PeterMP

For somebody that doesn't really care about MCW, you certainly are spending a lot of time worrying about him. There is no single perfect stats, but WS do a pretty good job of indicating somebody's worth, and MCW had a very low positive win shares last year. I'm not using WS to argue that MCW is the 150th best player in the NBA. Certainly not anything to suggest he's going to turn into a real good NBA player. We talked about 2 young guys that were in bad situations that had good WS (Curry and Gasol), but on MCW's own team Noel and Convington both already have significantly better WS than MCW did this year or last year, and Noel is younger than MCW and Covington is only a year older, but is also getting his first real shot at playing in the NBA. As the team around MCW has gotten better, he's gotten worse (and not just by WS). And yes, some guys fix their shot, but there are a lot of guys that don't. MCW is already 23 and in his 2nd year in the NBA and there's no real improvement in his shot and that's in terms of the stats and just looking at it in terms of the mechanics of it. Might he figure it out this off season? Yes, but there are lot's of guys that never do, and there really is no reason at this point in time to believe he will be one of the ones that does. **EDIT** I looked at every guard that is currently shooting 35% or over from the 3 pt. line. If you look at the first year in which they had more then 10 3 pt.shots (just to get rid of cases where somebody didn't play much and the numbers are pretty meaningless), they all shot over 30% from the 3 pt. line except for 3. JR Smith Who as a 19 year old rookie shot 28.8%, but then the next year came back and shot 37.1%. Chris Paul at age 20 and a rookie shot 28.2%, and the next year came back and shot 35%. Jason Terry at age 22 as a rookie shot 29.3%, and the next year shot 39.5%. Michael Cater Williams at 22 shot 26.4% and this year has stepped back to 25.8%. It is highly unlikely that MCW is going to turn into a good shooter for a guard.

Curry's first year in the NBA he was a 43.7% 3 pt. shooter. His effective FG% was 53.5%. If either of the two guys they traded had numbers that looked like that, I'd be saying they made a mistake considering what they got back. Gasol was a 7 footer that averaged double digit points with an eFG% of 53%. They were both positive win share players in year one. Those are guys that you keep. Trading those types of guys would have been more akin to the Sixers trading Convington or Noel, and they didn't do that. I mean heck, if McDanies isn't a free agent this year that changes things. You traded one guy that has negative win shares for the year, and another guy that looks like he's a better player and probably has more upside, but is a free agent at the end of the year. Those aren't people that you can really build around. Might MCW fix his shot and become a really good player? Yes. Is it ikely? No. (And again, MCW becomes a much more valuable player if you know you are going to get scoring from somewhere else, especially on the perimeter. But right now at least that doesn't appear to be in the Sixers future. It appears they'll need a PG that can shoot. MCW as a defensive stopper and a general play makers on a 2nd unit with a 3 or 4 that score/shoot (for a 2nd unit player) makes a lot of sense) Might McDaniels turn into a really good player? Yes. Consider he's a free agent at the end of the year is there much reason to believe if he does it is likely to happen with the 76ers? No.

Does anybody consider him a good shooter now for a guard? He's a 30% 3 pt. shooter. And I'm pretty sure his shot has always been considered better than MCW's.

The Sixers dumped two guards that can't shoot. There's no reason to think they were going to be able to become a really good team with those two guys, especially remembering one of them is a FA at the end of the year. It isn't like they are getting really good shooting from their 4 or their 5 or expect to in the future (Embiid doesn't have a reputation as a stretch 5) that would off set having non-good shooting guards. It made complete sense to dump the guards or you have to think about dumping Noel with the idea that you are going to get a stretch 4/5 to pair with your non-shooting guards. Noel is already a positive player in terms of things like win shares, and he's not a FA at the end of the year.

Honestly, if I were the Wizards I would have kept rebuilding because I don't think they are going to win an NBA title with the group they have unless they get really really lucky. And I'd be looking to be "rebuilding" even now. I think you look at a guy like Wiggins and what he's doing already in the NBA, and if he stays healthy I think it is pretty clear he's going to be a really good player. Was there any real doubt after year 1 that Lebron or KD were going to be great players very early in their careers? The Sixers (nor the Wizards) have that kind of player currently that is actually playing (Embiid might be that guy, but he's also a big man with foot problems. If I were running an NBA team, I'd not be to eager to gamble the future of my franchise on him. They also got a 6-10 guy in Europe who I know even less about). Could the Sixers have kept the group they had together added players with the picks they had and made the playoffs in a few years? Sure! Absolutely! Maybe somewhere along the line they would have even made some conference championships. And maybe they would have gotten lucky and made an NBA final or two. And maybe they could get really really lucky and win an NBA championship. In 3 years, could they have been where the Wizards are? Yes! But who really wants to be the 4th best team in what is clearly the weaker of the two NBA conferences with no clear path to improve? Maybe KD will come to DC and that'll be the key. But I wouldn't really want to bet the future of my franchise on that.

