Larry

Federal furlough thread.

Some really convenient editing, there. Like, taking one sentence, then skipping a few, then taking a different sentence. However, I seem to be having trouble selecting and copying text from the document. I assume that the document is an image, rather than a text document. And I'm too lazy to type the whole thing in. (It's the first paragraph, on the second page of the pdf, if anybody wants to go look at the source.) Here's what it says: (My summary of their summary.) 1) The effects of Obamacare on the long-term budget mostly depends on whether the cost containment parts of the bill, work. 2) Two projections were done in January of '10 (before Obamacare was passed), and in the Fall of '10 (after it was passed). Each projection looked at a "baseline" scenario (in which all existing laws remain), and an "alternate" projection (in which we assume that a lot of laws that are on the books, won't really happen) 2a) The January '10 projection was pre-Obamacare. The baseline projection, for example, assumed that all temporary tax cuts would expire on schedule, and that things like the Medicare payment reductions would take effect. The "alternative" projection assumed that all tax cuts except for the SS tax cut would be made permanent (and, in fact, that as the economy grows and natural progression tends to make taxes a higher percentage of GDP, that other, unspecified, tax cuts would be passed, to keep tax revenues from exceeding the historical average percentage of GDP). It assumed that the "doc fix" would continue. (That Medicare payments would not be automatically reduced, but would actually increase.) 2b) The Fall 2010 projections also produced two projections. The "baseline" again assumed that all existing legislation (which now includes Obamacare) continue. The "alternative" projection makes all of the assumptions that the previous alternative projection makes (that tax cuts would continue, that "doc fix" would continue.) AND it assumes that all of the parts of Obamacare that increase costs (things like increasing insurance coverage) continue, but that all of the parts that reduce costs get phased out after a few years. 3) Comparing the "with Obamacare baseline" and the "without Obamacare baseline", The Obamacare version shows "notable improvement" (their words). (Obamacare makes the long-term budget situation notable better, if all of the assumptions work.) 3) However, that "baseline" projection assumes that the cost-cutting provisions of Obamacare will remain in effect, and that they will work. There is some question about this. It may be a bad assumption. 4) If we compare the "pessimistic assumptions, and no Obamacare" projection, to the "pessimistic assumption, and we assume that all of the parts of Obamacare that cost money, cost money, but we assume that all the parts that save money, don't exist" projection, then things get worse, by a slight amount. "Slight amount" is my characterization. If you'd rather have just numbers, then I will observe that, looking at the pretty picture just below the summary paragraph, and just applying Larry's eyeball (because I can't find actual numbers), It looks to me like: The "pessimistic scenario, including the parts of Obamacare that cost money, but without the parts that save money" projection says that, along about 2029, the national debt will be 200% of GDP. Whereas, with pretty much the same assumptions, but no Obamacare at all, the projection shows it as more like 195% of GDP. No, it says we have unsustainable deficit problems. What the GOP says is "whenever somebody talks about the deficit, pretend that they said 'spending', because we wouldn't want people to get the impression that the lowest taxes in 70 years might be part of the problem". Uh, could you quote me that part? (Cause the part you selectively edited sure doesn't say that. But I'll confess I haven't read the whole thing.) The opening paragraph that you cherry picked parts out of, says that in their baseline scenario Obamacare shows "notable improvement" compared to without Obamacare. And it says that the parts of Obamacare that cost money, if you eliminate all of the cost-reducing parts makes things slightly worse.

Just looking at a few things in the report. 1). Observing that the title of the report is well, I don't seem able to copy and paste, but it's basically that their projection hinges on whether it pushes costs down or not. 2). Observing that, as the pretty picture and the text on the second page of the PDF says, under their "baseline" projection (which assumes that existing laws remain in effect), the long term budget, while still not good, is considerably better than projected 2 years ago. Whereas their "alternative" projection, (which assumes that lots of laws will be changed, like assuming that the "doc fix" gets applied, that all temporary tax cuts become permanent except for the SS tax, AND THAT ALL OF THE OBAMACARE COST SAVING MECHANISMS ARE PHASED OUT), got slightly worse. 3). I haven't seen anything whatsoever that even implies that this study even looks at the effects of Obamacare. This study does not look at "budget with Obamacare vs budget without Obamacare". It looks "what we predicted, with Obamacare, two years ago, vs what we predict, with Obamacare, now".

