Colorado Representative Betsy Markey has announced that she will vote yes on the health care reform bill on Sunday, following her no vote last November. The new CBO numbers that were released this week apparently had a lot to do with her decision; she stated that reducing the deficit by “$138 billion in the first 10 years, $1.2 trillion in the second 10 years — those are figures I simply cannot ignore.” The CBO numbers are better than expected, and will likely convince some fence-riding Democrats to vote for the bill. Another Colorado Representative, John Salazar, has also announced that he will support the bill this weekend.
In the Health Wonk Review this week, an article by Joe Paduda pointed out that the current health care reform bill might be built on fantasy, since it was mainly focused on expanding coverage, without a lot of substance directed at cost containment. And ultimately, such a structure isn’t sustainable. I agree with Joe, and believe that we have to aggressively address the issue of health care cost. But since we have so many people who have no health insurance and are dying as a result, it seems that we have to tackle the access to care issue first, and then figure out the money part – those people simply don’t have time for us to spend years working on cost containment before we expand access to care. And according to the CBO, it looks like the changes that were made in the compromise version of the bill will end up making health care reform more sustainable and affordable than it has looked so far.
The new CBO numbers predict a large long-term deficit reduction, partially because the bill was amended to address paying for health care by slowing the growth of government subsidies, and increasing the growth of excise taxes to pay for the reform. As Ezra Klein points out, doing things that constituents might not like in the short term, but that solve problems in the long run, is what governing is all about. Nobody said it’s easy, but sometimes it’s got to be done.
{ 17 comments… read them below or add one }
Sorry to wake you from the illusion that our Colorado representatives Markey and Salazar have been swayed by the CBO numbers, but the truth is that their vote decisions are based on rather cynical political calculation. They both understand the power of the Speaker and also realize that a “No” vote would make the rest of their short tenure in Washington very unpleasant. Oh and did I mention that if they want jobs with the administration after they’re voted out they’d better fall in line?
You must know that the CBO numbers are based on faulty assumptions. If we can save 400-500 billion from Medicare, why isn’t that already being done? The program could use some financial help to face its looming deficits. Additionally, if the cost of undocumented workers and the “Doc Fix” were included it would probably turn this “reform” negative by about 700 billion over 10 years.
If representatives Markey and Salazar were actually worried about covering the great masses of uninsured residents, they’d be pushing to include undocumented aliens under the current bill. They’d also be advocating for an earlier start date than the current phase-in schedule. No, their decisions were based on pure political calculation and support a path of deception to move us closer to a Single Payer system.
It has never been about health care, its about control and power. Health care is not a right, no other right we have needs anyone elses partipation to enjoy it. The so called healthcare take over is just a way to limit our liberty, and force us into slavery(working and paying for those who don’t)
Jim,
I agree that the CBO numbers are likely flawed in some way. From what I’ve read on the subject, it is virtually impossible to come up with a completely accurate projection for the financial impact of such a wide ranging bill over multiple decades. With that said, I can’t think of anyone I would trust to come up with more accurate numbers than what the CBO has put together. Anyone with a vested interest in the outcome of the legislation (ie, Democrats, Republicans, grass roots organizations aimed at promoting or blocking the bill, and any person or business with a strong opinion one way or the other about health care reform) is likely to come up with biased figures, or to focus on the financial aspects of the reform that best suit their position. The CBO numbers might be flawed, but who would do a better, unbiased job of coming up with more accurate numbers?
“no other right we have needs anyone elses partipation [sic] to enjoy it”
For starters:
1) Fire protection
2) Police protection
3) Military protection
4) Legal representation
Is there any way to opt out of paying for these if I don’t want to use them?
Louise:
In response to your question about “who” other than CBO might do a better job in scoring the numbers, I submit that it’s not CBO that is in question here, it’s the process. The CBO does the job it is assigned to d and does it as best they can given the constraints under which they work. Recently Rep. Mike Coffman noted that in the Colorado legislature bills are scored to determine their fiscal impact on the state. In that process, the underlying assumptions may be questioned. In the U.S. Congress, assumptions that are made cannot be questioned by CBO. So, when Congress says that it will pay for a bill by “saving 400+ billion from Medicare, CBO must include that assumption in the score whether or not its credible. The current bill, H.R. 3590 assumes that the “Doc Fix” doesn’t expsit (even though Democratic have promised future legislation with a $371 billion price-tag to fix it. H.R. 3590 also assumes that undocumented aliens will have no effect on the cost of health care. How many billions df cost does that ignore? These assumptions are intellectually dishonest and make the CBO numbers a sham. It doesn’t matter who scores a lie. It’s still a lie.