Ehh I like what the Sixers have done. They got a 1st round pick for taking a 7 footer for one year. Maybe he figures things out or not, but it isn't like their capped out next year, and if it doesn't work, then you let him walk after next year. Heck, if he's a really pain in the neck, they could cut him and eat his contract. Unless MCW puts in a tremendous amount of time on his shot, he's always going to be offensively limited. He's not really a starting PG on a good team. MCW actually has negative win shares. And McDaniels was on a 1 year contract, and it isn't like they are competing for the playoffs so they got something for a guy that they can go out and get again as FA at the end of the year if they really want to (and are willing to pay him which they would have to have done anyway). They'll have the cap space even with the McGee contract to give sign him to a nice offer sheet if the really like him. Now, this doesn't mean this is all going to work. They still need to get lucky and find some real players somewhere. The rebuilding begins when you have a (healthy) possible top 6 player to build around. I don't think any of the guys they traded are that guy.

I guess I just assume that if somebody says tax credit, and they don't stipulate that it is a refundable tax credit that it isn't. Otherwise, why wouldn't you say you were talking about a refundable tax credit?

1. Sorry. Right. Medicaid not Medicare. 2. I'm still not sure how a tax credit help people that don't pay any taxes. 3. Has the CBO scored it? Scoring very general things like encouraging states to carry out tort reform is going to be hard (How encourage? What type of tort reform?), etc. 4. Isn't the ACA being paid for by increased taxes on the "Cadillac" and the penalties for the uninsured primarily?

I didn't read the plan just the Forbes story, but are there subsidies and tax credits? I thought they were two different things based on the story. How much is somebody 200% below FPL paying in taxes that they are actually going to be able to afford insurance based on a tax credit? Larry, I think they are going to long term gut Medicair unless the rate at which health care costs go up change dramatically. The block-grants say something like, we'll give peg health care costs increases at some increase over time and simply give that money to the state. The problem is if healthcare costs go up faster than what people want them to pegged to (which is what has happened over the last 30 years or so), then what you are really doing is cutting Medicare. If you separate the insurance part of this plan from the Medicare reform part (which long term essentially results in a cut in Medicare), then I doubt they save money. **EDIT** From the plan: "This capped allotment would grow over time at CPI+1 and reflect demographic and population changes." The problem is that health care costs (not insurance costs) have gone up more than CPI+1 over the last 30 years essentially every year. And while that's slowed some now, I don't think anybody wants to bet that it is going to stay slow. The end result will be over time the states will be harder and harder pressed to meet the needs of the poor in terms of providing health care. http://www.hatch.senate.gov/public/_cache/files/bf0c9823-29c7-4078-b8af-aa9a12213eca/The%20Patient%20CARE%20Act%20-%20LEGISLATIVE%20PROPOSAL.pdf **EDIT 2** In a "good" year for health care increases (2012), the CPI increase was less than 2%. Health care was about 4%. Even CPI+1 didn't cover the increase in health care increases and that's a good year.

While not doubting that Medicare has its problems, I don't think anybody that has looked at the issue really doubts that Medicare is more efficient. Now, there are reasons for that, and they aren't all good, but the ability to no have to worry about advertising and profit is a huge advantage, and you see it when you compare Medicare to the total US private market. But also the US market to the Canadian single payer system. http://voices.washingtonpost.com/ezra-klein/2009/07/administrative_costs_in_health.html From only a cost efficiency/overhead issue, there really is no doubt about what the best solution is, and I don't think it is a doubt even taking into account fraud.

Philly has been hoping the ping balls will fall their way in the last 2 drafts where they will be able to draft a clear stud. That hasn't really happened. Lacking that, they've stock piled young talent in hopes that they can get lucky and find a clear stud or trade some of them when the opportunity presents in order to acquire a stud or more veteran pieces to surround the stud when/if they find one. It isn't an unreasonable approach.

Just to be clear a single payer and public option are not the same thing. Obama certainly wanted a public option. It had strong support amongst Democratic voters. It was dropped as a concession to people that didn't want one. Now, whether you consider those people the "right" or not is something I'm not going to argue over.

They did jettison the public option.

