Excerpts from Obama's Speech Tonight

[ieatcrayonz]

I agree with all of this except the "it's over" part. To folks like us, it's over. But folks like us aren't responsible for the news, and it may be an unfortunate turn of events for Obama that for any watercooler folks discussing last night's speech today, this is what they'll discuss leading into the weekend. While it won't help Wilson a whole lot during the next week, there's a chance the media will ensure that by demonizing him -- which many of them seem to be doing loudly today -- the message of the "big" speech is lost. If I thought Republicans were crafty enough, I'd almost suggest they planned it that way. But they just ain't that crafty.

 

In the end, nothing new came from the speech last night, and when the Wilson dust settles, I would wager to guess that everyone will head back to where they were prior to the speech: most don't like the plan, poll numbers going down, and by the end of September, when stocks are down again and unemployment goes up again, the American people may start being less concerned with what Obama wants and more concerned with their own futures.

 

Nice speech. Waste of time.

I don't think so. I think there will be tons of people that feel sorry for Obama that the mean guy yelled at him and they will start to go along with his plan. I think the news people that hate republicans will make it look like all republicans, not just Charlie Wilson's kid. I think if the democrats were crafty they would have planned this.

[Kelly the Dog]

You mean other than raising my taxes? Oh, that's right. These plans are "deficit neutral." What a load.

How do you even have a job to pay taxes if you can't read?

[Kelly the Dog]

I hate the slippery slope arguments, but in this case I will make the exception.

 

The concern is a long term one, because I have not seen much in the opaque proposals that will actually reduce the total cost of medical care. As you toss more people into the public plan, the buying power of the government will slowly crowd out private insurance. The natural response will be for premiums to be raised or for standards of care to be lowered. I am too old and cynical to think that people will behave to serve a common good to ensure good medical care if there is no profit motive at the end of the rainbow.

 

So if you are serious about reforming the way healthcare is delivered in the US, then you better put the entire system into the grinder, and that includes eliminate the tax inequality of employer provided care, make people more accountable for the costs they are consuming in the system, address the skyrocketing malpractice premiums, etc.

 

But the plans as discussed right now are in the unicorn fart variety that promise more service and leave the long term funding questions unresolved. So if we take history as a guide, in a democracy where the population is not accountable for costs, people are always willing to vote themselves a free lunch.

Most of what you just wrote is true or could turn out to be true. The "public plan" that is being discussed however is very, very limited. Again, you have to be eligible for it. The vast majority of the people already insured are not eligible for it, so people can't flock to it. It also is not going to be subsidized the way other plans the government has installed in other areas has been. But the one they are talking about is NOT.

 

IF that were the case, a slippery slope argument may hold more water. But right now, it's like saying if a new administration and congress comes in and completely changes legislation, we may have an entirely different health system.

 

The private citizens and private companies are going to be required to pay for the options in the "public plan". That plan is going to be less than the private versions because of the lower overhead, the lack of need for profit and the payment to doctors and providers less than private insurers (more than they pay Medicare but less than private). But unless the legislation is drastically changed by a future congress, it can't be subsidized more by the government and companies with over, say, 100 employees, and individuals making decent money are not going to be able to join it en masse and drive out private insurance.

 

A lot of the Democrats are wrong about what this public option is going to be, too. It won't DRASTICALLY reduce costs. But it will make it a lot more affordable for a chunk of the population.

 

Without it, costs are going to go up even more because private insurers are going to have 30 million more people on their books but numerous costly requirements they have to meet with the new legislation. Joe Public, if they really knew the story, would be highly in favor of the public option because if it doesn't exist, their rates are probably going up in the short run.

[GG]

Nice post.

 

Which means that you didn't understand it, because the unions are fully opposed to true reform and equalization because of the tax free benefits their members receive through their health plans.

[Kelly the Dog]

The fact that you DON'T see how it will enter the lives of people like myself is rather startling, but I'll walk you through it one more time.

 

It'll enter my life when I have to pay taxes to cover it. It'll enter my life when the bottomless resource pit known as the federal government makes it impossible for private insurers to compete, leaving me with no other option BUT to take on the government plan. I currently pay 12.4% every paycheck for a Social Security program that'll likely never pay me a dime. So I'm sorry if you have a hard time understanding that my business and I are slated to be taxed for yet ANOTHER government program that I won't use or need...a program that will be bloated, underfunded, and add to a deficit that my son's children will have to pay off. (Yeah, I know, it'll be deficit neutral. Right. ) But hey, taxing my company more won't have any ramifications to it. So I stop hiring and raise my price to cover costs. Who cares, right?

 

And again, I want less government, not more, regardless of whether it directly enters my personal life. Entitlements bother me. You like them. We'll never see eye to eye on that, but in the end, the more the government gives to people for free, the less the people are really free.

