CBO deals new blow to health plan

jackalope said:

Hey Owl, I was just reading some interesting posts of your in another thread.

Re: Gallup, there is a new poll out this am. It was taken after Pres Obama's presser this week.

I disagree that they don't want us to know what they're going to do. I think the problem is there isn't final agreement yet, and there isn't a final product to discuss.

Appreciate the Noonan excerpt. I enjoy her writing. In this case, I think she's wrong tho. We will see !

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If they wanted us to know, why aren't they telling us? Whatever happened to the pledge for the most transparent administration in history?

Late last year, we got a mega billion bailout package and we don't have a clue about what they did with that money. We do know half of it was held over for President Obama to use.

Early this year we got a second mega billion bailout package and we don't have a clue about what they did with that money or how it has benefitted anything. At least Biden was honest enough to say that some of it was wasted.

Early this year Congress passed a massive omnibus spending bill, the last for this year's budget, and the President's excuse for not letting us have a good look at that was that it was George Bush's budget and therefore he would just sign it.

Early this year we got a massive--unheard of in size and scope--stimulus bill that had to be delivered to Congress in the wee hours of the morning, voted on the same day with minimal debate and before anybody had time to read it, and signed into law immediately by the President because the whole economy was about to crash and it was vital to get the economy rolling and save jobs immediately. Well the economy continues to founder, unemployment keeps going up month by month, and now we are told that they never intended for it to really kick in before the next year or so. But it was a flat out emergency.

And now we have them overhauling the healthcare system with obvious intent to mostly dismantle and rebuild it, it represents 17% of the GDP of the nation and is being rush through at breakneck speed, will probably be delivered to Congress in the wee hours of the morning, voted on the same day before anybody has a chance to read it, and the President will sign it into law without letting us see it first because we 'can't afford to wait any longer'. By that time, it will be too late for us to intervene.

Oh yes, and the President says he hasn't read it and is leaving it up to Congress to put it together. And who is writing it? Not our elected leaders. It's Congressional staffers and lobbyists who are creating this masterpiece for us. The only coherent thing we got out of his last press conference on this was that he and Congress have no intention of subjecting themselves or their families to what they will be mandating for the rest of us.

Doesn't that all give you huge confidence?

Give me a break.

Those who want whatever is done to be done slow, careful, and right, had better be hollering from the rooftops and hope we can encourage more members of Congress to get really squeamish and cold feet. The way things are right now, anybody who trusts this bunch with their healthcare needs to have his/her head examined.

jackalope said:

No, I made an error, and copped to it. I've tried very hard to stay generic in talking about legislation, but more than once I shorthanded it and had to go back and re-type.

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Except the legislation isn't generic, and hasn't been generic for quite some time. You know this, or you are not nearly as current on these matters as you suggest.

I've been very explicit that my criticisms are in regards to the horror show known as HR3200. It is the bill Americans do not want.

It's easy to say "I want reform." Hell, if that's all there was to the debate you would be agreeing with me. It is not all there is to the debate.

There is a bill, a bill the Anti-Republicans in Congress want to bring to a vote, a bill Americans reject. There is 1018 pages of proposed legislation that does not reform, does not control costs, does not improve competition, does not improve insurance, does not do a damn thing except spend $1 Trillion and leave us $239 Billion in debt.

We do not dare wait until this boondoggle gets into its final form, because if we wait until then to oppose its passage, we will have lost the opportunity to prevent a great wrong being done to America's health care system and America's future. This bill needs to be shot down, and it needs to be shot down now. Waiting until it is finalized is waiting at the barn door for the horse to run out before closing it.

AlbqOwl said:

If they wanted us to know, why aren't they telling us? Whatever happened to the pledge for the most transparent administration in history?

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Go to the legislative sites and pull up the bills, or to the CBO, and pull up the analysis. If you want to know what's in the various bills, you can find out.

Once there is ONE bill, out of conference, then it will be easier to follow, of course, b/c there won't be competing bills and proposals and counterproposals.

AlbqOwl said:

Late last year, we got a mega billion bailout package and we don't have a clue about what they did with that money. We do know half of it was held over for President Obama to use.

Early this year we got a second mega billion bailout package and we don't have a clue about what they did with that money or how it has benefitted anything. At least Biden was honest enough to say that some of it was wasted.

Early this year Congress passed a massive omnibus spending bill, the last for this year's budget, and the President's excuse for not letting us have a good look at that was that it was George Bush's budget and therefore he would just sign it.

