Will the real 10 year cost of ObamaCare be over $6 trillion?

[BeAChooser]

The CBO's estimates for the second ten year period (yes, they provided those) were for an even greater deficit reduction.

First,

http://ztruth.typepad.com/ztruth/20...-care-concept-is-substantially-uncertain.html

The CBO projected that the revenue from the insurance excise tax and other sources will grow more quickly from 2020 to 2029 than the parts of the bill that cost the government - amounting to a net reduction in the federal deficit. But the CBO cautioned its projection is "subject to substantial uncertainty."

http://www.politifact.com/truth-o-m...e-health-care-bill-pays-itself-over-long-run/

The CBO did not create numerical projections for the years 2020 to 2029, but the report notes that for those years, the bill would probably result in "slight reductions in federal budget deficits. Those estimates are all subject to substantial uncertainty."

http://www.mcclatchydc.com/330/story/79567.html

From 2020 to 2029, while the CBO said that health care savings should cause deficits to drop sharply, it also warned that any precise forecasts "would not be meaningful because the uncertainties involved are simply too great."

Second, those health care savings primarily depend on reducing Medicare costs. But no real details on how they will actually do it are provided. So convince us they can be achieved before tossing us over this cliff. Obama and the democrats should first prove they can actually reduce the cost of Medicare before pushing the rest of their plan down our throats. The sorry history of government in controlling costs in programs like this strongly suggests they won't be able to deliver what they are promising.

You say it's immaterial that the money doesn't go to the government, but that really is largely what defines a tax.

A statement coming from the same group of people that redefined "is".

 

[BeAChooser]

Because it's an article of faith among the right wing that the government cannot do anything as cheaply or as efficiently as the free market.

I say "article of faith" because as usual, reality has a left-wing bias and this particular belief is wrong, but it's held nevertheless, in the teeth of the evidence

And what *evidence* is that? Please be specific. What US government run programs have been demonstrably cheaper than their private sector counterparts? Show examples where government social programs have been cost effective much less effective at all? The War on Poverty? LOL! The War on Drugs? LOL! Public Education? LOL! Medicare? LOL!

 

[drkitten]

And what *evidence* is that? Please be specific. What US government run programs have been demonstrably cheaper than their private sector counterparts?

Provision of public goods, among others.

Police protection, fire protection, environmental protection, public health such as water treatment and fluoridation, vaccinations and so forth.

Basically, everything that is in the chapter in the econ textbooks that libertarians never read about "public goods."

 

[BeAChooser]

Police protection, fire protection, environmental protection, public health such as water treatment and fluoridation, vaccinations and so forth.

You haven't proven that public programs to provide these services are more cost effective than private programs that provide similar services. Take fire protection for instance.

http://blog.heritage.org/2009/08/26/how-private-fire-departments-success-undermines-obamacare/

How Success of Private Fire Departments Undermines Obamacare

... snip ...

Despite being a very small sliver of our economy, and having a long tradition that has always mixed private volunteer service with public funding, in fact many cities have contracted with private groups or completely privatized their systems. Those cities that have tried it report great success, for all the same reasons that privatization works in every other industry.

For example, the Elk Grove district in rural Illinois put together a private fire service when they faced an imminent loss of protection by a nearby municipal fire department. They found that the private company was able to provide the service far cheaper than contracting with another local government. The private provider explains why:

“Our first-year contract was $300,000, and we were providing the same level of service the consultant said would cost $1 million,” Jensen said. “We continue to provide service as good as that of our municipal neighbors, but because we are private, we can operate more efficiently. We save 30 to 40 percent over what a similar municipal department would cost to operate.”

 

[BeAChooser]

One reason ObamaCare won't realize the health care savings that are claimed:

http://www.healthcarebs.com/2009/12/06/obamacares-111-new-bureaucracies/

OBAMACARE’S 111 NEW BUREAUCRACIES

http://www.friesian.com/bureau.htm

The Practical Rules of Bureaucracy

... snip ...

1. Spend Your Budget

... snip ...

2. Fail

... snip ...

3. Cover Your Ass

... snip ...

4. Replace Useful Work With Useless Work

... snip ...

5. Multiply Procedures and Paperwork

... snip ...

6. Pass the Buck

... snip ...

7. Don't Rock the Boat

... snip ...

8. Join the Union

... snip ...

9. Jerk People Around

 

[drkitten]

You haven't proven that public programs to provide these services are more cost effective than private programs that provide similar services. Take fire protection for instance.

http://blog.heritage.org/2009/08/26/how-private-fire-departments-success-undermines-obamacare/

You cited the Heritage Foundation. You lose.

 

[BeAChooser]

You cited the Heritage Foundation. You lose.

http://www.heartland.org/publicatio...istrict_Keeps_Costs_Low_and_Service_High.html

 

[Meadmaker]

Public Education? LOL!

