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February 25, 2010

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Paul Zrimsek

Most of that change would stem from an influx of enrollees with below-average spending for health care, who would purchase coverage because of the new subsidies to be provided and the individual mandate to be imposed.

Gotta love the way he slides the individual mandate in there as an afterthought. Similarly, the new subsidies will be paid for by taxes which people will pay because of patriotism and the threat of jail if they don't.

Middle Aged Bush Supporter

THANKS, Healthy 18-35yo Democrats!

Danube of Thought

"...taxes which people will pay because of patriotism and the threat of jail if they don't."

But only if they make more than $250K, right?

Paul Zrimsek

Heck, people making $10,000 might pay the new taxes if they're patriotic enough. Didn't Harry reid remind us that it's all voluntary?

Jane

Someone, somewhere, said that Obama conceded Alexander was right. I clearly have too much media going on.

Clarice

Let them pay they voted for this dope.

Ignatz

There are two questions here.
1) The unimportant one:
Is the CBO right in its narrow version of assumptions?
2) The $64T one:
Has any government in the history of the world by subsidizing and interfering with markets ever made something cheaper overall?

Ignatz

--Has any government in the history of the world by subsidizing and interfering with markets ever made something cheaper overall?--

Besides my real estate assets, I mean.

Neo

Try to stay awake: the President has a healthcare Bill to pass

'Obama, looking incongruously glamorous in a crisp white shirt and blue tie - like Jamie Foxx chairing a convention of Pittsburgh cement contractors - gave an Oscar-worthy performance as the Concerned Listener'

Ouch.

bunkerbuster

I wonder if healthy Mormons (to pick a tee-total group at random) really want to pay extra for substance abuse coverage. I assume no one sets out to end up in rehab, but plenty of people can predict that they are simply not on a path heading there.

Wonder no more, Google is your friend:
http://www.deseretnews.com/article/595106667/New-rehab-center-caters-to-LDS-addicts.html

``Tucked away just off I-80 in Parleys Summit, the new residential treatment center geared specifically to members of The Church of Jesus Christ of Latter-day Saints doesn't have to market.
``There's already a waiting list.
``It is one of a number of service-oriented businesses springing up to serve the unique needs of Latter-day Saints whose theology regarding sin, redemption and the vital nature of healthy family relationships is well-defined.''

Jeff

the total amount paid in premiums will rise considerably under Obamacare. Almost all actual rates will rise with the destruction of catastrophic plans and more people will be "required" to buy plans they would never choose to do of their own free will.
The fact that Obama wants to tax some to hand out kick backs doesn't change the fact that Americans will pay considerably more in total (new taxes and higher premiums) under Obamacare.

Tom Bowler

Obama retorted: "No, no, no, no, no. This is an example of where we've got to get our facts straight. Let me respond to what you just said. Because it's not factually accurate."

There's nothing factual there! That's the CBO making a politically rosy guess! The whole thing is a farce because there is nothing anywhere that attempts to address health care costs - only insurance costs. Is there anything about the capacity to deliver actual care? More doctors? More nurses? Pardon me for saying, but it's all a bunch of horse shit.

Cecil Turner

Is there anything about the capacity to deliver actual care? More doctors? More nurses? Pardon me for saying, but it's all a bunch of horse shit.

Bingo. Both are out to lunch. The CBO specifically declined to evaluate the effect of the bill on the market (from TM's link above):

The analysis does not incorporate potential effects of the proposal on the level or growth rate of spending for health care that might stem from increased demand for services brought about by the insurance expansion or from the development and dissemination of less costly ways to deliver care that would be encouraged by the proposal. The impact of such “spillover” effects on health care spending and health insurance premiums is difficult to quantify precisely, but the effect on premiums in 2016 would probably be small.
The whole point of the legislation was supposedly to "bend the cost curve" . . . and they're not even discussing it.

Cecil Turner

As to the effect, let's see: we're planning on pumping more money into the program, increasing coverage, and removing individual incentives to keep down costs. Gee, I wonder how that'll work out.

Soylent Red

Let them pay they voted for this dope.

They voted for this dope precisely because they wanted someone else to pay.

I don't understand how people fail to understand that realizing any savings under Obamacare is impossible. This is due to several immutable laws:

1. When given the choice on the quantity and quality of "free" shit being given to them by the gubmint, the answer will always be, "More. Better."

2. When spending someone else's money to purchase the aforementioned "free" shit, the government will always pay more than the individual would have in the first place.

3. The resulting price inflation from 1 and 2 will force more actual paying customers to resort to getting "free" shit from the gubmint, and thus exacerbate the problem.

