"Obamacare" fallout-first datum

[Unabogie]

The CBO report was already revised back in May:

http://blogs.abcnews.com/politicalp...15-billion-more-than-previously-assessed.html

Wait until it's actually implemented...

Ok, but this isn't what we were talking about. We were talking about eliminating the Medicare Advantage program which wasted money. That saves money, right? Not wasting it saves it?

ETA: Oops, you were replying to Lurker.

 

[WildCat]

Last I saw, the house passed an extension of payments and the senate literally walked away from it and went on recess. I think the cuts went into effect as a result.

No, the "doc fix" passed: http://www.nytimes.com/2010/06/25/health/policy/25medicare.html

 

[JoeTheJuggler]

Did you miss the flawed premises it was based on, like the $500 bazillion that would be saved by cutting Medicare payments?

That canard has long been debunked (though the GOP kept repeating it in many of their campaign ads).

From Politifact.com:

t's important to note that the law does not take $500 billion out of the current Medicare budget. Rather, the bill attempts to slow the program's future growth, curtailing just over $500 billion in future spending over the next 10 years. Medicare spending will still increase -- the nonpartisan Congressional Budget Office projects Medicare spending will reach $929 billion in 2020, up from $499 billion in actual spending in 2009.

Next, we wanted to address how those reductions are expected to affect the quality of care.

"Some (changes) increase Medicare spending to improve benefits and coverage," said Tricia Neuman, director of the Medicare Policy Project at the nonprofit Kaiser Family Foundation. "Other provisions reduce the growth in Medicare spending to help the program operate more efficiently and help fund coverage expansions to the uninsured in the underlying health reform legislation. Other provisions are designed to improve the delivery of care and quality of care."

Linky.

 

[WildCat]

A new round of cuts in payments to doctors is scheduled to take effect in December: http://thehill.com/blogs/healthwatc...-roundup-medicare-qdoc-fixq-lobbying-heats-up

Anyone want to bet it won't happen? Even the Obama admin. is urging the cuts be eliminated.

 

[WildCat]

That canard has long been debunked (though the GOP kept repeating it in many of their campaign ads).

From Politifact.com:



Linky.

How is it debunked? Yes, it's being cut from growth. So what? These cuts were what put the health law in the black.

 

[Lurker]

The CBO report was already revised back in May:

The director of the Congressional Budget Office said Tuesday that the health care reform legislation would cost, over the next ten years, $115 billion more than previously thought, bringing the total cost to more than $1 trillion.

The revised figure is due to estimated costs to federal agencies to implement the new health care reform bill – such as administrative expenses for the Internal Revenue Services and the Department of Health and Human Services -- and the costs for a "variety of grant and other program spending for which specified funding levels for one or more years are provided in the act."

CBO had originally estimated that the health care reform bill would result in a net reduction in federal deficits of $143 billion from 2010-2019; this revised number would eliminate most of that savings.

http://blogs.abcnews.com/politicalp...15-billion-more-than-previously-assessed.html

Wait until it's actually implemented...

OK, quick analyzing of cost with new data -$143B (projected savings) + $115 (revised cost) = -$28B

So still a net savings of $28B even after the revision. Next?

 

[WildCat]

OK, quick analyzing of cost with new data -$143B (projected savings) + $115 (revised cost) = -$28B

So still a net savings of $28B even after the revision. Next?

There's been one round of doc fic already since then, and another one likely within the next few weeks.

And we haven't even got to the meat of the bill yet.

 

[willhaven]

The "doc fix" stuff would be need to be dealt with regardless of other reforms.

In other words, it's fallout from 90's era policy, not "Obamacare" itself. If "Obamacare" did not exist, this $300bn would still be required to fix medicare payments to doctors.

 

[Meadmaker]

t's important to note that the law does not take $500 billion out of the current Medicare budget

I love it. Right out of the Reagan playbook, with roles reversed. I'm sure it was going on before then, too, but I was too young to remember it.

A "budget" is a spending plan. That's the definition. If you spend $500 this year, and plan to spend $1000 next year, but then you change the plan and decide that you will only spend $800 next year, spending will increase by $300, but the budget will decrease by $200. That's a definition.

