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  #51  
Old 12-03-2018, 07:42 PM
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Originally Posted by Ravenman View Post
When someone writes that something "could have been funded already" then it's an open-and-shut case that she thought the $21 trillion has purchasing power, and is not simply a abstract measurement that happens to use a dollar sign.
Yeah, I can't defend this gaffe. Does everyone realize that the OP linked to a Vox article, not Breitbart?
  #52  
Old 12-03-2018, 08:03 PM
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Same way Trump claimed Medicare could save 300 billion a year if it was allowed to negotiate on drug prices.
Have you no sense of perspective? Trump is just the leader of another banana republic heading downhill; his gaffes are hardly newsworthy. In fact he was chosen because his constant lying showed an Understanding of a Higher Truth. Ocasio-Cortez, OTOH, is a Member of the Sole Superpower's House of Representatives, one heartbeat away from being the 434th most senior Member of that esteemed Chamber. Surely her words matter more than those of a janitor, a reactionary fool, or a banana gaffer-in-chief.
  #53  
Old 12-03-2018, 08:05 PM
Jonathan Chance Jonathan Chance is offline
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Is there a real discussion here.

The OP was a rant. Off to the Pit.
  #54  
Old 12-03-2018, 08:17 PM
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Originally Posted by Dacien View Post
I think her major confusion stems from the fact that the 21b was counted multiple times in transactions, not a total. Either way, it's a hilariously huge number that she should have caught straight from the gate.

Good for a chuckle. Of course, having a chuckle means we're "scared" of her, or something like that. But she just keeps spitting these howlers out.
Well, yeah, it does.

There are two different ways to interpret her statement: one that makes sense and one that doesn't. And you are insisting the one that doesn't make sense is what she actually meant. This is a tactic that is only used to try discredit an opponent when you can't discredit them directly.

It's not remotely uncommon, even on this board. I've had it used against me so many times it's ridiculous. I say something with a good, rational meaning, but also there's this one way of looking at it that makes it seem stupid. And so what do my opponents do? They accuse me of meaning the stupid one.

This is a tactic that is unnecessary if what the person is saying is actually wrong. You can just prove it wrong. You don't need to cherry pick an interpretation.

All Ocasio-Cortez is guilty of is being unpolished. Her brand is outspoken, but she lacks the experience in how to guard things so that the stupid interpretation doesn't make sense.

You're all going after her for the trivial, not her ideas. That means you're scared of her. It's like when people went after Obama for the 57 states remark.
  #55  
Old 12-03-2018, 08:41 PM
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Well, yeah, it does.

There are two different ways to interpret her statement: one that makes sense and one that doesn't. And you are insisting the one that doesn't make sense is what she actually meant. This is a tactic that is only used to try discredit an opponent when you can't discredit them directly.
You think Matthew Yglesias, cofounder of Vox and the author of the article, considers her an opponent to be discredited?
Quote:
Originally Posted by Matthew Yglesias
The US military budget is such a bloated monstrosity that it contains accounting errors that could finance two-thirds of the cost of a government-run single-payer health insurance system. All Americans could visit an unlimited array of doctors at no out of pocket cost. At least that’s a notion spreading on left-wing Twitter and endorsed and amplified by newly elected Rep. Alexandria Ocasio-Cortez, one of Democrats’ biggest 2018 sensations and an undeniable master at the fine art of staying in the public eye.

Unfortunately, it’s not true.
  #56  
Old 12-03-2018, 09:27 PM
TimeWinder TimeWinder is offline
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Anyway, thinking about it, 2.1T per year for medicare for all, that seems high.
Which is why all these threads are stupid from the start. Nearly every other country manages to pay for it; but for the US to do it would take astronomically more money than has ever existed (or something).
  #57  
Old 12-03-2018, 09:30 PM
Wesley Clark Wesley Clark is offline
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They probably can't, but that 32 trillion figure is misleading too.

Roughly 60% of medical bills are paid by the public sector in the US. Around 20% are paid by the insurance industry, and about 20% are paid by individuals out of pocket.

Keep the 60% paid by the public sector (keep the taxes and funding).

Of the remaining 40%, since medicare for all is cheaper that may only be 30% (could be lower, especially over time. A study on Vermont found if they had adopted single payer, their health system would've been 25% cheaper after 10 years).