Old Lurker

4. Giving free stuff to 30M more takers costs more than not adding them.

Patrick R. Sullivan

My favorite part was when Obama cut Henry Waxman off, because he was so blatantly making political statements. Too bad he didn't do the same to John Dingell and Rangel.

bunkerbuster

Tom's conclusion does spell it out succinctly:

``So healthy people currently opting out will be forced by mandates to enroll in a plan, thereby cutting costs for the rest of us.''

And I can see why Ayn Rand devotees would object. But really, what they're objecting to is the entire concept of insurance.

Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?

I do wonder whether Rand thought health insurance was only for shiftless parasites, or whether it was one of those details she deemed unworthy of fictionalizing.

anduril

Is it over now?

Here's what Paul at Powerline thought:

The House Republican Conference Press Office has collected some reviews of the health care summit, from sources that are hardly in the Republican camp. These reviews find that the Republicans did quite well.

CNN's David Gergen:


The folks in the White House just must be kicking themselves right now. They thought that coming out of Baltimore when the President went in and was mesmerizing and commanding in front of the House Republicans that he could do that again here today. That would revive health care and would change the public opinion about their health care bill and they can go on to victory. Just the opposite has happened


CNN's Gloria Borger:


The Republicans have been very effective today. They really did come to play. They were very smart.

They took on the substance of a very complex issue. ... But they really stuck to the substance of this issue and tried to get to the heart of it and I think did a very good job.

They came in with a plan. They mapped it out.

CNN's Wolf Blitzer:


It looks like the Republicans certainly showed up ready to play.

The Hill's A.B. Stoddard:


I think we need to start out by acknowledging Republicans brought their 'A Team.' They had doctors knowledgeable about the system, they brought substance to the table, and they, I thought, expressed interest in the reform. I thought in the lecture from Senator John McCain and on the issue of transparency, I thought today the Democrats were pretty much on their knees.

One of the problems for President Obama may have been that he had to take on all comers without much real help from his fellow Democrats. Obama is quite good at this sort of exchange, and seems to have shown it again today. But the Republicans kept throwing fresh and usually reasonably bright and/or attractive faces at him. The Democrats had to let Reid and Pelosi [UPDATE: and Joe Biden) speak, and neither is none are fresh, attractive, or especially bright.

It also didn't help Obama that the Republicans have a good case on the merits.

Soylent Red

Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?

This would be a wonderful argument if we weren't talking about me and the rest of my "insurance group" subsidizing and extending better-than-group-coverage to those who do not contribute to the insurance group in the first place, under pain of prosecution.

But other than that, it's a pretty good argument.

You, of course, should be free to find the nearest fourth generation welfare recipient and purchase insurance for them and their progeny. I encourage it. Hop to.

Rob Crawford

You, of course, should be free to find the nearest fourth generation welfare recipient and purchase insurance for them and their progeny. I encourage it. Hop to.

Silly Soylent -- leftists never intend to personally help the poor; their plan is to force other people to help the poor.

(While the leftists skim a good 60% "brokers fee" off the top, of course.)

bunkberbuster

Red: you could make exactly the same point about income taxes. Why should you have to pay for the bullets that killed Pat Tillman just so that the local Taliban could have more opportunities to collect payoffs from U.S. military contractors while they make heroin and IEDs and so on.

Most Americans assume the basic argument about taxes was settled a long time ago. Those who don't agree should at least be clear about where they're heading with their ideas.

bgates

Most Americans assume the basic argument about taxes was settled a long time ago.

Most Americans aren't as stupid as you are, November 2008 not withstanding. What do you think the "settlement" was - 90% top marginal rate on income? The 4% FICA of 1956?

Soylent Red

you could make exactly the same point about income taxes. Why should you have to pay for the bullets that killed Pat Tillman just so that the local Taliban could have more opportunities to collect payoffs from U.S. military contractors while they make heroin and IEDs and so on.

Are you on dope, son?

There is no parallel to that argument whatsoever. We all pay for national security (whether it results in friendly fire or not) because we all "use" national security equally. My tax dollar killing goat f*cking homicidal Pashtuns benefits you the same as it benefits me. Whether you are willing to admit it or not.

In contrast, my tax dollar (extracted from the fruit of my labor at a disproportional rate because I make more than you) paying for your health care benefits only you. Particularly if, as a result of being unwilling to hold a job, you are contributing nothing in tax revenue, and thus nothing toward paying for the benefits of either yourself or others.

Moreover, if I am somehow morally obligated to pay for others' health care, shouldn't I get to negotiate the best deal for what I'm going to pay? How does giving my money to the demonstrably wasteful government to spend unwisely benefit a single poor person using her dead sister's teeth?

