Friday, November 12, 2010

The Kroog Versus The Catfood Commission

Like something out of epic mythology, Paul Krugman takes on the 310-million-tit beast that is Simpson-Bowles.

Still, can’t we say that for all its flaws, the Bowles-Simpson proposal is a serious effort to tackle the nation’s long-run fiscal problem? No, we can’t.

It’s true that the PowerPoint contains nice-looking charts showing deficits falling and debt levels stabilizing. But it becomes clear, once you spend a little time trying to figure out what’s going on, that the main driver of those pretty charts is the assumption that the rate of growth in health-care costs will slow dramatically. And how is this to be achieved? By “establishing a process to regularly evaluate cost growth” and taking “additional steps as needed.” What does that mean? I have no idea.

It’s no mystery what has happened on the deficit commission: as so often happens in modern Washington, a process meant to deal with real problems has been hijacked on behalf of an ideological agenda. Under the guise of facing our fiscal problems, Mr. Bowles and Mr. Simpson are trying to smuggle in the same old, same old — tax cuts for the rich and erosion of the social safety net.

Can anything be salvaged from this wreck? I doubt it. The deficit commission should be told to fold its tents and go away. 

And this is the same argument  Kevin Drum was making yesterday:  any serious attempt to lower the national deficit, let alone the national debt, must focus on containing health care costs.  Social Security is not the friggin problem.  It has always, always, always been health care costs (and to an extent, massive defense spending).  Obama's health care reform was a start, but only a start.

If you really want to "harpoon the whale" there boys, start with the Pentagon and health care.  We don't need advanced air-superiority jets to stop car bombs in Kabul, dig?  And we've got to do something about health care costs most of all.

So at this point, it's safe to say that any deficit reduction proposal that doesn't include those two items can be and should be completely ignored.

The faster the President kills the Catfood Commission, the better off the Democrats will be.

20 comments:

JoyfulA said...

And the better off the country will be.

SteveAR said...

And this is the same argument Kevin Drum was making yesterday: any serious attempt to lower the national deficit, let alone the national debt, must focus on containing health care costs.

And how is that to be accomplished? By cutting what the government pays to health care providers? By establishing price controls? Benefit cuts to those who rely on Medicare or Medicaid?

The first option will increase health care costs to the private sector, which will really piss the people off.

The second option will lead to health care shortages, whether its in the form of doctor shortages, hospital closures, medicine shortages, etc. Then we become Canada, Britain, etc.

The third option will really piss off seniors and they will be around awhile.

So how do liberals propose to contain health care costs?

...(and to an extent, massive defense spending)...

We don't need advanced air-superiority jets to stop car bombs in Kabul, dig?


Unlike health care, the Constitution requires the government to defend the nation. We don't need air-superiority jets to stop car bombs in Kabul, but we need them against potential enemies that have an advanced air force. Defense costs need to be streamlined and less politicized, but not cut to the point the country can't defend itself. Defense of the nation is the sole responsibility of the federal government.

Zandar said...

Yes, because Canada is an awful third world hellhole with no health care and people dying in the streets because they have to wait six months to see a doctor.

Only that's not actually true, and taking the profit motive out of health care would actually lower costs. What's the point of the most advanced health care on the planet if only a small fraction of our own people can afford it? Canada seems to have a pretty good hybrid solution, the equivalent of Medicare and Medicare Advantage for all citizens and it contains costs far better than we do now.

Second, who is going to attack us with jets? Iran? Zee Germans? Soviet Russia? COBRA? Give me a break. These are all pork programs and you know it.

And how much does it cost to maintain our huge nuclear arsenal? If we shed nukes, we'd require less yearly spending to maintain them and save money.

That's deficit reduction I'd like to see.

SteveAR said...

Only that's not actually true, and taking the profit motive out of health care would actually lower costs. What's the point of the most advanced health care on the planet if only a small fraction of our own people can afford it?

Look at what you wrote. The reason our health care is the most advanced is because of the profit motive. What makes it affordable is competition, which lowers prices. Government involvement has done nothing but raise prices. Besides, taking the profit motive doesn't reduce costs; even non-profits have to make enough revenue to meet its costs and deal with increasing costs. Taking the profit motive would save either nothing or next to nothing.

So you still haven't addressed the question of how to contain health care costs.

By the way, HHS set up the national insurance pool, and 27 states designed their own pools, at cut-rate premiums, to immediately sign up around what the government claimed were 375,000 people without health insurance. The number signed up so far? 8,011. Total. HHS is going to lower the cut-rate premiums even further (meaning an increase to taxpayers) to get more people signed up. Again, this is an unmitigated failure.

Yes, because Canada is an awful third world hellhole with no health care and people dying in the streets because they have to wait six months to see a doctor.

Tell that to the thousands of Canadians who are in pain and have to wait that six months for health care help. Yes, it's a problem that shouldn't be duplicated here. Forget the Canadian system. Besides, we're not Canada.

Second, who is going to attack us with jets? Iran? Zee Germans? Soviet Russia? COBRA? Give me a break. These are all pork programs and you know it.

