Universal Health Insurance Coverage, new proposal

[ziggy29]

Chances of passage are looking strong.

Intrade Prediction Markets

Interesting. I thought this might happen, but not until after the election. If it's not popular in its current form, I wonder how many people in Washington will willingly fall on their swords to support it. After all, no matter what almost all of them talk about wanting, all they *really* want is to be re-elected.

 

[Texas Proud]

It's not the CBO projection. It's from a Harvard Economist, David Cutler.

Sorry.... can not read the article as it is cut...

Is there anybody else that agrees with his number Has anybody checked it?

 

[ERD50]

Sorry.... can not read the article as it is cut...

Is there anybody else that agrees with his number Has anybody checked it?

I wanted to check it, but I also found the article cut off, could not get to the meat of it to check.

Maybe GTG has a subscription that allows reading (it didn't ask, so I don't think that's it)? I dunno, but I'm curious.


-ERD50

 

[ls99]

Chances of passage are looking strong.

Intrade Prediction Markets

Woke up too darn early. Just checked intrade, collapsed to 35. Do some insiders know stuff no one else does?

 

[ERD50]

Woke up too darn early. Just checked intrade, collapsed to 35. Do some insiders know stuff no one else does?

It is back up on very thin trading, 2 trades. I do wonder what that was about. Someone got a wire on Pelosi?

also, this might give you a better view: Time and Sales Chart - 'Obamacare' health care reform (see contract rules) to become law before midnight ET 30 Jun 2010

then manually set the time to last day, that does not seem to carry in the url.

from the 'download' button on intrade (if this pastes):

Mar 16, 2010 10:34 PM CDT 65 20
Mar 16, 2010 10:49 PM CDT 65 1
Mar 16, 2010 11:49 PM CDT 64 3
Mar 16, 2010 11:58 PM CDT 63.5 1
Mar 16, 2010 11:58 PM CDT 63.5 9
Mar 16, 2010 11:58 PM CDT 62.1 1
Mar 16, 2010 11:58 PM CDT 62 1
Mar 16, 2010 11:58 PM CDT 60.7 1
Mar 16, 2010 11:58 PM CDT 60.6 10
Mar 16, 2010 11:58 PM CDT 60 1
Mar 16, 2010 11:58 PM CDT 60 9
Mar 16, 2010 11:58 PM CDT 60 9
Mar 17, 2010 12:08 AM CDT 60 8
Mar 17, 2010 1:09 AM CDT 60 8
Mar 17, 2010 1:09 AM CDT 59 8
Mar 17, 2010 1:10 AM CDT 58 4
Mar 17, 2010 1:10 AM CDT 57.1 1
Mar 17, 2010 1:10 AM CDT 57 5
Mar 17, 2010 1:10 AM CDT 53 1
Mar 17, 2010 1:16 AM CDT 50.5 10
Mar 17, 2010 1:16 AM CDT 50 1
Mar 17, 2010 1:16 AM CDT 50 1
Mar 17, 2010 1:16 AM CDT 47.3 1
Mar 17, 2010 1:18 AM CDT 46 10
Mar 17, 2010 1:18 AM CDT 41 1
Mar 17, 2010 1:18 AM CDT 40.6 1
Mar 17, 2010 1:18 AM CDT 36.5 4
Mar 17, 2010 1:18 AM CDT 35.1 1
Mar 17, 2010 5:02 AM CDT 66.6 1
Mar 17, 2010 6:10 AM CDT 66.9 1 < but then back up? Odd

 

[FIRE'd@51]

Mar 17, 2010 1:18 AM CDT 36.5 4
Mar 17, 2010 1:18 AM CDT 35.1 1
Mar 17, 2010 5:02 AM CDT 66.6 1
Mar 17, 2010 6:10 AM CDT 66.9 1 < but then back up? Odd

I think this was due to the announcement that Dennis Kucinich would be holding a press conference this morning, in which he subsequently switched his NO vote to YES.

 

[ERD50]

I think this was due to the announcement that Dennis Kucinich would be holding a press conference this morning, in which he subsequently switched his NO vote to YES.

That explains the rise back to 60-70, but what about the drop in the first place?


OK, I just checked their forums, and the regulars there seem perplexed as well. Hard to say.


-ERD50

 

[Gone4Good]

Somebody should pass this news about overall cost savings to the Centers for Medicare & Medicaid Services (which, of course, is part of President Obama's executive branch and unlikely to be understating the costs of this plan). In January they wrote about the Senate plan (Link to coverage of their report):

Wow, you really like to selectively read things. If you continue just one sentence beyond the part you quote it says this . . .

