CBO ESTIMATES ON OBAMACARE TOP $1 TRILLION
That $1 trillion is a number the Congressional Budget Office is looking at right now. Estimates by others have used $1 trillion as a starting point and go up to $1.5 trillion.
Please recall that our president “budgeted” only $637 billion for health insurance. But that number presupposes that almost everyone who is not now insured will buy the subsidized package. The only way to realize the $2 trillion in savings Obama needs to make the plan work is for nearly everyone to be on board.
But the CBO says that’s a crock as The New Republic’ s Jonathan Cohn points out in his exclusive look at the early CBO estimates:
So what does CBO think this time around? Late last month, after weeks of working overtime to keep up with the huge domestic agenda, CBO began delivering some prelimiary estimates on health reform. According to several sources familiar with the estimates, it’s something of a good news/bad news story:
The good news for reformers is the CBO’s determination that expanding health-insurance coverage would cost a lot less than many outside experts had predicted. Instead of a politically daunting $1.5 trillion, the CBO figures the price tag will be closer to $1 trillion, at least under certain parameters. But the reason for the lower estimate is a bit unsettling. Even with a requirement that everybody obtain insurance–a so-called individual mandate–the CBO assumes a that between a quarter and a third of the uninsured still wouldn’t have coverage. That would leave the country short of universal coverage, the goal Obama and his allies have repeatedly cited.
What Cohn doesn’t mention is that the reason Obama needs almost everyone on board his health insurance boondoggle is that the uninsured are one of the major reasons for skyrocketing health care costs. No one knows the true number of uninsured in the country. The Democrats like to throw around the number 48 million but that is too high by almost a factor of 4. Many of those 48 million are between jobs and will get health insurance when they are employed again or there are other factors as this AP article, summarized by The National Review Institute makes clear:
- The Census Bureau itself says that “Health insurance coverage is likely to be underreported…” (See Appendix C of THIS report) For example, “16.9 percent of people with an MSIS record indicating Medicaid coverage reported…that they were uninsured.”
- According to Sally Pipes of the Pacific Research Institute, “as many as 12 million uninsured Americans are eligible for Medicaid and the State Children’s Health Insurance Program-but they haven’t signed up.”
- More than half of the uninsured are between 18 and 34 years of age, a group which has relatively few expensive health issues and for whom self-insuring (paying their own medical bills) makes sense. Only 14% of people over the age of 55% are uninsured.
- Over 9 million of the “uninsured” have household incomes over $75,000.
- Roughly 30% of the uninsured are without insurance for less than 6 months (though this statistic will likely worsen during the current recession).
- And finally, estimates are that between 7.5 million to over 10 million of the uninsured (15% of them or more) are illegal immigrants.
A more cautious estimate of the uninsured is perhaps 12 million - most of them young and single. And that’s not the only myth about health care that the left has been promoting:
The top three myths are: 46 million Americans have no health insurance and therefore no health care; an individual mandate will lead to universal coverage; and socialized systems such as those in Canada and Europe are cheaper and more efficient than ours. If I were to write the book today, I would add another myth: that America’s health-care system puts our employers at a competitive disadvantage and hurts our economy. No less an authority than the Congressional Budget Office has debunked this myth, noting that it is employees who pay the tab, not the company, as it’s merely a substitute for wages. Yet this is a major selling point in the Democratic push to government health care.
The more uninsured, the higher the cost of health care. The higher health care costs will mean a larger subsidy for health insurance. This is exactly what they are finding in Massachusetts where the state subsidy has skyrocketed.
The estimate of $9.3 trillion in deficits the budget will run over the next decade has to be increased - perhaps by as much as $800 billion. Here’s Robert Samuelson writing in Investor’s Business Daily:
It’s true that since 1961 the federal budget has run deficits in all but five years. But the resulting government debt has consistently remained below 50% of GDP; that’s the equivalent of a household with $100,000 of income having a $50,000 debt. Adverse economic effects, if any, were modest.
(Note: Deficits are the annual gap between government’s spending and its tax revenues. The debt is the total borrowing caused by past deficits.)
But Obama’s massive, future deficits would break this pattern and become more threatening. At best, the rising cost of the debt would intensify pressures to increase taxes, cut spending - or create bigger, unsustainable deficits.
