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We can't pay for the subsidies; even after the tax hike they increase debt in the short term. Joel Send a noteboard - 23/03/2010 04:12:14 PM
I'm sure you saw the post over at fivethirtyeight about lessons Democrats should learn from this debate and the Clinton era one, and it echoed many of my own thoughts over the past year. Obama completely lost, even ceded, control of the debate, to a party that rests most successes for a generation on framing debate in terms favorable to them. One issue Nate Silver raised was that there were so many different possible forms the final bill could take, and the administration was so taciturn about which specific points they supported, that it was very difficult for Obama supporters to defend positions that remained vague and undefined. Put more simply, Obamas particular views on healthcare throughout 2009 were uncertain and dubious, so it was very easy for opponents to sow additional uncertainty and doubt.

I'd say this is because Obama wants to claim credit for whatever bill happens to be passed, rather than put his beliefs out there and risk failing.

The Medicare accusations are a good example; at one point some Medicare services WERE on the chopping block simply because they were envisioned as being universally available through the new national healthcare system. If the national healthcare plan guarantees cancer screening to all patients at no cost, it's rather pointless to have Medicare provide them as well, yes? Further, one thing that seemed completely ignored in the negotiations with Lieberman is that Medicare will be operating at a net loss within a decade because more people will be paying out than paying in; lowering the enrollment age so that those people began receiving Medicare NOW rather than then was a rather questionable carrot to offer liberals. Yahoos article on the bill early this morning mentioned reduced federal payments to retirement homes and similar private institutions partially paid for by Medicare, and the Yahoo article linked below says of GOP plans for the midterms that, "McConnell signaled his intent to zero in on items like planned cuts to the hugely popular government-run Medicare program for the elderly, and tax increases on the wealthy. " Reality notwithstanding, Republicans seemed to have learned the lesson that when one side says a popular public program is under attack and the other denies it the public has enough snap to know they're only in danger if the latter is lying.

The proof is in the pudding, but the fact remains that the motive to healthcare reform was existing high costs continuing to rise at alarming rates, and the only provision of the healthcare bill addressing that directly are in the reform of the reform set for a Senate vote later this week. It was added as an afterthought, and only barely even then. Meanwhile, all the current bill does is require the entire country to buy into a private system while doing little to reduce costs or limit their growth. That's why it will take a $900 billion dollar subsidy to those who can't afford to do so, but that so few know where that number originates speaks as poorly of Democrats as it does of Republicans who want to focus on the cost of the bill without explaining it. And that's still a very pressing concern; opponents say it's irresponsible to allow government input in 1/6th of the economy, but that's a BIG chunk of GDP whose growth shows no sign of abating.

From where I sit it still seems that we're trying to eliminate ravenous private insurance greed by shoving so much additional money down their throats that they choke on it. At the risk of sounding like a right wing conservative, while some problems may be resolved by throwing money at them, greed is not among them.


What I don't get is how medicare and medicaid costs are out of control, yet somehow expanding the same concepts which drove those programs, through government subsidies, is supposed to HELP the problem. The problem with the cost of healthcare from the start has been an inability to control rising costs of healthcare, which is why medicare costs so much. HOW then are we supposed to continue paying for these subsidies?

Although, relative to general healthcare, Medicare costs aren't rising at anywhere near the rate of the rest because (wait for it) Medicare, as a single payer program, can and frequently DOES refuse to pay the full price charged for medical care. In fact there was an article posted here a few months ago discussing how many specialists with inflated fees have begun billing patients on Medicare for the difference between what they charge and what Medicare pays. No, yet another irony in this debate has been the sheer volume of people who insist a single payer government program for everyone is a horrid idea and in the same breath attack Obamacare as an assault on a Medicare program that's been very effective precisely because it's a single payer government program. Of course, they weren't too thrilled about Medicare either back in 1964, but the difference between how LBJ handled that and how Obama handles this is night and day, so it was a much better bill. ;) Medicares problems are more looming than present, and as much about Baby Boom demographics as anything, but in considering things like that it's important to remember the Boomers had kids a generation later, so the situation is likely to reverse by 2035 or so.

Anyway, another of the problems with this bill is that the $900 billion dollar subsidy is NOT entirely covered by the combination of the upper class tax hike and the tax penalty for people who refuse to buy insurance they can't afford (this was true when the penalty started at $750 the first year, but part of the horse trading to pass the bill involved reducing that penalty. ) The rest will be paid with IOUs. I'm honestly not sure how the CBO figures it will lower the deficit in the foreseeable future, unless the taxes they added on "gold plated" union healthcare generate a LOT more revenue than I think they will, but maybe I'm wrong. I personally think it far more likely that with everyone in the country forced to buy in and government promises to make up the cost if they can't private insurance is about to unleash a feeding frenzy that makes their previous one look tame.
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We can't pay for the subsidies; even after the tax hike they increase debt in the short term. - 23/03/2010 04:12:14 PM 411 Views
Re: We can't pay for the subsidies; even after the tax hike they increase debt in the short term. - 23/03/2010 09:40:53 PM 412 Views
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ah yah. Fair enough. - 22/03/2010 10:01:41 PM 313 Views
The $900 billion is essentially just government subsidies: Healthcare's gotten THAT expensive. - 23/03/2010 06:23:01 AM 328 Views
you make it sound like this is the end-all bill. - 23/03/2010 12:01:20 PM 309 Views
I doubt we'll see another bill after the reconciliation bill. - 23/03/2010 02:05:59 PM 316 Views
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Most people still understand what I mean. - 29/03/2010 01:16:35 PM 295 Views
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It's quite simple. - 23/03/2010 04:23:45 PM 371 Views
And what does government-run health care have to do with this bill? - 23/03/2010 04:25:28 PM 330 Views
You mean it is still - 23/03/2010 04:29:55 PM 322 Views

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