Back in the '80s, Reagan kept proposing budget cuts, i.e. lowered spending projections for future years, and claiming that he wasn't actually cutting the budget because he was still planning on spending more next year than this year. Meanwhile, Democrats would scream bloody murder and insist he was taking money out of the mouths of little old ladies.

And one way or another, they almost all managed to keep spending a lot more. Only Clinton ever actually paid the bills in my lifetime, and even that required a combination of some shifty accounting and an uncooperative Republican majority. I'm hoping gridlock produces the same result this time around.


Meanwhile, on health care, you can't provide better health care to more people for less money. Anyone who says you can is blowing smoke.

 

[Unabogie]

More datum about EVUL SOSHALIST GUBMINT HEALTHCARE.

http://tpmdc.talkingpointsmemo.com/2010/11/freshman-goper-hey-wheres-my-health-care.php?ref=fpa

According to Glenn Thrush of Politico, Harris created a stir at the orientation meeting by demanding to know why he had to wait a month after he was sworn in in January for his government-subsidized health care to kick in. After responding in a huff, he even asked if there was some way he could buy into the government care in advance, seemingly thinking there might be a government program similar to the so-called 'public option' championed by progressive Democrats in 2009.

 

[Bob Blaylock]

Only Clinton ever actually paid the bills in my lifetime, and even that required a combination of some shifty accounting and an uncooperative Republican majority.

Funny how Clinton continues to get so much credit for this. Does nobody remember the sort of Obamaesque policies that he pursued during his first two years? It was pretty much the same sort of uncontrolled spending and out-of-control government bloat that Obama has pursued. Fortunately, that time, Congress wasn't nearly so cooperative with him as this time under Obama. Though the Democrats had majorities in both houses, they couldn't run fast enough away from the sort of crap that Clinton was trying to push through; and in spite of their best attempts to distance themselves from it, the voters associated “Democrat” with the sort of out-of-control crap that Clinton was trying to push, hence the big Republican wins in the 1994 election.

Of course, Clinton is a political whore, who was more concerned with what would keep him in power than with what he believed was good for the country. After the big ass-kicking his party got in 1994, he spent the rest of his Presidency pretending to be a conservative. Who can forget his big “The era of big government is over” speech, given shortly after the voters soundly repudiated the big-government policies he had previously been trying to pursue?

 

[Unabogie]

Funny how Clinton continues to get so much credit for this. Does nobody remember the sort of Obamaesque policies that he pursued during his first two years? It was pretty much the same sort of uncontrolled spending and out-of-control government bloat that Obama has pursued.

Funny how Republicans seemed to gloss over uncontrolled spending during the eight years the GOP had under Bush. Like when Bush grew the government and the debt to twice its size under Clinton, how he took a surplus and tuned it into our largest debt ever, and how Obama has shrunk the debt a tiny amount over Bush.

Except not funny ha ha. The other kind.

 

[MikeMangum]

Let me know when the cost of US health care come down to what the rest of the industrialized world pays, then you can claim we had health care reform.

You did normalize for wages, right? Oh, you mean you didn't?

The only way that the cost of health care in the US could fall to what the rest of the industrialized world pays is if wages in the US dropped to compensate. Baumol's cost disease strikes again.

 

[WildCat]

The "doc fix" stuff would be need to be dealt with regardless of other reforms.

In other words, it's fallout from 90's era policy, not "Obamacare" itself. If "Obamacare" did not exist, this $300bn would still be required to fix medicare payments to doctors.

Which doesn't alter the fact that the doc fix was assumed by the CBO in calculating the cost of the bill.

 

[WildCat]

You did normalize for wages, right? Oh, you mean you didn't?

The only way that the cost of health care in the US could fall to what the rest of the industrialized world pays is if wages in the US dropped to compensate. Baumol's cost disease strikes again.

Which is why we need more GPs and fewer specialists. All the specialists practicing in the US don't seem to have much of an effect on our health and life expectancy, but it sure does drive up costs.

 

[MikeMangum]

Funny how Republicans seemed to gloss over uncontrolled spending during the eight years the GOP had under Bush.

