The Debt and Health Care Reform

Damn fools, you are going to pay fore it anyway. One way or the other you are going to pay for it.Through your employer, through your county taxes, through, the State government, through the National Government, and through your own pocket, and you are going to pay with least efficient methode that we have now. 17% of our GDP is going to Health Care, and we have one of the least effective systems in the developed world. Our care is no better then anywhere else in the Developed world.

Eventually, and probably soon, the value of the dollar will sink like a stone. In order to sell American debt, the Fed will be obliged to raise interest rates to the high teens.
Say good-by to any economic recovery, say good-by to jobs.
Say hello to inflation.
The whole world will pay for this mistake, electing Obama, another Jimmy Carter.
Watch & see.

Where were all these “citizen activists” the past eight years, Jake Tapper, when the national debt more than doubled during a so-called and self-proclaimed era of Republican prosperity?
Why all the sudden concern about deficits now that a Democratic president is in office, and is trying to clean up the GOP’s mess?
Should we be concerned about the deficits? Absolutely.
But to be frank, I don’t give much creedence to persons who engage in selective and disingenuous outrage, and whose idea of public debate consists of clinging desperately to obsolete GOP talking points like a baby blanket, trafficking in blatant misinformation, and verbally abusing anyone who dares to disagree with their ignorant opinions.

Milan, of course private health insurance companies are about money first! They are a private business and in order to stay in business they must make a profit. The more profit they make, the more investors will be attracted to their company. That is called Capitalism! Capitalism, the Free Market, Individual Freedom are what drive the entrepreneurial spirit–the American Dream. And it is the entrepreneurial spirit that has made this country the great nation on earth.
You are correct when you say that President Obama is talking about healthcare reform costing the government $1 trillion over ten years. President Obama’s estimated cost is based on the public option having about 50-60 million clients–the 47 million currently uninsured plus another few million who will change over.
BUT the truth is that HE and the LEFT, in spite of what most of them are saying publicly, they KNOW that the private sector will be unable to compete with the public option. There are some who opening admit this…
*Rep. Jan Schakowsky (D-IL) speaking before an audience on April 18, 2009 said: “And next to me was a guy from the insurance company who then argued against the public health insurance public option saying, ‘It wouldn’t let private insurance compete. That a public option will put the private insurance industry out of business and lead to single payer.’” To which the crowd erupted into a huge applause. She then followed with, “He was right. The man was right.”
*Rep. Barney Frank (D-MA) said on July 27, 2009: “I think if we get a good public option it could lead to single payer and that’s the best way to reach single payer.”
Now then WHEN the private sector is eventually eliminated then the public option will have 330,000,000 clients. That will be an increase of nearly 6 to 7 fold–raising the cost to about $600-700 billion per year. THEN when mandatory annual physical exams are implemented THAT will mean even more doctor’s visits being covered, which will be a tremendous increase in the overall cost of the program. So eventually it WILL cost $1 trillion per year.

These guys need some basic economics lessons. How is health care going to get cheaper by subsidizing the customer? The only way they can do that is price controls. We saw the result of price controls in the late 70′s with gasoline. Lines. Oh isn’t that what people are complaining about in other socialist health systems? Lines?
Why is no one talking about the costs to health care providers? Little economy 101, cheaper production means cheaper prices. Fixed prices means fixed production. This is so simple but seemingly rocket science to congress.

Obama’s numbers has sunk to 47% approval, lowest for any president at this same time in office. The Dems have awaken a “sleeping giant” the American public, who is refuting Obama and his lies. Keep the grassroots movement alive!

Jake isn’t insulting US citizens today. I guess he is in such a good mood because he gets to spend his vacation in the middle-class, inner city, among the non-elitists in Martha’s Vineyard. Let us watch the nice treatment the Obama’s get compared to the harsh treatment given Bush when he went on vacation.

