April Pink #1 2014 (click for full photo)

Getting to the Heart of Obamacare

What is it--is everybody in the media just too busy to do their jobs?  Headline after headline described President Obama's remarks on Tuesday as a "victory lap" or "crowing" about the surprising 7.1 million signups for Obamacare through the health exchanges.  But President Obama wasn't crowing about a political victory.  He talked about a law that is not perfect but that is helping to fix a broken health care system and providing the opportunity for economic security, peace of mind, and a sense of value and dignity by providing the opportunity for affordable health insurance. ( See for yourself--here's the video.  I tried to embed it but for some reason couldn't.)

Yes, the success of the initial signup period beyond even supporters' expectations allowed President Obama to frame his remarks in a positive way.  But most of his 18 minutes were a robust explanation of the value of the ACA, including how it has already helped individual Americans, and the way forward.  Examples that tell the story:"that’s what the Affordable Care Act, or Obamacare, is all about -– making sure that all of us, and all our fellow citizens, can count on the security of health care when we get sick; that the work and dignity of every person is acknowledged and affirmed."

"Change is hard," the President said.  "Fixing what’s broken is hard. Overcoming skepticism and fear of something new is hard. A lot of times folks would prefer the devil they know to the devil they don’t. But this law is doing what it’s supposed to do. It’s working. It’s helping people from coast to coast, all of which makes the lengths to which critics have gone to scare people or undermine the law, or try to repeal the law without offering any plausible alternative so hard to understand."

And then he asked the key questions. "Why are folks working so hard for people not to have health insurance? Why are they so mad about the idea of folks having health insurance?"

Another question that these signups raise (and they don't include the many more who now have healthcare through Medicaid expansion) is: why were the pundits and the major media in general so sure Obamacare would fail?

The answer seems to be that they read polls which are simply responses to particular questions with results that seem to say more than they actually do.  They listened to the lavishly funded and unremittingly shrill opposition, the Washington insiders who are so inside that they believe each other instead of finding out what is really happening.  And in particular the media failed to report.

But Sarah Kliff did not fail to report.  Writing in the Wonkblog in December (hat tip to Jonathan Bernstein for linking to this article on Tuesday): "As a reporter who has covered the Affordable Care Act, I’ve spent a lot of time talking to uninsured Americans. Aside from the daily federal updates and traffic statistics, it’s been one of the more helpful ways to understand how the health-care law is working — and what its rocky rollout will mean.  And what I've learned from all those discussions is this: The people shopping on HealthCare.gov are incredibly, unwaveringly persistent in their attempts to purchase coverage."

As one of the few to actually report on individual Americans, she was also one of the few who suggested that 7 million signups might be possible.  As of Tuesday there were 7.1 million and counting.

The entire key to the Obama presidency is the 70 or so letters from Americans he reads each week.  President Obama provided examples of people already helped and what that help meant to them in his remarks Tuesday, and White House.gov shows quotes from other Americans helped by ACA, with before and after numbers concerning premiums and coverage.  But even beyond individuals, how about hard aggregate numbers?  How many reporters were keeping track of those?

Apparently none, including all the well-paid reporter/pundits.  But someone was, and he was doing it for free. His name is Charles Gaba and he blogs at Daily Kos under the name Brainwrap.  According to Kos himself, he " meticulously recorded all Obamacare signup information. Then, after gaining the attention of reporters everywhere, that blogger used hard data to utterly dismantle every bogus Republican talking point."

Not everybody who signed up did so on their home computer.  Many stood in long lines all over the country to get help signing up.  They were helped, informed about the sign-ups etc. by volunteers.  They were determined to get health care coverage.  (There are many more of these photos at whitehouse.gov.)

I was part of a dialogue about all this at Jonathan Bernstein's Bloomberg blog. Here's one of the responses, from "ochospantalones":

"It has been amazing for me to watch so many people acting like there are hordes of people who are happy they don't have health insurance, and will be angered at now having access to it. When I was younger I knew plenty of people who had no health insurance or had near-useless catastrophic plans, and none of them were in that situation because they thought it was great. They didn't have health insurance because they couldn't afford a decent plan, usually because they didn't have access to employer-based plans, and almost all of them prioritized getting the sorts of jobs that would offer health insurance. Many reporters act like someone without health insurance will check the website, see it doesn't work, and just forget about the whole thing. Most people I've known without insurance will put in the effort it takes to make it happen."

