Now that we have the outlines of a final Healthcare bill (from the Senate), what are its good parts? How will it help the average voter?
The negative parts are apparently increased healthcare costs due to increased taxes on suppliers. Mandated insurance coverage on those who previously could legitimately (low risk individuals) avoid coverage. Draconian threats to healthcare coverage for the the elderly (this one may be arguable.) A huge increase in bureaucratic overhead (also raising taxes.) An increase in Federally funded entitlements during a period of serious economic duress. A huge hit to future state budgets for increased Medicare payments/enrollment. A very large tax increase in the early years with few if any benefits for the average voter. A huge political hit for Democrats for passing these one party versions.
Many new costs and few savings. If the goal was to lower healthcare costs, where is that buried or carried out in this bill?
You forgot to mention death panels and killing babies.
Mandated insurance coverage on those who previously could legitimately (low risk individuals) avoid coverage.
This is a downside for healthy young individuals who have no problem with passing a small risk onto the rest of society. Even young people have motorcycle accidents. Young people are more likely to get serious cases of H1N1 flu this February. Young people are not immortal, so not contributing to health insurance as long as the risk is greater than zero is just wrong. And young people will eventually become middle aged and old people, and at that point they will be paying less than they would have without the subsidy from younger workers. And younger, healthy workers will get other kinds of offsetting benefits. For example, younger workers are more likely to be lower income earners, and they will get significant assistance in the new bill. So this provision is a lot like having to pay into Medicare; it doesn’t help the young while theiry young, but it does help them a lot when they get older.
Draconian threats to healthcare coverage for the the elderly (this one may be arguable.)
Yes, it is arguable. It’s also a strange argument coming from those who say they are opposed to government run single-payer systems. It seems that the GOP’s primary argument against the Senate bill is the one set of provisions that they actually supported not long ago. There will be some cuts to Medicare, but calling those cuts “draconian threats” is a bit over the top. And don’t forget that the Senate bill does fill in the so called donut hole, which is an important feature for seniors.
A huge increase in bureaucratic overhead
This is just way off base and pretty clearly wrong. It will marginally increase the number of government bureaucrats, but will dramatically reduce the number of private sector bureaucrats. Afterall, that’s where a lot of the cost saving comes from. Of course, if you’re worried about bureaucratic overhead, then you should be arguing for a single payer system because single payer has the lowest overhead by far. That’s not even a close call.
An increase in Federally funded entitlements during a period of serious economic duress.
Isn’t that exactly the time that you would want to increase entitlements? You’ve slipped into the old Hoover “Treasury View” line of thinking.
A huge hit to future state budgets for increased Medicare payments/enrollment.
I think you mean Medicaid payments and enrollments. It’s not a hit to state budgets if the federal goverment picks up the difference. Again, if you want to argue that the federal government should assume more responsibility for Medicaid, then fine, but I don’t think that’s what you want to argue. I suspect that you and Mr Scrooge are arguing that we should replace Medicaid with the workhouses.
increased healthcare costs due to increased taxes on suppliers.
Not sure what you mean by increased taxes on suppliers.
A very large tax increase in the early years with few if any benefits for the average voter.
Fair enough, so we can expect you to urge Republican senators to work with Democrats in trying to accelerate the benefit stream???
Many new costs and few savings.
Well, the CBO says that there will be significant savings. And there will be some significant efficiency savings as well. For example, it will increase worker mobility because having healthcare from an employer will be less of a reason for staying at a lower paying job. The tax free status of high end health insurance plans creates a fair amount of ecoonomic deadweight […]
2slugs, why not add to the list instead of just countering my thoughts. That was my hope. I will explain my viewpoints in reverse order of your counterpoints, but I do not intend to get into an continuing and ongoing point-by-point coutner argument scenario.
I suspect you are saying here: “The other equally important goal was increasing access to healthcare, and this bill goes a long way towards that goal.” is not access but coverage. Access has not changed, ACAICS.
Savings from the CBO Report/Scoring? Only if you believe that Drs will have thier reimbursements cut, and that the double counting of Medicare cuts is a valid saving. And you believe that benefits should be taxed as salary/wages? OK!
Inceased taxes. The bill increases taxes on the Insurance providers, medical implement suppliers, Gold plated insurance packages (unless if you are a union member) and even tanning salons. I’m sure once we pull back the covers we can add to this list, dramatically.
You are correct I thought medicaid and typed Medicare.
Bureucratic increase. So how much of the increase in Fed and State agencies do you consider on the margins? Or marginal? Some might think any increase unwarranted. Tell us how the private sector staffing is diminshed.
Do I think that dramatically increasing Fed entitlements during economic stress are good for the economy? MAYBE! If used for short term benefits, but I have been taught since the 60s that Fed entitlements are what will be the final issue to kill our Fed budget flexibility. Care to dispute that with Medicare/medicaid and even to a lesser extent SS being problematic as far as growing budget demands.
Draconian cuts are going to be a HUGE perception problem for Dems for the elderly who are high volume voters. But, the real issues are just being discussed. The added demand on the medial community coupled with the reduced reimbursements to providers will drive many of those in medicine to refuse covered patients. It a growing problem in many areas. Especially for Medicaid, and in some areas Medicare, but this bill will seriously exacerbate that problem. Poor and elderly charged more for lesser coverage? Good idea!
Finally, maybe you think the poor need to be taxed higher ($750/Yr fine if they choose to not get insurance.) Or, that they need to lose another choice on how to best manage their limited financial resources by mandating they get health insurance. Some may be entitled to a total subsidy, but the vast majority will only get a partial subsidy. Are we creating another class of scofflaws? Or are most Dems standing in line to receive their thanks? You know where my bet is.
And finally, how do we control insurance costs when the insured are allowed to opt in and out depending on their medical conditions?
The unanticipated ill effects in this bill are just enormous. I surely hope they are out weighed by the benefits.
“Draconian” refers to the ancient Greek lawgiver Draco, who estalished a severe and harsh set of codes for Athens back in the 7th century. The Draconian law code was replaced by Solon in the 6th century.
Well this new thread seems to have accomplished its purpose.
I suggested it to Dan because obviously Health Care Reform and this proposed Entitlements Commission are in the news, and to the degree that the latter takes in Social Security that overall issue is out there as well. But that doesn’t mean that every post relating to the details of the Health Care Bills, or the specifics of the structuring of the Entitlements Commission or about some aspect of Social Security needs to become a top level review of the whole topic which has unfortunately been the pattern.
I put up a post on the MLR provisions of the new Senate Bill as passed yesterday and I plan to put up a new post on the interrelation between the subsidy table and the insurance risk pool regulations today. Nitpicky but I think important. So I am extremely happy that CoRev launched this discussion on this new thread and that I hopefully won’t be faced with the same on my more narrowly focused thread.
I hope everyone will read my post, but those who want to talk about Health Care Reform more broadly will be politely (at least initially) referred back here.
Dan has asked, or perhaps dared, commenters to submit posts for potential front paging with little luck. But now that Angry Bear has the No GW Open Thread, the GW Open Thread, and the Health Care/SS/Entitlements Open Thread the door is open for thoughtful conservatives to present their own take rather than as now having to take an adversarial approach to insert their point of view. And all without pre-publication review (though of course post-publication editing and moderation are possible).
First, even today the government provides more healthcare (measured in dollars) than the private sector, but yet the cost growth in private health insurance exceeds the growth Medicare…any by a pretty wide margin. So the least efficient cog in the wheel is private health insurance. One of the reasons is that private health insurance devotes a lot of economic resources into figuring out how to exclude groups and how to avoid paying claims. They won’t be able to do that under the Senate plan, so those costs should be reduced. That will be an economic savings. And hospitals and doctors’ offices won’t have to hire a team of clerks to run down claims and fight with insurance companies, which is pretty much what you see in a doctor’s office today. Ditto with hospitals. And the cuts in useless procedures covered by Medicare (e.g., those bogus wheelchair commercials on TV) will save money. Note, seniors will still be able to obtain those services, it’s just that the taxpayer will no longer be obligated to pay for procedures with no proven medical benefit. Again, that’s a savings. And bringing people into the healthcare system sooner will save money because they will get treatment earlier instead of in emergency rooms.
And finally, how do we control insurance costs when the insured are allowed to opt in and out depending on their medical conditions?
That’s what they do today…or at least try to do today. Under the Senate bill people won’t be able to opt in or out because they will be mandated to participate in one form or another.
And yes, benefits absolutely should be taxed. Absolutely. It’s one of the first principles of public finance economics…or at least it was when I took the course. Untaxed benefits create deadweight economic loss. That’s one of the bedrock principles of economics.
And you only want to talk about the increase in federal and state bureaucrats, but you completely ignore the reduction in private sector bureaucrats. For example, the ENTIRE Dept of HHS has fewer than 65,000 employees and manages more healthcare dollars than the entire private sector market. Aetna alone has 30,000 employees and is responsible for only a fraction of the healthcare dollars as HHS. So in terms of pure bureaucratic waste, this one is a no brainer.
but I have been taught since the 60s that Fed entitlements are what will be the final issue to kill our Fed budget flexibility.
Then you were taught wrong. What kills the budget is creating entitlements and then refusing to fund them, which is what the GOP likes to do.
And United Health as almost as many employees as HHS (58K vs 65K) but only one-tenth the revenues. So is United Health your standard for bureaurcratic efficiency?
2slugs, your other points are just counters to mine. Ok, we have differing views.
But, the following comment is one of the falsest of falsehoods in comparing Public and Private implementations. “but yet the cost growth in private health insurance exceeds the growth Medicare…any by a pretty wide margin. “
When comparing public costs to private costs we are ALWAYS in an apples to elephants world of comparisons. Public/private comparisons are almost always bunk. You of all people know that!
For those outside the Govt and not economists nor trained in Public Administration the biggest differences in costs are not ever covered, and that is profits. That amount is usually to a low double digit difference in comparison at the start.
But it does not come close to ending there. There is the cost of financing, the actual support public entities get from the other public agencies, GSA for supplies, transportation and buildings, the treasury for financial processing, much of HR is from another agency, security from other entities. This list just touches on the totality that seldom is ever included in the public/private cost comparisons. But, the final and most important difference is the built-in customer base, whereby, Govt crowds out the other private suppliers of the service. (Think in terms of the US Postal Service until some competition was opened up.) Or how about the costs to conform with Fed regulations that the public sector is usually exempt or significantly relieved from conforming.
So, as you can see these cost comparison discussions are almost always specious and/or disingenuous.
That goes fifty one times over when we see comparisons of the public/private staffing comparisons. All the above differences plus the fifty states apply in this comparison arena.
It will be interesting to see if the MLR becomes the center of the healthcare debate. If it does then you get the credit for highlighting it as an issue. And that’s the last nice thing that i’m going say to you for the rest of the year.
It will be interesting if the MLR becomes the center of the healthcare debate. If it does then you get the credit for highlighting it as an issue. And that’s the last nice thing that i’m going say to you for the rest of the year.
With the prospect of reform in sight, [knock knock] I am sort of looking and planning forward, wondering what can be done in order to ensure memory isn’t lost. (And doing the laundry and deep vacuuming, too, prepping for New Years. But the three tasks aren’t mutually exclusive.)
Once some sort of health reform bill is passed, assuming it isn’t too damn watery, the day of signing should become an annual national day of observance — National Health Day, maybe. (Preferably a name with more punch than that.)
Newspapers like these sorts of days, novel or not, since it provides them with a ready topic they can jump on. I oughta know – we got three or four stories out of Fire Safety Week alone, back in my reporter days.
Reporting and celebrating the state of US health and health care, along with articles tracking progress, world standing, and things still to be fixed, would I hope do the same thing for people’s memories of just how difficult and important this was, the same as Veteran’s Day with it’s prayers and memorials.
Given how quickly Americans seem to have forgetten the genesis of Medicare and Social Security, I think the great medical breakthrough is going to need some help. Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too. Mind you, we have our annual dose of Dickens but that’s far from 100% effective.
First, we’re talking about differences in growth rates, not expenditure levels. It is perfectly valid to compare differences in growth rates. Fixed differences between the govt and the private sector are irrelevant when you’re talking about growth rates.
Those support costs that you talk about are not free to other govt agencies. HHS does not get its HR support from OPM for free; they have to buy that HR support. Same with GSA supplies and transportation, etc. Those are all funded through revolving account. So you’re just flat out wrong about the financing between govt agencies.
There is a difference in the built-in customer base. And here the govt is at a disadvantage because the govt cannot cherry pick and only insure those least likely to submit a claim. Medicare provides insurance for precisely the one group that absolutely could not get it at anything like an affordable price through the private market. That’s why Medicare was invented 45 years ago. The govt is not crowding out the healthiest customers; the govt is crowding in the unhealthiest and still managing to do so at a lower cost growth trajectory than the private sector insurance market.
The whole tone of your post is bizarre and really defeats your larger intent. You go on about how unfair it is for govt to get further involved because the govt has so many inherent advantages. Well, excuse me but this isn’t about “fairness” to insurance company profit margins. It’s about providing insurance at less cost to a broader base and if the govt has certain competitive advantages, then we should take advantage of those advantages. Why hobble ourselves intentionally by insisting on “fairness” to insurance companies. We owe them nothing. Companies are only entitled to a profit if they can outperform the competition, and that competition includes the govt.
I would note: if the republicans want the strong, fit, and young citizen to be selfish (they graciously defend them from being exploited to help (through entitlements) the less fortunate; old, weak and unwell) , the strong fit young soldiers and marines should also be selfish and not run off to war (using discretionary funds pillaged from the US productive pool).
I suspect it is alright to exploit the strong, fit and young for war profits (discretionary waste).
But it is wrong to suppose the strong fit and young should enter the risk pool for health insurance (entitlements) rather than wait to enter the risk pool when they are no longer strong fit and young…………
But, war profits are not for the less fortunate they are for the bagmen paying off republican senators.
The debate hidden in all this is: entitlements for regular people are bad, however discretionary spending for war profits and federal support for the income of the 1% is good.
To me the entire issue with US health care is leveling risk.
The private insurance industry manages its financial risk exposure and does nothing for “health” and the high risk persons generally go to medicaid. If over 65 to medicare.
There is no issue about cause and effect.
The taxpayer bears the risk.
Someday the value of a healthy US citizen will be worth debating.
Until then let the sick hope to die fast and cheap.
2slugs, soemtimes you commentary is just amazing to me. I do not think I ever used the term “fair.” Regardless, some of these agencies are created to provide “no cost” support to other agencies. some of the cost is recovered, but seldo all. GSA’s revolving funds may have changed somewhat since I worked there, but they are not ever fully replaced by charges to other agencies. They are usually used to fund the overhead and some portion of the seed money needed to make the basic purchases, but your charges do not refund that originally Congressionally funded amount. I believe the Finance Act adds even more restrictions, but it has been a while since I worked in that environment.
Moreover why do you try to make a case for growth when the basic components included in the measeurements are so dramatically different? Unless and until the totality of those components are included, then it is still an apples to elephants comparison. Moreover, why ignore the two big issues I listed earlier, profits and regulatory conformance costs? Trying to make a weak case for equality of costing is truly a bizarre position for an analyst, economist, and Fed Govt employee.
I really do wish you would add to the issues list, and not just try to take my entries apart.
2slugs, soemtimes your commentary is just amazing to me. I do not think I ever used the term “fair.” Where did that come from?
