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Saturday, June 30, 2012


3 Essential Takeaways From the Obamacare Decision: Gov't is Still Unlimited, Romney's Still Lame, & Health Costs Still Set to Rise.

So now that the sages of the Supreme Court have spoken about the constitutionality of The Patient Protection and Affordable Care Act, a.k.a. Obamacare, let's get straight to the takeaways:
1. There's no credible way to spin this as a "win" for limited government. Folks such as Wash Post columnist George Will and legal theorist Randy Barnett, to name two of many on the conservative and libertarian ends of things, are working hard to say the real silver lining in the SCOTUS decision is the clear language the court used in limited Congress' use of the Commerce Clause. As Will put it, "At least Roberts got the court to embrace emphatic language rejecting the Commerce Clause rationale for penalizing the inactivity of not buying insurance."
Yeah, well, when Chief Justice Roberts closed a window, he opened a door. Sure, I'd like to have some of what I assume Roberts and the rest of the Supes were smoking when they signed off on the it's-a-tax-not-a-penalty decision, but medical is illegal even in states where it's legal (wha?). That's due to the decision in a slightly older Supreme Court case, Raich v. Gonzalez, which showed the Commerce Clause to be infinitely stretchable when need be.
Will may be right that yesterday's decision may spark a backlash in favor of smaller government (or at least one that calls a tax a tax), but anybody who thinks government at any level will feel even the slightest bit limited by the ruling is flat-out wrong.
2. Hey Republicans: Mitt Romney is the worst possible candidate you could have right now. Before the ruling was even clearly reported, Republican and Democratic "strategists" (can't we call them something more accurate and less flattering?) were all claiming that yesterday's decision sealed the deal for their preferred party.
Let's leave aside the large and unchanged fact that Obamacare remains unpopular (most recent polls show majorities of Americans opposed to it and the number rises among those who say they are "well-informed"). The 2012 election will largely turn on the overall state of the economy, not whether the crux of Obamacare is recognized tax now rather than a mandate (though I must admit that now it's a tax, I kinda miss the broccoli mandate).
More to the point: Obamacare is essentially Romneycare on steroids (hmm, are those covered under the new law?), so having the architect of the latter blasting the former for doing what Romney crowed about doing in the Bay State is a tad confusing. It doesn't help that Romney, whose vagueness when it comes to spelling out anything about any of his policies is muy legendary, is vowing to "repeal and replace" Obamacare immediately upon taking office. The repeal part is self-explanatory (if not fully convincing) but what's he gonna replace it with? And if it's not a real market-driven plan that dismantles not only Obamacare but Medicare, why am I listening?
3. Health care will continue to cost more and more. One of the two major selling points of the new law was that it would "bend the cost curve down." Do Obamacare supporters seriously think that increasing government involvement in health care is going to keep costs low? Medicare, a single-payer system run by the federal government, is the single-biggest factor in rising entitlement costs; by design, the program's payroll taxes and premiums don't cover anything like the full cost of services (indeed, it's something like 50 percent, with the rest be covered by general tax revenue and borrowing). Medicaid is a classic case of Paying More for Less. That is, costs keep going up while outcomes are truly dismal for the folks trapped in the system: "A University of Pennsylvania study, for example, reported that colon cancer patients in Medicaid have a 2.8 percent mortality rate, compared with 2.2 percent for the uninsured. A study of Florida’s Medicaid patients found they were more likely to have late-stages of prostate cancer, breast cancer, and melanoma at diagnosis than the uninsured."
As CNN's Erin Burnett noted on OutFront last night, the "Affordable Care Act" has virtually no cost control mechanisms in place and a recent analysis by the firm Bradley Woods projects that insurance premiums will rise about 7.5 percent annually under the law.
Watch Burnett discuss the Supreme Court ruling with me, RedState's Erick Erickson, Buzzfeed's Ben Smith, and CNN's Roland Martin:
Nick Gillespie is co-author with Matt Welch of The Declaration of Independents: How Libertarian Politics Can Fix What's Wrong With America, now out in paperback with a new foreword. Follow him on Twitter.

123 comments:

  1. Have we heard from Romney?

    Must have Missed it.

    What did he say?

    I can’t remember either.

    ReplyDelete
  2. Is Robert Dole still alive?

    What does John McCain think?

    ReplyDelete
  3. A Libertarian - Surprise, Surprise


    Poll out, yesterday, showing support for Obamacare had firmed up 46 - 46

    Romney now goes into the debates, forced to attack all the ideas he's supported in the past - Renewable Energy, Romneycare, etc.

    Oh well, he still has "low taxes for billionaires."

    ReplyDelete
  4. Romney got a little 1.5 to 2 point bump on intrade, but it's dissipated, and he back to trailing 54.7 to 42.1.

    ReplyDelete
  5. "And if it's not a real market-driven plan that dismantles not only Obamacare but Medicare, why am I listening?"

    And, there you have it. Only 13 Republican Senators voted for Medicare; they hate it,

    and will still be trying to do away with it when the celestial clocks quit ticking, and the Good Lord calls all his chilluns back to the eternal (some would say "infernal") harpsichord rodeo.

    ReplyDelete
  6. If Libertarianism is such a great idea, why is Massachusetts such a great place to live, and Mexico so shitty?

    Of course, I guess I should substitute Al, Ga, Ms, and Ar for Mexico. Mexico City, alone, has a higher GDP than those states, combined, and the poor DO have healthcare, there.

    ReplyDelete
  7. 15% of California's electricity came from Renewables, yesterday. Add in Large Hydro and you're probably around 28%.

    CaISO

    ReplyDelete
  8. And, if Obamacare is such an expensive proposition, why is it affecting Massachusetts' budget by only about 1%?

    ReplyDelete
  9. And, why is "healthcare inflation" running lower, now, in Massachusetts than in the average American state?

    ReplyDelete
  10. And, why does Romneycare enjoy an 80% Approval Rating?

    ReplyDelete
  11. Oops, Romney slip-sliding away.

