The CBO thinks you’re wrong.
And for that matter, so do I. Care to produce some cites for your doom and gloom?
You are correct about the $41 billion plus $13 billion equals $54 billion, but last I checked $54 billion plus $110 billion equals $164 billion, not 154.
$164 billion in real savings vs. a promise that they will start cutting ten years from now? Especially given that they have voted down the Medicare reimbursement reductions to doctors for the last six or seven years? I’m not that naive.
They are not going to cut Medicare. They say they are, but that’s just a way to sell the program. Most of them will be long out of office, especially Obama, when the cuts come due.
You are excessively gullible. They are going to sell the bill based on the CBO estimates which include the cuts, and then cross their fingers and hope for another economic boom like we had in the 80s and 90s so it will all just go away and they can pretend you can get something for nothing.
Obamacare is going to cost a shitload, drive health care costs higher for everyone, and still not cover everyone.
I don’t believe that Republicans would refuse to support tort reform. It would seem to me that including tort reform would make the bill more centrist, as well as more believeable.
Pay for $154 billion towards catastrophic care. Doesn’t require a tax increase during a recession, and has a reasonable chance of not adding to the deficit even without any political courage by Congress.
But no, even with veto-proof margins the Dems can’t put together a bill that passes the smell test.
Regards,
Shodan
Heh, I was working on some numbers when I did that post, it seems neither of us can do math.
I’m certain that the current bill + tort reform would sill get no Republican votes. They’ve spun off the moderates (the northeasterners aside), I just can’t see them getting more Republicans than they’d lose Democrats.
And remember, they have a “veto-proof” majority because they have moderates. There is going to be disagreement between Democrats.
That said, I’d wish there were some decent Republicans who at least would consider voting the other way, but it doesn’t look like that’s in the cards.
Like I say, I agree that tort reform is worth doing, but I think the best bet to get it would be to pass it as a separate law. That way the vast majority of Republicans and a few Democrats can vote for it.
“Tort reform” refers to legislation capping payouts for medical malpractice claims. These claims are filed against healthcare providers, and paid for by their malpractice insurers.
An arbitration-first clause in your own private healthcare contract does not affect your relationship with your healthcare providers or their malpractice insurers. You do not enter into a contract with them. I suppose it would theoretically be possible for providers themselves to require that their patients execute arbitration-only contracts as a condition of care, but I suspect that raises all sorts of legal hobgoblins or somebody would already be doing it.
I don’t have much to add at this time (WAAAAAAY too busy) but I’ll just say that I’m enjoying this debate. Both sides are providing food for thought. I appreciate that.
No, to my knowledge.
No. Yes. Bad. This is the worst financial crisis since WWII. Monetary policy has become ineffective, since the Fed can’t drop interest rates below zero. So the government should be running huge deficits now. Tax increases (and yeah spending cuts) can come later.
Well, a lot of this depends upon whether you’re operating in normal times. But yeah, there’s an offset to consider. Again, tax increases now are a bad idea.
Nope. This liberal is highly skeptical of tort reform in the absence of universal or near-universal health care. Assuming the much compromised version of the bill passes (thank Joe L.!), I anticipate favoring some form of it moving forwards.
[hijack]And the teacher’s unions![/hijack] In a functional political system, we’d rely on the Republicans for tort reform and educational reform. But let’s face it, their heart is really not in either one. When the Republicans controlled all 3 branches of government, they didn’t make the smallest of moves towards tort reform - not even a tweak. Liberals are actually somewhat sympathetic to these initiatives, properly handled.
There’s probably some low lying fruit in the system. And rural docs can be compensated by tweaking the funding formulas. But let’s face it: some will have to be squeezed. But it’s better to do that gradually, rather than wait for the trainwreck that’s coming due in ten or more years.
Beats me. 
Bullshit. The argument was that we can’t afford healthcare because it’s too expensive. Well if we can afford the Iraq War and Bush tax cuts --each of which were more expensive and the latter which is reversible then we can afford health care reform. Absence of universal health care is estimated to cost 25,000 lives per year.
Well you have to read the fine print. The Base Closure Commission worked because they demanded an up or down vote on the entire package. It’s true that commissions that are wholly advisory can be a way of creating the appearance of responsiveness, without the reality of it. But generally speaking (at the very least) these sorts of Commissions are at least necessary for reform, when the issue is as technical and complicated as this one.
Well, I see your recollection doesn’t extend to 15 seconds or so.
I think you may have received a few too many roundhouse kicks to the head Shodan. Did you disclose this pre-existing condition to your insurer? I sure hope so, because otherwise some contracts permit rescission, whereby a failure to disclose everything can eliminate the insurers obligation to pay for an entirely different disease or condition.
Existing bills address this nonsense. Practical libertarians should also oppose such horseshit contracting.
Smashy - I have to turn in for the night, but I don’t want you to think that I’ve ignored the other posts.
Methinks that it’s worth it to read (or in practice skim) the CBO materials. But I want to make sure we’re in sync on something. Whatever happens, health care costs are likely to grow, both in inflation adjusted terms and in terms of GDP shares. That’s really a given. The question is whether reform can make it grow slower than it otherwise would have – which is an awkwardly technical question. What’s pretty clear is that the current combination of health care inflation and baby boom retirement is unsustainable.
Well, “That which cannot continue forever will eventually stop.” What we have to figure out is a) what does the current plan do? b) what does the current plan not do? Be specific. And c) Are the promises in the plan credible?
It’s fashionable to trash the Federal government with a very broad brush. But the fact is they have gotten things roughly right in the past – 1986 tax reform, CFC regulation and Clinton’s budgetary discipline (yes Virginia, there were once budget surpluses) are 3 examples. So it’s not enough to say “I’m skeptical”. You need to examine the details.
