universal healthcare

[eppie]

So the house of representatvives voted for this bill, which is a historic change in the US healthcare system.

The costs of these reforms (don't know how they calculated that) is 938 billion dollars the first 10 years.
I think to make this healthcare system work (we have discussed this before) other things need to change. If no good cost savings can be made this new system will kill the economy.
(but on the other hand, bank bail-outs and wars also cost these amounts of money so nothing really changes there)
Maybe stopping the employer paid health insurance would be a good idea. It seems it will get cheaper for companies to stay in the US and work with american employees, compared to moving to another country where they don't need to pay healthcare benefits.

[Jester]

So the house of representatvives voted for this bill, which is a historic change in the US healthcare system.

The costs of these reforms (don't know how they calculated that) is 938 billion dollars the first 10 years.
I think to make this healthcare system work (we have discussed this before) other things need to change. If no good cost savings can be made this new system will kill the economy.
(but on the other hand, bank bail-outs and wars also cost these amounts of money so nothing really changes there)
Maybe stopping the employer paid health insurance would be a good idea. It seems it will get cheaper for companies to stay in the US and work with american employees, compared to moving to another country where they don't need to pay healthcare benefits.

I disagree with you on several fronts. First, your title is misleading - this is not universal health care.

Second, 938 billion dollars in the first 10 years amounts to only 93.8 billion dollars annually. The government budget, even in a normal year with no stimulus, is somewhere in the neighbourhood of three trillion dollars. The chances of this system "killing the economy" even with zero cost improvements is low. At most, tax revenue would have to increase by 3 or 4%.

Third, the CBO scores this as saving money vs. the status quo of doing nothing - about 138 billion over that same period of 10 years, and over a trillion in the decade after that. It certainly doesn't save as much as I would like, or as much as is necessary in the long term, but discussing this bill as a net cost is probably deceptive.

But yes, this is a historic moment. Health care was famously untouchable. Now finally the ball has started rolling.

-Jester

[eppie]

I disagree with you on several fronts. First, your title is misleading - this is not universal health care.

Second, 938 billion dollars in the first 10 years amounts to only 93.8 billion dollars annually. The government budget, even in a normal year with no stimulus, is somewhere in the neighbourhood of three trillion dollars. The chances of this system "killing the economy" even with zero cost improvements is low. At most, tax revenue would have to increase by 3 or 4%.

Third, the CBO scores this as saving money vs. the status quo of doing nothing - about 138 billion over that same period of 10 years, and over a trillion in the decade after that. It certainly doesn't save as much as I would like, or as much as is necessary in the long term, but discussing this bill as a net cost is probably deceptive.

But yes, this is a historic moment. Health care was famously untouchable. Now finally the ball has started rolling.

-Jester

My information came mainly from an article in a dutch online newspaper. They quoted republicans who were concerned about the huge costs.

[Jester]

My information came mainly from an article in a dutch online newspaper. They quoted republicans who were concerned about the huge costs.

And what, if the Republicans say it, it must be right? :rolleyes:

Republicans stand to gain politically from this bill being defeated. If the Democrats, already suffering in the polls thanks to the economy, put their weight behind a high-profile program like this, only to see it fail, the Republicans would gain a major advantage in the 2010 elections. It happened before, with the Clintons, and it could have happened here. The Republican strategy was to make this the Dems' "Waterloo". Their critiques are not, in my opinion, motivated by a reasonable estimation of the costs and benefits of this program, but primarily by ideology, political pressure from their base ("tea parties") and the zero-sum nature of a two-party electoral system. If the Dems lose, the Reps win.

-Jester

[--Pete]

Hi,

And what, if the Republicans say it, it must be right? :rolleyes:

Of course! They were right about yellow cake uranium and WMD, weren't they? How could you possibly imply that people who support family values and religion could possibly lie? :lol:

Of course, knowing the truth might be a bit difficult. First, who really knows what's in the bill -- I doubt that more than a handful of people outside the lobbies have actually read it. As to its cost, estimates supported by conjectures based on guesses (from both sides).

