How’s your semester going? You ready for finals?
I never knew as much as you seem to think you do except when I was a sophomore in college.
I notice you can’t manage to address the many things you’ve gotten wrong in this thread, instead you attack.
I’m not the issue here. It’s your adherence to lies even when shown that you are factually wrong. You attack because you’re too cowardly to face the reality that you’ve been lied to.
Ok, but let’s not miss the point. This Poly Sci prof didn’t provide any substantiation AFAIK. There is no paper. There is no memo. There is no specific sourcing. There is only a chart. Now I haven’t looked at the CBO report. But often there are multiple estimates that are made. Tying your complaint to cost numbers that begin 10 years out is inherently problematic and beg for attention.
I’m not blaming you for linking to the blog post though. I’m blaming Reason magazine for publishing it without sufficient due diligence. That chart reeks of hackery. This sort of stuff reinforces my impression that Reason magazine is made up of a bunch of ideologues. (In contrast, I disagree a lot with Cato --and I frankly believe that they put out a lot of nonsense. But I have also read some gems in the dross at that think tank. There’s a streak of curiosity at Cato that is absent in certain other conservative institutions.)
Well, Reagan talked about balancing the budget on the backs of waste/fraud/abuse but that was generally understood at the time to be politicing.
But “Bending the cost curve” is a little different than that. For one thing there is a lot of specificity-- not just general assurances. A Independent Medicare Advisory Board is established and given some teeth - their recommendations can’t be filibustered. The goals set are tough --6% nominal growth. Frankly, I can’t see how they can hit that, so expect a lot of angst, handwringing and melodramatic rolling of the eyes (oh Washington why are you forever thus?) moving forward. Changes in payment rates are instituted – and again given specificity across hundreds of pages. Experiments are instituted. And there are further pushes on evidence based practice, IIRC. As Gruber claimed, they are trying pretty much everything.
Well, actually we do. And put the figures in context: they cost less than the Bush tax cuts. And they are joined with efforts to get economy-wide health care costs under control. In other words, they are the most serious attempt at addressing entitlement spending in over 20 years. True deficit hawks should love this bill.
Sigh. He’s not offering them health insurance. He’s offering them the joy of paying for someone else’s health insurance.
M4M, great post.
Lobo, I’m the one who attacks? Riiiggghhhht. Anyway, good luck with finals, I hope you can get a ride home for winter break, and there’s a hackeysack tourney in the quad.
M4M, now that I’ve read through your links… a question: Does the senate bill include repeal of the 2001 and 2003 tax cuts? If so, is raising taxes in the latter part of a recession a good idea to fund this? Won’t this hamper our efforts to get out? How about the effect on unemployment (ie, less investment dollars out there means unemployment must rise higher than it otherwise would be)?
Your link about Krugman’s claim was interesting. I liked that you linked to a factcheck site and not to the direct claims that so many true believers here would do. The factcheck site acknowledges that tax cuts are about 25% self paying due to the economic stimulus effect. Does a tax increase work the other way, ie damage by an extra 25%?
Finally, is tort reform also included? If not, how can anyone say with a straight face that the current court-system lottery we have for claims is the best way to go? How can anyone be happy that the Democratic party is evidently bought and paid for by the trial lawyers?
PS I agree with you, I like the idea of an indy Medicare cost-cutting commission. Of course there’s still the unfortunate truth of my post upthread, that Medicare only pays 80% of the healthcare delivered. If it’s cut even more… how will hospitals and rural docs survive? And if people opt into Medicare at lower ages, doesn’t that make the problem even worse?
The less-than-reassuring words in the above are “advisory” and “recommendations”.
If Congress has the will to enact painful cuts in Medicare spending, why don’t they do it now? What difference will it make that some commission tells them to do it?
It seems to be implying that we can be quite sure that Congress spends the money now, they will make cuts in Medicare spending later. Off the top of my head, I cannot recall any instance where Congress cut Medicare spending. Not one.
The CBO head says -
The CBO projections, IOW, are based on promises of future cuts. This is the sort of financial sleight of hand that we always get - spending now, cuts later. Somehow or other, later never comes.
Me either, and therefore along with the angst and hand-wringing I expect an increase in the deficit - exactly what the Advisory Committee and Obamacare was supposed to prevent.
If Congress were going to do the things they say they are going to do in the future, they would do them already. They don’t. And they aren’t going to.
