Open thread April 10, 2015 Dan Crawford | April 10, 2015 7:42 am Tags: open thread Comments (21) | Digg Facebook Twitter |
I don’t get states not grabbing every Medicaid dime they can. 50% of the would-have-been-covered patient care (okay, rough guess) is going to be administered anyway and it is going to be paid for with higher private insurance premiums to state residents or through other government channels — while Medicaid typically relieves the state of the burden of 60-70% of all costs. ??? We sent all this money to Washington; don’t we want it back? ???
Medicaid expansion under Obamacare will pay 90% of costs (100% at first). !!!
States cut businesses billions in tax breaks hoping to attract jobs. Medicaid wants to give states (back) billions of (their) dollars which will create tens of thousands of good paying medical field jobs (ask Kentucky, one of the most successful subscribers to expansion). Am I missing something here?
Denis when your whole Party mantra is “Government is not the solution. Government is the problem” counter-examples are not welcome.
Take my own particular policy obsession. Social Security has never been in any kind of existential crisis, not at least by the numbers. Which is why no one has ever made a successful specific pushback on Baker and Weisbrot’s 1999 book “Social Security: the Phony Crisis”. Which didn’t mean them giving up, oh no!!
Because the reality is that the Bad Guys can’t afford to have Social Security add to its status as the most popular program in government the status of being the most efficient and with a few tweaks the most solidly financed one. Instead it has to be the poster child for “Unsustainability” and “Road to Hell is Paved With Good Intention-ism”.
And the same is true of Medicaid. In the abstract most people admit that everyone should have basic access to medical care, this is why the Right insists this actually exists via the absurd claim that poor people can just go to the Emergency Room. But the Right cannot concede that this public good can be most efficiently delivered via public institutions. Even if that means
“is going to be administered anyway and it is going to be paid for with higher private insurance premiums to state residents or through other government channels”
The answer of the Right to this logical and numerically sound argument is “So what? You gonna let Big Government win?” Because the next thing you know we would have Universal Pre-K and funding for all public schools that was both full and equitable.
We have a movement that after Hayek’s “Road to Serfdom” of 1945 believes that the road signs to that are marked in order “Liberal Democracy”, “Social Democracy”, “State Socialism” and “Communistic Fascism” (Or “Fascistic Communism). That are NOT about to take that FIRST STEP on Serfdom Road. And you don’t battle people with this frame of mind with logic and spreadsheets.
yes. and at the risk of annoying you, but because Denis didn’t seem to get it on another recent thread:
Social Security can pay for itself forever simply by raising the payroll tax one tenth of one percent per year while incomes are going up over one full percent per year. That’s eighty cents per week for most people. Money they would get back with interest. REAL interest more than most people could hope to get “on the market.” Together with a guarantee that if “something happened” to them, the other people in the pool would contribute enough to keep them above water.
Yet everyone and his idiot brother has another “idea” to save Social Security…. some goddawful Rube Goldberg plan for which they haven’t a clue how to actually implement, or telling the world that Peterson was right all along and Social Security needs to raise their taxes a staggering amount.
let me go out on a limb here with respect to my friends:
when the enemies of Social Security are pointing at “the Road to Serfdom” how much sense does it make to propose a “fix” to Social Security (which doesn’t need a fix) that looks to everybody like the road to Socialism.
my friends are blind to that because they think socialism is fine. i might think so too. but it’s a sure way to lose elections in the United States, as well as to destroy Social Security which works exactly because it is not welfare. that is, it is not paid for by “the rich” or by “the government” but by the people who will get the benefits.
it is “government run” but not “government paid.”
and to those who don’t see the point of Social Security if it is not a handout, i can only say where have you been the last seventy five years?
i should point out that when Peterson says that SS will raise “our” taxes, he means “us the rich, the people who pay taxes in this country.”
he sees “you” as the undeserving poor, those who will sit idle rather than work if “we the rich” just pay your bills.
he’s wrong about us. but we don’t do ourselves any good by demanding that “they” pay for our retirements.
SS protects your savings from inflation and market losses, and insures you against deep poverty… without “taxing the rich,” because you “pay for it yourself.”
if SS is not going to be enough, then we may need another program… a real welfare program paid for perhaps by taxes on financial transactions. that would be hard enough to get. but it is not very smart to load down Social Security, which works, with the burden of “socialism.”
and what has this to do with Denis’ “thread”?
well, maybe that Obamacare, while making some poor and sick people better off, does it by subsidizing the insurance companies and “providers” by heavily taxing “the rich.”
it would have been better to tax the people a reasonable amount for their own (on average) health care, while creating government oversight to keep costs down. the tax for this would be high but not excessively burdensome… as long as you think health care is worth having, worth paying for. a “flat” tax up to some cap would pay for it about 5% of income… understanding that even with a cap, the rich would be paying more for “their share” than the poor, but could be convinced that their “excess” premiums amount to a premium for insurance against the day that they might become one of “the poor.”
i entertain the illusion that a rational approach like this (it sure looks like Social Security) could be sold to the country, rich and poor alike.
but maybe all we can think in terms of is class war and mindless slogans on both the right and the left.
and as for “more jobs at better wages”… by all means.
but that’s going to take a while. paying for SS and medical care is easy. lets do that and then spend the rest of the century convincing the honest rich that they do not gain by supporting a government that is entirely in the hands of the criminal rich.
as for “do nothing” too late. it is now 25 years since Baker said we had time to fix the roof while the sun is shining. we are running out of time.
oops, SIXTEEN years not 25. still, we are running out of time.
Wouldn’t dream of converting Tea Partiers. Thinking of embarrassing Republican governor fools far and wide, especially who wont expand Medicaid under Obamacare. Been reading Axelrod’s book. Surprised to see some of that political advertising actually works. Maybe (I think Dave’s retired) some Democratic consultants could pre-package some commercials attacking Medicaid foolishness to used by any Dems around the country.