Much like Magna Carta, it changes little yet it changes everything. Lets hope fruition takes less than six centuries this time. :whistling:

--Pete

[kandrathe]

Second, 938 billion dollars in the first 10 years amounts to only 93.8 billion dollars annually.

The accounting trick on this bill is that the benefits are delayed four years, but the increases in taxes begin immediately. After that, it becomes unsustainable.

But yes, this is a historic moment.

Perhaps infamous. 38 states are moving forward to the supreme court with a challenge to this laws constitutionality. The largest issue, which we talked about earlier, is that the federal government is forcing the citizens to purchase a service. The progressive don't really care about that part either, since if the court strikes down that part of the law, it just undoes the "favor" that private insurance had in the bill, and forces them into bankruptcy sooner.

[Chesspiece_face]

38 states are moving forward to the supreme court with a challenge to this laws constitutionality.

I'd love to know where you get your numbers on this. From what I've seen 3 state AGs are talking about this. South Carolina, Virginia, and Florida. Quite different than 38.

[eppie]

The largest issue, which we talked about earlier, is that the federal government is forcing the citizens to purchase a service.

Yes I read this too.
This seems just conservative dogma to me.

I guess you agree with them Kandrathe, so I ask you.

Is it really such a disaster to force people to take a health insurance? Or is it just appealing to people's problems with spending money (on things other than huge flat screen TVs) to try and get more votes?

[kandrathe]

Is it really such a disaster to force people to take a health insurance?

It seems somewhat anti-freedom, don't you think? Is your argument that we need to force people to do what you think is proper for their own good? I believe almost everyone in the US sees the evidence of a systemic problem, in the run away cost of health insurance, and the percentage of people who either opt out, or can't afford it.

Every act of force by government will have unforeseen consequences. Some percentage will be forced into an already struggling Medicaid system (resulting in shortages of care). There is a huge cut in Medicare (for the elderly), which result in rationing care to the elderly. And, since no one can be denied coverage anymore, "insurance" is no longer the word we should use to describe the product. It's now merely a health care bureaucracy that you must pay for whether you use it or not. Prices of all plans will need to increase, and rigorous health screening will become part in parcel of being accepted to a plan (including DNA screening). The government doesn't need to offer their own public option, if by force of law they convert all private options into de facto public options by legislating who and what the health care plans cover.

Next, we will need to enforce that everyone exercises the proper amount, and eats only nutritious food. We had prohibition here once, and we have an idiotic "war" on drugs. And, lately, the "cold war" on tobacco.

What else might we force people to do? Let's see, consume less energy? Have no more than two children? Those might be popular enough to grind through the sausage mill of Congress.

[Jester]

The accounting trick on this bill is that the benefits are delayed four years, but the increases in taxes begin immediately. After that, it becomes unsustainable.

The projected savings actually increase after the first 10 years, do they not? In what way would that be unsustainable, at least relative to the status quo?

Perhaps you'll have to show me in some more detail what this "accounting trick" entails.

Perhaps infamous. 38 states are moving forward to the supreme court with a challenge to this laws constitutionality.

You mean that some random Republican legislator in each of 38 states has put forward the idea? Because that's a long, long way from 38 states "moving forward to the supreme court with a challenge." Pending bills are like being nominated for a Nobel Prize - any idiot can put an idea in the ring. The question is whether it goes anywhere.

The largest issue, which we talked about earlier, is that the federal government is forcing the citizens to purchase a service. The progressive don't really care about that part either, since if the court strikes down that part of the law, it just undoes the "favor" that private insurance had in the bill, and forces them into bankruptcy sooner.

I don't like the individual mandate, but without some form of single-payer, which is far and away my preference, it is a necessary component of reform. Otherwise, adverse selection will destroy the system before it gets off the ground. If that is unconstitutional, then I suggest that a lot of states need to take a long, hard look at their auto insurance legislation. Not to mention the government "forcing" people to buy all sorts of stuff they don't want, through taxation. Did the good folk of Massachusetts really want the Iraq war? I somehow doubt it, and yet, they own it just the same as the rest of the country.