As far as comparing private to public sector accounting and claiming external agencies are completely refunded by charging user agencies is dead wrong. Regardless, some of these agencies are created to provide “no cost” support to other agencies. It is why they are separately funded. Some of the cost is recovered, but seldom all. GSA’s revolving funds may have changed somewhat since I worked there, but they are not ever fully replaced by charges to other agencies. They are restricted from doing that by law. They are usually used to fund the overhead and some portion of the seed money needed to make the basic purchases, but your charges do not refund that originally Congressionally funded amount. I believe the Finance Act adds even more restrictions, but it has been a while since I worked in that environment.
Moreover why do you try to make a case for growth when the basic components included in the measeurements are so dramatically different? Unless and until the totality of those components are included, then it is still an apples to elephants comparison. Moreover, why ignore the two big issues I listed earlier, profits and regulatory conformance costs? Trying to make a weak case for equality of costing is truly a bizarre position for an analyst, economist, and Fed Govt employee.
I have not checked into the past year’s federal budget (still working!! outside my house) to get the percent, but one chart in the green book (I think) tells you the percent of federal outlays for discretionary spending versus entitlements.
Discretionary spending is all those things which require an “authorization” bill each year to set what the US constitution says can be appropriated. The largest single discretionary category is the warfare state (minitruth calls it defense appropriations, but what s going on now is 20 times larger than needed to keep the Afghan cavemen from bombing Detroit). About half of “discretionalry spending is for the warfare state, the rest is for things like the FAA and going to Mars.
The federalists fearing the US would be run by guys like Rumslfeld, Petraeus and McChrytal made it so funds for the war machine were limited to 2 years.
Entitlements is the second contender for the fruits of US economic activity. It includes things that are not limited by their threat to life and liberty, things that help individuals and provide a social safety net for individuals. Not much chance of a military coup among the elderly, disabled and poor children.
Entitlements include: OASDI, SSI, Medicare, federal subsidies for medicaid, welfare etc.
The shares: entitlements roughly two thirds of federal outlays; discretionary the remaining third.
The third for welfare for the rich is jealously guarded, even though Medicare and SS income has exceeded outlays keeping the deficit artificially low while always fighting to lower entitlement outlays.
Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too.
The system in the United States is awfully good. The only reason we might need increased mental healthcare services here are for those that go to Canada for medical treatment.
Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too.
The healthcare system in the United States is awfully good. The only reason we might need increased mental healthcare services here are for those that go to Canada for medical treatment.
Ask any ordinary Canadian if they would trade. One of the surest ways to get in trouble politically up here is to suggest adding a commercial element to our health system.
True, most Americans have the care they need. But at triple the price (much of it hidden from the recipients) that we pay.
i agree with what you are saying here, but can you understand why i want people to understand that Social Security (and some of Medicare) is NOT “federal outlays.” These are programs where people pay for their own benfits rather directly in terms of dollars to dollars. While a case could be made that I personally benefit from the government building a new Submarine, that benefit is not as obvious as getting my payroll tax returned, kept safe and adjusted for inflation, when I will really need the money.
There are none, but who cares? Government run health care is a fait accompli; the morons here have bought into their lies, and we will get the vaunted efficiency and quality associated with all government run programs. The real benefits accrue to the D party, and the libs, who have another entitlement program they get to manipulate for votes, control lives, and tax the rich for. Hoo ray!
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. Andy the don’t hold the purse strings.
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. And the don’t hold the purse strings.
Either bill provides the skeleton to Heathcare Reform. The passage of the bill was just the start with much to be determined over the next couple of years. There is still more to come in detail and in benefits. A huge negative would be to once again to do nothing which would cost $billions. I posted on those costs previously.
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. And they don’t hold the purse strings
C’mon folks! Where’s the list of benefits? We’ve already listed many of them. But why not try again. The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance. That’s a benefit. The Senate bill will prevent insurance companies from cherry picking only low risk customers. That’s a benefit. The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns. That’s a benefit. The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance. That’s a benefit. The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss. That’s a benefit. The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit. That’s a benefit. Had enough?
The real benefits accrue to the D party, and the libs, who have another entitlement program they get to manipulate for votes,
I thought you and CoRev were just telling us that healthcare reform was going to doom the Democratic party because it wasn’t popular with voters. Now you’re saying that it’s all about winning elections. You guys need to get your stories straight.
But that’s only roughly double. Where do I get the triple? From the people not covered in the USA, and the people covered, who don’t get or are afraid to ask for the level of care they might seek if they didn’t fear losing their coverage.
That’s hard given we don’t know that will happen in the future. I don’t see healthcare reform helping the democrats that much. It won’t help me. It won’t help you. It has a chance of being a fiasco. Time will tell.
You know if we go to 100 percent coverage and healthcare costing only 10-11 percent of GDP then it will be a big win for the democrats. But what’s the chance of that?
1) The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance.
Yes by forcing them to purchase insurance or be fined. Medical insurance is already available to just about every citizen who wants it now, with the exception of pre existing conditons. Just call up an insurance company. A lot of the unisured are voluntarily so.
2) The Senate bill will prevent insurance companies from cherry picking only low risk customers.
Most group policies have very limited underwriting, so all risk classes are included. If you are going to force plans to accept people with pre-existing conditions, then yes, those people are benefitted, at the expense of the rest of the policy holders
3) The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns.
Executive salaries and advertising are small components of insurance company costs. Gratuitous class warfare alert!
4)The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance.
We already have this with COBRA and HIPA.
5)The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss.
Yes I see. It is a benefit to the people to tax them. The ingrates!
6) The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit.
Why have we been doing this all along? Government incompetence?
Slugs, see my comment about “morons who have bought their lies.”
1) The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance.
Yes by forcing them to purchase insurance or be fined. Medical insurance is already available to just about every citizen who wants it now, with the exception of pre existing conditons. Just call up an insurance company. A lot of the unisured are voluntarily so.
I could have accomplished this in a ONE SENTENCE BILL>
2) The Senate bill will prevent insurance companies from cherry picking only low risk customers.
Most group policies have very limited underwriting, so all risk classes are included. If you are going to force plans to accept people with pre-existing conditions, then yes, those people are benefitted, at the expense of the rest of the policy holders
3) The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns.
Executive salaries and advertising are small components of insurance company costs. Gratuitous class warfare alert!
4)The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance.
We already have this with COBRA and HIPA.
5)The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss.
Yes I see. It is a benefit to the people to tax them. The ingrates!
6) The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit.
Why have we been doing this all along? Government incompetence?
Slugs, see my comment about “morons who have bought their lies.”
Yes I see. It is a benefit to the people to tax them.
Which would you rather receive as a belated Xmas gift, $100 cash or a gift certificate at a local restaurant that you rarely visit worth $101? Most people would prefer the cash. It’s the same with “cadillac” insurance plans. Not taxing “cadillac” health insurance policies is essentially the same thing as compensating employees with gift certificates at rarely used restaurants…you have to increase the nominal value of the compensation beyond what employees would take as a cash payment. It is economically inefficient. This is pretty basic stuff for anyone who has ever taken an econ course.
I pay $800/mo for health insurance and have not seen a quack in 8 years. The last thing I want, at this stage of my life (56) is an internet ready evaluation of my fitness.
I think we, in America, are missing the whole point. Mr Happy, Valium Reagan, initiated a national delusion that persists to this day, turning his back on the very things that allowed him to be Mr. Happy in the first place. Anyone thinking the Civil War ended the discussion between Plantation and Social Capitalism was sorely mistaken. Do not look to academia to settle the dispute. They are probably the most clueless of all.
We have allowed the Plantation Capitalists from the South to reassert their sick view of a wealth polarized nation with the aristocracy “owning” their employees, Walmart is the largest retailer in the world, hiring millions and millions of gulag laborers to produce products for sale in the US.
We cannot expect the government of the US to explicitly limit mercantilist trade in the US. But educated citizens of our country can stop buying imported goods. I have. The collapse of jobs in the US has reached an epidemic of much greater proportion than the H1N1 virus. Every foreign produced car, appliance, what have you we buy is a loss of family level wage jobs in the US in favor of a lower standard of living society in the future. Adam Smith is not a party to mercantilist trade.
And here is a special offer. My birthday is next Friday Jan 1. And a “Happy Birthday” can clear your “Saying nice things about Bruce” quotient for a whole nother year!! Even the late Billy Mays couldn’t offer you a better deal!!! 😛 😛
Interesting, why not develop some cost benefit comparisons for the discretionary side?
What about the health of individual citizens needs quantified?
Aside from the fact that 16% of US GDP strained through the US (39th in the world) private system (subsidized by medicare and medicaid) is not really the best return.
Ilsm that two thirds on non discetionary spending includes nearly a third of financing the public debt, which to the degree that it is an ‘entitlement’ is one for billionaire bond holders and the Chinese Central Bank and is 100% funded out of General Fund receipts. Lumping it in with Social Security which has it’s own dedicated revenue stream and whose Trust Fund balances are roughly half due to interest owed on dollars borrowed by that General Fund and attributing all that to “entitlements” is false framing.I know you know this, in fact it is implicit in your comment but your explicit omission of it in your two thirds total is a little misleading.
This “moron” stood on the ramparts and kept the red menace from overrunning your rich folks, big mistake. But you see I am a “moron”. Rather a sucker than a “moron”?
Some of us “morons” are not concerned about our pittance falling off the rich folk tables like you higher IQ folk.
Some of us “morons” are laughing at you so much higher IQ folk sucking up to the man for a little security and the chance to “make it”. Whatever they let you higher IQ folk get, before they throw the US economy under a bus to get you serfs with such higher IQ’s back to your insecurity and dependence on them rich folk.
You higher IQ folk make us “morons” feel quite proud.
If the reports about the Senate bill are true it moves medicares date for going negative out 9 years which is quite an accomplishment. If we start asking people to think and plan for end of life issues to avoid Shaivo like cases then we can save more. Social Security is said to really only need changing the indexing from wages to inflation to push the issue out a good ways. I could also see continuing the increase in full benfit age from 67 to 70 at about the rate it is currently going. Third uncap it, provide a 3 rd bend point in the benfit formula where it goes from 15% to 5% at the point where todays limit is.
Which healthcare bill provisions stay and which go away? I wouldn’t know. So, compare the legislation. Find a good source.
Most of the information necessary to compare the Senate and House healthcare bills is available from Kaiser Family Foundation. More than that, Kaiser is sitting on a wealth of information regarding healthcare statistics and general facts. Info available includes:
– Side-by-Side Comparison of Major Health Care Reform Proposals, December 2009 – Assessing Congressional Budget Office Estimates of the Cost and Coverage Implications of Health Reform Proposals, November 2009 – Uninsured Young Adults: Who They Are and How They Might Fare Under Health Reform, December 2009 – Survey of Employer Health Benefits, September 2009 – Kaiser Health Tracking Poll, December 2009
My focus is normally on results. This legislation is no exception.
I am interested in observing what effect the Congressional conference healthcare bill will have on the following healthcare insurance issues noted in 2009. All statistics are from Kaiser’s Employer Health Benefits 2009 Annual Survey, September 2009.
Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 2009: Individual, $779; Family, $3515
Percentage of All Firms Offering Health Benefits, 2009: 60% Percentage of Small Firms (3-9 employees) Offering Health Benefits, 2009: 46%
Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits, 2009: 29%
Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size, 2006-2009: – All Small Firms (3-199 Workers): 16%, 21%, 35%, 40% – All Large Firms (200 or More Workers): 10%, 12%, 18%, 22% – All Firms: 6%, 8%, 9%, 13%
Among Firms Offering Health Benefits, Distribution of Firms Reporting the Likelihood of Making the Following Changes in the Next Year. Very Likely and Somewhat Likely: – Increase the Amount Employees Pay for Health Insurance: 41% – Increase the Amount Employees Pay for Deductibles: 36% – Increase the Amount Employees Pay for Office Visit Copays or Coinsurance: 40% – Increase the Amount Employees Pay for Prescription Drugs: 37% – Restrict Employees’ Eligibility for Coverage: 9% – Drop Coverage Entirely: 8%
If these healthcare statistics do not improve substantially, expect more fallout from this legislation.
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
Senator Jim DeMint (R-SC) has raised concerns on the Senate Floor about a provision in Reid’s substitute healthcare bill (the one passed by the Senate). This goes to the matter of overriding or changing Senate Rules without the required 2/3 vote to change a Senate Rule as well as violating the U.S. Constitution.
Senator DeMint explains (as part of a broader inquiry regarding modification of Senate Rules):
“There’s one provision that I found particularly troubling. And it’s under a section c, titled “Limitations On Changes To This Subsection”.”
And I quote: “It shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
“This is not legislation. It’s not law. This is a rule change. It’s a pretty big deal. We will be passing a new law and at the same time creating a Senate Rule that makes it out of order to amend or even repeal the law.”
“I’m not even sure that it’s Constitutional, but if it is, it most certainly is a Senate rule. I don’t see why the majority party wouldn’t put this in every bill. If you like your law, you most certainly would want it to have force for future Senates.”
“I mean, we want to bind future Congresses. This goes to the fundamental purpose of Senate Rules: To prevent a tyrannical majority from trampling the rights of the minority or of future Congresses.”
Pushing Aside the Senate Rules? Or creating new Senate Rules?
Senator Jim DeMint (R-SC) has raised concerns on the Senate Floor about a provision in Reid’s substitute healthcare bill (the one passed by the Senate). This goes to the matter of overriding or changing Senate Rules without the required 2/3 vote to change a Senate Rule as well as violating the U.S. Constitution.
Senator DeMint explains (as part of a broader inquiry regarding modification of Senate Rules):
“There’s one provision that I found particularly troubling. And it’s under a section c, titled “Limitations On Changes To This Subsection”.”
And I quote: “It shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
“This is not legislation. It’s not law. This is a rule change. It’s a pretty big deal. We will be passing a new law and at the same time creating a Senate Rule that makes it out of order to amend or even repeal the law.”
“I’m not even sure that it’s Constitutional, but if it is, it most certainly is a Senate rule. I don’t see why the majority party wouldn’t put this in every bill. If you like your law, you most certainly would want it to have force for future Senates.”
“I mean, we want to bind future Congresses. This goes to the fundamental purpose of Senate Rules: To prevent a tyrannical majority from trampling the rights of the minority or of future Congresses.”
Language remained in the final passed bill: “(C) LIMITATION ON CHANGES TO THIS SUBSECTION- It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
It appears the US doesn’t want any tourists or visitors if possible. If you need to plug a gap in your balance of payments, destroying tourism is not smart. Further the US seems to be so completely stupid it doesn’t comprehend that waging war on a religion is a fool’s errand. Islam will emerge triumphant; the US in the mud from this stupidity.
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? How many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance. • According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance. • According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Getting back to domestic issues. The decent people got what they could and will have to simply try to expand on it. America is a miserably stupid country that spends money by the billions and trillions where it doesn’t have to and then shorts the poor and the unfortunate on the excuse of overspending. The majority of people suffer from this but are too dumb to stop it. Duped and swindled by the plutocrats. America richly deserves it problems most of which come from its general stupidity.
MEDICAID/CHIP: 71 Million Enrollment and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
MEDICAID/CHIP Future Enrollment: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
Only an incredibly dumb President and an incredibly dumb nation would continue this fool’s errand. The idea of ‘turning the fighting over to local Afghan forces” is EXACTLY Nixon’s laughable policy in Vietnam. The “local forces” don’t want to fight America’s war on Islam and as soon as the Americans leave it will all collapse as it did in Vietnam. We suffered through that lesson, learned NOTHING and are repeating it now EXACTLY again. How dumb can a nation get?
