Damn the deficit: Full speed ahead on health care

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I am quite sure the bolded part is incorrect, but I share most of your opinions in the rest of the post.

The actual upfront costs for the wars have surpassed $900 billion dollars. Then there are all the behind the scenes costs, like VA benefits, replacement of equipment that wears down in Iraq, transportation and logistics when you wind down, plus the fact the wars haven't even ended yet.

Next time some president wants to start sending troops for a long term occupation deal just remember what Nancy told you - just say no!
 
http://www.treasurydirect.gov/govt/reports/pd/histdebt/histdebt_histo4.htm

This seems to indicate the historical debt tripled under Reagan...

http://www.marktaw.com/culture_and_media/TheNationalDebt.html

An interesting read, economically technical though it may be. No matter how you look at it, Reagan to Bush Sr. screwed us over royally in terms of economics. And I actually liked Bush Sr. Carter did double the new debt and then pulled it back down before Reagan took over.

There's a difference between debt and deficit.
 

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From your 2nd link. 1977 would be Carter's first year, 1981 would be Reagan's.

Who's president in the scariest part? ;-) (that would be 2009-2010)

And you can see why I'm such a fan of Clinton.

Also, I would counter your war theory with "don't let the banks blow up" (or the S&Ls). They're far more causal of big deficits than the wars were. Notice the deficits decreased from the Iraq war period until Obama's election.
 
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They insure 26.5M vets, even if only one shows up for care or signs up. Period. This is an indisputable fact.

It's quite disputable. The VA itself disagrees with you. But of course they are wrong and you are right.

You claim ~$7000 is the cost of insuring a veteran, yet it's the expense of providing health care services per veteran who shows up at a VA hospital. You even cited it as "medical budget" which is not "insurance budget" and you glossed over that in your "proof."

If 10 people buy insurance and one shows up and it costs $100K for his care, the insurance company's medical budget costs are $100K, but 10 people are still insured. By your faulty reasoning, the cost of insurance per person is somehow $100K, as if only one person was insured.

The problem with that is that vets aren't paying for insurance.

Good luck finding another population where 2/3rds of the "insured" don't ever use any healthcare services. If you can do that, then yes, you can provide healthcare for $1400.

Too bad that in the real world, 82% of people DO use healthcare in any given year.

I realize now that you aren't capable of ever admitting you are wrong about something. That's ok, I just won't bother arguing anymore. Over and out.

barfo
 
It's quite disputable. The VA itself disagrees with you. But of course they are wrong and you are right.

You're simply wrong. The VA talks about the medical care they provide, which is not the same thing as who they're required to cover (whether they show up or not). You just don't get it.

The problem with that is that vets aren't paying for insurance.
We're paying it for them, in the form of a portion of our taxes.

Like an insurance company, the government uses what's not paid out in BENEFITS for other things.

Good luck finding another population where 2/3rds of the "insured" don't ever use any healthcare services. If you can do that, then yes, you can provide healthcare for $1400.

Too bad that in the real world, 82% of people DO use healthcare in any given year.
Count me as one of the 82%. My employer pays $6K to $12K (I don't know the actual number) for my health insurance, and I had 2 clinic visits last year at a cost of $600 (including lab fees). The insurance company pocketed a big chunk of cash on guys like me, who are the vast majority.

I realize now that you aren't capable of ever admitting you are wrong about something. That's ok, I just won't bother arguing anymore. Over and out.

barfo
I realize you can't prove me wrong when I'm not.

If it truly cost $7000 per veteran, the VA budget would be $7000 * 26.5M.

It's not.

You're wrong.
 
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From your 2nd link. 1977 would be Carter's first year, 1981 would be Reagan's.

Who's president in the scariest part? ;-) (that would be 2009-2010)

And you can see why I'm such a fan of Clinton.

Also, I would counter your war theory with "don't let the banks blow up" (or the S&Ls). They're far more causal of big deficits than the wars were. Notice the deficits decreased from the Iraq war period until Obama's election.

