The Hill on the cusp of healthcare

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Not gonna happen with Pelosi treatening everyone........;)

Fortunately Pelosi is in the House, while I was talking about the Senate. ;)

But the same holds for Harry Reid, so point taken.
 
The whole purpose of the Public Option is to introduce more competition driving down cost.
I want to believe this but the government has rarely shown that it can run things too efficiently. The employment in those "public" entities, be it education, package delivery and transit tend to become like social programs with benefits we can't afford -- and we are repeatedly faced with service reductions or tax/fee hikes to continue to sweeten the deal for those employees or sustain the unsustainable for a couple more years. Look at the cost of education, K-12 adjusted for inflation per pupil.

Total and current expenditures per pupil in public elementary and secondary schools: Selected years, 1919–20 through 2005–06

Look at this table per student in constant 2007 dollars:

1960: $3,272
1970: $5,161
1980: $6,549
1990: $8,923
2000: $10,360
2006: $11,643

Again: constant dollars per student. Is public K-12 education almost twice as good today as in 1980? Or 3.5 times better than it was in 1960? That's what we're paying for it today. So why are schools starving today when they weren't in 1960? Is that public option cost control at work?

I have no reason to believe that a "public option" in healthcare would do anything but include highly compensated public employees with a strong union and unaffordable benefits the private sector can only dream about. And I don't see the crowd that wants the "public option" putting limits on trial lawyers or junk lawsuits, either.

This is no anti-government rant. I'd like for a public option to work. But government's track record in running affordable and cost-conscious enterprises is terrible, largely because they are in denial that it's not 1960 any more and the kind of public sector employee benefits we could afford back then are no longer sustainable in today's global economy.

Public sector employment costs simply can not grow faster than the private sector employment costs any more. Businesses and private sector employees simply can't bear that burden any more.
 
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I want to believe this but the government has rarely shown that it can run things too efficiently. The employment in those "public" entities, be it education, package delivery and transit tend to become like social programs with benefits we can't afford. Look at the cost of education, K-12 adjusted for inflation per pupil.

Total and current expenditures per pupil in public elementary and secondary schools: Selected years, 1919–20 through 2005–06

Look at this table per student in constant 2007 dollars:

1960: $3,272
1970: $5,161
1980: $6,549
1990: $8,923
2000: $10,360
2006: $11,643

Again: constant dollars per student. Is public K-12 education almost twice as good today as in 1980? Or 3.5 times better than it was in 1960? That's what we're paying for it today.

I have no reason to believe that a "public option" in healthcare would do anything but include highly compensated public employees with a strong union and unaffordable benefits the private sector can only dream about. And I don't see the crowd that wants the "public option" putting limits on trial lawyers or junk lawsuits, either.

This is no anti-government rant. I'd like for a public option to work. But government's track record in running affordable and cost-conscious enterprises is terrible, largely because they are in denial that it's not 1960 any more and the kind of employee benefits we could afford back then are no longer sustainable in today's global economy.

Public sector employment costs simply can not grow faster than the private sector employment costs any more. Businesses and private sector employees simply can't bear that burden any more.

You make great points, but to combat your numbers, the education talking heads would merely apply an inflation number and say the spending levels are the same, in inflation-adjusted dollars.........:rolleyes:
 
You make great points, but to combat your numbers, the education talking heads would merely apply an inflation number and say the spending levels are the same, in inflation-adjusted dollars.........:rolleyes:

he said it's in 2007 dollars, read the post before you talk
 
And remind me what the opposition's solution to these problems were?

Health Care - GOP Solutions for America - GOP.gov

I'm not saying that plan is any good, haven't analyzed it much at all. And I don't trust either major party further than I could throw them.

It's all rhetorical anyhow, with the other party having a super-majority, nothing that the opposition brought up was going anywhere. Could they, should they, have taken steps to improve the health care problems while they had a larger representation in Congress? IMO, yes, and I wish they would have. But that is now water under the bridge.

But you asked.


-ERD50
 
The whole purpose of the Public Option is to introduce more competition driving down cost.

No partisanship suggested or implied:

Hmmm.... the Government's track record on administering these types of programs this isn't so impressive...


SS-will be broke soon
Medicare- broke
Medicaid-broken
FannieMay-broke
FreddieMac-broke
Cash 4 Clunkers-broke down
TARP-broken
ACORN- broke
USPS-almost broke
NASA- broke

Can anyone name a government/quasi-government program administered and/or funded by the federal government that isn't in financial trouble? Or that has performed to OMB budget projections?

