Sunday, December 07, 2008
TigerHawk TV: Stimulating stuff!
After a month-long respite, TigerHawk TV returns with a discussion of Barack Obama's massive stimulus program. As usual, unrehearsed, apart from some notes, and -- obviously -- unedited!
Calculated Risk gets the credit for the "shovel ready" reference, by the way. Ed Morrissey has Obama's announcement video, which is worth watching.
And, yes, that logo on my sweatshirt is, indeed, the Iowa "tigerhawk."
Previous episodes of TigerHawk TV are at this link, always available on the right sidebar.
12 Comments:
By 
, at
Sun Dec 07, 12:15:00 PM:
Agreed. At least Obama's shovel ready stimulus involves creating jobs and infrastructure. In the past two months, Taxpayers have just spent huge sums of money bailing out the finanacial industry in staggering amounts,
Citi $45B
AIG $40B
Goldman $10B
JP Morgan $25B
Bank of America $25B
Morgan Stanley $10B
Well Fargo $25B
[Yes, that's B as in billion$]
and to entities that seemingly didn't even ask for the $$), and whom are not even using the $$ as intended (lending). Heckuva job, Hank. Goodbye, George. Don't let the door hit you on the way out.
By 
TigerHawk, at
Sun Dec 07, 12:34:00 PM:
Well, there is a big difference between the financial industry interventions and simply spending money. With a few exceptions, the point was to allow healthy institutions that had not mismanaged themselves survive, and to crush the equity of the unhealthy institutions. It was not, really, a "bail out" in the same sense as is being proposed for the auto industry, and it has worked at some basic level. Short version, I do not think that Hank Paulson has done a bad job at all.
But, that said, I am convinced that if the government does not spend money directly the economy will suck for most of Obama's first term. There is just too much deleveraging to be done.
By SR, at
Sun Dec 07, 03:13:00 PM:
Sure, but the ultimate road back will be longer with the government allocating funds rather than the market.
By , at
Sun Dec 07, 03:44:00 PM:
TH, if you ran for office, I'd vote for you in a heartbeat.
By , at
Sun Dec 07, 03:53:00 PM:
With a few exceptions, the point was to allow healthy institutions that had not mismanaged themselves survive
Huh??? AIG? Citicorp? Morgan Stanley? They're all up to their balance sheets in CDSs that haven't yet to be unwound. We (US Gov't) just guaranteed up to 300 billion of Citicorp's losses. You call that healthy? Managed well?
By , at
Sun Dec 07, 07:00:00 PM:
Writing a $35 billion check (with conditions) to the auto industry is better than the $200 billion check taxpayers will write in unemployment claims, ($25 billion alone), lost payroll taxes ($150 billioon), and mortgage foreclosures if we let the companies collapse.
By Elise, at
Sun Dec 07, 08:49:00 PM:
Writing a $35 billion check (with conditions) to the auto industry is better than the $200 billion check taxpayers will write in unemployment claims, ($25 billion alone), lost payroll taxes ($150 billioon), and mortgage foreclosures if we let the companies collapse.
Here's my problem with this logic. Let's say Americans will buy 100 cars next year: 20 made by GM, 20 by Ford, 20 by Chrysler, and 40 made by foreign automakers at their US-based plants. If GM goes out of business, someone else will have to make their 20 cars. That means Ford, Chrysler, and the foreigns will be hiring more workers.
We'll pay unemployment to GM employees but stop paying it to the people hired by the remaining auto companies. We'll lose taxes paid by the GM workers and by GM but gain taxes paid by the new workers and by corporations that are now making more money through selling more cars. I don't see how the government is on the hook for health benefits if GM goes down unless it's through increased use of Medicaid and, like unemployment, Medicaid costs will decrease for new workers hired by the remaining manufacturers.
In fact, laid off GM workers may be the very workers hired by Ford and Chrysler and even by the foreigns if the workers will relocate.
So it looks to me like the only Federal costs that aren't a wash are pension guarantees. The "new measures that would be needed to revive economic growth after millions of auto-related job losses" are not necessarily Federal costs: the affected states can assume them or no one can assume them.
(BTW, the $200 Billion Bloomberg is citing is for GM alone not for all 3 US automakers.)
In an unrelated issue I've never really understood how having medical records on central computers would save all the money everyone talks about. Could someone explain?