Another pre-package target could be the new $84,000 Hepatitis C drug. Could virtually wipe out Hep C if it were affordable. According to Brill the firm that developed it didn’t even do the starting research — relied on the feds fund. But once they smelled money they switched to raising private research money. The original firm was going to sell it for $350 a pill. Gilead bought it from them for $11 billion — a big gamble for which it now expects to profit obscenely. Brill says one-tenth the price would be reasonable.
Another good pre-package possibility: a disease that might be wiped out except for a drug monopoly. The chief scientist behind the research made $440 million for himself. Imagine if the polio vaccine was sold like this. Dem politicians don’t have to offer specific remedies at first (goodness forbid they should take the chance of getting specific) — that can wait until a national dialogue gets going on the topic.
Bruce said: “And you don’t battle people with this frame of mind with logic and spreadsheets.”
How does one battle such people? By going before SCOTUS and claiming that the Commerce Clause grants Congress the power to compel commerce? Or by claiming that the CC grants Congress the power to regulate each person’s economic decisions? Those tea partiers just might be justified in applying the ancient rule that -If it walks like a duck…
are you arguing that because the Supreme Court sometimes employs specious logic we should give up trying to be logical?
Or are you arguing the strong form: because most people are incapable of anything like we were told logic was supposed to be, we should just give up trying?
The trouble with the “walks like a duck, talks like a duck” people is that they only THINK it walks like a duck, and are incapable of imagining that something might share a feature with another thing and still not be that other thing.
me, i’ll stick with the spreadsheet that Bruce is referring to… in this case it is a pretty tight piece of “logic” that shows that SS can pay for itself forever with timely one tenth of one percent raises, amounting to no more than a two percent raise over the next 75 years and no reason to expect any need for a raise after that,
not sure what the hell the Commerce Clause has to do with that.
Spreadsheets and logic are dandy, but Obamacare was defended on the supposed power of Congress to compel commerce and to regulate the economic decisions of each person. It is laughable that the side which made such claims now wants to portray itself as the paragon of logic and clear thinking.
On the topic of SS, the data says SS can pay for itself now (pay out at least some positive rate of return for each cohort for next 75 years), so why not just leave it be?
there is no “side” Obama is as much the enemy of SS as the Republicans.
SS can pay out 75% of “promised.” not enough for decent survival. by raising the tax eighty cents per week it can pay enough. forever.
what is it about eighty cents per week you don’t understand?
Just thought I’d drop in a couple of comments I left over at CEPR this morning (lazy way):
[cut and paste]
Building the trust fund reminds me of fois gras — continually packing away TF bonds that will never be cashed except perhaps to cover a temporary shortfall in FICA revenue (happened a couple of times), never as a continuing source of SS payouts (as envisioned), not under our current 1% governance anyway.
Reason: cashing the TF bonds with income tax revenue would REVERSE the cap. Instead of exempting taxation above roughly 90 percentile income as under FICA, incomes under roughly 50% would not be taxed while the biggest hit would be on incomes above 90 percentile. Couldn’t have that — not under our current politics.
All the trust fund really needs to hold is a reserve enough to cover temporary shortfall in FICA tax until Congress gets around to raising FICA. Legally the TF is considered solvent if it has one year of full replacement (for all payouts — not just shortfall) which should cover that need.
I can’t imagine a sensible rationale for setting up income tax to partially (up to 25% at the highest) cover SS payout at some point in the future.
The only fiscal effect is to tax more regressively early on when per capita income is lower and more progressively later when economic growth will have provided higher incomes. OTH, the hybrid system does provide politicians with an advantage: not having to raise the FICA tax rate for 60 years — the first 35 while the bonds accumulate, the last 25 as they run down. And income tax increase can be avoided by running up the deficit (can’t do that with FICA). Doubt the politicians were smart enough to think of that though.
[cut and paste]
Assuming the TF ran out of bonds Congress can pass a law that from then on SS retirement benefits not sufficiently funded by FICA are to be paid for with income tax — which of course is what we would have been doing for decades by then (by cashing the bonds).
I can’t really tell what you are saying here.
why invent a Rube Goldberg solution when there is an easy, straightorward, cheap, and honest solution:
just raise the payroll “tax” (it’s really an insurance and savings contribution) one tenth of one percent “at need”… or each year over the next twenty years.
stop thinking of it as a tax: it does NOT go to pay for “the government”. it goes to pay YOU when you retire or get disabled or die with dependents. and it’s the best insurance you can buy on any market.
What I understand is that any additional amount put into a low yielding investment is too much.
Sure people should save more for their retirement, but SS is not the only means.
SS is not an investment tool…and should not be thought or treated as one.
no. not the ONLY means. it is INSURANCE in case something happens to those high yielding investments.
and poor people can’t afford any risk at all. for those who end up poor after a lifetime of work, SS is a higher yield than anything they could hope to find in the market.
you are absolutely correct. but don’t get hung up on the words. SS is insurance, savings, investment, tax…
all of those things… forced insurance and savings. people get hung up on a word and can’t manage to look at what it DOES. which is force people to save their own money, and insure that money against inflation and market losses, and insure them against personal bad luck like death, disability, and a lifetime of wages too low to save enough to be able to retire, and against common lack of prudence.
it is the best Deal workers have ever had. and it’s a better Deal for “the rich” than most of them can understand. a country with 25% of the population starving in old age, or terrified of starving in old age, would not be good for “the economy.”
Well said, Coberly.
well, speaking of words
“improvidence” was more what i meant than “lack of prudence”
though lack of prudence can bite you too.