    Intrade:

    Obama 54.8

    Romney 41.8

    ReplyDelete
  12. Of course, Intrade had Obamacare at 20 - 80, also.

    Sometimes the "crowd" doesn't know its ass from a hole in the ground. :)

    ReplyDelete
  13. .

    And, if Obamacare is such an expensive proposition, why is it affecting Massachusetts' budget by only about 1%?


    Gee, the only reason I can think of is peak oil.


    More correlation equals causation?

    Are you really this goofy or just on a roll?

    .

    ReplyDelete
  14. ?

    Okay, let's try again. The Republicans said Romneycare would "Bankrupt" Massachusetts, But, expenditures for Romneycare have only increased the Massachusetts State Budget by a little over 1%.


    How did that prompt a snarky comment about peak oil, and/or "correlation vs. causation?"

    I might be too "goofy" to understand, but, please, try to 'splain it to me.

    ReplyDelete
  15. .

    Trying to relate Romneycare with Obamacare is like trying to compare apples to oranges. They are two differnt animals.

    The differences are many and substantial. We have talked about them here on a number of occasions. If you force me to repeat them I can.

    I assumed yours was just a flippant argument in support of Obamacare, therefore, my flippant response.

    .

    ReplyDelete
  16. Please elaborate (with facts, not just "blanket statements") on the difference between Romneycare, and Obamacare.

    ReplyDelete
  17. In the meantime, I'm going to make one of my famous "ad hominem/appeal to authority" Hybrid arguments and say,

    "If the Republicans were that wrong about Romneycare, why would I believe them about Obamacare?"

    ReplyDelete
  18. Who should pay for healthcare for those that cannot afford it or are irresponsible? One problem is that food is way too cheap. For many, it costs them almost nothing. They are also some of the fattest and most prone to degenerative disease and will ultimately cost the health services a fortune. Why do we subsidize obesity?

    Obviously, the money is coming from taxes, but whose?

    My choice would be to drop it on the fast-food industry. A nine dollar hamburger, four dollar French fries and a three dollar sugar water will do more to help the healthcare system than an annual checkup.

    ReplyDelete
    Replies
    1. Rufus should pay for it. He is the one so happy to shove it up everyone else's ass, let Rufus pay for it.


      b

      Delete
    2. Deuce - you're going to see those incentives "big time." I bitched earlier that I wasn't getting any breaks but they're coming. So little Erin BooBoo did her high school essay thingie and found no cost control measures in ACA?? D-- my dear. (If there were None/Little, then the Death Panel primal screams are directed at what?) The behavior-related stuff is second to end-of-life care and treatment, but a close second.

      Blanket statement with no appeal to authority. I predict.

      And I know things.

      Delete
  19. One of my pet peeves is having Food Stamps cover "Sugar Smacks," and Coca Cola.

    ReplyDelete
  20. Why not, Rufus is paying for you Not To Farm you old fraudulent asshole.

    ReplyDelete
    Replies
    1. When and if the Republicans get rid of this monstrosity, you and yours can move to Massachusetts and suck off the system there Rufus.

      Rather than fast food, I'd suggest raising the tax on alcohol about 5,000 percent.

      b

      Delete
    2. You old fraudulent drunken asshole, you......

      So there!

      heh

      b

      Delete
  21. .

    Please elaborate (with facts, not just "blanket statements") on the difference between Romneycare, and Obamacare.

    Geez, Rufus. Again?

    Give me a few minutes. This will likely be an extended post.

    By the way, we were initially talking about the cost aspects of both programs. I assume that is where you want the differences listed.

    (By the way, the 'reply' button isn't working for me this morning so I will have to post separately from the original post.)

    .

    ReplyDelete
  22. It sharply expands likely utilization of the health-care system at a time when there is already a shortage of primary-care physicians in much of the nation. Older doctors on the brink of retirement are much more likely to be family doctors than new doctors, more of whom are specialists. This would be a problem even without Obamacare. With Obamacare, this problem will become immense. Getting a timely doctor’s appointment is going to become increasingly difficult, and, in many areas, impossible.

    So much for all of the fundamental claims the president made in lobbying for the health overhaul. It doesn’t allow people to keep their doctors. It won’t save money. And for millions, it will make receiving care more difficult.


    http://www.utsandiego.com/news/2012/jun/28/ruling-doesnt-make-obamacares-vast-flaws-go-away/

    And of course what treatment you get, and if you get any, won't be decided by you and your doctor but by the Bureaucracy.

    Only an old fraudulent drunken asshole like Rufus could love this.

    b

    ReplyDelete
    Replies
    1. As for this old fraudulent asshole, I still maintain the money would be far far better spent investing in a new generation of doctors, teaching hospitals and etc.

      b

      Delete
  23. Wrong, Diseased-Buffalo Breath; The ACA HAS more money for Doctors/Internships/etc.

    And, back to "That was said about Mass, but proved not to be true."

    ReplyDelete
    Replies
    1. Brain dead Budweiser breath -

      FINALLY A CLASSMATE OF OBAMA SPEAKS OUT


      An Obama classmate speaks out
      Yes, Wayne Allyn Root’s statement below has been “Correctly Attributed.” The link to Snopes.com is at the end of his statement. If Obama is re-elected in 2012, the US is finished. The following is in simple language that everyone can understand. Not the gibberish that our government keeps telling people.

      Please read this carefully and make sure you keep this message going.

      This needs to be emailed to everyone in the USA ....



      OBAMA’S COLLEGE CLASSMATE SPEAKS OUT





      By Wayne Allyn Root



      Barack Hussein Obama is no fool. He is not incompetent.

      To the contrary, he is brilliant. He knows exactly what he’s doing.

      He is purposely overwhelming the U.S. Economy to create systemic
      failure, economic crisis and social chaos – thereby destroying
      capitalism and our country from within.



      Barack Hussein Obama was my college classmate.



      ( Columbia University , class of '83).



      He is a devout Muslim; do not be fooled. Look at
      his Czars.... Anti-business…anti-American.