And why we should think this Health Care Bill will be any different?

BTW, I don't see any of the folks who voted for this bill agreeing to sign themselves and their families up for it. Or am I missing something?
 
. And while not perfect, 2014 is better than never, which was the alternative.

No, one of the alternatives was immediate implementation which the authors of the bill chose to set aside and go with 2014. This makes the bill less useful for folks who are near FIRE but need some help with the HI issue in order to be able to pull the plug.
 
I agree that the argument a "public option" is needed as competition for private insurers is bogus. The real purpose of the "public option" is as a Trojan horse for single payer. There are plenty of good reasons for single payer (chiefly that insurance for the sick and elderly isn't insurance at all, but is really just subsidization. The private market doesn't do subsidization. Government does.) But providing competition to the private market isn't one of them.
 
BTW, I don't see any of the folks who voted for this bill agreeing to sign themselves and their families up for it. Or am I missing something?

And that's the acid test.

It seems that the strongest motivator for the Bill's authors to drop the public option here was their observation of recent events in Canada. When some Canadian pols took minor heat for bailing out on Canadian public health care and coming to the USA for treatment, our pols saw it as a threat. They don't want to pass any reform that they would be subject to or that they would be criticized for going around.

I know it's subjective, almost silly, but I just can't get excited about reform where the authors work so hard to ensure they're able to go forward with their current circumstances.
 
I just wonder how many of the bill's supporters are going to actually pay for any of it. As one of the few people whose taxes will ultimately finance this bill, I find the price tag pretty steep for what it promises to achieve.
 
But you asked.

I did ask. And I have already seen the GOP proposal, which is why I asked what their solution was to the specific problem of adverse selection and pre-existing conditions.

These are huge, and important, problems with health insurance. And they are not ones that have acceptable market based solutions. And because they don't have market solutions, the opposition side-steps the problem altogether.

And it's not entirely water under the bridge. I think its important for those people who oppose a heavy handed government solution to things like pre-existing conditions to come up with a realistic alternative. If they have no realistic alternative, then maybe they should reconsider their opposition.
 
I just wonder how many of the bill's supporters are going to actually pay for any of it. As one of the few people whose taxes will ultimately finance this bill, I find the price tag pretty steep for what it promises to achieve.
The bigger concern for me is the question of how many high earning (and highly taxed) individuals will see this as an incentive to get off the hamster wheel, stop w*rking, and start collecting a lot of "lower income" health insurance subsidies instead of paying a lot of taxes.

For someone like me who has configured a decent asset base, a paid-off house, no debt and can live on a rather modest income comfortably, this is potentially a gift that allows me to retire several years earlier than planned. But if enough people decide work ain't worth it any more as ants are taxed more and more to subsidize the idle grasshoppers -- and if enough people become grasshoppers as a result -- costs will explode and revenues will shrink.

Even though it could benefit me personally, it doesn't feel like you can build a sustainable system by increasingly taxing production and increasingly subsidizing the idle. I'd feel a little guilty about gaming the system that way, but unfortunately the alternative to taking advantage of the system seems to be the system taking advantage of me, and with no middle ground. And it is ultimately that same "incentive to quit" that could benefit me that concerns me most about the viability of this plan.
 
BTW, I don't see any of the folks who voted for this bill agreeing to sign themselves and their families up for it. Or am I missing something?

And that's the acid test.

I
Seems like a lot of people around here are happy to have Medicare waiting for them to get a few years older. And no one seems to be proposing to abolish Medicare despite the fact that it will take a substantial influx in funding to fix. As to the public option, if no one would sign up for a public option why is the insurance industry so frightened of it? And don't pile on with the canard that it's losses would be covered by tax dollars. It was to be structured as a stand alone program that had to rely on on premiums to fund its costs. It ain't rocket science to make that an iron clad requirement.
 
It was to be structured as a stand alone program that had to rely on on premiums to fund its costs. It ain't rocket science to make that an iron clad requirement.

:ROFLMAO: ...right... successful examples, please?
 
It was to be structured as a stand alone program that had to rely on on premiums to fund its costs. It ain't rocket science to make that an iron clad requirement.
That's a howler. Medicare, SS, the entire Federral budget --we have a great track record of writing checks for the kids to pay off. Every year since 1969 Congress has spent more than the tax revenues that came in. Anyone remember the "iron clad" Gramm-Rudman-Hollings Act? How did that work out?

