Saturday, October 10, 2009
That CBO score
The Baucus mark-up matches 10 years of taxes with 7 1/2 years of new health care spending, thereby cooking the books sufficiently to make them digestible for the CBO scorekeepers. I understand they go well with a nice chianti.
Of course, the real benefits come in the out years, when there is less new health care technology to spend money on, "saving" money for the government at the cost of shortening or degrading our lives.
16 Comments:
By 
, at
Sun Oct 11, 09:48:00 AM:
That's it, exactly. We're moving to an centrally planned autocracy here, and liberty will necessarily be the price.
By 
JPMcT, at
Sun Oct 11, 10:18:00 AM:
I'm shocjed...SHOCKED!...that they would cook the books in such a deceptive manner.
The CBO has become like a housepet flipping on it's back for a tummy rub every time The White House gets another loony idea. Like so many other things in our government, they cannot be trusted.
IF you compare apples to apples over an equal 10 year period...the cost goes up to 1.5 TRILLION DOLLARS (with a "T").
I guess when we all lose our homes and our pension plans..we will at least have free health care. Of, course, not having any doctors to administer the care is a bit of a wrinkle...but hey...it's worth every penny!
By , at
Sun Oct 11, 11:46:00 AM:
The CBO process ignores the elephant in the room. As proposed, Healthcare is a big entitlement to be paid for by the top 5% earners. In good times, this could be bearable. But we already have an $800 billion permanent structural deficit. We could double taxes on the top 5% earners and not close the gap we already have.
Federal tax receipts have been 18-19% of GDP for the last 50 years, no matter the particular tax regime in place at the time. This is a remarkable fact … almost a law of nature. Like anyone, we should try to manage our federal spending to match our receipts. Instead, our government has often spent 20% to 21% ... which is bearable.
But we’re now boosting federal spending into the high 20s. This is unsustainable. Unless we cut spending, we should expect much higher tax rates and very aggressive IRS collections. This will of course kill growth, and only make the actual results worse. It's insane to cost out a new healthcare entitlement, while ignoring this coming train wreck.
We can't expect the top 5% earners to pay for all this ... they don't make enough. That's the elephant in the room.
By , at
Sun Oct 11, 11:46:00 AM:
Meant to sign, that was Link at 11:46 am
By , at
Sun Oct 11, 12:21:00 PM:
IF you compare apples to apples over an equal 10 year period...the cost goes up to 1.5 TRILLION DOLLARS (with a "T").
Gosh, that would make providing health care for 94% of Americans almost as expensive as the cost of conducting the wars in Iraq and Afghanistan for 8 years. Excluding, of course, the cost of VA healthcare.
By , at
Sun Oct 11, 01:13:00 PM:
Link response to Cinzia,
Point taken. The Republicans in power were profligate. But that doesn't mean we can double down on profligacy. Dad's buying a sports car doesn't mean Mom can put add a great room extension on the house, if the money's not there.
We need to budget to 18% of GDP at the federal level is my point. Instead we're committing to an unprecedented increae in federal spending. It'll blow up.
By Dawnfire82, at
Sun Oct 11, 03:18:00 PM:
So, $1.5 trillion is 'almost as expensive' as $1.071 trillion?
Or were you running with the inflated, ridiculous to the point of stupidity $5 trillion estimate that includes 'social costs,' 'a higher cost of oil,' and foreign aid budgets?
By , at
Sun Oct 11, 03:33:00 PM:
We could afford the Iraq War.
We could afford the Prescription Drug Benefit.
We could afford Stimulus, and lots of miscellaneous pork.
We could continue to support Social Security.
We could continue to support Medicare/Medicaid for some time.
We could afford the current healthcare proposal.
... but we can't afford all of them. Trillions start adding up. Federal spending is already far ahead of our ability to tax. Unfunded federal mandates are a big factor in why many states are going broke.
Foreign leaders see this -- most of our political class is in denial.