Anyway, that means we have to pay for 30% of our health care system ($900 billion a year) in a medicare for all system.

If you assume about 200-300 billion is still paid out of pocket (which is far less than is paid out of pocket now), that leaves 600-700 billion a year.

That can be funded with a mix of payroll taxes and progressive taxes on the wealthy. I've seen various figures, but a 6-8% payroll tax split between employer and employee combined with some new taxes on the rich should fund it.

Easy peasy.

But no, the military budget can't cover it unless we convert the entire military budget to medicare funding.
This article has some good info about the math of funding medicare for all.

https://jacobinmag.com/2018/12/medic...-peri-sanders/
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  #58  
Old 12-03-2018, 09:54 PM
Fear Itself Fear Itself is offline
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I look forward to the obsessive, bloated reactionaries making fools of themselves over one U.S. representative. If they could just teach little missy a lesson...
Ocasio-Cortez is the new Hillary, and they just can't help themselves.
  #59  
Old 12-03-2018, 10:15 PM
Dacien Dacien is offline
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Well, yeah, it does.

There are two different ways to interpret her statement: one that makes sense and one that doesn't. And you are insisting the one that doesn't make sense is what she actually meant. This is a tactic that is only used to try discredit an opponent when you can't discredit them directly.

It's not remotely uncommon, even on this board. I've had it used against me so many times it's ridiculous. I say something with a good, rational meaning, but also there's this one way of looking at it that makes it seem stupid. And so what do my opponents do? They accuse me of meaning the stupid one.

This is a tactic that is unnecessary if what the person is saying is actually wrong. You can just prove it wrong. You don't need to cherry pick an interpretation.

All Ocasio-Cortez is guilty of is being unpolished. Her brand is outspoken, but she lacks the experience in how to guard things so that the stupid interpretation doesn't make sense.

You're all going after her for the trivial, not her ideas. That means you're scared of her. It's like when people went after Obama for the 57 states remark.
I don't even know what makes sense about her statement. Like I said earlier, you sort of have to fill in the gaps to make sense of it. I think she believed that the $21 trillion number was an actual total of wasteful spending, and jeez you guys, that money could be better spent elsewhere!
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  #60  
Old 12-03-2018, 10:31 PM
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Well, yeah, it does.

There are two different ways to interpret her statement: one that makes sense and one that doesn't. And you are insisting the one that doesn't make sense is what she actually meant. This is a tactic that is only used to try discredit an opponent when you can't discredit them directly.

It's not remotely uncommon, even on this board. I've had it used against me so many times it's ridiculous. I say something with a good, rational meaning, but also there's this one way of looking at it that makes it seem stupid. And so what do my opponents do? They accuse me of meaning the stupid one.

This is a tactic that is unnecessary if what the person is saying is actually wrong. You can just prove it wrong. You don't need to cherry pick an interpretation.

All Ocasio-Cortez is guilty of is being unpolished. Her brand is outspoken, but she lacks the experience in how to guard things so that the stupid interpretation doesn't make sense.

You're all going after her for the trivial, not her ideas. That means you're scared of her. It's like when people went after Obama for the 57 states remark.

I can't claim to read AOC's mind but based off of "that could have funded 66 percent of Medicare for all" (a crucial window into her thinking,) I think she DID believe that there was a cumulative $21 trillion in defense spending over the years that could have been better diverted elsewhere.
  #61  
Old 12-03-2018, 10:42 PM
Dacien Dacien is offline
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Which is why all these threads are stupid from the start. Nearly every other country manages to pay for it; but for the US to do it would take astronomically more money than has ever existed (or something).
Jake Tapper recently had Ocasio on and asked her three times how she would pay for the grand total $40 trillion in spending she's proposing, and each time she launched into messages about who we are, our future, how cost-effective it would be, how other countries are doing it... everything except explaining how she was going to pay for it.

Finally, at the end, Tapper concludes, "I guess I'm not going to get an answer on how you're going to pay for it."
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  #62  
Old 12-03-2018, 10:54 PM
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Here we go.

https://www.cnn.com/videos/politics/...n-sotu-vpx.cnn

Last edited by Dacien; 12-03-2018 at 10:57 PM.
  #63  
Old 12-03-2018, 11:08 PM
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I watched the interview, thanks for sharing that.