Early this year we got a massive--unheard of in size and scope--stimulus bill that had to be delivered to Congress in the wee hours of the morning, voted on the same day with minimal debate and before anybody had time to read it, and signed into law immediately by the President because the whole economy was about to crash and it was vital to get the economy rolling and save jobs immediately. Well the economy continues to founder, unemployment keeps going up month by month, and now we are told that they never intended for it to really kick in before the next year or so. But it was a flat out emergency.

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The second mega bailout, is that the auto bailout? I'm pretty sure we know what we did with that money.

And, the economy was in crisis, and there was a flat out emergency. Thank God a flat out free fall has been averted. Bad as this is, THAT would have been a world of hurt worse.

AlbqOwl said:

And now we have them overhauling the healthcare system with obvious intent to mostly dismantle and rebuild it, it represents 17% of the GDP of the nation and is being rush through at breakneck speed, will probably be delivered to Congress in the wee hours of the morning, voted on the same day before anybody has a chance to read it, and the President will sign it into law without letting us see it first because we 'can't afford to wait any longer'. By that time, it will be too late for us to intervene.

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There is absolutely not an obvious intent to dismantle and rebuild the system. There is an annoying and obvious intent to preserve private health insurance options. Not annoying in that they will be there, but annoying in that big companies will not have access to either the proposed health insurance exchange, or the proposed public option - specifically so that everyone will not get the hell out of their current plans. I think choice should be freer, and if large companies want access too, they should have it, but they won't.

AlbqOwl said:

Oh yes, and the President says he hasn't read it and is leaving it up to Congress to put it together. And who is writing it? Not our elected leaders. It's Congressional staffers and lobbyists who are creating this masterpiece for us. The only coherent thing we got out of his last press conference on this was that he and Congress have no intention of subjecting themselves or their families to what they will be mandating for the rest of us.

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I don't know, that's how our gov't works. Noone thinks it's perfect, but then again, dismantling and rebuilding our legislative process isn't really on the agenda right now. We have alot of other things on our plate right now. Although, I've heard some in the progressive blogosphere talking about the committee process and how it needs to be blown up.

AlbqOwl said:

Doesn't that all give you huge confidence?

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I do have a great deal of optimism that this will be addressed and accomplished. I'm looking forward to it. Of course, I don't expect perfection, but we never get perfection. That's not a reason not to move forward tho.

AlbqOwl said:

Give me a break.

Those who want whatever is done to be done slow, careful, and right, had better be hollering from the rooftops and hope we can encourage more members of Congress to get really squeamish and cold feet. The way things are right now, anybody who trusts this bunch with their healthcare needs to have his/her head examined.

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I trust my doc with my healthcare needs, but I'm trusting the Congress to improve - vastly - on the wreck of health insurance that exists right now.

Here is a question; why don't we just end Medicare and Medicaid? Why are the Republicans who are so opposed to "Socialism" not propose ending Medicare? They could of in 2003, controlling both House, Senate, and White House. We could save $500+ billion, and growing, each year.

celticlord said:

Except the legislation isn't generic, and hasn't been generic for quite some time. You know this, or you are not nearly as current on these matters as you suggest.

I've been very explicit that my criticisms are in regards to the horror show known as HR3200. It is the bill Americans do not want.

It's easy to say "I want reform." Hell, if that's all there was to the debate you would be agreeing with me. It is not all there is to the debate.

There is a bill, a bill the Anti-Republicans in Congress want to bring to a vote, a bill Americans reject. There is 1018 pages of proposed legislation that does not reform, does not control costs, does not improve competition, does not improve insurance, does not do a damn thing except spend $1 Trillion and leave us $239 Billion in debt.

We do not dare wait until this boondoggle gets into its final form, because if we wait until then to oppose its passage, we will have lost the opportunity to prevent a great wrong being done to America's health care system and America's future. This bill needs to be shot down, and it needs to be shot down now. Waiting until it is finalized is waiting at the barn door for the horse to run out before closing it.

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No, what I know, and what you do too, is that there are THREE bills in Congress right now. Two in the Senate, and one in the House. There is no single bill. And, any of the bills that exist now, will not be the final bill.

I don't understand the need to go back over that again and again. HR3200 is not the same as either Senate bill. And HR3200 is not the bill that will be final. HR3200 today is not even the same bill as it was yesterday. Last night they added the Medicare regional pmts deal. And it's not the same bill as it was last Tuesday, when they added the Medicare independent board to address long term costs. And it's not the same bill as it was several weeks ago when it didn't contain the public option.

I don't even know why you keep talking about it like it's been voted on and is on it's way to conference committee. That makes no sense.

sam_w said:

Here is a question; why don't we just end Medicare and Medicaid? Why are the Republicans who are so opposed to "Socialism" not propose ending Medicare? They could of in 2003, controlling both House, Senate, and White House. We could save $500+ billion, and growing, each year.