Until our lifetimes, American public education was envied worldwide. We became the world's most technologically advanced country largely on the strength of our public edcuation system.

I'm a big fan of school choice, but it's not because I think that government is inherently inferior at providing services. Government can do things well, and for most of our history public edcuation was a shining example of that. Even today, it does a great job in many circumstances.

 

[Upchurch]

All of the people who could see into the future. I guess the people we elect should never do anything about anything unless unless it was an issue in the last election.

That's my point. You can't claim that the two situations are equivalent the way that you did. We didn't elect people in 2000 based on what they said they would do in Afghanistan and Iraq after 9/11. We did elect people in 2008 based on what they said they would do concerning health care reform. This debate is decades old, now. This wasn't a surprise.

To claim, as you did, that we elected people because of their stance on an event that was unforeseeable and their consequents is a false comparison.

Sorry, you're too late to play move the goalposts again.

You don't know what that phrase means, do you?

Let's check:

We start with a claim that we elect people to make decisions and most of the people elected are in favor of something (health care reform in this case).

Correct....

Then we modify the claim so it doesn't apply to decisions made by most of the people we elected if one person made counter promises in an election.

Incorrect. I provided a specific example of a platform where a (notable) elected figure did the exact opposite of what he said he would do during the campaign. I also gave you the opportunity to point out anyone else who campaigned that year on the basis of invading Afghanistan and Iraq, which you neglected to do.

I didn't modify the claim. I supported it.

Then we move the touchdown zone into making the initial claim only apply to things that were a central issue of a campaign.

And you see that as a modification of the initial claim, why? Did you not watch the campaign? Were you not aware that it was a main topic of the domestic debate?

Regardless, whether or not it was "central" is immaterial to the argument. It was discussed. At length. The information was available to voters and taken into account in their decision on who to elect. That simply wasn't the case with Afghanistan and Iraq in the 2000 election.

(or rather, where it was discussed, I provided an example of one politician's position that turned out to be the polar opposite of what he eventually did. Any voter decision made based on that bit of information would suggest that they had intended their elected official to do something different than what he did. If you want to jump to that conclusion, although there is no need.)

Glad I could clear that up for ya.

Oh, you made it clear, alright. You don't know what "moving the goalposts" means.

 

[Meadmaker]

What US government run programs have been demonstrably cheaper than their private sector counterparts? !

And why do we restrict ourselves to US programs? A major element in convincing me that we ought to move toward socialized medicine is that nations who have it spend less on health care than we do with our largely private system.

Surely if they can do it, we can do it.

 

[BeAChooser]

And why do we restrict ourselves to US programs?

Because it's the US government that's going to *manage* this program. Isn't that obvious?

 

[Meadmaker]

Because it's the US government that's going to *manage* this program. Isn't that obvious?

Sort of, but you've set the question up in a fairly dishonest manner. We can't compare the US government performance on health care to the private sector, because the US government hasn't tried to do it. The US government has done lots of other things, and done it well, but never health care. On the other hand, lots of other governments have done it, and they have done it better, or at least less expensively, than the US private sector.

Unless you are going to assert that our government has some deficiency that makes it inherently less efficent than the government of France or Britain, your premise that government programs won't be as efficient as private sector programs fails. I think that our government can perform at least as well as France's government in the provision of health care service, and that is better than the US private sector is doing now.

 

[psychictv]

What US government run programs have been demonstrably cheaper than their private sector counterparts? Show examples where government social programs have been cost effective much less effective at all?

It's a mistake to focus solely on cost. The biggest advantage of public programs over private industry is that they can provide equal services to everyone. A private mail company might be able to compete with the USPS in some limited geographical areas but no corporation would ever commit to delivering to every address in the U.S. for a single flat rate. Private schools might appear to perform better but that's pretty easy to do if you pick and choose your students and aren't required to accept every troubled child, or provide special education to the disabled, kids with learning disabilities, e.s.l. students, etc. Public programs are more effective because they are the only effective way of achieving universal service.

 

[jimbob]

Because it's the US government that's going to *manage* this program. Isn't that obvious?

But the UK government manages, and it has nothing to learn from anyone about cockups.

 

[JoeTheJuggler]

But the CBO cautioned its projection is "subject to substantial uncertainty."

Yes, that's exactly what I said. The farther into the future you project, the less certain we are of those estimates. This is why the CBO report does fairly in-depth analysis of the first 10 years, and just gives a crude guestimate on the period beyond that. It's also why we have daily weather forecasts and don't rely on the daily weather prediction made in the Farmer's Almanac more than a year ahead of time.

So?

Do you have a crystal ball or something?

A statement coming from the same group of people that redefined "is".

What? Now Bill Clinton is in control of the CBO? That's some conspiracy theory you have going there.