You're right, she doesn't say how she'll come up with $40T. (And I personally already really want to know how we are going to come up with $21T and counting to pay off the national debt) OTOH, she discusses total costs of the health care system, and suggests the medicare for all version would cost far less overall than the current, private for-profit system costs. So, and I don't think this will make righties feel much better, she is basically suggesting the government destroy America's for-profit health care system and appropriate and manage the whole thing.

I'm not sure she accepts the $40T figure, I'm not sure I do either. Medicare is something like a $600B program. Expanding it to cover everybody shouldn't balloon it to $3.6T. I mean, really?
  #64  
Old 12-03-2018, 11:24 PM
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How hard is it really to add a few zeros to the next batch of bills to be printed? If socialism does take hold in the US how bad can zoo donkey stew be?
Our president thought we could just print more bills to make up the deficit. You like your zoo donkey stew with salt?
  #65  
Old 12-04-2018, 05:21 AM
jz78817 jz78817 is offline
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Oh and by the way, Charles C.W. Cooke detailed some factors that were baked in to the cost estimate in order to reach the $32 trillion price tag over ten years:
  • Force every doctor and hospital in America to accept Medicare reimbursement rates for all patients — these are 40 percent lower than the rates paid by private insurance — while assuming that this would have absolutely no effect on their capacity or willingness to provide services
  • Raise taxes by 10 percent of GDP
  • Explain to the 150 million people with private insurance that the rules have been changed so dramatically that (a) they can no longer keep their plans, and (b) henceforth, tens of millions among them will be paying more in taxes than they were previously paying in both premiums and out-of-pocket costs

In short, things that will never happen for $32 trillion, Alex.
I'm calling sock puppet. Convenient how you just showed up here last week and are relentlessly carrying Shodan's water.
  #66  
Old 12-04-2018, 05:22 AM
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Originally Posted by Dacien View Post
Jake Tapper recently had Ocasio on and asked her three times how she would pay for the grand total $40 trillion in spending she's proposing, and each time she launched into messages about who we are, our future, how cost-effective it would be, how other countries are doing it... everything except explaining how she was going to pay for it.

Finally, at the end, Tapper concludes, "I guess I'm not going to get an answer on how you're going to pay for it."
Just like getting Trump to explain how he was going to get Mexico to pay for his useless wall.

Right?

Right?
  #67  
Old 12-04-2018, 05:33 AM
Grim Render Grim Render is offline
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I'm not sure she accepts the $40T figure, I'm not sure I do either. Medicare is something like a $600B program. Expanding it to cover everybody shouldn't balloon it to $3.6T. I mean, really?
Yes, like I posted earlier, if you project it based on current medicare expenditure, you get 1.6 T. Which happens to be fairly average for one of the richest developed nations.

I am also really sceptical of the 32 T over 10 years number.

The current total expenses are 3.2 T per year. So it sounds like they just assumed that government would pay all the bills of all the actors currently in the system and multiplied that by ten years. And then took an early lunch.
  #68  
Old 12-04-2018, 06:05 AM
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The 32 trillion estimate for medicare for all is over 10 years, that's the first reason for your confusion, and overall spending on healthcare would be about the same. ...
Facts, logic and simple arithmetic are all just left-wing distractions; American "conservatives" seek A Higher Truth.

A few days ago, one right-wing dolt here made an off-by-a-factor-of-1000 error when attempting long division, deducing that the cost of the trillion-dollar F-35 worked out to $3 per American or some such gibberish. Best is just to completely ignore any right-wing post with any numbers in it at all: The conclusions will be wrong even if the numbers aren't themselves lies. (Amusingly though, it was HurricaneDitka — nominee for stupidest Doper of all — who first corrected his fellow traveler's off-by-a-factor-of-1000 error.)

Are there any conservatives in the thread? Do you understand that when a price is quoted for single-payer health, employers and citizens will no longer need to pay premiums, and, depending on details, there may no longer be co-pays, or money wasted on deny-coverage red-tape? Most right-wingers are unwilling to even acknowledge that! I've never been sure whether they're really too stupid to understand this, or hope that the Undecideds they're trying to gull are so stupid. Sincere question: Will any of that ilk respond?

