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Archive for Friday, July 31, 2009

Obama lowers sights on care reform

July 31, 2009

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— Yesterday, Barack Obama was God. Today, he’s fallen from grace, the magic gone, his health care reform dead. If you believed the first idiocy — and half the mainstream media did — you’ll believe the second. Don’t believe either.

Conventional wisdom always makes straight-line projections. They are always wrong. Yes, Obama’s aura has diminished, in part because of overweening overexposure. But by year’s end he will emerge with something he can call health care reform. The Democrats in Congress will pass it because they must. Otherwise, they’ll have slain their own savior in his first year in office.

But that bill will look nothing like the massive reform Obama originally intended. The beginning of the retreat was signaled by Obama’s curious reference — made five times — to “health-insurance reform” in his July 22 news conference.

Reforming the health care system is dead. Cause of death? Blunt trauma administered not by Republicans, not even by Blue Dog Democrats, but by the green eyeshades at the Congressional Budget Office.

Three blows:

1. On June 16, the CBO determined that the Senate Finance Committee bill would cost $1.6 trillion over 10 years, delivering a sticker shock that was near fatal.

2. Five weeks later, the CBO gave its verdict on the Independent Medicare Advisory Council, Dr. Obama’s latest miracle cure, conjured up at the last minute to save Obamacare from fiscal ruin, and consisting of a committee of medical experts highly empowered to make Medicare cuts.

The CBO said that IMAC would do nothing, trimming costs by perhaps 0.2 percent. A 0.2 percent cut is not a solution; it’s a punch line.

3. The final blow came last Sunday when the CBO euthanized the Obama “out years” myth. The administration’s argument had been: Sure, Obamacare will initially increase costs and deficits. But it pays for itself in the long run because it bends the curve downward in coming decades.

The CBO put in writing the obvious: In its second decade, Obamacare significantly bends the curve upward — increasing deficits even more than in the first decade.

This is obvious because Obama’s own first-decade numbers were built on arithmetic trickery. New taxes to support the health care plan begin in 2011, but the benefits part of the program doesn’t fully kick in until 2015. That excess revenue is, of course, one time only. It makes the first decade numbers look artificially low, but once you pass 2015, the yearly deficits become larger and eternal.

Three CBO strikes and you’re out cold. Though it must be admitted that the White House itself added to the farcical nature of its frantic and futile cost-cutting when budget director Peter Orszag held a three-hour brainstorming session with Senate Finance Committee aides trying to find ways to save.

“At one point,” reports The Wall Street Journal, “they flipped through the tax code, looking for ideas.” Looking for ideas? Months into the president’s health care drive and just days before his deadline for Congress to pass real legislation? You gonna give this gang the power to remake one-sixth of the U.S. economy?

Not likely. Whatever structural reforms dribble out of Congress before the August recess will likely not survive the year. In the end, Obama will have to settle for something very modest. And indeed it will be health-insurance reform.

To win back the vast constituency that has insurance, is happy with it, and is mightily resisting the fatal lures of Obamacare, the president will in the end simply impose heavy regulations on the insurance companies that will make what you already have secure, portable and imperishable: no policy cancellations, no pre-existing condition requirements, perhaps even a cap on out-of-pocket expenses.

Nirvana. But wouldn’t this bankrupt the insurance companies? Of course it would. There will be only one way to make this work: Impose an individual mandate. Force the 18 million Americans between 18 and 34 who (often quite rationally) forgo health insurance to buy it. This will create a huge new pool of customers who rarely get sick but will be paying premiums every month. And those premiums will subsidize nirvana health insurance for older folks.

Net result? Another huge transfer of wealth from the young to the old, the now-routine specialty of the baby boomers; an end to the dream of imposing European-style health care on the U.S.; and a president who before Christmas will wave his pen, proclaim victory and watch as the newest conventional wisdom reaffirms his divinity.

Comments

exhawktown 5 years, 1 month ago

I only hope Charles is right about the "end to the dream of imposing European-style health care on the U.S." but I don't think we're there.

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exhawktown 5 years, 1 month ago

Do you support "single payer" health care?


This is definitely worth a look if you care about this issue, whatever side you're on.