I am tempted to equate the stupidity of Afghanistan with health reform. In short the administration is engaged in two hopeless endeavours both of which will consume all its energy and money and turn out to be failures in the end. Talk about stupid. How stupid can you be?
One the republicans only support federal spending on things the US government buys from large private companies, paying unmarket-like excessive margins for faulty products and services, e.g. the warfare state, missions to Mars and the hugely expensive high profit for drug and insurance comanies medicare drug program.
The second thing republicans support is borrowing money at good interest rates from people who should be sending the money over in the form of taxes rather than pillaging the income tax payers.
The deficit outrage from them is merely excuse to continue pillaging the wage earner.
ILSM said: “What is the value of getting better health outcomes than the 100 poorest nations in the world?” Better health outcomes? I thgink the jury is out on that. Now, it looks like for the short term, first decade after implementing this bill, therre will be more demand than supply for Drs. Fewer Drs will be accepting Medicare and even more will be denying access to Medicaid patients. Do these numbers exceed those of the new recipients of this bill? Few can predict at this point, but it isn’t a pretty picture.
There are ways to have radiologists in Mumbai serve patients in the Eurozone and US.
There are tons of ways to deliver health care, shortage of physicians and price fixing physicians would be no issue if there were a market in US health deliver.
There is no market, therefore, government intervention is necessary to make it efficient.
At least that is the thinking Teddy Roosevelt used………..
It’s the imperialists, ingrained imperialists, of the West who don’t “get it.”. When somebody like this is willing to give his life for a cause, you can’t win. This is a self sacrifice that stupid westerners, comfy and smug, can’t understand. But it will defeat them and their imperialism just as the Vietnamese defeated the imperialists who tried to prevent their independence.
You’re losing the debate. The Romer work shows JFK/LBJ set the economy in the wrong direction. This kills your implied story that your data mining is trying to sell. The Romer work shows the worst economic policy happened under Kennedy/Johnson/Carter.
FDR had 15 percent undemployment going into the run up to WWII; and Truman is hard to judge because he inherited an economy winding down from war. Moreoover,you’re throwing Obama under the bus because given the economy he inherited he’s unlikely to have strong number. Therefore, you are left with Slugs sitting in the bleachers with those big number 1 finger gloves for Clinton. I can live with that, he’s the guy said big government was over (and sex in the dish room had just begun).
Which healthcare bill provisions stay and which go away? I wouldn’t know. So, compare the legislation. Find a good source.
Most of the information necessary to compare the Senate and House healthcare bills is available from Kaiser Family Foundation. More than that, Kaiser is sitting on a wealth of information regarding healthcare statistics and general facts. Info available includes:
– Side-by-Side Comparison of Major Health Care Reform Proposals, December 2009 – Assessing Congressional Budget Office Estimates of the Cost and Coverage Implications of Health Reform Proposals, November 2009 – Uninsured Young Adults: Who They Are and How They Might Fare Under Health Reform, December 2009 – Survey of Employer Health Benefits, September 2009 – Kaiser Health Tracking Poll, December 2009
My focus is normally on results. This legislation is no exception.
I am interested in observing what effect the Congressional conference healthcare bill will have on the following healthcare insurance issues noted in 2009. All statistics are from Kaiser’s Employer Health Benefits 2009 Annual Survey, September 2009.
Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 2009: Individual, $779; Family, $3515
Percentage of All Firms Offering Health Benefits, 2009: 60% Percentage of Small Firms (3-9 employees) Offering Health Benefits, 2009: 46%
Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits, 2009: 29%
Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size, 2006-2009: – All Small Firms (3-199 Workers): 16%, 21%, 35%, 40% – All Large Firms (200 or More Workers): 10%, 12%, 18%, 22% – All Firms: 6%, 8%, 9%, 13%
Among Firms Offering Health Benefits, Distribution of Firms Reporting the Likelihood of Making the Following Changes in the Next Year. Very Likely and Somewhat Likely: – Increase the Amount Employees Pay for Health Insurance: 41% – Increase the Amount Employees Pay for Deductibles: 36% – Increase the Amount Employees Pay for Office Visit Copays or Coinsurance: 40% – Increase the Amount Employees Pay for Prescription Drugs: 37% – Restrict Employees’ Eligibility for Coverage: 9% – Drop Coverage Entirely: 8%
If these healthcare statistics do not improve substantially, expect more fallout from this legislation.
MEDICAID/CHIP Future Enrollment: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance. • According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance. • According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
It’s a good start, but there are plenty of problems with Hennessey’s analysis. First, it is largely based on Sen. Grassley’s staff work and therefore has to be taken with a grain of salt. But note that it also assumes the healthcare bill has no good effect on insurance premiums, which is a bit hard to swallow. For years Sen. Grassley’s staff has compleained about how the uninsured drive up insurance premiums for those who do have health insurance. Fair enough, but if that’s the case, then expanding health insurance coverage to those that don’t currently have it should push down premiums for those who do currently have health insurance. Sen. Grassley’s staff seems to want to have it both ways. Sorry, that won’t wash. And the Senate bill has a fairly robust MLR, which will provide strong pressure to bring down premiums. And while the Medicare tax increase is part of the bill, I don’t think it’s fair to say that the tax hike is because of the bill. By that I mean the Medicare tax increase was something that was all but certain to have happened even without the larger healthcare bill. It’s like counting the AMT as part of the ARRA fiscal stimulus….yes, it was part of it, but it would have happened anyway under a different umbrella. Now there will be two tax increases for sure. One will be a tax on high end insurance plans, and that is a good thing. If the IRS can tax high value reserved parking spaces for executives (and those are taxed), then surely they can tax high end health insurance plans. And healthy, young freerider adults who just don’t want to play will also be taxed. Again, this is a good thing.
“How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?”
Is reducing “premia” for health insurance (private, and medicare) a proper goal of health care reform?
Is reducing premia important or is it a secondary effect of improving health care in the US?
Sorry for answering a question with a question.
Here is what I have observed, in part sitting in a high tech thorax-cardio ICU with my 82 year old Dad.
The oldsters on medicare make those places possible. If it were not for medicare the facility would have been empty and not there for a 40 year old with a bad ticker.
So, I have observed that medicare increases the capital stock of health care.
Similar would be observed for medicaid because the hospitals would be broke without it. Medicaid is public subsidy for health care for the poor. Pays for both direct charges and capital charges.
Both government programs from my observation cause a substantial part of the health care capital to exist.
This existence reduces costs and insurance premiums for the general population.
If the old just went bankrupt when sick then so would a good part of the capital base in health provisions.
The government sector has been taking responsibility (medicare through the trust fund) for a significant part of the acute care investment security in the US.
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
Same for mortgage interest on real estate and state and local taxes. The government uses the tax code for faulty economic reasons.
A huge hit to future state budgets for increased Medicare payments/enrollment.
Assuming you mean Medicaid here, this is the one that needs to be fixed urgently. Most states are pretty much up to the political limit on what they levy in taxes (about 10% of state GDP for combined state/local taxes). In many cases, Medicaid costs are already growing faster than state GDP, with the consequence that other programs are being crowded out. At some point, some states are going to have to choose between Medicaid participation and the other things they want to do. Medicaid participation is not mandatory, but once you’re in you’re subject to the federally-imposed minimums.
In Colorado, the state whose budget I know best, road maintenance is falling farther and farther behind, prisoners are being released sooner, higher education has been cut, K-12 spending is likely to be cut, and the state is attempting some accounting trickery with the unemployment insurance program, but Medicaid spending goes up and up. There is open discussion of which public colleges will have to be closed when the federal ARRA assistance ends.
Colorado may not be one of the first states to bail, but you have to believe that we are not too far from seeing some states choose roads and higher education over health care for the poor. Or at least, make radical changes in the type of health care they provide; Half of what Colorado pays for Medicare would fund an awfully large network of community clinics in poor counties and neighborhoods that could handle routine care.
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
This could be a compromise in a brand new bill that seeks to make individuals key in driving down healthcare costs. However, I think you can make a pretty good argument that healthcare expense is like maintenance of capital equipment in a corporation. Maintaining the human physical plant seems like a legitimate cost of doing business and like with other business expenses its pre-tax.
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
This could be a compromise in a brand new bill that seeks to make individuals key in driving down healthcare costs. However, I think you can make a pretty good argument that healthcare expense is like maintenance of capital equipment in a corporation. Maintaining the human physical plant seems like a legitimate cost of doing business and like with other business expenses it should be pre-tax.
2slugbaits – “It’s a good start, but there are plenty of problems with Hennessey’s analysis. First, it is largely based on Sen. Grassley’s staff work and therefore has to be taken with a grain of salt.”
If you have any complaints about the source data, try blaming the JCT and CBO.
The problem with your “explanation” is that the “Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019.”
Hennessey goes on to explain:
“Senate Democrats have used a different JCT analysis that show the combined effects on these two populations when blended together. You have a relatively small group of people getting big net benefits, and a much larger group paying net costs. The aggregate impact for the two populations combined is a net benefit for the group as a whole, and advocates for the bill have therefore argued the bill is a “middle class tax cut.” Senator Grassley and his staff deserve credit for separating the effects on distinct (and large) subpopulations.”
“Here is an analysis of the premium changes, tax subsidies, and tax increases under the Reid bill. Here are the JCT tables that were the basis for these findings: 4 tax provisions in 2019, tax credits in 2019, and universe of returns in 2019. The other data source is the November 30th CBO letter to Senator Bayh.”
Links for each of the data sources were provided in Hennessey’s presentation along with tabulated breakdowns.
“Based on this analysis, Finance Committee staff believes we can summarize the benefits and disadvantages to individuals, families, and single parents under the Reid bill this way: First, there is a group of low- and middle-income taxpayers who clearly benefit under the bill. This group, however, is relatively small. There is another much larger group of middle-income taxpayers who are seeing their taxes go up due to one or a combination of the following tax increases: (1) the high cost plan tax, (2) the medical expense deduction limitation, and (3) the medicare payroll tax. In general, this group is not benefiting from the tax credit (because they are not eligible for the tax credit), but they are subject to the tax increase(s). Also, there is an additional group of taxpayers who would be affected by other tax increase provisions that JCT could not distribute. Finance Committee staff is working with JCT to determine how to identify this “un-distributed” group of people.”
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
“Premium Analysis – CBO has estimated the average premiums in 2016 for a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group health insurance markets under both the Reid bill and current law. Based on CBO data, we can identify the average annual increase in premiums in each of these markets under the Reid bill and current law. Based on these CBO’s estimates and data, we can project the cost of a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group markets under the Reid bill and current law in 2019.”
“Tax Increase and Subsidy Analysis – JCT has provided Finance Committee staff with a distributional analysis of four of the major tax provisions in the Reid bill – (1) the advance-refundable tax credit for health insurance, (2) the high cost plan tax, (3) the medical expense deduction limitation, and (4) additional Medicare payroll tax. Separately, JCT has provided a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance. Based on this data, we can determine how many individuals, families, and single parents receive the premium tax credit for health insurance. We can also identify (1) those individuals, families, and single parents who are NOT eligible to receive the tax credit and (2) those individuals, families, and single parents whose taxes may go up before they see some type of tax reduction from the tax credit.”
“Eligibility for the Subsidy for Health Insurance – Under the Reid bill, individuals, families, and single parents between 133% and 400% of the Federal Poverty Level (FPL) who purchase health insurance through the “exchange” would be eligible for a subsidy for health insurance. In general, individuals, families, and single parents who get health insurance through their employer are NOT eligible for the subsidy, even if they are below 400% of FPL.”
“Based on this analysis, Finance Committee staff believes we can summarize the benefits and disadvantages to individuals, families, and single parents under the Reid bill this way: First, there is a group of low- and middle-income taxpayers who clearly benefit under the bill. This group, however, is relatively small. There is another much larger group of middle-income taxpayers who are seeing their taxes go up due to one or a combination of the following tax increases: (1) the high cost plan tax, (2) the medical expense deduction limitation, and (3) the medicare payroll tax. In general, this group is not benefiting from the tax credit (because they are not eligible for the tax credit), but they are subject to the tax increase(s). Also, there is an additional group of taxpayers who would be affected by other tax increase provisions that JCT could not distribute. Finance Committee staff is working with JCT to determine how to identify this “un-distributed” group of people.”
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
“Premium Analysis – CBO has estimated the average premiums in 2016 for a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group health insurance markets under both the Reid bill and current law. Based on CBO data, we can identify the average annual increase in premiums in each of these markets under the Reid bill and current law. Based on these CBO’s estimates and data, we can project the cost of a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group markets under the Reid bill and current law in 2019.”
“Tax Increase and Subsidy Analysis – JCT has provided Finance Committee staff with a distributional analysis of four of the major tax provisions in the Reid bill – (1) the advance-refundable tax credit for health insurance, (2) the high cost plan tax, (3) the medical expense deduction limitation, and (4) additional Medicare payroll tax. Separately, JCT has provided a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance. Based on this data, we can determine how many individuals, families, and single parents receive the premium tax credit for health insurance. We can also identify (1) those individuals, families, and single parents who are NOT eligible to receive the tax credit and (2) those individuals, families, and single parents whose taxes may go up before they see some type of tax reduction from the tax credit.”
“Eligibility for the Subsidy for Health Insurance – Under the Reid bill, individuals, families, and single parents between 133% and 400% of the Federal Poverty Level (FPL) who purchase health insurance through the “exchange” would be eligible for a subsidy for health insurance. In general, individuals, families, and single parents who get health insurance through their employer are NOT eligible for the subsidy, even if they are below 400% of FPL.”
i think this points to an area of huge cost savings. The gov’t needs to finance the training costs of the next generations of drs entering med school now. those drs can pay back their costs by working at gov’t clinics and hospitals. and keep working there if they like the hours and pay and “non tangible rewards.”
if you are still around. there are bettter and cheaper fixes to social security that stealing the money from the benficiaries with a phony “inflation index” fix. most people would be happy to pay an extra twenty cents per week in order to be able to… let us say have a refrigerator and indoor toilet like the rest of their neighbors, even though this is a “standard of living” not a “cost of living” increase since the day social security was first started.
Is reducing “premia” for health insurance (private, and medicare) a proper goal of health care reform?
Is reducing premia important or is it a secondary effect of improving health care in the US?
The President has made it very clear that reducing health insurance premium costs is of paramount importance. It is my judgment that reductions in insurance premiums is the foremost healthcare reform goal of the Administration.
The health care reform, for whatever it is, is pretty much a done deal. I find incessant discussion of it now rather boring. It’s over. We need first to find out what the results are in reality. Then we can assess what more needs to be done. If anything more can be done.
Really, awfully good? As a healthcare provider, and a practicing Emergency Med PA, I think I would argue that. Surely you have data to support such an assertion correct?
We are good at on thing though, we sure can spend money.
And your solution is? What would you do. Keep in mind that “the market” has failed. Costs are rising at an average pace of 6.2% per year over the last decade. Surely you have some solutions right? Healthcare does not always behave like other commodities, likely due to having low price elasticity scores, but also because it is a necessity.
Okay, here’s the deal. If you want people to voluntarily be uninsured, than you change the EMTALA requirements, and allow me to DENY care at the ER. You allow me to do a wallet biopsy first, and then decide if I will intervene in the young kid who got hit by a drunk driver at 90 mph, or the middle aged unemployed guy having a heart attack. You let me deny care, and I will agree to allow people to remain uninsured, otherwise, you have no clue what you are talking about.