By CBO’s estimates, interest on the debt as a share of federal spending will double between 2008 and 2019, from 8% of the total to 16%. Huge budget deficits could also weaken economic growth by “crowding out” private investment.
At worst, the burgeoning debt could trigger a future financial crisis. The danger is that “we won’t be able to sell it (Treasury debt) at reasonable interest rates,” says economist Rudy Penner, head of the CBO from 1983 to 1987. In today’s anxious climate, this hasn’t happened.
At risk in this fiscal crisis is spending on national defense. At a time when our military must reassess its priorities due to the changing nature of enemy threats, it is likely we will be hamstrung by the massive deficits. Since most experts believe we have to increase the size of the army, Marines, and Special Forces, it is difficult to see where the money will come from - especially since cutting entitlements is off the table with Democrats in charge.
More likely, Obama will take a meat cleaver to our defense budget, cutting modernization and perhaps even cutting benefits to defense personnel. There are several vital programs that will likely see the ax, including the F-22 fighter and a drastic cutback in the number of next generation destroyers for the navy.
Samuelson guesses that the reason that few are speaking out about these catastrophic deficits and piling up of a massive amount of debt is the severity of the recession. But given the stratospheric budget deficits being run by Obama, any recovery will be stillborn as interest rates will have to be raised significantly to entice people to purchase Treasuries in order to fund the debt while inflation is likely to take hold as the trillions in bail out monies dumped into the economy by the Fed means too many dollars will be chasing too few goods and services.
Even a Keynesian can understand those basic economic principles.
We are in for a very rough ride for the next several years. It will take someone with courage and leadership ability to call for making tough choices. Obama has said time and time again that such choices are “false,” that we can have it all by only raising taxes on the rich.
When that chicken comes home to roost, it will probably be too late to stop the disaster from occurring.
Rick;
I could not disagree more with this statement;
While “cost shift” is A factor for increasing health care costs it is not THE factor and I suspect not a major factor. There is very good evidence that the relationship goes the other way: increasing health care costs lead to higher levels of uninsured (as a rest of employers foregoing health care a benefit, employers demanding higher employee cost-sharing leading to some employees opting out, states tightening income eligibility levels due to increasing costs). I’ll get some citations.
Beyond that I would wholeheartedly agree that we as a nation need to carefully consider the costs before we jump into a massive healthcare initiative. IMHO it all comes down to one key phrase “Its all about the costs!”
Comment by c3 — 5/17/2009 @ 9:28 am
I recommend a private commission of healthcare providers and experts who look at every private alternative available, including charity hospitals, and give a full report to congress. Unless we consider private solutions, we’re stuck with a bureacratic nightmare. If the private solutions don’t match up to government run healthcare, then so be it, but I think they will, if the private commission goes back to the beginning and looks at a total private restructuring, sans Medicare, Medicaid and stifling regulations and taxes levied to pay for the current mess. In other words, a private commission should show what private health care would look like if we were starting from scratch without government involvement and taking the disadvantaged into account.
Comment by Mike Farmer — 5/17/2009 @ 9:48 am
The lesson of subisidies: they cause whatever is subsidized to be used uneconomically, therefore raising the cost of it. This is well understood and applies to goods and services. We subsidize home ownership, to get more home owners, and we get a steady rise in home prices over time… before you put in extras like no money down mortgages.
We subsidize health care and it costs more over time, outpacing inflation.
We subsidize sugar and pay above world market prices for it.
When something is made universal you get the tragedy of the commons: it loses all valuation on a personal scale as you have no value vested in it. Thus you use it uneconomically and start degrading the entirety of the common good. This works beyond grazing commons, and the UK has seen native Brits unwilling to be trained as doctors, thus needing to bring in foreign help mainly from India and Pakistan.
Companies that abused public air and water stopped doing so when they had to pay for their misdeeds, and then realized that in waste there is a revenue opportunity that they would never have found if they abuse of the commons had not been seen. Perhaps that common good should have had better caretakers… but when put in the public the government is steward and not so good a one at most times, thus the tragedy of it.
This goes before the inefficiencies of government and the ternary inter-relationship concept for those things that are not directly inter-related but that everyone wants to be inter-related. Both of these cause major problems with anything that is government subsidized, government run or given to government, which is why we like to have as little as possible given to it. That, of course, has been true for centuries, distilled into the Constitution so as to limit the power and scope of government at the National scale. Large governments, even Republics, prove to be inflexible and should have little as possible power at the local scale so that local ways can reflect local values and needs. That increases accountability and the ability of the citizenry to have a say in their government, while going up to the National scale reduces those immensely for individuals.
