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« Yes! and no | Main | The failed failure narrative and the Tillis trap »

Apr 09, 2014


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Who believes these healthcare enrollment numbers?


"In the survey, taken after President Obama announced a surprising 7.1 million Americans had signed up for health care through the law's exchanges, more than eight in 10 registered voters say a candidate's stance on the law will be an important factor in determining their vote. A 54% majority call it very important. By 2-1, those who rate the issue as very important disapprove of the law."


Ed Cone

Definitely a lot of work to be done, and no guarantee it will work.

But do you see another plausible path for Hagan?



Andrew Brod

He said plausible.

David Wharton

Looks like she's running against the Kochs and air pollution (which seems odd, because water pollution is what's in the news).

Andrew Brod

Running against the Kochs polls well, at least among the base.

Ed Cone

I'm lukewarm on the Koch-bashing strategy, DW. Done well, it seems like a reasonable complementary narrative, but not a game-changer...especially since she'll need big outside money herself to run all those happy-happy-healthcare ads I await.

I do think some coal-ash, sensible regulation spots could work for her this cycle, and that Raleigh-bashing should be part of her plan, although taking on Duke Energy has not been a Democratic strength, either.

Andrew Brod

The Dems have some coal ash on their hands too, but I suppose complete accuracy isn't always the biggest concern when it comes to campaign advertising. What matters is whether the message resonates. If there's enough anger at Raleigh out there over the Dan spill (is there?), bashing Raleigh with it could work.

I'm not saying that's okay, but that's how I see it being done.

Bill Bush

Kay needs to be getting out the vote. The R group will vote for Tillis, who was endorsed today by R leadership, I think I heard on the radio while doing other things. Getting Democrats out for votes is the ultimate winning move. Giving them some red meat (pollution of air and water, weakening DENR, Koch undue influence buying, R attack on education and tax cuts for the wealthy, voter suppression, and the massive lies about Obamacare with their fake "victims") should be helpful. The people who believe Faux will never change, so no appeal to them is needed.


Hagan can do the Emmanuel Goldstein Two Minute Hate all she wants with the Koch Brothers. The vast majority don't know who they are or why we should be so oooga-booga afraid of them.

And I think it is far too early for a victory lap on Obamacare. the Pew Research/USA Today poll Spag linked to is not exactly brimming with warm & fuzzies.

To your point, Ed, in 2008 Hagan had the Hope & Change tailwind to push her across the finish line. That's not happening in 2014, not in a mid-term election in the second administration of a president with 50+% disapproval ratings.

Close? Yes. Expensive? Absolutely; this could rival a Helms re-election when it comes to the price tag.

But I think Hagan is cooked to a golden turn this November.

Andrew Brod

It's too early to take "a victory lap on Obamacare" but not too early to declare Hagan the loser in November?

Of course you might be right about the latter. But your recollection of 2008 is faulty. Hagan ran nearly 3 points ahead of Obama in North Carolina in 2008, 52.7% to his 49.9%. More importantly, her margin of victory over Dole was 8.5 points as compared to Obama's 0.4 points (a Libertarian took 3% of the Senate vote). Take away the surge in black turnout and Obama loses North Carolina, but Hagan probably wins anyway.

Second, talk about running a victory lap misses the point by a country mile. Everyone knows that the ACA is still unpopular. Well, strictly speaking, Obamacare's unpopular; the provisions of the ACA are not. But so what? Kay can't run away from her ACA vote, and "repenting" isn't a viable option. Her only choice is to run on her ACA vote, educate the public about the law, and hope for the best.

If public opinion turns positive by November (and the national polling may have started moving in that direction), then she'll be in great shape as the candidate who not only voted for the ACA but has been saying so for months on the campaign trail. However, if North Carolinians still dislike the ACA, then yeah, her goose is cooked in November.

We don't know if this strategy will work, but it seems obvious that this is the strategy Hagan has to go with.

Ed Cone

The GOP narrative was: We all know Obamacare is a disaster. The launch was a disaster, the rollout is a disaster, and the results will be a disaster.

The launch was in fact a disaster -- but a short-lived one.

The roll-out, we know now, was not a disaster. Too soon to assess it fully, and plenty of room for debate as the numbers solidify, but the disaster narrative is an increasingly tough sell. GOP has to be careful here of the 2012 "skewed polls" problem, aka Baghdad Bobism. If you're explaining, you're losing.

The results of the law itself? This is where I see real trouble for the GOP. People like a lot of the things the law does, and they're thinking about healthcare in a new light. Hagan's job is to pound the message that More Insured Families + No Caps/Preexisting Condition Denial = ACA = Obamacare. The GOP is left with opposing the law outright, or peddling some watered-down version.

I agree that it's far too early for a victory lap, for ACA or Hagan, but the plausibility of the strategy is real.

Running against the Kochs polls well, at least among the base.

And what have the Kochs done?


I think we can all agree that speech is an American virtue, so what does that say of the Democrat base clearly prefers selectively denying that virtue?

While running against the Kochs polls well among the unAmerican Democrat base, it tars the larger Democrat party with an undeniable strain of unAmericanism.


polifrog (aka nitwitcharmer),

How is running against the Kochs any more "unamerican" than running against Soros?

The whole "unamerican" movement was "cool" and en vogue back in 2002, but it's tired now.

Also, what makes one "unamerican," these days? If I don't have an angry eagle flying in front of a battle worn Old Glory as my Facebook picture, am I unamerican? Sign me up, regardless.


