39 thoughts on “ObamaCare”

  1. Rand,

    Umm…did I miss something? I thought you were a supporter of the Iraq War, and thought that anyone who wasn’t was suffering from Bush Derangement Syndrome. I’m not saying that the analogy isn’t apt–I think it’s disturbingly apt. I’m just surprised that you’d bring it up.

    ~Jon

      1. The Iraq War cost $1 trillion and produced a quagmire abroad. Obamacare will cost $1 trillion and will create a quagmire at home.

        There’s a nice symmetry with the $1T amount, but the latest Iraq cost estimates are 2-3 times that, and Obamacare, unlike Iraq, pays its own way. So the real comparison is that Iraq added $2-3T to the debt, and Obamacare adds nothing.

        As for it being a quagmire, the worst case scenario is that tens of millions of relatively healthy people defy the mandate, leading to an adverse selection death spiral. I’m skeptical — we haven’t seen anything like that in Massachusetts. But if worst did come to worst, there are a variety of “exit strategies”: require a waiting period for new coverage to discourage free-riders, make the penalties more onerous to alter the pay vs. penalty calculus, offer a public option to lower premiums, loosen coverage requirements, etc.

        1. Yes, that should make it even more popular than it is today. Force feeding this crap sandwich down our throats solves what problem again?

          1. It solves free-riding and adverse selection, so that everyone can have affordable health insurance. Universal health coverage is a priority for one of the country’s two political parties.

        2. The same math that calculates $2 to $3 trillion in costs for the Iraq war also says we’ll have to spend $25 trillion just to care for those injured in domestic traffic accidents just during the Iraq war. That or it proves that sociology and poli-sci majors should never be allowed near any math, accounting, or budgeting. Anything involving numbers, really.

          1. I also noticed how quickly Jim is willing to stick it to the proles if they don’t behave the way their betters figured they would. I wonder though, f you make the tax onerous enough, would it still qualify as a tax? And if it doesn’t, would it still be constitutional?

          2. The same math

            Cite? I was referring to the recent Harvard paper. Abstract:

            The Iraq and Afghanistan conflicts, taken together, will be the most expensive wars in US history – totaling somewhere between $4 to $6 trillion. This includes long-term medical care and disability compensation for service members, veterans and families, military replenishment and social and economic costs. The largest portion of that bill is yet to be paid. Since 2001, the US has expanded the quality, quantity, availability and eligibility of benefits for military personnel and veterans. This has led to unprecedented growth in the Department of Veterans Affairs and the Department of Defense budgets. These benefits will increase further over the next 40 years. Additional funds are committed to replacing large quantities of basic equipment used in the wars and to support ongoing diplomatic presence and military assistance in the Iraq and Afghanistan region. The large sums borrowed to finance operations in Iraq and Afghanistan will also impose substantial long-term debt servicing costs. As a consequence of these wartime spending choices, the United States will face constraints in funding investments in personnel and diplomacy, research and development and new military initiatives. The legacy of decisions taken during the Iraq and Afghanistan wars will dominate future federal budgets for decades to come.

          1. Every single CBO

            I see the problem already. The CBO reports are going to say something different in a few years especially if the Republicans should get control of both branches of Congress.

    1. The little ‘landmines’ like the voter registration line in the application sheets. “You’ve got to pass it to find out what’s in it”, remember?

      1. The “the voter registration line” is a result of the Motor Voter law passed in 1994. You’ve had nearly twenty years to find out what was in that one.

  2. The economic cost of the Iraq War are minor compared to the housing mortgage crisis created by Democrat lawmakers like Barney Frank and other friends of Angelo Mozilo. Less we forget, we are still in that quagmire, and Obama hasn’t found a way out of it even with Trillions already spent to supposedly soften the blow.