Of course that is just the Common Sense that Paine wrote about… as we now seem to have forgotten.
Comment by ajacksonian — 5/17/2009 @ 10:42 am
What are the costs of a pregnant woman getting inadequate pre-natal care and giving birth to a child with serious, lifelong health issues?
What are the costs of diabetes going undiagnosed and untreated? Or of missing a heart disease issue that could be dealt with early my 4 or 5k in meds or later with 100k worth of surgery followed by those same meds?
What are the costs in man hours and dollars of millions of people having to game an absurd system whose core raison d’etre seems to be to refuse to pay for treatments it has agreed to pay? Likewise for the doctors themselves who are pushed to play the system rather than treat the patient?
Obama is trying to find a moderate path that keeps most of the health insurance establishment in place. Many of us are so pissed off at the system you’re defending that we’d like to see health insurers replaced in toto by a French-style system. The question is not whether we are going to have a major revamp of health insurance, but how broad and extensive that change will be.
As for a trillion dollars, if in the end we have a healthier population then there will be un-accounted benefits. As opposed to the same trillion spent on Iraq (without objection raised from the GOP) where we end up with un-accounted problems.
On the separate issue of the military, I was pushing for more men back when Republicans were all claiming that Rumsfeld was a genius. So yes, we need more men and especially more unconventional warriors. We do not however need more F22’s. We have complete dominance in the air over every conceivable enemy force or combination of enemy forces. We should continue to develop new technologies so as to keep that edge, but that research does not require purchases of vast numbers of aircraft.
Every current enemy is lo-tech. Al Qaeda does not have an air force or a navy. The only hi-tech enemy we are likely to face in the next generation is China. We should certainly keep an eye on them and respond as necessary.
Comment by michael reynolds — 5/17/2009 @ 12:06 pm
“Many of us are so pissed off at the system you’re defending that we’d like to see health insurers replaced in toto by a French-style system.”
The system we have has been broken by government, so the answer is to have government fix it? Are you open to private solutions if they work? Let’s hear what the private sector would do, without government interference.
Comment by Mike Farmer — 5/17/2009 @ 1:27 pm
I submit several admittedly ignorant questions for your consideration and response:
1. Isn’t one component of rising health care costs the additional options for treatment available now, as opposed to twenty or fifty years ago? We continue to find new treatments for previously untreatable conditions(not me personally mind you, as I stated before, I am admittedly ignorant). Employment of those new treatments costs money. If we are doing more than we used to, and doing things costs money, doesn’t it follow that costs will increase?
2. Is it possible to cut health care costs by doing anything other than increasing the efficiency of delivery or reducing the delivery of services? Assuming the actual direct costs for providing the services demanded is X, and the system is only 70 percent efficient in delivery, the total cost of delivering health care about 1.42X. We appear to be unwilling to limit(ration) the services provided or to make the changes needed to improve the efficiency of delivery (tort reform, complete privatization of Medicare, etc.). If so, then the only option for reducing costs is reducing demand. How does a free market system facilitate a reduction in demand?
3. Assuming prevention and early treatment of most conditions are less expensive than care of late stage diseases and conditions, how can healthy behaviors be promoted?
Your thoughts and kind responses are solicited.
Comment by Mark — 5/17/2009 @ 1:51 pm
Mike:
The answer to what the private sector would do is obvious and set by the logic of the marketplace: they’d cherry-pick the most profitable policies and exclude as much risk as possible.
They have no choice: that’s what shareholders demand. Would you buy stock in a company that deliberately took on riskier, less-profitable policies?
There really are some areas where the government can do a better job. This is not a place where profit-seeking is helpful. The needs of shareholders should not be the determining factor in who gets care or what kind of care they get.
Comment by michael reynolds — 5/17/2009 @ 2:12 pm
Michael,
I don’t hold your cynical view of the private sector, but even if it’s true, government is subject to the same cost pressures and will have to make decisions just like private businesses– rationing, for example — the only problem with government run healthcare is that it will be a monopoly and there will be no where to turn — at least in a free market, companies will have to compete by providing better services.
