Ezra Klein Provides Party Line on CBO Scoring of Obamacare
Tags: health care.
Click here to get Caucus of Corruption: The Truth About The New Democratic Majority by Matt Margolis and Mark Noonan.
Perhaps he’s auditioning for Obama’s forthcoming Ministry of Truth?
I would, however, like to propose a couple of rules for commenting on this story. Politicians who are going to use this CBO report against the existing health-care reform proposals must do some combination of the following:
a) Support, as the CBO says you should, the eradication of the tax exclusion that protects employer-based health-care insurance;
b) Support, as Lewin and Commonwealth say you should, a public insurance option that can bargain at Medicare’s rates;
c) Support, as the Office of Management and Budget and every health-care wonk in town says you should, one of the various policies floating around to give MedPAC authority to continually reform and modernize Medicare;
d) Support some form of aggressive cost-sharing that would make people extremely angry because it will save money by reducing their access to health-care services;
e) Support comparative effectiveness review that can judge not only the effectiveness but also the cost-effectiveness of various treatments, and give the federal government authority to use that data when deciding reimbursement rates.
How about, instead, I support ending a system where the sniffles are to be covered right along side lung cancer? You see, Ezra, this isn’t just an exercise in debating which bit of socialized medicine we’ll have, but whether or not socialized medicine is a worthwhile objective. Given that my view is that its unworkable, your rules for objecting are nonsense.
The root cause of our health care insurance crisis (and that is what it is – not a health care crisis, but a crisis in the insurance we use to pay for health care) is Medicare, Medicaid and the rapid spread of health care insurance which was triggered by the massive run-up in health care costs stemming from Medicare and Medicaid. Once upon a time, no one had health insurance – and everyone could go to the doctor; now we’ve got health insurance out the wazoo, and 46 million can only go to the doctor by heading for the ER and burdening everyone with their health care costs.
Now, we can’t end Medicare and Medicaid because the people simply will not see where their problem lies – plus, the left side of the aisle will say we want granny and the grand-kids to die, because we’re mean, old Republicans. Our problem then comes about in how to reform Medicare/Medicaid to prevent it from bankrupting the country while at the same time creating programs which will take away the “everyone will die without socialized medicine” propaganda meme from the left. The solution?
1. Charge $50 for doctor visits for Medicare/Medicaid recipients – that’s all; everything else is free…but by putting a significant charge on going, we’ll get people to stop going for every trivial thing which comes up.
2. Allow people to buy insurance where ever they choose.
3. Allow people to band together in whatever groups they wish to buy insurance in bulk.
4. Provide a government-subsidized catastrophic health care insurance – doesn’t cover basic care, but it does cover you for sudden terrible injuries or illness, as well as care for debilitating, chronic conditions.
5. Work via the Department of Education to provide grants to ease the cost of medical school and other medical training in order to vastly increase the number of health care providers, thus driving down the cost of using medical services over time.
And that, Mr. Klein, will solve the problem – without trillion dollar increases in spending, massive new taxation, or government control.
UPDATE: As is entirely expected, Obamacare opens up vast, new revenue sources for trial lawyers. What? You thought that with a fair and wonderful government plan that malpractice suits would stop? Geesh! What planet have you been on?
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21 Responses to “Ezra Klein Provides Party Line on CBO Scoring of Obamacare”
Caucus of Corruption
Medicare is the most efficient form of insurance in our country; I think the only reform efforts we need there are reforming the abusive excesses.
Sounds kind of like the notions that insurance companies shouldn’t be able to discriminate based on pre-existing conditions, preventing the ability of people choosing their own insurance. I do hope you win the argument on this point.
I also hope attempts to prevent small businesses forming buying cooperatives fails…
Wow, what a socialist you are… can’t disagree about the social and economic stability you advocate.
Makes lots of sense. I guess government isn’t all bad, eh?
Seems you’ve got some sense in you.
Mark or anyone;
Have you seen anything about the cost or coverage of medications under the public health care plan?
Medicare is the most efficient form of insurance in our country; – winnowhead
Winnow,
You have a very distorted definition of “efficient”, which renders the rest of your drivel meaningless and boneheaded.
The CMS Office of the Actuary on Friday projected that state and federal spending on Medicaid will total about $339 billion in 2008 and will rise at a rate of 7.9% annually to $674 billion by 2017,
http://www.medicalnewstoday.com/articles/126123.php
The Medicaid program has grown from covering 34 million individuals in 1999 to 47 million last year, and Medicaid costs have soared from $159 billion in 1997 to $295 billion in 2004 – an increase of 85 percent.
Lol… cluster, do the math on your logic….
