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The five most promising cost controls in the health-care bill

1. Creates a competitive insurance market: Government takes over...again

2. Reforms Medicare: Assures it's destruction in 1/2 the time..

3. Taxes "Cadillac Plans": Damn the Constitution.. we make our own rules!

4. Bundles Costs: this ain't cable TV folks

5. Adds incentive for lowering costs.Or just runs private insurance companies off American soil providing complete socialized heathcare for all Americans

YEP ...does ALL those things!
:doh
 
1. Creates a competitive insurance market: Government takes over...again

2. Reforms Medicare: Assures it's destruction in 1/2 the time..

3. Taxes "Cadillac Plans": Damn the Constitution.. we make our own rules!

4. Bundles Costs: this ain't cable TV folks

5. Adds incentive for lowering costs.Or just runs private insurance companies off American soil providing complete socialized heathcare for all Americans

YEP ...does ALL those things!
:doh

Did you even read the article?
 
Ezra Klein - The five most promising cost controls in the health-care bill

Interesting read. To sum up, the ways that this bill helps medical costs:

1. Creates a competitive insurance market

2. Reforms Medicare

3. Taxes "Cadillac Plans"

4. Bundles Costs

5. Adds incentive for lowering costs.

1. A couple of problems with this one. First, most people get their insurance from their employers so this will have no effect. Next we were told during the debate that in many states there are virtual monopolies. How are you going to both add competitors while reducing profits as this would suggest.

2. Time will tell on this one. We have talked about the fraud and abuse in Medicare for decades with no fixes.

3. As the article states this does not into effect until 2018. If it is that great an idea why wait so long? Also 27.5 thousand is 2X to 3X the cost of the average family plan so hard to see how this will get a lot of savings.

4. See #1

5. It will have experiments, but no real answers in this bill which is the tragedy. The article says congress will have to act or their constituents will get bad, guess what, they are mad already and congress clearly does not care.
 
Ezra Klein - The five most promising cost controls in the health-care bill

Interesting read. To sum up, the ways that this bill helps medical costs:

1. Creates a competitive insurance market

2. Reforms Medicare

3. Taxes "Cadillac Plans"

4. Bundles Costs

5. Adds incentive for lowering costs.
I still don't get this "cadillac" plan tax.

If people are paying $27,000 premiums then they are probably paying WAY more than they will ever spend. For normal medical care w/o insurance.

It sounds like a bunch of voodoo economics, political labeling (E.g., "cadillac"), and poor reasoning for taxing plans that don't really provide anything unfair but higher premiums for less hassle at the doc's office.

It would be like taxing car insurance more for plans that cover expensive cars. It makes no sense except as a way to tax the wealthy in some strange way.
 
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Ezra Klein - The five most promising cost controls in the health-care bill

Interesting read. To sum up, the ways that this bill helps medical costs:

1. Creates a competitive insurance market

His explanation for how this will create a more competitive insurance market is incredibly tenuous at best. First, the only people who will be affected by this are the 6-7% of the country that will be on the exchange. Second, the bulk of the "competitive" effect that he refers to will come from making it easier for consumers to pick between providers, like they do with those online auto insurance calculators. This is certainly a useful thing, but the impact will likely be minimal and there's no reason that it couldn't be done privately.

2. Reforms Medicare


The Senate bill would establish an Independent Medicare Advisory Board, which would be required to recommend changes to the Medicare program to limit its spending growth. Its recommendations would go into effect automatically unless Congress votes to block them.

That sounds strikingly similar to the Doc Fix, the AMT patch, and the PAYGO rules. They're great ways to tell the public that you'll be fiscally responsible in the future without actually having to follow through. Do you honestly believe that the same Congress (on either side) that passes the Doc Fix every year to avoid cutting reimbursement rates is now going to have the political courage to allow these cuts to come into play.

3. Taxes "Cadillac Plans"

There is absolutely no chance on earth that the excise tax will ever come into effect. None. It's already been pushed back to 2018, and I'd be astonished if it isn't pushed back or repealed before we even get that far.

