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Health Costs and the Federal Budget

Harry Guerrilla

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Director's Blog

In CBO’s judgment, the health legislation enacted earlier this year does not substantially diminish that pressure. In fact, CBO estimated that the health legislation will increase the federal budgetary commitment to health care (which CBO defines as the sum of net federal outlays for health programs and tax preferences for health care) by nearly $400 billion during the 2010-2019 period. Looking further ahead, CBO estimated that the legislation would reduce the federal budgetary commitment to health care in the following decade—if the provisions of the legislation remain unchanged throughout that entire period. CBO also estimated that the legislation will reduce budget deficits by about $140 billion during the 2010-2019 period and by an amount in a broad range around one-half percent of gross domestic product (GDP) during the following decade—again, under the assumption that the legislation remains in force as enacted.
Just a follow up blog post from the CBO director.

In the bold, you'll notice the caveat.
Which has already occurred.
 

Boo Radley

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I think most realize more work is to be done.
 

Kandahar

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I'm not too worried about the costs. The CBO's estimates were pessimistic if anything. This is because they plan for the worst-case scenario, as they should. But there were hundreds of potential cost-savings proposals in the bill. Some of them may work, and some may not. But the CBO erred on the conservative side for nearly ALL of those potential savings. Of course they won't all pan out...but certainly some fraction higher than 0% will.

Also, I'm not worried about the costs because I believe that the coming biotechnology revolution will make most of our existing treatments obsolete (and therefore cheap). So either we'll pay a lot for top-notch medical care that adds many healthy decades to our lifespans, or we'll pay a lot less than we currently do for the same level of care. Either of those would be an improvement over what we have now.
 

Deuce

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I think most realize that we were lied to about the costs of this pig.
No, we weren't. The CBO scores amendments too. If we propose changes (like the reconciliation package that passed) the CBO will score those too. (which it did) The CBO can't predict the effects of legislation that hasn't been proposed yet. Or would you like them to start projecting every possible scenario? "Well let's see if an amendment is passed that increases everyone's taxes to 90% then ____. Next, if they pass an amendment that requires all doctors to perform surgery while singing 'You are my sunshine,' we predict that will cost ____"
 

cholla

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No, we weren't. The CBO scores amendments too. If we propose changes (like the reconciliation package that passed) the CBO will score those too. (which it did) The CBO can't predict the effects of legislation that hasn't been proposed yet. Or would you like them to start projecting every possible scenario? "Well let's see if an amendment is passed that increases everyone's taxes to 90% then ____. Next, if they pass an amendment that requires all doctors to perform surgery while singing 'You are my sunshine,' we predict that will cost ____"
Who exatly are you arguing with here? Straw arguments?

I was speaking about the double count of medicare monies, deleting the doc fix, things that are in the law and were presented to the CBO in such a way that the scoring given was not a true representation of the actual costs.
Thus my saying that we were lied to about this pig of a bill.
 

Boo Radley

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I think most realize that we were lied to about the costs of this pig.
I do't think so. I think most of us understood much more than you give creidt for.
 

cholla

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I do't think so. I think most of us understood much more than you give creidt for.
You are right, we understood that we were being lied to. There was no mystery there. Unfortunately, we did not have the representation to stop it. November should fix that.
 

samsmart

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You are right, we understood that we were being lied to. There was no mystery there. Unfortunately, we did not have the representation to stop it. November should fix that.
You're right. We were being lied to about there being government death panels should a public option occur, when, currently, we have to deal with death panels by private insurance companies.
 

Boo Radley

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You're right. We were being lied to about there being government death panels should a public option occur, when, currently, we have to deal with death panels by private insurance companies.
And these lies won. Sadly.
 

mpg

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You're right. We were being lied to about there being government death panels should a public option occur, when, currently, we have to deal with death panels by private insurance companies.
I just read Palin's "death panels" comment for the first time and it certainly has been spun by the media and many others. I'd always been told that she claimed that the bill before Congress contained a provision for death panels. She made no such claim. You guys really had me fooled these last few months.

Sarah Palin: Statement on the Current Health Care Debate | Facebook
 

Boo Radley

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I just read Palin's "death panels" comment for the first time and it certainly has been spun by the media and many others. I'd always been told that she claimed that the bill before Congress contained a provision for death panels. She made no such claim. You guys really had me fooled these last few months.

Sarah Palin: Statement on the Current Health Care Debate | Facebook
FacebooK?

Palin, Aug. 7: The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care.