Play Ball!

In some places it was a strange Opening Day to the 2014 Major League Baseball season.  The New York Mets game couldn't start on time because nobody was playing first base.  Angels coach Don Baylor broke his leg during the ceremonial first pitch.  But in Pittsburgh's PNC Park, it was all good.

Former Pirates star (and twice MVP in a Pirates uniform) Barry Bonds was there to award the 2013 NL MVP to Andrew McCutchen.  Former Pirates manager Jim Leyland was back to award the 2013 NL Manager of the Year to Clint Hurdle. He told the Post-Gazette: "I've said this many, many times, but this is the most beautiful ballpark in America. It's nice to have the fans really be able to cheer for something."

And did they.  After expanded instant replay was used for the first time (and then the second), Pirates ace Francisco Liriano (who struck out 10) and four relievers combined on a 9 inning shutout.  And in the top of the 10th, Pittsburgh boy Neil Walker parked one in the right field seats for a walk-off win, 1-0 over the Chicago Cubs.

Going to Opening Day of the Pirates was a tradition when I lived in western PA.  And I recall a similar Opening Day game in 1980 when Bill Robinson parked one right in front of me in the right field stands at the top of the tenth to win that one.  They were the World Champion Pittsburgh Pirates that day.  Fans in the burgh figure that day could come again real soon.

Additional Dialogue

In the hours since I rambled on in the post below, there are more stories about the UN report on the climate crisis.  Here are some worth checking out:

The Guardian: A United Nations report raised the threat of climate change to a whole new level on Monday, warning of sweeping consequences to life and livelihood....“We are now in an era where climate change isn't some kind of future hypothetical,” said Chris Field, one of the two main authors of the report.

New York Times: Climate change is already having sweeping effects on every continent and throughout the world’s oceans, scientists reported on Monday, and they warned that the problem was likely to grow substantially worse unless greenhouse emissions are brought under control.

BBC: The costs of inaction on climate change will be "catastrophic", according to US Secretary of State John Kerry. Mr Kerry was responding to a major report by the UN which described the impacts of global warming as "severe, pervasive and irreversible". He said dramatic and swift action was required to tackle the threats posed by a rapidly changing climate.

This Real Climate link itself links to the actual summary and full UN panel report.

An NPR report offers both a print and audio summary of the UN report findings. 

Another NPR piece asks if the report is "too much of a downer," which is the opinion of one of it's authors, who didn't sign the summary.

Tipping Points

“Humans aren’t the first species to alter the atmosphere; that distinction belongs to early bacteria, which, some two billion years ago, invented photosynthesis. But we are the first species to be in a position to understand what we are doing. Computer models of the earth’s climate suggest that a critical threshold is approaching. Crossing over it will be easy, crossing back quite likely impossible.”

Elizabeth Kolbert in  Field Notes From a Catastrophe (2006)

That critical threshold is the tipping point, beyond which the climate begins to essentially feed on itself, changing the Earth significantly for thousands of years.  But along the way there are other tipping points, and we have quite likely passed some.  The Earth's atmosphere is getting hotter and will continue to do so for probably hundreds of years.  The climate is changing right now.  What's not known is whether it has passed the point at which human civilization will no longer be possible.

The latest UN climate report says as much.  It is about changes that can no longer be stopped, but it holds out hope that the ultimate tipping point has not yet been reached, though it probably will soon.  A changed climate cannot be changed back, not for a very long time.  We've made the world of the near future.

The CNN story on the report begins: "Your forecast for the next century: Hotter, drier and hungrier, and the chance to turn down the thermostat is slipping away. That's the latest conclusion from the United Nations, which urged governments to address the "increasingly clear" threats posed by a warming climate before some options are closed off for good.

The UN report analyzes efforts to deal with causes (mitigation) and effects (adaptation.)  There are lots of details but quite simply nobody is doing a very good job at either.

The report pleads with nations of the world to control greenhouse gases.  CNN quotes: Cutting emissions now "increases the time available for adaptation to a particular level of climate change," the report states. But it adds, "Delaying mitigation actions may reduce options for climate-resilient pathways in the future."