Correction from my below post, added a number that was already added together, if a mod could delete my original post…
If a company can afford to hire someone for 90k a year, start there and back down to what the person will actually take home. So income tax is 40% in France, that brings it down to 54k a year. However, need to add in 18.8% for single payer health care, roughly 54k-17k. Now that employee is down to 37k a year take home. That person now has to pay for an apartment, car or public transportation, utilities, and food. Sounds appealing doesn’t it?
Lets take a look at JUST the health care costs.
That 90k a year is going to be taxed 18.8% to pay for the health care system. That means between the employer, and the employee, the pay into the sytem is 16,920 per year. Divide that by 12 months and thats 1,410 dollars per month going into the system for someone bringing home 32k per year. (add 100-200 per month for private supplimental and your close to 1600 a month).
Me and my employer pay a total of 800 a month for a non deductable, 10$ copay coverage.
The math doesn’t add up to be a better system. And with those high taxes, the French system is still running at a deficit. How is this so wonderful?

Why all the sudden concern about deficits now that a Democratic president is in office, and is trying to clean up the GOP’s mess?
Should we be concerned about the deficits? Absolutely.
But to be frank, I don’t give much creedence to persons who engage in selective and disingenuous outrage, and whose idea of public debate consists of clinging desperately to obsolete GOP talking points like a baby blanket, trafficking in blatant misinformation, and verbally abusing anyone who dares to disagree with their ignorant opinions.
Posted by: Donald from Hawaii
——————
Don,
First off, most of us were not happy with Bush’s deficits.
Those on the left seem to think because we were not in the streets protesting, that it means its ok for Obama to use the same ideas with deficits, except on steriods!
A huge problem looming down the road with these deficits that is virtually never brought up is the fact that China is the only nation right now in bed with our debt. It is going to be extremely difficult to move China on ANY issue while they hold our financial future in the their hands.
fotget telling your kids to learn Spanish, Chinese would be a better choice!

“huge problem looming down the road with these deficits that is virtually never brought up is the fact that China is the only nation right now in bed with our debt. It is going to be extremely difficult to move China on ANY issue while they hold our financial future in the their hands.
fotget telling your kids to learn Spanish, Chinese would be a better choice!”
The PRC has us by the short hairs. Paying that debt will really, really suck. Small payoffs have been made, like Hillary’s comment on human rights. But eventually, the ChiComs are going to want tangibles.

“But eventually, the ChiComs are going to want tangibles.”
They are essentially buying Tawain. They want it more than anything. Tawain represents an ugly past to the communists, the remaining bastion of the free chinese government. They will do anything to have it stomped out and under communist control, including buying our debt.

“re: the deficit, but why weren’t you screaming bloody murder about his tax cuts, wars, and Medicare prescription bill that added hundreds of billions to the deficit?”
Tax cuts were fine, but needed to be coupled with spending cuts and they weren’t. Wars weren’t as expensive as people think, about 7 Billion a month compared to 1 trillion a month in government spending. Agree with it or not, it wasn’t unruly expensive in perspective. Medicare prescription drug bill was hated by every conservative I knew. Even talk show hosts back then were criticizing it. We also hated the gross pork spending (which you left out). But no one was paying attention to what we were saying. They were busy sticking microphones into the mouths of Cindy Sheehan, liberal congressman, Michael Moore, and other Hollywood misfits. Had you asked a conservative back then, they would have told you how unhappy they were with the spending.
Even if they didn’t, its not an excuse to spend even more now.

Don from Hawaii wrote: “Where were all these “citizen activists” the past eight years, Jake Tapper, when the national debt more than doubled during a so-called and self-proclaimed era of Republican prosperity?
Why all the sudden concern about deficits now that a Democratic president is in office, and is trying to clean up the GOP’s mess?”
At least from my perspective, the concern is the vast scope of the deficits that the CBO is projecting based on the spending that the Democratic controlled Congress and White House are planning to spend. (Bear in mind that it is really Congress that has the power of the purse when it comes to government spending.) The deficits under Bush were actually on their way down, from the peak in 2004; it wasn’t until all of the spending related to TARP and the financial bailouts where the 2008 deficit ballooned to a bit over $400 billion(I’d suggest looking through archived news reports on what everyone, Democrats and Republicans, were saying about need and size of government bailouts at that time.).
CBO’s 2009 projected deficit is roughly $1.8 Trillion, four times the size of the 2008 deficit. It’s projected to go down to around $1.35 Trillion for 2010; $900 billion for 2001; $600 billion for 2012; then start climbing again to where the 2019 deficit is projected to be $1.2 Trillion.
So, yeah, the deficits sucked in the last 8 years; but compared to where they are heading, they were pretty tame. THAT is why there is the rise in concern over deficits.