Comment by Mike Farmer — 5/17/2009 @ 2:27 pm
Michael,
If by cherry-pick you mean set prices based on conditions, yes they would. Shouldn’t they, and employers, be able to adjust either price, contribution, or benefit based on factors that can be controlled by the beneficiary of the policy? Assuming all the other factors are equal, shouldn’t a 6 foot tall 180 pound man pay less than a 6 foot tall 400 pound man?
Also, are you saying there should be no limits on what benefits are provided? Should an insurer be required to pay $10 million for a treatment that has a 2% success rate? If so, no cost controls are possible.
Respectfully
Comment by Mark — 5/17/2009 @ 2:42 pm
Mike:
It’s not cynical in any way. The free market is required by its own internal logic to seek to maximize profit.
The same expense pressures may apply to government, but that’s a very different question. The government is not required by its own logic to maximize profits. It doesn’t make profits, it responds to different imperatives. So government will not throw people off the insurance rolls in order to make more profit while private industry, unregulated, would have no other practical choice.
Comment by michael reynolds — 5/17/2009 @ 2:45 pm
Mark:
Yes, we should provide health care to everyone. I know that’s not how you framed the question, but it is the actual question. Every other wealthy country manages to do it.
As for the health insurance companies denying coverage for reasons of profit, that’s precisely why we shouldn’t leave the matter in their hands. If we can cover everyone and keep the companies, okay. If not, then we get rid of the companies and good riddance.
Comment by michael reynolds — 5/17/2009 @ 2:48 pm
Michael,
Every wealthy country does not provide what you are stating. All of them ration health care to some degree. Services are limited based on a cost benefit ratio. Expensive treatments that have a lower success rate are regularly denied.
I did not say we shouldn’t provide health care to everyone, I asked if they should all pay the same price for the same services. What incentive is there to be personally responsible if the government will pay regardless of your behavior? Should the 400 pound couch potato that eats ding dongs and pizza pay the same as the 180 pound jogger that eats broccoli and tofu? No, is the obvious answer in case you want some help with that.
Respectfully submitted for your consideration.
Comment by Mark — 5/17/2009 @ 3:42 pm
Mark:
I think people should pay by ability to pay. If you’re wondering, yes: that means I would pay more.
A system that charges more based on health factors opens the door to penalizing those already penalized by nature. Let’s say you have a birth defect that limits how much work you can do. Should you then, in addition to your disability, have to pay ten times more for insurance?
How about if we find that you have a gene for Alzheimers? Or breast cancer? Are we okay with a system that creates huge economic incentives for aborting girls with a breast cancer genetic marker?
Taking your “couch potato” example, do you have sufficient knowledge to know who is at higher vs. lesser risk? Only to a very limited extent. So you might be going along and enjoying your “healthy lifestyle” discount and then we discover via new testing that you are likely to get cancer.
Do you mind if just as you get this news we triple your insurance rates? Or better yet, can we simply cut off your insurance at that point? You pay for 20 years and then get cut just as the risk becomes clear? So that you end up bankrupt and on the taxpayer nickel?
In fact, what you’re pointing to is the fact that private insurers already ration. They just ration without regard to the health or well-being of the patient and ration instead for the benefit of their stockholders.
Comment by michael reynolds — 5/17/2009 @ 3:58 pm
In a free market there will always be a company which will provide coverage, and, if not, there will be charity hospitals which will likely provide better service than the government is prosposing for everyone. Competition, and lack of stupid regulations, will keep costs down and promote innovation in service delivery to lower costs - profit is also a means of testing the efficiency of a company, not just something that’s an excess. Government healthcare will become bloated and inefficient and taxes will rise to the point that it hurts the whole economy, simply because they don’t have to be concerned with efficiency and competition. If healthcare is privatized, along with other government responsibilities which should be privatized, workers will be able to keep their money and buy healthcare coverage, and a society challenged to help the unfortunate will have the money to donate to charity. I imagine that most private facilities will accept a certain number of indigent cases as community goodwill — I worked in a private specialty hospital for 10 years and through the years we treated many many indigent cases.
Comment by Mike Farmer — 5/17/2009 @ 4:43 pm
Michael R.
