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!
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.
What’s funny about it?
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.
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.
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.
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?
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 -
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.
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
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.
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.
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.
and not letting pharmaceutical companies kick off an epidemic of addiction which requires an increasing amount of emergency care for those affected?
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:
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.
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
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.
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?
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”)
Well, okay. 
But I’m not gonna kiss you.
We would have to increase taxes by more than double, since doubling the income tax will not pay for it.
Didn’t read the cite, did you.
Regards,
Shodan