Repeating Hennessey’s points doesn’t really address my concerns about his analysis. Note the sly caveat in his analysis: he assumes that the healthcare bill will not reduce premiums. But that’s a whopper of an assumption given that there are many provisions in the bill that are intended to reduce premiums. For example, the cost of free riders is something that we can pretty much put in the bank as a savings. The bill tries a lot of different things to bend the cost curve. Some will fail, but some will probably succeed. And the two big tax increases (i.e., taxing cadillac benefits and the increase in Medicare taxes) just make good sense in their own right irrespective of healthcare reform in general. It’s just good fiscal policy.
Part of life is fate. Bankruptcy is certainly bad but it’s hardly a death sentence. Those that want to reduce the chance of going bankrupt could spend a larger part of their lives accumulating a safety cushion. We no longer throw bankrupt people into debters prision and send their children to orphanages. We do quite a bit as a society to mitigate the vicissitudes of life.
Part of life is fate. Bankruptcy is certainly bad but it’s hardly a death sentence. Those that want to reduce the chance of going bankrupt could spend a larger part of their lives accumulating a safety cushion. We no longer throw bankrupt people into debters prision and send their children to orphanages. We do quite a bit as a society to mitigate the vicissitudes of life.
CoRev and Sammy are Swiss Army Knives, if one blade/tool doesn’t accomplish the task just whip out another one and try try again. Eventually you accomplish your end.
Michael, but, but growing entitilements, redoubling themd does not cause crowding out in discretionary spending. I know it, cause my buddy, 2slugs told us so!
This is the perfect forum to introduce the kind of resource and/or open questions you like to advance. Hopefully all of us can dial down what has been unneccesarily antagonistic relations in the new year.
“Repeating Hennessey’s points doesn’t really address my concerns about his analysis. Note the sly caveat in his analysis: he assumes that the healthcare bill will not reduce premiums. But that’s a whopper of an assumption given that there are many provisions in the bill that are intended to reduce premiums.”
Hennessey never made that statement or suggestion. What he stated in the lead in to the data that I posted was this:
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
One difference I noted in reading the CBO report:
“CBO and JCT estimated that roughly 23 million people would purchase their own coverage through the exchanges in 2016 and that roughly 5 million of those people would not receive exchange subsidies. Therefore, of the 32 million people who would have nongroup coverage in 2016 under the proposal (including those purchased inside and outside the exchanges), about 18 million, or 57 percent, would receive exchange subsidies.”
This is a larger number than Hennessey cited from JCT. 13.2 million vs. 18 million.
Well the real problem comes when you define the population actually spending healthcare dollars. It is estimated that only 5% of our population accounts for nearly 50% (47%) of total healthcare spending, and that only 1% of our population is responsible for over 25% of healthcare spending.
I don’t personally believe that insurance premiums will necessarily decrease across the board. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a few and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur? Ten years out, the premium costs will be substantially higher…perhaps almost doubling once again. We’re not out of the woods on healthcare costs.
I don’t personally believe that insurance premiums will necessarily decrease across the board if such decrease at all. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a small portion of the population and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur. Ten years out, the premium costs will be substantially higher…perhaps almost doubling once again. We’re not out of the woods on healthcare costs. Not even close.
I don’t personally believe that insurance premiums will necessarily decrease across the board if such decrease at all. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a small portion of the population and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur. Ten years out, the premium costs will be substantially higher. The question is whether the individuals, families, and companies will be able to afford the premiums as the increases continue. We’re not out of the woods on healthcare costs. Not even close.
I would like to see more individuals engage in discussions on the comment threads. I think AB needs more liberals and independents at this point to balance it out.
Open threads tied to specific subjects is a good move. Hope this effort continues.
I will work on improving the scope and tone of my comments.
Note that the proposals are not retroactive, only forward looking so that folks over 55 would not see much change, younger folks would. Then moving the full retirement age so that it increase 1 year for every 16 years starting in 2025 would help solve the problem. Add the third and then if you have to much money you can cut the contribution from each piece a bit. If the choice is between one and two which does one go for, both operate on a long enough time constant that people can adjust. So do you favor raising the retirement age, because without cutting benefits some way you won’t ever get the increased earnings limit thru.
What’s not over? You mean the health care legislation has not passed? That we don’t know the results? That there is still voting to be done? Tell me about it.
The main issue for Obama’s reelection will not be health care but the Afghan war. It will still bedevil the nation in 2012 and may finish his Presidency. That and the impact of another recession in the second half of 2010 that Krugman and Stiglitz now think is likely. Another new recession and Obama will be toast.
Unless oil prices go above $100 I don’t see another recession. With dropping the public option the government will only get to tinker but not be nationalizing healtcare. Cap ‘n trade is dead on arrival. These are both positive developments.
And forget about Afghanistan if the economy gets better; once the economy turns around that’s the end of Obama’s once a week international road trips.
I hope I didn’t give you the impression that I thought we were “out of the woods” on healthcare costs, because I think we can all agree that we are not. Not by a long shot. And healthcare costs will surely increase as a percent of GDP even with healthcare reform. But the issue is whether or not that increase will moderate under the Senate plan and there is good reason to believe that it will, and that’s why I question the Hennessey piece about assuming not reduction in healthcare premiums. Obviously, when people talk about a “reduction” in healthcare premiums they do not mean a reduction in the absolute value of the premiums, but a reduction in the rate of growth. This is just understood. And no one is pretending that the Obama plan is a finished product. We’re looking at another 20 years of fix’n up.
Both Stiglitz and Krugman warn of a strong possibility (but not a likelihood) of a contraction in the second half of 2010. That’s because the effect of the stimulus will have peaked and unless the private sector kicks in over the next six months aggregate demand will weaken. This economy is still on life support. Cap and trade is not dead on arrival in the sense that businesses will care about the issue. The House bill may be dead on arrival, but the larger issue of cap and trade parameters are not. I don’t think there are many carbon intensive industries out there that actually believe there will not be some kind of cap and trade (or a carbon tax) somewhere down the line and in the not-too-distant future. The idea that there won’t be some kind of legislation eventually is implausible. So that introduces a lot of uncertainty into business investment. No business is going to invest a lot of money on the bet that cap and trade is dead and will not come back in a stronger form down the line. What businesses do need is a cap and trade bill that they can count on and plan around. Right now they don’t know what to expect. Passing a credible cap and trade bill would help businesses because it would give them some relative certainty about the future. All they know now is that EPA has identified CO2 as a health threat and that the status quo cannot be maintained. It’s really the worst of all possible worlds in terms of a climate for investment.
A mention of one of the hidden costs of Medicaid: my Minneapolis friend of whom I have spoken before had to go on Medicaid last year, when he was unemployed, had lost most of his 401K before he even got to access it after being laid off, was suicidal, and needed life-or-death counseling.
One of the stipulations of entry into the program was that his bank balance had to be below $1000.
That’s about his rent and utilities for a single month. Icarus didn’t fly as close to the sun as he had to fly to get the medical care he needed.
Assuming this story is not unusual, the stipulations of Medicaid, like those of social assistance, force Americans who are merely poor to dig down into full destitution. This might be the best individual choice for someone needing cancer, depression or other major health care, but subsequently creates and maintains an underclass with none of the resources they might need to rebuild their lives or help others build theirs.
Noni
PS my friend found a job and is now hanging on by his fingernails. No pension offered, no savings, and now that his company plan covers him, he has worse health coverage than what Medicaid offered.
Well it’s a glorious thing to be poor in such a wonderful plutocracy as the USA. You can be sure you’ll be taken care of well and are so much better off than if you were in some socialist dump like Sweden.
And 2slugs has again specified how Dem policies are devestating business planning and investment, and eventually recovery from this recession. 2slugs, instead of asking why we don’t have these policies implemented, ask yourself why are they even considered? If they were so darned important, why is there no consensus?
What businesses do need is a cap and trade bill that they can count on and plan around. Right now they don’t know what to expect.
What businesses want most is for the government to commit themselves to never doing a cap N trade bill. Next best is never to do a cap N trade bill but don’t tell anyway (the status quo).
Suppose the Obama Administration came out this afternoon and said that it would not pursue cap and trade. And suppose you were an investor interested in coal powered utility plants. Do you honestly think that such an announcement would reduce the uncertainty over your investment??? Would you suddenly be willing to accept a lower return due to reduced uncertainty risk? Only if you were living in BizarroLand. Get real. That kind of announcement would not have any credibility because it would be viewed that such an announcement was only transient, just as a “no new taxes” pledge would not have credibility because it would have to be reversed eventually. Temporarily denying what we all know will happen sooner or later is not my recipe for helping businesses. What’s needed is a credible policy that businesses can rely upon.
you are absolutely right about that. the minimum assets requirement for medicaid.. or food stamps.. is ridiculously low and leads a lot of people to become “welfare cheats.” i can understand not wanting to give welfare to someone with a million bucks in the bank. but a years survival money?
Suppose the Obama Administration came out this afternoon and said that it would not pursue cap and trade. And suppose you were an investor interested in coal powered utility plants. Do you honestly think that such an announcement would reduce the uncertainty over your investment???
In your hypothetical does the investor get to pass whatever he has pay Swaziland for carbon offests to rate payers in the United States? Why not skip Cap N trade and just send money directly to swaziland?
Now that we have the outlines of a final Healthcare bill (from the Senate), what are its good parts? How will it help the average voter?
The negative parts are apparently increased healthcare costs due to increased taxes on suppliers. Mandated insurance coverage on those who previously could legitimately (low risk individuals) avoid coverage. Draconian threats to healthcare coverage for the the elderly (this one may be arguable.) A huge increase in bureaucratic overhead (also raising taxes.) An increase in Federally funded entitlements during a period of serious economic duress. A huge hit to future state budgets for increased Medicare payments/enrollment. A very large tax increase in the early years with few if any benefits for the average voter. A huge political hit for Democrats for passing these one party versions.
Many new costs and few savings. If the goal was to lower healthcare costs, where is that buried or carried out in this bill?
Your thoughts.
CoRev,
I continue to work, do not have a life aside from blogging here.
Please elucidate: “Draconian threats to healthcare coverage for the the elderly (this one may be arguable.)”
Describe the word draconian, I am not that literate.
Please explain the threats and why a nation with all the worlds’ nukes is threatened by anything.
Who is picking on the elderly and why ain’t AARP (insurance shills whom I no longer pay due to) up in arms?
PLease correct my ignorance.
Aside from what’s in it for the rich.
CoRev,
You forgot to mention death panels and killing babies.
Mandated insurance coverage on those who previously could legitimately (low risk individuals) avoid coverage.
This is a downside for healthy young individuals who have no problem with passing a small risk onto the rest of society. Even young people have motorcycle accidents. Young people are more likely to get serious cases of H1N1 flu this February. Young people are not immortal, so not contributing to health insurance as long as the risk is greater than zero is just wrong. And young people will eventually become middle aged and old people, and at that point they will be paying less than they would have without the subsidy from younger workers. And younger, healthy workers will get other kinds of offsetting benefits. For example, younger workers are more likely to be lower income earners, and they will get significant assistance in the new bill. So this provision is a lot like having to pay into Medicare; it doesn’t help the young while theiry young, but it does help them a lot when they get older.
Draconian threats to healthcare coverage for the the elderly (this one may be arguable.)
Yes, it is arguable. It’s also a strange argument coming from those who say they are opposed to government run single-payer systems. It seems that the GOP’s primary argument against the Senate bill is the one set of provisions that they actually supported not long ago. There will be some cuts to Medicare, but calling those cuts “draconian threats” is a bit over the top. And don’t forget that the Senate bill does fill in the so called donut hole, which is an important feature for seniors.
A huge increase in bureaucratic overhead
This is just way off base and pretty clearly wrong. It will marginally increase the number of government bureaucrats, but will dramatically reduce the number of private sector bureaucrats. Afterall, that’s where a lot of the cost saving comes from. Of course, if you’re worried about bureaucratic overhead, then you should be arguing for a single payer system because single payer has the lowest overhead by far. That’s not even a close call.
An increase in Federally funded entitlements during a period of serious economic duress.
Isn’t that exactly the time that you would want to increase entitlements? You’ve slipped into the old Hoover “Treasury View” line of thinking.
A huge hit to future state budgets for increased Medicare payments/enrollment.
I think you mean Medicaid payments and enrollments. It’s not a hit to state budgets if the federal goverment picks up the difference. Again, if you want to argue that the federal government should assume more responsibility for Medicaid, then fine, but I don’t think that’s what you want to argue. I suspect that you and Mr Scrooge are arguing that we should replace Medicaid with the workhouses.
increased healthcare costs due to increased taxes on suppliers.
Not sure what you mean by increased taxes on suppliers.
A very large tax increase in the early years with few if any benefits for the average voter.
Fair enough, so we can expect you to urge Republican senators to work with Democrats in trying to accelerate the benefit stream???
Many new costs and few savings.
Well, the CBO says that there will be significant savings. And there will be some significant efficiency savings as well. For example, it will increase worker mobility because having healthcare from an employer will be less of a reason for staying at a lower paying job. The tax free status of high end health insurance plans creates a fair amount of ecoonomic deadweight […]
2slugs, why not add to the list instead of just countering my thoughts. That was my hope. I will explain my viewpoints in reverse order of your counterpoints, but I do not intend to get into an continuing and ongoing point-by-point coutner argument scenario.
I suspect you are saying here: “The other equally important goal was increasing access to healthcare, and this bill goes a long way towards that goal.” is not access but coverage. Access has not changed, ACAICS.
Savings from the CBO Report/Scoring? Only if you believe that Drs will have thier reimbursements cut, and that the double counting of Medicare cuts is a valid saving. And you believe that benefits should be taxed as salary/wages? OK!
Inceased taxes. The bill increases taxes on the Insurance providers, medical implement suppliers, Gold plated insurance packages (unless if you are a union member) and even tanning salons. I’m sure once we pull back the covers we can add to this list, dramatically.
You are correct I thought medicaid and typed Medicare.
Bureucratic increase. So how much of the increase in Fed and State agencies do you consider on the margins? Or marginal? Some might think any increase unwarranted. Tell us how the private sector staffing is diminshed.
Do I think that dramatically increasing Fed entitlements during economic stress are good for the economy? MAYBE! If used for short term benefits, but I have been taught since the 60s that Fed entitlements are what will be the final issue to kill our Fed budget flexibility. Care to dispute that with Medicare/medicaid and even to a lesser extent SS being problematic as far as growing budget demands.
Draconian cuts are going to be a HUGE perception problem for Dems for the elderly who are high volume voters. But, the real issues are just being discussed. The added demand on the medial community coupled with the reduced reimbursements to providers will drive many of those in medicine to refuse covered patients. It a growing problem in many areas. Especially for Medicaid, and in some areas Medicare, but this bill will seriously exacerbate that problem. Poor and elderly charged more for lesser coverage? Good idea!
Finally, maybe you think the poor need to be taxed higher ($750/Yr fine if they choose to not get insurance.) Or, that they need to lose another choice on how to best manage their limited financial resources by mandating they get health insurance. Some may be entitled to a total subsidy, but the vast majority will only get a partial subsidy. Are we creating another class of scofflaws? Or are most Dems standing in line to receive their thanks? You know where my bet is.
And finally, how do we control insurance costs when the insured are allowed to opt in and out depending on their medical conditions?
The unanticipated ill effects in this bill are just enormous. I surely hope they are out weighed by the benefits.
ilsm
“Draconian” refers to the ancient Greek lawgiver Draco, who estalished a severe and harsh set of codes for Athens back in the 7th century. The Draconian law code was replaced by Solon in the 6th century.
http://history-world.org/draco_and_solon_laws.htm
Well this new thread seems to have accomplished its purpose.