The estimated effects of the bill on overall national health expenditures is that the share of GDP is projected to be 20.9 percent in 2019 compared to 20.8 under current law -- "primarily as a net result of the substantial expansions in coverage."

So we're covering far more people and spending roughly the same share of GDP and you're claiming that health care isn't less costly under this bill?

So if the store is running a 50% off sale on bread and you come home with two loaves instead of your typical one do you look at the bill and say "boy they didn't lower the price at all because I spent the same amount as I did before"?

 

[samclem]

If the question is "will we as a nation save any money on our medical costs as a result of this legislation" the answer, from the Centers for Medicare & Medicaid Services is "No, there are no cost savings." It might do a lot of other things, but apparently it doesn't save any money.

 

[Gone4Good]

If the question is "will we as a nation save any money on our medical costs as a result of this legislation" the answer, from the Centers for Medicare & Medicaid Services is "No, there are no cost savings." It might do a lot of other things, but apparently it doesn't save any money.

Well, gee, my two loaves fed twice as many people at the same cost but the program is worthless because we didn't spend less (meanwhile my original argument was that it was worthless because it would drive up the price of bread, but forget I said that).

 

[Texas Proud]

Well, gee, my two loaves fed twice as many people at the same cost but the program is worthless because we didn't spend less (meanwhile my original argument was that it was worthless because it would drive up the price of bread, but forget I said that).

The flaw in your argument is that you are postulating that the 30 plus million people are getting no healthcare. I think they are getting a good amount, but not paying for it. Maybe not what you and me get, but it is not like 30 million people get NO healthcare now and after the bill becomes law they will all be getting some....

So, yes, I would like to see a reduction in the cost of health care... to less than 15% of GDP... heck, from what you see with other countries spending I would like to see 10%.... but that will not happen in my lifetime...

 

[ziggy29]

The main reason we are having a "crisis" in health care is failure to control costs and the price of health care spiraling out of control.

To that end, cost control should be priority one. If that occurs, we'd have a lot more wiggle room to discuss universal coverage options. I'd like to see universal coverage -- done right. And that, to me, means stopping the double-digit annual increases in health care costs first. If we can tame the cost beast, we'd have a lot more flexibility in implementing universal access.

 

[FIRE'd@51]

The main reason we are having a "crisis" in health care is failure to control costs and the price of health care spiraling out of control.

Exactly right, and I'm afraid that this bill does little, if anything, to bend down that cost curve. The only reason it doesn't add to the deficit in the first 10 years is because the benefits (e.g. subsidies to buy insurance, etc) don't start until 2014 while most of the tax and other revenue increases start next year. So we have ten years of revenues paying for six years of benefits.

 

[ERD50]

The flaw in your argument is that you are postulating that the 30 plus million people are getting no healthcare. I think they are getting a good amount, but not paying for it. Maybe not what you and me get, but it is not like 30 million people get NO healthcare now and after the bill becomes law they will all be getting some....

Exactly. I happen to know of two individuals, with zero net worth and zero funds at the time, who got treated for non-emergency conditions. Totally free to them, and they felt they got excellent treatment.

The downside was that they stood in the Cook County Hospital waiting room for a long time, while several GSW victims got treated ahead of them. But they all got treated, free of charge.

I know of another individual, this time an emergency case ( but effectively 'self inflicted' due to a stupid action), free treatment.

I'm not saying that we should continue that system, but if we look at costs of coverage it is not an all-or-nothing thing.

-ERD50

 

[ERD50]

... the benefits (e.g. subsidies to buy insurance, etc) don't start until 2014 ... .

I would love to know:

A) What % of the voting public understands that point.

B) What % of the voting public who feels that they are reasonably well-informed about the HC debate, understands that point.

C) What % of the voting public who showed up at a pro-HC rally, understands that point.

D) What % of members of Congress who voted "Yes" have made that point to their constituents.

There have been a number of TV/radio news blurbs with some harried pro-HC bill person saying ' my relative came down with some terrible disease, and now they can't get insurance! We need to pass this bill!!!!'. I have yet to hear the news person say, 'and they won't even if this bill passes - not until 2014'.

I mentioned this before, but back around the holidays at a dinner party, only one of the three other guys that I mentioned this to was aware of it.

-ERD50

 

[samclem]

It now looks like the "Deem and pass" strategy has been abandoned by House leaders. Apparently, some legislators can still have the ability to feel shame if the offense is especially egregious and public scrutiny is high enough.