Moreover, absence of universal health care (especially the tying of health care coverage to employment) is massively economically inefficient.
Labor markets would be a lot freer in practice if they weren’t dragging around this ball and chain of unequal and inconsistent health insurance costs. How much are we as a nation losing in job and career mobility because so many people are afraid to leave dead-end or unsatisfying jobs for riskier but more potentially rewarding ventures because they can’t take the risk of losing health insurance?
How much time and money is wasted when people do change jobs by selecting and setting up new insurance coverage options, getting records changed, and so on? The lack of sensible portability in health coverage is a huge clog on the efficiency of our healthcare system. Losing a job generally means more expensive premiums and more paperwork for COBRA coverage. All of this hassle and uncertainty is costing us money all the time.
And as you note, these costs are just going to go on rising if we don’t do anything to reform the system. It’s not as though the system we have now isn’t disastrously broken already.
The system we have now is going to cost a shitload, drive health care costs higher for everyone, leave many more people uninsured and many others inconsistently or insecurely insured, fail to take advantage of massive potential savings in overhead costs and bargaining power, and in addition keep subjecting people to all the draining uncertainties, fears, hassles, and unnecessary complications of the private-insurer patchwork.
You are offering people a costly shit sandwich, and complaining that the opposition is offering them a meager and overpriced veggie-burger instead of Kobe steak for seventy-five cents. Do you seriously imagine that you can get us so upset about the failure to provide 75-cent Kobe steak that your shit sandwich will seem like a better option than the veggie-burger?
I email and PM some folks on this message board, and we talk about various things. Just from talking to a few people, and not talking specifically on this subject, I can count half a dozen or so who don’t feel free to leave their jobs because they can’t lose the health insurance.
Wow, I’ve got to hand it to you. While the rest of us are worried about the charging rhino, you have figured out that the ticks on the rhino’s ass, if left long enough, could become somewhat significant. $110 billion over 10 years is nothing. Why, over 91 years that would be a trillion dollars! Over a mere 90,909 years you could save the government a quadrillion dollars! Oh, that the rest of us could only have your intellect!
I’m not sure what you are talking about. We should do Obamacare because it will cost a trillion or so dollars and do nothing to address the root causes of health care inflation, and not do tort reform, because it will save $154 billion over ten years and actually address the root cause?
No, it is a tu quoque all right. Just because the government is wasting money in one place is not a valid argument for wasting money somewhere else. You would see that if it were not in the usual liberal blind spot.
Suppose I have a weekly income of $1000. I am already spending $250 a week on booze and $250 a week on lottery tickets. Surely I can afford to buy a new house with a monthly mortgage payment of $2000. After all, real estate is a great investment, and I can always cut back on lottery tickets two years from now.
Besides, the argument is that we cannot afford Obamacare because it is too expensive and does nothing to address the root causes of health care inflation. Tort reform is much less expensive, and does address those causes.
But you are correct in pointing out another of the problems with Obamacare - it is going to be that much more difficult to actually “fix” health care if there is a huge, expensive program in place. That is why the package pushes all the cuts years down the road - they aren’t actually going to make any cuts, and are hoping to tie the hands of those who come after.
Actually, it goes back much farther than that. Back in 1997, Congress put together a realistic approach to Medicare spending that included a Sustainable Growth Rate for doctor’s bills (cite). Every year since 2003, Congress has failed to actually stick by that rate. Democrats want to institutionalize that failure by pulling these cuts out of Obamacare altogether. This allows them to pretend that Obamacare will not add hundreds of billions of dollars to the already unsustainable deficit.
I fully realize that Obama, the Democrats, and their allies in the MSM will repeat the lie endlessly that Obamacare will not increase the deficit. You know, I know, everybody with common sense knows (so perhaps you don’t know after all) that this is so. Mr. Smashy has already linked to polls where strong majorities of those who refused the Flavor-Aid recognize that this is so.
If we put in place a system that doesn’t address the causes, this is so. But we don’t have to do that.
There are other, sensible things that we could do. I would prefer that we do those things, not saddle ourselves with a system that costs a trillion dollars and makes everything worse.
Regards,
Shodan
Tort reform does not address the root cause of health care inflation. No matter how many years you multiply out the amount of money tort reform would save, it will never be significant.
Saving $164 billion over ten years vs. spending $1 trillion over ten years isn’t significant?
Uh-huh.
Regards,
Shodan
You keep saying that tort reform addresses the root cause of health care inflation, despite repeated cites that put it at a small fraction. How is tort reform the root cause of health care inflation?
The root causes, if you want to think of them that way, of health care inflation are probably:
a) constantly advancing technologies, especially in pharma, which need to be paid for
b) an entitlement mentality (I actually heard someone on the metro say once, “Why should I pay for my own healthcare… let Congress use their money to pay for it”)
c) Expectations; most thinking people agree in the abstract that life isn’t exactly priceless, that there need to be rational decisions made when it comes to rationing care (either by price or gov fiat, every scarce good gets rationed). But nobody wants their grandma to be the fulfillment of that otherwise logical public policy
d) the last year of life costs have risen over time. From a dated study I found:
Mr. Smashy,
You terms like “The root causes, if you want to think of them that way, of health care inflation are probably:” and you are quoting a dated study, but you are linking to it. Can you provide links?
In what possible way could an “entitlement mentality” lead to health care inflation, assuming the same even exists?
What kind of jobs do these people do? Are they talking about quitting altogether, or just finding other work in their field? Short of McDonald’s and some retail work, I am having a hard time coming up with occupations where the health insurance would be the factor tying you to your job, unless you’re in a legacy era job that picks up a much higher portion of the cost than is typical nowadays.
Pre-existing conditions, dude.