I think we're all a fan of Clinton's.

Which is why they need to get rid of that limit on presidential terms.
 
As you wish.

barfo
 
I think we're all a fan of Clinton's.

Which is why they need to get rid of that limit on presidential terms.

Reagan repeatedly asked for a balanced budget amendment and line item veto. Those would have required amending the constitution, but would have been well worth it.

I don't want guys getting elected president at age 40 and serving until they die at age 95. It'd make us something of a dictatorship.
 
As you wish.

barfo

You confuse benefits paid out with what it would cost to insure the entire population of eligible veterans. You made the case it costs $7000 per veteran to provide insurance, when it costs $7000 per veteran who shows up at a VA facility for the benefits (care given).

As soon as you figure this out, you'll get it.

The VA is not an insurance company, they're more like an HMO. They only siphon from the govt. coffers the bare minimum of what they need to provide the actual medical care, plus 40% overhead (280,000 employees).

The VA denies service like an HMO, too.

I'll say this. If I am wrong about this, then all the reasons I support a form of public option are wrong and we shouldn't have one.
 
Or we could just pull out of Iraq or Afghanistan. Either one would save more than double what it costs for health care.


I have tried hard to be supportive of these efforts, but am coming around to this point of view that Obama needs an exit strategy- and the sooner the better.
 
You confuse benefits paid out with what it would cost to insure the entire population of eligible veterans. You made the case it costs $7000 per veteran to provide insurance, when it costs $7000 per veteran who shows up at a VA facility for the benefits (care given).

As soon as you figure this out, you'll get it.

The VA is not an insurance company, they're more like an HMO. They only siphon from the govt. coffers the bare minimum of what they need to provide the actual medical care, plus 40% overhead (280,000 employees).

The VA denies service like an HMO, too.

I'll say this. If I am wrong about this, then all the reasons I support a form of public option are wrong and we shouldn't have one.

Ok, Denny, one last shot at this.

You say VA healthcare costs $1400 per living veteran. While your numbers are a little off, that is not what is being disputed. You also claim that healthcare provided to the 30 million uninsured people should cost about the same per person.

Yet I've shown that approximately 2/3rds of vets use insurance other than the VA to pay for their healthcare. We should be able to provide the 30 million uninsured people VA-level care for the same price per person as we spend per veteran, but only if the same fraction of uninsured people as veterans decline to use the services.

But - and this is a key point - the uninsured don't have any other insurance. That's why they are called "uninsured". So they won't be using the other insurance they don't have. So it follows that 2/3rds of them won't be opting out of the plan.

Therefore, it won't cost the same per uninsured person as the VA plan costs per veteran. It will, in fact, cost (very roughly) three times more. I'm stunned that you haven't been able to grasp this. Veterans and uninsured people are not equivalent.

barfo
 
Ok, Denny, one last shot at this.

You say VA healthcare costs $1400 per living veteran. While your numbers are a little off, that is not what is being disputed. You also claim that healthcare provided to the 30 million uninsured people should cost about the same per person.

Yet I've shown that approximately 2/3rds of vets use insurance other than the VA to pay for their healthcare. We should be able to provide the 30 million uninsured people VA-level care for the same price per person as we spend per veteran, but only if the same fraction of uninsured people as veterans decline to use the services.

But - and this is a key point - the uninsured don't have any other insurance. That's why they are called "uninsured". So they won't be using the other insurance they don't have. So it follows that 2/3rds of them won't be opting out of the plan.

Therefore, it won't cost the same per uninsured person as the VA plan costs per veteran. It will, in fact, cost (very roughly) three times more. I'm stunned that you haven't been able to grasp this. Veterans and uninsured people are not equivalent.

barfo

One more shot at this.

I've been saying that the government should be opening clinics all over the place. If they do, they'd be only incurring the cost of delivering the actual health care for people who show up needing care. Of the 30M uninsured, 83% will show up for services, but the vast majority of those people would be showing up for flu shots and blood and urine tests and those sorts of things.