Very clever of the hypocrites to insist on 10-year numbers to inflate the numbers on spending they don't like. In the past they've sometimes been too enthusiastic and gone with 100-year numbers — "Quadrillion dollar cost over the next century; perhaps quintillions if the Hillaryist Inflationary Terrorists have their way" — but even right-wing morons may see through that.
  #69  
Old 12-04-2018, 06:23 AM
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Are there any conservatives in the thread? Do you understand that when a price is quoted for single-payer health, employers and citizens will no longer need to pay premiums, and, depending on details, there may no longer be co-pays, or money wasted on deny-coverage red-tape? Most right-wingers are unwilling to even acknowledge that! I've never been sure whether they're really too stupid to understand this, or hope that the Undecideds they're trying to gull are so stupid. Sincere question: Will any of that ilk respond?
there's a special class of shithead who believes both that anything run by the government is inherently evil, and that poor people must have done something to deserve to be poor so if they don't have a job which includes health insurance they should be happy to get sick and die.

It's really laid bare by the utter MORONS who believe that "prosperity gospel" horseshit just because some slick, well dressed sociopath gets up on stage and preaches it.

these people are so stupid they buy into the notion that if God loves you He will make you rich. therefore they despise poor people (because God obviously hates them) and give all of their money to the charlatans. Curiously, when they don't get rich they never think "hey, maybe God doesn't love me."
  #70  
Old 12-04-2018, 06:24 AM
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The Nation article that started the controversy:

Quote:
. . . it is impossible to trace the actual sources and destinations of the $21 trillion. . . The upshot is that no one can know for sure how much of that $21 trillion was, or was not, being spent legitimately.
The Vox article linked in the OP:

Quote:
The Pentagon’s accounting errors are genuinely enormous, but they’re also just accounting errors — they don’t represent actual money that can be spent on something else.
He can't know this.

To be fair, he could be right:

Quote:
does not contend that all of this $21 trillion was secret or misused funding. And indeed, the plugs are found on both the positive and the negative sides of the ledger, thus potentially netting each other out.
but there's no way to know.

The Nation article summarizes:

Quote:
The status quo has been generating ever-higher DoD budgets for decades, not to mention bigger profits for Boeing, Lockheed, and other military contractors.

The losers in this situation are everyone else. The Pentagon’s accounting fraud diverts many billions of dollars that could be devoted to other national needs: health care, education, job creation, climate action, infrastructure modernization, and more. Indeed, the Pentagon’s accounting fraud amounts to theft on a grand scale—theft not only from America’s taxpayers, but also from the nation’s well-being and its future.
The author of The Nation article seems to believe that there's actual money that could be used for other things. The author of the Vox article doesn't provide any proof that it's not true or even attempt to show why he says there's no actual money behind these transactions. For all he knows, that $21T could be even higher.

How could it be higher when Congress hasn't even appropriated that much over the years? Because the amounts flowing into the accounts don't match the amounts appropriated by Congress, and there are thousands of missing records. Were these just made up numbers? No one seems to know.

Quote:
Time and again, they found that the amounts of money reported as having flowed into and out of the Defense Department were gargantuan, often dwarfing the amounts Congress had appropriated: $1.7 trillion in 1998, $2.3 trillion in 1999, $1.1 trillion in 2000, $1.1 trillion in 2007, $875 billion in 2010, and $1.7 trillion in 2012, plus amounts in the hundreds of billions in other years.
  #71  
Old 12-04-2018, 07:17 AM
Gary Kumquat Gary Kumquat is offline
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Out of interest, can anyone advise where the estimate of $3.2tn for universal healthcare per annum comes from?

I mean, the UK spent approx $180 billion for a population of 67 million in 2017. So let's say you want to spend twice as per much person, and let's say you can't get any economy of scale whatsoever...you're still looking at $1.75 trillion, a little north of half the amount being thrown around.
  #72  
Old 12-04-2018, 07:49 AM
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Fuck my ass. We ALREADY spend enough public money to cover every person in the country with EuroCare*.

If we actually fixed our idiotic system, stopped it from being criminally inefficient, and quit letting Americans be the bottomless pocketbook of the medical industry, we wouldn't have to be shaking down the Pentagon for anything.



*EuroCare is my made up name for "Pick whatever country in Europe you think isn't a giant shithole, and assume we have the health care system they have".
  #73  
Old 12-04-2018, 08:05 AM
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Originally Posted by Dacien View Post
Jake Tapper recently had Ocasio on and asked her three times how she would pay for the grand total $40 trillion in spending she's proposing, and each time she launched into messages about who we are, our future, how cost-effective it would be, how other countries are doing it... everything except explaining how she was going to pay for it.

