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Re: "Free market" is a VERY big phrase. MalkierKnight Send a noteboard - 25/03/2010 10:31:13 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.

There was a post earlier in this thread that projected healthcare costs (from Medicare and Medicaid) costing immensely more than predictions for Obamacare. So I'm not sure how healthcare costs aren't out of control. And to your point about single payer programs, as the cost of healthcare continues to rise exponentially, I think a lot of people are on the same page that medicare can't continue. SOMEwhere the money has to be made up for, that's where the government is supposed to step in, no? The numbers just don't add up. I like the fact that the bill sets up exchanges for insurance, but other than that...I'm not so high on it.

Thus:
The Congressional Budget Office (CBO) has indicated that: "Future growth in spending per beneficiary for Medicare and Medicaid—the federal government’s major health care programs—will be the most important determinant of long-term trends in federal spending. Changing those programs in ways that reduce the growth of costs—which will be difficult, in part because of the complexity of health policy choices—is ultimately the nation’s central long-term challenge in setting federal fiscal policy." Further, the CBO also projects that "total federal Medicare and Medicaid outlays will rise from 4 percent of GDP in 2007 to 12 percent in 2050 and 19 percent in 2082—which, as a share of the economy, is roughly equivalent to the total amount that the federal government spends today. The bulk of that projected increase in health care spending reflects higher costs per beneficiary rather than an increase in the number of beneficiaries associated with an aging population."[49]

So with that correction I largely agree with you, and perhaps that is the real spur to attempted (but failed) reform, the reality that if costs remain unchecked Medicare will fail financially regardless of the political consequences of telling seniors they can't have what they spent decades buying. And the same CBO saying that is very clear that:

1) It's not due to seniors becoming a larger share of the total population,

2) Costs of the recent prescription drug benefit have actually been over rather than underestimated and

3) Even scaling back the more expensive Medicare Advantage program only delays the inevitable by a year and a half.

For all the charges of socialism (and I'm not sure how forcing everyone in the country to BUY PRIVATE INSURANCE is socialist) the private sector is failing the nation, and looting it to boot. When an industry on which people depend for survival is doing that, almost entirely free of federal regulation and while enjoying a number of statewide monopolies, yes, that's where government is supposed to step in to remedy things. Social contracts in the form of governments were created to prevent the powerful preying on the powerless, whether it be an invading army or a ravenous industry, "all enemies foreign and domestic" as the military oaths put it. That's not socialism, it's civilization.

The state level insurance exchanges might end the monopolies (in four years, though I think they're more likely to just replace them with collusion, particularly if effective federal regulation doesn't exist) but otherwise we're trying to cure private insurers insatiable appetites by shoving enough taxpayer, consumer and debt funds down their throats that they choke on it. The solution to greed is never "throw money at it. "


This might be the private sector's fault, but it's certainly not the fault of capitalism and the free market. Costs would go down if there was competition between insurance companies, or even just health providers. I only see a real need for catastrophic insurance set up in a similar way as term life insurance (so as to avoid suddenly changing rates).

It amazes me that democrats are so opposed to and republicans are so hesitant to support a bill that allows americans to buy healthcare with their own hard earned money, in the same way that everything else is provided. With competition, costs go down. It's the most BASIC fact of economics, whether you're a keynesian, austrian, or whatever.

To appease the democrats, we could still have government support for the needy, but this support would not be out of control (because cost would be controlled).

I just don't see the need for 900 billion dollars, however spread out and structured it might be, and all this government involvement. Pretty much everyone in this nation can get a decent cell phone if they want one (unlimited calling plans are now $30 per month in some cases). Clothing. You don't see people roaming the streets in search of clothes, because it's a necessity with competition. If healthcare is such a necessity, we need not fear the cost when left to the free market.

Bottom line, it's really all about appeasing this big companies. Politicians are afraid and just looking to get reelected. It's a shame. It really is.

You do realize the moment you introduce any degree of government oversight you're moving away from capitalism and toward communism, right? I don't dispute the need to do that, but that's the the funny thing about pure laissez-faire capitalism: It only allows a free market until the first few entrepreneurs solidify their market share, and after that a variety of perfectly legal practices (such as collusion and underselling new competition) will restrain any competition, unless the government says it's illegal.

Short form of the above: Pure capitalism OR communism makes a truly free market impossible. Which means if we really want a free market socialism is the best choice by default, because it avoids the other two systems most tyrannical private and government abuses.

Catastrophic health insurance would be necessary if only to prevent insurers from dropping anyone and everyone the first time they have a sizable or long term claim. Which, incidentally, is common, and not just with health care insurers, as the people who filed flood insurance claims after Katrina learned.

As to why there's so much opposition to a bill that allows people to buy health insurance, it's because people are already ALLOWED to do it if they can afford it; this bill REQUIRES it (which, once again, is where the $900 billion federal subsidy comes in; despite a market regulated by little more than private insurers will, tens of millions can't afford their "service. " )

And whether you see them or not, there are people roaming the streets in search of clothes (and other necessities; ) that's why we have annual coat drives for underprivileged kids. Just because something's a necessity doesn't mean competition will make it affordable; for one thing, even when there are multiple manufacturers or providers, without regulation there's no reason they won't agree among themselves on a price that ensures them all a tidy profit. There's every reason they will, in fact, because, unlike with cell phones, consumers don't have the luxury of doing without their product/service. That's why we don't let the market alone set the price of necessities like food and shelter; we've made provision for government assistance to those who can't afford what the market price. Every other industrialized nation on Earth has done the same with healthcare, for the same reasons.