The cost of delivering the care is not $7000 per person. For the vast majority of people, it costs a few $hundred a year.

The VA doesn't cover 100% of the costs of Vets' care, except in cases where the Vet is dirt poor and can't afford to pay the co-pay for service and co-pay for prescription drugs. The govt. option should work the same.

The government should charge those 30M people $1400 apiece, or $2000 apiece, and charge them co-payments. They shouldn't be paying for cadillac plans from insurance companies. It's supposed to compete, not be a guaranteed source of income for those companies.

There are catastrophic health care services that do cost a lot of money. Like Open-Heart Surgery. In the USA in 2006, there were 694,000 of them costing an average of $20,673, or a total of $14B. That's 694,000 out of 275M people, or .2% of the population. The cost of paying for all those heart surgeries is $52 per person per year in premiums.

The cost for all the trauma cases is about $80B, or $290 per person. That includes the vast majority of the brain surgeries people need.

I use 275M, which is the insured population. The actual population is about 310M, so the costs per person I've provided here are 10% less. And I'm being quite generous in using the worst case figures for how many are uninsured.

Prescription drugs represent 10% of all medical expenses in the USA.

So far, I've talked mostly about catastrophic care/needs. For $30/mo per person, the cost of two doctor visits per year plus x-rays and lab tests would be covered. Probably less since there's a lot of people who hate doctors and hospitals and won't even show up for the two visits.

As for veterans, those who do show up for care are far more likely to have some sort of expensive medical care needs. After all, they've been shot at, shot, lost limbs, subjected to psychological trauma, radiation and other toxins, etc. That you don't get it that these people represent the worst case in per capita health care needs is rather stunning.

The part of your post I bolded is utter nonsense.
 
I think Denny also has some good ideas.

Personally, though I lean to the left, I could care less about who gets a health bill be is the dems or 'pubs. Whoever has the best idea that will not only lower people's medical expenses, but start seriously cutting the deficit, is the idea i'll be for.

I also want limited government intervention in this, but I think in order to accomplish what I was talking about, we need some more government intervention. But I think the bill right now may be too much, thought i'd rather have this bill than nothing.

If we compare what the "right" has proposed so far, to what the "left" has proposed, I favor the "left" right now, though. But I think the bill should be re-done. Thing is, so many in congress, especially many on the "right", are in the pockets of the health insurance lobby, that even if we decided to start from scratch and make the best bi-partisan bill possible, many, at least on the right, would still not vote for it.

That takes you to the problem where you might as well say "screw them" and try to get something done. But that bill would not/will not be the best bill for the country.

Politics...
 
I think Denny also has some good ideas.

Personally, though I lean to the left, I could care less about who gets a health bill be is the dems or 'pubs. Whoever has the best idea that will not only lower people's medical expenses, but start seriously cutting the deficit, is the idea i'll be for.

I also want limited government intervention in this, but I think in order to accomplish what I was talking about, we need some more government intervention. But I think the bill right now may be too much, thought i'd rather have this bill than nothing.

If we compare what the "right" has proposed so far, to what the "left" has proposed, I favor the "left" right now, though. But I think the bill should be re-done. Thing is, so many in congress, especially many on the "right", are in the pockets of the health insurance lobby, that even if we decided to start from scratch and make the best bi-partisan bill possible, many, at least on the right, would still not vote for it.

That takes you to the problem where you might as well say "screw them" and try to get something done. But that bill would not/will not be the best bill for the country.

Politics...

As we have witnessed with the "emergency" stimulus bill, a bad bill is not worth passing; it's costly and at this size, you're only going to get one shot at it. It's better to pass limited but effective incremental type legislation, like elimination of pre-existing conditions clauses, making insurance portable, and those kinds of things while we take our time and get it right.