There's three issues: 1. Insuring people that weren't insurable before 2. Insuring people that were insurable, but didn't have insurance, but then ended up having some sort of catastrophic event. 3. Actually doing something to lower healthcare costs/spending. The ACA does something with all 3 of those things. There was little to no motivation before to insure high risk (i.e. pre-existing conditions). The ACA simultaneously makes it a requirement and decreases the incentive not to by capping profits. The ACA strongly encourages the group in #2 to get insurance. The ACA does things to do things like limit re-hospitalization, which everybody agrees raises health care usage and therefore spending. There are some other things in the ACA that are similarly driven. Some will work. Some will not. Over time we can discard the ones that won't. That's a pretty good combination.

I'm not arguing for anything. I'm not saying that long term that high deductible plans are good. I'm explaining to you why the rate at which the increase in out of pocket costs goes up can go down even as there is a shift to high deductible plans. The percentage of people with insurance that have high deductible plans is up. Simultaneously to that, the rate at which out of pocket spending is increasing is going down. Those two things are both true. You seem to be having an issue with that and I'm trying to explain it to you. (Though, I don't of anybody that studies health economics that doesn't believe that part of our problem is that we simply use too much health care, and everybody that I know that studies health care economics believes high deductible plans will help with that. They aren't the only way. They might not be the best way. And they might not be an efficient way to do it. And no matter what happens as long as we have for profit insurance companies, the result is going to be great for insurance companies. **EDIT** I'll also point out that there are real long term costs to over prescription of antibiotics at a economic and healthcare level. http://www.ncbi.nlm.nih.gov/pubmed/25194120

1. That's right in 2013. 2013 saw a small increase as compared to what we were seeing in the last 2 decades. The rate at which the increase is going up is down. There was still an increase, but it was a smaller amount than in the past. The rate at which costs are going up is decreasing. There were years where the increase in prescription drug spending was double digits. It was regularly over 5% in the last 2 decades. That wasn't the case last year (or 2012) and that has been driven by the patent cliff largely. 2. Yes in a high deductible plan, but most no deductible plans have a co-pay. Going back to my example of an office visit for a congestion with a minor fever: 1. High deductible plan. I wait 2 days to see if I start to feel better. After two days, I do. My costs: $0 2. No deductible plan. I go to the doctor. I pay my co-pay for the sick visit and for the antibiotics he prescribes that aren't actually going to do me any good: My costs $50 The high deductible plan helped control my out of pocket spending.

The doctor prescribes antibiotics because I have a fever when I go there sick. It is almost certainly just viral, but just in case the doctor prescribes them any way. I have a co-pay for the antibiotics. or blood tests or whatever the doctor decides to do based on what drove me to the visit them. The end result is that not visiting the doctor for a case where it is really probably unnecessary saves me money. On a side note, the other thing that is happening with the move to high deductible plans is plans that limit annual out of pocket costs. I pay more up to a spending point, but then I actually pay less (or none). On an average year, I pay more, but if I have a year with a lot of expenses, I pay less. This helps control out of pocket costs at a population wide level. http://www.washingtonpost.com/blogs/wonkblog/wp/2014/09/10/yes-you-are-paying-a-lot-more-for-your-employer-health-plan-than-you-used-to/

1. I never said that anybody gets free sick visits. 2. That's not from the NYT link. It is from the other link I gave you, and I've quoted from (including that quote) several times now. Here's the other quote I pulled from it: "Between 2012 and 2013, out-of-pocket ex-penditures per capita rose from $660 to $800 (Table 1). This 4.0% increase was the lowest growth in the out-of-pocket spending during the study period." Can you tell me what is included in out of pocket costs? 3. And if it was just my mom, you'd have a point, but it isn't so: http://online.wsj.com/articles/SB10001424127887323494504578340393335386084 "Spending on basic prescription drugs like cholesterol-lowering pills recorded a rare decline in the U.S. last year, but spending on more complicated drugs continued to soar, according to the nation's biggest pharmacy-benefit manager." It is something that is happening on a population wide (at least with in the US) level.

I've already explained this in the concept of a sick visit. If for minor issues, I don't go to the doctor, then I don't pay the co-pay for the visit (I'm guessing your insurance didn't completely cover sick visits before going to a high deductible plan). I don't pay whatever the co-pay are to me because the doctor is practicing defensive medicine. And other costs are going down. The most highly used prescription drugs are all getting cheaper. My mom has gone to something that she was paying $150 for (I don't know what her insurance was paying) to $3 because it is now a generic. That sort of savings can off set spending shifting to high deductible plans. Here's quote from the link again that talks about what is in out of pocket expenses: ""Out-of-pocket expenditures per capita: Out-of-pocket payments include the patients’ share of payment for the provision of health care services and prescriptions covered by insurance; this includes any copayments, coinsurance payments, or deductible payments. If an insurance claim was not filed (for example, for the purchase of over-the-counter medicines), the expenditures are not included in this metric. HCCI calculated out-of-pocket expenditures per capita by dividing total out-of-pocket expenditures by the total insured population."" Just because you don't understand something doesn't make it wrong. And the results of that study show that the rate of growth of out of pocket costs is decreasing for people with insurance. Guess what the numbers they are talking about includes? Can you tell me?