I suggested it to Dan because obviously Health Care Reform and this proposed Entitlements Commission are in the news, and to the degree that the latter takes in Social Security that overall issue is out there as well. But that doesn’t mean that every post relating to the details of the Health Care Bills, or the specifics of the structuring of the Entitlements Commission or about some aspect of Social Security needs to become a top level review of the whole topic which has unfortunately been the pattern.
I put up a post on the MLR provisions of the new Senate Bill as passed yesterday and I plan to put up a new post on the interrelation between the subsidy table and the insurance risk pool regulations today. Nitpicky but I think important. So I am extremely happy that CoRev launched this discussion on this new thread and that I hopefully won’t be faced with the same on my more narrowly focused thread.
I hope everyone will read my post, but those who want to talk about Health Care Reform more broadly will be politely (at least initially) referred back here.
Dan has asked, or perhaps dared, commenters to submit posts for potential front paging with little luck. But now that Angry Bear has the No GW Open Thread, the GW Open Thread, and the Health Care/SS/Entitlements Open Thread the door is open for thoughtful conservatives to present their own take rather than as now having to take an adversarial approach to insert their point of view. And all without pre-publication review (though of course post-publication editing and moderation are possible).
Let a thousand flowers bloom!
CoRev,
First, even today the government provides more healthcare (measured in dollars) than the private sector, but yet the cost growth in private health insurance exceeds the growth Medicare…any by a pretty wide margin. So the least efficient cog in the wheel is private health insurance. One of the reasons is that private health insurance devotes a lot of economic resources into figuring out how to exclude groups and how to avoid paying claims. They won’t be able to do that under the Senate plan, so those costs should be reduced. That will be an economic savings. And hospitals and doctors’ offices won’t have to hire a team of clerks to run down claims and fight with insurance companies, which is pretty much what you see in a doctor’s office today. Ditto with hospitals. And the cuts in useless procedures covered by Medicare (e.g., those bogus wheelchair commercials on TV) will save money. Note, seniors will still be able to obtain those services, it’s just that the taxpayer will no longer be obligated to pay for procedures with no proven medical benefit. Again, that’s a savings. And bringing people into the healthcare system sooner will save money because they will get treatment earlier instead of in emergency rooms.
And finally, how do we control insurance costs when the insured are allowed to opt in and out depending on their medical conditions?
That’s what they do today…or at least try to do today. Under the Senate bill people won’t be able to opt in or out because they will be mandated to participate in one form or another.
And yes, benefits absolutely should be taxed. Absolutely. It’s one of the first principles of public finance economics…or at least it was when I took the course. Untaxed benefits create deadweight economic loss. That’s one of the bedrock principles of economics.
And you only want to talk about the increase in federal and state bureaucrats, but you completely ignore the reduction in private sector bureaucrats. For example, the ENTIRE Dept of HHS has fewer than 65,000 employees and manages more healthcare dollars than the entire private sector market. Aetna alone has 30,000 employees and is responsible for only a fraction of the healthcare dollars as HHS. So in terms of pure bureaucratic waste, this one is a no brainer.
but I have been taught since the 60s that Fed entitlements are what will be the final issue to kill our Fed budget flexibility.
Then you were taught wrong. What kills the budget is creating entitlements and then refusing to fund them, which is what the GOP likes to do.
CoRev,
And United Health as almost as many employees as HHS (58K vs 65K) but only one-tenth the revenues. So is United Health your standard for bureaurcratic efficiency?
2slugs, your other points are just counters to mine. Ok, we have differing views.
But, the following comment is one of the falsest of falsehoods in comparing Public and Private implementations. “but yet the cost growth in private health insurance exceeds the growth Medicare…any by a pretty wide margin. “
When comparing public costs to private costs we are ALWAYS in an apples to elephants world of comparisons. Public/private comparisons are almost always bunk. You of all people know that!
For those outside the Govt and not economists nor trained in Public Administration the biggest differences in costs are not ever covered, and that is profits. That amount is usually to a low double digit difference in comparison at the start.
But it does not come close to ending there. There is the cost of financing, the actual support public entities get from the other public agencies, GSA for supplies, transportation and buildings, the treasury for financial processing, much of HR is from another agency, security from other entities. This list just touches on the totality that seldom is ever included in the public/private cost comparisons. But, the final and most important difference is the built-in customer base, whereby, Govt crowds out the other private suppliers of the service. (Think in terms of the US Postal Service until some competition was opened up.) Or how about the costs to conform with Fed regulations that the public sector is usually exempt or significantly relieved from conforming.
So, as you can see these cost comparison discussions are almost always specious and/or disingenuous.
That goes fifty one times over when we see comparisons of the public/private staffing comparisons. All the above differences plus the fifty states apply in this comparison arena.
It will be interesting to see if the MLR becomes the center of the healthcare debate. If it does then you get the credit for highlighting it as an issue. And that’s the last nice thing that i’m going say to you for the rest of the year.
It will be interesting if the MLR becomes the center of the healthcare debate. If it does then you get the credit for highlighting it as an issue. And that’s the last nice thing that i’m going say to you for the rest of the year.
With the prospect of reform in sight, [knock knock] I am sort of looking and planning forward, wondering what can be done in order to ensure memory isn’t lost. (And doing the laundry and deep vacuuming, too, prepping for New Years. But the three tasks aren’t mutually exclusive.)
Once some sort of health reform bill is passed, assuming it isn’t too damn watery, the day of signing should become an annual national day of observance — National Health Day, maybe. (Preferably a name with more punch than that.)
Newspapers like these sorts of days, novel or not, since it provides them with a ready topic they can jump on. I oughta know – we got three or four stories out of Fire Safety Week alone, back in my reporter days.
Reporting and celebrating the state of US health and health care, along with articles tracking progress, world standing, and things still to be fixed, would I hope do the same thing for people’s memories of just how difficult and important this was, the same as Veteran’s Day with it’s prayers and memorials.
Given how quickly Americans seem to have forgetten the genesis of Medicare and Social Security, I think the great medical breakthrough is going to need some help. Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too. Mind you, we have our annual dose of Dickens but that’s far from 100% effective.
Noni
CoRev,
First, we’re talking about differences in growth rates, not expenditure levels. It is perfectly valid to compare differences in growth rates. Fixed differences between the govt and the private sector are irrelevant when you’re talking about growth rates.
Those support costs that you talk about are not free to other govt agencies. HHS does not get its HR support from OPM for free; they have to buy that HR support. Same with GSA supplies and transportation, etc. Those are all funded through revolving account. So you’re just flat out wrong about the financing between govt agencies.
There is a difference in the built-in customer base. And here the govt is at a disadvantage because the govt cannot cherry pick and only insure those least likely to submit a claim. Medicare provides insurance for precisely the one group that absolutely could not get it at anything like an affordable price through the private market. That’s why Medicare was invented 45 years ago. The govt is not crowding out the healthiest customers; the govt is crowding in the unhealthiest and still managing to do so at a lower cost growth trajectory than the private sector insurance market.
The whole tone of your post is bizarre and really defeats your larger intent. You go on about how unfair it is for govt to get further involved because the govt has so many inherent advantages. Well, excuse me but this isn’t about “fairness” to insurance company profit margins. It’s about providing insurance at less cost to a broader base and if the govt has certain competitive advantages, then we should take advantage of those advantages. Why hobble ourselves intentionally by insisting on “fairness” to insurance companies. We owe them nothing. Companies are only entitled to a profit if they can outperform the competition, and that competition includes the govt.
2slugs,
Thank you.
I would note: if the republicans want the strong, fit, and young citizen to be selfish (they graciously defend them from being exploited to help (through entitlements) the less fortunate; old, weak and unwell) , the strong fit young soldiers and marines should also be selfish and not run off to war (using discretionary funds pillaged from the US productive pool).
I suspect it is alright to exploit the strong, fit and young for war profits (discretionary waste).
But it is wrong to suppose the strong fit and young should enter the risk pool for health insurance (entitlements) rather than wait to enter the risk pool when they are no longer strong fit and young…………
But, war profits are not for the less fortunate they are for the bagmen paying off republican senators.
The debate hidden in all this is: entitlements for regular people are bad, however discretionary spending for war profits and federal support for the income of the 1% is good.
CoRev never talks to me.
We disagree and that is it.
Good point.
To me the entire issue with US health care is leveling risk.
The private insurance industry manages its financial risk exposure and does nothing for “health” and the high risk persons generally go to medicaid. If over 65 to medicare.
There is no issue about cause and effect.
The taxpayer bears the risk.
Someday the value of a healthy US citizen will be worth debating.
Until then let the sick hope to die fast and cheap.
And Palin thinks the liberals are for death!!
2slugs, soemtimes you commentary is just amazing to me. I do not think I ever used the term “fair.” Regardless, some of these agencies are created to provide “no cost” support to other agencies.
some of the cost is recovered, but seldo all. GSA’s revolving funds may have changed somewhat since I worked there, but they are not ever fully replaced by charges to other agencies. They are usually used to fund the overhead and some portion of the seed money needed to make the basic purchases, but your charges do not refund that originally Congressionally funded amount. I believe the Finance Act adds even more restrictions, but it has been a while since I worked in that environment.
Moreover why do you try to make a case for growth when the basic components included in the measeurements are so dramatically different? Unless and until the totality of those components are included, then it is still an apples to elephants comparison. Moreover, why ignore the two big issues I listed earlier, profits and regulatory conformance costs? Trying to make a weak case for equality of costing is truly a bizarre position for an analyst, economist, and Fed Govt employee.
I really do wish you would add to the issues list, and not just try to take my entries apart.
2slugs, soemtimes your commentary is just amazing to me. I do not think I ever used the term “fair.” Where did that come from?
As far as comparing private to public sector accounting and claiming external agencies are completely refunded by charging user agencies is dead wrong. Regardless, some of these agencies are created to provide “no cost” support to other agencies. It is why they are separately funded.
Some of the cost is recovered, but seldom all. GSA’s revolving funds may have changed somewhat since I worked there, but they are not ever fully replaced by charges to other agencies. They are restricted from doing that by law. They are usually used to fund the overhead and some portion of the seed money needed to make the basic purchases, but your charges do not refund that originally Congressionally funded amount. I believe the Finance Act adds even more restrictions, but it has been a while since I worked in that environment.
Moreover why do you try to make a case for growth when the basic components included in the measeurements are so dramatically different? Unless and until the totality of those components are included, then it is still an apples to elephants comparison. Moreover, why ignore the two big issues I listed earlier, profits and regulatory conformance costs? Trying to make a weak case for equality of costing is truly a bizarre position for an analyst, economist, and Fed Govt employee.
Bruce,
Thanks for opening one of my favorite issues.
I have not checked into the past year’s federal budget (still working!! outside my house) to get the percent, but one chart in the green book (I think) tells you the percent of federal outlays for discretionary spending versus entitlements.
Discretionary spending is all those things which require an “authorization” bill each year to set what the US constitution says can be appropriated. The largest single discretionary category is the warfare state (minitruth calls it defense appropriations, but what s going on now is 20 times larger than needed to keep the Afghan cavemen from bombing Detroit). About half of “discretionalry spending is for the warfare state, the rest is for things like the FAA and going to Mars.
The federalists fearing the US would be run by guys like Rumslfeld, Petraeus and McChrytal made it so funds for the war machine were limited to 2 years.
Entitlements is the second contender for the fruits of US economic activity. It includes things that are not limited by their threat to life and liberty, things that help individuals and provide a social safety net for individuals. Not much chance of a military coup among the elderly, disabled and poor children.
Entitlements include: OASDI, SSI, Medicare, federal subsidies for medicaid, welfare etc.
The shares: entitlements roughly two thirds of federal outlays; discretionary the remaining third.
The third for welfare for the rich is jealously guarded, even though Medicare and SS income has exceeded outlays keeping the deficit artificially low while always fighting to lower entitlement outlays.
thats BC
Noni,
Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too.
The system in the United States is awfully good. The only reason we might need increased mental healthcare services here are for those that go to Canada for medical treatment.
ILSM, Yup! Why discuss the same things over?
Noni,
Also, a sentimental and powerful movie in which the current system is shown in its full awfulness, might help too.
The healthcare system in the United States is awfully good. The only reason we might need increased mental healthcare services here are for those that go to Canada for medical treatment.
C’mon folks! Where’s the list of benefits? I started with a very short list of benefits and then listed the major or most obvious costs/negatives.
2slug
thank you for your masterful exposition here. and thank CoRev for making it possible.
Open your eyes, pull the plank out, here is the biggest benefit.
Take the money away from the war mongers, who deliver nothing at all, and use it for “we the people”.
The poor are only going to inherit the earth not take it like the war mongers would.
Ask any ordinary Canadian if they would trade. One of the surest ways to get in trouble politically up here is to suggest adding a commercial element to our health system.
True, most Americans have the care they need. But at triple the price (much of it hidden from the recipients) that we pay.
ilsm
i agree with what you are saying here, but can you understand why i want people to understand that Social Security (and some of Medicare) is NOT “federal outlays.” These are programs where people pay for their own benfits rather directly in terms of dollars to dollars. While a case could be made that I personally benefit from the government building a new Submarine, that benefit is not as obvious as getting my payroll tax returned, kept safe and adjusted for inflation, when I will really need the money.
Correction: Awful good.
39th in the world is awful for the “leader” of the G 7.
CoRev,
What is the value of getting better health outcomes than the 100 poorest nations in the world?
CoRev,
C’mon folks! Where’s the list of benefits?
There are none, but who cares? Government run health care is a fait accompli; the morons here have bought into their lies, and we will get the vaunted efficiency and quality associated with all government run programs. The real benefits accrue to the D party, and the libs, who have another entitlement program they get to manipulate for votes, control lives, and tax the rich for. Hoo ray!
Sammy,
Government run health care is a fait accompli;
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. Andy the don’t hold the purse strings.
Government run health care is a fait accompli;
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. And the don’t hold the purse strings.
CoRev:
Either bill provides the skeleton to Heathcare Reform. The passage of the bill was just the start with much to be determined over the next couple of years. There is still more to come in detail and in benefits. A huge negative would be to once again to do nothing which would cost $billions. I posted on those costs previously.
Noni,
What do you mean “that we pay”. I thought you were Canadian. Aye?
It Seems like this issue is none of your business.
Government run health care is a fait accompli;
I don’t see it. When they lost the public option I think they lost to ability to socialize medicine. With the public option they could have pushed the private insurers out of the market. Without the public option they are on the hook for making the system work. And they don’t hold the purse strings
coberly,
Yes, that’s BC. Sorry, just sort of thought it was understood when talking about ancient Greeks, but you’re right.
CoRev,
C’mon folks! Where’s the list of benefits?
We’ve already listed many of them. But why not try again. The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance. That’s a benefit. The Senate bill will prevent insurance companies from cherry picking only low risk customers. That’s a benefit. The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns. That’s a benefit. The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance. That’s a benefit. The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss. That’s a benefit. The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit. That’s a benefit. Had enough?
sammy,
The real benefits accrue to the D party, and the libs, who have another entitlement program they get to manipulate for votes,
I thought you and CoRev were just telling us that healthcare reform was going to doom the Democratic party because it wasn’t popular with voters. Now you’re saying that it’s all about winning elections. You guys need to get your stories straight.
“True, most Americans have the care they need. But the total cost Americans pay is triple the price … that Canadians pay.”