Also, supposing that government should be administering health care (using my money), would you be willing to allow the upcoming Dick Cheney administration to make healthcare decisions for you? See, government control of healthcare cuts both ways, which is why government shouldn't be in control of it at all.

bgates

Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?

The basis of health or any other kind of insurance is that the insured think it's worth the cost of their premium to be protected against the risk of needing to collect on the policy, and the insurer figures it's worth the cost of paying some of the policies to collect the premiums.

Weed

Are you on dope, son?

That's all him, dude.

Abad man

"Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?"

you start our wrong and go down hill from there. The basis of real health insurance is that I pay for my own care based on the risk that I will need that care. I don't carry it to "collectively" pay for someone else nor should I have to.

Weed

Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?

You know what? You're free to start an insurance company on exactly that basis. Tell healthy people you'll take their money and give it to somebody else.

Or you could start - or join - a charity that does the same thing. That would probably work better.

Hell, since you have such a hardon for taking money from people by force, you could even go into a rich neighborhood and mug some old ladies and take the cash to a soup kitchen.

But don't tell us how generously European you would feel if only your hero got the coercion to happen out of your sight.

Ranger

Isn't the basis of health insurance that healthy individuals collectively contribute to paying to treat sick ones?


Posted by: bunkerbuster | February 25, 2010 at 05:35 PM

Well, if that is really the case, then it completely explains why the model is broken.

Apply that to any other form of insurance and see if it makes sense.

Isn't the basis of car insurance that safe driving individuals collectively contribute to paying to fix the cars of unsafe drivers?

or

Isn't the basis of life insurance that healthy young individuals who don't engage in risky behavior collectively contribute to paying to provide death benifits for the families of elderly sick people or individuals who engage in high risk behavior?

No, I don't think either of those make much sense.

MayBee

bunkerbuster:
And I can see why Ayn Rand devotees

Maybe you could go find a blog full of Ayn Rand devotees to argue with.

Charlie (Colorado)

I do wonder whether Rand thought health insurance was only for shiftless parasites, or whether it was one of those details she deemed unworthy of fictionalizing.

You know, considering the number of times I've been excommunicated by Objectivist groups for unauthorized open-mindedness, the whole premise here is sort of wryly amusing. In any case, though, if you understood the concept of insurance, it would help the discussion along. Here's a piece I wrote in">http://pajamasmedia.com/blog/todays_health_insurance_aint_i/">in 2008 that will help, if you read it.

link fixer

Chralie droppin some knowledge...

Porchlight

One thing that gets left out of this discussion, possibly because it's so depressing, is that even if we could give everyone a pre-paid Cadillac plan tomorrow, a whole hell of a lot of people would still never go to the doctor until they were very, very sick.

You can't assume that the only reason people aren't getting health care is because they can't afford it.

Neither can you assume that outcomes are dependent solely on quality or quantity of care. As has been mentioned, even patients who do get treated often don't take their meds, or don't show up for follow-up visits, or are so obese/out of shape that not much will help them at a certain point.

Sara (Pal2Pal)

Wonder no more, Google is your friend:
http://www.deseretnews.com/article/595106667/New-rehab-center-caters-to-LDS-addicts.html

But do they expect government subsidies to pay for it? I seriously doubt it since they preach that being on the public dole is a very bad thing. The LDS church members give their tithes to support the programs that help their needy members and provide distribution centers as well. I'll look into it, but I'd be willing to bet it is self-financed by the Church funds and/or through private insurance. The LDS church takes care of its own.

bunkberbuster

``We all "use" national security equally.''

Not even close to true.

We spend millions on private mercenaries to protect private oil company projects in Iraq and around the world. Those companies, their stockholders and their customers are benefitting far more and far more directly than I am.

I am of course perfectly willing to pay taxes for this purpose, because I understand that the mercenary stuff -- which I oppose unreservedly -- is but one exceptional thread in the fabric of national security that makes it so much easier for me to sleep at night.

I see a health care subsidy the same way: even if I may not agree with every detail of how the benefits are distributed, I am inclined to support such a program because of the contribution to overall health and productivity of all Americans.

I guess the real difference in our view is that you see no public "everyone" benefit to raising the overall health level of citizens, as a group. I do see how EVERYONE benefits from that.

Ignatz

--I guess the real difference in our view is that you see no public "everyone" benefit to raising the overall health level of citizens, as a group.--

You not only have a bad habit of assuming facts not in evidence you assume ones not even in existance.

EBJ

"I do see how EVERYONE benefits from that."