I see. So you'd sacrifice the defense of the nation for...what exactly? Diplomacy without teeth is a useless endeavor, as history has taught time and time again. Hoping the bad actors of the world will recognize our good will does nothing, which history has also taught time and time again.

Look, I got no problem getting rid of defense pork, which doesn't include air superiority jets. If you know anything about warfare, air supremacy is key, even when used to stop car bombs in Kabul.

And how much does it cost to maintain our huge nuclear arsenal? If we shed nukes, we'd require less yearly spending to maintain them and save money.

Only when it serves the national security agenda of the U.S., not through some ridiculous treaty. And not to serve programs that the federal government has no business being in or involved with.

Zandar said...

Wow. All that and you actually didn't say anything.

1) Competition lowers prices, it's true. Too bad insurance companies don't want competition. Many large insurers have functional monopolies in the areas they serve. Remember, creating insurance exchanges where people could shop all insurance carriers for the best deal was a Republican idea, as well as the mandate to get as many people to participate in the exchanges. When Obama said "Hey these Republican ideas are great, let's use them" the Republicans went apeshit. We do have competition among drugmakers and medical device companies. We don't have competition among insurers. That's the point. That is how you contain health-care costs. You get rid of insurance monopolies and make them compete on the open exchange.

2) You completely missed the sarcasm on Canada, but okay. Look into their system sometime. It's a public/private partnership where Canada covers basics and you can buy affordable insurance to cover other procedures. Companies compete in exchanges to provide it. It really does work great.

3) You are already facing a shortage or limitation on health care by what you can afford, so the shortage argument doesn't work. It already exists thanks to insurance companies.

4) Yes, because not coming up with a trillion dollar strike fighter is going to cause all of us to die. I thought we had to worry about Islamic terrorists, not jets.

5) A nuke treaty DOES serve the national security interests of the US, or is Reagan a pussy too?

SteveAR said...

Too bad insurance companies don't want competition. Many large insurers have functional monopolies in the areas they serve.

Maybe if government didn't mandate insurance companies to cover every little thing that could be paid out of pocket and permit them the ability to negotiate prices with health care providers but not individuals, and if government weren't also in the health insurance business, you'd have a point. But this is a government-created problem that requires government to loosen up on these restrictions and reduce their involvement in health care. What you call a "Republican" plan, which is debatable since so many other Republican ideas didn't get added, couldn't get implemented without Democrats, so it's still the Democrat plan. Which made all this worse. I mentioned this the other day; my insurance premiums increased 11%. They would have increased even if the insurance was run by a non-profit; it's the costs that increased, not the profit margin (which is very low compared to other industries).

We don't have competition among insurers.

There are 1300 health insurance providers in the country. But the Democrat plan doesn't allow plans to go across state lines (a Republican idea shot down by Democrats), thus reducing competition. That isn't the fault of the Republicans.

Republicans also wanted to curb employer-based health insurance, but Democrats wouldn't put that in either.

All that's happened is that Democrats have created a new burstable bubble and encouraged the creation of a health insurance monopoly.

You completely missed the sarcasm on Canada, but okay. Look into their system sometime. It's a public/private partnership where Canada covers basics and you can buy affordable insurance to cover other procedures. Companies compete in exchanges to provide it. It really does work great.

Right. That's why Canadian government officials come to the U.S. for care.

Again, Canada is Canada, the U.S. is the U.S. Big difference.

You are already facing a shortage or limitation on health care by what you can afford, so the shortage argument doesn't work. It already exists thanks to insurance companies.

Again, government set the mandates and excessive rules. Shortages exist because of the government.

SteveAR said...

Yes, because not coming up with a trillion dollar strike fighter is going to cause all of us to die. I thought we had to worry about Islamic terrorists, not jets.

And one strike fighter costs a trillion dollars. Do you think that Islamist terrorists are the only threats in the world? Don't tell me you're that naive?

A nuke treaty DOES serve the national security interests of the US, or is Reagan a pussy too?

Nope. But he played hardball with the Soviets for years and made it so the U.S. came out with a great advantage. Reagan was vilified by the left for this, even though we who supported Reagan knew he was right. Plus, the only nuke treaty he signed was the INF treaty, although he did introduce the START treaty as well. Obama ain't no Reagan, seemingly happy to give away the store so that he can concentrate on socializing this country.

Zandar said...

One strike fighter PROGRAM does cost about that much, yes, lifetime. Right now the f-35 program has cost $400 billion and we don't have a single friggin jet yet.

And the state line argument is bullshit because just like credit card companies (which already have this advantage) they will all move to whatever state will bribe them with the most advantageous state laws. In the case of credit cards it's South Dakota.

That arrangement does precisely zero for competition as all are subject to the same rules, and they all collude on them.

Real competition would create state exchanges for insurance companies, which of course they don't want.

Get some better talking points.

SteveAR said...

Right now the f-35 program has cost $400 billion and we don't have a single friggin jet yet.

The thing is designed to replace four other aircraft and to be stealthy. That doesn't come cheap.