You say that it doesn't matter that insurance premiums go to insurance companies and not to the government but they still count as tax. That's just nonsense.

But, as I've said about 3 or 4 times now, even if you counted premium payments as taxes (because it would be mandatory to have insurance, with exceptions), tax counts as revenue to the federal budget, so these "taxes" would reduce the net cost of the program. (And that net cost is negative--that is, it will reduce the deficit.)

In the broad perspective of how much we as a society spend on healthcare, the very point of the mandate is to defray the costs by getting low-risk people to participate.

 

[JoeTheJuggler]

And I still think it's curious that many proponents of "fiscal responsibility" when it comes to health care don't seem to mind that billions (if not tens of billions) of dollars dispersed in Iraq will never be accounted for.

 

[DavidJames]

And I still think it's curious that many proponents of "fiscal responsibility" when it comes to health care don't seem to mind that billions (if not tens of billions) of dollars dispersed in Iraq will never be accounted for.

That's because it's not about money it's about who spends or loses it and on what. In other words it's about politics, not money.

 

[JoeTheJuggler]

That's because it's not about money it's about who spends or loses it and on what. In other words it's about politics, not money.

Yup. That's pretty much my point. When they talk about "fiscal responsibility" they're being hypocrites--or at least grossly inconsistent.

 

[BeAChooser]

We can't compare the US government performance on health care to the private sector, because the US government hasn't tried to do it.

But they have tried to do all manner of other social engineering ... and failed repeatedly and wastefully. War On Poverty. War On Drugs. Public Education. Medicare (and by the way, Medicare is health care). Those programs have cost trillions and trillions of dollars and have not accomplished their originally stated goals. Often, they've made things worse. And in many of those instances it has been shown that the private sector can do it better (such as education). The private sector was doing fine with getting rid of poverty before the WOP came along. The WOP if anything simply built in a minimum poverty level. The failure of the government in these cases does not give one much assurance they will do it right this time. At the very least the government should demonstrate it can fix Medicare before starting what might be another major boondoggle.

The US government has done lots of other things, and done it well

Such as? Specifics please. DrKitten tried and failed to show that government has been more cost effective or effective in general at any of the *successes* she named. You want to try now? And note I'm not saying that government can't do "anything" right. Or that government doesn't have a legitimate role or authority in some areas. Like Defense.

, but never health care. On the other hand, lots of other governments have done it, and they have done it better, or at least less expensively, than the US private sector.

But perhaps the reason the US private sector has not done it as cheaply as those other governments (and I'm glad to see you are not stating with certainty that those other governments have done it better because that's highly debateable, albeit off topic) could be due to differences in their society and ours ... things that are beyond the control of the private sector and probably beyond the ability of our government to *fix* (at least without ruffling a lot of liberal feathers). Differences in the power of trial lawyers (who just happen to be primarily democrat), for example. Differences in the number of and way we treat illegal immigrants. Differences in ethnic and cultural makeup and expectations. Differences in the way the governments themselves are structured and make decisions (compare ours to that of the Netherlands, for example). Differences in the amount of research being done (i.e., who now is paying for most medical development and therefore subsidizing the others). Differences in the impact of media on the decision making processes. Differences in the rights accorded citizens and our what the society historically judges to be most important.

Unless you are going to assert that our government has some deficiency that makes it inherently less efficent than the government of France or Britain, your premise that government programs won't be as efficient as private sector programs fails. I think that our government can perform at least as well as France's government in the provision of health care service, and that is better than the US private sector is doing now.

We probably can. But the French are moving back in our direction ... not the direction that Obama and company are headed. And the truth is that I think the republicans offered an alternative plan that would have addressed many of the real reasons our costs are higher (like lawyers) but democrats wanted nothing to do with it and simply shot it down. The truth is that Obamacare isn't about health care but control and power. Socialism.

 

[psychictv]

Differences in the power of trial lawyers (who just happen to be primarily democrat), for example. ... And the truth is that I think the republicans offered an alternative plan that would have addressed many of the real reasons our costs are higher (like lawyers) but democrats wanted nothing to do with it and simply shot it down.

"Trial lawyers" are not a serious expense for our medical system.

The cost of the medical malpractice liability system -- if measured broadly by adding all malpractice insurance premiums -- fell to less than 0.6 percent of the $2.1 trillion in total national health care costs in 2006, the most recent year for which the necessary data to make such comparisons are available.

The cost of actual malpractice payments fell to 0.18 percent -- one-fifth of 1 percent -- of all health care costs in 2006. Annual malpractice payments have subsequently fallen from $3.9 billion in 2006 to $3.6 billion in 2008, but comparative data on total health care costs are not available.

"Any way you measure it, medical liability accounts for less than 1 percent of the country's health care costs, and the vast majority of victims receive no compensation whatsoever,"

http://www.consumeraffairs.com/news04/2009/07/medical_payments.html