I like the current system: half the country gets to brag how moral they are (unicorns for all!) and the other half gets to laugh at them. But give the keys to healthcare to the moral preeners? Ummm, if MA passes I think I'll do the same.

bgates

I guess the real difference in our view is

you don't understand that while there is no good way to come up with the dollar value each individual derives from the collective provision of our national security, it ain't that hard to work out how much each person should pay for his own health care.

bgates

We spend millions on private mercenaries to protect private oil company projects in Iraq

You should rent "The Red Danube" sometime. There's a character who makes exactly that tired old leftist claim about America's foreign policy - that we talk about democracy, but it is really about oil. The character in that movie is a Soviet colonel, the movie was made in 1948, and the war he was talking about was the liberation of Germany, Italy, and Japan. You're repeating slanders that are older than you are by a couple generations.

bgates

I am of course perfectly willing to pay taxes for this purpose

Terrific. Let's pay taxes for the stuff we're all perfectly willing to pay taxes for, and we can each decide on our own how to spend our own money outside of that.

William Teach

The biggest point that they neglected to discuss was that the Senate bill mandated a $2,000 fine per employ for companies with over 50 employees that do not offer insurance.

Now, if you are a company and paying anywhere from $6,000 to $12,000 per yer per employee (which is why so many are switching to HSAs, which bring costs down from $8k-$12k per year to $6k-$8 per year), wouldn't it make more sense to dump your health insurance offerings and pay the fine? Savings of $4k to $10k per year per employee could be used for many other purposes, plus, no need to deal with insurance companies, red tape, have on staff HR pro's who handle the insurance plans, etc.

So, more and more people pushed into the government exchange.

Old Lurker

Nice 2008 piece, Charlie.

When do you work?

MayBee

I guess the real difference in our view is that you see no public "everyone" benefit to raising the overall health level of citizens, as a group. I do see how EVERYONE benefits from that.

Everybody has their limits on what they are willing to pay for in the name of EVERYONE benefiting. Even you. It's what makes preening so unseemly.

That, and probably a majority of the people who feel superior that they want to see health care reform passed are supporting it because it will raise "other" people's taxes. Have you heard rich people used to pay a 90% tax rate? They should do that again! Then we could all feel so accomplished.

bunkberbuster

Where are you getting that I feel superior? That's gotta be the paranoia talking.

We have a disagreement on the role of government in the economy, not over who's more moral. My understanding of the "free market" view is that it's basically immoral to demand tax payments and, similarly, immoral to demand unearned benefits. Our disagreement is really over where to draw the line on those issues.

But I do get a sense that a lot of conservatives feel guilty and that those feelings drive them crazy.

bgates

Where are you getting that I feel superior? That's gotta be the paranoia talking.

Where are you getting that she said you feel superior? That's gotta be the paranoia talking.

I do get a sense that a lot of conservatives feel guilty

Yeah, but that's mostly from the dead hookers.

MaryW

Rob Crawford

Thanks for the killfile link. It works well with Trollblocker.

Since we now seem to have more than 1 Mary I am using MaryW again.

bunkberbuster

I'm wondering if the conservatives here feel the same about public education.

Is it always wrong for the government to insist that citizen A pay for the education of citizen B's children?

Or is it again a question of where you draw the line?


Soylent Red

Is it always wrong for the government to insist that citizen A pay for the education of citizen B's children?

Yes. I have no stake in the education of your children. Particularly in the public school centers of indoctrination and entitlement.

In fact, I benefit from your children being ignorant and uneducated. It will make them easier to trick and exploit for my profit and amusement.

Also, they will be excellent cannon fodder during my next mercenary-driven war for oil.

Melinda Romanoff

Soylent-

Can we pick and choose which state's, or commonwealth's, constitution to read, or is everything Federal, like BB thinks?

Rob Crawford

Is it always wrong for the government to insist that citizen A pay for the education of citizen B's children?

Arguable. It is, however, horrifically immoral to demand that citizen A pay for teachers, bureaucrats, and hangers-on to staff a system that utterly fails to educate citizen B's children and indulges in political indoctrination that teaches the kids that citizen A is a criminal for wanting to hold onto the fruits of his labor.

Soylent Red

Well Melinda, as you know, I trend in somewhat the other direction from Federalism...

But, in the unlikely event that BB is a State's Rights Statist, rather than a Federal Statist, my vibe is that he would be much happier adhering to the constitution of a place like Massachusett(e)s than a place like Nebraska.

I guess people like BB just need to have the government legislate their morality for them, whatever the level it comes from.

Rob Crawford

I guess people like BB just need to have the government legislate their morality for them, whatever the level it comes from.