“In 2006, per-capita spending for health care in Canada was US$3,678;in the U.S., US$6,714.” http://en.wikipedia.org/wiki/Comparison_of_Canadian_and_American_health_care_systems
But that’s only roughly double. Where do I get the triple? From the people not covered in the USA, and the people covered, who don’t get or are afraid to ask for the level of care they might seek if they didn’t fear losing their coverage.
Noni
Slugs,
You guys need to get your stories straight.
That’s hard given we don’t know that will happen in the future. I don’t see healthcare reform helping the democrats that much. It won’t help me. It won’t help you. It has a chance of being a fiasco. Time will tell.
You know if we go to 100 percent coverage and healthcare costing only 10-11 percent of GDP then it will be a big win for the democrats. But what’s the chance of that?
1) The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance.
Yes by forcing them to purchase insurance or be fined. Medical insurance is already available to just about every citizen who wants it now, with the exception of pre existing conditons. Just call up an insurance company. A lot of the unisured are voluntarily so.
2) The Senate bill will prevent insurance companies from cherry picking only low risk customers.
Most group policies have very limited underwriting, so all risk classes are included. If you are going to force plans to accept people with pre-existing conditions, then yes, those people are benefitted, at the expense of the rest of the policy holders
3) The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns.
Executive salaries and advertising are small components of insurance company costs. Gratuitous class warfare alert!
4)The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance.
We already have this with COBRA and HIPA.
5)The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss.
Yes I see. It is a benefit to the people to tax them. The ingrates!
6) The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit.
Why have we been doing this all along? Government incompetence?
Slugs, see my comment about “morons who have bought their lies.”
1) The Senate bill will dramatically expand coverage to just about every citizen who wants health insurance.
Yes by forcing them to purchase insurance or be fined. Medical insurance is already available to just about every citizen who wants it now, with the exception of pre existing conditons. Just call up an insurance company. A lot of the unisured are voluntarily so.
I could have accomplished this in a ONE SENTENCE BILL>
2) The Senate bill will prevent insurance companies from cherry picking only low risk customers.
Most group policies have very limited underwriting, so all risk classes are included. If you are going to force plans to accept people with pre-existing conditions, then yes, those people are benefitted, at the expense of the rest of the policy holders
3) The Senate bill will require insurance companies to actually pay out against claims rather than expensive executive salaries and advertising campaigns.
Executive salaries and advertising are small components of insurance company costs. Gratuitous class warfare alert!
4)The Senate bill will give employees greater mobility and flexibility in changing jobs because they won’t feel tied to less productive employment solely because of health insurance.
We already have this with COBRA and HIPA.
5)The Senate bill will tax high end health insurance packages which create labor market inefficiencies and deadweight loss.
Yes I see. It is a benefit to the people to tax them. The ingrates!
6) The Senate bill will at least attempt to restrain Medicare spending by not funding procedures that show no medical benefit.
Why have we been doing this all along? Government incompetence?
Slugs, see my comment about “morons who have bought their lies.”
sammy,
Yes I see. It is a benefit to the people to tax them.
Which would you rather receive as a belated Xmas gift, $100 cash or a gift certificate at a local restaurant that you rarely visit worth $101? Most people would prefer the cash. It’s the same with “cadillac” insurance plans. Not taxing “cadillac” health insurance policies is essentially the same thing as compensating employees with gift certificates at rarely used restaurants…you have to increase the nominal value of the compensation beyond what employees would take as a cash payment. It is economically inefficient. This is pretty basic stuff for anyone who has ever taken an econ course.
[Cue: Sound of ball bearings clicking]
I pay $800/mo for health insurance and have not seen a quack in 8 years. The last thing I want, at this stage of my life (56) is an internet ready evaluation of my fitness.
I think we, in America, are missing the whole point. Mr Happy, Valium Reagan, initiated a national delusion that persists to this day, turning his back on the very things that allowed him to be Mr. Happy in the first place. Anyone thinking the Civil War ended the discussion between Plantation and Social Capitalism was sorely mistaken. Do not look to academia to settle the dispute. They are probably the most clueless of all.
We have allowed the Plantation Capitalists from the South to reassert their sick view of a wealth polarized nation with the aristocracy “owning” their employees, Walmart is the largest retailer in the world, hiring millions and millions of gulag laborers to produce products for sale in the US.
We cannot expect the government of the US to explicitly limit mercantilist trade in the US. But educated citizens of our country can stop buying imported goods. I have. The collapse of jobs in the US has reached an epidemic of much greater proportion than the H1N1 virus. Every foreign produced car, appliance, what have you we buy is a loss of family level wage jobs in the US in favor of a lower standard of living society in the future. Adam Smith is not a party to mercantilist trade.
Good job Dan and Bruce. I think over time we’ll be able to put some clothes on this skeleton to see how well it fits the real world.
2slugs, nice list. Thank you. Soon I’ll be asking the obvious cost benefit comparison for each benefit, but for now just getting a list is important.
Bruce any time you want to step in here and add to that list would be fine.
Cantab thanks.
And here is a special offer. My birthday is next Friday Jan 1. And a “Happy Birthday” can clear your “Saying nice things about Bruce” quotient for a whole nother year!! Even the late Billy Mays couldn’t offer you a better deal!!! 😛 😛
Interesting, why not develop some cost benefit comparisons for the discretionary side?
What about the health of individual citizens needs quantified?
Aside from the fact that 16% of US GDP strained through the US (39th in the world) private system (subsidized by medicare and medicaid) is not really the best return.
Ilsm that two thirds on non discetionary spending includes nearly a third of financing the public debt, which to the degree that it is an ‘entitlement’ is one for billionaire bond holders and the Chinese Central Bank and is 100% funded out of General Fund receipts. Lumping it in with Social Security which has it’s own dedicated revenue stream and whose Trust Fund balances are roughly half due to interest owed on dollars borrowed by that General Fund and attributing all that to “entitlements” is false framing.I know you know this, in fact it is implicit in your comment but your explicit omission of it in your two thirds total is a little misleading.
Not paying attention and did not even read the condensed version. Sammy, you obviously did not get it.
Queeg was the likely most sane guy on the USS Caine!!
Ball bearings and all.
I have sat on juries and court martial boards. The better attorney always won. Despite the facts of the case.
Sammy,
This “moron” stood on the ramparts and kept the red menace from overrunning your rich folks, big mistake. But you see I am a “moron”. Rather a sucker than a “moron”?
Some of us “morons” are not concerned about our pittance falling off the rich folk tables like you higher IQ folk.
Some of us “morons” are laughing at you so much higher IQ folk sucking up to the man for a little security and the chance to “make it”. Whatever they let you higher IQ folk get, before they throw the US economy under a bus to get you serfs with such higher IQ’s back to your insecurity and dependence on them rich folk.
You higher IQ folk make us “morons” feel quite proud.
If the reports about the Senate bill are true it moves medicares date for going negative out 9 years which is quite an accomplishment. If we start asking people to think and plan for end of life issues to avoid Shaivo like cases then we can save more.
Social Security is said to really only need changing the indexing from wages to inflation to push the issue out a good ways. I could also see continuing the increase in full benfit age from 67 to 70 at about the rate it is currently going. Third uncap it, provide a 3 rd bend point in the benfit formula where it goes from 15% to 5% at the point where todays limit is.
Which healthcare bill provisions stay and which go away? I wouldn’t know. So, compare the legislation. Find a good source.
Most of the information necessary to compare the Senate and House healthcare bills is available from Kaiser Family Foundation. More than that, Kaiser is sitting on a wealth of information regarding healthcare statistics and general facts. Info available includes:
– Side-by-Side Comparison of Major Health Care Reform Proposals, December 2009
– Assessing Congressional Budget Office Estimates of the Cost and Coverage Implications of Health Reform Proposals, November 2009
– Uninsured Young Adults: Who They Are and How They Might Fare Under Health Reform, December 2009
– Survey of Employer Health Benefits, September 2009
– Kaiser Health Tracking Poll, December 2009
My focus is normally on results. This legislation is no exception.
I am interested in observing what effect the Congressional conference healthcare bill will have on the following healthcare insurance issues noted in 2009. All statistics are from Kaiser’s Employer Health Benefits 2009 Annual Survey, September 2009.
Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 2009: Individual, $779; Family, $3515
Percentage of All Firms Offering Health Benefits, 2009: 60%
Percentage of Small Firms (3-9 employees) Offering Health Benefits, 2009: 46%
Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits, 2009: 29%
Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size, 2006-2009:
– All Small Firms (3-199 Workers): 16%, 21%, 35%, 40%
– All Large Firms (200 or More Workers): 10%, 12%, 18%, 22%
– All Firms: 6%, 8%, 9%, 13%
Among Firms Offering Health Benefits, Distribution of Firms Reporting the Likelihood of Making the Following Changes in the Next Year. Very Likely and Somewhat Likely:
– Increase the Amount Employees Pay for Health Insurance: 41%
– Increase the Amount Employees Pay for Deductibles: 36%
– Increase the Amount Employees Pay for Office Visit Copays or Coinsurance: 40%
– Increase the Amount Employees Pay for Prescription Drugs: 37%
– Restrict Employees’ Eligibility for Coverage: 9%
– Drop Coverage Entirely: 8%
If these healthcare statistics do not improve substantially, expect more fallout from this legislation.
MEDICIAD: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
Pushing Aside the Senate Rules…
Senator Jim DeMint (R-SC) has raised concerns on the Senate Floor about a provision in Reid’s substitute healthcare bill (the one passed by the Senate). This goes to the matter of overriding or changing Senate Rules without the required 2/3 vote to change a Senate Rule as well as violating the U.S. Constitution.
Senator DeMint explains (as part of a broader inquiry regarding modification of Senate Rules):
“There’s one provision that I found particularly troubling. And it’s under a section c, titled “Limitations On Changes To This Subsection”.”
And I quote: “It shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
“This is not legislation. It’s not law. This is a rule change. It’s a pretty big deal. We will be passing a new law and at the same time creating a Senate Rule that makes it out of order to amend or even repeal the law.”
“I’m not even sure that it’s Constitutional, but if it is, it most certainly is a Senate rule. I don’t see why the majority party wouldn’t put this in every bill. If you like your law, you most certainly would want it to have force for future Senates.”
“I mean, we want to bind future Congresses. This goes to the fundamental purpose of Senate Rules: To prevent a tyrannical majority from trampling the rights of the minority or of future Congresses.”
More information available in the video.
DeMint Challenges Democrats on Rules Changes in Reid Health Bill
Dec 21, 2009
http://www.youtube.com/watch?v=EnmvVo_itT0&feature=channel
Reid Bill Says Future Congresses Cannot Repeal Parts of Reid Bill
December 21, 2009
http://www.weeklystandard.com/Weblogs/TWSFP/TWSFPView.asp#14552
.
Pushing Aside the Senate Rules? Or creating new Senate Rules?
Senator Jim DeMint (R-SC) has raised concerns on the Senate Floor about a provision in Reid’s substitute healthcare bill (the one passed by the Senate). This goes to the matter of overriding or changing Senate Rules without the required 2/3 vote to change a Senate Rule as well as violating the U.S. Constitution.
Senator DeMint explains (as part of a broader inquiry regarding modification of Senate Rules):
“There’s one provision that I found particularly troubling. And it’s under a section c, titled “Limitations On Changes To This Subsection”.”
And I quote: “It shall not be in order in the senate or the house of representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
“This is not legislation. It’s not law. This is a rule change. It’s a pretty big deal. We will be passing a new law and at the same time creating a Senate Rule that makes it out of order to amend or even repeal the law.”
“I’m not even sure that it’s Constitutional, but if it is, it most certainly is a Senate rule. I don’t see why the majority party wouldn’t put this in every bill. If you like your law, you most certainly would want it to have force for future Senates.”
“I mean, we want to bind future Congresses. This goes to the fundamental purpose of Senate Rules: To prevent a tyrannical majority from trampling the rights of the minority or of future Congresses.”
More information available in the video.
VIDEO
DeMint Challenges Democrats on Rules Changes in Reid Health Bill
Dec 21, 2009
http://www.youtube.com/watch?v=EnmvVo_itT0&feature=channel
Reid Bill Says Future Congresses Cannot Repeal Parts of Reid Bill
December 21, 2009
http://www.weeklystandard.com/Weblogs/TWSFP/TWSFPView.asp#14552
Amendment (final bill) text
Text as discussed by Senator DeMint.
SEC. 3403. INDEPENDENT MEDICARE ADVISORY BOARD.
See Page 1020 for the subsection
http://www.weeklystandard.com/weblogs/TWSFP/Reid%20bill%20language.pdf
H.R. 3590 (Patient Protection and Affordable Care Act )
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:HR03590:
*See [H.R.3590.EAS]
Language remained in the final passed bill: “(C) LIMITATION ON CHANGES TO THIS SUBSECTION- It shall not be in order in the Senate or the House of Representatives to consider any bill, resolution, amendment, or conference report that would repeal or otherwise change this subsection.”
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
.
MEDICAID/CHIP: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
MEDICAID / CHIP: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
.
Premiums $$$
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
.
Here’s a nice bit of news.
http://www.kwch.com/global/story.asp?s=11732573
It appears the US doesn’t want any tourists or visitors if possible. If you need to plug a gap in your balance of payments, destroying tourism is not smart. Further the US seems to be so completely stupid it doesn’t comprehend that waging war on a religion is a fool’s errand. Islam will emerge triumphant; the US in the mud from this stupidity.
Insurance Premiums $$$
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? How many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
.
Insurance Premiums $$$
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
.
Getting back to domestic issues. The decent people got what they could and will have to simply try to expand on it. America is a miserably stupid country that spends money by the billions and trillions where it doesn’t have to and then shorts the poor and the unfortunate on the excuse of overspending. The majority of people suffer from this but are too dumb to stop it. Duped and swindled by the plutocrats. America richly deserves it problems most of which come from its general stupidity.
MEDICAID/CHIP: 71 Million Enrollment and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially. I expect that my estimate is low.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
MEDICAID/CHIP Future Enrollment: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported today, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
http://www.guardian.co.uk/commentisfree/2009/dec/27/american-withdrawal-afghanistan
Only an incredibly dumb President and an incredibly dumb nation would continue this fool’s errand. The idea of ‘turning the fighting over to local Afghan forces” is EXACTLY Nixon’s laughable policy in Vietnam. The “local forces” don’t want to fight America’s war on Islam and as soon as the Americans leave it will all collapse as it did in Vietnam. We suffered through that lesson, learned NOTHING and are repeating it now EXACTLY again. How dumb can a nation get?
I am tempted to equate the stupidity of Afghanistan with health reform. In short the administration is engaged in two hopeless endeavours both of which will consume all its energy and money and turn out to be failures in the end. Talk about stupid. How stupid can you be?
Bruce,
Two things the party line votes show:
One the republicans only support federal spending on things the US government buys from large private companies, paying unmarket-like excessive margins for faulty products and services, e.g. the warfare state, missions to Mars and the hugely expensive high profit for drug and insurance comanies medicare drug program.
The second thing republicans support is borrowing money at good interest rates from people who should be sending the money over in the form of taxes rather than pillaging the income tax payers.
The deficit outrage from them is merely excuse to continue pillaging the wage earner.
ILSM said: “What is the value of getting better health outcomes than the 100 poorest nations in the world?” Better health outcomes? I thgink the jury is out on that. Now, it looks like for the short term, first decade after implementing this bill, therre will be more demand than supply for Drs. Fewer Drs will be accepting Medicare and even more will be denying access to Medicaid patients. Do these numbers exceed those of the new recipients of this bill? Few can predict at this point, but it isn’t a pretty picture.