Discussing the federal bureaucracy.

Deleted post

Predicto on Elizabeth Warren.

deleted post. Didn't notice the dates.

Is it possible that a precedent is being established? That governments are accountable to the people? (Crossing fingers.)

If I read their page correctly, their "free preview" feature will let you watch one minute, live. And then you have to pay. And you can only do it once per day.

I just installed a (free) app on my iPad that supposedly lets me watch.

Somebody on Facebook posted this. Lunar Recon Orbiter: Question Answered! The Lunar Recon Orbiter has photos which they claim show that the flags planted on the Moon by the Apollo missions are still standing. (Except, apparently, the one for Apollo 11. As the site explains, Buzz Aldren claimed that when they lifted off from the Moon, that the exhaust from the LM ascent engine blew over the flag. And that's the only landing site where they don't see the shadow of a flag.) ---------- Post added July-31st-2012 at 08:13 PM ---------- Somebody on Facebook posted this. Lunar Recon Orbiter: Question Answered! The Lunar Recon Orbiter has photos which they claim show that the flags planted on the Moon by the Apollo missions are still standing. (Except, apparently, the one for Apollo 11. As the site explains, Buzz Aldren claimed that when they lifted off from the Moon, that the exhaust from the LM ascent engine blew over the flag. And that's the only landing site where they don't see the shadow of a flag.)

Not in the House. First thing the new, Republican, Tea Party ("The most important thing in the world is the deficit") Congress did when they took office, was to change the pay as you go rules of the House. Now, all proposals that increase the deficit have to be paid for except: 1) Repealing Obamacare. 2) Tax cuts.

That sounds a lot like an idea I've had for years. (So it must be a great idea.) I'd been looking at the problem of feeding the poor, and I'd observed that it would be vastly cheaper to set up soup kitchens and hand out free food to anybody who shows up, than it is to hand people cash (or things easily convertible to cash), and tell then to go to the grocery store and pay retail. Now, in the health care soup kitchen situation, we all know that there will still be rationing. You can't give away anything for free and not have demand exceed supply. I would assume that the rationing mechanism would be time based. Demand would rise until people weren't willing to wait in line for (however long it is.) But yeah, that does sound, to me, like an idea that would be a whole lot cheaper.

Why would you chose not to be insured, when pre-existing conditions are covered?

Some thoughts on the subject of this claim that Obamacare will increase use of the ER. Let's look at a few demographics, and compare how things are now, and how they supposedly will be, under Obamacare. 1) The wealthy and most of the middle class will see no change. They're carrying insurance now, (and paying their various deductibles and copays), and they still will. It's possible that their coverage will change a small amount. Some things that they weren't covered for, before, but Obamacare mandates that they must be covered now. And their cost may rise a slight amount, to reflect the increased coverage. 2) People who are covered by Medicaid right now, also shouldn't see much change. In effect, they will keep their present insurance. 3) Now, let's consider a hypothetical person who isn't quite poor, but who chooses not to carry insurance. Let's divide that demographic into two groups, depending on whether Obamacare successfully persuades them to get insurance. 3a) The people who don't have insurance, and who will choose to remain uninsured under Obamacare: These people's health care situation really doesn't change. Their access to health care is the same as it was before. They still have the option of going to the ER, and sticking someone else with the bill. Only difference is that now, because of The Tax, part of that bill is actually being paid for, by their demographic. Net result: The expense is the same, but the expense has been partially shifted onto the people receiving the service. 3b) People who can afford insurance, have been choosing not to, but Obamacare's Tax persuades them to get insurance. These people's access to the ER hasn't increased. They can go to the ER, and if they do, the bill will be the same. Part of the bill will have been shifted to other people in their demographic (via the insurance company.) Their personal bill will likely be the same, though. Before, going to the ER cost them everything they had, till they were bankrupt. And it likely still will. Net result: No change in access. No change in their personal bill. But instead of the rest being paid by society, part of it gets paid by the other "formerly uninsured, but I decided to get insurance" demographic. (Society as a whole likely still gets stuck with a part of the bill, it's just a smaller part.) Obamacare really doesn't change their access to the ER. they have access now, and they still will. What it will do, however, is to give them access to places besides the ER. Right now, the people in this demographic have full access to the ER, but they don;t have access to the Urgent Care clinic down the street. Under Obamacare, those people will now have access to Urgent Care. The guy who used to take his "my arm might be broken" to the ER, can now take it to the Urgent Care center. If he goes there, then his total bill will (IMO, I have no actual idea of the relative costs) likely be half what it was in the ER. And his bill will likely be paid entirely by members of his demographic (via the insurance company), and by him (his deductible and copay.) In short, yes, Obamacare increases access to health care. But it doesn't increase access to the ER. It increases access to urgent care. (Thus, greatly lowering costs.) And it shifts part of the costs to the "currently uninsured" demographic. Just my opinion, but that is going to be the big "cost savings" of Obamacare: The shifting of health care for the lower class, to places where it's cheaper to care for them.