-So, yeah, the deficits sucked in the last 8 years; but compared to where they are heading, they were pretty tame. THAT is why there is the rise in concern over deficits.-
Esentially, Obama is continuing Bush’s disasterous policies.

Here are some facts from John Boehner (read in usatodayopinion):
“White House officials have acknowledged the president’s rhetoric shouldn’t be taken “literally.” That’s because the White House cannot guarantee that Americans will be able to keep their health plan. They simply don’t know how many employers will drop their coverage altogether if their plan goes into effect.”
“The president said, “I look at the federal budget and realize that if we don’t control costs on health care, there is no way for us to close the budget deficit — it will just keep on skyrocketing.” Yet according to the non-partisan Congressional Budget Office, the House Democrats’ bill would raise costs and the deficit by $239 billion over 10 years.”
“We’re not talking about cutting Medicare benefits.” But one of the reasons seniors are so alarmed is that the plan would cut Medicare to the tune of $361.9 billion over 10 years. That means fewer choices and lower quality care — exactly what then-Sen. Obama blasted during his campaign.”
“Finally, the president claimed the plan will not lead to rationing. But the bill, on page 30, section 123, would create a “Health Benefits Advisory Committee” that would make determinations about what kinds of treatments, items and services can be covered within certain benefit classes, and what kind of cost sharing will occur. “
Obama is a LIAR

Posted by: Mike_C | Aug 13, 2009 11:36:35 AM
Hi Mike. I agree it’s about managing costs. I also want equitable access to good coverage, not only because I think it’s humane, but also because I think we end up paying for the lack of equity via spreading the fairly high costs of providing emergency care and so on to the uninsured and flat broke. (Not sure if that’s very articulate because there’s construction going on by me and it’s LOUD so I’m a little distracted.)
So, anyway, here’s the thing about single payer, Mike, and managing costs, IMO. If you keep health care in the hands of for-profit companies, you can increase coverage by putting more money into the system, or you can control costs by decreasing coverage. But it’s really difficult to see how you can possibly do both unless you change the basic structure of the system, right? On way to change the basic structure would be to make it not-for-profit– including making the delivery system would be nonprofit. Medicare costs are rising at an unsustainable rate because care is provided in a profit-maximizing system. By changing that, that’s how costs would be best managed– and, of course, that’s why so many people object to single payer. Not that all European nations have gone that route–
In France, people get basic insurance from nonprofit funds that effectively operate as extensions of the state, then have the option to purchase supplemental insurance on their own. (It’s as if everybody is enrolled in Medicare.) But the physician practices are still private practices. And costs are rising there. And everywhere.
Full disclosure: I don’t object to single payer. I go back and forth because there are serious pros and serious cons. I think it’s worth looking at honestly and listing the pros and cons calmly.
Health care costs are a hot mess– and we need a deliberate and rational nonpartisan discussion– or as nonpartisan as we can get.
IMO, one a way to cut premium costs is to eliminate middlemen–On average, the private insurance industry siphons off 15 to 20 percent right off the top of the premium dollar for its administrative costs and profits. These middlemen add almost nothing of value to the system, right? I mean, what do they add?
I don’t think we’re headed toward single payer, of course. Many, many Americans say they’re satisfied with their coverage, at least until they become very ill or start bumping up against issues with pre-existing conditions, unemployment, lack of portability, or wanting to try their hand at running a small business or being self-employed. So, I personally think we DO need comprehensive medical malpractice reform that considers patient safety alongside tort reform– and I’ll stress here that of course tort reform is an important component of that and would help lower costs. I mean, it’s pretty obvious that the cost of malpractice insurance can be overwhelming and leads to defensive medicine. And, for crying out loud, Obama has said he is open to malpractice reform, but, IMHO, it hasn’t been included in the Congress bill because trial lawyers are a major special-interest group.
Another way to reduce costs is to provide incentives for IT and electronic medical records.
I know I’m not offering up solutions, but I am trying to address the issues honestly.
Ramble, ramble:)

I don’t think we’re headed toward single payer, of course.”
Barry and Barney disagree.

