birdog1960 Posted January 4, 2013 Posted January 4, 2013 rising health care cost IS the issue. robert reich was on pbs the other night making this point, convincingly. it's now 18-19% of gdp. that's just carzy and totally unsustainable.
3rdnlng Posted January 4, 2013 Posted January 4, 2013 I guess you start by asking why we spend twice as much as any other industrialized country. Re economists, not ones influenced by Minsky. Who is we? Private citizens, government?
Magox Posted January 4, 2013 Posted January 4, 2013 rising health care cost IS the issue. robert reich was on pbs the other night making this point, convincingly. it's now 18-19% of gdp. that's just carzy and totally unsustainable. Rising health care costs are the main driver. But certainly isn't the only issue.
TPS Posted January 4, 2013 Posted January 4, 2013 And what is the quality of care in contrast to other industrialized countries? Hint, a friend of mine had a brain tumor. Where do you think her husband sent her to get treatment? Another hint, I'm a Canuck (in passport only). I guess it depends whether you are insured or not. For every story of Canucks going elsewhere for treatment that takes too long to get or is not as good, there are multiple stories in the US about people who can't get care because they aren't insured or are bankrupted by it.I certainly don't want to get into the debate as I know it's been done here before, and I am not well-versed in all things healthcare. I do know that there is no system that meets everyone's needs, but there are systems that meet the basic needs for all at less cost.
TakeYouToTasker Posted January 4, 2013 Posted January 4, 2013 You most likely misunderstand the point. I understand that making changes today helps resolve today's deficit and tomorrow's deficit. What I'm railing against is the argument that the funds raised today can somehow be "saved" to make future payments. Simple question: Does a SS trust fund exist that can be used to fund SS for the next 20 years or not? Obviously not. Everyone knows that the "Social Security Trust" contains nothing more than many trillions of dollars in IOU's from an organization which has never turned a profit, and has long term issues with servicing it's debt.
birdog1960 Posted January 4, 2013 Posted January 4, 2013 Rising health care costs are the main driver. But certainly isn't the only issue. no, it's not the only issue. under and unemployment are big factors, too. i thought this discussion was right on:http://www.pbs.org/newshour/bb/politics/jan-june13/budget_01-03.html. i think the statemnt that "medicare reform is healthcare reform" is an important point. medicare defines how medicine is practiced to a large extent. stop medicare incentivizing quantity over quality and we're well on the way to lowering costs.
Magox Posted January 4, 2013 Posted January 4, 2013 stop medicare incentivizing quantity over quality and we're well on the way to lowering costs. I agree with this concept for just about all health care. But I believe with the nation of fat asses we have, it's gonna take an organic approach that entails healthier living to compliment a better delivery system of how we administer medicine.
TakeYouToTasker Posted January 4, 2013 Posted January 4, 2013 no, it's not the only issue. under and unemployment are big factors, too. i thought this discussion was right on:http://www.pbs.org/n...dget_01-03.html. i think the statemnt that "medicare reform is healthcare reform" is an important point. medicare defines how medicine is practiced to a large extent. stop medicare incentivizing quantity over quality and we're well on the way to lowering costs. But... we... we just passed a major overhaul that serves to increase quantity at the cost of quality... and you... you were championing it...
GG Posted January 4, 2013 Posted January 4, 2013 It is a fraud when working Americans are told that taxes need to be increased today to fix a problem in the future, while at the same time cutting taxes on the rich. It was complete bull ****. Not sure I follow. Taxes were cut a decade ago under the guise to grow the economy, which was in a small recession. In retrospect, the tax cuts should have been smaller across the board. The issue IS today's deficit, not tomorrow's. Let's stop pretending that income taxes and payroll taxes are "separate." (of course, that also throws out the 47% pay no taxes BS too!). All taxes go to supporting current expenditures, therefore all government programs are pay-as-you-go programs. You can't pre-fund a program. We need to start by fixing the number one long term issue which is rising healthcare costs. The issue is both, and no one has the stomach to address both. To solve today's deficit, taxes need to go up on everybody, but you also have to start controlling spending. You won't solve a $1.5tr annual deficit by hopefully raising $80bn from the "rich" You also won't kick start the economy with roadblocks on promising growth sectors. Clinton's boom was driven by tech & finance. Bush benefited from real estate. Obama made sure those ships have sailed. We can argue whether that's good or bad for long term health, but the only promising area for new growth is energy, and he's not a fan of dirty energy. So where is his mythical growth going to come from, when he can't pass up the opportunity to beat up on the job and wealth creators? Does anyone pay attention to what the ratings agencies say? They lost all credibility in 2008. Then why do the press keep quoting them, investment banks still use them and the SEC can't write them out of regulatory capital?
birdog1960 Posted January 4, 2013 Posted January 4, 2013 But... we... we just passed a major overhaul that serves to increase quantity at the cost of quality... and you... you were championing it... it's a start. it's a base from which to enact more sweeping reform and a clear signal to providers large and small that things are going to change. compensation models for docs ar4 already starting to phase in a greater percentage of payment on quality. hospitals, too. it won't happen overnight, however.
GG Posted January 4, 2013 Posted January 4, 2013 it's a start. it's a base from which to enact more sweeping reform and a clear signal to providers large and small that things are going to change. compensation models for docs ar4 already starting to phase in a greater percentage of payment on quality. hospitals, too. it won't happen overnight, however. Yet, ACA is going to turn that on its head, because to get paid, doctors will have to adopt either a full private model where they don't take any insurance, or the ones who do will start running their practices like production lines to maximize patient flow. Yeay progress.
birdog1960 Posted January 4, 2013 Posted January 4, 2013 Yet, ACA is going to turn that on its head, because to get paid, doctors will have to adopt either a full private model where they don't take any insurance, or the ones who do will start running their practices like production lines to maximize patient flow. Yeay progress. we can't really get any worse as far as "production lines". especially in primary care, many docs are at capacity. we will see more and more use of midlevels for more mundane problems with docs tackling the more difficult cases. have no idea what you're talking about with either "full private" or not. i'm assuming you're talking about concierge medicine. obamacare didn't start or grow that very small trend. and i think it right that if you want to pay for special and priviledged access, medicare should not be paying your bills. that will limit this trend to remaining rather small and inconsequential with only a small sliver of the population able to afford it.