      As Glenn Beck correctly predicted from day one, Barack Hussien Obama is following the plan of Cloward & Piven, two professors at Columbia University ... They outlined a plan to socialize America by overwhelming the system with government spending and entitlement demands.



      Add up the clues below. Taken individually they're alarming. Taken as a whole, it is a brilliant, Machiavellian game plan to turn the United States into a socialist/Marxist state with a permanent majority that desperately needs government for survival... And can be counted on to always vote for even bigger government.



      Why not? They have no responsibility to pay for it.



      Universal health care!

      The health care bill had very little to do with health care.

      It had everything to do with unionizing millions of hospital and health
      care workers, as well as adding 15,000 to 20,000 new IRS agents (who will
      join government employee unions).

      Obama doesn’t care that giving free health care to 30 million Americans will add trillions to the national debt.

      What he does care about is that it cements the dependence of those 30 million voters to Democrats and big government.

      Who but a socialist revolutionary would pass this reckless spending bill in the middle of a depression?

      Delete
    2. Cap and trade!

      Like health care legislation having nothing to do with health care, cap and
      trade has nothing to do with global warming. It has everything to do with
      redistribution of income, government control of the economy and a criminal
      payoff to Obama’s biggest contributors.

      Those powerful and wealthy unions and contributors (like GE, which owns NBC, MSNBC and CNBC) can then be counted on to support everything Obama wants. They will kick-back hundreds of millions of dollars in contributions to Obama and the Democratic Party to keep them in power.

      The bonus is that all the new taxes on Americans with bigger cars, bigger homes and businesses helps Obama “spread the wealth around.”

      Make Puerto Rico a state. Why?

      Who’s asking for a 51st state? Who’s asking for millions of new welfare recipients and government entitlement addicts in the middle of a depression?

      Certainly not American taxpayers! But this has been Barack Hussien Obama’s plan all along. His goal is to add two new Democrat senators, five Democrat congressmen and a million loyal Democratic voters who are dependent on big government.

      (This will tip the balance of those living off the government to
      more than those who must pay for it; and we’re done for)



      Legalize 12 million illegal Mexican immigrants.

      Just giving these 12 million potential new citizens free health care
      alone could overwhelm the system and bankrupt America .

      But it adds 12 million reliable new Democrat voters who can
      be counted on to support big government.

      Add another few trillion dollars in welfare, aid to dependent children, food stamps,
      free medical, education, tax credits for the poor, and eventually Social Security...

      (see note above re: Puerto Rico)

      Delete
    3. Stimulus and bailouts. Where did all that money go?

      It went to Democrat contributors, organizations (ACORN), and unions -- including billions of dollars to save or create jobs of government employees across the country.

      It went to save GM and Chrysler so that their employees could keep paying union dues.

      It went to AIG so that Goldman Sachs could be bailed out (after giving Obama almost $1 million in contributions)..

      A staggering $125 billion went to teachers (thereby protecting their union dues).

      All those public employees will vote loyally Democrat to protect their bloated salaries and pensions that are bankrupting America ....

      The country goes broke, future generations face a bleak future, but Obama,
      the Democrat Party, government, and the unions grow more powerful.



      The ends justify the means.

      Raise taxes on small business owners, high-income earners, and job creators. Put
      the entire burden on only the top 20 percent of taxpayers, redistribute the income,
      punish success, and reward those who did nothing to deserve it (except vote for Obama).

      Reagan wanted to dramatically cut taxes in order to starve the government.

      Barack Obama wants to dramatically raise taxes to starve his political opposition.



      With the acts outlined above, Barack Hussein Obama and his regime have created a vast and
      rapidly expanding constituency of voters dependent on big government; a vast privileged class
      of public employees who work for big government; and a government dedicated to destroying capitalism and installing themselves as socialist rulers by overwhelming the system.



      Add it up and you’ve got the perfect Marxist scheme – all devised by my Columbia
      University college classmate Barack Hussein Obama using the Cloward and Piven Plan...





      http://www..snopes.com/politics/soapbox/overwhelm.asp


      b

      Delete
    4. Ever the comedian, that ignores history

      Reagan wanted to dramatically cut taxes in order to starve the government.


      Reagan instigated what, at the time, was the largest tax increase in history and did nothing to diminish or starve the Federal government.

      In fact his policies led to the US borrowing that first "trillion" in peace time dollars, to facilitate that "recovery" he is so famous for.

      That Mr Reagan was a fine actor and revitalized the spirit of America, after the Carter duldrums, of that there is no doubt. That Mr Romney is not Ronald Reagan, well, no doubt there either.

      Delete
  24. If you guys just had any idea how much of your money is being wasted on an inefficient ER Sytem of Treatment.

    ReplyDelete
    Replies
    1. People will still be going to the Emergency Room because they won't be able to find a doctor that will be able to make a timely appointment.

      b

      Delete
  25. And, for that matter, how many Doctor/Hours are wasted on this flawed system.

    ReplyDelete
    Replies
    1. What trick, what device, what starting-hole canst thou now find out, to hide thee from this open and apparent shame? Thou art a wretch whose natural gifts were poor. O, thou art as tedious as a tired horse, a railing wife, Worse than a smoky house.

      b

      Delete
  26. Reagan increased the Social Security Tax. Obama promoted a 2% Payroll Tax Holiday.

    Oh, btw, the Social Security SURPLUS so far this year is $34 Billion.

    ReplyDelete
  27. Yeah, we'll see how Romney does in Michigan, and Ohio campaigning against "saving the American automobile industry."

    ReplyDelete
  28. About as well as he'll do in Iowa, and Colorado campaigning against Renewable Energy.

    ReplyDelete
  29. Speaking of SS Surpluses: Did you all know that the Social Security SURPLUS, last year, was $67.17 Billion?

    Treasury Statement at end of 2011

    ReplyDelete
  30. And, in 2010 the Surplus was $68.6 Billion.

    Link


    And, these numbers are just from Operations, they don't include the accumulation of Interest in the Trust fund ($2.6 Trillion.)

