How Would You Balance the Budget? Preferred ratio of tax increases and spending cuts

[M Paquette]

Just in time, the NY Times has this interactive feature:

Budget Puzzle: You Fix the Budget - Interactive Feature - NYTimes.com

The interactive version without all the costly computer equipment is here, or here.

Kill the earmarks, and See the Enormous Progress!

I have to go tenderize some meat for the Congressional BBQ I'm hosting.

[Independent]

Quote:

Originally Posted by keegs Thanks for posting this....America could be well on its way to solving its debt problems if we would agree on a way to get our arms around healthcare costs.

"Well on it's way" is definitely true. The "horrific deficits" projected for 2014 and 2015 are 3.9% of GDP. The US spends about 16% of GDP on health care, while the top end for European nations is about 11%. If we could simply get the European results by taking any one of the European programs, we'd save enough in total to eliminate out deficit.

(The "in total" doesn't reflect the private/public split. In those years the federal government's share of medical costs will be about 6% of GDP, so we'd have to use some of the private savings to completely balance the federal budget.)

[samclem]

Quote:

Originally Posted by Independent The US spends about 16% of GDP on health care, while the top end for European nations is about 11%. If we could simply get the European results by taking any one of the European programs, we'd save enough in total to eliminate out deficit.

In fact, since the US is considerably wealthier than Europe on a per capita basis, if we had per-person medical costs like some of those programs, the percentage of our GDP would also be considerably less than the equivalent European country.

2008 numbers: EU GDP per person: $31,182
For reference: Germany: $35,511
UK: $36,689
US GDP per person: $46,588
For reference: Alabama: $36,469

The big "however": A primary reason the US is far wealthier than Europe is that the economy is more efficient and government is less intrusive (and takes a smaller tax toll). I'm sure we could create a "Europe of the US"--same welfare state, same helpful government safeguards and bureaus, same "free" health care, and all the personal wealth of Alabama--just like Europe.

[keegs]

Paul Ryan voted for president Bush's unfunded prescription drug plan says Obama-care will bust the budget and thinks Germany's got it right on economic policy .....go figure.


Charlie Rose - Rep. Paul Ryan, Wisconsin (R)

[Gone4Good]

Quote:

Originally Posted by samclem In theory, the new health care law could usher in some needed changes. For example, the exchanges might work to improve competition. But the law carries over so many bad parts of the present system, and fails to incorporate so much change that is desperately needed, that I just can't see how we can call it an enhancement.

Thanks for the clarification.

But, ahem, at least half of those bullet points are a direct result of the opposition to the big picture reform.

1) We couldn't change the employer sponsored health care system directly because reformers were forced to say that everyone who has insurance will be able to keep it. And in fact, a big criticism, then and still, is that reform would encourage corporations to drop coverage and force people on to exchanges. So the complaint seems to be both that corporations will continue to provide coverage, and that they won't.

2 & 3) I think are kind-of the same thing. Yes, getting rid of Medicare Advantage was a philosophical difference. But there certainly is cost savings here. And, unlike the Medicare Prescription drug benefit expansion, health care reform had to lower deficits as determined by CBO projections. So MA is one place where spending was cut. Hardly a fatal flaw.

4) None of those pay-offs would have been necessary if the folks who sponsored the Republican's alternative to "Hillary Care" in 1993(?) supported the same fundamental reforms in 2010. In fact, if the 1993 alternative was used as a starting position for honest negotiations, we could have ended up with very good reform legislation. Too bad.

Even with these criticisms, it still seems to me that we agree about the basic foundation reform must have (i.e. individual mandates, blah, blah, blah). And we also seem to agree that 'ObamaCare' contains that basic foundation. So lets strip away the bad parts and build on the good parts. Unless, of course, the real problem isn't with the foundation, but with who built it.

[samclem]

Much hinges on the SCOTUS ruling regarding the individual mandate. If that is ruled unconstitutional, then we'll have to rethink quite a bit of this. It's possible that in the US "universal coverage" will look a lot different from anywhere else--more like "universal access and the government will do everything possible to help everyone afford coverage. Those who don't sign up, if not ruled legally incompetent, will not be taken on as the collective responsibility of everyone else at the national level. When they get sick, States can choose to have programs for them, or they will be left on their own or to the voluntary help they can get from others." Tough love, but maybe that's what freedom looks like.

While we wait for the SCOTUS, we can deal with the other aspects of our fiscal problems. That should keep everyone fully occupied.

Edited to add: Regarding the changes in what Republicans are willing to accept-- Hey, my own "bar" changes depending on the environment. Sometomes a "less bad" alternative looks great after the reality sinks in concerning some crazy package that's about to become law. Everyone recognizes that our present "system" is a mess and that we have to do something about health care costs (to individuals and to society). So, if the passage of the new health care law encourages Republicans to come off their perch and give on some issues, that's good. And if the impending dismantlement of the "reform" law causes Democrats to compromise some more, that would be good.