As I see it, the constitution guarantees people the right of free association. Being forced to participate in a govt. plan violates the 1st amendment. I have no beef with the govt. offering an attractive service and people willingly sign up for it.

There's only four concepts that make sense to discuss: socialized medicine, single payer, market based, and some hybrid. I suggested a hybrid of socialized medicine and market based; the govt. option is almost completely socialized - the clinics are owned and run by the govt., and the doctors and other staff on the govt. payroll. Yet you don't have to participate, and if you do you can still write a check to a non-govt. doctor and get a 2nd opinion or other care you want that way.

The bill the democrats are attempting to pass represents a huge transfer of money from the taxpayer's pockets to the treasury to the insurance companies. They're not going to build a bunch of clinics, they're not training enough new doctors, they're not doing much of anything to put downward pressure on costs, and it clearly plays partisan favoritism ($300M to buy Landreau's vote, no limits on trial lawyers' take, etc.). To top that off, they're rushing to pass it for political reasons and not because the bill is good or well thought out; it's pork and stupid, the people know it, and those who intend to vote for it don't want to do so in an election year. How about passing something they'd be proud to pass in an election year and that the people would be happy with?
 
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Being forced to participate in a govt. plan violates the 1st amendment.

If you are talking about the mandate, noone is forced to buy into the public option. Just be covered, like is required with auto insurance.
 
If you are talking about the mandate, noone is forced to buy into the public option. Just be covered, like is required with auto insurance.

There's a huge difference between not being allowed to drive a car without insurance and not being allowed to breath without insurance. I was more referring to why single payer and socialized medicine are non-starters.


And it really smells like the public education system; nobody is forced into the public option, but how many are (by %)?
 
There's a huge difference between not being allowed to drive a car without insurance and not being allowed to breath without insurance.

I see what you are saying. But a large majority of people 25+ drive and have health insurance. But its important to get everyone insured, imo. It helps the person being covered and lowers prices.

I'm guessing most of the uninsured will go through private anyway. Public option isn't even available until like 2013, no? And I think it is only available for a select few, with others getting some type of tax credit to help them afford insurance.

And it really smells like the public education system; nobody is forced into the public option, but how many are (by %)?

Well, school should be free, IMO. :)
 
Correct. That is why a health insurance mandate is important. It not only helps the person being covered, but lowers prices.

I'm guessing most of the uninsured will go through private anyway. Public option isn't even available until like 2013, no? And I think it is only available for select few, with others getting some type of tax credit to help affordability.



Well, school should be free, IMO. :)

No such thing as a free lunch.

I think we don't want the health care system to turn out like the education system, with politicians diverting funds from inner cities to where the campaign donors are.
 
I think we don't want the health care system to turn out like the education system, with politicians diverting funds from inner cities to where the campaign donors are.

You are right in that. But I think this is much different. most children go to public schools, while (IMO) a much less % will be insured by the public option (those will probably be the ones who can't afford regular healthcare and qualify for it).

Personally, i'm fine with the public option only being available for people who simply can't afford health insurance (very low income). For moderately low income, i'd do tax breaks and have them buy private. I'd do a health exchange where you can shop for the lowest price. I'd do a mandate.

After that, i'd put things in the bill like no discriminating for pre-existing conditions, allowing to buy across state lines, and stuff like that.
 
You are right in that. But I think this is much different. most children go to public schools, while (IMO) a much less % will be insured by the public option (those will probably be the ones who can't afford regular healthcare and qualify for it).

Personally, i'm fine with the public option only being available for people who simply can't afford health insurance (very low income). For moderately low income, i'd do tax breaks and have them buy private. I'd do a health exchange where you can shop for the lowest price. I'd do a mandate.

After that, i'd put things in the bill like no discriminating for pre-existing conditions, allowing to buy across state lines, and stuff like that.

You're describing a two-tier system, one of better benefits for the haves and one of DMV quality for the have nots.

The bolded test is what they should pass now.
 

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