Finally, at the end, Tapper concludes, "I guess I'm not going to get an answer on how you're going to pay for it."
Oh boo hoo, cry me a fucking flood. It's a disaster when someone you don't agree with does it! That sounds like every politician that ever existed.

Maybe she should ban Tapper from her press conferences for asking hard questions! Did she shake his hand? Maybe she could 'shop it to make it look like he hit her!
  #74  
Old 12-04-2018, 08:11 AM
Gary Kumquat Gary Kumquat is offline
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the grand total $40 trillion in spending she's proposing
Is there a link somewhere that outlines how the $40 trillion figure was calculated?
  #75  
Old 12-04-2018, 08:17 AM
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Is there a link somewhere that outlines how the $40 trillion figure was calculated?
Don't ask AOC - she doesn't apparently know how to count.

Regards,
Shodan
  #76  
Old 12-04-2018, 08:26 AM
Shodan Shodan is offline
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Out of interest, can anyone advise where the estimate of $3.2tn for universal healthcare per annum comes from?
It's based on estimates from the Urban Institute and the Mercatus Center. The estimate is probably optimistically low, since it is based on the assumption that we double all personal and corporate federal income taxes*, AND dramatically reduce payments to health care providers, drug costs, and administrative costs. (Cite.)

Regards,
Shodan

*It would have to be more than double, if we don't want to add to the deficit.
  #77  
Old 12-04-2018, 08:28 AM
Gary Kumquat Gary Kumquat is offline
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Rest assured, if I'm ever curious as to whether AOC wrongly construed spending in the 2018 election cycle, and was incorrect to directly compare conclude Handel spending $7.99m compared to McBath's 1.23, I now know where to look.

It is unfortunate that it's not actually relevant to the question I raised, but thanks anyhow.
  #78  
Old 12-04-2018, 08:34 AM
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AOC also puts her TP on the roll incorrectly. She's clearly unfit for office.
  #79  
Old 12-04-2018, 08:46 AM
Cheesesteak Cheesesteak is offline
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if we don't want to add to the deficit.
We wouldn't want to do THAT, now would we?
  #80  
Old 12-04-2018, 08:46 AM
Gary Kumquat Gary Kumquat is offline
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It's based on estimates from the Urban Institute and the Mercatus Center. The estimate is probably optimistically low, since it is based on the assumption that we double all personal and corporate federal income taxes*, AND dramatically reduce payments to health care providers, drug costs, and administrative costs. (Cite.)
With respect, that report does not explain at all why you would have to spend more than the $10,000 per annum you're already currently spending. I've already pointed out that the UK is 43% of that, but even if you were to look at Switzerland -which by any standard has far better healthcare than the US - you should be looking at a 30% saving over your current spend.

This is the part I struggle with. Your current system costs you far more than anywhere else, yet delivers lower results...but the argument against change is that somehow if the US were to do the same thing as many other countries do, you'd fuck it up so badly it'd cost you even more?

Last edited by Gary Kumquat; 12-04-2018 at 08:50 AM. Reason: correction for clarity
  #81  
Old 12-04-2018, 09:11 AM
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I'm pretty sure that if she joined the Straight Dope, she would be taken about as seriously as, say, Reeder. But elect her to office, and wow -- people will rush to her defense!
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Old 12-04-2018, 09:30 AM
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Precisely. There are plenty of people who believe global warming is a hoax and are lukewarm in condemning birtherism who are in Washington, and they'd be laughed at here too. I think it's funny how this same behavior from AOC is now triggering the conservatives.

Last edited by Ludovic; 12-04-2018 at 09:30 AM.
  #83  
Old 12-04-2018, 09:40 AM
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What's funny about it?
  #84  
Old 12-04-2018, 09:48 AM
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I'm pretty sure that if she joined the Straight Dope, she would be taken about as seriously as, say, Reeder. But elect her to office, and wow -- people will rush to her defense!
I hate to say it, but the posters who engage in political debates on the Dope are, by and large, way smarter than the average Congressperson. Shodan, for all his faults, would be a smarter Congressman than most of the people who will be representing the GOP in Congress next month. Reeder would be too, and he'd be smarter than a number of the Dem Congresspersons as well. So I'm going to judge AOC at least somewhat in the context of her new peer group.