In its typically leaden language, the report is saying two things here.  First, the reason to cut emissions is to increase the time we have to deal with the effects of the climate change that's coming.  It's no longer to stop the climate from changing, with the effects we're beginning to see.  It's changing, and it's going to keep changing, probably much faster, to a hotter world than humans have ever experienced.  We need time to adapt to this world, which means a whole lot more than getting used to hotter summers.  It means dealing with huge changes in what food grows where, with droughts, floods and superstorms, with the spread of hot-weather infectious diseases, with rising seas and acidic oceans. With the dominoes of displaced and dying species of animals and plants as they affect the food chain and a lot more.  It means dealing with conflicts and even wars caused by these effects.

The second point is that if we don't deal with the causes--with greenhouse gases--we "may reduce options for climate-resilient pathways in the future."  Translation: if it gets worse, civilization and perhaps the human species will be fighting for survival.

There's a lot more in the report, and a lot more in the news that supports the main points of the report.  If anything, the news suggests things are getting worse faster.  (And there have been cries from within the climate community that the report's summary has been watered down.)

But I want to move onto another tipping point--the one in which an emotional consensus is reached to deal with this reality, and it becomes the central issue driving our political and civic life.

Some have hoped that a particularly eloquent clarion call might do it.  (I wrote a little about this recently.)  That hasn't happened.  Some fictional stories in print and on film suggest that a big enough terrible event will do it.  Paul Gilding's nonfiction book The Great Disruption (2001) suggests that when environmental calamities combine with resource depletion the global economy will stop growing, and the ensuing catastrophes will lead swiftly to a new economic and environmental system based on new priorities and principles that will, among other things, deal with the climate crisis : a tipping point.

Gilding believes civilization will not collapse and the outcome will eventually be positive (though he mentions that we will probably lose a billion people along the way,) based on his faith in humanity's response.  The whole process will take decades.

But why?  When scientists are all but unanimous, when the effects are already happening--why is human civilization incapable of anticipating such a mortal threat and preemptively acting to prevent it?  That's the question of our age, and I've tried to suggest some possibilities in my "climate inside" posts, for example.

Whatever the reasons, it's clear that no report, no catastrophe is going to convince the hardcore of people whose worldview is religiously political (or politically religious), and who believe that the vast majority of scientists are inventing the climate crisis for political reasons. (Everybody but their scientists, who are demonstrably inventing things for political and economic reasons.)

Exactly why we listen to these people and allow them to control things is another question.  It may be partly because we naturally don't want to believe it either, at least not now that we know it's coming.

Last week this story asserts that forecasters are saying that there's a 60 to 75% chance that a new El Nino is forming, perhaps as soon as April, and that it might be a Super El Nino, which could send temperatures soaring in 2015 for sure and possibly in 2014 as well.  The considerable heat trapped in the oceans could be released quickly.

These are changes we will feel immediately (if this happens.) It will also be further evidence that "normal" no longer exists.  The extremes of 2013 will be replaced by different extremes in 2014.  Could it be a tipping point in public perception?  Anything is possible.  But I wouldn't count on it.

 When it comes to the climate itself, the tipping point is a result of physics, brought about by the accumulation and complex interaction of factors. This El Nino could be a climate tipping point, which we would eventually realize. But it's perhaps more likely that things will change noticeably in fits and starts, both gradually and suddenly.  The most important changes may well remain invisible for awhile.  Others will accumulate over time before they have noticeable effects.

The fact that we're getting El Ninos so close together is itself yet another possible indication that global heating has already tipped over into a self-reinforcing regime.  The same is true about the violence and nature of storms and extreme weather, as this post at Real Climate explains.  Extreme events are extreme because they are out of the ordinary.  But they are becoming ordinary.  Yet even this is controversial, well beyond the usual deniers.

But what are the chances that this El Nino's effects will provide a political tipping point into robust public support for aggressive efforts to deal with the climate crisis?  As noted in comments to the Think Progress post, Australia is already experiencing the kind of heat that El Nino could bring to the U.S. for example.  But that didn't stop Australia from voting out the government that made dealing with the climate crisis a priority, and voting in a government that is busily trying to roll back all sorts of environmental measures.  So it's hard to hold out much hope.

The human species has missed all kinds of opportunities to be prepared for this.  Yet some of that same preparation--moral commitments, clarity, psychological skills included--will be necessary to deal with this future.  Because one way or another, life is lived.