“FACTS FROM JOHN BOEHNER”
Why do right wingers consider the opinions of Republican leaders facts? \
Is it a natural gravitation to authoritarian figures?

“Yet you cheered the war and scowled at rescinding the tax cuts.”
You know what happens when you assume.

Americans are suffering now because of numerous governmental programs that were put into place by elected officials that have failed misserably. Perhaps it would be helpful if the administration could point to a successful program that cut costs and helped the consumer/taxpayer?

“Americans are suffering now because of numerous governmental programs that were put into place by elected officials that have failed misserably”
What nonsense.
Greed and arrogance have brought about this economic situation.

Jake. When are you going to ask Gibbs if this is just another choice in a list of choices, why are there soooooo many ways you can be forced onto the public option?

Greed and arrogance have brought about this economic situation.
I agree that the arrogance and greed of our elected officials have caused this problem.

“Medicare costs are rising at an unsustainable rate because care is provided in a profit-maximizing system.”
I would disagree. On average, health insurance companies operate at a 5% profit margin, well below retail and technology sectors that commonly operate at the 15%-20% range. Also, medical profits from a range of area’s pay into medical research, technologies and new procedures, that ultimately benefits us all.
That’s not to say however that doctors themselves do not operate for maximum profits. But, the idea of profits is what creates good doctors. With the current HMO/PPO system, they have little competition among each other and charge the maximum rate possible allowed by insurance. That won’t change be it government or private. Until that is flipped and consumers are more involved in the payout process, and they feel it is their money being spent, the cost increases will only continue. Government interjecting itself into this process and introducing price controls won’t help, could even make it worse. To give an example,
If an OBGYN in Oklahoma is paying 4k a year for malpractice insurance, and an OBGYN in Dade county, FL is paying 250k a year in malpractice insurance, and the government puts a cap on how much an OBGYN can charge for a particular service, those doctors will flee area’s like Dade County, limit the supply of doctors, and create long lines to those that remain. Because doctors in each state have unequal costs, they will be unable to charge equally.
There are a host of market forces that can be dealt with to bring down the costs of health care, this reform bill doesn’t seem to address any of them.

French Health care system which is supposedly attractive..
If a company can afford to hire someone for 90k a year, start there and back down to what the person will actually take home. So income tax is 40% in France, that brings it down to 54k a year. However, need to add in 18.8% for single payer health care, roughly 54k-17k. Now that employee is down to 37k a year take home. That person now has to pay for an apartment, car or public transportation, utilities, and food. Sounds appealing doesn’t it?
Lets take a look at JUST the health care costs.
That 90k a year is going to be taxed 18.8% to pay for the health care system. That means between the employer, and the employee, the pay into the sytem is 16,920 per year. Divide that by 12 months and thats 1,410 dollars per month going into the system for someone bringing home 37k per year. (add 100-200 per month for private supplimental and your close to 1600 a month). They also enjoy 10%-40% copayments. So even with that guy putting 1400* a month into the system, he still has to pay as he goes.
Me and my employer pay a total of 800 a month for a non deductable, 10$ copay coverage. And just to keep it in perspective, my wife and I are both covered under this plan so it effectively costs us 400 a month per person, where as in France we would be paying double in payroll taxes making it effectively 3,000 per month for the two of us.
The math doesn’t add up to be a better system. And with those high taxes, the French system is still running at a deficit. How is this so wonderful?