Again winnow, brilliant rebuttal. Medicaid is fast approaching to be a trillion dollar program that covers a fraction of the populace and you called it “efficient”
Hopefully you’re not an accountant.
uffy: Have you seen anything about the cost or coverage of medications under the public health care plan?
Here you go.
again, do the math on your own logic..
Let’s do the math: $339 billion to cover 47 million people. That equals $7,213 per year, per person, or $600 per month, per person.
I currently cover my entire family for roughly $500/mo.
Care to talk more about efficiencies?
fun isn’t it?
Let’s approach healthcare from a different perspective. What if they were cafeteria options and tort reforms? What do you think would happen to healthcare costs?
the douche needs somewhere to go, it seems… and he likes to do imaginary math, at that. (give the douche his math, the fairy says)
cluster: Let’s do the math: $339 billion to cover 47 million people. That equals $7,213 per year, per person, or $600 per month, per person.
About half of enrollees are children, who got an estimated $2,435 worth of benefits, while adults obtained $3,586 in benefits. Expenses are substantially greater for the disabled and elderly — more than $14,000 per person.
Read more: http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2008/10/17/national/w142753D85.DTL&type=politics#ixzz0Lcg9nrN4
I currently cover my entire family for roughly $500/mo.
But that’s only if you don’t avail yourself of medical care. Say your kid broke his or her arm. Do you have any idea how much it would cost you? How about if someone in your family ended up in the hospital for, say, three days? In short, your medical coverage costs you $500/mo only if you don’t use it. At all.
Anyway, for the sake of comparison, see this.
From the link:
Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, and inappropriate care, waste and fraud. These problems significantly increase the cost of medical care and health insurance for employers and workers and affect the security of families.
And we haven’t even addressed yet the elephant in the room: Lawyers and mal practice suits.
Rico,
Your link actually support market based solutions and not government control. We need to take the lawyers out of the equation, and offer cafeteria option to healthcare. Not eveyone needs full coverage.
Market based solutions will stream line inefficiencies and lower admin costs. Government will only exascerbate those problems. Then when serious tort reform is enacted, costs will drop dramatically.
cluster: And we haven’t even addressed yet the elephant in the room: Lawyers and mal practice suits.
While I do believe it is something that needs to be addressed, I wouldn’t call it the elephant in the room. The fact is, in states where tort reform has been enacted, the effect on insurance premiums and over-all cost of health care has been negligible. See, for example, http://www.dallasnews.com/sharedcontent/dws/bus/columnists/jlanders/stories/DN-Landers_21bus.State.Edition1.9be351.html“>this article. I’m afraid the elephant in the room is exactly those things you highlighted from my previous link. That is, the private market has generally done a piss-poor job so far. It seems to me obvious that the status quo has to be rattled in some kind of major way. I’m not saying a public option is necessarily the answer. I’m just not ready to rule it out.
“…the private market has generally done a piss-poor job so far.” Which no doubt explains why people come to the United States from socialized-medicine nations for health care. While the system has its defects, “generally” it has provided the best quality of health care in the world.
I say the elephant in the room is the illegal alien problem. Anyone who has been in an ER in the past few years has seen it packed with Mexicans, there for rashes and nausea and other symptoms that could be and certainly should be addressed in any venue other than an ER. If we remove the illegal alien population from the number of uninsured, we will have a much more reasonable number to deal with. There are Urgent Care clinics in nearly every city which can, and do, serve the semi-emergency crowd much faster, much cheaper, and much more efficiently than hospital emergency rooms. Privately run, of course.
Mark’s post was an excellent one, which addressed specific problems and offered reasonable approaches to solving them—as opposed to the sweeping “reform” Our Glorious Leader is trying to stampede us into, which is to simply dump the system and get into a whole new one.
Opening up insurance competition, so companies can compete nationally, is an option—the Constitution does say the feds are to control interstate commerce, so this is a legitimate place to start. Just as auto companies have found specialty niches—-bad drivers, older drivers, etc.—health insurance companies could do the same. There might not be enough people in a specific category in one or two states to make a niche policy profitable, but nationally there would probably be enough who have had a skin cancer removed, for example, and are now uninsurable, to make a company specializing in this circumstance worth starting.
And as for Medicare and Medicaid, all you have to do look at the amount of fraud and waste to see how well government handles health care.
What we are not getting is that this whole plan is less about health care and more about instituting government control over as many aspects of life in this country as possible, as quickly as possible, before we start to see the pattern and get alarmed enough to stop it.
RE: What we are not getting is that this whole plan is less about health care and more about instituting government control over as many aspects of life in this country as possible, as quickly as possible,
Exactly! The government thinks they are more sovereign than Almighty God…so they think they can do as they please with everybody and everything.
We are only seeing the initial set-up plan being put in place, when things start to rolling then we’re going to see times go bad in a hurry.