Yes, a lot of this is about doing what large corporations want; in laissez-faire capitalism that's how things work, and why they don't. Just ask the junior Senator from Connecticut (location of Hartford, the insurance capital of America. )


I'm not sure I agree with you at all about socialism being more free market oriented than laissez-faire capitalism, but I follow your point. At a certain point, both socialism and laissez-faire go away from the basic goals of capitalism and that is: competition drives down costs and the consumers determine what gets produced. The best thing to do is have limited government oversight, ensuring that things are fair (I don't mean to beg the question here) and that the rights of individuals are protected.

There are people roaming the streets looking for clothing, but the percent of citizens below the poverty line is incredibly low in the united states. And, I would venture to say, that the number of people who cannot find enough clothes to survive is far less than the number of people who will not be able to afford insurance in Obamacare. To say that clothes are a necessity people are unable to obtain is just pure wrong. Some people might want to be warmer or more fashionable, but Obamacare doesn't promise the BEST healthcare fore everyone does it? No, it does not. We only need to clothe ourselves enough to survive and to provide whatever comfort we can afford. The same is true of healthcare.

Necessities that aren't natural resources ARE prone to prices being driven down, because there's always someone willing to appeal to that sector of the economy which can't afford expensive meals. A pasta dinner costs $5. There are tshirts at aeropostale, a well known brand, that go for $10.

Now, I'm not saying people shouldn't have government aid for things like healthcare. I'm just wondering WHY the government has to pay for all of it? The answer to that is probably "because healthcare costs too much." Well, then lets control cost. HOW? Capitalism!! Is food THAT expensive? Is clothing? Is water? All essential components to survival that most people can afford to indulge on. What keeps this cost down? Capitalism. Not laissez-faire, but a moderate free market economy. Look at the things people can't afford in this country. Healthcare and rising gas prices. Both either government run or monopolized.
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Obamacare: Explained? - 22/03/2010 07:21:44 PM 664 Views
Someone had a good link earlier... - 22/03/2010 07:32:36 PM 506 Views
Thanks - 23/03/2010 03:48:04 AM 290 Views
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This is wonderful thank you. I've already picked my favorite. - 22/03/2010 07:47:59 PM 327 Views
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this is why I believe in dictatorships - 22/03/2010 08:05:14 PM 311 Views
It's all populism, really - 23/03/2010 03:51:31 AM 305 Views
OOoo I like that idea. - 23/03/2010 04:20:48 AM 313 Views
Re: OOoo I like that idea. - 23/03/2010 03:01:08 PM 311 Views
Senators don't constantly campaign though. - 23/03/2010 04:20:51 PM 296 Views
I don't think that's the point though... - 23/03/2010 09:35:29 PM 326 Views
At one point some of the concerns were valid. - 23/03/2010 06:03:29 AM 487 Views
Re: At one point some of the concerns were valid. - 23/03/2010 03:05:58 PM 374 Views
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 405 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 404 Views
Can't find that link in this thread, but the CBO seems to agree with you, not me. - 23/03/2010 11:47:29 PM 613 Views
I don't agree - 24/03/2010 08:52:12 PM 403 Views
"Free market" is a VERY big phrase. - 25/03/2010 07:32:06 AM 308 Views
Re: "Free market" is a VERY big phrase. - 25/03/2010 10:31:13 PM 431 Views
I'm not sure competition is a primary goal of capitalism. - 29/03/2010 12:14:06 PM 409 Views
Re: This is wonderful thank you. I've already picked my favorite. - 22/03/2010 08:04:50 PM 309 Views
Re: This is wonderful thank you. I've already picked my favorite. - 22/03/2010 08:07:39 PM 302 Views
Re: This is wonderful thank you. I've already picked my favorite. - 22/03/2010 08:28:10 PM 309 Views
ah yah. Fair enough. - 22/03/2010 10:01:41 PM 305 Views
The $900 billion is essentially just government subsidies: Healthcare's gotten THAT expensive. - 23/03/2010 06:23:01 AM 322 Views
you make it sound like this is the end-all bill. - 23/03/2010 12:01:20 PM 300 Views
I doubt we'll see another bill after the reconciliation bill. - 23/03/2010 02:05:59 PM 311 Views
I agree 100% - 23/03/2010 03:18:08 PM 308 Views
Too bad for America. - 23/03/2010 04:29:19 PM 339 Views
no, the "now or doomed" mindset is not why I'm willing to wait - 23/03/2010 03:23:21 PM 313 Views
Well, if you really are waiting for them to fix it later you'll wait a long time. - 23/03/2010 04:33:25 PM 285 Views
broken legs are not longer a good metaphor - 24/03/2010 12:33:14 AM 293 Views
Most people still understand what I mean. - 29/03/2010 01:16:35 PM 287 Views
Not surprising - 23/03/2010 10:37:25 PM 305 Views
Supposedly it's fixing part of that. - 23/03/2010 11:21:32 PM 307 Views
It's quite simple. - 23/03/2010 04:23:45 PM 365 Views
And what does government-run health care have to do with this bill? - 23/03/2010 04:25:28 PM 321 Views
You mean it is still - 23/03/2010 04:29:55 PM 314 Views

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