    ReplyDelete
  31. Why am I posting all this? Because, a lot of the same assholes that are Screaming, and Crying about the ACA are the same ones that are regularly telling you that "Social Security is burning through its money, and GOING BROKE!"

    The psychological/sociological term for these people is "Lying Assholes."

    Pardon me if I don't pay them too much attention on healthcare.

    ReplyDelete
    Replies
    1. Are the ss funds segregated and invested?

      Delete
  32. They can only be "invested" in "special" U.S. Treasury Bonds. :)

    ReplyDelete
    Replies
    1. So the ss revenues are funding the deficit ?

      Delete
    2. How do those treasury bonds differ from others?

      Delete
  33. The largest portion of U.S. Intergovernmental Securities and the biggest holder of U.S. debt is the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund, together comprising the Social Security Trust Fund or OASDI. When tax revenues for the Social Security exceed current expenses, the funds are legally obligated to invest in interest-bearing Federal securities guaranteed by the government, such as bonds from the U.S. Treasury.

    According to the Treasury, as of December 2011, the Federal Old-Age and Survivors Insurance Trust Fund held $2.54 trillion of U.S. debt, while the Federal Disability Insurance Trust Fund held $153.9 billion, together more than doubling the amount of debt held by the Federal Reserve or China. Although the Social Security Trust Fund commands huge debt holdings in comparison to others, the amount of debt has held relatively stable, increasing by only $173 billion - approximately 7% - since 2009.

    LINK

    ReplyDelete
  34. So, what about 2009? We must have run a Huge deficit in SS that year, right? I mean, it was the worst Recession since the Great Depression.

    Wrong, Doomsaying asshole breath; in 2009 Social Security

    Ran a SURPLUS of $136 Billion

    ReplyDelete
    Replies
    1. The problem for ss is the looming demographic shift as the boomers start to collect is it not?

      Delete
  35. Yep, Ash, they've been doing that for decades, now.

    Traditionally, they get a lower interest rate than Bonds sold to the Public (but, I assume that might not be the case at present.)

    ReplyDelete
    Replies
    1. One of my concerns is that the chronic deficits will lead to a surplus of bonds on the market requiring higher interest rates to sell the suckers. If the ss fund is also selling...

      Delete
    2. Since it is such a seller’s market for bonds, why doesn’t social security sell their bonds that they currently hold?

      Delete
  36. Max, this is where I lost respect for Simpson. He was running around a few months back, denying that Social Security was ever "Meant" to be an "Old Age Pension" - in spite of the fact that the name of the Fund, itself, belies his claim.

    ReplyDelete
    Replies
    1. I have to leave shortly but I am confused about the SS "debt" (not Alan Simpson although he gave a pretty good interview recently.)

      The way I read the link above is that SS is obligated to invest the surplus when revenues exceed expenses. SS is currently "invested" in Treasury bonds, which is to say the SS fund is holding US debt.

      That is *not* the same thing as saying that SS is "underfunded" or "going broke."

      Delete
  37. I, also, have to post "in-line," as the reply button doesn't work for me, either, today.

    The jury is a bit out on that, I think, Ash. A lot of Boomers are taking "early benefits" due to the recession. You give up quite a lot by taking your benefits before the due date.

    Others that qualify for Complete benefits are continuing to work.

    Just remember this, No One, absolutely No One, has been worth a tinker's damn trying to predict Social Security income, and outgo, even a lousy one year in advance. Take it with a huge block of salt when anyone starts babbling about "social security In .. . . . . . . pick a date."

    ReplyDelete
  38. Well, that's as good a thing to worry about as anything else. :)

    ReplyDelete
  39. :)

    No Maxine, it is not.

    If you listen carefully, the ones that try to cover their asses a little bit will say something like (as they're pounding on the table, and looking all concerned, and serious,

    "Social Security will start running a deficit In 2017 (or, somesuch made up year,) and . . . .

    ReplyDelete
  40. And, you could lay'em 10 to 1 that they couldn't come within $50 Billion of next years numbers, and they'd crawfish out the door faster'n old bob trying to sneak a peek under Sarah Palin's pantaloons.

    ReplyDelete
  41. In 1960 the SCOTUS declared that there is no "Trust".
    The monies collected are purely taxes, they go into the General Fund and are distributed, by Congress as appropriations.

    That the Congress has facilitated a fraud upon the people, well, that goes without saying.

    www.socialsecurity.org/dailys/01-13-99.html
    Jan 13, 1999 – Nestor (1960), the Supreme Court ruled that workers have no legal right to Social Security: Congress can cut or eliminate Social Security ...



    From the decision, itself

    THE TAX PROCEEDS ARE PAID INTO THE TREASURY "AS INTERNAL
    REVENUE COLLECTIONS," I.R.C., SEC. 3501, AND EACH YEAR AN AMOUNT EQUAL TO THE PROCEEDS IS APPROPRIATED TO A TRUST FUND, FROM WHICH BENEFITS AND THE EXPENSES OF THE PROGRAM ARE PAID.
    ...
    TO ENGRAFT UPON THE SOCIAL SECURITY SYSTEM A CONCEPT OF "ACCRUED PROPERTY RIGHTS" WOULD DEPRIVE IT OF THE FLEXIBILITY AND BOLDNESS IN ADJUSTMENT TO EVER-CHANGING CONDITIONS WHICH IT DEMANDS. SEE WOLLENBERG, VESTED RIGHTS IN SOCIAL-SECURITY BENEFITS, 37 ORE. L. REV.299, 359. IT WAS DOUBTLESS OUT OF AN AWARENESS OF THE NEED FOR SUCH FLEXIBILITY THAT CONGRESS INCLUDED IN THE ORIGINAL ACT, AND HAS SINCE RETAINED, A CLAUSE EXPRESSLY RESERVING TO IT "THE RIGHT TO ALTER, AMEND, OR REPEAL ANY PROVISION" OF THE ACT. SEC. 1104, 49 STAT. 648,42 U.S.C. SEC. 1304.

    ReplyDelete
  42. If ss posts a surplus of 150 billion, say, last year, what kind of revenue did they have? In other words what percent of revenues was the 'profit'?