 

But what REALLY pisses me off in this particular debate is that the left is ONLY interested in a government option. They have NO interest in true tort reform. NO interest in national competition. No interest in helping the free market work it's way through this because it's too self-absorbed to consider that maybe, just maybe, government's current role in health care is part of the problem, not part of the solution. It's either a government-run option or something that leads to a government-run option. I know you embrace that. I don't. And I plan to keep yelling and fighting against it.

We'll just have to agree that you refuse to read what the plan actually is, how many people are eligible, whether it will be actually subsidized or underwritten by the government, and what the non-partisan CBO that you have quoted numerous times before says it will be and how many people will join it. Or even can join it.

[IDBillzFan]

We'll just have to agree that you refuse to read what the plan actually is, how many people are eligible, whether it will be actually subsidized or underwritten by the government, and what the non-partisan CBO that you have quoted numerous times before says it will be and how many people will join it. Or even can join it.

We'll also agree that either I'm not communicating it well, or you have no ability to understand why I don't want a government-run plan. You're a liberal. I'm a conservative. No surprises in this revelation.

 

Meanwhile, I look forward to seeing all the money this government plans to save by immediately addressing the Medicare fraud. We don't need a reform bill to address that, but it's a key part of reform, so since they know how they're going to do it (since it's going to help pay for the government plan), what is stopping them?

[Kelly the Dog]

We'll also agree that either I'm not communicating it well, or you have no ability to understand why I don't want a government-run plan. You're a liberal. I'm a conservative. No surprises in this revelation.

 

Meanwhile, I look forward to seeing all the money this government plans to save by immediately addressing the Medicare fraud. We don't need a reform bill to address that, but it's a key part of reform, so since they know how they're going to do it (since it's going to help pay for the government plan), what is stopping them?

 

I understand why you say you don't want one by principle, but not by specifics. I also understand why you may not want this health care reform, because it IS more government control and DOES specifically affect your life and your business and your ideology. But IMO what you are completely missing is that the reform is going to happen, all of the stuff that directly affects your life is already agreed on and is almost inevitable. That's the government involvement way more than the "public option" element of it is.

 

If the public option was the one first being discussed by SOME Democrats, AND had no limits on it, AND anyone could join, AND the government would underwrite it, AND they used Medicare rates to pay doctors and hospitals, it would be a legitimate worry than some private insurers couldn't compete and a lot of people would flock to the option.

 

That kind of thing is long gone and doesn't exist anymore. None of those things are part of the "public option".

 

As for your last question on why they don't do it now... So you don't understand politics either?

 

That needs to be done regardless. A lot more needs to be done about Medicare and Medicaid regardless. A lot of reform that is not part of the bill needs to be done regardless. Tort reform in some form needs to be done regardless. And many other preventative and administration and IT and other elements need to be done to the non-system system regardless of this reform.

[GG]

If the public option was the one first being discussed by SOME Democrats, AND had no limits on it, AND anyone could join, AND the government would underwrite it, AND they used Medicare rates to pay doctors and hospitals, it would be a legitimate worry than some private insurers couldn't compete and a lot of people would flock to the option.

 

This is about as tantamount an admission of the belief in the rainbow farting unicorn as I can imagine.

 

Of course the proposed plans don't have the scary monsters in them. But that's not what the criticism is about. It's about using past examples to guide expectations of future performance, which shows that in every case, the initial cost estimates were nowhere near the actual results.

 

Plus, even though this plan will not tie directly into Medicare/Medicaid, it's unfathomable to imagine that the two will not be intertwined in their purchasing power. Lastly, you are not naive enough to believe that when the actual costs come in way over budget that the politicians will have the strength to curb costs (or cut people's insurance) instead of raising taxes?

[Kelly the Dog]

This is about as tantamount an admission of the belief in the rainbow farting unicorn as I can imagine.

 

Of course the proposed plans don't have the scary monsters in them. But that's not what the criticism is about. It's about using past examples to guide expectations of future performance, which shows that in every case, the initial cost estimates were nowhere near the actual results.

 

Plus, even though this plan will not tie directly into Medicare/Medicaid, it's unfathomable to imagine that the two will not be intertwined in their purchasing power. Lastly, you are not naive enough to believe that when the actual costs come in way over budget that the politicians will have the strength to curb costs (or cut people's insurance) instead of raising taxes?

 

The reason a lot of programs eventual cost is way more is because they are completely open ended or have few restrictions.

 

The actual cost for a lot of this stuff is unknown, that is true. But A] the costs are skyrocketing anyway and all kinds of reform needs to be done anyway. B] There should be zero question in anyone's mind that in this 2.5 trillion a year industry there is tremendous waste and inefficiency across the board, probably by far more than in any other industry. c] There are numerous ways to help control costs that will take those ten years to implement that are immeasurable right now. There are also things on the horizon that will likely make care cost rise, not decline.