This is a tu quoque, obviously - libs were having fits over how dreadfully costly the Bush tax cuts were. Now you want to argue that this is a good idea because it only costs $1 trillion?
Regards,
Shodan
OK, M4M, one more for you:
Please read today’s excellent piece by Samuelson in the WaPo. He outlines most of the fiscal reasons I’m against this ‘reform’ bill.
Here’s the money shot:
Also mentioned is Congress’ history of blocking the Sustainable Growth Rate reductions to Medicare in the past. You say the BRAC-like commission may fix that problem; perhaps it will, perhaps not. But the track record isn’t good, and I don’t usually trust politicians when they promise to do the easy stuff now but swear they’ll do the hard stuff down the road.
I notice that Sho made pretty much the same point as our posts crossed in the ether.
Why do you assume that what is currently being proposed can only be done instead of cost control? There’s no inherent reason why tort reform and pay caps and the like cannot be implemented alongside the currently proposed reforms.
In any case, if national health care spending doubles in the next 10 years, either the government will be bankrupt, or the rest of us will. Why is the former scenario so much more troubling for you than the latter?
Just loved this line!
Assuming you were directing those comments at me:
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I agree there’s no reason why they cannot be done simultaneously. But they’re not being proposed that way. Tort reform: how about a gummint panel that reviews claims objectively and provides legit compensation to those that get screwed, instead of relying on a very inefficient court system? How about a federal cap on malpractice that doesn’t discourage the high-risk side of healthcare (try to find an OB GYN in Florida, for example). I’d love to see something like what DHS did with the SAFETY act (for those of you not hip on Gov contracting, that is a law that immunizes to a certain extent companies that make good faith efforts to help with Homeland security)
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anyone spending beyond their means is troubling. Me, you, the government. The problem is when the government does it, you don’t have to pay the piper until several years down the road, at which time it catches up with the next generation.
You can’t put a federal cap on malpractice suits; that’s the states’ job.
A gummint panel that reviews claims objectively and provides legit compensation to those that get screwed is called a court.
that this point is missed among many people that dislike the current legal system and venture to propose new and better ways of adjudicating disputes is a constant source of amusement for me.
And if they are doing their job properly, they are applying the law, which is set by legislators. That’s the purpose of tort reform, which restructures the law.
So if some law were passed such that there was a hard upper limit of $250K on pain and suffering claims, or that neither plaintiff nor plaintiff’s attorneys were entitled to receive any portion of punitive damages, the court would ensure that the compensation involved would be legitimate - i.e., did not violate those laws.
So it would be preferable to continue to use courts even after tort reform. IMO.
Regards,
Shodan
Right - I have no problem with setting limits on damages. I was responding to **Mr Smashy’**s two specific points. That said, the total cost of medical malpractice suits and defensive medicine is 11% or less of the total cost of health care spending, according to the DHHS, so even eliminating malpractice claims entirely wouldn’t take care of the cost issues under our current system.
I would still like to note that every claim you’ve made has been proven wrong and you aren’t honest enough to admit it. Your claims are based on lies and misinformation and when you’ve been shown that you revert to attacks.
HCR will save money. It is paid for.
Again, HCR will save money. It is paid for.
Agian, HCR will save money. It is paid for.
You can decide you don’t like the cuts and taxes that will fund it, but you can’t keep hashing up a lie you really really like.
Also, tort reform is worth doing, but it will save 1% or so off of HC costs. It isn’t a panacea, it’s a small bit that can help. To focus on tort reform is a distraction.
But 11% is over 100 billion dollars!
Incidentally, here are some obstetricians/gynecologists in Florida, since you asked:
Yes, and? Let’s pretend we could knock it down to 5%. That’s a 60 billion dollar saving, which would be nice, but is still a drop in our current bucket, let alone our 10-year bucket (per your own quote). As Lobohan says, tort reform is a worthwhile aim, but is not going to solve the healthcare crisis.
ETA: That 11% figure came from the Bush Administration’s DHHS, incidentally.
So you really don’t see a difference between a panel of technocrats dispassionately examining incidents and awarding damages based on standards, vs emotional appeals to juries that sometimes award nothing and sometimes award unbelievably outsized damages? Oh yeah plus the full-employment act for Trial Lawyers/Ambulance Chasers, along with the motivations for frivolous suits, that the second path ensures?