    ReplyDelete
  43. Last year, SS took in $565.8 Billion.

    Outlays were $498.6 Billion.

    For a "profit" of $67.2 Billion. or, 11.9%.

    ReplyDelete
  44. Umhh, wait a minute. 67.2/498.6 would be 13.4%.

    whatever.

    ReplyDelete
  45. Maybe Lincoln was the worst President in American history, keeping Mississippi in the Union like that.

    b

    ReplyDelete
    Replies
    1. If you like stubborn autocrats, central power control freaks and leaders that have utter contempt for the lives of ordinary Americans, Lincoln stands head and shoulders over every other US president. The Lincoln apologists talk about the personal burdens of his getting so many of America’s youth slaughtered and maimed but there is no evidence that the sadistic ugly closet queen cared a whit. Good ol Abe Sandusky Lincoln.

      Delete
    2. FWIW, Lincoln killed more Americans than Hitler and Tojo combined. I never heard about him being a homosexual. Care to share?

      Delete
  46. "Marxism/Socialism works great until you run out of other people's money!" Between our Marxist run government and the massive expansion of entitlements (aka: social justice redistribution programs), we have about 4 more years before the Obama ponsi scheme comes crashing down. This nit-wit couldn't run a Popsicle stand, but he like his other Marxist heroes is a champ at collapsing economies (please refer to the USSR, Eastern Europe, Western Europe, Cuba, et al).

    ReplyDelete
  47. .

    Well I finally got back to it, Ruf. My first attempt was about two thirds finished when I hit some button in Word and ended up with two pages on one screen with the size of the page and the text minimized. By the time I had finished trying to find the right button, I had
    somehow not only made the text read-only but I couldn't make a copy of it. By becoming more agressive with the button pushing, I was finally able to lose the text altogether.

    At that point, I took my wife to lunch.

    What will follow in the next post will be a slightly abreviated reincarnation of the original post.

    .

    ReplyDelete
    Replies
    1. You see, you need some of my daughter's red fingernail polish on those forbidden buttons.

      b

      Delete
  48. .

    And, if Obamacare is such an expensive proposition, why is it affecting Massachusetts' budget by only about 1%?

    The implications of this question are incorrect in both its parts and its entirety.

    And, if Obamacare is such an expensive proposition...

    Forget the inappropriateness of the analogy with Romneycare, from what we know about ACA the question is silly on its face. The CBO indicates the cost estimates on the ACA have doubled from those they initially put out. Add in the fact, that the expanded Medicaid provision being shot down by SCOTUS and you can only increase the program costs. Some projections I have seen lately project the new 10 year cost of the program to near $2.6 trillion. Of course the ACA is expensive! It is by its very nature. But that has nothing to do with Romneycare in MA.

    (continued below…)

    .

    ReplyDelete
  49. http://online.wsj.com/article_email/SB10001424052702304830704577496580986417316-lMyQjAxMTAyMDMwMDEzNDAyWj.htm

    New investment tax to help fund the program.

    b

    ReplyDelete
  50. .

    (continued…)

    ...why is it affecting Massachusetts' budget by only about 1%?

    It's not.

    First, the ACA is not fully implemented yet and won't be until the end of 2013. Second, taking a particular state's experience and trying to project that across the US is short on analysis, there are too many variables, it's kinda like the number 42 solution. Third, although you likely got the 1% from that article I posted recently, I see you rounded it down from the 1.4% mentioned and you also ignored the differences noted in the article. Finally, although the individual mandate and the goal of universal coverage are included in both plans, the idea of trying to project a correlation in costs is at best iffy especially given the abundant evidence that they are wide apart.

    In addition, the two programs have different stated objectives. MA attained theirs while it appears very unlikely that the ACA will even come close on theirs. In MA, the primary goal was universal coverage with cost control as only a secondary objective. With the ACA, it was the opposite.

    (continued below…)

    .

    ReplyDelete
  51. .

    (continued…)

    With regard to the differences between the costs of the two plans, let me start with some observations.

    First, there are some major differences between the MA market and that of the US as a whole. In 2006, MA already had the highest percentage of "insured" citizens among the states. It also had and continues to have the highest insurance costs in the nation. In 2006, only 6% of their population was uninsured. In 2010, it was down to about 2% uninsured and it seems to have stabilized at that number. We are talking maybe 500,000+ down to about 100,000+. [The percentages are correct although I have seen different total numbers. However, the total numbers aren't big enough to affect my next point.] In the US we are talking 30-40 million people depending on whose estimate you use, 10-15% of the population. Trying to project ACA's cost trends from the MA data is hard to do statistically.

    (continued below…)

    .

    ReplyDelete
  52. .

    (continued…)

    Another major difference has to do with competition. In 2006, I believe it was something like four insurance providers that elected to participate with the MA Health Connector (HC), the umbrella organization that sets up insurance for the uninsured or underinsured in the state. In order to be selected to participate, the providers had to substantially cut costs, initial premiums, co-pays, etc. This was a rational move on the part of MA even though cost containment was not their primary concern.

    Compare this to the ACA, where it required a complete sellout to organizations across the board, states, businesses, unions, doctors, healthcare (HC), big pharma (BP), etc. in order to get the bill passed. Surely, I don't have to re-list once again the various bribes, waivers, games (the doc-fix, Cadilac insurance policy waivers, etc) employed by the administration to get ACA passed. When there were some 'negotiations', they amounted to PR gambits and a de facto sell-out, BP being one clear example. The fact that most programs under ACA don't get implemented until 2013 or later, not only help with the 10 year projections in the budget battles but also provide HC and BP plenty of time to recover anything they have purportedly given away. Since ACA passed, healthcare costs have been going up 8-9% while general inflation has been going up around 2%.

    (continued below…)

    .

    ReplyDelete
  53. .

    (continued…)

    With regard to MA, even looking at their price inflation at 1.4% is misleading. First, the 1.4% represents the healthcare rise within the overall budget. It is state public sector spending and doesn't reflect the cost of those in the private sector including the previously uninsured who now have insurance. Those premiums are going up in line with the rest of the nation. And MA still has the highest insurance costs in the nation.

