Since 2001 ........... Remade in June 2008 ........... Latest version since January 2022
Friday, December 23, 2011
Friday, April 02, 2010
The costs of healthcare reform
"Our debt crisis began when the previous administration tried to finance two wars with tax cuts. We are overburdened. What we face is a debt crisis, due to military over-commitments, which has devastated our ability to improve our quality of life through government programs," Frank continued.
"We would have had $1 trillion now to help fix the economy and do the things for our people that they deserve."But, no point following counterfactuals. It is what it is. As Rumsfeld once arrogantly and stated (where is he now, BTW?) "you go to war with the army you have--not the army you might want or wish to have at a later time." Yeah, right, we know how that worked out .... aaah, can't afford digressions here ...
Anyway, at an instinct-level, a major effort like this healthcare reform not quite adding to the costs just does not resonate with me. If it is too good to be true, then ... I bet we will begin to hear more and more on this issue.
For starters, here is John Cassidy at the New Yorker--one of the two regular economics-related writers there (the other is James Surowieki.) Both are fantastic in their analysis and writing--well, everybody at the New Yorker writes well, of course :)
Cassidy writes:
If all of these predictions turn out to be accurate, ObamaCare will go down as one of the most successful and least costly government initiatives in history. At no net cost to the taxpayer, it will have filled a gaping hole in the social safety net and solved a problem that has frustrated policymakers for decades.
Does Santa Claus live after all? According to the C.B.O., between now and 2019 the net cost of insuring new enrollees in Medicaid and private insurance plans will be $788 billion, but other provisions in the legislation will generate revenues and cost savings of $933 billion. Subtract the first figure from the second and—voila!—you get $143 billion in deficit reduction.Yes, it is that voila that worries me.
Cassidy has more:
My two big worries about the reform are that it won’t capture nearly as many uninsured people as the official projections suggest, and that many businesses, once they realize the size of the handouts being offered for individual coverage, will wind down their group plans, shifting workers (and costs) onto the new government-subsidized plans. The legislation includes features designed to prevent both these things from happening, but I don’t think they will be effective.
Consider the so-called “individual mandate.” As a strict matter of law, all non-elderly Americans who earn more than the poverty line will be obliged to obtain some form of health coverage. If they don’t, in 2016 and beyond, they could face a fine of about $700 or 2.5 per cent of their income—whichever is the most. Two issues immediately arise.
Even if the fines are vigorously enforced, many people may choose to pay them and stay uninsured. Consider a healthy single man of thirty-five who earns $35,000 a year. Under the new system, he would have a choice of enrolling in a subsidized plan at an annual cost of $2,700 or paying a fine of $875. It may well make sense for him to pay the fine, take his chances, and report to the local emergency room if he gets really sick. (E.R.s will still be legally obliged to treat all comers.) If this sort of thing happens often, as well it could, the new insurance exchanges will be deprived of exactly the sort of healthy young people they need in order to bring down prices. (Healthy people improve the risk pool.) ...
So, the individual mandate is a bit of a sham.
Hmmm .... more for us worrywarts :(
Sunday, May 17, 2009
Torture, and government transparency
In today's NY Times, Frank Rich writes that we need to do this, and now:
the new administration doesn’t want to revisit this history any more than it wants to dwell on torture. Once the inspector general’s report on the military analysts was rescinded, the Obama Pentagon declared the matter closed. The White House seems to be taking its cues from the Reagan-Bush 41 speechwriter Peggy Noonan. “Sometimes I think just keep walking,” she said on ABC’s “This Week” as the torture memos surfaced. “Some of life has to be mysterious.” Imagine if she’d been at Nuremberg!The administration can’t “just keep walking” because it is losing control of the story. The Beltway punditocracy keeps repeating the cliché that only the A.C.L.U. and the president’s “left-wing base” want accountability, but that’s not the case. Americans know that the Iraq war is not over. A key revelation in last month’s Senate Armed Services Committee report on detainees — that torture was used to try to coerce prisoners into “confirming” a bogus Al Qaeda-Saddam Hussein link to sell that war — is finally attracting attention. The more we learn piecemeal of this history, the more bipartisan and voluble the call for full transparency has become.
And I do mean bipartisan. Both Dick Cheney, hoping to prove that torture “worked,” and Nancy Pelosi, fending off accusations of hypocrisy on torture, have now asked for classified C.I.A. documents to be made public. When a duo this unlikely, however inadvertently, is on the same side of an issue, the wave is rising too fast for any White House to control. Court cases, including appeals by the “bad apples” made scapegoats for Abu Ghraib, will yank more secrets into the daylight and enlist more anxious past and present officials into the Cheney-Pelosi demands for disclosure.
It will soon be every man for himself. “Did President Bush know everything you knew?” Bob Schieffer asked Cheney on “Face the Nation” last Sunday. The former vice president’s uncharacteristically stumbling and qualified answer — “I certainly, yeah, have every reason to believe he knew...” — suggests that the Bush White House’s once-united front is starting to crack under pressure.
I’m not a fan of Washington’s blue-ribbon commissions, where political compromises can trump the truth. But the 9/11 investigation did illuminate how, a month after Bush received an intelligence brief titled “Bin Laden Determined to Strike in U.S.,” 3,000 Americans were slaughtered on his and Cheney’s watch. If the Obama administration really wants to move on from the dark Bush era, it will need a new commission, backed up by serious law enforcement, to shed light on where every body is buried.