I didn't include Energy in this list because it's just shithead stupid.
We've been running a controlled experiment lately and the results are in. Do we want the federal govenment to act more like Texas or like California?
Link, over
By JPMcT, at
Sun Oct 11, 03:52:00 PM:
"providing health care for 94% of Americans almost as expensive as...blah, blah"
Well, Cinza, the Constitution of the United States DEFINES the role of our government...can we agree on that?
Having a military and protecting our citizens is a part of that definition...YES?
Gosh... I can't seem to find ANYTHING in there about healthcare, as hard as I look.
Even if you can twist the life out of the Constitition to make it a "living" document...and say that the government should control our diet, work habits, income, healthcare, mortgage payments, transportation and reproduction...well, Cinza, I DEFY YOU to tell me that they can do it well.
For instance...where do you think they are going to get all the doctors to work for union wage to administer the "healthcare".
The result will be Chaos, Corruption and Incompetence.
Truly a "NOBEL" effort, heh??
By , at
Sun Oct 11, 07:22:00 PM:
where do you think they are going to get all the doctors to work for union wage to administer the "healthcare".
Good grief, JPMcT. Not every doc has a private practice on Park Avenue. Nearly 50% of the doctors in the United States ALREADY are salaried employees working in hospitals, HMOs etc! The numbers of licensed physicians joining unions has been increasing for years. What's your point?
Pppffffttt. Turn off Fox News and stop your Chicken Little/Sarah Palin imitation. You're embarrasing yourself, and wasting people's time.
By JPMcT, at
Sun Oct 11, 08:50:00 PM:
"You're embarrasing yourself, and wasting people's time"
The average physician in this country, like myself, currently get about 22 cents on the dollar from Medicare.
This nation, even WITHOUT "Obamacare", will need about 20,000 new surgeons over the next 20 years to replace those who are retiring and handle the increasing number of Medicare enrollees.
Being a surgeon, I follow those stats...but they are not much different for internists and Family Medicine graduates.
Bottom line...we are NOWHERE NEAR the number of "watm bodies" needed to handle our CURRENT projected patient load.
Add another 25-40 million people to the mix, rachet down physician reimbursement yearly (we drop ANOTHER 22% in January), do nothing about tort reform, pull another 400 Billion out of Medicare and make physicians employees rather than independent practitioners...and what do YOU think, ANON 07:22, will happen?
My family will always have a doctor...ME...and I don't charge them very much here on Park Avenue.
Good luck finding somebody for YOUR family, Anon!!!
Sorry to have wasted your time...I suspect you'd best make the most of it!
By , at
Sun Oct 11, 10:56:00 PM:
From Link,
On current track, we'll see 80% marginal tax rates on incomes over $150,000 -- or something like that. If so, if you did an NPV of a doctor's earnings -- considering the investment of time and education dollars required -- it wouldn't match a higher tier civil service job.
In ObamaLand, it won't pay to be a doctor ... or an entrepreneur, unless you're in a cash business.
Medical care will be a lot like what you see in the VA system I suspect -- unless you're in the UAW or in Congress.
By , at
Mon Oct 12, 08:41:00 AM:
Anon said, "Not every doc has a private practice on Park Avenue. Nearly 50% of the doctors in the United States ALREADY are salaried employees working in hospitals, HMOs etc! The numbers of licensed physicians joining unions has been increasing for years. What's your point?"
Well, my point would be that tort reform would allow more doctors to have a private practice. That way it was before the early 70's when lawyers like President Obama sued the doctors until their malpractice insurance premiums skyrocketed.
Also, the Democrats should stop lying about health care reform and start proposing health care reform. The Republican plan has been around for decades, but Nancy Pelosi's "Culture of Corruption" accepts too much money from the tort lawyers to discuss it.