-Jester

[kandrathe]

I'd love to know where you get your numbers on this. From what I've seen 3 state AGs are talking about this. South Carolina, Virginia, and Florida. Quite different than 38.

11 are poised to do something as soon as it is signed (Virginia, Florida, South Carolina, with Alabama, Nebraska, Texas, Pennsylvania, Washington, Utah, North Dakota, and South Dakota signing on in support), and the others I've heard are contemplating challenging the unfunded mandate on the States in increasing medicaid enrollment without providing funding.

[Vandiablo]

Is it really such a disaster to force people to take a health insurance? Or is it just appealing to people's problems with spending money (on things other than huge flat screen TVs) to try and get more votes?

This is Van Diablo's wife, not the big V himself. Pardon me for intruding, but I just can't help myself.

I can't speak for a lot of the bill (I gotta admist I lost interest around page 153), but I digress.

I agree that it seems unAmerican to force someone to purchase a particular product, but I look at this in the reverse. It is NOT taking away a person's liberty to use the tax code to entice a person to take a certain action (like purchasing energy saving appliances or any other the other three million things you can tax credits for).

Uninsured people have direct financial and social costs to society. The cost of indigent care is burdensome to hospitals (and to the states that subsized them). ERs are overcrowded by those who use them as primary care, rather than care of last resort.

Don't want to purchase health insurance? No problem. Just help us defray the costs associated with that risky choice.

[kandrathe]

If that is unconstitutional, then I suggest that a lot of states need to take a long, hard look at their auto insurance legislation.

There is a difference. If you want to have the privilege of driving a car, then you can be mandated to own liability insurance, have a proper registration on the vehicle, and be tested on knowing how to drive. If you don't want to buy insurance, then no one is forcing you to drive the car in the first place.

Not to mention the government "forcing" people to buy all sorts of stuff they don't want, through taxation.

Now you are talking my language! :) I agree, the government probably does spend too much money on things that are only popular with and only benefit a few, and therefore should not be a part of government. This kind of pork get slipped into needed legislation as amendments all the time.

Did the good folk of Massachusetts really want the Iraq war? I somehow doubt it, and yet, they own it just the same as the rest of the country.

The vote in the House was 297 for /133 against (2 of 9 Reps in MA supported it), and in the Senate it was 77 for / 23 against. Sen. Kennedy was one of the senators who opposed it.

Interesting choice of state. My states congressional representatives were more unanimous than Massachusetts in opposition to the war, including both our Senators (Wellstone and Dayton). They are one of the states who are generally opposed to Obama-care, as it will probably mess up their own version of universal health coverage.

[Delc]

There is a difference. If you want to have the privilege of driving a car, then you can be mandated to own liability insurance, have a proper registration on the vehicle, and be tested on knowing how to drive. If you don't want to buy insurance, then no one is forcing you to drive the car in the first place.

So you would be ok if instead of requiring everyone to buy insurance, they just required people to buy it before they would have the privilege of going to the hospital?

[kandrathe]

So you would be ok if instead of requiring everyone to buy insurance, they just required people to buy it before they would have the privilege of going to the hospital?

No. That would be putting words into my mouth.

The consequence of not having insurance is that you may get sick, and either be given inadequate medical care and die, or end up owing a huge amount of money, and perhaps needing to declare bankruptcy. These are two very unhappy consequences for those people who risk not having any form of health insurance.

Even with automobiles, or owning a house, if you are determined to be liable for something beyond the limit of the policy, then you may lose everything.

The better (more accurate) question is; Should government prevent any bad outcomes? Should the government use all the resources at its disposal to attempt to preserve and prolong the lives of all sick people regardless of cost?

[Jester]

There is a difference. If you want to have the privilege of driving a car, then you can be mandated to own liability insurance, have a proper registration on the vehicle, and be tested on knowing how to drive. If you don't want to buy insurance, then no one is forcing you to drive the car in the first place.

Nobody is forcing you to buy health insurance, either. If you don't want to buy it, then don't earn enough income to cross the threshold beyond which you would be fined for not buying it. (You don't have to pay taxes either - just don't own anything, earn anything, or spend anything.)