Also, AOC fucking nails it enough of the time already that I'm willing to overlook the times like this where she misses by a country mile. She's 29 years old, and she's going to get better and more knowledgeable over the next few months, let alone the next several years.

Congress is filled with old white men who think the presence of enough snow outside the Capitol to make a snowball out of, is evidence that global warming is a hoax, at the very same time the U.S. Naval Academy raises its seawall to prepare for a substantial rise in sea level - and those men will always be every bit as dangerously stupid as they are right now. So I'm willing to cut her some slack while she learns. If it's clear by this time next year that she isn't learning, I'll change my tune.
  #85  
Old 12-04-2018, 10:00 AM
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What's funny about it?
I think it's funny that Trump lead the Moron Brigade "investigating" Obama's birth certificate, and now the people who voted for him to be our President are all atwitter over a freshman Rep making a mistake or two.
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Old 12-04-2018, 10:05 AM
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It's based on estimates from the Urban Institute and the Mercatus Center. The estimate is probably optimistically low, since it is based on the assumption that we double all personal and corporate federal income taxes*, AND dramatically reduce payments to health care providers, drug costs, and administrative costs. (Cite.)

Regards,
Shodan

*It would have to be more than double, if we don't want to add to the deficit.

Thanks. It did wonder where they got that number. On a quick skim...Mercatus. They list themselves as the premier source for market-oriented ideas, and list Friedrich Hayek as the first of their inspirations.

My intital impression is that this does not seem like someone you'd go to if you wanted an impartial estimate.

So looking at the estimate itself...well. Its not good. Charitably, I suppose they may have had very tight instructions about what they were supposed to look at. I can't on an initial skim see that they did anything to fight that.

The spending estimate is pretty much just assuming that "Medicare for all" will mean that the government will pay all the bills with no real change to the system from that. They do go briefly into paying Medicare rates, and savings from that, and they do make an adjustment for administrative savings, although the latter is unbelivably small.

Basically, they assume Medicare for all means the government will pay all the costs as they stand, and then add small adjustments for increased coverage, administrative savings etc. So the new setup would have the same costs as the current one, just paid by the government.

The lack of any systemic savings really make this unusable as any kind of practical considerations go. There are a few other issues as well. But I just have time to skim it, I could have missed things.

Maybe this document could make a GD thread when I have time to go through it properly.
  #87  
Old 12-04-2018, 11:08 AM
Ravenman Ravenman is offline
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Originally Posted by RTFirefly View Post
Also, AOC fucking nails it enough of the time already that I'm willing to overlook the times like this where she misses by a country mile.
What's "MRA" in that context? I'm familiar with that acronym for minimum retirement age, but that's clearly not it.

But I'm afraid she's pushing the limits of what most would consider a "living wage" for congressional staff. The lowest paid non-interns appear to average about $31,000 per year, which is indeed low for jobs that basically require college degrees. But DC's "living wage" is $12.50 per hour, which works out to be, what, like $25,000 per year?
  #88  
Old 12-04-2018, 11:08 AM
Shodan Shodan is offline
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With respect, that report does not explain at all why you would have to spend more than the $10,000 per annum you're already currently spending.
With respect back, the report says that, if we implement Medicare for all, it will cost $32T over ten years. Which they (and the Urban Institute, which reported pretty much the same thing) say is something like $2T less than we would spend if we didn't implement Medicare for all.

From the report -
Quote:
By conservative estimates, this legislation would have the following effects:
•M4A would add approximately $32.6 trillion to federal budget commitments during the first 10 years of its implementation (2022–2031).
•This projected increase in federal healthcare commitments would equal approximately 10.7 percent of GDP in 2022. This amount would rise to nearly 12.7 percent of GDP in 2031 and continue to rise thereafter.

These estimates are conservative because they assume the legislation achieves its sponsors’ goals of dramatically reducing payments to health providers, in addition to substantially reducing drug prices and administrative costs.

