” shows that US health care will continue to cost about twice what it does anywhere else in the world far longer than most of us will live.

    Last year a CBO projection estimated about $245 million savings after a decade, that was later revised down. Even the smaller number sounded pretty good, it’s a savings, right?

    However, health care spending over the same period runs about $2.5 trillion per year or more, not including ACA increases. Even at the $245mm figure, after a decade and expenditures of $25+ trillion, the savings are projected to be less than 1% per year.

    Dunno about you, but I’d not bet the farm on a projection of a sub 1% favorable variance a decade out in a for profit market with the Feds enforcing and driving consumer purchases.

    At that rate it would take a century to reduce health costs by 10%. 10% over 100 years. 1/10th of 1% a year. “We are not talking overnight solutions” is a profound understatement.

    Changing the cost basis is what O gave away. Here is how and when it happened:

    March 2009 = Deal with Pharma
    April 2009 = Deal with hospitals/providers
    May 2009 = Deal with the insurance industry

    “If the Act is overturned, we are back to square one, we all lose.”

    Yep, and if it’s not we all lose worse. We’re 3 years down the road, huge opportunity has been kicked in the slats, and we’re in a hell of a mess.

    The marginal good in ACA, and there clearly is some, does not come close to balancing the institutionalization of unsustainable costs. That will kill us all.

    That is why some of us have been advocating for finding a better way since the spring 2009 when it became clear that Change really meant Same or Worse.

  31. lefty665 says:

    @Bay State Librul:

    “Imagine if we had McCain….”

    At least under Duhbya a few of the Dems asked a couple of hard questions before rolling over.

    “Things could be worse”. Boy that’ll inspire me to be out working the polls at 5am again this year. Yep, that’s the campaign we’ve got this time. 3 years of setting up “Lesser Evil”, one half step to the left of the dingiest of right wing Teabagger bats.

    We are a long, long way from “Change we can believe in”.

    More like Shoeless Joe. Buckner was just a klutz, happens to all of us.

  32. lefty665 says:


    I’ll bring some fire and brimstone I got from my neighbor across the street. You bring a rack and we’ll cook us up some liberal pie. You gotta bring someone to say grace over it. That’s not my department, but odds are I’ve seen ’em cruzin the neighborhood.

  33. Bay State Librul says:


    Good comeback with Shoeless. Actually, Buckner has close to “Hall of Fame” numbers. I admit I was so emotionally drained, that I did indeed
    “hate” Billy for fucking up.

  34. Bay State Librul says:


    You are right, you do deserve an answer.
    Right now, I do taxes and audits so I’m swamped.
    The only thing keeping me sane is Emptywheel/Bmaz’s website.
    BTW, Roger Clemens is a lying sack of shit.

  35. bmaz says:

    @Bay State Librul: And, yet, Clemens is ten time more honest and admirable than the DOJ, FDA and IRS jackals prosecuting him. The DOJ is currently proving clearly why Rusty was spot on right that the case should have been dismissed as the government is attempting some of the most chickenshit attempts imaginable to profit from their own heinous misconduct in the first trial. What a bunch of pukes.

  36. Bay State Librul says:


    Can you do a post on the 5-4 strip search.
    See On point today at WBUR
    We should be outraged at that fucking decision by the Radical Supremos

  37. bmaz says:

    @Bay State Librul: I disagree with the Florence decision and think it was unnecessary and somewhat contorted by Kennedy. But it holds no real interest for me.

    By the way, with all of your bellowing about the “Radical Supremes”, you realize, do you not, that your man Obama and his DOJ argued passionately in favor of EXACTLY the ruling made by the “Radical Supremes”. You knew that, right? Because I have not seen your rage note that yet that I am aware of.

  38. bmaz says:

    @Bay State Librul: I think it sucked too. But I will point out that it has long been permissible to strip search inmates and detainees that are being placed into general population housing and/or detention at facilities. This was an unnecessary extension, but it is not quite the giant change many have made it out to be, at least is some regards. I read Breyer’s dissent when the decision was issued and agree with it. The case is Florence v. Freeholders, and somewhere there is an amicus brief submitted by the Obama DOJ stating pretty much everything that Kennedy’s decision did and asking the court to do just that.

  39. Bay State Librul says:


    Thanks. The point some have made, is that this was a great case for
    “drawing a line” in the sand with respect to strip-searching. The Justices failed to do this, and instead whiffed.
    After listening to this discussion, I’m now pretty sure that the ACA
    will go down in a blaze of glory………..

  40. lefty665 says:

    @Bay State Librul:

    “You are right, you do deserve an answer.”

    Thank you, I appreciate that, and look forward to it when you get clear.

    Auditing is interesting. We can often get a sense of about what the numbers ought to be. When they vary materially it is a flag to start looking a little harder. That is what happened for us with health care.

    (1) The long term numbers never came around.
    (2) O and other Dems (think Warner-D VA) started going after long term shredding of SS, Medicare.
    (3) Econ/finance team. Rubin, Summers, TTTimmehG. We knew by Thanksgiving ’08 we were in the soup.
    (4) Massachusetts, a scary percentage of people were forced to buy insurance they cannot afford to use.

    That and more led to asking “Why do all these numbers suck?” The answers were not hard to find. For ACA it’s my mantra… major deals in 2009: March-Pharma, April-Hospitals/providers, May-Insurers. They’re all out there, press conferences and celebrations of Rahmian Realpolitik Macho Mofo. They had such a hot hand they were wearing out their boners.

    The next year makes a lot more sense when viewed as an exercise in preserving those deals. The cherry on top was O’s profession of satisfaction when ACA finally passed. He said he got what he wanted. He did. The deals held and the rest of us are screwed, just like 2big2fail, universal surveillance, executing citizens without judicial review, and anti-recovery fiscal policies. Can you say “Defalcation recidivism”?

    It is bizarre that Dems are now up in arms defending retread Repub privatization that screws us for profit, and O is telling the court it has no standing to overturn unconstitutional laws. It reinforces our decision to stop defending the indefensible, resign from the party and work for change from the outside.

    After tax season, take a ride down the coast to Richmond and we can tour John Marshall’s house. The docents there talk about Marbury v Madison. That is about a half dozen blocks from our own dingbat AG, Ken “Kooki”nelli’s offices. It is humiliating that he has a better take on ACA and separation of powers than our president. Regards, Lefty

  41. lefty665 says:

    @Bay State Librul:

    “Mass considers how to control health care costs” Again, thank you.

    The kicker from that article:
    “His (Patrick’s) plan would set parameters to help private insurers and providers follow suit, in the hope that they would gradually gravitate to global payments, without coercive legislation.” If pigs had wings…

    However, the issue is right. Until we get away from for profit, fee for service health care and funding, nothing will change. O worked very hard to ensure that would NOT happen in the US for a long time.
    That is at the heart of what is wrong with ACA, along with creating commerce and some other “details”.

    HMOs, essentially what Patrick seems to be proposing, are better than fee for service. They too have a past and some issues that are worth looking at pretty carefully before just jumping in. Looks like Patrick’s enshrining mandated for profit insurance as a sweetener.

  42. lefty665 says:

    @P J Evans:

    Good question, the answer’s probably “Yes”. S. Inquisition and I had been working on Bay State pretty hard, and the silly handles we’ve chosen made me laugh when I saw them all together. S.I. & B.S. may beg to differ on the “silly” part. The old tune “Methodist Pie” started rattling around in my head and I was doomed. An issue with solitary late night humor can be that doesn’t parse very well in the light of day.

    Dunno why “Del” is on an obscure key and “Post” just takes a mouse click (left). The gods have a funny sense of humor too.

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