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Interesting question. Of course, being that they just expanded it - largest expansion since the 60s? I think - and didn't pay for that expansion (who cares, chuck it onto the debt), I don't expect them to propose that

jackalope said:

You, and the rest of the group that is the the three in 10 Americans are of this opinion. The rest of us 7 in 10 Americans are movin' on forward. And, btw, you'll notice that 70% is not the percentage of Democratic registration in this country. There is a rump Republican party playing hyper partisan politics, and they are playing it in order to kill health reform legislation.

Thankfully, we don't have to wait until 10 out of 10 Americans are of the same opinion. But, it'll be okay, 100 yrs ago people got used to cars, 60 yrs ago people got used to televisions, and the idea that your lifetime employer would provide health insurance coverage for you, woooo-eeeeee, in the 70s people got used to COLOR television. In this new century! god, has it taken this long? even those who will be dragged kicking and screaming across the finish line, will get used to the new health insurance landscape, and will come to realize (it'll take decades for some, I know) that they and the country dodged a big bullet back in '09, when they tried to kill health care reform. And, they'll be thankful. :2wave:

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You seem a lot more reasonable than others here who like to talk at people instead of trying to have a civil debate so we'll be on good terms because I know you mean well. Just wanted to say that to start.

Back to the meat of things though, most people like to use other countries as an example of what we should do but they never research anything about the particular system other than they know that government controls some part of it.

The French system is often used an example of a good system of government health care, however, when you look closer you'll find that it actually resembled a private HMO plan and it is not a single payer system.

They pay approximately 19% in taxes for just their health care and that does not cover the entire amount. The citizens are responsible for 10-40% of the rest of that the government doesn't pay, in fact the French system uses a reimbursement method and not a direct payment system.

In effect they are using the price as a way of discouraging treatment and usage. The citizen has to foot the whole bill initially and is only later reimbursed for 60-90% of the costs. They government also pays for the doctors education which I'm almost certain is not included in the cost of the health care system when it actually should be.

There are a lot of hidden costs and things that no one realizes is going on in specific health care systems world wide and we shouldn't just adopt a UHC type plan because more people agree with it.

sam_w said:

Here is a question; why don't we just end Medicare and Medicaid? Why are the Republicans who are so opposed to "Socialism" not propose ending Medicare? They could of in 2003, controlling both House, Senate, and White House. We could save $500+ billion, and growing, each year.

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We should as it is an unfair burden on the states but the largest voting block in this country is elderly people. Elderly people "think" they have already paid for these services through taxation when in reality they never paid enough for the services they are getting. In regards to medical care they get about $3 for ever $1 they have paid in and over all the government spends $6 on the elderly for every $1 they spend on children.

Harry Guerrilla said:

We should as it is an unfair burden on the states but the largest voting block in this country is elderly people. Elderly people "think" they have already paid for these services through taxation when in reality they never paid enough for the services they are getting. In regards to medical care they get about $3 for ever $1 they have paid in and over all the government spends $6 on the elderly for every $1 they spend on children.

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Except who in their right mind would ever propose this? The AARP would mount an insurrection worse than the Iraq insurgency. The party/politician that pushes an end to Medicare is one who will never see public office again. Let's put it this way, there may be a lot of elderly Republicans who would become immediate Democrats at the first bill they get for medical or prescriptions. It is politically unattainable, and financially unsustainable. The only option then is to drastically reduce the cost trajectory which is currently rising at a faster rate than inflation (hence why it is now costing $500b/year).

sam_w said:

Except who in their right mind would ever propose this? The AARP would mount an insurrection worse than the Iraq insurgency. The party/politician that pushes an end to Medicare is one who will never see public office again. Let's put it this way, there may be a lot of elderly Republicans who would become immediate Democrats at the first bill they get for medical or prescriptions. It is politically unattainable, and financially unsustainable. The only option then is to drastically reduce the cost trajectory which is currently rising at a faster rate than inflation (hence why it is now costing $500b/year).

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Then you have answered your own question.

Republicans don't pursue Medicare repeal because their constituents would oppose it.

Anti-Republicans pursue HR3200 despite their constituents opposing it.

sam_w said:

Except who in their right mind would ever propose this? The AARP would mount an insurrection worse than the Iraq insurgency. The party/politician that pushes an end to Medicare is one who will never see public office again. Let's put it this way, there may be a lot of elderly Republicans who would become immediate Democrats at the first bill they get for medical or prescriptions. It is politically unattainable, and financially unsustainable. The only option then is to drastically reduce the cost trajectory which is currently rising at a faster rate than inflation (hence why it is now costing $500b/year).