4. Bundles Costs

This is a proposal that sounds like it might have a positive effect. Of course, it might also save no money or produce worse outcomes. Either way, this is hardly a monumental proposal.

5. Adds incentive for lowering costs.

His rationale on this point makes absolutely no sense. He first says that by adding more people to the system, there will be more people complaining about costs, which he concludes will make Congress more attentive. He then says that because Congress will be on the hook for the extra spending, it will have its own incentives to keep costs down.

This is absurd in two ways: First, people already complain constantly to Congress about health care. Does he actually think complaints about health care will increase now that more people are covered? Common sense would say that complaints would be larger when those people didn't have insurance at all.

Second, he really thinks that the threat of increased deficits will cause Congress to take bold action to cut medical costs? The same Congress that won't touch Medicare's unfunded liability with a 10 foot pole and that passes an annual doc fix every year that adds to the deficit and increases medical costs?

Ezra Klein is a smart guy, but there's no way that he can actually believe the things he writes.
 
klein posits:
The bill says congressmen and their staff members need to buy their insurance from these exchanges, too.
if that is the case then why is this measure in the present bill:
These multistate
plans will be offered separately from the
Federal Employees Health Benefit Program and
will have a separate risk pool.
page 13 of this http://www.kff.org/healthreform/upload/housesenatebill_final.pdf
there would seem to be no further reason to offer the Federal Employees Health Benefit Program if federal employees were going to be expected to buy insurance from the state/multi-state offerings

the Independent Medicare Advisory Board is touted to be the mechanism to adjust pricing of medicare in a way congress is not. but the key will be the 15 person panel ... how long until they too, are bought by the insurance industry. they should face strong, constant scrutiny, in order to actually be effective. if that is done, this is one promising aspect of the bill

taxing the cadillac plans is a bogus approach to increasing revenue. klein acknowledged that. but he makes this comment while articulating that taxing the cadillac plans is a legitimate effort:
... that means individuals don't know how much their insurance really costs and don't have as much incentive to keep those costs down. Imagine the pressure for cost control if the 70 percent that employers pay were coming out of our own pockets, instead of quietly coming out of our wages.
the cadillac plan will not tax the first dollar of these plans but only that portion which exceeds the ceiling. those high value employees who realize such plans pay little of them - seldom the 30% portion most pay for their employer provided plans. i see no real ability for this provision to actually do anything. it will not be a source of significant revenue and it will not hold down the size of the plans of the heavy hitters who enjoy them
... the most immediately promising of which are the "bundling" programs. Instead of getting paid for everything they do to help a diabetic, hospitals will get paid once for treating that person's diabetes and all related conditions over a certain period of time. If this leads to lower costs and doesn't harm patients, it will be expanded. That would be the beginning of the end of paying for quantity of treatment, and the beginning of paying for quality of treatment.
excuse me. how is bundling going to actually save money? the physician cannot project how much care patients will require. so, are they going to price lean, recognizing that a bundle will deal with medical unknowns or price high in order to cover any unanticipated costs required to aid the patient. this is the democrats' version of voodoo economics
and it is unfortunate the republicans refused to participate in this debate. in the end, anti-trust protection is still available to the insurers and cross state competition is not. we lost the opportunity to introduce the competitiveness of buying from any plan available in any state; there is nothing about insurance which could not be provided across state lines. so why can't we purchase it that way?
hopefully, that will be rectified in round two
 
From FDL, responding to the same article:

Yes, The Health Bill Really Lacks Serious Cost Controls | FDL Action

The idea of lousily regulated health insurance exchanges is not new. The Federal Employee Health Benefit plan (FEHB) has been a health insurance exchange for several decades now. With roughly 8 million users, it is bigger than any state exchange will be. Yet, the evidence is that health care costs on the FEHB grow at at effectively the same rate as the rest of the employer market. Even Klein himself has admitted this. Exchanges will probably smooth out the fluctuations and imbalances in the individual market and should reduce some amount of administrative overhead in a small part of the health insurance market, but the evidence they will systematically bring down cost is sorely lacking.
 