  3. Jim says:

    “As for it being a quagmire, the worst case scenario is that tens of millions of relatively healthy people defy the mandate, leading to an adverse selection death spiral. I’m skeptical — we haven’t seen anything like that in Massachusetts. ”

    Oh haven’t we now? Maybe YOU haven’t seen that but that’s totally in keeping with your obama-bot view. How about some real data?

    http://www.cbsnews.com/8301-18563_162-57459563/massachusetts-health-care-plan-6-years-later/?pageNum=2

    “Still, insurance premiums in Massachusetts have increased from an average of $331 per month in 2006 to $401 per month in 2010. ”

    George Montilio, who runs a 65-year-old family wholesale and retail bakery business in Brockton, is among the employers opting out.

    “If we had to put health insurance into our company — that would totally make us unprofitable,” Montilio said. “It’s almost seven percent of my gross.”

    With 70 employees – 30 full-time and 40 part-time – he calculates that complying with the mandate would cost him $300,000 per year in premiums. Instead, he chooses to pay the state’s annual fines per employee, which for him amount to almost $20,000 a year.

    “We pay the penalty,” Montilio said. “My choice.”

    “Yet since the reform, overall health spending has risen from as a piece of the state budget pie, from 36 percent in 2006 to 43 percent in 2011, and Massachusetts spends $9,278 per person per year on health care, more than any other state.”

    And of course, your using Massachusetts is disingenuous because when the Romney plan was signed off, 90% of the people here had coverage. Now it’s 98%. The situation was and is nothing like that in the rest of the nation.

    Or there’s this statement from Jay Gonzalez – Patrick’s top budget official (4th para):

    ” State leaders expect to collect nearly $22 billion in taxes next fiscal year, roughly $940 million more than this year. Gov. Deval Patrick has proposed to increase next year’s state budget by nearly the same amount.

    So why does Patrick’s plan call for a number of new cuts to state programs, layoffs and more taxes on candy, soda and cigarettes to balance the books?

    Because so-called safety net programs and a handful of huge, escalating costs, such as health care, are crowding out most other sections of the state budget, said Jay Gonzalez, Patrick’s top budget official.

    “It means that everything else in state government is being reduced,” the finance and administration secretary said in a recent interview with editors of the Daily News and wickedlocal.com.”

    “Altogether, that [health care money] accounts for about 41 percent of the state budget, up from 22 percent in 1998, according to Gonzalez. ”

    H3ll Jim you don’t even know what’s going on in your own state. The budget is taking a drubbing because of the health care plan.

    These are Deval Patrick’s (the gov) toadies talking. And even they know we hit an iceberg.

    sheesh

    1. when the Romney plan was signed off, 90% of the people here had coverage. Now it’s 98%.

      Exactly — no adverse selection death spiral.

  4. when you spend a trillion in iraq, very few of the dollars come home, very few of the dollars go to building capital, paychecks or salaries at home. At least if you spend a trillion dollars on Obamacare, you would end up with bigger salaries for doctors, more clinics, more hospitals. I would imagine that as Obamacare spools up, we will see more Minute Clinics at CVS and Walmart, more nurse practitioners being hired to support doctors and more health care workers. At best it may make the system more efficient by treating people at the doctors office not the hospital ER and at worst, it’s a little more domestic spending.

    1. when you spend a trillion in iraq, very few of the dollars come home, very few of the dollars go to building capital, paychecks or salaries at home.

      I think most of that money goes to buttering someone’s biscuit at home either via cushy defense service or procurement constructs, or via the health care system.

      At least if you spend a trillion dollars on Obamacare, you would end up with bigger salaries for doctors, more clinics, more hospitals.

      Why do you think that would happen? We had a post the other day from “Al” claiming that Seattle has been losing its independent outpatient care clinics.

      Before Obamacare, there were in excess of thirty small (1-10 doctor) oncology outpatient clinics in the greater Seattle area. I’m only personally conversant with five – but they’ve all been assimilated by one of the major hospitals. I hear all of the rest have also been completely subsumed.

      What I think we’ll see as Obamacare kicks in is a whole lot more part time jobs.

      1. Here’s one example.

        PSCC was a collection of two small clinics. Then an “Affiliate” before the ink on Obamacare even dried, and now (as the details have solidified) just sold out to Swedish.

        http://pscc.cc/contact.php
        http://www.bizjournals.com/seattle/morning_call/2013/03/swedish-opening-edmonds-cancer-center.html

        The second link is exactly the same clinic moved 200 feet. Same people. Same Doctors. But the near-monopoly has money to burn, while the smaller clinics evaporate.