 

I don't think, after reading a ton about this issue, from all kinds of different sources, anyone can convince me that if we do nothing it is better. We're inarguably on an unsustainable course with or without reform. If we do nothing, figures came out this week that by 2016 (IIRC) 41% of each American's income will go to Health Care. The reform needs to be massive, short and mid and long term, and everyone has to pay and everyone has to sacrifice.

[Magox]

I understand why you say you don't want one by principle, but not by specifics. I also understand why you may not want this health care reform, because it IS more government control and DOES specifically affect your life and your business and your ideology. But IMO what you are completely missing is that the reform is going to happen, all of the stuff that directly affects your life is already agreed on and is almost inevitable. That's the government involvement way more than the "public option" element of it is.

 

If the public option was the one first being discussed by SOME Democrats, AND had no limits on it, AND anyone could join, AND the government would underwrite it, AND they used Medicare rates to pay doctors and hospitals, it would be a legitimate worry than some private insurers couldn't compete and a lot of people would flock to the option.

That kind of thing is long gone and doesn't exist anymore. None of those things are part of the "public option".

 

As for your last question on why they don't do it now... So you don't understand politics either?

 

That needs to be done regardless. A lot more needs to be done about Medicare and Medicaid regardless. A lot of reform that is not part of the bill needs to be done regardless. Tort reform in some form needs to be done regardless. And many other preventative and administration and IT and other elements need to be done to the non-system system regardless of this reform.

 

For me Dog, it's not an issue of not understanding the details, it is an issue of the plan lacks good business rationale and the feasibility of it and the anticipated execution of should I say lack of in regards to getting this reform done right.

 

The profit margins are small, relatively speaking, http://biz.yahoo.com/p/522qpmd.html . Health insurance industry ranks #86 in profit margins. Industry average is below 4%.

 

It is obvious that adding competition is not the biggest issue. If you look into the overall costs, there is much more money being wasted on malpractice suits and wasteful spending due to doctors giving unnecessary tests because they are afraid that they will get sued if they don, than there is in the profit margins.

 

It's just a matter of economics dog, If the government steps in, and they compete against private insurers, and significantly bring down costs, then many of the private insurers will go under. They can't compete with the government, the government can sustain and subsidize their losses, and they have unlimited pockets. Eventually there will be a "crowding out" of this sector. It will happen. It's just economics.

 

The only way the government will be able to lower the costs significantly is to reduce the quality of the coverage. That is the only way, if we go with the "public option" as opposed to effective tort reform. Once the government starts cutting the quality of coverage, guess what the rest of it's competitors will do to try to compete? Cut it's quality of coverage as well. It's a no brainer.

 

Anyone who has an understanding of economics, knows this.

 

Also, do you really believe that if they cut $500 Billion in Medicare, it won't reduce the quality of health insurance coverage for the seniors? do you really believe that? Once again, any one with a rational thinking mind knows that this won't be achieved.

 

This is also tied in to the whole discussion, but not directly. Do you have any idea how close we are right now of the value of the dollar being under a serious threat of losing significant value? We are at an inflection point right now, and I can tell you this, 50% of the threat has to do with the unsustainability of our deficits. Do you know, even according to the pink farts and green shoots projections of the White House, that we will have a deficit of $20 Trillion in ten years. That means the interest payments alone will be close to a $1 Trillion a year alone.

 

Chinese students laugh at our Treasury secretary when he tells them the US dollar is a good store of value.

 

This is a disaster Dog, this public option plan. I just hope that someone can explain the numbers and business side of this to the American Public, so that they understand that this makes very little sense at all, and that it will add to the deficit, and that it will lessen the quality of coverage of health care and ultimately won't even bring down the costs in a significant manner.

[IDBillzFan]

This is about as tantamount an admission of the belief in the rainbow farting unicorn as I can imagine.

 

Of course the proposed plans don't have the scary monsters in them. But that's not what the criticism is about. It's about using past examples to guide expectations of future performance, which shows that in every case, the initial cost estimates were nowhere near the actual results.

 

Plus, even though this plan will not tie directly into Medicare/Medicaid, it's unfathomable to imagine that the two will not be intertwined in their purchasing power. Lastly, you are not naive enough to believe that when the actual costs come in way over budget that the politicians will have the strength to curb costs (or cut people's insurance) instead of raising taxes?

Thank you. I regretably am unable to communicate as well as you. The bottom line is, I think, a question of trust in what the government says it's trying to do and what history says it will ultimately do. And again, there are many things that can be done before we need to get the government running health care and using it's seemingly endless supply of borrowed taxpayer money to wipe out private insurance companies.