“I think people should pay by ability pay” … And who gets to determine what that amount is? I know your answer … why, the government of course. Which puts us exactly in the mess we are in now where the goverment has decided 40% (and soon to be 50% or more) don’t have to pay anything and all the other ‘rich’ people get to pay for themselves as well as those who don’t pay a dime. Until EVERYONE actually and truly has some skin in the game we will NEVER be able to devise a system that will cover everyone and be fair (as possible) to everyone. I know your enamoration with the current administration and how it’s going to rescue us from the mess that is the sole responsibility of the ‘the past 8 years of the evil, Republican Bush tenure’, but the reality of the situation goes so far beyond the past 8 years and crosses party lines. We can blog and post here about which party’s fault it is (both), but until you and others like you can come to the realization that it makes no difference what-so-ever which party is currently in power we are doomed forever to failure. Sorry, but until there is a fundamental change and our govermental system returns to running how it was intended and how it was written in the Constitution, I truly fear for economic well-being and viability. Medicaid already runs at a deficit, while Medicare and Social Security gain momentum and will soon follow it. I no faith in our government’s ability to come up with a healty care system that will do anything other than pull the lever and flush it all down the drain.
Comment by Michael S. — 5/17/2009 @ 4:43 pm
Mike:
In a free market there will always be a company which will provide coverage, and, if not, there will be charity hospitals which will likely provide better service than the government is prosposing for everyone.
That’s a statement of religious faith. It is irrational, not based in fact but in your personal convictions.
In fact the government already runs a health care service called the VA. It is not less efficient than private health care, it is generally rated more efficient.
There is no law of nature that dictates that a free market is best for all things. It is best for many things. But I don’t think you’d want the free market running our national defense, for example. That is run by the government and is the best in the world.
We need to have reason not faith.
In point of fact I am currently unable to get health insurance despite being well-off and currently healthy. In order to game the system I have to form a corporation. This is absurd. And the only reason that dodge works is because of a quirk of California law.
The fact is our system is a mess. It was not broken by the government, it has been broken by our reliance on a work-based health care system that is now utterly obsolete. We need to change it.
As for “charity hospitals” large swathes of this country have only a single hospital, not mutiple. That single hospital may be 50 miles away. The nearest tax-supported hospital — which is what I suspect you mean by “charity” may be hundreds of miles away.
Even here in Orange County, CA — not exactly Nebraska — I know of no “charity hospital.” We have a county hospital but if I show up there sick the care isn’t free. I’m billed. And in the absence of insurance I could quite easily be bankrupted.
That’s the reality. You are defending a massively screwed up system on the basis of nothing more than quasi-religious beliefs.
Comment by michael reynolds — 5/17/2009 @ 5:47 pm
What you fail to realize is that, for the most part, we’ve had government-run healthcare for a long time — hardly anything about the current system works on free market principles. Reason tells me that if the government has done this to healthcare, total control which eliminates competiton will be much worse. My “faith” in private solutions is based on evidence of private companies doing a better job of delivering services. To be honest, I’m not sure private national defense wouldn’t be more effective than what government offers. The point is to look at private alternatives — that’s reasonable — to paraphrase Niebuhr — contempt prior to investigation ensures ignorance.
Comment by Mike Farmer — 5/17/2009 @ 6:33 pm
Micheal,
With greatest respect, you did not answer my questions or respond to my comments. Are you unwilling to impose any form rationing? If so, no system, public or private will ever be affordable. Costs will spiral out of control and the system will collapse.
No system in place today, in any country, provides unlimited health care. Aside from some form of rationing, how do you propose to control costs?
Comment by Mark — 5/17/2009 @ 7:28 pm
I meant Spencer, not Niebuhr
Comment by Mike Farmer — 5/17/2009 @ 7:59 pm
Mark:
There will always be some version of rationing. We have rationing now. We’ll have some form of rationing going forward.
Comment by michael reynolds — 5/17/2009 @ 8:07 pm
Mike:
Defense could not be handled by private industry because their motivations are fundamentally different. Private industry seeks profits. By definition. So if a battle became unprofitable a private enterprise army would disengage. They’d have to by the logic of the free market.
Similarly in health care private enterprise must seek profits at the expense of other considerations. Government is not required to seek profits so they can make a different set of decisions.
If you turned the entire thing over to government you’d eliminate the profits taken by business — many billions of dollars. You’d eliminate duplication of paperwork and administration — many billions of dollars. None of these expenses are evil, they are the warp and woof of competing businesses. But the government would have neither.
