It Does But It Does Not

In the continuing saga of the GOP House efforts to undo the Affordable Care Act, the House is currently working on a repeal of the Independent Payment Advisory Board (IPAB).

Speaker of the House John Boehner’s office:

The House will act this week to repeal another part of ObamaCare: IPAB, which empowers a board of unelected bureaucrats to deny care and raise costs.

If the IPAB will raise costs then repealing it will save money, right?

Well…

Tea Party activists are upset about something else entirely. GOP leadership has opted to fund the $3.1 billion cost of repealing IPAB with legislation written by Rep. Phil Gingrey (R-GA) that would reform medical malpractice laws.

So repealing the IPAB will cost 3.1 billion.

The bill has to have a “pay for” element to offset the costs of repealing IPAB. Boehner’s office simply makes reference to the IPAB raising costs.  Which to believe….

Those Damn Socialists!

I am currently having to spend a few minutes each day driving my van which lacks an FM radio.  The pickings on AM radio are rather slim, so I sometimes end up listening to conservative talk radio (or “conversation radio” as the host called it today).  I have no idea whose program I was listening to today (but not Rush or Beck…does Beck still have a show?).

Anyways, the guy was going on at great length about how the Obama socialists were setting things up in the Affordable Care Act.  He was keying in on the business mandate.  Any business that has more than 50 employees is going to have to include health insurance in the employee  benefit package.  If the business fails to do this, the fine will be $2,000 per employee.

The host makes the point that any business (including ones that already offer health insurance)  would look at the choice and choose to pay the fine.  After all, it is much cheaper!  This will force all the employees into the Socialist Health Care that Obama set up…and then “they” (the Socialists) will have “them” and come election time the Democrats will say of the Republicans “They want to take away your health care!”

Where to begin.  Well, in the first place, if a business is today offering health care to its employees, why would it suddenly stop when there is a fine added to the costs of stopping?  Why not just stop now?   There is no fine today!  Hmmmm, could it be that there are reasons beyond government mandates why businesses supply health insurance?

But some businesses will not offer insurance.  Most of these are probably not offering insurance today.  So none of the employees will be forced into the Socialist Health Care that is ObamaCare.  No, they will be buying insurance from a private company just as they are doing today!  Only they will get a subsidy if they do not make enough money.

And if the individuals do not buy a policy?  They will be fined:

Impose an annual penalty of $95, or up to 1% of income, whichever is greater, on individuals who do not secure insurance; this will rise to $695, or 2.5% of income, by 2016. This is an individual limit; families have a limit of $2,085.[44][45] Exemptions to the fine in cases of financial hardship or religious beliefs are permitted

and they will not have insurance.  They will have to rely on charity and emergency rooms just like today!  (at least, I think that’s what happens.)

But wait!  What about the Socialist Health Care that is ObamaCare?  People have to buy private insurance with a subsidy if they qualify.  Jeepers, how much more socialistic can you get?

Finally, there is the host’s point about how the Democrats will use the Health Care to retain/gain power.  How DARE they try and use the policies they favor to curry favor with the voters!   This would be like a Republican saying he or she will cut your taxes to retain/gain power!

Remember, “the Republicans want to take away your Health Care!”

This is an admission that people will like the Affordable Care Act once it is fully implemented in the same way Tea Partiers protested with signs that read “Keep your government hands off my Medicare!”  Damn those Socialists creating Medicare!    Oh wait!  The Tea Partiers are voting for Republicans!

Well, it was on the radio.  It must be true.

Maybe It Is Infectious

Senator Ron Johnson has an op-ed in the Wall Street Journal and tells the touching story of the medical care that saved his daughter’s life and goes on to claim that under the Affordable Care Act this medical care might not have been there for his daughter.    He offers no evidence of this, but what  need is there of evidence when one has a touching anecdote regardless of how relevant it is.   He also manages to cherry pick a bunch of statistics to show the US is good and Europe is bad

So, of course, liberal bloggers are  jumping all over his absurd claims.

One such blogger is Igor Vlosky writing in the Wonkroom blog at Think Progress.  Mr. Vlosky makes the case for why Senator Johnson’s op ed mostly displays Senator Johnson’s lack of understanding of heath care and the Affordable Care Act.  He finishes up with some comparisons of the US to Europe, ending with

The United States is also “ranked 29th in the world in infant mortality, tied with Poland and Slovakia.” And so, Johnson gets it wrong. The ACA wouldn’t have killed Johnson’s daughter, but thousands of other uninsured babies would have died without it.