[Pine Barrens Mafia]

How do you even have a job to pay taxes if you can't read?

 

 

I can read, all right. I just don't BELIEVE it.

[pBills]

Which means that you didn't understand it, because the unions are fully opposed to true reform and equalization because of the tax free benefits their members receive through their health plans.

 

 

No actually it meant that I am happy that people were actually debating instead of the usual crap. Way to assume though.

[pBills]

I can read, all right. I just don't BELIEVE it.

 

 

You're a liar.

[DC Tom]

How do you even have a job to pay taxes if you can't read?

 

Not all jobs require literacy. Joe's probably in sales.

[KD in CA]

Third, Joe are you from Chicago? If not, then what do you know about Chicago politics other than what you see on Fox News? Is he a liar because you disagree with him? Let me know why you feel that way?

 

 

Nice to see you perfecting that "Fox News" shield as the blanket excuse for every reality that doesn't jibe with your pre-programmed agenda.

[GG]

The reason a lot of programs eventual cost is way more is because they are completely open ended or have few restrictions.

 

The actual cost for a lot of this stuff is unknown, that is true. But A] the costs are skyrocketing anyway and all kinds of reform needs to be done anyway. B] There should be zero question in anyone's mind that in this 2.5 trillion a year industry there is tremendous waste and inefficiency across the board, probably by far more than in any other industry. c] There are numerous ways to help control costs that will take those ten years to implement that are immeasurable right now. There are also things on the horizon that will likely make care cost rise, not decline.

 

I don't think, after reading a ton about this issue, from all kinds of different sources, anyone can convince me that if we do nothing it is better. We're inarguably on an unsustainable course with or without reform. If we do nothing, figures came out this week that by 2016 (IIRC) 41% of each American's income will go to Health Care. The reform needs to be massive, short and mid and long term, and everyone has to pay and everyone has to sacrifice.

 

So now you've looked into the abyss, and it's staring back at you.

 

So how do you deal with it? Do you offer up a comprehensive reform that touches every point that needs to be fixed (understanding that you won't fix it all with one legislation). Or do you throw something that sops to your constituency, while pushing serious financial ramifications to the guy who'll come after you?

[Magox]

To further support my argument:

 

http://www.bloomberg.com/apps/news?pid=206...id=aAtF5MQA.3QE

 

“There are other sectors whose profits dramatically exceed our modest profits,” Williams said.

 

Publicly traded insurers generated about $11 billion in net income in 2008 and nonprofit Blue Cross Blue Shield plans made less than $2 billion, said Carl McDonald, an Oppenheimer & Co. analyst in New York, in a July note issued when Democrats first raised the idea of industry fees.

 

Obama hasn’t given a fair portrait of the industry, or the true reasons for rising medical costs in the U.S., said Binns, the spokeswoman for Indianapolis-based WellPoint. UnitedHealth Group Inc., of Minnetonka, Minnesota, is the largest provider.

 

“We disagree with the president’s continued mischaracterization of the health-care industry,” she said in an e-mail. “Health insurer profits account for less than 1 percent of every health-care dollar.”

‘Leading the Effort’

 

The industry has been “leading the effort to increase access to preventive services and wellness programs,” which Obama said will curb health spending, she said.

 

“We would have liked to hear more about policies to bend the trend,” Binns said. That would include changing the way doctors are reimbursed to focus on the quality of care, rather than the quantity of tests or procedures.

 

The American Medical Association applauded the president’s inclusion of medical-liability reform as a potential way to lower expenses.

 

It “is something we’ve mentioned for years is a way to reduce unnecessary costs, as well as streamline health-care waste we have in our system,” said James Rohack, president of the Chicago-based AMA, in a telephone interview.

 

“Paying for the cost of this without adding a dime to the deficit means you’re going to have to eliminate unnecessary costs,” he said.

 

Some estimates put the price of unneeded tests as high as 20 percent of overall health-care expenses, Rohack said. “If one can eliminate even half of that, you’re going to have a significant health savings,” he said.

 

 

The answers lie in the numbers, not in the pink farts and promises.

[IDBillzFan]

The industry has been “leading the effort to increase access to preventive services and wellness programs,” which Obama said will curb health spending, she said.

Interesting AP article doing some fact-checking on Obama's speech last night, and one of the issues is his claim that preventative care will save money. According to the article, citing a CBO report from August, while preventative care and wellness is good, it does not reduce costs but rather increases them.

 

AP article here.

[KD in CA]

So now you've looked into the abyss, and it's staring back at you.

 

So how do you deal with it? Do you offer up a comprehensive reform that touches every point that needs to be fixed (understanding that you won't fix it all with one legislation). Or do you throw something that sops to your constituency, while pushing serious financial ramifications to the guy who'll come after you?

 

Which one gets me reelected?