BTW…
Louise…. Thanks, for hositng the debate. I’ll work on my typing.
jls
“no other right we have needs anyone elses partipation [sic] to enjoy it”
For starters:
1) Fire protection
2) Police protection
3) Military protection
4) Legal representation
Is there any way to opt out of paying for these if I don’t want to use them?
Fire protection is the jurisdiction of the county or fire district.
Police protection is the jurisdiction of the city/state/county.
And, yes, if enough people within a jurisdiction opted to eliminate these services, it certainly could be done. In many places there are still volunteer fire departments, and in small towns/counties, many times the position of sheriff is unpaid.
These services protect all citizens equally, with payment being primarily based on property taxes. People pay proportional to the value they have to protect. You can opt out, for the most part, by not owning property or by moving to another jurisdiction.
Police and Fire protections are not, in fact, rights. They are services that citizens within a jurisdiction have opted to fund by taxing themselves because of an overall greater perceived benefit than the cost.
Military protection is both a mandate of the Constitution, and enjoyed by all citizens equally.
Free legal representation is as a result of court decisions, not any Constitutional mandate – purportedly fulfilling the legal theory behind the equal protection clause of the 14th Amendment.
Medicine, on the other hand, is an individual for-fee service provided by doctors to people who opt to pay for the service. Medicine is possible because of the large amount of knowledge, training, experience and labor of physicians.
It would be ridiculous for a fireman or policeman to negotiate a fee at the site of a fire or the scene of a crime.
However, it is not so ridiculous for a physician to negotiate the price of care with you.
It is about the market effects of the law. These will ultimately deny (because of the inevitability of single-payer and subsequent rationing) citizens capable and willing to pay for services the ability to pay for those services.
Transferring the costs to taxpayers also provides a benefit to those who then have no incentive to remain healthy – because they incur no penalty for not doing so. In fact, the more unhealthy they become, the greater the amount of services they receive.
Each taxpayer incurs a double-burden, because they must pay not only for themselves, but for another individual’s health care as well (or fraction of an individual), but without any say as to how the other individual lives their life.
Medicine requires a provider – someone who expends their labor, thought, wealth, and time providing a service. What someone else produces, quite simply, cannot be your right.
Proclaiming that a service provided by another is a right prohibits the provider from engaging freely in the exchange of that service. Rather, they are forced to provide their services to the person claiming the right.
In fact, any claim to what someone else must provide as your right makes the other person a slave and it makes you the slaver. Without the other person to provide the service or give up their property, your right cannot be provided.
By claiming such rights, you may not perceive that you are engaging in slavery directly – and therefore somehow feel relieved of such crimes. However, if you have engaged your government to force others to provide services to you, all you have done is hired out the wet work to men with a lot of guns.
Sometimes the law defends plunder and participates in it. Thus the beneficiaries are spared the shame and danger that their acts would otherwise involve… But how is this legal plunder to be identified? Quite simply. See if the law takes from some persons what belongs to them and gives it to the other persons to whom it doesn’t belong. See if the law benefits one citizen at the expense of another by doing what the citizen himself cannot do without committing a crime.
- Frederic Bastiat
Besides, the idea behind “you can live here if you pay a fee, otherwise you go to jail” is a little outrageous, don’t you think?
DEA, FBI… do republicans/tea baggers have a problem with these? How is marijuana legal in Denver and some jurisdictions in California, but the first person you will hear tell you “it’s still illegal under federal law” is a pro-gun rights republican?
Emergency room doctors don’t negotiate the prices and how or even if you will pay while they are treating you. There is an expensive process to negotiate it after they’ve treated you. Or, they write it off and pass the costs on to other people. Either way, it gets paid.