    Further the 1.4% itself is misleading. That represents the states cost rise associated with healthcare. The actual cost is double that. One of the prime movers in introducing Romneycare was the fact that MA was told they would be losing over $300 million in federal subsidies unless they came up with a better way of allocating those subsidies, thus came Romneycare. They ended up saving their subsidies and they are still enjoying them. MA has continued to run deficits on their HSN program, with a recent $100 million shortfall being covered by a three year federal commitment for subsidies running to about $1.5 billion.

    In addition, the MA legislature is projected to pass measures in 2012 to substantially cut premiums to the providers because of the escalating costs. This refers to increase in both the private and public programs. The 1.4% you referenced previously was merely the public costs (less significant subsidies by the Feds). In fact, the private cost of healthcare in MA, has continued to increase unabated as in most of the nation. In 2009 and 2010, MA costs were up 9% in both years.

    (continued below…)

    .

    ReplyDelete
  54. .

    (continued…)

    As for the public program, (from Wiki)

    In 2012, the Blue Cross Foundation of Massachusetts funded and released in April research that showed that the 2006 law and its subsequent amendments -- simply in terms of measuring the state-budget effect on the uncompensated care pool and funding subsidized insurance (see Background section above) had cost approximately $2 billion in fiscal year 2011 vs approximately $1 billion in fiscal year 2006. Some of this doubling in cost was funded by temporary grants and waivers from the United States federal government.

    These comments are not to downgrade the MA program. Their primary goal was not to control costs but to minimize the uninsured. Even saying that, they have, at a minimum, kept up with the rest of the nation in trying to control HC spending given whatever resources were or are available to them.

    However, comparing the MA program the ACA just doesn’t wash. MA had one goal, universal coverage, and they accomplished it. The ACA is a conglomeration of liberal wet dreams thrown into a 2300 page document that nobody even read. One would think that given 2300 pages (the MA program only took 70 pages) that it would be pretty specific; however, we have seen that it was sold on lies that are only now coming to light as the petty bureaucrats in ‘staff’ write the applicable rules and regulations.

    No, there are plenty of differences between the MA program and the ACA, more than enough to know you can’t use one as a proxy for the other, at least on costs.

    .

    .

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  55. .

    You see, you need some of my daughter's red fingernail polish on those forbidden buttons.

    You are probably right. As I mentioned this morning, none of the reply buttons work for me today. Probably something I did.

    What shade do you use?

    .

    ReplyDelete
  56. .

    If you guys just had any idea how much of your money is being wasted on an inefficient ER Sytem of Treatment.


    How much?

    [I've heard this meme before but have never seen it quantified or an explanation given of how they came up with the numbers. I could be mistaken, but I seem to recall that the issue was studied in MA and they found there wasn't that much difference pre- and post-Romneycare.]

    .

    ReplyDelete
  57. .

    By Wayne Allyn Root


    Is that Dale's real name, bobbo?


    .

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  58. .

    Reagan increased the Social Security Tax. Obama promoted a 2% Payroll Tax Holiday.

    The Obama SS tax cut is questionable policy IMO. Too little to have a significant effectin spurring the economy, and merely aggravates the existing long-term problem. So far it has moved up the projections on the tipping point for SS by a couple years.

    .

    ReplyDelete
  59. .

    And, these numbers are just from Operations, they don't include the accumulation of Interest in the Trust fund ($2.6 Trillion.)


    :)

    Oh yeh, the lock-box.


    .

    ReplyDelete
  60. .

    Ash: If ss posts a surplus of 150 billion, say, last year, what kind of revenue did they have? In other words what percent of revenues was the 'profit'?

    Rufus: Damn, Ash, click on the link.

    Rufus: Last year, SS took in $565.8 Billion.

    Outlays were $498.6 Billion.

    For a "profit" of $67.2 Billion. or, 11.9%.



    Yeh, Ash, click on the link. The one rat's post referred too. Any assets in the SS 'trust fund' are a bunch of IOU's. Any profits equate to those generated by Madoff's firm. They are promises.

    Talk of SS surpluses or deficits are useless except in how they affect the total US debt and from that what effect they have on the priorities that are established by Congress. SS is not a monetary issue as much as it is a political one.

    The money from the SS tax goes into the general fund and its benefits are paid out of the general fund and not necessarily on a 1:1 basis. The SS trust fund is a mere record keeping function. The value of the funds rests not on assets but on a political promise.

    However, calling it a ponzi scheme is also ridiculous. Regardless, of future surpluses or deficits, there will always be a SS systems as long there is a political will to have a SS system. It will only go away if the political will for the program disappears.

    It's a simple matter of setting priorities.

    .

    ReplyDelete
    Replies
    1. Rufus and max did state that by law the ss surplus must be deployed by buying US bonds. Is that not the case? Are there not approximately 2.6 trillion of those bonds in the "lock box"? Bonds are real assets are they not?

      Delete
  61. .

    FWIW, Lincoln killed more Americans than Hitler and Tojo combined. I never heard about him being a homosexual. Care to share?

    Reference Joshua Speed.

    What can I say. Sometimes I watch the History Channel with my wife.

    .

    ReplyDelete
  62. All I read in your screed was a lot of opinions, sprinkled with might be's, could be's, and oughta be's, Q. Except for one thing that I will address.

    Mass did have a much higher ratio of insured to population than the U.S. as a whole. The number I saw was 92%, but at a certain point one starts to engage in false precision.

    I figure they covered about 5%, and we'll cover about 10%. So, instead of figuring 1.4%, I'll make it 2.8%, and tack on another 1.2% for good measure. 4% of $3.6T would be about $144 Billion/Yr (which is in the ballpark of where I've always said it would be.)

    Another way of looking at it is to just ask yourself what it would cost to insure thirty million people (mostly young adults, but some with preexisting conditions.) Minus, of course, what "premiums" I can wheedle out of them. This is the question I asked myself when I made my first SWAG at it. I came up with "about %5,000.00/yr, apiece, and it still seems, to me, like a reasonable number.