1. Creates a competitive insurance market: Government takes over...again

2. Reforms Medicare: Assures it's destruction in 1/2 the time..

3. Taxes "Cadillac Plans": Damn the Constitution.. we make our own rules!

4. Bundles Costs: this ain't cable TV folks

5. Adds incentive for lowering costs.Or just runs private insurance companies off American soil providing complete socialized heathcare for all Americans

YEP ...does ALL those things!
:doh

Look how well the far-righties serve their sith masters...

They've got their talking points all memorized and ready spout without thought or explanation...
 
Look how well the far-righties serve their sith masters...

They've got their talking points all memorized and ready spout without thought or explanation...

Unlike the progressives.. WE make our own decisions as to what is good and bad according to the Founding Documents, the writings of the Founding Fathers and hold little regard for Madcow and the likes of her.. I understand how it works with liberals, so I don't blame you your confusion.
 
Ezra Klein - The five most promising cost controls in the health-care bill

hmm, alrighty, let's see:

t's hard to overstate how important the Congressional Budget Office (CBO) -- which makes the official judgments on how much bills cost and save -- is in Washington

hmmm. this would be the CBO that stated that insurance premiums would go up under this new health care legislation?

1. Creates a competitive insurance market

actually no it doesn't. had we gotten rid of state barriers to purchasing health insurance, then we would have a "competitive insurance market". instead all that happened was that the current list of State mandates placed on insurance (which is what helps to make the market uncompetitive) got added to with a list of Federal mandates. in those states where multiple options are available, now fewer are, and for those Americans with HSA's, they aren't allowed on the exchange.

the health insurance market just got less competitive. but as a market advocate, it's nice to see that the opposition is at least now paying us the compliment of attempting to hijack our arguments to defend their policies.

2. Reforms Medicare

from the article: Enter the Independent Medicare Advisory Board. Modeled off of the highly respected (but totally toothless) Medicare Payment and Advisory Commission, IMAC is a 15-person board of independent experts chosen by the president, confirmed by the Senate and empowered to cut through congressional gridlock. IMAC will write reforms that bring Medicare into like with certain spending targets. Congress can't modify these proposals, it can't filibuster these proposals, and if it wants to reject them, it needs to find another way to save the same amount of money. Making the process of passing tough reforms easier is the single most important thing you can do to make sure tough reforms actually happen.

this is what republicans were talking about when we warned of the death panel. this is a board that is slated to find ways to begin to reduce available health care, and is designed in such a way as to make it nigh impossible for congress (you know, representative government - that thing that is supposed to be making our political decisions?) to counteract. this will indeed lower health care costs paid by the government; similar to how NICE operates in Britain:

Tens of thousands with chronic back pain will be forced to live in agony after a decision to slash the number of painkilling injections issued on the NHS, doctors have warned. Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy.

Specialists fear tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 each for private treatment.

The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million.


so yes, this will actually cut government costs. :thumbsup: good job on that one, if there is something we can all agree on, it's hurting the elderly.

incidentally, on that 'medicare cost cut'?

the "Doc Fix" is currently working it's way through congress. so that "bending of the cost curve" will last, oh, about two weeks.

3. Taxes "Cadillac Plans"

yeah. i thought this was hilarious. if the government deems that your health care plan is too sparse, they will tax you! but if the government deems that your health care plan is too generous.... then they'll tax you for that, too! why anyone would think that the bozos in congress are going to be able to fine-tune what your health insurance plan should include better than, say, the job they've done on the federal budget is beyond me, but oh well.

then they slapped the same disaster growth rate on it as they did with the Alternative Minimum Tax.

from the article on this: if your plan costs $27,600, the final $100 bucks would be taxed (technically, the insurer pays the tax, but it'll pass that onto your employer). That's a very expensive plan, but over time, that $27,500 threshold grows by inflation, usually around 3 percent) rather than health-care inflation (closer to 7 percent). So if we don't get health-care inflation down, this will hit many more plans.

this reminds me of the underpands gnomes business plan from South Park. We tax expensive plans + over time we tax more people + something magical happens = costs go down!