And say fire and police protection were currently private only, and the ‘individual for-fee service‘ fire and police providers had to have staff and resources getting the money from people the same way emergency room doctors and physicians do now. Now say there was a bill being passed to make fire and police protection just the exact same as it is now…
My guess is you’d be against it and call it ‘socialism’ or ‘slavery’ – You might say I’m wrong, but I don’t think so.
Frankly, I am not a “teabagger” – never have been to a demonstration. However, I do find the use of the term pejorative and that it goes a long distance towards discrediting the speaker/writer. It reminds me too much of a particular racial slur – and I am positive that in most cases, it carries the same degree of disparagement. Nor am I a Republican.
I believe the war on drugs is a ridiculous waste of money and, in fact, has resulted in more deaths than the Vietnam war (both sides of it)… most of those innocent bystanders, mules, and victims of the fuedal system imposed in drug producing nations.
Yet another example of the failure of government to regulate behavior of factually free people.
Either way, it gets paid.
Not true. Hospitals, on average, collect 4% of fees billed to uninsured patients.
Emergency care represents 3% of all health care expenditures.
http://www3.acep.org/patients.aspx?id=25902
So, let me revise and extend my remarks:
However, in 97% of all cases, it is not so ridiculous for a physician to negotiate the price of care with you.
Now say there was a bill being passed to make fire and police protection just the exact same as it is now.
I guess that if the federal government were doing it, yes, I would call it socialism and slavery – because firemen and policemen would not have the ability to negotiate rates of pay with a local jurisdiction – their fellow citizens – but rather would be forced to accept what some nameless, faceless bureaucrat in one of the 88,000 federal government agencies says they must. They can either eat that dirt, or find another job.
And citizens would have no voice in defending themselves against the abuses of police or the incompetence of firemen because both would be accountable to the people paying the bill, not the people from whom the money to pay it was extracted.
Perhaps you have forgotten that the lack of a voice – or anyone willing to listen to it – and the desire for autonomous representation was the reason the revolution was fought in the first place.
It’s not about “public” health care. It is about having control over one’s own existence – their life and health.
In our not-so-distant past, rural communities would collect taxes or fees from everyone so they could bring in a doctor – who would make the rounds from village to village. That, was, in fact, public health care.
They would do the same with teachers, to build public structures such as town squares, courthouses, and the like.
But the local citizens had the right to go to the town hall meeting and suggest that perhaps they should look for another doctor or teacher for whatever reason. There existed both a voice, and responsive accountability.
In those cases, citizens were dealing with neighbors, friends, extended family, and the elected officials/magistrates who presided over the meetings were accountable to them and, more importantly (in a quaint and nostalgic remembrance of ethics and moral obligation) felt a sense of duty to them.
I realize that such a time is long gone and we’re lucky if we even know the name of our next door neighbor.
However, in contrast, under the new public health care regime, though I will be free to rage against the establishment all I want if I am harmed by it, it will do me as much good as boxing with the wind (unless I am a heavy campaign contributor to some politician).
It’s not about the “publicness” of the endeavor, it’s about to what degree people involved in the transaction can engage freely and have a voice in the exchange, and it is about how much control and influence I am able to exert over the only thing I truly have: my life.
It is incredible how as soon as a people become subject, it promptly falls into such complete forgetfulness of its freedom that it can hardly be roused to the point of regaining it, obeying so easily and willingly that one is led to say that this people has not so much lost its liberty as won its enslavement.
- Etienne de la Boetie
DH – There has been a lot of extreme talk thrown around over the course of the last couple years regarding health care reform, and I believe that a lot of the aspects of reform have been so twisted (by both parties) that it’s hard to separate fact from fiction anymore. But one thing that I think is very important to note is that the health care reform bill includes only a tiny amount of expansion of government-run health insurance (making more people eligible for Medicaid). Most of the changes will take place within the private sector, which will continue to be private. Doctors are not going to become federal employees, nor will health insurance companies be owned by the government.
People will still have complete choice in terms of whether they want to get into the medical profession (or any profession within the health care industry), and most of those people will continue to work for private companies.
Louise,
I don’t understand your optimism that implies that you believe this is somehow the last bill that will ever pass and the last encroachment on our rights on this issue.