GG Posted January 4, 2013 Posted January 4, 2013 we can't really get any worse as far as "production lines". especially in primary care, many docs are at capacity. we will see more and more use of midlevels for more mundane problems with docs tackling the more difficult cases. have no idea what you're talking about with either "full private" or not. i'm assuming you're talking about concierge medicine. obamacare didn't start or grow that very small trend. and i think it right that if you want to pay for special and priviledged access, medicare should not be paying your bills. that will limit this trend to remaining rather small and inconsequential with only a small sliver of the population able to afford it. But that's the whole point, that small sliver of the population will afford better care and attract better doctors. So the rest of the people herded into socialist medical care will get inferior care. But hey, everyone will be insured.
birdog1960 Posted January 4, 2013 Posted January 4, 2013 But that's the whole point, that small sliver of the population will afford better care and attract better doctors. So the rest of the people herded into socialist medical care will get inferior care. But hey, everyone will be insured. as i said, concierge medicine predates obamacare. conceirge docs usually have a patient panel of about 300 patients. regular docs about 10x that. if everyone had concierge practices we'd need 10x more docs. wanna outlaw concierge practices cuz that's the only solution? fine by me... and this differential to access to care happens regardless of the law or guidelines.. remember when the goldman sachs guys got swine flu shots when only kids and the pregnant were supposed to? as far as i know trhere was no investigation or punishment.
John Adams Posted January 4, 2013 Posted January 4, 2013 I agree with this concept for just about all health care. But I believe with the nation of fat asses we have, it's gonna take an organic approach that entails healthier living to compliment a better delivery system of how we administer medicine. And I'll tack on that we need to get better at letting people die. The vast majority of healthcare costs are spent in the last 2 years of someone's life. What the !@#$ sense is that?
Magox Posted January 4, 2013 Posted January 4, 2013 I agree, but how do you sell that? I'll tell you how, you don't.
TPS Posted January 4, 2013 Posted January 4, 2013 (edited) Not sure I follow. Taxes were cut a decade ago under the guise to grow the economy, which was in a small recession. In retrospect, the tax cuts should have been smaller across the board. The issue is both, and no one has the stomach to address both. To solve today's deficit, taxes need to go up on everybody, but you also have to start controlling spending. You won't solve a $1.5tr annual deficit by hopefully raising $80bn from the "rich" You also won't kick start the economy with roadblocks on promising growth sectors. Clinton's boom was driven by tech & finance. Bush benefited from real estate. Obama made sure those ships have sailed. We can argue whether that's good or bad for long term health, but the only promising area for new growth is energy, and he's not a fan of dirty energy. So where is his mythical growth going to come from, when he can't pass up the opportunity to beat up on the job and wealth creators? Then why do the press keep quoting them, investment banks still use them and the SEC can't write them out of regulatory capital? Re, the first issue. At the same time taxes were cut on the top, Reagan raised taxes on everyone else--payroll taxes. Surely you are familiar with the Greenspan Commission? They raised taxes on SS on the basis that the fund would be insolvent in the 2000s. In reality it was to fund the tax cuts for the rich. Edited January 4, 2013 by TPS
TPS Posted January 4, 2013 Posted January 4, 2013 Obviously not. Everyone knows that the "Social Security Trust" contains nothing more than many trillions of dollars in IOU's from an organization which has never turned a profit, and has long term issues with servicing it's debt. You don't get it. First, it's a government fund, they don't operate to make a profit. Second, despite everything politicians say, it's not designed to be solvent in perpetuity, it's designed to get workers to pay more taxes over time than what they get out of it, so that the elite don't have to pay a greater share. From 1983 (when the payroll taxes increased) to now, workers paid more taxes than what was paid out, creating the surplus. NOW, rather than pay on the accumulated IOUs, politicians are telling us that the future liabilities are so great that we need to raise taxes or cut benefits TODAY to make it solvent in the future. The same game that was played from 1983 to 2012. This is the real kick the can down the road issue. Taxes will be raised and benefits cut TODAY so as to generate a "surplus" that will "fund" SS until 2075, but the reality is those resources are needed to pay the IOUs that the government must start making good on TODAY.
3rdnlng Posted January 4, 2013 Posted January 4, 2013 You don't get it. First, it's a government fund, they don't operate to make a profit. Second, despite everything politicians say, it's not designed to be solvent in perpetuity, it's designed to get workers to pay more taxes over time than what they get out of it, so that the elite don't have to pay a greater share. From 1983 (when the payroll taxes increased) to now, workers paid more taxes than what was paid out, creating the surplus. NOW, rather than pay on the accumulated IOUs, politicians are telling us that the future liabilities are so great that we need to raise taxes or cut benefits TODAY to make it solvent in the future. The same game that was played from 1983 to 2012. This is the real kick the can down the road issue. Taxes will be raised and benefits cut TODAY so as to generate a "surplus" that will "fund" SS until 2075, but the reality is those resources are needed to pay the IOUs that the government must start making good on TODAY. Stick to the numbers. There you are just wrong. When you start your partisan schit you become wrong and an idiot, eh comrade?
Recommended Posts