Why is it that every time I read a post that consists entirely of empty platitudes trying to wrap themselves in a flag, I think of the guy in Green Acres, who, every time he'd pontificate, a fife and drum would start playing in the background? (Afraid that the answer is "because you're old".)

There were some awfully good points in there. IMO, well thought out and reasoned. I have some problem with the "opposing view" you presented, the "block grant", which, as year as I can tell, consists of the feds telling the states "Here, take all this money, and any money that you can figure out an excuse, you can divert to whatever else you want". But IMO, your observation of pressures to grossly extend coverage appear (at least from my ignorance of the subject) to be valid ones.

Curious how the definition of "unsustainable" has now come to mean "The Republican Party has decided, for political reasons, to do everything they can to get rid of something which (in the case of Welfare, Food Stamps, Social Security, and Medicare) is successful and working. And they have almost enough political power to succeed in their efforts to ruin it."

That certainly seems counter-intuitive, to me. Although I do recall readong about a study, several years ago, that looked at health outcomes for four common major medical procedures. (The one procedure I remember was coronary bypass surgery. I forget what the other three were.) The study looked at: 1) People who had had coronary bypass surgery (and whatever the other three were), and 2) People who had had coronary bypass surgery recommended, but who declined the procedure. And they looked at how many of each group were still alive, five years later. And what they concluded was that all four of these procedures had no significant effect on the patient's odds of still being alive after five years. Both the croup who had the surgery, and the group who didn't, had roughly the same percentage of deaths over the next five years. One of the things I remember from the article I read about the study was that the study didn't say that coronary bypass surgery didn't reduce the number of heart attacks. But that a lot of the people who had the various procedures would up dying from some other condition, within five years. In particular, one thing the study noted was that, of the "had coronary bypass surgery, but died, anyway" group, more than half of them died from an infection that they picked up in the hospital.

I obviously have no idea what kind of statistics you're referring to. But I will observe that, IMO, it's real tough to compare "government health care" and "private health care", because in many cases, they're covering wildly differing demographics (how many 80 year olds aren't covered by Medicare?), or, if you want to compare the insurance offered to government employees (which, I believe, are all private insurance), then you're looking at employees who generally accept lower salary in exchange for much better coverage. In short, I would think that it would be really tough to make an apples to apples comparison.

Yeah, I've thought ever sonce this theme came up, that the best health care system would be for the government to run a single national system that covered essentials. Just the minimum level of care that we think that the poorest person in the nation is entitled to. And then allow the free market to compete to offer "medicare supplemental insurance", that covers more things. But then, I have to reflect that, if we ever passed such a system, then the government would instantly be under pressure to expand the system to include more and more things. And everybody would be wanting the thing to expand. The doctors, the providers, employers, voters, even the insurance companies would want for the government to cover more and more things. And, it occurs to me, that when all of those groups, and their lobbyists, want the government to expand it's "bare minimum" coverage, then it's going to get expanded.

So, the Democrats cut Medicare, huh? Guess that means it's time for the Republicans to agree to a tax hike, huh?

There's a pic going around of Obama recreating the "Dewey Defeats Truman" pose, holding up a tablet displaying CNN's web page.

Agree that that's one of the factors that affest the statistics: People who will wind up paying more, but will also get better coverage. I'll also observe that every time a person who wasn't insured, buys insurance, then the "average person's health insurance costs" go up, because that person used to be averaged into the statistic as a zero.