(snip)

On Aug. 12, Palin attempted to clear up her argument with a detailed Facebook post. She discussed Section 1233 and said that "it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients." Palin goes onto argue:

Palin, Aug. 12: The issue is the context in which that information is provided and the coercive effect these consultations will have in that context. … These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?

The fact remains that the bill wouldn’t require patients to receive counseling sessions, nor would it require a doctor to offer one. Rather, it modifies Section 1861(s)2 of the Social Security Act, defining what services Medicare will pay for. So if a patient receives a counseling session from a doctor or health care practitioner, he or she doesn’t have to pay for it – Medicare will. As we pointed out in our earlier story, Medicare will also pay for prosthetic limbs, but that doesn’t mean that every recipient gets those, too.

Palin vs. Obama: Death Panels | FactCheck.org

Let's be objective here.
 

Deuce

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I just read Palin's "death panels" comment for the first time and it certainly has been spun by the media and many others. I'd always been told that she claimed that the bill before Congress contained a provision for death panels. She made no such claim. You guys really had me fooled these last few months.

Sarah Palin: Statement on the Current Health Care Debate | Facebook
No, you see, that's exactly our point. She talked about her baby with Down's Syndrome facing "Obama's Death Panel" when clearly no such thing ever existed. She was ****ing lying. Worse, other people picked up on it and the GOP used the phrase as a club to beat people into opposing the bill. There was never going to be any government body that sits and decides on a particular case and whether it was cost-effective to keep grandma alive. It didn't exist.
 
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Gill

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No, you see, that's exactly our point. She talked about her baby with Down's Syndrome facing "Obama's Death Panel" when clearly no such thing ever existed. She was ****ing lying. Worse, other people picked up on it and the GOP used the phrase as a club to beat people into opposing the bill.
You don't believe rationing will be an eventuality with this bill?? Really.????

If not, the U.S. will be the first country with government mandated health care that hasn't resorted to healthcare rationing.
 

Deuce

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You don't believe rationing will be an eventuality with this bill?? Really.????

If not, the U.S. will be the first country with government mandated health care that hasn't resorted to healthcare rationing.
What do you mean by rationing? Sometimes I suspect people don't really understand what that word means as it applies to health care. We already ration health care in this country.

Do you even know what the provision Palin was talking about did?

Allowed medicare to pay for an end-of-life consultation.

That's it.

This is something doctors already do, and every person should get such a consultation in their later years. The doctor talks to you about your will, your medical desires for your final days, do-not-rescusitate orders, medical power of attorney, that sort of thing. The provision would allow medicare to pay for that consultation. A consultation with your doctor, not a government employee. Edit: And if you think your doctor would try to coerce you into taking the cheaper way to die, you should probably find a new doctor.
 
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Gill

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Do you even know what the provision Palin was talking about did?

Allowed medicare to pay for an end-of-life consultation.

That's it.

This is something doctors already do, and every person should get such a consultation in their later years. The doctor talks to you about your will, your medical desires for your final days, do-not-rescusitate orders, medical power of attorney, that sort of thing. The provision would allow medicare to pay for that consultation. A consultation with your doctor, not a government employee. Edit: And if you think your doctor would try to coerce you into taking the cheaper way to die, you should probably find a new doctor.
It's obvious that you didn't read Palin's comments. She was NOT talking about end of life counseling, she was talking about healthcare rationing.

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
 

Deuce

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It's obvious that you didn't read Palin's comments. She was NOT talking about end of life counseling, she was talking about healthcare rationing.
Right, and the extremely convoluted (and incorrect) manner in which her supporters tried to retroactively prove her statements via the bill itself was through this end-of-life consultation, and something about a doctor's rating system.

In any case, what she was describing simply didn't exist. There was no panel that gauges a person's value to society. Again, I'll ask you, what do you picture as "rationing" that this bill will cause? Will I be potentially unable to get an MRI? Denied chemotherapy? Have to just deal with that broken ankle instead of having the bone set?
 

Gill

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Right, and the extremely convoluted (and incorrect) manner in which her supporters tried to retroactively prove her statements via the bill itself was through this end-of-life consultation, and something about a doctor's rating system.
No, actually it was liberals that tried to manipulate her comments into the end of life counseling non-issue.