Nobody is alarmed or worried about it because they’ve been made to believe Obama, get down on their hands and knees and worship Obama, beg for more money from Obama. Well, they in for a surprise, too.
We in big trouble unless people picks up arms!
winnow touts Medicare as the most efficient?
Medicare/Medicaid rations care and coverage! And she touts it as an accomplishment?!?
Amazing, two government programs, Medicare/Medicaid and Social Security, are fast approaching bankruptcy and are incapable of sustaining themselves. These lemmings, especially winnow, are going to trust the government with their health, 100%, no questions asked.
Well, they are government indoctrinated in the highest order.
It’s nice to know you have been thinking about the problem, amazona. If you keep it up I suspect you’ll come to appreciate the fact that most of Mark’s “solutions” suffer from fiscally and/or ideologically illogical holes big enough to drive an ambulance through. But at least he’s trying. The problem is indeed complex. It can’t be blamed on any one thing, and I sincerely doubt that any single simple solution will fix it. Some very hard choices will be involved.
And there is no question that health care in the US is among the best in the world, particularly when it comes to cutting-edge treatments. But there is an obvious and growing caveat: you have to be able to afford it. Some folks from other countries can. Many US residents can’t. And if you’re not covered by your employer, heaven help you if you have a pre-existing condition. Partially for that reason the medical tourism industry to destinations like Singapore, Thailand, India, etc., is much larger and growing faster than the medical tourism industry to destinations in the US. I can’t find any reliable numbers that directly address the question of revenue inflow vs. outflow to/from the US specifically, but from what I’ve read it seems reasonable to assume that the money being outsourced is larger than that being insourced. If so, while it might benefit the medical industry individually, it doesn’t benefit the economy as a whole. You always have to consider those transactional externalities to get a complete picture, ya know?
The same could be said vis-a-vis the “illegal alien problem”. After all, for some folks (namely those that employ them) illegal aliens are a feature not a bug. And of course without them various commodity prices will likely rise. So again, you have to pay attention to the various externalities of that transaction.
Given that you’re a fan of the Law of Unintended Consequences I can only guess you’re loving my comment so far, right?
As for fraud and waste in Medicare and Medicaid, the bigger question is how does it compare with fraud and waste in the private sector? Given that the per-capita cost of Medicare and Medicaid — and VA health care for that matter (which is arguably a better domestic test case for publicly provided health care) — is lower than the per-capita cost of private health care (even though the private health care industry currently enjoys the ability to deny coverage to the worst cases, making them Medicaid cases by default), I’d say you have some up-hill sledding on your hands.
tiredoflibbs: Amazing, two government programs, Medicare/Medicaid and Social Security, are fast approaching bankruptcy and are incapable of sustaining themselves.
What would you suggest? Here’s one option: delay both Medicare and Social Security to the age of 70. That and/or extend payroll/FICA to higher incomes. Do you have a problem with that? Personally, I think those things should have been done 5 or 10 years ago. Had it happened, poof, problem disappears. Of course if it did, the burden on the private sector would have been greater. But hey, that’s what you want, isn’t it?
“And there is no question that health care in the US is among the best in the world, particularly when it comes to cutting-edge treatments. But there is an obvious and growing caveat: you have to be able to afford it. Some folks from other countries can. Many US residents can’t. And if you’re not covered by your employer, heaven help you if you have a pre-existing condition. Partially for that reason the medical tourism industry to destinations like Singapore, Thailand, India, etc., is much larger and growing faster than the medical tourism industry to destinations in the US”…ricorun
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Well said, ricorun. I don’t think anyone, even amazona, can dispute the truth in those statements.
Well said.
Rico,
Uphill sledding? From what? You didn’t answer ANY of the contended points.
Illegal immigrants: Your response was too simply point out that some industries find them to be a “feature” (interesting choice of words), and did not even address the ER problem they create. So what if commodity prices rise slightly? The larger issue is the overall cost to the economy that problem creates from schools, to jails, to ER rooms. There costs they create far outweigh the benefits they bring. And if that prblem was addressed, maybe Americans could get faster treatments in the ER rooms, specifically in AZ.
Medical tourism industry: If you can find one shred of supportive evidence, I might entertain a response. Until then, I disagree.
Fraud and waste in the Private sector: No question fraud and waste is an issue in any industry, but government is in a class all by itself in regards to this issue, and that is undeniable.
Now re: amazona’s, and my proposal of cafetreria options in re: to health care. I see that everyone is avoiding this, but this option could have wide appeal, be very affordable, and help tremendously on bringing down costs. And in re: to tort reform, no serious effort has ever been made. Doctors insurance premiums are off the charts (no pun intended), and those costs simply get passed down.