Charts of total healthcare costs include co-pays and deductibles. There is one at the NYT link I posted earlier in this thread. But your largest issue seems to be how high deductible plans can actually lower out of pocket costs. The other link I linked to directly addresses out of pocket costs. And the rate at which they are increasing is going down. In addition, the CMS link that I provided has a link for an Excel sheet that includes health care costs (which includes co-pays and money paid because it was not covered by high deductible plants), and then they break down into sections (e.g. out of pocket expenses). The rate at which health care costs are going up is declining. The rate at which out of pocket health care costs are going up is declining.

From my post previously: "Out-of-pocket expenditures are payments made by insureds directly to medical professionals, facilities, pharmacies, and other providers and suppliers, and are among the most visible health care costs to consumers" And from the link I gave earlier: "Out-of-pocket expenditures per capita: Out-of-pocket payments include the patients’ share of payment for the provision of health care services and prescriptions covered by insurance; this includes any copayments, coinsurance payments, or deductible payments. If an insurance claim was not filed (for example, for the purchase of over-the-counter medicines), the expenditures are not included in this metric. HCCI calculated out-of-pocket expenditures per capita by dividing total out-of-pocket expenditures by the total insured population." Would that include payments required because a deducatable hasn't been reached healthcare costs? YES! Here's an idea. In the future, if you don't understand something instead of insisting things that are clearly wrong (that health care costs and out of pocket health care costs must not include costs that people are paying because they have a high deductable), try asking a question. Instead of insisting that number X must not include number Y even though based on the definition of the number (e.g. total healthcare costs wouldn't really be total health care costs if they didn't include the money that people were paying because their costs wasn't covered by their deductible) and pretending like you have any clue what you are talking about, try saying that doesn't make sense to me can you explain it. And MAYBE somebody will explain it to you. The reason that high deductible plans are believed to lower health care costs is that they make the payer more responsible for the costs and therefore the payer more likely to make decisions based on costs and end up in many cases using less health care and/or cheaper health care (e.g. generics vs. brand prescriptions). For example, I am slightly sick. Maybe I have a small fever. I have a no deductible insurance and a sick visit to my doctor is completely covered in my plan. So I go to the doctor. The doctor decides to practice defensive medicine and prescribes me an antibiotic. There's costs associated with that. That usage increases the amount of health care spending. I'm in a high deductible plan. The sick visit isn't going to be covered. If I go, I am going to be paying out of pocket. I don't go (at least not right away). I wait two days and after two days I'm starting to get better. It was probably just a virus and the doctor visit and antibiotics would have in reality done me no good. I've used less health care. I've spent less money on health care. Health care spending is down. There's actually quite a bit of literature on high deductible plans and their expected affect on health care spending and health out comes. And the use of less health care is at least a large part of what we see with respect to lowering spending recently in health care. (I'll also point out that lowering usage is part of what parts of the ACA is attempting to do too. The link I quoted before talks about re-hospitalization. If you leave the hospital unsure about what you are supposed to do at home (in terms of things like taking medications), get sick because of it, and end up back in the hospital as a result, then you've used more health care then really needed, and health care spending will god up.) The rate at which total healthcare spending is increasing is falling and that includes payments made because of high deductible plans. The rate at which out of pocket spending for health care, which includes payments made because of high deductible plans, is increasing is falling.

That's the point you made the first time I posted it, which is why I went out and found a link that talked directly about out of pocket costs. Out of pocket costs growth rates are lower in 2013 then any year analyzed in the link I've already given you. What significant point do you have other than nobody in the internet has actually collated the data the way you want in a single source and graph. The rate at which out of pocket costs are increasing is going down.

Which is why I mentioned estimates into the future above. They've done projections for 2013 based on available data, which you can also get and is related to the ACA.

The link at the NYT that I posted before includes a graph based on the CMS data. The link includes a link to the zip file that includes an excel and a cvs file that includes all costs from 1960-2012, and then is broken down into categories, including out of pocket costs, insurance costs, and government costs. Then it breaks it down further into other categories (e.g. hospital spending). I've posted links that include analysis on total health care costs, and out of pocket costs in this thread. In each cases, the rate at which costs are growing is decreasing. If you have a significant question that is worth any discussion at this point in time, I don't see it.

The CMS reports, including the NHE report are the go to source for the information on health care spending in the US. http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html And are regularly cited in scholarly work about health care spending in the US and how to control it. (They also do estimates into the future.)