Not realistic, you say? Not a real option? So is not driving, at least in most states, for most people.

Interesting choice of state. My states congressional representatives were more unanimous than Massachusetts in opposition to the war, including both our Senators (Wellstone and Dayton). They are one of the states who are generally opposed to Obama-care, as it will probably mess up their own version of universal health coverage.

Massachusetts just came to mind first. Certainly there were others. However, in my defense, what you say is not true: Massachusetts had a much larger share of their representatives vote against the war. Minnesota just had both Senators.

As Brad DeLong never tires of pointing out, Obama-care is almost identical to Romney-care. You couldn't have crafted a more "moderate Republican" proposal if you tried - no funds for abortion, no public option, no hint of single payer, almost nothing contrary to the interests of health companies at all. Massachusetts likes their health care, and I suspect the rest of the US is going to come to like their very similar care quite soon. But "we've got ours, screw you guys" is not a great argument against health care reform.

-Jester

[Chesspiece_face]

The consequence of not having insurance is that you may get sick, and either be given inadequate medical care and die, or end up owing a huge amount of money, and perhaps needing to declare bankruptcy. These are two very unhappy consequences for those people who risk not having any form of health insurance.

Even with automobiles, or owning a house, if you are determined to be liable for something beyond the limit of the policy, then you may lose everything.

Oh, if it were only this blindingly simple. Unfortunately when an individual or family faces these consequences their effects are not isolated and it has repercussions across everyone, even people who are diligently paying for insurance and taking wonderful care of their health.

The better (more accurate) question is; Should government prevent any bad outcomes? Should the government use all the resources at its disposal to attempt to preserve and prolong the lives of all sick people regardless of cost?

No, that is unequivocally not a better question. And it's so laden with ideology and hyperbole that the idea of it being more accurate borders on laughable. The real question underlying this is; Does the government have the power, through taxation, mandates, and regulation to promote behavior which it finds to be individually and socially beneficial. I'm sure you will find that the resounding answer to this question is yes.

A corrollary question would be; Should the government have this power? I'm sure you would answer no. I disagree.

To quote Howard Zinn: "The Constitution set up big government, big enough to protect slaveholders against slave rebellion, to pay off bondholders, to pass tariffs on behalf of manufacturers, to tax poor farmers to pay for armies that would then attack the farmers if they resisted. ...Big enough to use the armed forces to clear Indians off their land, to put down labor uprisings, to invade countries in the Caribbean for the benefit of American growers, bankers, investors. This was very big government. "Big government" in itself is hardly the issue. That is here to stay. The only question is: Whom will it serve?"

[Ashock]

Ahh, Obama, Pelosi and Reid. Lenin, Trotsky and Dzerzhinsky of the 21st century.

Enjoy the fruits of their labor, you naive children.

[Jester]

Ahh, Obama, Pelosi and Reid. Lenin, Trotsky and Dzerzhinsky of the 21st century.

Enjoy the fruits of their labor, you naive children.

Yes... because... they totally overthrew the government... and set up a secret police that killed millions of people...

Oh, I get it. They're "leftists". I guess that's just an undifferentiated point on the horizon, from wherever you sit?

-Jester

[--Pete]

Hi,

Should the government use all the resources at its disposal to attempt to preserve and prolong the lives of all sick people regardless of cost?

Putting aside your exaggerated use of 'all', that is a bridge long crossed and burned. Right or wrong (and that's a different topic), we as a society have already decided to take on the burden for everyone's health care. That's ancient history -- if you wish to fight that battle, then you'll need a time machine. The question is how do we minimize those costs, because we're not going to totally avoid them. We could do nothing until the situation explodes. We could actually look around at what really works in the real world and 'solve' this problem (insofar as it is solvable). Or we can try to please everyone and come up with a completely lame plan, which at least opens the door to a real solution.

Should the government do it? Doesn't matter. Right or wrong it *is* doing it. So, within the parameters of the possible, the real question is how should the government do it.

--Pete