Posted by: KR | Aug 13, 2009 2:41:30 PM
***
KR, how are you calculating your numbers? I sent a message via Facebook to my pal in France to see if that big of a chunk a change is taken out of her pay and she said, no, taxes are high ( and complicated), but not so severe that a 90k salary translates to less than 40k, or even half, in take home pay. She said she’d email me later with the breakdown (and, incidentally, she does love the health care, but she’s not chronically ill or anything so her care basically involves just her primary care physician, and she has asthma).

So in my example, that person would be showing on their paycheck a 73k a year income, but the employer would be paying out (adding payroll tax for just health) 90k.
Posted by: KR | Aug 13, 2009 3:37:02 PM
Okay, thanks. I misunderstood.

“Medicare costs are rising at an unsustainable rate because care is provided in a profit-maximizing system.”
I would disagree.
****
I can handle disagreement:) One of the problems with rising costs has been found to be the way medical technology is utilized, so let’s see if I can explain this intelligently in the context of for-profit, non-profit and why I think for-profit is part of the problem when looked at the issue through one lens (besides the obvious, which is the way medical providers charge patients; fee-for-service medicine if often lucrative for providers because of incentives to deliver more (and more costly) services, it typically does not offer incentives to improve quality or efficiency or to deliver preventative care that has a low profit margin). Last fall, the health care blogs (see Maggie Mahar and Robert Laszewski) were all abuzz with news of a report titled “High and Rising Health Care Costs: Demystifying Health Care Spending.” It found that one of the culprits of long-term health care inflation, the study reveals is “advancing medical technologies” combined with low productivity. Advancing technology has a particularly large impact on spending in the United States because there are “few requirements that effectiveness be demonstrated before technologies are used broadly.” In addition, much of our technology is overpriced. And most importantly, we often use the technology on a broad swathe of patients when only a few, who fit a very specific profile, actually benefit from it. Okay, so that really doesn’t have anything to do with the for-profit system, BUT the technology itself is not the only problem. Rather than collaborating to share new technology, hospitals and outpatient centers all invest in the same equipment as they vie for well-insured patients. As a result, “costs in outpatient settings are higher” than they need to be. So, competition leads to redundancy and lower productivity, duplication of services and so on.

“So, competition leads to redundancy and lower productivity, duplication of services and so on.”
Good post. I know profits are a bit disconnected. One thing about for-profit organizations however, the strive for more profits in the medical insurance industry means the strive for healthier people. Obviously, most of us pay more into health insurance than we get out in a given year. However, I would argue health insurance companies, for profit, in the drive to gain profits, want their subscribers to be healthy. Doing some searches here and there, you find insurance companies investing in health studies, health education, and yes technologies that can help keep you healthy. Cause if your healthy, they are bringing in more money than paying out, which is their goal. The government has no such goal. As a veteran of military health system, my first hand account is that the doctors really do care, but they also ration that care. I got into an arguement with my flight doc for an MRI of my back. I had severe back pain and an X-ray didn’t show anything. A year later, with a different doc, he gave me an MRI that showed 4 bad discs.
So I think the bottom line is, neither system is perfect, but at least one has incentive for you to be healthy.
Also on research and technologies, I might also agree and disagree. A Clinton report I found a week ago pointed to the return on investment in medical research showing that, if every person in the US put 65 dollars a year into medical research and tech, they would save 5k a year per person in future efficiencies of these new technologies. That’s a pretty broad claim but it makes some sense in long term controls of pricing. For example, compare prenatil care today to just 20 years ago. The research on the folic acids and other vitamins that help reduce birth irregularities. Without that research, where would we be?
The government can help here with incentives for insurance and other medical industries to invest in research and tech, offering tax free benefits of doing so. It’s something they want to do already, lets make it easier for them.
And redundancy isnt a bad thing in all cases. It does make it quicker to access those technologies. Even if its overkill, I’d rather we err to the side of too much diagnostics than too little.