Either Sammy is worth 100 million dollars at least or else he is a fool. If the former, he may have a selfish case now and then.
There are ways to have radiologists in Mumbai serve patients in the Eurozone and US.
There are tons of ways to deliver health care, shortage of physicians and price fixing physicians would be no issue if there were a market in US health deliver.
There is no market, therefore, government intervention is necessary to make it efficient.
At least that is the thinking Teddy Roosevelt used………..
http://www.independent.co.uk/news/world/americas/wealthy-quiet-unassuming-the-christmas-day-bomb-suspect-1851090.html
It’s the imperialists, ingrained imperialists, of the West who don’t “get it.”. When somebody like this is willing to give his life for a cause, you can’t win. This is a self sacrifice that stupid westerners, comfy and smug, can’t understand. But it will defeat them and their imperialism just as the Vietnamese defeated the imperialists who tried to prevent their independence.
Cactus,
You’re losing the debate. The Romer work shows JFK/LBJ set the economy in the wrong direction. This kills your implied story that your data mining is trying to sell. The Romer work shows the worst economic policy happened under Kennedy/Johnson/Carter.
FDR had 15 percent undemployment going into the run up to WWII; and Truman is hard to judge because he inherited an economy winding down from war. Moreoover,you’re throwing Obama under the bus because given the economy he inherited he’s unlikely to have strong number. Therefore, you are left with Slugs sitting in the bleachers with those big number 1 finger gloves for Clinton. I can live with that, he’s the guy said big government was over (and sex in the dish room had just begun).
Which healthcare bill provisions stay and which go away? I wouldn’t know. So, compare the legislation. Find a good source.
Most of the information necessary to compare the Senate and House healthcare bills is available from Kaiser Family Foundation. More than that, Kaiser is sitting on a wealth of information regarding healthcare statistics and general facts. Info available includes:
– Side-by-Side Comparison of Major Health Care Reform Proposals, December 2009
– Assessing Congressional Budget Office Estimates of the Cost and Coverage Implications of Health Reform Proposals, November 2009
– Uninsured Young Adults: Who They Are and How They Might Fare Under Health Reform, December 2009
– Survey of Employer Health Benefits, September 2009
– Kaiser Health Tracking Poll, December 2009
My focus is normally on results. This legislation is no exception.
I am interested in observing what effect the Congressional conference healthcare bill will have on the following healthcare insurance issues noted in 2009. All statistics are from Kaiser’s Employer Health Benefits 2009 Annual Survey, September 2009.
Average Annual Worker Premium Contributions Paid by Covered Workers for Single and Family Coverage, 2009: Individual, $779; Family, $3515
Percentage of All Firms Offering Health Benefits, 2009: 60%
Percentage of Small Firms (3-9 employees) Offering Health Benefits, 2009: 46%
Among All Large Firms (200 or More Workers) Offering Health Benefits to Active Workers, Percentage of Firms Offering Retiree Health Benefits, 2009: 29%
Percentage of Covered Workers Enrolled in a Plan with a General Annual Deductible of $1,000 or More for Single Coverage, By Firm Size, 2006-2009:
– All Small Firms (3-199 Workers): 16%, 21%, 35%, 40%
– All Large Firms (200 or More Workers): 10%, 12%, 18%, 22%
– All Firms: 6%, 8%, 9%, 13%
Among Firms Offering Health Benefits, Distribution of Firms Reporting the Likelihood of Making the Following Changes in the Next Year. Very Likely and Somewhat Likely:
– Increase the Amount Employees Pay for Health Insurance: 41%
– Increase the Amount Employees Pay for Deductibles: 36%
– Increase the Amount Employees Pay for Office Visit Copays or Coinsurance: 40%
– Increase the Amount Employees Pay for Prescription Drugs: 37%
– Restrict Employees’ Eligibility for Coverage: 9%
– Drop Coverage Entirely: 8%
If these healthcare statistics do not improve substantially, expect more fallout from this legislation.
MEDICAID/CHIP Future Enrollment: 71 Million and Counting…
How are the States supposed to pay for increased enrollments in Medicaid after 2016? I am assuming that support for increased enrollment will involve state tax increases, reduction in other state services, further assistance from the Federal Government, or a combination of the above.
The Medicaid expansion will involve 20 million new recipients according to CMMS; CBO says 15 million. That’s excluding any consideration of further expansion likely to occur once a new immigration bill is passed. It’s possible that Medicaid/CHIP growth may involve 25-35 million new enrolles this decade, particularly if the economy doesn’t improve substantially.
Medicaid enrollment stood at 43.54 million in June 2008 according to Kaiser. CHIP enrollment stood at 7.368 million in FY2008. Combined Medicaid/CHIP enrollment was almost 51 million in 2008. An enrollment increase by another 20 million with passage of the healthcare bill will bring total enrollment to 71 million without consideration of a new immigration bill or expansion of other related government healthcare programs that would impact State source funding.
The New York Times reported, “Medicaid covers about 60 million Americans, mostly low-income families and pregnant women, though some states have expanded eligibility to include childless adults under 65. It accounts for about one-fifth of state budgets, on average.”
I have no idea where the New York Times found the 60 million figure, although the Times did quote Diane Rowland, executive director of the Commission on Medicaid and the Uninsured, Kaiser Family Foundation. I’ll stick with the published figures Kaiser provides which are cited above.
The issue, however, is how will Medicaid growth be funded down the road?
What is the plan for Medicaid funding to cover the enrollment growth and related expenses after 2016? What is the Medicaid plan after a new immigration bill is passed?
Some States are already complaining if not screaming. They have reason to be worried.
Insurance Premiums $$$
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
Insurance Premiums $$$
How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?
There no way to know what the Conference bill will indicate (after a subsequent analysis), but back on 10 December a quantitative summary of the Senate healthcare bill was provided.
“As of 2019:
• According to JCT, 13.2 million individuals, families, and single parents or 8% of all tax returns under $200,000 in 2019 will benefit from receiving the government subsidy for health insurance, net of any health insurance premium increases under the Reid bill.
• According to JCT, a group of 4.6 million individuals, families, and single parents or 3% of all returns under $200,000 in 2019 will also benefit from a premium reduction, net of a tax increase, under the Reid bill. In general, this group of 4.6 million individuals, families, and single parents are NOT eligible to receive the subsidy for health insurance.
• According to JCT, a group of 68.4 million individuals, families, and single parents or 41% of all returns under $200,000 in 2019, however, will be worse off as a result of a tax increase, net of any premium reduction, under the Reid bill. In general, this group of 68.4 million individuals and families are NOT eligible to receive the subsidy for health insurance.
• An average individual who receives health insurance through a small employer and earning between $0 and $200,000 would be paying, on average, a range of $31 to $726 more. In the large group market, an average individual making between $20,000 and $200,000 would be paying, on average, a range of $36 to $561 more.
• An average family who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $82 to $892 more. In the large group market, an average family making between $30,000 and $200,000 would be paying, on average, a range of $116 to $724 more.
• An average head of household who receives health insurance through a small employer and earning between $20,000 and $200,000 would be paying, on average, a range of $383 to $1,587 more. In the large group market, an average head of household also making between $20,000 and $200,000 would be paying, on average, a range of $185 to $1,419 more.”
Keith Hennessey explains the rest of it here:
http://keithhennessey.com/2009/12/10/reid-bill-middle-class/
MG,
It’s a good start, but there are plenty of problems with Hennessey’s analysis. First, it is largely based on Sen. Grassley’s staff work and therefore has to be taken with a grain of salt. But note that it also assumes the healthcare bill has no good effect on insurance premiums, which is a bit hard to swallow. For years Sen. Grassley’s staff has compleained about how the uninsured drive up insurance premiums for those who do have health insurance. Fair enough, but if that’s the case, then expanding health insurance coverage to those that don’t currently have it should push down premiums for those who do currently have health insurance. Sen. Grassley’s staff seems to want to have it both ways. Sorry, that won’t wash. And the Senate bill has a fairly robust MLR, which will provide strong pressure to bring down premiums. And while the Medicare tax increase is part of the bill, I don’t think it’s fair to say that the tax hike is because of the bill. By that I mean the Medicare tax increase was something that was all but certain to have happened even without the larger healthcare bill. It’s like counting the AMT as part of the ARRA fiscal stimulus….yes, it was part of it, but it would have happened anyway under a different umbrella. Now there will be two tax increases for sure. One will be a tax on high end insurance plans, and that is a good thing. If the IRS can tax high value reserved parking spaces for executives (and those are taxed), then surely they can tax high end health insurance plans. And healthy, young freerider adults who just don’t want to play will also be taxed. Again, this is a good thing.
MG,
“How many people will be saving money on insurance premiums with passage of the Senate healthcare bill? And how many people will not be saving money?”
Is reducing “premia” for health insurance (private, and medicare) a proper goal of health care reform?
Is reducing premia important or is it a secondary effect of improving health care in the US?
Sorry for answering a question with a question.
Here is what I have observed, in part sitting in a high tech thorax-cardio ICU with my 82 year old Dad.
The oldsters on medicare make those places possible. If it were not for medicare the facility would have been empty and not there for a 40 year old with a bad ticker.
So, I have observed that medicare increases the capital stock of health care.
Similar would be observed for medicaid because the hospitals would be broke without it. Medicaid is public subsidy for health care for the poor. Pays for both direct charges and capital charges.
Both government programs from my observation cause a substantial part of the health care capital to exist.
This existence reduces costs and insurance premiums for the general population.
If the old just went bankrupt when sick then so would a good part of the capital base in health provisions.
The government sector has been taking responsibility (medicare through the trust fund) for a significant part of the acute care investment security in the US.
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
Same for mortgage interest on real estate and state and local taxes.
The government uses the tax code for faulty economic reasons.
A huge hit to future state budgets for increased Medicare payments/enrollment.
Assuming you mean Medicaid here, this is the one that needs to be fixed urgently. Most states are pretty much up to the political limit on what they levy in taxes (about 10% of state GDP for combined state/local taxes). In many cases, Medicaid costs are already growing faster than state GDP, with the consequence that other programs are being crowded out. At some point, some states are going to have to choose between Medicaid participation and the other things they want to do. Medicaid participation is not mandatory, but once you’re in you’re subject to the federally-imposed minimums.
In Colorado, the state whose budget I know best, road maintenance is falling farther and farther behind, prisoners are being released sooner, higher education has been cut, K-12 spending is likely to be cut, and the state is attempting some accounting trickery with the unemployment insurance program, but Medicaid spending goes up and up. There is open discussion of which public colleges will have to be closed when the federal ARRA assistance ends.
Colorado may not be one of the first states to bail, but you have to believe that we are not too far from seeing some states choose roads and higher education over health care for the poor. Or at least, make radical changes in the type of health care they provide; Half of what Colorado pays for Medicare would fund an awfully large network of community clinics in poor counties and neighborhoods that could handle routine care.
ilsm
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
This could be a compromise in a brand new bill that seeks to make individuals key in driving down healthcare costs. However, I think you can make a pretty good argument that healthcare expense is like maintenance of capital equipment in a corporation. Maintaining the human physical plant seems like a legitimate cost of doing business and like with other business expenses its pre-tax.
ilsm
To fit with 2Slugs, I believe all health related insurance tax deductions need to end. And both employee and employer contributions be after tax.
This could be a compromise in a brand new bill that seeks to make individuals key in driving down healthcare costs. However, I think you can make a pretty good argument that healthcare expense is like maintenance of capital equipment in a corporation. Maintaining the human physical plant seems like a legitimate cost of doing business and like with other business expenses it should be pre-tax.
2slug
actually, you are right. i was just being pedantic. happens sometimes.
2slugbaits – “It’s a good start, but there are plenty of problems with Hennessey’s analysis. First, it is largely based on Sen. Grassley’s staff work and therefore has to be taken with a grain of salt.”
If you have any complaints about the source data, try blaming the JCT and CBO.
The problem with your “explanation” is that the “Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019.”
Hennessey goes on to explain:
“Senate Democrats have used a different JCT analysis that show the combined effects on these two populations when blended together. You have a relatively small group of people getting big net benefits, and a much larger group paying net costs. The aggregate impact for the two populations combined is a net benefit for the group as a whole, and advocates for the bill have therefore argued the bill is a “middle class tax cut.” Senator Grassley and his staff deserve credit for separating the effects on distinct (and large) subpopulations.”
“Here is an analysis of the premium changes, tax subsidies, and tax increases under the Reid bill. Here are the JCT tables that were the basis for these findings: 4 tax provisions in 2019, tax credits in 2019, and universe of returns in 2019. The other data source is the November 30th CBO letter to Senator Bayh.”
Links for each of the data sources were provided in Hennessey’s presentation along with tabulated breakdowns.
Hennessey explains:
“Based on this analysis, Finance Committee staff believes we can summarize the benefits and disadvantages to individuals, families, and single parents under the Reid bill this way: First, there is a group of low- and middle-income taxpayers who clearly benefit under the bill. This group, however, is relatively small. There is another much larger group of middle-income taxpayers who are seeing their taxes go up due to one or a combination of the following tax increases: (1) the high cost plan tax, (2) the medical expense deduction limitation, and (3) the medicare payroll tax. In general, this group is not benefiting from the tax credit (because they are not eligible for the tax credit), but they are subject to the tax increase(s). Also, there is an additional group of taxpayers who would be affected by other tax increase provisions that JCT could not distribute. Finance Committee staff is working with JCT to determine how to identify this “un-distributed” group of people.”
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
[see my posted data at 12:01:36 PM, Sunday]
Hennessey explains: (continued)
“Premium Analysis – CBO has estimated the average premiums in 2016 for a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group health insurance markets under both the Reid bill and current law. Based on CBO data, we can identify the average annual increase in premiums in each of these markets under the Reid bill and current law. Based on these CBO’s estimates and data, we can project the cost of a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group markets under the Reid bill and current law in 2019.”
“Tax Increase and Subsidy Analysis – JCT has provided Finance Committee staff with a distributional analysis of four of the major tax provisions in the Reid bill – (1) the advance-refundable tax credit for health insurance, (2) the high cost plan tax, (3) the medical expense deduction limitation, and (4) additional Medicare payroll tax. Separately, JCT has provided a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance. Based on this data, we can determine how many individuals, families, and single parents receive the premium tax credit for health insurance. We can also identify (1) those individuals, families, and single parents who are NOT eligible to receive the tax credit and (2) those individuals, families, and single parents whose taxes may go up before they see some type of tax reduction from the tax credit.”
“Eligibility for the Subsidy for Health Insurance – Under the Reid bill, individuals, families, and single parents between 133% and 400% of the Federal Poverty Level (FPL) who purchase health insurance through the “exchange” would be eligible for a subsidy for health insurance. In general, individuals, families, and single parents who get health insurance through their employer are NOT eligible for the subsidy, even if they are below 400% of FPL.”
Hennessey explains:
“Based on this analysis, Finance Committee staff believes we can summarize the benefits and disadvantages to individuals, families, and single parents under the Reid bill this way: First, there is a group of low- and middle-income taxpayers who clearly benefit under the bill. This group, however, is relatively small. There is another much larger group of middle-income taxpayers who are seeing their taxes go up due to one or a combination of the following tax increases: (1) the high cost plan tax, (2) the medical expense deduction limitation, and (3) the medicare payroll tax. In general, this group is not benefiting from the tax credit (because they are not eligible for the tax credit), but they are subject to the tax increase(s). Also, there is an additional group of taxpayers who would be affected by other tax increase provisions that JCT could not distribute. Finance Committee staff is working with JCT to determine how to identify this “un-distributed” group of people.”