I'm ready now for a balanced budget amendment.
 
IIRC the data for the claim [smokers costing less] is pretty flimsy.

The preventing insurance company from denying people health insurance due to pre-existing conditions is something you and other highlight as one of the reforms of the bill. While I can definitely see some advantages of it, the unintended consequence is very likely to be there less is incentive for people to stop doing stupid things that drive up health care cost. I don't know if insurer are allowed to charge more for fat, smokers I think under the bill they aren't.

I haven't looked at the data for smokers. It might well be flimsy.

I doubt people will smoke more simply because their lung transplant will be covered. Smokers smoke now, and the rest of us - even with good insurance - don't want the risk of lung cancer (or like the stench). That concern, at least, seems far-fetched. Same with eating fatty foods. It happens now, health costs and food costs be damned. Diabetics at the city health clinics (eg, the poor) regularly violate their doctor's rules, even when money and larger health problems are a concern. It's a cultural matter.

I'm all for charging more premiums for choices. Smokers, the obese (through a "fat tax"), the dangerous.
 
I'm all for charging more premiums for choices. Smokers, the obese (through a "fat tax"), the dangerous.

Careful there, cowboy.. under this logic the LBYM'ers will be getting penalized for saving instead of helping to spend us out of the recession. :whistle:
 
:ROFLMAO: ...right... successful examples, please?
The Federal Thrift Investment Program. Works just like Vanguard but simpler and cheaper. But, unlike Merrill Lynch, et al., their mission is to maximize value for their investors. And, mirable dictu, they contract out much of the work to the private sector.

That's a howler. Medicare, SS, the entire Federal budget --we have a great track record of writing checks for the kids to pay off.
.
Look, I agree that the health care bill as passed will end up costing a boatload of dough. We will spend a whole lot of time working to adjust to it. A major portion of the cost problem comes from the subsidies to low income citizens (something we as a nation have decided is worthwhile). But the subsidies simply go to pay for premiums - to the public insurer or a private insurer. It isn't rocket science to devise a Federally managed program like the TSP to offer health insurance. If it isn't effective its premiums will price it out of the exchange and out of existence.
 
I'm all for charging more premiums for choices. Smokers, the obese (through a "fat tax"), the dangerous.
Do smokers and the obese get bigger SS and public pension checks to make up for the fact that they "save us money" by dying earlier? Do we place a tax on healthy choices because of the cost "the healthy" are putting on our SS and public pension systems by collecting more from those systems on average?

If not, then why not? Fair is fair. None of this picking and choosing, IMO.
 
... the specific problem of adverse selection and pre-existing conditions.

These are huge, and important, problems with health insurance. And they are not ones that have acceptable market based solutions.

Hey, we have some common ground here!

Yep, adverse selection and pre-existing conditions are not going to be handled in a totally free market in a way that would be socially acceptable to most people. It would mean turning people away at the ER for example. We just are not going to let that happen routinely.

So we need some sort of involvement - But that does not mean that I should be 'happy' with what passed. I still think it is a mess. One party or the other could have done much better, and should have done much better. I am disappointed in all of them.

I don't see what is wrong with opposing something. Lincoln opposed slavery. The only thing that even has a semblance of bipartisanship in this was the opposition to the bill. Both Rs & Ds opposed it, but only Ds supported it.


We agree, then. I'm glad you stopped trying to change the subject.

Changes Synonyms | Synonyms of Changes and Antonyms of Changes at Thesaurus.com

Not following you. Change can be positive or negative. This is change, well, some of it not until 2014. Mostly the stuff that we were told was 'urgent'.

-ERD50
 
Gotta pipe in to note that despite the worries of the moderators this has remained a very respectful discussion. Given the rhetoric surrounding it in media land, that is a tribute to the population on this forum.
 
The Federal Thrift Investment Program. Works just like Vanguard but simpler and cheaper. But, unlike Merrill Lynch, et al., their mission is to maximize value for their investors. And, mirable dictu, they contract out much of the work to the private sector.

the exception that proves the rule?


If it isn't effective its premiums will price it out of the exchange and out of existence.

how many non functioning government programs ever actually get eliminated instead of recapitalized with our tax dollars every time they get into trouble?
 
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