As far as operational performance, 2 B-2 stealth bombers and a refueling plane can conduct the same kind of mission as an air fleet mix of B-52s and radar-jamming and escort fighters. If the F-35 delivers anywhere near that kind of performance, the cost will be worth it.

SteveAR said...

And the state line argument is bullshit because just like credit card companies (which already have this advantage) they will all move to whatever state will bribe them with the most advantageous state laws...

Get some better talking points.


Where a company is based has nothing to do with it. States have regulations on the books requiring what health insurance providers need to be cover in order to sell health insurance in the state (See here for Illinois' requirements). That's where the cost increases come in. Add the new federal mandates on top of the existing ones, along with government being involved in the health insurance business and not paying providers what the private sector has to pay, and you can see why health care costs are increasing at a greater rate. All thanks to government. As you can see, these aren't just talking points.

Zandar said...

What state they are based in has everything to do with it, because the state line law Republicans want says specifically that whatever state the insurer is in, those laws would apply to all policies issued by that company to all states and not the laws of the states that the policyholder lives in.

Find the state with the most lax insurance laws, you win. It doesn't matter how great the insurance laws in your state would be if all the insurance companies are issuing policies under that provision from State X.

SteveASS said...

what kind of business is steveAR running that allows him so much time to bore the living fuck out of us this way?

SteveAR said...

What state they are based in has everything to do with it, because the state line law Republicans want says specifically that whatever state the insurer is in, those laws would apply to all policies issued by that company to all states and not the laws of the states that the policyholder lives in.

You are missing two points from the Republican proposal. If people who live in one state are allowed to buy insurance from another state, the Commerce Clause kicks in and Congress can set the standard for what is required. Second, what you describe is competition, which is what lowers consumers' premium costs, which then lowers health care costs.

Zandar said...

Sure. That creates competition. Just like in the credit card industry.

How's that working out for America?

SteveAR said...

You do understand that it was competition that allowed banks to offer low-interest credit cards in the first place. Yes, they've raised their rates on me, too. You know what you did? Get a credit card from a different bank that offers low interest.

I see. So nobody has ever, not since the beginning of man, benefited by owning a credit card, right? Even those owned by a for-profit bank, correct?

Tell me something. If your clothes washer breaks, do you leave it broken until you've saved enough money to repair it or buy a new one? Until you get your money, do you then use a washboard to clean your clothes or just allow them to stay dirty? What about a computer? Do you wait until you have enough money for that, or figure you can make payments and buy it on credit?

FTA:

As the economy revives, defaults will ease. Washington's assault on the industry might not. In February, the Credit Card Accountability, Responsibility and Disclosure (CARD) Act wiped out many of the banks' most lucrative billing practices, including their ability to raise rates on existing debt at any time.

Now the banks have to give cardholders 45 days' warning on any rate rise and cannot apply a new rate on existing debt.


Did the interest rate on your credit cards go up in the period before that bill was passed? Mine did, along with a shrinking of the availability. And my wife and I have great credit. So my current credit card increases are thanks to the Democrats in the federal government. Just like with health care.

And before you say it, spare me any rhetoric that it's the banks' fault for people being irresponsible with their credit. I ain't buying it.

Zandar said...

No, it's the banks' fault for being irresponsible with their investments, losing trillions and requiring a taxpayer bailout.

So yes, we should continue to listen to these guys because they are super extra smart.

SteveAR said...

Your straw man is pointless and ridiculous.

Competition creates improvement and lower costs. It's basic economics. About the only people who don't believe it are those dwindling numbers of people, liberals, still stuck perpetuating Karl Marx's theories as workable.

Zandar said...

And lower costs and improvements DO NOT AUTOMATICALLY GET PASSED TO THE CONSUMER AS LOWERED PRICES.

That is my point. Competition does not always benefit the consumer when there are other factors. In the case of credit, it's a host of them. In the case of health insurance, there are a host of other factors there as well.

Your simplistic bleating of "competition is good!" does not reflect the real situation.

SteveAR said...

And lower costs and improvements DO NOT AUTOMATICALLY GET PASSED TO THE CONSUMER AS LOWERED PRICES.

When it's done by a monopoly, you are correct. But we are talking about when more than one business is in competition to sell similar products. Lower costs and improvements allow for a business to lower prices to induce consumers to buy that company's product and not buy the same or similar thing from someone else. Yes, it happens. It always happens.

Credit cards are a great example of this. Costs to consumers were reduced. Take a look at the chart on page 21 of this PDF from the GAO. As you can see, it doesn't fit your worldview since it shows a reduction in consumer costs to buy stuff with a credit card. My so-called "simplistic bleating" of "competition is good" is backed up by facts. Recent interest rate increases had to do with other factors related to the government-induced mortgage bubble, not competition.

As far as health insurance, I've explained how it is government that has caused increases in premiums, which now includes Obamacare.

Zandar said...

Costs were reduced thanks to the credit card bill that Obama signed into law. Competition had nothing to do with it.

Enforcing regulation did. Same with Obamacare.

For 3 days now you've been throwing every Republican talking point against the wall now and ignoring everything I said or taking it out of context, then you run back to your own blog or Red State and declare yourself victor.

I'm getting extraordinarily tired of you.

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