The government might be highly inefficient, that is certainly possible. But there is no law of nature forcing them to be inefficient.
There’s a misunderstanding that free enterprise is necessarily efficient in the delivery of services: demonstrably untrue. Their aim is not efficiency but profit, and profit may sometimes be improved by an inefficient delivery of services. For example, the computer industry is notoriously awful at delivering customer service. Service is expensive, and since sales don’t depend entirely on service, the computer company may profit by delivering lousy service. (I’m looking at you, Dell.)
So there is simply no reason to assume that private industry would deliver better health care. Or the inverse. And given the awfulness of our current system it may be time to try something very different.
Comment by michael reynolds — 5/17/2009 @ 8:16 pm
If a country wanted to win a war, they’d pay what is necessary, but national defense isn’t the topic, it was just an example of your logic that government provision of some services is necessary — we don’t really know it’s necessary unless we consider alternatives. It may turn out after analysis that government is best suited for defense and courts, but there’s no proof of this. You’re simply being obstinate now. If you refuse to acknowledge government’s role in the present healthcare mess, and if you can’t entertain the alternative of free market solutions, then there’s nothing left to discuss. We’ll see once we have national healthcare how it works. There’s simply no reason to assume anything, especially that government healthcare will be more efficient, less costly, and will provide better or similar services, but we could study the issue and consider free market solutions — private, voluntary solutions are certainly better than government confiscating money from producers against their will to pay for the healthcare of others. The damage to the economy and the waste will be far greater than any profits hospitals make. You don’t believe or accept this, I do. But, concerning costs and benefits, the reasonable thing to do would be to analyze the two approaches objectively — one thing that can’t be accounted for, though, is innovation. We can only go by the historical lack of innovation in government run programs, and the history of smart innovation by the market when left alone. Finally, regarding service, look at the airlines for the history on service and how competition affects the market — study People’s Airline, then you’ll see the computer industry will be affected by the same principles.
Comment by Mike Farmer — 5/17/2009 @ 11:59 pm
Michael,
Although I admire your obvious concern about the state of the current system, I feel compelled to disagree with several of your statements.
I do not grant your premise regarding “the awfulness of our current system”. In what specific way is it awful? Most of us will agree that it is expensive and services are not delivered equitably to all residents of our country. On the other hand, it produces remarkable innovation and is the envy of the world for treatment of many life threatening diseases and conditions.
“If you turned the entire thing over to government you’d eliminate the profits taken by business” To what extent would you turn it all over to government? Would all health care be provided through government run hospitals and clinics? Would all health care providers be employees of the government? If so, which government? Would this system be administered on a national, state, or local level. Without answers to these questions, you can’t state that you would be able to eliminate the profit or reduce paperwork and administration.
The statements you have made about computer services illustrate the basic problems in your philosophy beautifully. Dell is marvelously efficient at building, selling, and delivering computers. More than likely you purchased a Dell because you got the product you wanted for an acceptable price. You got what you paid for. You didn’t want to pay the extra cost for better service from a different manufacturer or reseller. Under the system you are advocating, choice will be gone. You will get the health care the government says you should get, end of story. You say you want a second opinion on your diagnoses? Thanks for sharing, move on to window number three for your prescription please. “Oh, but in California where I live we like to try a more holistic approach to treatment. I want to include yoga and an organic vegetarian diet in my treatment plan” Not on the approved list, sorry. (FYI, I live in California as well, so I can pick on us).
Respectfully submitted
Comment by Mark — 5/18/2009 @ 12:35 am
It seems like the line of dispute is how to classify healthcare itself: is it a good/service, or is it a necessity?
If its simply a good or service (like computers), thea private system (with all the pros and cons) seems like a good route.
If its a necessitiy (National Defense, Law Enforcement, Utilities), then having a more government-centric system (again, with all the pros and cons) seems to make sense.
I’m curious as to how many people that favor the free-market system do not have healthcare and vice versa.
Comment by busboy33 — 5/18/2009 @ 8:17 am
Why is it that these “cost reduction” always seem to cost more money ?
Comment by Neo — 5/18/2009 @ 8:27 am
Mike:
We can only go by the historical lack of innovation in government run programs, and the history of smart innovation by the market when left alone. Finally, regarding service, look at the airlines for the history on service and how competition affects the market — study People’s Airline, then you’ll see the computer industry will be affected by the same principles.