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
[see my posted data at 12:01:36 PM, Sunday]
Hennessey explains: (continued)
“Premium Analysis – CBO has estimated the average premiums in 2016 for a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group health insurance markets under both the Reid bill and current law. Based on CBO data, we can identify the average annual increase in premiums in each of these markets under the Reid bill and current law. Based on these CBO’s estimates and data, we can project the cost of a single and family health insurance policy in (1) the non-group, (2) the small group, and (3) the large group markets under the Reid bill and current law in 2019.”
“Tax Increase and Subsidy Analysis – JCT has provided Finance Committee staff with a distributional analysis of four of the major tax provisions in the Reid bill – (1) the advance-refundable tax credit for health insurance, (2) the high cost plan tax, (3) the medical expense deduction limitation, and (4) additional Medicare payroll tax. Separately, JCT has provided a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance. Based on this data, we can determine how many individuals, families, and single parents receive the premium tax credit for health insurance. We can also identify (1) those individuals, families, and single parents who are NOT eligible to receive the tax credit and (2) those individuals, families, and single parents whose taxes may go up before they see some type of tax reduction from the tax credit.”
“Eligibility for the Subsidy for Health Insurance – Under the Reid bill, individuals, families, and single parents between 133% and 400% of the Federal Poverty Level (FPL) who purchase health insurance through the “exchange” would be eligible for a subsidy for health insurance. In general, individuals, families, and single parents who get health insurance through their employer are NOT eligible for the subsidy, even if they are below 400% of FPL.”
CoRev
as to “fewer Drs will be accepting Medicare”…
i think this points to an area of huge cost savings. The gov’t needs to finance the training costs of the next generations of drs entering med school now. those drs can pay back their costs by working at gov’t clinics and hospitals. and keep working there if they like the hours and pay and “non tangible rewards.”
that would be a good place to begin.
lyle
if you are still around. there are bettter and cheaper fixes to social security that stealing the money from the benficiaries with a phony “inflation index” fix. most people would be happy to pay an extra twenty cents per week in order to be able to… let us say have a refrigerator and indoor toilet like the rest of their neighbors, even though this is a “standard of living” not a “cost of living” increase since the day social security was first started.
ilsm
helluva good point. and one rarely if ever heard.
Is reducing “premia” for health insurance (private, and medicare) a proper goal of health care reform?
Is reducing premia important or is it a secondary effect of improving health care in the US?
The President has made it very clear that reducing health insurance premium costs is of paramount importance. It is my judgment that reductions in insurance premiums is the foremost healthcare reform goal of the Administration.
The President’s perspective is explained here:
The Burden of Health Insurance Premium Increases on American Families
EXECUTIVE OFFICE OF THE PRESIDENT
SEPTEMBER 22, 2009
http://www.whitehouse.gov/assets/documents/Health_Insurance_Premium_Report.pdf
The health care reform, for whatever it is, is pretty much a done deal. I find incessant discussion of it now rather boring. It’s over. We need first to find out what the results are in reality. Then we can assess what more needs to be done. If anything more can be done.
Really, awfully good? As a healthcare provider, and a practicing Emergency Med PA, I think I would argue that. Surely you have data to support such an assertion correct?
We are good at on thing though, we sure can spend money.
And your solution is? What would you do. Keep in mind that “the market” has failed. Costs are rising at an average pace of 6.2% per year over the last decade. Surely you have some solutions right? Healthcare does not always behave like other commodities, likely due to having low price elasticity scores, but also because it is a necessity.
So surely, you have some ideas right?
Okay, here’s the deal. If you want people to voluntarily be uninsured, than you change the EMTALA requirements, and allow me to DENY care at the ER. You allow me to do a wallet biopsy first, and then decide if I will intervene in the young kid who got hit by a drunk driver at 90 mph, or the middle aged unemployed guy having a heart attack. You let me deny care, and I will agree to allow people to remain uninsured, otherwise, you have no clue what you are talking about.
MG,
Repeating Hennessey’s points doesn’t really address my concerns about his analysis. Note the sly caveat in his analysis: he assumes that the healthcare bill will not reduce premiums. But that’s a whopper of an assumption given that there are many provisions in the bill that are intended to reduce premiums. For example, the cost of free riders is something that we can pretty much put in the bank as a savings. The bill tries a lot of different things to bend the cost curve. Some will fail, but some will probably succeed. And the two big tax increases (i.e., taxing cadillac benefits and the increase in Medicare taxes) just make good sense in their own right irrespective of healthcare reform in general. It’s just good fiscal policy.
Health costs are bankrupting families and state and local governments.
Insurance premia are one part, and I disagree that reducing them is a valid object.
From health care to Afghanistan Obama is disappointing.
If you have no company plan or medicare premium costs are huge.
It is easy to go bankrupt in the US unless you are going to die fast and cheap.
Yes, insurance premium costs are an issue, but reducing out of pocket individual costs is hard to compare.
ilsm,
Part of life is fate. Bankruptcy is certainly bad but it’s hardly a death sentence. Those that want to reduce the chance of going bankrupt could spend a larger part of their lives accumulating a safety cushion. We no longer throw bankrupt people into debters prision and send their children to orphanages. We do quite a bit as a society to mitigate the vicissitudes of life.
ilsm,
Part of life is fate. Bankruptcy is certainly bad but it’s hardly a death sentence. Those that want to reduce the chance of going bankrupt could spend a larger part of their lives accumulating a safety cushion. We no longer throw bankrupt people into debters prision and send their children to orphanages. We do quite a bit as a society to mitigate the vicissitudes of life.
Margery,
It’s not over until the fat lady sings.
CoRev and Sammy are Swiss Army Knives, if one blade/tool doesn’t accomplish the task just whip out another one and try try again. Eventually you accomplish your end.
Michael, but, but growing entitilements, redoubling themd does not cause crowding out in discretionary spending. I know it, cause my buddy, 2slugs told us so!
Thank you MG.
This is the perfect forum to introduce the kind of resource and/or open questions you like to advance. Hopefully all of us can dial down what has been unneccesarily antagonistic relations in the new year.
I am enjoying the new tone already.
“Repeating Hennessey’s points doesn’t really address my concerns about his analysis. Note the sly caveat in his analysis: he assumes that the healthcare bill will not reduce premiums. But that’s a whopper of an assumption given that there are many provisions in the bill that are intended to reduce premiums.”
Hennessey never made that statement or suggestion. What he stated in the lead in to the data that I posted was this:
“On November 30, 2009, the Congressional Budget Office (CBO) estimated the average premiums for single and family health insurance policies purchased in the non-group market and offered by small businesses and large employers under both the Reid bill and current law. The Joint Committee on Taxation (JCT) has provided Finance Committee Republican staff with a distributional analysis of four of the major tax provisions in the Reid bill, along with a distributional analysis of the number of tax returns that will receive the premium tax credit for health insurance for 2019. Based on this data, Finance Committee Republican staff compared the average premium change, according to CBO, with the average subsidy or tax increase individuals, families, and single parents would see, based on JCT data in 2019, and concluded following:”
One difference I noted in reading the CBO report:
“CBO and JCT estimated that roughly 23 million people would purchase their own coverage through the exchanges in 2016 and that roughly 5 million of those people would not receive exchange subsidies. Therefore, of the 32 million people who would have nongroup coverage in 2016 under the proposal (including those purchased inside and outside the exchanges), about 18 million, or 57 percent, would receive exchange subsidies.”
This is a larger number than Hennessey cited from JCT. 13.2 million vs. 18 million.
Well the real problem comes when you define the population actually spending healthcare dollars. It is estimated that only 5% of our population accounts for nearly 50% (47%) of total healthcare spending, and that only 1% of our population is responsible for over 25% of healthcare spending.
2slugbaits,
I don’t personally believe that insurance premiums will necessarily decrease across the board. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a few and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur? Ten years out, the premium costs will be substantially higher…perhaps almost doubling once again. We’re not out of the woods on healthcare costs.
2slugbaits,
I don’t personally believe that insurance premiums will necessarily decrease across the board if such decrease at all. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a small portion of the population and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur. Ten years out, the premium costs will be substantially higher…perhaps almost doubling once again.
We’re not out of the woods on healthcare costs. Not even close.
2slugbaits,
I don’t personally believe that insurance premiums will necessarily decrease across the board if such decrease at all. Perhaps there will be some changes in the adjustment phase, but thereafter the question will focus on how much annual premiums will increase. That will be the issue prior to any consideration of subsidies for a small portion of the population and other tax credits.
It is my expectation that the ten year goal is to reduce the rise in insurance premium costs by 1 to 1.5 percent annually. The President has stated this and a number of reports indicate that such is a goal.
The Congress did not abolish medical inflation. It’s yet to be seen if medical costs and insurance premium costs can be brought in line with general inflation. I doubt that will happen.
I expect that insurance premiums will increase 4-7 percent a year during the next decade. I wonder how employers and individuals will react to increases at those levels if such occur. Ten years out, the premium costs will be substantially higher. The question is whether the individuals, families, and companies will be able to afford the premiums as the increases continue.
We’re not out of the woods on healthcare costs. Not even close.
Bruce,
I will try to be a better person.
I would like to see more individuals engage in discussions on the comment threads. I think AB needs more liberals and independents at this point to balance it out.
Open threads tied to specific subjects is a good move. Hope this effort continues.
I will work on improving the scope and tone of my comments.
Note that the proposals are not retroactive, only forward looking so that folks over 55 would not see much change, younger folks would. Then moving the full retirement age so that it increase 1 year for every 16 years starting in 2025 would help solve the problem. Add the third and then if you have to much money you can cut the contribution from each piece a bit. If the choice is between one and two which does one go for, both operate on a long enough time constant that people can adjust. So do you favor raising the retirement age, because without cutting benefits some way you won’t ever get the increased earnings limit thru.
What’s not over? You mean the health care legislation has not passed? That we don’t know the results? That there is still voting to be done? Tell me about it.
The main issue for Obama’s reelection will not be health care but the Afghan war. It will still bedevil the nation in 2012 and may finish his Presidency. That and the impact of another recession in the second half of 2010 that Krugman and Stiglitz now think is likely. Another new recession and Obama will be toast.
Ok Margery, healthcare legislation has not passed yet. It’s passed when it becomes law.
Unless oil prices go above $100 I don’t see another recession. With dropping the public option the government will only get to tinker but not be nationalizing healtcare. Cap ‘n trade is dead on arrival. These are both positive developments.
And forget about Afghanistan if the economy gets better; once the economy turns around that’s the end of Obama’s once a week international road trips.
MG,
I hope I didn’t give you the impression that I thought we were “out of the woods” on healthcare costs, because I think we can all agree that we are not. Not by a long shot. And healthcare costs will surely increase as a percent of GDP even with healthcare reform. But the issue is whether or not that increase will moderate under the Senate plan and there is good reason to believe that it will, and that’s why I question the Hennessey piece about assuming not reduction in healthcare premiums. Obviously, when people talk about a “reduction” in healthcare premiums they do not mean a reduction in the absolute value of the premiums, but a reduction in the rate of growth. This is just understood. And no one is pretending that the Obama plan is a finished product. We’re looking at another 20 years of fix’n up.
Cantab,
Both Stiglitz and Krugman warn of a strong possibility (but not a likelihood) of a contraction in the second half of 2010. That’s because the effect of the stimulus will have peaked and unless the private sector kicks in over the next six months aggregate demand will weaken. This economy is still on life support. Cap and trade is not dead on arrival in the sense that businesses will care about the issue. The House bill may be dead on arrival, but the larger issue of cap and trade parameters are not. I don’t think there are many carbon intensive industries out there that actually believe there will not be some kind of cap and trade (or a carbon tax) somewhere down the line and in the not-too-distant future. The idea that there won’t be some kind of legislation eventually is implausible. So that introduces a lot of uncertainty into business investment. No business is going to invest a lot of money on the bet that cap and trade is dead and will not come back in a stronger form down the line. What businesses do need is a cap and trade bill that they can count on and plan around. Right now they don’t know what to expect. Passing a credible cap and trade bill would help businesses because it would give them some relative certainty about the future. All they know now is that EPA has identified CO2 as a health threat and that the status quo cannot be maintained. It’s really the worst of all possible worlds in terms of a climate for investment.
A mention of one of the hidden costs of Medicaid: my Minneapolis friend of whom I have spoken before had to go on Medicaid last year, when he was unemployed, had lost most of his 401K before he even got to access it after being laid off, was suicidal, and needed life-or-death counseling.
One of the stipulations of entry into the program was that his bank balance had to be below $1000.
That’s about his rent and utilities for a single month. Icarus didn’t fly as close to the sun as he had to fly to get the medical care he needed.
Assuming this story is not unusual, the stipulations of Medicaid, like those of social assistance, force Americans who are merely poor to dig down into full destitution. This might be the best individual choice for someone needing cancer, depression or other major health care, but subsequently creates and maintains an underclass with none of the resources they might need to rebuild their lives or help others build theirs.
Noni
PS my friend found a job and is now hanging on by his fingernails. No pension offered, no savings, and now that his company plan covers him, he has worse health coverage than what Medicaid offered.
Yeah I imagine Nixon was told in 1973 that Vietnam was no problem and to forget about it because the economy was in good shape. LOL
Well it’s a glorious thing to be poor in such a wonderful plutocracy as the USA. You can be sure you’ll be taken care of well and are so much better off than if you were in some socialist dump like Sweden.
And 2slugs has again specified how Dem policies are devestating business planning and investment, and eventually recovery from this recession. 2slugs, instead of asking why we don’t have these policies implemented, ask yourself why are they even considered? If they were so darned important, why is there no consensus?
What businesses do need is a cap and trade bill that they can count on and plan around. Right now they don’t know what to expect.
What businesses want most is for the government to commit themselves to never doing a cap N trade bill. Next best is never to do a cap N trade bill but don’t tell anyway (the status quo).
Cantab and CoRev,
Suppose the Obama Administration came out this afternoon and said that it would not pursue cap and trade. And suppose you were an investor interested in coal powered utility plants. Do you honestly think that such an announcement would reduce the uncertainty over your investment??? Would you suddenly be willing to accept a lower return due to reduced uncertainty risk? Only if you were living in BizarroLand. Get real. That kind of announcement would not have any credibility because it would be viewed that such an announcement was only transient, just as a “no new taxes” pledge would not have credibility because it would have to be reversed eventually. Temporarily denying what we all know will happen sooner or later is not my recipe for helping businesses. What’s needed is a credible policy that businesses can rely upon.
noni
you are absolutely right about that. the minimum assets requirement for medicaid.. or food stamps.. is ridiculously low and leads a lot of people to become “welfare cheats.” i can understand not wanting to give welfare to someone with a million bucks in the bank. but a years survival money?
yep. start raising gas taxes a little at a time. slow enough to give people a chance to adapt, but fast enough to show you mean business.
doesn’t help that one political party can sow confusion by telling the people it’s all a gummint plot.
and why is there no consensus among the inmates in how to run the insane asylum ?
Suppose the Obama Administration came out this afternoon and said that it would not pursue cap and trade. And suppose you were an investor interested in coal powered utility plants. Do you honestly think that such an announcement would reduce the uncertainty over your investment???
In your hypothetical does the investor get to pass whatever he has pay Swaziland for carbon offests to rate payers in the United States? Why not skip Cap N trade and just send money directly to swaziland?