A doubling of all currently projected federal individual and corporate income tax collections would be insufficient to finance the added federal costs of the plan.
Again, this is based on the assumption that we dramatically cut payments to health care providers, and cut drug prices, and reduce administrative costs. And even if we do that, federal health care spending would still rise as a share of GDP, and a doubling of federal income taxes would not be sufficient to pay for the whole thing - i.e. it would increase the deficit.
Quote:
This is the part I struggle with. Your current system costs you far more than anywhere else, yet delivers lower results...but the argument against change is that somehow if the US were to do the same thing as many other countries do, you'd fuck it up so badly it'd cost you even more?
If we can dramatically cut payments to health care providers and reduce drug prices and cut costs on administration, then we can save money. That's not an argument against change, but it is also not an argument in favor of M4A. If we do that for any system, whether single-payer or not, we can save money.

But if we want to save money, we have to do that. The question is, can we?

If we cover everybody, people who are now not insured will increase their utilization of the system. Emergency room visits under Obamacare went up along with visits to PHPs. Visits to PHPs did not, by and large, replace emergency room visits. More utilization means higher costs. That has to be taken into consideration, because more utilization means more costs.

If we dramatically cut payments to doctors and hospitals, how will that affect health care delivery? I for one rather doubt that doctors (and nurses and technicians and pharmacists and janitors and health aides) will simply shrug their shoulders and accept a 25% pay cut and continue to treat patients at the same level as they do now. They will adjust, one way or another, and the ways in which they adjust may or may not be to everybody else's liking. OB-GYNs, by and large, don't have a lot of Medicare patients now. How are they going to pay for their medical malpractice insurance when their fees are reduced by 25%? Will they simply stop accepting high-risk pregnancy cases?

OK, we simply cut drug prices by 25% by fiat. Great - now the drug companies can't afford to send glossy brochures to doctors to try to sell Viagra or whatever. It seems naïve to me to assume they won't make any cuts to R&D - the ROI on the very few drugs that actually make it to market has been substantially reduced. Antibiotic resistant bacteria is a concern for a lot of people - what will be the effect of pushing drug companies to concentrate on selling proven profit-makers instead of low-return R&D?

OK, we more than double federal income tax, and spend it largely on the uninsured. That might be a good thing, but that is a big whack of money that can't be spent on anything else. Maybe it would have been spent on beer and hookers, or dividends to stock holders. Or maybe it would have been spent on housing, or child care for working mothers, or invested in the stock market, or on venture capitalism. We don't know what it might have been spent on. We only know what it will be spent on. And since preventative care, overall, does not save money, the ROI on that spending is not likely to pay for itself in the long run. Increased quality of life is a good thing, no doubt - but it costs more. And the argument "it will save money" is a different argument from "it will cost more but it is worth it".

If we cut spending on health care, it will cost less. That's certainly true. But it is never a matter of simply saying, "OK, now we are going to spend less."

Regards,
Shodan
  #89  
Old 12-04-2018, 11:30 AM
Grim Render Grim Render is offline
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Thing is, Shodan, your setup is not normal. It is fucking exceptional. Everyone else in the developed world manages to cover their entire populations at half your cost and most with better results. Thats normal. And that includes countries with higher costs of living than yours and countries that contribute as much to R&D as the US. From the viewpoint of people who consider this a fairly simple and basic facet of what being a nation is fundamentally about, all the protestations just come across as whining.

For example have you considered outlawing advertizing for drugs and perscrition medicines? Works pretty fine actually.
  #90  
Old 12-04-2018, 11:39 AM
elucidator elucidator is offline
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...And almost NO money for the Ministry of Silly Walks!
I take that one in stride.

Ms OAC is pretty smart by rough estimation. She is, indeed, an idealistic amatuer at this point, but smart people learn. Louie Gohmert, (R, Shitforbrains) has no such option. Ignorance can be fixed, stupid goes right down to the bone.

Last edited by elucidator; 12-04-2018 at 11:42 AM.
  #91  
Old 12-04-2018, 11:43 AM
Cheesesteak Cheesesteak is offline
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Quote:
Originally Posted by Shodan View Post
If we can dramatically cut payments to health care providers and reduce drug prices and cut costs on administration, then we can save money. That's not an argument against change, but it is also not an argument in favor of M4A. If we do that for any system, whether single-payer or not, we can save money.
I'll start by saying you can't reduce these costs at all unless you have some measure of government interference. You can't cut payments to providers until you lower their cost of doing business.

You can't cut administration until you institute controls over the industry that eliminates the need for administration. The need for administration is a byproduct of our structure of public and private insurance, notably the lack of controls over private insurance, and the fact that public insurance is basically a gov't run version of private insurance.