Yes. polifrog = NitWiCharmer

I thought I'd comment via a Typepad recognized Twitter account as wordup seems to have become resilient to polifrog comments.

To be clear, I do not feel that this is Ed's deliberate doing, but rather TypePad filtering.

Who is running against Soros?

And was it not the Senate leader, Harry Reid, who called the Koch's unAmerican?

As a side note, I have yet to see any Conservatives say "you don't get to call [the Kochs] unamerican, dude".

And it goes without saying that this sort of Democrat unAmericanism, attacking a citizens for their speech, would play as poorly for Hagan as it has for Reid.

Andrew Brod

Evidence of the tough road Hagan has ahead of her.

Andrew Brod

Then there's this, which is specifically about Medicaid expansion but applies to the entire ACA: "The left's greatest political strength and weakness [is] its relatively healthy epistemological standards, and its at-times lamentable unwillingness to seize its own political advantage."

David Wharton

AB, the article you cite puts much faith in a lot of observational studies and mortality "estimates", and discounts the value of the only recent randomized, controlled study since the 1970s on the effect of insurance on health outcomes. No citations, no links (except to partisan websites), no evaluation of different research methods.

What intelligent person could call that a "healthy epistomological standard"? Certainly not anyone who wants to be taken seriously as a social scientist.


Then there is two Americas as legislated via the Democrat ACA. Not that that truly matters to unAmerican Democrats if it leads to a party-positive destructive monopsony in healthcare.

And on the off chance that individual accounts suddenly matter to our resident economist there is Julie's story. No need for concern by the callous party, though, as Harry Reid, like all Democrats, believes stories like Julia's "are all lies".

Where is the concern for Americans?
Where is the love for America?
Where has the Democrat party gone?

Andrew Brod

DW, you left out "relatively." The TNR piece referred to "the left's... relatively healthy epistemological standards." What they mean is relative to the Right, in particular the far Right, about which much has been written regarding its "epistemic closure," i.e. its rejection of, and often indifference to, facts or research that aren't part of conservative ideology.

Tax cuts don't pay for themselves? Obviously we know that's wrong. Climate change is being caused by humans? Obviously the scientists are part of a huge conspiracy. And etc.

The term "epistemic" is probably being used incorrectly, as I believe philosophers have pointed out, but this is what it's come to mean in the context of political punditry.

Therefore, the point of the TNR piece is not about being taken seriously as a social scientist, but to advise Democrats to hammer away on points that favor Democrats at least as hard as Republicans when it benefits them. The "epistemic" difference is that Democrats, in the opinion of the TNR writer, are more reluctant to hammer away on points that involve uncertainty. In this example, we can't know for sure that the Florida woman would have survived if she'd had health coverage. But it's quite likely, and if the tables were turned, Republicans wouldn't hesitate to use this death to their political advantage. You may or may not agree with this characterization, but the writer is urging Democrats to do what Republicans do.

Andrew Brod

But let's talk social science.

You're quite right that the Oregon study didn't yield obvious improvements in health outcomes. But you're not right in claiming that it's the be-all and end-all of studies of health insurance. For one thing, it wasn't completely randomized. Participants were randomly selected but were then given the option to sign up for the test program. Those who did were less healthy on average. Even though the control group were the people who weren't randomly selected, and were effectively randomly selected themselves, there's still a strong possibility of selection bias. Other studies have tried to address this and have found health benefits.

And it's not obvious that the Oregon study didn't find them. Insured participants were more likely to reported themselves as being good health than the control group, which is remarkable given that they started out less healthy on average. To be sure, self-reported assessments are problematic, but direct objective measures can be hard to come by.

We do have indirect indications, however. The Oregon study revealed greater utilization of health-care services by a population that apparently needed it.

The Oregon study shouldn't be your example of health insurance not improving health.


I don't understand the push by some Democrats to influence other Democrats to stand with the ACA.

Does it not matter to any of you that none of what the ACA promised to bring has materialized while all the dire results predicted by the Tea Party have come to pass?

The TeaParty predicted:

==Fewer people would have insurance.
==Fewer doctors.
==The loss of one's preferred insurance.
==Reduced hospital choice.
==Higher Premiums to cover the cost of mandated "Cadillac plans".
==Higher deductibles.
==Some would lose their Jobs.
==Some would be forced out of full-time work and into part-time work.
==Loss of individual, economic and religious liberty to bureaucratic control.

These American predictions have proven correct while Democrat predictions have been proven to be less prediction than broken promises.

Consider history. In 1964 Democrats made their sole contribution to Civil Rights by changing their mind in regard to embracing the American virtue of liberty for all. Politically the party profited handsomely from that choice.

Hagan can repeat that wisdom today and choose stand with American virtue instead of with the ACA. So can the Democrat Party.

David Wharton

AB, you said of me, "But you're not right in claiming that it's the be-all and end-all of studies of health insurance," and "The Oregon study shouldn't be your example of health insurance not improving health."

But I didn't claim what you said I claim, and I didn't cite the Oregon study for the purpose that you say. Your inferences are not warranted by what I wrote. I only intended to point out that the article you linked, which claimed for itself "healthy epistemological standards", was absurdly lacking in those. I did it because it is fun to hoist preeners with their own petard.

You don't actually know what I think about the various provisions of the ACA or the expansion of medicare.

Andrew Brod

Perhaps not, but I think you're missing the point of what that article is saying.

Andrew Brod

Kay needs to locate a few North Carolina examples of this.

Andrew Brod

More fuel for Kay.

How many consecutive days of good news for the ACA has it been now?

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