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exhawktown 5 years, 1 month ago

I think most people are against the notion of "single payer" health care at this point. I think many people think conservatives are paranoid about a health care bill that would emerge from this administration and congress. If you look at the above link, you'll see that it's not paranoia. Barney Frank admits single payer health care is a goal of his, and if it takes a watered down bill to start the process, so be it. And so it begins.

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just_another_bozo_on_this_bus 5 years, 1 month ago

" Yesterday, Barack Obama was God. Today, he’s fallen from grace, the magic gone, his health care reform dead. If you believed the first idiocy — and half the mainstream media did — you’ll believe the second."

When a piece starts with a straw man like that, you know there's nothing but idiocy to follow.

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Flap Doodle 5 years, 1 month ago

The Cash for Clunkers program is in deep trouble already. Do you really want the Feds to run health care in America?

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exhawktown 5 years, 1 month ago

Idiocy is not fully understanding what you read. Idiocy is not reading a bill before you vote on it. Idiocy is placing in the hands of someone else full power and control over your life.

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SettingTheRecordStraight 5 years, 1 month ago

Liberty One,

You stated it perfectly. It's time to reduce the size, reach and rake of government at all levels, and it's time to lower taxes on all wage earners.

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jaywalker 5 years, 1 month ago

Wow. Exhawk, snap, Liberty, and STRS all stated exactly what I was gonna say.

Government need be smaller, not swollen even more by absorption of a program they can't possibly run efficiently. The Postal system, Social Security, Medicare.....massive failures. Do we really want the 'organization' that couldn't execute the digital cable box change-over with more than a year to implement it to sink their hands into the guts of healthcare? A billion dollars for "Cash for Clunkers"...........and six days in they're out of money AND stymied by a "backlog of red tape". In six days?!!!?

Something need be done with healthcare, but the first step needs to be focusing on the right problem which is cost. If there's any question whether our government should be given the reins of the healthcare system, it should be answered immediately by noting they're not working on the prudent issues. A billion here, a trillion there.........throwin' money at the problem...that's exactly how Enron operated. And imploded.

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Richard Heckler 5 years, 1 month ago

Medical insurance increases = increased cost of living across the board just like high dollar gasoline.

Looks like 2010 will be a very expensive year no matter how insurance gets paid if nothing changes.

Read this tidbit this AM

“In front of me I have a document from my employer that shows their cost for insurance.

Medical, Dental and Vision for the year 2010 my employer will pay $15,450. I will pay another $2860 out of my pay check. $18,310 a year for insurance is ludicrous, and we wonder why so many companies are having massive layoffs.

It is a real travesty that nothing is going to happen in the near future on health care.”

Based on what I've been reading $18,310 seems like a stiff increase. After spending $1.4 million health care dollars a day to for expensive commercials aka misinformation and special interest campaign dollars aka bribery the industry must recoup some large profits. Guess who gets to pay it back?

high dollar medical insurance spending on what 1,500 health insurers add to the actual cost of providing care: • its bureaucracy • profits • high corporate salaries • advertising over charges • sales commissions • Shareholders ! are the primary clients of for-profit insurance companies, not patients • Special interest campaign dollars Golden parachutes * Politicians as shareholders: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html

Current White Collar Crime: Medicare Fraud Indictments http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401906.html

Senate Report Finds Insurers Wrongfully Charged Consumers Billions http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html

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Richard Heckler 5 years, 1 month ago

The problem is we DO NOT have the best insurance coverage in the world.

According to the CBO HR 676 is the only proposal that DOES save dollars. Yes in fact $350,000,000,000(billion). HR 676 is the only proposal with 86 co-sponsors. Yet the media,the white house and too damn many legislators pretend this bill does not exist.

So what would the new Medicare For ALL Insurance offer to americans 365 days a year,24/7,employed or not,moving on to a new job or not,single mom or not,struck down with cancer or not?

What would a new Medicare Insurance Plan cover 365 days a year 24/7?

A family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. About $225 per month. Today the below insurance coverage actually costs about $1,100 per month.