Hey KR–thanks very much, I appreciate your posts as well. It’s definitely refreshing to start from agreeing there are some serious gaps in the system, and that there are probably several reasonable ways of fixing them.
To me it’s all about bringing the system into reasonable parameters, so everyone can get reasonably affordable health care.
The ideas you mention sounded good. I’m also reluctant to try to merge our entire system into single-payer, but on the other hand it seems impossible to avoid an increased government role in covering some people. I can see why people think it would be hard to stop that role from increasing towards single payer. But I don’t think the American people want that to happen, so I’m not too worried about that happening.
I’m definitely just beginning to take a more serious look at what’s being proposed.

We can’t afford this healthcare reform that is being crammed down our throats by fiscally irresponsible politicians.
• Medicare has a projected unfunded liability (the difference between the benefits that have been promised to current and future retirees and what will be collected in dedicated taxes and Medicare premiums) over the next 75 years of 32,000,000,000,000.00 (32 Trillion) dollars. Social Security also has an unfunded liability but it is nowhere near as large as the unfunded Medicare liability.
• Currently, Medicare claims about 11 percent of federal nonentitlement tax dollars.
• By 2020, Medicare deficits will claim one in every five federal tax dollars that are not already dedicated to Medicare and Social Security.
• This means that in just 13 years the federal government will have to stop doing one in every five things it does today if taxes are to remain at their current level and projected Medicare benefits are paid on behalf of the disabled and the elderly.
• By 2030, the deficits in Medicare will claim one in every three general revenue dollars; by 2050, they will claim one in every two.
In a July 26 letter to the Ranking Republicans on four key committees (Ways and Means, Energy and Commerce, Education and Labor, and Budget), the Director of the Congressional Budget Office (CBO), Doug Elmendorf, made it clearer than he ever had before that the bill, in its original July 14 form, would dramatically widen the already large gap between long-term government revenue and spending. Here’s the key paragraph:
“Looking ahead to the decade beyond 2019, CBO tries to evaluate the rate at which the budgetary impact of each of those broad categories would be likely to change over time. The net cost of the coverage provisions would be growing at a rate of more than 8 percent per year in nominal terms between 2017 and 2019; we would anticipate a similar trend in the subsequent decade. The reductions in direct spending would also be larger in the second decade than in the first, and they would represent an increasing share of spending on Medicare over that period; however, they would be much smaller at the end of the 10-year budget window than the cost of the coverage provisions, so they would not be likely to keep pace in dollar terms with the rising cost of the coverage expansion. Revenue from the surcharge on high-income individuals would be growing at about 5 percent per year in nominal terms between 2017 and 2019; that component would continue to grow at a slower rate than the cost of the coverage expansion in the following decade. In sum, relative to current law, the proposal would probably generate substantial increases in federal budget deficits during the decade beyond the current 10-year budget window.”
In other words, CBO expects the spending in the bill would grow at a rate of least 8 percent annually into the indefinite future, while the revenue to pay for it will only grow at about 5 per cent per year. Hence the “substantial increases” in federal budget deficits beyond 2019.
The first things the idiots in DC need to do is get Medicare under control and then address the growing debt of the federal government. For over 60 years the politicians have been spending at a rate which exceeds the revenue the government has collected, we can’t do this in our private lives and the government can’t do it either as the bill will become due and the only out will be the bankruptcy of the United States.

I suggest that we pay for this health care by getting rid of state and government pensions and use that money to pay for health care. After all the rest of us do not get a pension, and have to live with SS and 401K. And we as tax payers are paying for their pensions, so it wouldn’t be a new tax, just redirected money’s.

We can’t trust anything Obama says because he’s already lied about so many things. During the campaign he promised not to raise taxes on anyone making less than $200k. But two weeks after his inauguration he signed SCHIP into law which raised cigarette taxes by 62 cents a pack. This was just one of many many lies. And his claim that our economy would grow $1.57 for every $1 spent by the federal govt is laughable. If you believe his false logic, it means we can simply spend our way to prosperity. Obama is a liar and a joke, and the Dems in Congress are no better. These people are hardcore Socialists and they want to control our lives. This IS unAmerican and we must fight like hell to keep what few freedoms we still have.

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