I did a quick Google and I am pretty sure the infant mortality stats for 2010 are not yet available, though the rate did go down in Milwaukee.

Given that the US has been experiencing over four million  births a year and that the mortality rate has been over six per 1000, there are certainly thousands of babies to be saved.  But I do not believe there is as yet any evidence that the Affordable Care Act has in fact done so.

Senator Johnson makes claims based on no evidence and Mr. Vlosky does the same after reading Johnson’s claims.*  Is it infectious?

I can tell you that the Affordable Care Act has not just saved tens of thousands of lives already, but is largely responsible for the economic recovery as well as the freedom movements in northern Africa and the mid-east.

 

*and Steve Benen at the Washington Monthy blithely quotes Mr. Vlosky’s absurd claim.

Spare the Cheaters, Screw the Lower Income Earners

One of the provisions of the Affordable Care Act is a requirement that businesses more completely report payments made to others.   This is done with form 1099.  I believe currently the law requires a 1099 anytime payments exceeding $600 within a year are made to an individual or a company that is not incorporated.   I’m not sure how the ACA changed this, but I assume that the $600 threshold is lower, maybe all the way to zero.

The interesting thing here is, this change raises revenue (and it is doubly interesting that nobody argues with that).  The only way this could raise revenue is if it puts income on the radar of the IRS that would not otherwise have been reported.  In other words, it catches tax cheats.

Of course, the business community and Republicans do not talk about the tax cheats.  They talk about the extra burden of the additional 1099’s on business.

Extra burden?   If your business is so small that the books are not on computer, then you likely will not be making out very many 1099s, and doing so will not be that difficult since you can probably scan a years worth of checks for relevent payouts in a few minutes.  And if your books are on computer, then the next software upgrade will accommodate the new requirement.

I’m sorry, but the extra burden argument is bogus.   This is in defense of tax cheats.   Remember, every time you hear calls for the elimination of the IRS there is a good chance you are hearing “Tax cheats should be able to get away with it.”

So, to make sure that tax cheats can continue with impunity, Congress wants to remove the heightened 1099 requirement.  Since it raises revenue, its removal must be balanced with other revenue or costs must be cut.   It seems the choice is to lower the subsidy to low income people.

Obama has said that he is willing to take the 1099 requirement out of the Affordable Care Act.  We will see if he is happy with how it is paid for.

The class war continues.

Delegating Powers to the Vice President in the Mubarek Administration

OK, that does not roll off the tongue as nicely as rearranging deck chairs on the Titanic.  But either metaphor serves in the case of our elected federal officials and the deficit.

Let us begin with an old chart from the Congressional Budget Office via our, ahem,  good friend Ross Perot:

This chart is a bit dated, but the curves have not changed much.  Future deficits are the result of medicare/medicaid and interest.  The last being the same as saying future deficits are the result of future deficits.   If future deficits can be brought under control, then the interest payments will take care of themselves.

Want something more recent?

This is from February 25th, 2011.  It assumes that the Bush tax cuts will expire and that the Obama stimulus tax cuts also expire.   Note that the growth of health spending goes from over eight percent of GDP to 12% of GDP while the total deficit at that point is 3.2 percent of GDP.   So the entire projected deficit in 2021 could be attributed to the growth of medical spending.

The Affordable Care Act (Obamacare) actually includes several measures intended to bring down medical costs.  The CBO grades the Act as lowering the deficit even though they did not take many of the cost saving  measures into consideration on the grounds that the measures had not yet shown they would work (they were not even law at the time…).

So the only serious deficit reduction effort in Washington today is the Democrats defense of health reform.  Obama freezing spending and the Republicans talk of cutting spending amounts to nothing more that delegating powers to the vice president in the Mubarek administration.

Oh yes.  If you want to clear up the short term deficits, this chart might prove useful:

 

For good or for ill, the spending that the Republicans want to cut is there for a reason.  People like it.  That spending is popular.  War, the Bush tax cuts, and the recession drive the short term deficit.

Even if the wars end tomorrow, the savings there will be minimal.   Something else will come along.  It always does.

Many of the cuts the Republicans propose would actually weaken the economic recovery and so increase the deficit.

The Bush tax cuts should be allowed to expire.  All of them.