  • long term care such that cancer would require
  • prescription drugs
  • hospital
  • surgical
  • outpatient services
  • primary and preventive care
  • emergency services
  • dental
  • mental health
  • home health
  • physical therapy
  • rehabilitation (including for substance abuse)
  • vision care
  • hearing services including hearing aids
  • chiropractic
  • durable medical equipment
  • palliative care

A family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. About $225 per month. Today the above insurance coverage actually costs about $1,100 per month.

HR 676 ends deductibles and co-payments. If a deductible and/or co-pay policy is in effect this usually indicates under-insured.

HR 676 would save hundreds of billions annually by eliminating the high overhead of the private health insurance industry and HMOs. The privatized medical insurance industry is anything but efficient.

HR 676 contains costs and saves about $350,000,000,000 annually. But special interest politicians don't want to talk about HR 676. So they present bills that will increase the cost. Why? Special interest campaign funding(the industry) is writing those bills.... foxes in the chicken coop!

Changing nothing certainly will save nothing ever!

Senate Report Finds Insurers Wrongfully Charged Consumers Billions = BIG TIME CORRUPTION http://www.washingtonpost.com/wp-dyn/content/article/2009/06/24/AR2009062401636.html

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just_another_bozo_on_this_bus 5 years, 1 month ago

exhawktown said-- "I think most people are against the notion of “single payer” health care at this point."

Actually, most polls on this question state exactly the opposite. And a majority of doctors favor it as well.

It's easy to rail against the evils of government, but the worst evils of government are self-fulfilled prophesies, created by people who are using government to rip off taxpayers, and almost all of these folks are self-described "conservatives" and supporters of the "free market."

But for all the fear-mongering about government healthcare, our current system of private healthcare is the most expensive in the world, by almost double that of other industrial democracies, and it fails to provide adequate coverage to nearly 1/3 of our population. We could enlist a bunch of chimpanzees to come up with a better system than what we currently have.

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Richard Heckler 5 years, 1 month ago

WHAT INCREASES THE COST OF MEDICAL INSURANCE? high dollar medical insurance spending on what thousands of health insurers add to the actual cost of providing care: • its bureaucracy • profits • high corporate salaries • advertising over charges • sales commissions • Shareholders are the primary clients of for-profit insurance companies, not patients! • Special interest campaign dollars Golden parachutes Politicians as shareholders: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html

What increases the cost of medical insurance? The medical insurance industry and the majority of legislators( they love corrupt campaign money and dividends from stock).

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just_another_bozo_on_this_bus 5 years, 1 month ago

"Why not try deregulation like we did with the airlines, railroads and trucking industries? Prices went down when we deregulated those industries and the same will happen in healthcare. "

That'd certainly be a boon to the snake-oil industry.

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Richard Heckler 5 years, 1 month ago

Deregulation eh. Oddly all of those examples would be out of business with massive tax subsidies. Just like coal and nuke power.... energy costs have not dropped.

WE do have money to pay for HR676. We could bring vets care under this same umbrella bringing more tax dollars into the pie. Vets and their families would be far better off.

With mainsteam med insurance going to $18,310 a year X 500 in 2010 = $9,155,000 we must to get our elected officials off this luxury bandwagon. And all other government officials as well.

Then there are $1.2 trillion insurance tax dollars that could brought under this one big umbrella which would cover National Health Insurance for all by itself. Where are those tax dollars?

HERE they are: The U.S. health insurance system is typically characterized as a largely private-sector system, so it may come as a surprise that more than 60% of the $2 trillion annual U.S. health insurance bill is paid through taxes which comes to $1.2 trillion. $1.2 trillion is a sweet gravy train for the industry. http://www.dollarsandsense.org/archives/2008/0508harrison.html

That same $1.2 trillion would support National Health Insurance for All under HR 676. Because it would eliminate:

WHAT INCREASES THE COST OF MEDICAL INSURANCE? high dollar medical insurance spending on what 1,500 health insurers add to the actual cost of providing care: • its bureaucracy • profits • high corporate salaries • advertising over charges • sales commissions • Shareholders are the primary clients of for-profit insurance companies, not patients! • Special interest campaign dollars Golden parachutes Politicians as shareholders: http://www.washingtonpost.com/wp-dyn/content/article/2009/06/12/AR2009061204075.html

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