I always suspect such people of harboring the most horrible impulses, held in check solely by their worship of the State.

abadman

I guess the real difference in our view is that you see no public "everyone" benefit to raising the overall health level of citizens, as a group. I do see how EVERYONE benefits from that.

good maybe we can get the national guard to force everyone to walk 5 miles a day. It will raise the overall health more surely than current incarnations of health care reform at a fraction of the cost. I see how everyone benefits from that as well.

In the end it is just a question of who's head you want the Government to put a gun to.

bunkberbuster

Indeed, the capitalist utopia has never existed and never will.

America, and all the industrialized nations, are mixed economies. The intelligent debate isn't over socialism OR capitalism, but between how much socialism and how much capitalism...

Soylent Red

but between how much socialism and how much capitalism...

None. More. Got it?

MayBee

ha! bgates!

MayBee

good maybe we can get the national guard to force everyone to walk 5 miles a day. It will raise the overall health more surely than current incarnations of health care reform at a fraction of the cost. I see how everyone benefits from that as well.

See.
That's what I'm getting at. There's always some great idea that would make everyone healthy-- why not do it.
And.
It would be great if everyone in the world had American healthcare. Just because you are born in Cambodia, it doesn't mean you should die of asthma any more that little Malia Obama.
Why aren't we willing to pay for medical care for the Cambodians?

Jim Ryan

We need to stop letting greedy parasites siphon off the surplus value created by labor. The world would be a lot better off if the law prevented these takings and distributed the earnings more fairly, according to needs and beginning with the neediest (as MayBee says people living abroad to begin with.) Of course concentrations of capital are needed, but these should be possessed by the state so that its impartial experts can use the funds in a targeted and intelligent way, rather than in the arbitrary and senselessly unjust way that the now-moribund capitalist system forced upon us for so long.

The takeover of GM was a start. We need to bring an end to private health insurance and implement single-payer. We need to look at giving the UN more power in these kinds of decisions instead of arbitrarily drawing imaginary lines between this state and that. We need to look at who controls the food industry and how we can give the people who actually need the food more control of it. We need to look at the distribution of land which at this point still resembles that of 16th Century England in its outrageous injustice than it does any system even approximating social justice. Etc.

The debate is over on this. Capitalism is on its last legs, causing crisis after crisis due to its internal contradictions. The question now is Western European socialism or one of the more aggressive styles such as those implemented with considerable success in the PRC or the USSR.

Carol Herman

It's an interesting thing about this president's sensitivities. He had promised Brian Lamb big C-Span coverage on health care. And, he delivered. I think the whole thing dies, now. And, where's the complaints? Brian Lamb got his 'big show.' Even though 7-hours of theater seems a bit much; maybe, it's just a Kabuki world? Done to change the coverage that would have flooded the airwaves about secret deals. None such, now. Plus, he called the 2400 page bill "A PROP." So, you tell me? He signs a "prop" into law? How so?

Gabriel Sutherland

Actually, I don't think this would meet Obama's own CPSAN terms. The summit was on CSPAN3. The number of operators that actually carry CSPAN3 is small. Comcast doesn't cover it in most of their markets.

Now I don't have any insider knowledge of the broadcast terms, but I know it wasn't on CSPAN or even CSPAN2.

The debate was healthy. Pelosicare, Reidcare, and Obamacare were accurately disassembled to show what tricks are used to arrive at their CBO numbers. Speaker Pelosi did go out of her way though to cut new ads to kill her caucus. Her jobs proclamation and her closing remarks on abortion are ready cut ads for the NRCC. But her jobs claim is just devastating. 400,000 jobs right away?

Good heavens. Someone get the Speaker some accurate talking points.

qrstuv

"America, and all the industrialized nations, are mixed economies."

Yes, and ... ????

***
It astonishes me that people continually bring this up as being some kind of indictment of capitalism.

jorod

The magic of coercion.

Danube of Thought

"Is it always wrong for the government to insist that citizen A pay for the education of citizen B's children?"

No. I say that because I believe education is a public good, i.e. that we as a nation all benefit from having our fellow citizens educated. National defense is another example of a public good.

Health care is only a public good in the area of communicable diseases--we all benefit from having others inoculated against them, and for that reason I have no problem with their being provided at public expense.

Danube of Thought

"...the capitalist utopia has never existed and never will."

I know of no one who has claimed otherwise. But there is no dispute that the model of democratic capitalism has produced the greatest abundance for the greatest number, and that that abundance is generally suppressed by governmental intervention in private transactions between willing buyers and sellers.

Danube of Thought

"My understanding of the 'free market' view is that it's basically immoral to demand tax payments..."

Nonsense. See, e.g., public goods.

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