It's still not clear to me how the House will vote to amend a law that is not yet a law, but there's probably a slicky-way to get it done.

The amazing thing to me is that all the reporting is obediently quoting the CBO's numbers concerning the impact on the deficit, without calling out the extreme set of "givens" that they were directed to use. If we look at the impact on the debt, then the real magnitude of the spending, the required borrowing, and the huge burden it will impose in the future becomes very clear.

If/when it passes, there will be challenges in the Supreme Court and there will certainly be re-votes as amendments are offered to the pending legislation. As this drags out, it will be interesting to see if the public sees the Republicans as obstructionists, or if the bill/idea itself drops further in popularity as other national issues get put on the sidelines.

 

[M Paquette]

It now looks like the "Deem and pass" strategy has been abandoned by House leaders. Apparently, some legislators can still have the ability to feel shame if the offense is especially egregious and public scrutiny is high enough.

That would be a welcome, if unexpected change in Congress.

From the 95th to 98th Congresses (1977-1984), there were eight self-executing rules, or "deem & pass", making up 1 percent of the 857 total rules granted. In the 99th Congress under Speaker Tip O'Neill there were 20 self-executing rules, for 12 percent. In the 100th Congress under Speaker Jim Wright there were 18 self-executing rules, for 17 percent. Use of the self-executing rule ramped up a bit to 30 under Speaker Tom Foley in the 103rd Congress for 22 percent of all rules.

Use continued to rise in the next several Congresses. In the 104th Congress under Speaker Newt Gingrich the self-executing rule, or "deem & pass", was used 38 times for 25 percent of all rules. The 105th Congress, again under Gingrich, used the self-executing rule 52 times for 35 percent of all rules. The 106th Congress under Speaker Dennis Hastert used the rule 40 times for 22 percent of all rules. The 107th Congress again under Hastert used the rule 42 times for 37 percent of all rules, and the 108th Congress under Hastert used the rule 30 times for 22 percent of all rules.

The 109th Congress used the self-executing rule, or "deem & pass", at a modest 16 percent portion of all rules.

I am delighted to see the population at large taking such a keen interest in the parliamentary procedures and processes used by our elected representatives. It's rare to see such an interest in the fiddly, intricate details by which legislation is moved through the House and Senate.

 

[FIRE'd@51]

It now looks like the "Deem and pass" strategy has been abandoned by House leaders. Apparently, some legislators can still have the ability to feel shame if the offense is especially egregious and public scrutiny is high enough.

More likely, Pelosi now has enough votes to pass the Senate bill as it came to the House, without the need for "deem and pass".

 

[ERD50]

I am delighted to see the population at large taking such a keen interest in the parliamentary procedures and processes used by our elected representatives. It's rare to see such an interest in the fiddly, intricate details by which legislation is moved through the House and Senate.

It's rare that Congress passes a bill affecting 1/6th the GPD (I think that is the number tossed around) that could touch so many people in so many ways.

I've seen some of the stats you mentioned. It is a good point, but I wonder what kind of legislation was passed by those methods? I really don't know, are there examples where they passed bills that had polls showing over half the people were opposed to them?

-ERD50

 

[M Paquette]

It's rare that Congress passes a bill affecting 1/6th the GPD (I think that is the number tossed around) that could touch so many people in so many ways.

I've seen some of the stats you mentioned. It is a good point, but I wonder what kind of legislation was passed by those methods? I really don't know, are there examples where they passed bills that had polls showing over half the people were opposed to them?

-ERD50

The Congressional Research Service reports that it was originally used to expedite House action in disposing of Senate amendments to House-passed bills.

Significant or controversial uses in recent years include:

* On August 2, 1989, the House adopted a rule (H.Res. 221) that automatically incorporated into the text of the bill made in order for consideration a provision that prohibited smoking on domestic airline flights of two hours or less duration.

* On March 19, 1996, the House adopted a rule (H.Res. 384) that incorporated a voluntary employee verification program — addressing the employment of illegal immigrants — into a committee substitute made in order as original text.

* H.Res. 239, agreed to on September 24, 1997, automatically incorporated into the base bill a provision to block the use of statistical sampling for the 2000 census until federal courts had an opportunity to rule on its constitutionality.

* A closed rule (H.Res. 303) on an IRS reform bill provided for automatic adoption of four amendments to the committee substitute made in order as original text. The rule was adopted on November 5, 1997, with bipartisan support.