4. Bundles Costs

from the article: The health-care bill seeds Medicare with many experiments to change this status quo, the most immediately promising of which are the "bundling" programs. Instead of getting paid for everything they do to help a diabetic, hospitals will get paid once for treating that person's diabetes and all related conditions over a certain period of time.

IE: we're going to make it extremely difficult for providers to make a profit, and then we're going to offer them a powerful incentive to give people the minimum defensible amount of care. but we're going to keep tort law the way it is, so that if they actually do provide the minimum defensible amount of care, they get their butts sued off.

this is the "the way to lower health care costs is to get rid of all the doctors" argument. it puts providers in a no-win situation and then blames them for being there. of course they're not going to stay.

5. Adds incentive for lowering costs.

actually the article lists "Changing the politics of reform" and it contains a number of laughable provisions. for example:

" the individual mandate in the bill brings everyone into the insurance market"

actually the individual mandate combined with the provision that forces insurance companies to cover those with preexisting conditions at the same rate as healthy people provides a powerful incentive for anyone who is healthy to flee the insurance market. It makes everyone de facto insured because if something traumatic happens, you go to your local office, and not only do they have to take you, they can't charge you extra. so if i am Healthy Young Joe, and i have the option of paying a $750 fine or a $13,000 premium and no matter what i pick an insurance company will still be paying for me if i get really sick.... then i have a $12,250 incentive to get rid of my health insurance. heck, that's more than 50% higher than the incentive we're giving to try to get people to purchase houses.

"Congress will have to get serious about holding costs down in the system".

yes. just like they are having to get serious about deficit spending and our looming unfunded entitlement nightmare?

" Republicans and Democrats both agree that we need more cost control in the health-care system. But politicians don't like to actually cut costs, because those votes reduce benefits and make people angry."

easy solution. it's typical of a left-winger to think of everything as flowing through government; but by simply getting rid of the state barrier and enacting loser-pays tort reform we can lower costs without lowering anyone's government benefits or costing Washington a dime.
 
Ezra Klein is a smart guy, but there's no way that he can actually believe the things he writes.

I often get the impression the President feels the same way when he speaks.

Do you think the hypocrisy and lies are apparent to them and they trudge on relentlessly or do you think they actually believe the majority of what they say? This may be classified as a mental health issue under the new standards.
 
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Look how well the far-righties serve their sith masters...

They've got their talking points all memorized and ready spout without thought or explanation...

This is amusing, because three other conservatives and a liberal all took the time to point out substantive criticisms of the article, but all you were able to do was mock the one person who offered a more visceral reaction.

Rather than call names and offer your own talking points, why not try to raise the level of debate, or at least meet that which the rest of us have already raised it to?
 
Rather than call names and offer your own talking points, why not try to raise the level of debate, or at least meet that which the rest of us have already raised it to?

OK then.. respond to this this statement:

"Fit not your brother the chains of entitlements and think it a kindness, for the sin of slavery is it’s true intent"
 
Ezra Klein - The five most promising cost controls in the health-care bill

Interesting read. To sum up, the ways that this bill helps medical costs:

1. Creates a competitive insurance market

2. Reforms Medicare

3. Taxes "Cadillac Plans"

4. Bundles Costs

5. Adds incentive for lowering costs.

All this is good and done - somewhat.

But what I don't understand is why they're going to fine people for not having insurance, among other things that they're doing.
As well as their narrow minded focus on the portion of the CBO report that says that only for a limited time (10-29 years) *if* government spending stays at it's current point - will the plan reduce the deficit. If government spending goes up, and after 15-20 years go by - it will add to the deficit exponentially.

The bad outweigh the possible good.
 
Then comes the REAL math...

Deere sees $150 million hit from healthcare reform

The law could raise expenses for large U.S. employers.