Numerous politicians on the left, including Mr. Obama himself, have stated that this is the first step towards a single payer system – and that a single payer system is, in fact, what they desire. (Mr. Obama stating prior to his election that incremental steps will be required).
Several (on the left) have stated with glee that this will put health insurers out of business – and that is the intent of it.
I can look up the links on YouTube and post them here if you’d like – in their own words.
What I find truly befuddling is that people seem to be OK with being forced – on penalty of fine and ultimate imprisonment – to purchase a product/service. If the Supreme Court allows that to stand, then there is no limit to what the government can force you to buy. Nor is there a limit to what the government can force you to eat, for example, since what you eat effects your health, and your health is now a matter of interstate commerce and under the direct purview of Congress.
The only other time I know of in our history where individuals were mandated to engage in forced economic activity was when slavery was still legal (and I’m not saying that to be inflammatory… I majored in American history, and there is no other instance I have been able to find). Even the CBO stated that this is a the largest historical increase in scope of the interstate commerce clause.
That’s for starters.
But ultimately, it does not matter. At the current rate of monetary inflation and debt expansion, the United States is economically viable through 2014 at the latest.
Moody’s certainly thinks so. So does the founder of ShadowStats: http://www.shadowstats.com/article/hyperinflation-2010
Perhaps people don’t realize that 1.4MM in nominal obligations per taxpayer – before health care reform is factored in – is numerically impossible to pay off. The government could confiscate 100% of domestic production for the next six years and still not pay off the debt. They will have to do the equivalent through monetary inflation and/or taxation in order to do so. We all will pay, one way or another.
Not too optimistic of an outlook, I know.
DH,
Were you predicting doomsday when Bush ruined Clintons surplus and exploded the deficit? Were you writing angry comments on the internet about the Patriot Act, Faith Based Initiatives, and the invasion of Iraq? The Obama administration is still paying for these huge mistakes (the right) got us into.
And I believe you can find the links you talk about. We can all find links these days to ‘prove’ whatever conspiracy theory we want to believe. If you want to believe your shadowstats website, call the number of one of those gold ads you hear on Rush or Fox News and put all of your money in gold. Just save enough to stockpile plenty of guns.
http://www.econbrowser.com/archives/2008/09/shadowstats_deb.html
DH:
Thanks for providing the link to shadow stats.
Much of the statistics are tied to the Bureau of Labor Statistics, which is a good third party.
Louise:
Is there any way I could get DH’s E-mail?
He and I seem to have a lot in common.
Don Levit
Were you predicting doomsday when Bush ruined Clintons surplus and exploded the deficit?
Nice revisionist history… I believe that it was the:
a) bursting of the web bubble in Late 2000/Early 2001 before Bush even took office, and
b) the economic fallout accompanying 9/11
…that tanked federal tax revenues.
Individual Income Tax In Constant 1990 Dollars:
1999 – $714B
2000 – $744B (+4%)
2001 – $655B (-12%)
2002 – $579B (-12%)
2003 – $531B (-8%)
2004 – $575B (+8%)
Source: http://www.irs.gov/taxstats/indtaxstats/article/0,,id=96679,00.html
Which indicates that the tax cuts in 2001, although they had a net, short-term impact on tax revenues, ultimately resulted in a turn-around by 2004 – even with the drug benefit… and another round of cuts in 2003.
Here’s an interesting perspective: http://www.miseryindex.us/urbymonth.asp
It was the drug benefit that pissed me off.
Bush was/is a statist just like any other politician today.
If you want to believe your shadowstats website…
I don’t need to – the facts, ever present and ever ignored by most, do the talking for me.
Both China and Japan are net divestors of debt. We just had a Treasury auction that practically failed – pushing the 10-year bond up to near 4%.
Recall, also, that because of our fractional reserve banking system, the $800B in bailouts, $800B in stimulus ($1.6T) actually become $16T when leveraged fully. Currently much of bank reserves are held on deposit at the Fed. When the banks choose to move back into being creditors, the Fed will not be able to sop up $16T in monetary expansion. That would be a 200% increase in M2 (say goodbye, dollar).