By TigerHawk, at
Sun Dec 07, 09:00:00 PM:
In an unrelated issue I've never really understood how having medical records on central computers would save all the money everyone talks about. Could someone explain?
It's a long story, but digitized and organized patient treatment records confer at least three advantages: First, they would reduce errors a lot (such as all the errors in the taking of a patient history). Second, they are an essential first step to the most inefficient aspect of American healthcare, which is that we treat individual diseases rather than patients along a continuum of care. Third, the big "excess costs" in the American system come from big regional disparities in treatment. It turns out that in large parts of the country we get results comparable to and at similar cost to the best European systems (see, e.g., France). Unfortunately, in places where there are large concentrations of specialist physicians (because specialists want to live there) costs go through the roof because of over treatment more than anything else (all those specialists have to earn a living). The collection of data would allow us to drive physician practices in those areas with overtreatment problems toward the national average.
There's more than that to it, but those are three big reasons.
By , at
Sun Dec 07, 11:15:00 PM:
Writing a $35 billion check (with conditions) to the auto industry is better than ... blah,blah blah,.... let the companies collapse.
I'm really getting sick of this "if we don't bail out Detroit the auto companies will collapse and millions will be out of jobs" BS I keep hearing from the chicken little's. At most no bailout means reorganization through bankruptcy with the companies coming out stronger on the other side.
The only way no bailout means the auto companies are shut down is if they (meaning the UAW who are really who would be getting bailed out) stage a shutdown to extort money from the taxpayers.
Alan
By , at
Sun Dec 07, 11:23:00 PM:
Americans have forgotten the name of the political system which decides those industries which fail and those which are sponsored by the government. Has everyone forgotten basic civics? IMHO the whole bailout idea is bad for America.
Unemployment claims are overrated. Assuming the bank didn't steal the money, the entire auto industry could live off the bailout money and never work again for their entire lives.
Computerized health records help individual doctors bill properly. They help reduce the number of multiple billings. They speed up the billing process when HMOs and government care agencies are involved.
As a note, the 9th Circuit Court denied the ability for work-at-home Americans to work directly for individual doctors filling out the electronic data and submitting the electronic forms to the appropriate agencies. That decision made sure that only the large HMOs and large hospitals could participate in the health records business. Health care costs increased and Joe Cool American took another kick in the rear end.
Dave
By , at
Mon Dec 08, 10:20:00 AM:
In an unrelated issue I've never really understood how having medical records on central computers would save all the money everyone talks about. Could someone explain?
Adding to TH's earlier comment, every piece of medical record paper needs to be securely stored, in warehouses. That requires inventory control systems, trucks, and ongoing costs of storage in environmentally controlled, secure sites. Very expensive.
Similarly to medical record storage, almost every private payer payment transaction (and many Medicare transactions too) is evidenced by paper explanations. The paper (called EOP's and EOB's, which you also receive at home whenever you file a medical claim) is incomprehensible to most provider organizations, yet the documents are printed, mailed, used for extensive data entry into both Hospital Information Systems, for cash posting, and also Denial Management Systems (sometimes, but usually not), imaged for certain purposes and in some instances, trucked to storage warehouses and stored in those warehouses for up to ten years (depending upon which state we're talking about).
That's just two examples of the enormous cost of paper in this "industry", if it can be described as an industry. The major truth about how medical Providers run their business offices and certain parts of their clinical operations is that paper is hugely expensive and inefficient. Being able to access medical records electronically, as well as all claim and payment data, would bring enormous savings and better service to Providers.
By Elise, at
Mon Dec 08, 12:13:00 PM:
Thanks, TH. So I get Reason 1 - digital systems reduce errors - and it makes sense. Reason 2 - digital systems are an essential first step to the most inefficient aspect of American healthcare, which is that we treat individual diseases rather than patients along a continuum of care - I have reservations about. I'm simply not convinced it's possible to *not* treat individual diseases. I guess I need to do some reading on the thinking behind this.
As for the third reason - driving physician practices in those areas with overtreatment problems toward the national average - that makes me nervous. I'm pretty sure that if I didn't live in an area with an over-concentration of specialists (Essex County, NJ) I'd pretty much be dead. Or to put it another way, if I'd received the average treatment for what ailed me, I would definitely be dead. I understand the need to get medical costs under control and I'm sorry to sound selfish but I'm not very happy about the idea that I'll end up as Exhibit A in someone's presentation about how people in the greater New York metropolitan area get too much medical care.