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I'd like to note that I absolutely HATE AARP.

Of course no one will do anything about it, the only way to push prices down is to expose people to the actual cost of the services they are receiving.

I can already imagine the calls of "people dieing in the streets" from the lunatics in our country. That phrase should be included as an amendment to Godwin's Law.

jackalope said:

Go to the legislative sites and pull up the bills, or to the CBO, and pull up the analysis. If you want to know what's in the various bills, you can find out.

Once there is ONE bill, out of conference, then it will be easier to follow, of course, b/c there won't be competing bills and proposals and counterproposals.

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Not quite that easy at this stage, but at least the law still requires a CBO mark up on costs. Currently the CBO not only says that the cost will likely far exceed any numbers we are being spoon fed, but that the savings will be no more than a couple of billion against a trillion plus in increased spending, and even that couple of billion in savings is unlikely.

Do you ever hear the President or Pelosi or anybody else pushing this mentioning what the CBO says? Of course not. But still you trust them.

The second mega bailout, is that the auto bailout? I'm pretty sure we know what we did with that money.

And, the economy was in crisis, and there was a flat out emergency. Thank God a flat out free fall has been averted. Bad as this is, THAT would have been a world of hurt worse.

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Some of the second bailout was used for the auto industry, but it wasn't sold that way. And no, nobody does know what they did with most of that money. They don't even know what happened to most of it. But right now, our government is using that money--OUR money--to pay people $9000 to trade in an old car on a new one just so long as it is a GM or Chrysler product. Maybe you think that is a proper use of your tax money. I will be doing everything I can do to eject those in Washington who have so little understanding of the economy, who would screw over honest business enterprises that way, or who have so little concern for the taxpayer money.

(P.S. A substantial majority of Americans do not want the government to own the auto industry, the banks, or any other major industries. But it seems to own an awful lot of that right now.)

And if the economy was in so much crisis that they had to do this, why are they now saying that we can't expect any significant 'rescue' of the economy for a year or two. Of course they hope we'll forget what they initially said and promised by the next election day.

There is absolutely not an obvious intent to dismantle and rebuild the system. There is an annoying and obvious intent to preserve private health insurance options. Not annoying in that they will be there, but annoying in that big companies will not have access to either the proposed health insurance exchange, or the proposed public option - specifically so that everyone will not get the hell out of their current plans. I think choice should be freer, and if large companies want access too, they should have it, but they won't.

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I have been listening to what the President and the experts say. You obviously have not though I think you mean well. But I think it unwise to trust any government with 17% more of the economy especially after witnessing what they are doing with that they have already seized.

I don't know, that's how our gov't works. Noone thinks it's perfect, but then again, dismantling and rebuilding our legislative process isn't really on the agenda right now. We have alot of other things on our plate right now. Although, I've heard some in the progressive blogosphere talking about the committee process and how it needs to be blown up.

I do have a great deal of optimism that this will be addressed and accomplished. I'm looking forward to it. Of course, I don't expect perfection, but we never get perfection. That's not a reason not to move forward tho.

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The leftwing bloggers are fond of posting stuff like, well at least the President is doing something and nobody else has come up with a plan. The GOP is the party of NO. Etc. Etc. And most seem to be as trusting and willing to turn their lives over to more and more government control as you are.

But some--most of us now--are not willing to do that and don't trust government to have our best interests at heart considering how much they are lying to us to convince us that they do. It is not only necessary but critical to dig in our heels and try to stop this train wreck before it happens.

Thomas Sowell once said: "When you put out a fire, what do you replace it with?" I think most of us are attempting to put out a fire that, if left unchecked, could permanently change our glorious Republic experiment into something far less satisfactory. And we will not easily get it back.

Not everything is appropriate for government to "fix". And the more it arrogantly presumes to do so, the worse it will make things. We are witnessing that now.

I trust my doc with my healthcare needs, but I'm trusting the Congress to improve - vastly - on the wreck of health insurance that exists right now

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You are a far more trusting soul when it comes to handing people power over your life than I am.

celticlord said:

CBO deals new blow to health plan - Chris Frates - POLITICO.com

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When it comes to past health care reform efforts, Washington has made little meaningful effort to address budget neutrality, which is, in part, a function of addressing the persistence of health expenditures rising faster than economic growth. Instead of making tough, unpopular, but necessary choices, two common devices have been used to try to circumvent the costs/budget impact:

1. Savings will appear from technology or efficiency gains. In reality, such savings have been very small relative to political expectations. Of course, government is not alone in touting such savings. One sees similar statements following mergers. In a majority of cases, those savings either never materialize to the level that had been expected and, in some, don't materialize at all.