By , at
Mon Oct 12, 11:26:00 AM:
Well, my point would be that tort reform would allow more doctors to have a private practice. That way it was before the early 70's when lawyers like President Obama sued the doctors until their malpractice insurance premiums skyrocketed.
Oh, so now Obama was an ambulance chaser, too? Was that before or after he was a community organizer? LOL.
Here a real fact, Doc. With or without medical malpractice and litigation, costs are at are at 1.5% of medical costs.
Hmmmmm....Perhaps the insurance companies are overcharging doctors? Or perhaps all you doctors are ordering expensive tests and driving up costs because you're afraid of lawsuits???
By , at
Mon Oct 12, 12:52:00 PM:
From Link,
Recent Anon posts are ignoring JPMcT's main point. We're going to need more doctors, and doctor equivalents, because of demographics. We have a huge shortage coming. It's one of the biggest problems in healthcare. Nothing in ObamaCare aims to solve this. In fact, ObamaCare will make it worse.
Many doctors run what are actually small businesses. All small businesses are getting crushed. It'll only get worse. So that's an added problem.
Here's are two relevant personal stories:
1) My son is a high school senior. I think he'd make a great surgeon. He's smart enough and has good hands. Surgery is fast becoming a video game, at which he excels. But from a strictly financial assessment, I don't know that it's worth the investment. If you ran numbers, he'd be better off playing my relative's political connections to get a tit job in government.
2) My sister was a nurse that should have gone to med school. After years as an OB/GYN nurse she became a midwife working out of a big NYC hospital. This is exactly the kind of thing we need more of -- "doctor multipliers." But she got driven out by lawsuits, even though she'll swear she never made a serious mistake. It's too easy to blame "bad babies" on a claim of supposed second rate care. My sister's now in admin and studying finance part-time at Columbia Business School.
There's an enormous gap between the professed goals of Obama's Hope and Change and the reality of the detail. It's rife ... which ought to tell us something.
Link, over
By JPMcT, at
Tue Oct 13, 11:44:00 PM:
Thanks, Link. The Anon posts offer as "fact" a link to what is essentially a free-lance book review from the New York Times of a tome written by an insurance law professor...and is used extensively in Democrat talking points (when they aren't busy opening their mail and posting campaign donations from the trial lawyers)
The hard facts are that malpractice costs sure as hell aren't 1.5% on MY costs. I live in a capped state and am LUCKY to pay ONLY about $45,000 a year for malpractice insurance...and I have never been sued.
Last ime I checked, I wasn't clearing a cool 3 million a year!
You can bet your bottom dollar that when I have the choice of getting an MRI scan, or a full battery of tests on some crazy person who clearly has nothing serious wrong, I think of my wife, my kids, my retirement and my business...and I order away at full tilt boogie.
Almost HALF of medical malpractice cases, when reviewed by panels, have no evidence of medical wrongdoing or permanent injury...and yet almost a fifth of these cases get awards.
You can get medical grade silicone products at reasonable cost anymore because of the Dow Corning litigation involving breast implants causing various somatic complaints...even without a SHRED of medical evidence that such was the case...the whole company wnet into the dumper on that one.
Everytime a valuable drug develops a side effect. I see a TV commercial inviting people to sure over the side effect...and fear that we will lose the drug in the process.
Either we should call a halt to the free-for-all and allow consumers to sue for verifiable damages as a result of intentional negligence (that's the criteria that one must use if you try to sue a LAWYER)or just shut up and put up with the BILLIONS of extra dollars inherent in the cost of defensive medicine.
Our buddies in the CBO just did a study and stated that simple tort reform measures could save around 50 billion bucks in the deficit over ten years. They will probably
change that tune when they get called into the oval office.
My original point was that we are running out of doctors. Even worse, we are running out of good people who WANT to be doctors.
Even though I truly love what I do...I discouraged my three kids, who are every bit as smart and talented as I am, from going into medicine because the handwriting is on the wall...clear and simple.
Hope and Change....if you live long enough.
