Opinion: The complex mess of health insurance

View in [Browser] | Add [nytdirect@nytimes.com] to your address book. Thursday, January 5, 2017 [The New York Times] [NYTimes.com/Opinion »] [Opinion] Thursday, January 5, 2017 The Kaiser Family Foundation is one of the best sources of information on health care, and it recently convened some focus groups in the Midwest and Pennsylvania. These groups included people who received health insurance through an Obamacare exchange and who also voted for Donald Trump. You can read about the results in [an Op-Ed] today by Drew Altman, Kaiser’s chief executive. It underscores how messy and uncertain the coming debate over Obamacare’s future will likely be. I want to point out one theme that keeps popping up in Altman’s piece — and existed long before Obamcare: A lot of Americans are deeply frustrated by the logistical headaches built into our health care system. As Altman writes: “They were especially upset by surprise bills for services they believed were covered. They said their coverage was hopelessly complex.” If they had their way, Altman says, their insurance would become “much more understandable.” I share their frustration, and I imagine most of you do, too. Just this week, a member of my family endured the Kafkaesque experience of being told that she needed to show up for an appointment even if she were no longer sick or face a penalty, thanks to insurance rules. Strikingly, some of the Trump voters told Kaiser that they resented lower-income people who were enrolled in Medicaid, which they viewed as a better deal. Medicaid has its own complexities (and its own problems), but government-run programs do tend to be simpler than private ones. It’s true of Medicare, and it’s true of single-payer systems in other countries. Obamacare looks the way it does because its designers wanted to cause the least possible disruption to the status quo while providing insurance to many more people. By that measure — and others, as [a new Times editorial notes] — the law has been a big success. But if it’s too complicated to have assured its own political survival and Republicans [really do repeal it] — throwing millions of people off of health insurance — the next push for health reform should probably be simpler. It should probably revolve around expanding the government programs that already exist. Wouldn’t that be ironic? The Republican passion for getting rid of Obamacare could ultimately lead to a bigger dose of Big Government. The full Opinion report from The Times follows, including Robert Leonard, writing from Iowa about [rural voters’ antipathy] toward liberals. I also invite you to watch this [Facebook Live video], recorded yesterday, in which I offer specific advice about how to avoid food brands that contain needless added sugars. David Leonhardt Op-Ed Columnist  ADVERTISEMENT  Editorial [Republicans Are Courting Disaster on Health Care] By THE EDITORIAL BOARD After years of attacking Obamacare they still aren’t ready to repeal it. They’re about to do so anyway.  Op-Ed Columnist [The Anti-Inauguration] By CHARLES M. BLOW Augment your outrage with actions that are affirming. Op-Ed Columnist [Reality Politics, Starring Donald Trump] By GAIL COLLINS It’s here and it can’t be canceled for four years. Op-Ed Columnist [President Obama at the Capitol on Wednesday after meeting with congressional Democrats about the Affordable Care Act.] [The G.O.P. Health Care Hoax] By NICHOLAS KRISTOF Republicans plan to replace Obamacare with TBD.  [Trump supporters at a rally in Iowa last January.] Trump supporters at a rally in Iowa last January. Sam Hodgson for The New York Times [Op-Ed Contributor] [Why Rural America Voted for Trump] By ROBERT LEONARD People in red counties resent the attention cities get — and don’t care for liberals.  Editorial [Governor Cuomo at LaGuardia Community College where he presented his proposal on free tuition for qualifying families.] [A Promising Proposal for Free Tuition] By THE EDITORIAL BOARD Although Gov. Andrew Cuomo’s proposal would help many families, a close examination of costs will be required to make sure it is workable. Editorial [Congolese bishops arriving for talks between the Kabila government and the opposition.] [An Exit Plan for Congo’s Kabila] By THE EDITORIAL BOARD Holed up in his Kinshasa mansion, the president is still trying to wait out his enemies.  Ellen Surrey [Op-Ed Contributor] [The Health Care Plan Trump Voters Really Want] By DREW ALTMAN The push to replace Obamacare does not reflect the desires of working-class voters. 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Ahmad Gharabli/Agence France-Presse Getty Images [Op-Ed Contributor] [Could an Embassy in Jerusalem Bring Us Closer to Peace?] By MARTIN INDYK Moving the U.S. embassy to Jerusalem might be a terrible idea — or crazy enough to work.  From The Blogs Nicholas Kristof [Cassidy McDonald, far right, films an interview with Nicholas Kristof and Annette Dove in Pine Bluff, Ark.] [Your Win-a-Trip Criticisms, Addressed] By CASSIDY MCDONALD Responses to common reader criticisms about incarceration, drug addiction, and breastfeeding.  Letters [A Conservative Who Was Inspired by Obama] J.D. Vance called the president “an admirable man” while disavowing his politics. 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