Government has run the defense industry and our defense has been incredibly innovative. Government also runs the space program which, while not perfect, has certainly done some amazing things. Government runs the army, it runs the service academies, it runs the Centers for Disease Control, the VA, the National Park Service.
So again, what you have is a quasi-religious belief that applies in many cases, but is not universally or necessarily true.
And you don’t really mean to point to the airlines as models of anything, do you?
Comment by michael reynolds — 5/18/2009 @ 9:41 am
“Many of us are so pissed off at the system you’re defending that we’d like to see health insurers replaced in toto by a French-style system.”
“The system we have has been broken by government, so the answer is to have government fix it?”
Well said. Obamacare is not ‘reform’ it’s just more of the same, down the slippery slope to socialized medicine which does NOT work. It costs too much for too little payback, and denies us choice, quality and innovation.
It’s a farce.
Comment by Freedoms Truth — 5/18/2009 @ 9:52 am
In what specific way is it awful? Most of us will agree that it is expensive and services are not delivered equitably to all residents of our country. On the other hand, it produces remarkable innovation and is the envy of the world for treatment of many life threatening diseases and conditions.
Well, in those specific ways, for a start: it is expensive and doesn’t serve all the people.
You’re absolutely right that it creates amazing techniques and equipment. But those businesses wouldn’t be affected by making the family doctor a government employee. You’re conflating two very different elements: research and development, much of which by the way is already carried out by the government, and health care delivery. My pediatrician just discovers ear infections, he doesn’t do a lot of tinkering with new machinery.
I don’t have a health care plan in mind. I’m just questioning assumptions.
As for your Dell example, I’d say you make my point. I use Apple products exclusively because they’re better, and the service is better, and I can afford it. So, yes, I have lots of choices and I can choose to get much better computers or cars or health care than most people. Goody for me.
The problem is that many people are priced out entirely, so they get little or no health care.
I’m suggesting that even poor people should have a right to decent medical care. I’m not saying they each need the private room I might get, but they need to be taken care of. Their wounds need to be treated, they need shots, they need prenatal care, they need chemo and operations and all the rest.
I don’t see why ensuring that working class people get medical care is disadvantageous to me except for the increased taxes. As I’ve made clear, I understand that it will cost me, and I am willing to help with that.
Comment by michael reynolds — 5/18/2009 @ 9:54 am
“Government has run the defense industry and our defense has been incredibly innovative. Government also runs the space program which, while not perfect, has certainly done some amazing things.”
… but both are at huge cost. I wouldnt doubt that a private mercenary army could have the same force-multiplier as the DoD for less cost (eg more UAVs and less pork-spent systems, less bases in every congression district, etc.)
Similarly on launching payloads into space, some private companies managed to be much more innovative and low-cost than NASA.
We are willing to pay the price since there is no alternative when it comes to national security and even 4% of GDP is small price for our national security … but don’t pretent there isn’t a cost-adder for Government-run over market-based. There is, and it is huge.
Comment by Freedoms Truth — 5/18/2009 @ 9:57 am
Freedoms Truth:
What is your basis for concluding that the French health care system does not work?
The French have a slightly longer life expectancy than we do. The French people consistently rate their system highly. They pay far less as a percentage of GDP than we do. And they fill out no paperwork, never engage in death-bed struggles with insurance companies, and their doctors don’t have to hire full-time employees just to wrestle with insurance companies.
So on what basis do you reach the conclusion that their system does not work?
Comment by michael reynolds — 5/18/2009 @ 9:59 am
don’t pretent there isn’t a cost-adder for Government-run over market-based. There is, and it is huge.
Prove it.
Comment by michael reynolds — 5/18/2009 @ 10:01 am
Freedoms Truth:
I’ve been reading a great deal about the possibilities with a nationalized health care system. Due to a couple of really really horrible personal experiences with the current system, I can say with great confidence that there simply must be a better way.
You try having a conversation with a disinterested third party at an insurance company who refuses to pay for tests on a loved one that the doctor deems necessary. You tell me how you feel after the lowest f’ing bidder tries to deny you services and you’re forced to mediate between the doctor and the insurance company. For services that you are paying for in your ridiculously enormous monthly premiums…
If nationalized health care is so bad, why has no country that I’ve ever read about, gotten rid of it yet? You’d think that if it denied us CHOICE, QUALITY, and INNOVATION, that these countries would have dropped it by now in favor of a better system. A system like the awesome one we have now.