    2. when you spend a trillion in iraq, very few of the dollars come home, very few of the dollars go to building capital, paychecks or salaries at home.

      If that’s your argument, then where is your evidence that a Trillion went to Iraq, rather than make the paycheck of military and civilian US personnel that served in Iraq. Rather than pay for the military hardware built in the US and used in Iraq? I’m not saying Iraq was cheap, but again, if your argument is the money went over there and stayed over there, then how does it add up to a Trillion?

      1. look at where the money went. Yes, many US soldiers got paychecks, but how much of that paycheck dollar was spent in bases in the US and how much was spent on R&R in Dubai, Qatar, Cyprus, Malta. Then the contractors washed their money overseas. Halliburton moved their HQ to the UAE, blackwater buried their money overseas and the individual contractors if they stayed over 18 months, were able to avoid income taxes. If you look at Consumable (Oil, Diesel, Kerosene, JP-8) that’s all bought overseas. Same with Food, water. All those truck drivers? Mostly pakistanis getting paid to hump supplies up the Khyber.

        There were some dollars spent in this country but all the O&M money, sure went there.

        1. Halliburton moved their HQ to the UAE

          Funny, I just drove by their headquarters off the Beltway. And here I thought I was in Houston. Anyway, back to the Trillion, how do you get to that number?

          1. “http://articles.marketwatch.com/2007-03-11/news/30722841_1_dave-lesar-halliburton-shares-oil-field-services

            Halliburton Co. will move its corporate headquarters from Houston to Dubai, the company announced Sunday.

            Halliburton (US:HAL), once run by Vice President Dick Cheney, plans to maintain a corporate office in Houston, but the company will be run from its new headquarters in the United Arab Emirates.”

            as for a trillion for the iraq war

            http://en.wikipedia.org/wiki/Financial_cost_of_the_Iraq_War

            “The costs of the 2003-2010 Iraq War are often contested, as academics and critics have unearthed many hidden costs not represented in official estimates. The most recent major report on these costs come from Brown University in the form of the Costs of War project,[1] which said the total for wars in Iraq, Afghanistan, and Pakistan is at least $3.2-4 trillion.[1] The report disavowed previous estimates of the Iraq War’s cost as being under $1 trillion, saying the Department of Defense’s direct spending on Iraq totaled at least $757.8 billion, but also highlighting the complementary costs at home, such as interest paid on the funds borrowed to finance the wars and a potential nearly $1 trillion in extra spending to care for veterans returning from combat through 2050.[1] “

          2. The Brown University study is joke, and it was its methods that I mentioned above which resulted in a $25 trillion dollar cost estimate for domestic traffic accidents during the Iraq War.

            In WW-II and Korea we had about 100 times as many casualties as in Iraq, so you’d expect the costs of their short and long term medical care to be, in constant dollars, roughly 100 times higher than the Iraq War’s, so the VA should’ve shelled out about $80 trillion dollars. Unfortunately the average veteran of those wars will be over a thousand years old by the time that much is spent on them.

            The Brown study had so many errors and unsupportable assumptions that it’s silly. They seem to assume that only people who’ve been to war actually have any health care costs, and claim that the costs actually peak 30 to 40 years later. Well no, WW-II’s health care costs peaked in 1947 or ’48, then declined.

          3. In WW-II and Korea we had about 100 times as many casualties as in Iraq, so you’d expect the costs of their short and long term medical care to be, in constant dollars, roughly 100 times higher than the Iraq War’s

            No, benefits are much more generous now, and health care costs are much higher.

            The Brown study

            Is not the only study on this subject.

            They seem to assume that only people who’ve been to war actually have any health care costs

            Veterans are unlike other citizens in the role that the government plays in paying for their health care costs.

          4. No, benefits are much more generous now, and health care costs are much higher.

            So it’s not a war cost, but a health care cost. We need to keep such things in mind.