In any case, what she was describing simply didn't exist. There was no panel that gauges a person's value to society. Again, I'll ask you, what do you picture as "rationing" that this bill will cause? Will I be potentially unable to get an MRI? Denied chemotherapy? Have to just deal with that broken ankle instead of having the bone set?
You're right... there is no rationing panel..........not yet anyway. Healthcare reform is not in affect yet. Just wait until they see that few of the young uninsured in this country will buy insurance, thus greatly increasing costs and requirements for more government subsidies. Then, you'll see rationing come into full force.
 

Deuce

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No, actually it was liberals that tried to manipulate her comments into the end of life counseling non-issue.



You're right... there is no rationing panel..........not yet anyway. Healthcare reform is not in affect yet. Just wait until they see that few of the young uninsured in this country will buy insurance, thus greatly increasing costs and requirements for more government subsidies. Then, you'll see rationing come into full force.
Buying insurance and consuming medical resources are not the same thing. Healthy people don't consume a great deal of such resources, because they're... well, healthy. And you still haven't explained what you mean by "rationing." Canada has socialized insurance, but you can get whatever treatment you need there.
 

Gill

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Buying insurance and consuming medical resources are not the same thing. Healthy people don't consume a great deal of such resources, because they're... well, healthy. And you still haven't explained what you mean by "rationing." Canada has socialized insurance, but you can get whatever treatment you need there.
Sure you can... as long as you don't mind waiting on it.
 

Deuce

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Sure you can... as long as you don't mind waiting on it.
So you define "rationing" as "waiting?"

Are you aware that America's average medical wait times for a primary care physician are actually some of the longest?

Article: Wait Times For Medical Care: How The US Actually Measures Up - Better Health
Source of article's info: Access & Equity Charts - The Commonwealth Fund

Canada had the highest percentage of patients (36%) who had to wait six days or more for an appointment with a doctor, but the United States had the second highest percentage (23%) who reported that they had to wait at least this long. New Zealand, Australia, Germany, and the U.K. all had substantially smaller numbers of people reporting waits of 6 days or longer. Canada and the United States, in that order, also had the lowest percentage of persons who said they could get an appointment with a doctor the same or next day.
Meanwhile, our wait times for non-emergency or elective surgeries are pretty good.

The U.K (60%) and Canada (57%) had the highest numbers of persons who had to wait four weeks or more to get to see a specialist physician. In the U.S., only 23% reported a wait of four weeks or more for specialty care.

* The U.S. also did very well on measures of wait times for non-emergency or elective surgery. Only 8% of surveyed patients in the United States reported a wait time of four months or more for elective surgery, compared to 33% in Canada and 41% in the U.K. Germany scored the best, with only 6% reporting a long wait for elective surgery.
Anyway, the point is that "government-mandated" health care does not necessarily lead to longer wait times. Several countries have just that and shorter wait times than the US. The US is not the shortest wait in any category, in fact. Waiting times are determined by the number of available doctors versus the number of patients, not the source of the money. If anything, the market will see a demand for more physicians and adapt to it by expanding medical practices and hospitals. Medical schools will up their enrollments to meet the increased demand.
 

rivrrat

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rationing means that they will not PAY for the treatment. So, thanks to the ****tard government, I'm required to purchase insurance I don't want and don't need, and then will be required to pay out of pocket for the treatments the government decides they don't want to pay for, or don't want to allow the insurance companies to pay for. All the while, my FORCED insurance premiums go up along with my out of pocket expenses! Happy happy, joy joy.

They can take their healthcare bill and shove it up their ass. All they did was take the worst aspects of healthcare and insurance and make them even worse. Yay for us. :roll:
 

Objective Voice

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I'm not going to get into the bickering over what political party lied or "fixed" the numbers, etc., etc. Unless you are an accountant and work in the health insurance/medical industry anything said concering the healthcare bill is pure speculation and political biasness.

The only things that concerns me over health care legistlation are:

1) How will it affect me in the short-term?

2) How will it affect my daily life and the lives of my loved ones once the legistlation goes into full effect?

3) How will the cost of health care affect my bottom line from now while part of the working class well into my retirement years?

4) How will the government pay health care cost after once enacted and beyond 2020 when deficit figures are slated to go down?

The health care industry will change; it's a given. How it will change will greatly depend on how well the medical and insurance industries adapt in the near turn and continue to make adjustments over the course of several years. Regardless of where you stand on the issue, the health insurance and medical industries did need to change. Too many people were either going without insurance (those who truly want it but can't afford it), getting denied health care or being gouged by the health care/insurance industries. You may not like what came out of the health care debate, but no one can deny that a major change was needed.
 
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