* On May 7, 1998, an intelligence authorization bill was made in order by H.Res. 420. This self-executing rule dropped a section from the intelligence measure that would have permitted the CIA to offer their employees an early-out retirement program.

* On February 20, 2005, the House adopted H.Res. 75, which provided that a manager’s amendment dealing with immigration issues shall be considered as adopted in the House and in the Committee of the Whole and the bill (H.R. 418), as amended, shall be considered as the original bill for purposes of amendment.


http://www.rules.house.gov/Archives/98-710.pdf

 

[ERD50]

OK, thanks for digging those up M Paquette. Yes, I don't think those measures were equal to the public interest and scrutiny of this current HC bill. It's hard to say if sometimes that process is just an expedient way to get non-controversial bills through with some agreed to changes, or if it was used as a 'trick' to avoid further debate on controversial changes.

Add the historically low approval rating for Congress, and the public disapproval of this bill, I just don't think this is the time to be doing anything that isn't 100% transparent (wait, where have I heard 'transparent' used before?).


-ERD50

 

[ERD50]

And the balance will come from higher taxes.

So yes, the deficit reduction claim is based on higher taxes offsetting higher spending.

I explained it to DW this way: Yes, I'm going to take $300 out of your paycheck to buy some techno-gizmo for myself. But not to worry, I'm going to take out an additional $400 and put in in our savings account. So you see, by me buying this techno-gizmo, we have actually saved $100! Aren't you proud of me!

That's a proper analogy, right? The 'higher spending' is on the American public, and it is the American public paying the higher taxes. I call BS on this 'deficit reduction', just as my wife would call BS on me claiming I'm 'saving' by 'spending'.

If that is wrong, pls explain.

BTW, Karl Rove hit David Plouffe with that Q on "This Week" today. Would have been a great opportunity for Plouffe to set the record straight. His response: something about the previous administration spending money ().... IOW, he sure didn't say "No, you are wrong". So that gives a pretty good idea where the truth is.

But the $600B cost savings estimate linked above is a reduction in medical costs versus what we would spend without the legislation. This estimate is debatable, of course.

Some use the word "ludicrous" instead of "debatable." ...

Health care: Democrats own whatever happens next. - chicagotribune.com

That dubious conclusion rests on a Congressional Budget Office guesstimate that Washington can spend nearly $1 trillion more on health care over 10 years — and also cut the deficit by $138 billion. Writing in Sunday's New York Times, former CBO director Douglas Holtz-Eakin profoundly disagreed: "(T)he budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out. In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion."

-ERD50

 

[Gone4Good]

I explained it to DW this way: Yes, I'm going to take $300 out of your paycheck to buy some techno-gizmo for myself. But not to worry, I'm going to take out an additional $400 and put in in our savings account. So you see, by me buying this techno-gizmo, we have actually saved $100! Aren't you proud of me!

That's a proper analogy, right? The 'higher spending' is on the American public, and it is the American public paying the higher taxes. I call BS on this 'deficit reduction', just as my wife would call BS on me claiming I'm 'saving' by 'spending'.

It seems there is confusion about the terms "savings" and "deficit reduction". These are different things. The $600B "savings" number was one economist's estimate of the amount we, as a nation, would not spend because of the legislation versus what we will spend under the status quo. Perhaps the confusion is that the "savings" estimate is not strictly government savings, but national savings.

The deficit reduction estimate is strictly a question of whether revenue increases will more than offset spending increases. The CBO says they will.

 

[Gone4Good]

Exactly right, and I'm afraid that this bill does little, if anything, to bend down that cost curve. The only reason it doesn't add to the deficit in the first 10 years is because the benefits (e.g. subsidies to buy insurance, etc) don't start until 2014 while most of the tax and other revenue increases start next year. So we have ten years of revenues paying for six years of benefits.

But in the second decade the CBO says it reduces the deficit by $1.2T.

 

[Gone4Good]

The flaw in your argument is that you are postulating that the 30 plus million people are getting no healthcare. I think they are getting a good amount, but not paying for it. Maybe not what you and me get, but it is not like 30 million people get NO healthcare now and after the bill becomes law they will all be getting some....

That is certainly true, the uninsured are getting some care. But study after study has shown that the uninsured have worse health outcomes than those with insurance. So while they might get some care, they are clearly not getting sufficient, or maybe more importantly timely, care. So if we're going to spend ~20.8% of GDP on health care regardless of whether this bill passes or not, aren't we getting more for our money (a.k.a. "saving") if those 30MM people have insurance they wouldn't have otherwise had?