Thursday, March 25, 2010
(Reuters) - Farm equipment maker Deere & Co (DE.N) expects after-tax expenses to rise by $150 million this year as a result of the healthcare reform law President Barack Obama signed this week.

Most of the higher expense will come in Deere's second quarter, the company said on Thursday. The expense was not included in the company's earlier 2010 forecast, which called for net income of about $1.3 billion.

Caterpillar Inc (CAT.N) said on Wednesday it would take a $100 million after-tax charge to earnings in the first quarter because the new law will lower its tax deductions. Obama on Tuesday signed the most sweeping U.S. social policy legislation in decades into law.........................

FOLKS... that is 5000, Five-thousand.... $50,000 jobs GONE! From just 2 companies!

GREAT JOB OBLABBA!
 
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Then comes the REAL math...

Deere sees $150 million hit from healthcare reform

The law could raise expenses for large U.S. employers.



Thursday, March 25, 2010
(Reuters) - Farm equipment maker Deere & Co (DE.N) expects after-tax expenses to rise by $150 million this year as a result of the healthcare reform law President Barack Obama signed this week.

Most of the higher expense will come in Deere's second quarter, the company said on Thursday. The expense was not included in the company's earlier 2010 forecast, which called for net income of about $1.3 billion.

Caterpillar Inc (CAT.N) said on Wednesday it would take a $100 million after-tax charge to earnings in the first quarter because the new law will lower its tax deductions. Obama on Tuesday signed the most sweeping U.S. social policy legislation in decades into law.........................

FOLKS... that is 5000, Five-thousand.... $50,000 jobs GONE! From just 2 companies!

GREAT JOB OBLABBA!

you speak of REAL MATH when what you demonstrate is a complete ignorance of BASIC ECONOMICS
 
you speak of REAL MATH when what you demonstrate is a complete ignorance of BASIC ECONOMICS

only using Whitehouse math ... I know I didn't use $250,000 per $50k job like the Stimulus jobs, but would you care to give me an explanation of my error?
 
only using Whitehouse math ... I know I didn't use $250,000 per $50k job like the Stimulus jobs, but would you care to give me an explanation of my error?

the math is not your problem. you seem capable of basic arithmetic
it is basic economics where you are lost in the weeds

the article you referenced indicated that john deere forecast earnings of $1.3 Billion, but was going to be about $150 Million short of that pro forma earnings amount because of the projected additional cost associated with new medical expenses (attributable to the Obamacare plan)
you lept to the wrong conclusion that would cost 3,000 jobs paying $50,000 per job
to use your "logic" we must then conclude that if john deere broke even, and did not earn any of its projected $1.3 Billion in profits, then it must be expected to shave its work force by 26,000 jobs (also paying $50,000 per job). the company has 51,300 employees. so, using your fuzzy economic "logic", john deere would cut over one half of its work force if it only broke even
that is not the way businesses are run
the only thing you would be able to conclude based on the data you had was that the profitability per employee was going to be reduced from $25,341 to $22,417 ... that john deere is anticipating the cost of the plan to absorb $2,924 per employee

again. your arithmetic skills are adequate. your understanding of economics - and business - is not

... you're welcome
 
Then comes the REAL math...

Deere sees $150 million hit from healthcare reform

The law could raise expenses for large U.S. employers.



Thursday, March 25, 2010
(Reuters) - Farm equipment maker Deere & Co (DE.N) expects after-tax expenses to rise by $150 million this year as a result of the healthcare reform law President Barack Obama signed this week.

Most of the higher expense will come in Deere's second quarter, the company said on Thursday. The expense was not included in the company's earlier 2010 forecast, which called for net income of about $1.3 billion.

Caterpillar Inc (CAT.N) said on Wednesday it would take a $100 million after-tax charge to earnings in the first quarter because the new law will lower its tax deductions. Obama on Tuesday signed the most sweeping U.S. social policy legislation in decades into law.........................

FOLKS... that is 5000, Five-thousand.... $50,000 jobs GONE! From just 2 companies!

GREAT JOB OBLABBA!

Do you have a link to the article?
 
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