It must be comfortable under that rock because I don't recall any glossing. I do recall conservatives using terms such as 'drunken sailor' to describe the spending proclivities of Bush. Exhibit A, Exhibit B. I know, Michelle Malkin is really a liberal operating in 'deep cover'.

Obama has shrunk the debt a tiny amount over Bush.

I see...you haven't been under a rock, you've been smoking rock.

United States public debt^WP

 

[Lurker]

Funny how Clinton continues to get so much credit for this. Does nobody remember the sort of Obamaesque policies that he pursued during his first two years?

Sure. I remember the Omnibus Budget Reconciliation Act of 1993.

http://en.wikipedia.org/wiki/Omnibus_Budget_Reconciliation_Act_of_1993

It created 36 percent and 39.6 income tax rates for individuals in the top 1.2% of the wage earners.
It created a 35 percent income tax rate for corporations.
The cap on Medicare taxes was repealed.
Transportation fuels taxes were raised by 4.3 cents per gallon.
The taxable portion of Social Security benefits was raised.
The phase-out of the personal exemption and limit on itemized deductions were permanently extended.
Part IV Section 14131: Expansion of the Earned Income Tax Credit and added inflation adjustments

After this passed we saw reduction in expenditures and increased revenues.

It was pretty much the same sort of uncontrolled spending and out-of-control government bloat that Obama has pursued.

That's odd. Let's look at the numbers, my friend, to assay the truth of what you claim.

Here are the Outlays by Dollars. Generally modest increases in spending (2-3% per year)

1993 $1.409
1994 $1.461
1995 $1.515
1996 $1.560

Next let's look at inflation adjusted dollars. Again, modest increases in spending (0-2% per year)

1993 $1.615
1994 $1.642
1995 $1.662
1996 $1.673

So your contention that Clinton was spending wildly is just not supported by the evidence.

Feel free to look at years under Saint Reagan or under Bush I or II to see if they spent wildly. My guess is you did not see such modest increases in spending in comparison to clinton's first few years.

I am positive you will flail about to explain why these numbers don't agree with your hypothesis. Good luck with that.

 

[willhaven]

Which doesn't alter the fact that the doc fix was assumed by the CBO in calculating the cost of the bill.

Because the initial bill scored by the CBO was attempting to do the doc fix and everything else too. Once it was realized that reconciliation would be needed to pass the legislation, they punted the doc fix in order to do more with the reforms and still keep the legislation deficit neutral and to keep their CBO score.

HCR didn't have to be deficit neutral in the first place if both sides were willing to play along, but that's not how it panned out. So the Dems did all the reform they could without taking on "doc fix." Can you really blame them?

Just because doc fix was once a part of "Obamacare" doesn't mean Obama now owns the fallout from the doc fix legislation. Those seeds were planted over a decade ago and didn't necessarily have to be tackled by HCR in the first place.

 

[leftysergeant]

This brings down costs?

Major cut in billable time in trhe accounting department because you usually only need to make one contact with the insurance carrier and the procedure is paid for. You don't have to deal with a couple levels of beaurocrats with a mission to deny the patient the treatment that the doctor has recommended and you don't have a death panel of actuaries deciding to pull the plug on a patient based totally on cost.

You also do not have a whole lot of emergency cases which are unpayable, thus must be born by patients who can pay.

What are tehy doing to cut fraud that wasn't already being done before?

There is no fraud worse than "recision."

 

[Meadmaker]

Which is why we need more GPs and fewer specialists. All the specialists practicing in the US don't seem to have much of an effect on our health and life expectancy, but it sure does drive up costs.

I said that you couldn't provide better care for more people at reduced cost, but I wasn't entirely correct. The above is one illustration of how there are potential cost savings that could be made in the way we provide health care.

Nevertheless, what I said remains largely correct, because there are very, very, few cases where those cost savings are contingent upon providing more coverage. If we assume that the above would work to lower costs, it would lower costs even further if we simply cut people off the medical roles altogether.

The bottom line is that while I support government involvement in health care, let's not pretend that it can be done for zero cost. Medical care isn't free.