2. A board will be created to help oversee expenditures growth.

CBO has done a good job to date in addressing the budget and cost impact of the proposed health care legislation. The reality is that such legislation is not paid-for and it would not address the critical issue of rising health expenditures that has put the nation's finances on an unsustainable fiscal course.

In a hint that Congress lacks the resolve to bring about budget neutrality, the recent pay-go legislation is filled with loopholes. One such loophole would exempt increases in Medicare payments to physicians from triggering offsetting budget cuts/tax hikes to maintain budget neutrality.

On the point of the loopholes, CBO Director Douglas Elmendorf explained:

However, the proposed process has other features—a proposed temporary rule to score certain changes in spending and revenues relative to “current policy” rather than current law; a modification of the baseline’s treatment of some expiring mandatory programs; and new procedures for scoring legislation that would convert programs’ spending from discretionary to mandatory—that could lead to greater spending or reduced revenues in the coming decade than would occur under the existing House and Senate rules. In addition, some features of the bill’s proposed sequestration mechanism would limit its usefulness in deterring increases in spending.

Re: CBO deals new blow to health plan...•

•►`That's an interesting plan everyone, a health plan..!:2razz:









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donsutherland1 said:

In a hint that Congress lacks the resolve to bring about budget neutrality, the recent pay-go legislation is filled with loopholes. One such loophole would exempt increases in Medicare payments to physicians from triggering offsetting budget cuts/tax hikes to maintain budget neutrality.

On the point of the loopholes, CBO Director Douglas Elmendorf explained:

However, the proposed process has other features—a proposed temporary rule to score certain changes in spending and revenues relative to “current policy” rather than current law; a modification of the baseline’s treatment of some expiring mandatory programs; and new procedures for scoring legislation that would convert programs’ spending from discretionary to mandatory—that could lead to greater spending or reduced revenues in the coming decade than would occur under the existing House and Senate rules. In addition, some features of the bill’s proposed sequestration mechanism would limit its usefulness in deterring increases in spending.

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The point you make is critical to the debate. In the President's eagerness to add meaningful healthcare reform to his legacy, and in some of Congress's eagerness to insert government control into every facet of the American economy and structure, they intentionally or negligently omit many many considerations that have to be included to show the American people what they are buying. So Congress lies, and the President obfusicates in his press conferences, and we are left trying to dig out the facts as best we can.

One elephant in the room not being discussed is this:

How Cap and Trade Affects the Health Care Debate
Posted July 14th, 2009 at 11.04am in Energy and Environment, Health Care.

The Waxman-Markey energy tax plan will have all sorts of unwanted side effects. As the healthcare debate ramps up, it’s worth noting problems misguided global warming legislation can generate for medical care.

Though it would be nearly impossible to trace all the impacts of higher energy costs on medical services, one broad measure is the impact on the costs of medical care. By driving up energy costs, Waxman-Markey will drive up the costs of running hospitals, manufacturing medical equipment, producing drugs, driving ambulances, and virtually every other component of our healthcare system.

The Center for Data Analysis analyzed the economic impact of the Waxman-Markey energy tax legislation using the sophisticated Global Insight macro model. This model allows detailed analysis of the impacts by industry.

So what happens to healthcare? On top of all the other factors that will lead to higher prices down the road, Waxman-Markey will add an additional 11.6 percent to healthcare costs by 2035 (the last year of the analysis). So, though Waxman-Markey aims its economic bombs at global warming, healthcare will suffer hundreds of billions of dollars in collateral damage each year.
How Cap and Trade Affects the Health Care Debate The Foundry

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Harry Guerrilla said:

Of course no one will do anything about it, the only way to push prices down is to expose people to the actual cost of the services they are receiving.

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Good luck. People are already so stuck in their sentimentalities that they don't care to see what would actually improve things.

AlbqOwl said:

The point you make is critical to the debate. In the President's eagerness to add meaningful healthcare reform to his legacy, and in some of Congress's eagerness to insert government control into every facet of the American economy and structure, they intentionally or negligently omit many many considerations that have to be included to show the American people what they are buying. So Congress lies, and the President obfusicates in his press conferences, and we are left trying to dig out the facts as best we can.

One elephant in the room not being discussed is this:

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Excellent point about cap-and-trade padding health care costs. Proves yet again that government control of any industry is at best a blunt instrument that is nearly impossible to wield without doing more harm than good.