The Japanese see it coming: http://www.bloomberg.com/apps/news?pid=20601109&sid=a_A5nqmw9Dq8
Moody’s talks about the U.S. as if it were a third-world nation.
I’m not predicting anything. I am just observing the trend, putting the numbers in a spreadsheet, and using simple arithmetic projecting the trend forward linearly (like any mutual fund prospectus does).
Then, looking at history for similar trends, I find some startling possibilities.
…
As far as the war in Iraq, I was not particularly for it, nor against it – from a moral perspective. However, I was quite against it from an economic perspective.
I was not a fan of the Patriot Act – but the only part I really have a problem with is the expansions of FISA powers (which is what allowed the warrantless wiretapping).
And, for faith-based initiatives, my belief is that the federal government should not spend on any ideologically-rooted causes – whether it be unions, faith-based initiatives, ACORN, or anything else the promotes a particular ideology.
Also, I don’t think I’ve suggested that there is any conspiracy going on… at least one that is hidden from view. Everyone has (which talking to their political bases – not in public) stated their intent clearly.
It’s not a conspiracy – just an agenda.
@Trosenkoetter,
Regarding ShadowStats:
Here is the original report by the BLS http://www.bls.gov/opub/mlr/2008/08/art1full.pdf
That is, as opposed to someone’s opinion of it.
Second, here is John Williams’ direct response to the BLS report:
http://www.shadowstats.com/article/special-comment
Instead of reading someone’s opinion and using it as gospel or as some sort of demonstration of truth, I would hope that you (and all of my fellow citizens) would seek out the original sources, read both sides, and then make a reasoned judgement.
I, you or anyone can type anything they want – and just because someone echoes something that you want to be true, it doesn’t make it so.
Opinions can’t be true. They can only be consistent or inconsistent with fact and reason.
I personally, find Mr. Williams’ research and explanations to be compelling and generally accurate – both empirically, and without errors of reasoning.
I’m not 100% certain of the accuracy of his models, per se, but his explanation of the skewing of CPI and other numbers makes a lot of sense.
Because he bases his models on the way statistics were calculated prior to political manipulation, I am more apt to lean towards his numbers as being potentially more accurate – or to at least look at the range and make a fair estimate of what is consistent with reality.
Anyway, I hope you’ll actually read those links.
DH
Thanks for the additional information DH. That looks to be an interesting report.
I’m also a lurker at an investment forum called bogleheads. They have an interesting and level headed discussion of the inflation statistics being presented by some of the more bearish economists like shadowstats (shadowstats gets mentioned a few posts in):
http://www.bogleheads.org/forum/viewtopic.php?t=52697&mrr=1270131532
A quote from later in the thread:
“You gotta wonder if these inflation conspiracists are even numerically literate. They claim that real inflation 6%, 7%, even 10%.
Let’s just assume one of the less nutty estimates of 6%. Now, most people are aware that the standard annual wage increase has been about 3%, roughly tracking the CPI number. There’s no conspiracy there — you can see it on your own paycheck. So if inflation were really 6% that means people are getting poorer by 3% per year and also means people’s real income today is one-half what it was 25 years ago.
Is there anyone that really believes that their standard of living has declined by one-half in the last 25 years? If that were true we would today be like our grandparents two generations ago, living in 400 square foot two-room apartments, walking to work and taking the bus, never eating out at restaurants. Instead the opposite has occurred. People have bigger houses, bigger and more cars, and eat at home less than ever. The inflation conspiracy doesn’t even pass the common sense test.”
And DH, facts ARE great, but I think it’s obvious that many of the bearish economists, including shadowstats, are twisting the facts.
Don Levit said: “Much of the statistics are tied to the Bureau of Labor Statistics, which is a good third party.”
I agree that the BLS is a good third party. I’ve also read the original report posted by DH above. My take is that the shadowstats statistics are NOT actually tied to the BLS statistics. They’ve been spun. The BLS link you gave, if you read it, is really a debunking of the shadowstats article. Greenlees and McClelland, the writers of the BLS article have said so many times themselves.
Shadowstats strikes me more as an economist with a political axe to grind, not an economist interested in determining facts from statistical data.