          5. Veterans are unlike other citizens in the role that the government plays in paying for their health care costs.

            And that illustrates one of the key flaws in their thinking. Most of the VA costs are completely unrelated to war, and are just a reflection of grouping X percent of our population into a particular accounting column. The health care costs of diabetes or heart disease among Vietnam veterans would exist regardless of whether they’d fought or not. If the VA is spending more per diabetes patient, it’s a reflection that all hospitals are spending more per diabetes patient. If the percentage of veterans increases, shifting costs over to the VA system, it means the costs carried by other hospitals decreases.

            Put more simply, they should be seeing a fixed pie (at least in terms of national health-care costs in any particular out-year) but they’re trying to scare you by changing how they slice the pizza, as if slicing it six ways is dramatically different than slicing it eight ways.

          6. Halliburton Co. will move its corporate headquarters from Houston to Dubai, the company announced Sunday.

            Halliburton (US:HAL), once run by Vice President Dick Cheney, plans to maintain a corporate office in Houston, but the company will be run from its new headquarters in the United Arab Emirates.”

            Did you check with Halliburton?

            The company will maintain its existing corporate office here as well as its legal incorporation in the United States, meaning that it will still be subject to domestic laws and regulations.

            If you go to Halliburton’s website, you’d see that the company divided operations between hemispheres. The Western Hemisphere with headquartered operations in Houston did over half of Halliburton’s revenue.

            But points for mentioning Halliburton, Iraq, War, and Cheney in a thread about Obamacare.

    3. Obamacare mandates everyone buy insurance and either pay a tax if they don’t or if their insurance is too good. Obamacare doesn’t mandate an increase in physician salaries or the construction of new hospitals.

      You are right that there will be a rise in businesses that will take advantage of mandatory coverages. This wont necessarily lead to improvement in the quality of care or increase access to vital services and it certainly wont drive costs down. We will see an increase of businesses offering things like massage therapy.

      1. well the way i look at it, you will have a larger market, and a greater demand.

        usually that results in an increase in revenue/price which will be showing up at the front end of medicine. If 30% of the population starts getting access to either medicaid or Obamacare exchanges, we will see more people going to the doctors for routine stuff and fewer people going to the ER for critical neglect.

        it’s a lot cheaper to treat someone at a minute clinic for an ear infection then to treat them at the ER for a blown out eardrum.

        1. The problem with that idea is that increasing demand does not automatically increase supply. It takes more than a few years of education to create a competant health care professional and Obamacare is already causing some people in that line of work to leave. When you have increased demand with little increased supply, costs rise.

          1. Hopefully we can attract immigrants with good medical education
            and much of the treatment may be simpler if done earlier.

            “An ounce of prevention is worth a pound of cure”– Franklin.

            If nurses and Physicians Assistants start treating the early problems, maybe we won’t need MD’s and ER doctors treating
            the emergency cases walking in the door.

          2. That’s good, because under Obamacare we probably won’t have any more MD’s and ER doctors. They’ll retire and new kids will go into law or the stock market.

    4. very few of the dollars come home, very few of the dollars go to building capital, paychecks or salaries at home

      Also we see here the broken assumption that economic activity somehow translates into economic prosperity. I’m not interested in dollars “coming home”. If we’re going that route, then don’t spend that money in the first place. The taxes not collected and not spent automatically becomes wealth “at home”.

  5. I wanna know how to get one of these big time jobs getting paid big bucks making “projections” for these massive pieces of legislation. Apparently one doesn’t even have to model anything that bears any semblance to reality. Accuracy in estimation is secondary to just helping to ram crappy legislation through. Why I can just sit around and make crap up and get paid for it, I got no problem with that. I’ll even do one better and tell you up front that my estimates are being pulled from ass so you don’t even have to second guess. It’s not like everyone in and around D.C. doesn’t already give each other a nod and *wink when they work on the projections anyway.

  6. In this context, calling Jim “Baghdad Jim” (even though the comparison to Baghdad Bob is so apt) is too obvious and easy even for me.

    1. I’m impressed that you’ve advanced from simple name calling to commentary on your own name calling.

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