    ReplyDelete
  63. Deuce, those "Bonds" the Social Security Trust Fund holds are Not regular Treasury Bonds. They can not, I'm quite sure, be sold to a 3rd party.

    ReplyDelete
    Replies
    1. well that renders them pretty darn useless as assets!

      Delete
  64. Rat, and the others are absolutely correct. They (the "bonds") are strictly a bookkeeping artifact. They serve, if anything, only to remind us that Social Security has always taken in more money than it's paid out.

    The bonds, most of them, anyway, will never be cashed. Congress will make wholesale changes to SS long before a significant amount can be taken out of the "trust fund."

    ReplyDelete
  65. Obama has gone from -1 to +2 in the Rasmussen Tracking Poll since the SC Decision. And, is back up to 55.0 : 41.7 on Intrade.

    ReplyDelete
  66. Here's where I think Obama has the advantage: When times are hard, people aren't looking for someone who can give a flowery speech, and talk in platitudes. They start looking around for someone that will say, "Let's try This."

    And, whether you agree with all, or any, of Obama's proposals (Renewable Energy Investment, Job Training, Healthcare,) at least, he Has proposals.

    And, like it or not, when Romney talks about "low taxes (the *for the wealthy* part is understood,) and the "magic of the free market,"
    all many people hear is Obama saying, "that's what got us into this mess."

    I think Romney is going to have a couple of rough debates.

    ReplyDelete
  67. Don't forget, people reelected FDR, Twice, in the middle of the worst Depression imagineable, in spite of the fact that things, at least in '36, didn't seem to be getting a single bit better.

    But, he was, constantly, "Trying" something, TVA, CCC, Social Programs, etc. And, people like him.

    ReplyDelete
  68. The CBO now estimates that Obamacare spending will hit $1.8 trillion over the next 10 years. That's a number that started out at only half as much. But that's what happens when you install European-style entitlements. You threaten to bankrupt the nation's finances. Or you threaten to literally tax us into perpetual subpar growth and high unemployment.

    It will go up from there.

    http://www.realclearpolitics.com/articles/2012/06/30/john_roberts_is_a_super-taxer_114665.html

    Larry Kudlow

    b

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  69. Any insurance salesman could have told them that their first number was too low, and now they're probably a touch high.

    CBO has one big disadvantage. Their analysis, by the rules that govern them, must be based on "stasis." That is to say, they are not allowed to consider the high probablity that a number that high, if realized, would probably lead to cost control measures being taken by the Congress.

    Having said that, there Is a risk that even one eighty could end up being too low IF the recession gets significantly worse.

    ReplyDelete
  70. Of course, we're basically taking the "worst case" scenario, and assuming that all of those twenty-somethings never actually pay any premiums until they're on their way to the hospital.

    For a myriad of reasons (one being that the congress gets tired of that ploy, mos' skosche) it may not work out that badly. One thing that's overlooked is that they haven't seem to have had that problem in any great extent in Mass. The youngsters seem to have, mostly, gone along with the program, and bought the insurance. Perhaps it will end up being the same in the country as a whole.

    ReplyDelete
  71. The Canada pension plan CPP actually has assets and asset managers.

    ReplyDelete
  72. http://www.nationalreview.com/blogs/print/304442

    So be it. It’s down to the people now — as it should be. But, meanwhile, a little less deference to judges wouldn’t go amiss. The U.S. Supreme Court is starting to look like Britain’s National Health Service — you wait two years to get in, and then they tell you there’s nothing wrong. And you can’t get a second opinion.

    Mark Steyn

    Rufus you've blogged all day and said nothing of much importance yet, side stepping the issue of the interference of the government in one's personal affairs, which is the heart of the question. Which of course you must avoid, since all this goes to the center of the patient/doc relationship.

    b

    ReplyDelete
  73. Oh, horsehockey. My Doctor works for the Gummint, and he works his ass off for me, and I like him just fine. I'm going to bed.

    It passed, it's constitutional, and it's the law. Get used to it.

    ReplyDelete
  74. This comment has been removed by the author.

    ReplyDelete
  75. .

    I used to like Mark Steyn and agree with many of his views. But lately I've noticed he is moving more and more into the 'dick' category, joining those kool-aid drinkers of the right who currently occupy the space.

    .

    ReplyDelete
  76. .

    Jeez, Bob, now you are even quoting Larry Kudlow?

    Have you no shame?

    .

    ReplyDelete
  77. This comment has been removed by the author.

    ReplyDelete
  78. All I read in your screed was a lot of opinions, sprinkled with might be's, could be's, and oughta be's, Q. Except for one thing that I will address.

    Screed? I thought my response was pretty civil with the possible exception of my gratuitous remark about the Dems wet dreams being incapsulated in the ACA. The comments were at least civil on a Quirkster scale.

    But to clarify, are you saying I made up the numbers I was talking about? I could always provide you with some links if you would like; however, I realize that would probably be a waste of time since they don't agree with your preconceptions.

    But it's really not necessary. Take a look at the quote that I initially responded to and then also at your request that I expand on that response.

    And, if Obamacare is such an expensive proposition, why is it affecting Massachusetts' budget by only about 1%?

    In my initial response, I was taking your words literally (something objected to by some of the more 'artistic' here). Obviously, a rhetorical question but one that implies that as far as costs are concerned Obamacare somehow has a direct effect on recent MA healthcare budget performance. The other alternative (the only one I can see) is your post was phrased sloppily and that what you were implying was that if MA is doing a good job controlling costs under Romneycare, why shouldn't we expect the same for the US under Obamacare?

    Regardless of which way your post was supposed to read, I think my expanded post answered it. However, the detail I provided was tangential to the real point, that being that your comment was wrong in it's totality and in it's parts.

    "If Obamacare is such an expensive proposition..."

    If it is expensive? Of course it is expensive, or at least, it would appear so to anyone who reads a newspaper or a blog. When you start calculating costs in trillions, that is expensive even for D.C.