And, regarding the continuation of employer involvement under the new law: While we are looking back and casting blame, I think we can agree that this was, in large part, a result of positions taken during the presidential campaign. Candidate A proposed a bold move away from employer-provided health care. Candidate B immediately used this as a bludgeon--"He wants to take away the health care you get now and you like! He wants to make you buy your own insurance!" It was effective and after that Candidate B was forced to ride that lame horse all the way through this ugly process, and the rotting hide of that varmint still stinks up the present legislation.

[Gone4Good]

Quote:

Originally Posted by samclem Much hinges on the SCOTUS ruling regarding the individual mandate.

True. But while we both seem to agree that it is a necessary aspect of health care reform, one of us is actively hoping for it to be overturned. How strange.

[FinanceDude]

Quote:

Originally Posted by Gone4Good Again, this is me being dense. But I don't see how that proposal is substantively different then the reform we have. The big picture things you suggest are all included. Why, then would you not support the legislation generally, while saying there are many specific things that still need to be fixed. I happen to share that view.

Just Youtube Paul Ryan...he has the answers to most of the questions and how to fix them. And, unlike the past few years, where Dems and Republicans alike just patted him on the head and said he was doing a "fine job", they're going to have to listen to him now.........

[FinanceDude]

Quote:

Originally Posted by keegs Paul Ryan voted for president Bush's unfunded prescription drug plan says Obama-care will bust the budget and thinks Germany's got it right on economic policy .....go figure. Charlie Rose - Rep. Paul Ryan, Wisconsin (R)

Bush's prescription drug plan is a drop in the bucket compared to Obama's behemoth.........

[ERD50]

Quote:

Originally Posted by Gone4Good Thanks for the clarification. But, ahem, at least half of those bullet points are a direct result of the opposition to the big picture reform. 1) We couldn't change the employer sponsored health care system directly because reformers were forced to say that everyone who has insurance will be able to keep it. ...

I didn't bother to read further, as this comment is just too 'self limiting' to be of any value.

You really can't envision some way that we can wean ourselves away from employer based health insurance (or don't want to?)? Maybe grandfather the current plans? There are many ways to deal with this, but you seem so set in your "this is a great bill" defense that you just can't allow yourself to envision the possible alternatives.

I doubt that many people are buying your line. When I see the opposing views as weak justifications, it just strengthens my own view. Keep up the good work!

-ERD50

[ERD50]

Quote:

Originally Posted by FinanceDude Bush's prescription drug plan is a drop in the bucket compared to Obama's behemoth.........

But that doesn't make it right. I agree that it needed to be properly funded, and I do think the R's lost some votes over it from true fiscal conservatives.

-ERD50

[Gone4Good]

Quote:

Originally Posted by ERD50 I doubt that many people are buying your line. When I see the opposing views as weak justifications, it just strengthens my own view. Keep up the good work! -ERD50

Ok.

Still waiting to see the details of the alternative, though.

[ERD50]

Quote:

Originally Posted by Gone4Good Ok. Still waiting to see the details of the alternative, though.

I think samclem has outlined what's workable. If you want details, send me to Congress to write them!


-ERD50

[samclem]

Quote:

Originally Posted by Gone4Good True. But while we both seem to agree that it is a necessary aspect of health care reform, one of us is actively hoping for it to be overturned. How strange.

We need to abide by the Constitution. If the individual insurance mandate is unconstitutional (I think it is), we can then decide as a nation if we want to amend the Constitution.
If the SCOTUS rules that the Constitution, as presently written, allows the government to force individuals to spend their money to purchase a product from a private company, then we move forward and use that ruling to our collective and individual benefit.

[FinanceDude]

Quote:

Originally Posted by Gone4Good Unless, of course, the real problem isn't with the foundation, but with who built it.

Therin, lies the root problem.........

[Gone4Good]

Quote:

Originally Posted by ERD50 I think samclem has outlined what's workable. If you want details, send me to Congress to write them! -ERD50

Well then, all we have to do to be in agreement is for either of you to acknowledge that every one of samclem's proposals is included in 'Obamacare' and that samclem's proposals are actually the very heart of the legislation.

[Gone4Good]

Quote:

Originally Posted by FinanceDude Therin, lies the root problem.........

That certainly clears things up.

[Gone4Good]

Quote:

Originally Posted by samclem We need to abide by the Constitution.

Abiding by the Constitution and hoping for a specific outcome are two completely different things.

In the former you say "this is the only way to do something, but we might not be able to if the Court won't allow it" in the latter you're saying "this is the only way to do something, but I don't want it to be done, so I hope the Court won't allow it."

I have to say, I don't understand the motivation for the latter.

[FinanceDude]

Quote:

Originally Posted by Gone4Good Well that clears things up.

Just because other European countries have socialized medicine, doens't mean it works for everyone. This thread is a rehashing of things that have been discusssed ad nauseum for years on here.......

[Gone4Good]

Quote:

Originally Posted by FinanceDude Just because other European countries have socialized medicine, doens't mean it works for everyone.

I'm fine with that. I'm just trying to understand the alternative, which has been not surprisingly difficult to unearth from its presumed supporters.