Who Puts a Value on a Life?

I am not sure (but I think so) if it made it into Health Care Reform, but there is no denying that many liberals want what the right referred to as “death panels”.   Of course, not death panels, but a method of determinating what treatments are not effective, including treatments that give little value for a high price.

Conservatives continue to insist that the first Health Care Reform that should be passed is malpractice reform including limits on jury awards.  Presumably, such limits would include cases where death was the result.

Who wants to put a dollar value on a life?

Health Care Reform!

Congress has passed it.  The President signed it.  It is law.  We still need the reconciliation to be passed, but I am confident that it will get done (may take more effort than one would think, but it will get done).

Seems like a common theme I was hearing in recent weeks was how Obama’s presidency was a failure (from conservatives).  Now I hear that the Obama presidency is an historic success (from liberals).  In both cases it is a bit soon to judge.   It is still too soon to judge George W. Bush’s presidency.

This was not rammed through against the wishes of the American people.  It was passed by normal legislative procedures against the wishes of a minority of the American people.   53% of voters voted for Obama.  Anyone who voted for Obama and did not know he or she was voting for health care reform was not paying attention.   Although there were recent polls showing that a majority were against the health care reform bill, those polls actually showed that a lot of people were against what they believed the health care bill to be, not what it was.  And a few were against it because it was not liberal enough.

Don’t believe it when Republicans claim they had no choice but to oppose the bill at all costs since the Democrats refused to negotiate in good faith.  It was the other way around.  In particular, Senator Baucus spent weeks trying to get a compromise that would garner some Republican support.  Later, the Democrats stuggled to find the ground that would get both the conservative and the liberal Democrats to vote for the bill.  If there were some moderate Republicans there to stand in for the loss of the liberal Democrats…..

This is not the salvation of the Democratic Pary (though it does and will stand as an important achievement).  There are still seats to lose in November.

This is not the Waterloo of the Republican Party.  The Party is not now exiled onto St. Helena to die six years hence.   There are seats to win in November.

Now the lawsuits begin.  Under the heading of  “be careful what you wish for”, if this bill gets thrown out as unconstitutional due to the individual mandate, then the next time around the bill that will be passed will be single payer.  Yes, it might take a few years to get us back to such a point, but it will happen if this gets tossed.

There are plenty of issues to occupy Washington after health care, but my vote for most important issue is the deficit.

Make It Say Whatever You Need It To Say

As we, supposedly, come down to the final hours before the House vote on Health Care Reform, the Republican National Committee has come out with a poll on the subject.  The timing of this poll is clearly intended to intimidate Democratic congressman into voting no.

From the link:

The RNC poll also holds other good indications of a strong Republican showing in November. Among undecided voters, 46% said that they would prefer a “Republican candidate who would be a check and balance to President Obama and the Democrats in Congress,” compared to 19% who disagreed with the statement. 53% said that the would consider voting for a Republican so as to “send a message to President to President Obama and the Democrats and make them listen to voters like me.”

If the poll shows that 46% would prefer a “Republican candidate who would be a check and balance to President Obama and the Democrats in Congress,” the poll had to have that language in the question.  Ditto with “send a message to President to President Obama and the Democrats and make them listen to voters like me.”

The result is that the poll is, for all intents and purposes, meaningless.  But it was guaranteed to give the result the Republicans were looking for.

The Republicans are desperate to prevent the bill from passing because they fear the electorate will like the bill once it is seen for what it is and not through Republican distortions.

So Good At Communicating He Fails to Communicate

Or something like that.

Obama reminds me of Clinton.  I remember thinking that Clinton would be a liberal Reagan in that he, too, could be a “great communicator.”  I thought that because he seemed to communicate with the public so well as a candidate.  But once he was in office, he stopped.  And the Republicans controlled the message.   Soon Clinton was declaring the era of big government over.

Obama seemed to be able to communicate as a candidate and seems to not be able to do so as a President.  The Republicans control the message and Obama is trying hard to sound more centric in the State of the Union address.

It is interesting that when polled about specific elements that make up (one of?) the health care reform bill, the majority of Americans are in favor of almost all of them.   http://www.kff.org/kaiserpolls/upload/8042-T.pdf

In other words, if people understood what was in the legislation, there would be a lot more support.

I found the poll from a link on Jonathan Chait’s blog at The New Republic.

If only Obama could communicate.