    "...why is it affecting Massachusetts' budget by only about 1%?"

    You are implying some kind of direct relationship between Obamacare and MA's healthcare budget performance, or you are implying that we can reasonably expect that the performance MA has achieved under Romneycare can be replicated for the US under Obamacare.

    The former implication is obviously false since Obamacare hasn't been fully implemented yet. The latter is unlikely for all the reasons I laid out in my extended post. There are too many differences between the two programs in size, demographics, and circumstances to use one as a proxy for the other, at least not on a cost basis.

    .

    ReplyDelete
  79. The fact that Roberts had to squirm like Houdini to reach middle ground (in the second part of his ruling, he held that the mandate to buy insurance is not a tax, but by the third section he announced that it is) only enhanced the bravura of the feat. As the saying goes, it’s one thing to dance like Fred Astaire, but Ginger Rogers did it backwards in high heels. Philosophical purity is easy — the blogosphere is lousy with it — while pragmatic solutions to difficult problems are as rare these days as virgins on Jersey Shore.

    ...

    It’s hard to believe, but generations of Americans considered compromise an admirable quality. Schoolteachers taught their students about the Great Compromise that produced the Constitution and the Missouri Compromise that — for a time — held it together. Now the word connotes something bad. A leaky gasket has been “compromised,” and cheating spouses are caught in “compromising” positions. What Roberts managed to do with Obamacare vindicated the virtue of compromise in an era of Occupiers, Tea Partyers and litmus-testing special interests.

    He didn’t seek some nonexistent middle ground halfway between irreconcilable poles. He didn’t listen to one side saying no and the other saying yes and write an opinion saying maybe, or blend black and white to make gray. He found a means of giving both sides just enough of what they wanted that he was able to avert a crisis. In the superheated conflict mill that is American politics these days, it’s good to have someone in a position of authority willing to try.

    ...

    And ultimately, even though his compromise left the enormous mechanism of health care reform lumbering onward to horrify his friends on the right, Roberts brought the court down squarely on the side of one of the most basic conservative principles of all: that big decisions in the U.S. should be made not by judges or bureaucrats but by voters. They’ll have their say in November. “The Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today,” he wrote at the end of his 59-page decision. “But the Court does not express any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people …

    LINK

    ReplyDelete
  80. backwards, and in high heels

    :)

    I like that

    ReplyDelete
    Replies
    1. Careful - don't want to start rumors.

      It's like one of those DirectTV commercials:

      Don't wake up with your own wiki page on [How High Heels Compromised Justice Roberts and Collapsed Western Civilization (with new Hush-Hush Closet Interviews Guaranteeing Full Disclosure from Scalia, Thomas, Kennedy, and Alito.)]

      ...

      Conservative talk show host Rush Limbaugh did not mince words: "Our freedom and choice just met its death panel: the Supreme Court."

      Rush is just grouchy because he's gonna have to go on a diet and give up the pills.

      Delete
  81. The thing is, Q, the same guys that were telling us that Romneycare was going to be an unmitigated disaster for Massachusetts are the ones that are now telling us that Obamacare is the "End of America as we know it."

    They were dead wrong about Romneycare, so why should I trust their judgement about its kissing cousin, Obamacare?

    ReplyDelete
    Replies
    1. Rufus was dead wrong about the mortgage crisis why should we trust hid judgment about...

      Delete
  82. They, also, tend to be the same crowd that gets on Fox News, and CNBC, and rants on about Ethanol being a boondoggle (even though it now comprises 10% of our gasoline, and lowers our cost of transportation,) and about how Solar, and Wind don't work, in spite of California getting 18% of its electricity from Renewables, yesterday, and close to 30% if you consider Hydro.

    It's just "old school thinking" I know, to "consider the source," but, sometimes, that's all we really have to go on.

    ReplyDelete
  83. And, THAT, Ash, IS a Valid Point.

    ReplyDelete
  84. Although, I did retire from the Insurance Bidness, Not the Mortgage Business.

    ReplyDelete
  85. Which, again, means absolutely nothing, of course. If I really was in the insurance business, I might have been the dumbest asshole to ever pull on a pair of cole haans, and discover later that his socks don't match.

    It Is the intertubes, bro.

    ReplyDelete
  86. First Solar, the company with the incredibly low price panel price of $0.74/Watt went over the Germany and got their ass handed to them by a couple of German Companies that came in at $0.60/Watt.

    That is just freakin' incredible. I now believe that we'll see a "utility-sized" system go in, somewhere, probably Germany, in the next 5 years for $1.00/Watt for Total Installed Costs.

    ReplyDelete
  87. For comparison, Solyndra was gearing up to produce their panels for $6.00/Watt, a price that would have been "competitive" 5 years ago.

    ReplyDelete
  88. Meanwhile, here’s how Romney put it in a July 30, 2009, op-ed in USA Today in which he’s telling Obama that insuring everyone doesn’t have to cost gajillions of dollars: “Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free riders’ to take responsibility for themselves rather than pass their medical costs on to others.”

    ReplyDelete
  89. There was a time when justices appointed by Democrats and Republicans intermingled in their judicial decisions. Ideological lines were murkier, and it was harder to predict who would fall where in a split decision. The last two justices who retired, David Souter and John Paul Stevens, were both Republican appointees who usually voted with the court's liberals.

    Since they left, the court has settled into a partisan pattern of 5 to 4.

    That was troubling to Chief Justice John Roberts. When he took office in 2005, he said it was bad for the court and bad for the country when the justices issue high-profile decisions on 5-4 partisan grounds.

    ReplyDelete
  90. Had just one more justice joined the Kennedy Four’s opinion, Medicare would have likely shut down. Approximately 100 million Medicare claims are processed each month using a formula that was altered by the Affordable Care Act. If the entire law were tossed, new rates could not be calculated under the old, pre-ACA formula until after a rulemaking process that can take months to complete. The result would be that Medicare would not be able to pay doctors for what could be many months, and because Medicare’s computers are not equipped to handle this kind of backlog, Medicare’s systems would likely crash.

    ReplyDelete
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