Comment by Chuck Tucson — 5/18/2009 @ 10:27 am
Monday evening links…
The giant garbage dump in the Pacific. What a shame. h/t, Cons. Grapevine
Pelosi first heard of 9-11 attacks in late 2003. Scrappleface
Jail for not holding those filthy handrails? I thought they were there for the old folks.
How to land …
Trackback by Maggie's Farm — 5/18/2009 @ 5:07 pm
Chuck,
“If nationalized health care is so bad, why has no country that I’ve ever about, gotten rid of it yet?”
Please do me the kind favor of naming a government program that was eliminated because of poor performance? The answer is it doesn’t happen. When government programs don’t work, the government throws more resources at them. It is never a bad idea or poorly executed, it was just under funded.
I have had the conversation you describe when my newborn son was in the neonatal intensive care unit. The sent me a $30,000 bill for 5 days because he wasn’t named on my policy before he was born, even though the terms of the policy clearly stated that newborns are covered for 30 days after delivery. It took me 18 months of fighting to get the issue resolved. As bad as that was, if it that fight had been with a government agency, I would have no chance of winning, and they could have used their police powers to enforce the decision.
With respect, do you really believe that handing this over to government is the way to get rid of services provided by the lowest bidder? How do you think they buy things
Respectfully submitted
Comment by Mark — 5/18/2009 @ 7:35 pm
They morph or merge into other programs. My question still stands. I have not read about this happening at all, and I’ll bet that you haven’t either.
So your 18 month long crappy experience with a public corporation led you to the conclusion that you were lucky it wasn’t the government. That’s great. My 4 month long nightmare led me to think, There is no way that the government could be worse than what I just went through. Our brains work differently. I can accept that.
You think you’ve got me on this one. That’s why you pulled the “With respect” bullshit. But there is a major difference between lowest bidder with whatever hidden requirements and standards we deem necessary, and lowest bidder with open requirements and standards which are accessible to the people who are actually paying the bill. Something a public corporation would never ever do.
Hell, the current bureaucracy in the corporate insurance world is more than enough to pay for all the uninsured people in the US RIGHT NOW! Oh, but the government would be WAY worse than that, right?
Comment by Chuck Tucson — 5/19/2009 @ 4:29 pm
Dearest Chuck,
My respect “BS’ was a genuine attempt at civility inspired by a recent re-reading of the Federalist Papers and other associated letters. I find it remarkable that these great men were able to maintain that level of decorum in their correspondence about such important matters. I apologize if you found my tone to be other than courteous.
With regard to bidding, I have a fair amount of experience and expertise on this subject. First, I should probably say that I have entered this discussion under somewhat false colors. Despite my libertarian leanings, I am now and have been for the last 25 years, a government employee. In the last four years I have managed approximately $138 million in public works contracts. Bids for government contracts are as open and transparent as the people putting them together want them to be. While I personally make every effort to be certain that every bidder is able to understand and respond to bids, that is sadly not always the case. If we want to hide things or set the bids up so particular bidders win, it isn’t that difficult.
My experience in government service also provides me with a fair amount of experience regarding the elimination of programs. I would be happy to point out a number of government programs and agencies in the State of California that do little to nothing except create more unnecessary work for others. These programs are massively ineffectual and inefficient, yet they still exist. The fact that government programs in this country and others have not been eliminated is no proof of their quality or success.
Respectfully submitted, once again, for your consideration and comment.
Comment by Mark — 5/20/2009 @ 9:21 pm
Well there was that one little Hamilton-Burr incident, but I think of that as the exception that proves the rule.
Comment by Mark — 5/20/2009 @ 11:33 pm
I think they were dicks to each other back then, their language was just a little more eloquent sounding.
Whenever someone says “With all due respect”, “Respectfully submitted”, etc. It’s always a precursor to some form of sarcasm or assholery. I’ve never actually seen it used sincerely. Thus, my bitterness spilled forth. My most sincere apologies if you were, in fact, submitting respectfully.
The thing I find most interesting is what our bad experiences left us thinking in the end.
Yeah, so anyhoo, rock on.
Comment by Chuck Tucson — 5/21/2009 @ 3:02 pm