You can't cut drug prices until the gov't institutes price controls, just like most other countries do.

My problem with M4A is that it leaves our inefficiencies intact.
  #92  
Old 12-04-2018, 01:00 PM
jz78817 jz78817 is offline
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Originally Posted by Grim Render View Post
Thing is, Shodan, your setup is not normal. It is fucking exceptional. Everyone else in the developed world manages to cover their entire populations at half your cost and most with better results. Thats normal. And that includes countries with higher costs of living than yours and countries that contribute as much to R&D as the US. From the viewpoint of people who consider this a fairly simple and basic facet of what being a nation is fundamentally about, all the protestations just come across as whining.

For example have you considered outlawing advertizing for drugs and perscrition medicines? Works pretty fine actually.
and not letting pharmaceutical companies kick off an epidemic of addiction which requires an increasing amount of emergency care for those affected?
  #93  
Old 12-04-2018, 01:16 PM
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Yeah, I can't defend this gaffe. Does everyone realize that the OP linked to a Vox article, not Breitbart?
Yep, if you read the article, she's clearly way off on the numbers. Even if that 21 trillion includes transactions, that doesn't equate to actual budget/revenue. And that's kind of unnerving that she doesn't realize it.

Her tweet says:

Quote:
$21 TRILLION of Pentagon financial transactions “could not be traced, documented, or explained.”

$21T in Pentagon accounting errors. Medicare for All costs ~$32T.

That means 66% of Medicare for All could have been funded already by the Pentagon.

And that’s before our premiums.
  #94  
Old 12-04-2018, 01:39 PM
Evil Economist Evil Economist is offline
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Originally Posted by Shodan View Post
With respect back, the report says that, if we implement Medicare for all, it will cost $32T over ten years. Which they (and the Urban Institute, which reported pretty much the same thing) say is something like $2T less than we would spend if we didn't implement Medicare for all.
That's the cite that actually shows that healthcare spending would actually fall by $2T over 10 years right? That government spending would increase by $32T, but it would be more than offset by the reduction in individual healthcare expenditures?

Great cite.
__________________
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  #95  
Old 12-04-2018, 02:01 PM
Shodan Shodan is offline
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And would increase the deficit, don't forget that part. IF we dramatically cut payments to health care providers, and drug prices, and administrative costs.

Regards,
Shodan
  #96  
Old 12-04-2018, 02:06 PM
Gary Kumquat Gary Kumquat is offline
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Originally Posted by Shodan View Post
But if we want to save money, we have to do that. The question is, can we?
Can you, for a mere 30% more per person than the Swiss spend, or nearly 50% more per person than the Germans, provide the same level of healthcare as those countries (i.e. better than the one you currently get using your setup)?

You're not making a great case for the market if it needs 50% more to deliver an equivalent service than socialism requires.
  #97  
Old 12-04-2018, 02:07 PM
Evil Economist Evil Economist is offline
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And would increase the deficit, don't forget that part.
Are Republicans opposed to increasing the deficit now? That's new.

More seriously, if it's possible to reduce healthcare costs by $2T over 10 years, then don't you suppose mathematically there's a way to pay for it without increasing the deficit. And in fact, to give $2T back to consumers?
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  #98  
Old 12-04-2018, 02:10 PM
Evil Economist Evil Economist is offline
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IF we dramatically cut payments to health care providers, and drug prices, and administrative costs.
Your scary fact is that we would reduce costs? Funny what Republicans find scary nowadays.

(p.s., you forgot "dramatically cut payments to insurance companies" and "realize huge cost savings through preventative care")
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  #99  
Old 12-04-2018, 02:13 PM
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Gatopescado Gatopescado is offline
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Fuck my ass.
Well, okay.

But I'm not gonna kiss you.
  #100  
Old 12-04-2018, 02:41 PM
Shodan Shodan is offline
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Originally Posted by Evil Economist View Post
More seriously, if it's possible to reduce healthcare costs by $2T over 10 years, then don't you suppose mathematically there's a way to pay for it without increasing the deficit.
We would have to increase taxes by more than double, since doubling the income tax will not pay for it.
Quote:
"realize huge cost savings through preventative care"
Didn't read the cite, did you.

Regards,
Shodan
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