CBO Fires Another Torpedo At Obamacare

[BarrySotero]

"CBO deals new blow to health plan"



"For the second time this month, congressional budget analysts have dealt a blow to the Democrat's health reform efforts, this time by saying a plan touted by the White House as crucial to paying for the bill would actually save almost no money over 10 years.

A key House chairman and moderate House Democrats on Tuesday agreed to a White House-backed proposal that would give an outside panel the power to make cuts to government-financed health care programs. White House budget director Peter Orszag declared the plan "probably the most important piece that can be added" to the House's health care reform legislation.

But on Saturday, the Congressional Budget Office said the proposal to give an independent panel the power to keep Medicare spending in check would only save about $2 billion over 10 years- a drop in the bucket compared to the bill's $1 trillion price tag...

Saturday's CBO analysis caps a tough week of blown deadlines, partisan bickering and fierce intra-party fighting among Democrats. On Friday, the tension between the Blue Dogs and Waxman exploded when Waxman threatened to bypass his committee and bring the reform bill straight to the House floor without a vote. The move infuriated Blue Dogs who have used their crucial committee votes to leverage changes to the bill."

http://www.politico.com/news/stories/0709/25415.html


I think Douglas Elmendorf is probably even being generous in his second report since Rahm brought Doug in for a little talk recently. Elmendorf also had Summers as a an advisor at Harvard. He was at Brookings for awhile as an economist. He might qualify for the Presidential Medal of Freedom if Obamacare can find it's place in the future as a nightmare that was "stopped just in time".

From Forbes:

"But ObamaCare isn't as dead as it looks to the pundits. Earlier this week, the man who on July 16 let it be known that the Emperor's New Health Care Plan would add a trillion dollars to the deficit over 10 years, was summoned to the White House for a little chat with Rahm and the boys. Will Douglas Elmendorf bend to the Chicago-style pressure? We'll see. I wouldn't bet against it."

http://blogs.forbes.com/digita...up-and-vice-versa.html

 

[Moonbeam]

Good, we need a real revolution in health care, particularly one that gets rid of private insurance companies.

 

[BarrySotero]

Ok yours first

 

[PJABBER]

Why rely on real data when anecdotal will do just as well?

 

[Moonbeam]

I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

 

[Engineer]

Originally posted by: Moonbeam
Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

Same for Social Security too!

 

[PJABBER]

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

 

[Moonbeam]

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

 

[quest55720]

Happy to see the CBO backing up what many of us have been saying. The democrats need to just start over during the august break. Until there is significant savings they should keep working at it. Once you get costs down the other things will fall right into place.

 

[BarrySotero]

There can be no credibility for a plan that avoids legal reforms (trail layers Obama's # money bundlers to boot). The health-care plans motivations have been about power/big gov and not health. Here are some interesting bits from bone docs:


American Academy of Orthopaedic Surgeons

The need for tort reform

The current medical liability system neither effectively compensates persons injured from medical negligence nor encourages the addressing of system errors to improve patient safety. The medical liability crisis has had many unintended consequences, most notably a decrease in access to care in a growing number of states and an increase in healthcare costs.

Access is affected as physicians move their practices to states with lower liability rates and change their practice patterns to reduce or eliminate high-risk services. When one considers that half of all neurosurgeons?as well as one third of all orthopaedic surgeons, one third of all emergency physicians, and one third of all trauma surgeons?are sued each year, is it any wonder that 70 percent of emergency departments are at risk because they lack available on-call specialist coverage?

The impact on the patient-physician relationship

Another unintended consequence of the medical liability crisis is a fundamental change in doctor-patient relationships, with attendant increasing healthcare costs secondary to defensive medicine practices. Many physicians are dissatisfied with the way they think they must practice medicine today. Many now adopt an attitude that ?views every patient as a potential lawsuit.?

This same attitude is also prevalent among residents. In a recent study of residents across specialties, 81 percent of responding residents said that they view every patient as a potential lawsuit. These protective, fear-of-lawsuit attitudes result in physicians adopting behaviors that increase healthcare costs through the practice of defensive medicine.

The study quoted most often is by Daniel P. Kessler and Mark B. McClellan. To really understand actual costs, Kessler and McClellan analyzed the effects of malpractice liability reforms using data on Medicare beneficiaries who were treated for serious heart disease. They found that liability reforms could reduce defensive medicine practices, leading to a 5 percent to 9 percent reduction in medical expenditures without any effect on mortality or medical complications.

If the Kessler and McClellan ( Kessler-McClellan study won the 1997 American Economics Association?s award in health economics)estimates were applied to total U.S. healthcare spending in 2005, the defensive medicine costs would total between $100 billion and $178 billion per year. Add to this the cost of defending malpractice cases, paying compensation, and covering additional administrative costs (a total of $29.4 billion). Thus, the average American family pays an additional $1,700 to $2,000 per year in healthcare costs simply to cover the costs of defensive medicine.

Excessive litigation and waste in the nation?s current tort system imposes an estimated yearly tort tax of $9,827 for a family of four and increases healthcare spending in the United States by $124 billion. How does this translate to individuals? The average obstetrician-gynecologist (OB-GYN) delivers 100 babies per year. If that OB-GYN must pay a medical liability premium of $200,000 each year (which is the rate in Florida), $2,000 of the delivery cost for each baby goes to pay the cost of the medical liability premium.

The impact on care

Although hard data are difficult to acquire, several studies on physician attitudes indicate that a fear of lawsuits tends to drive providers to adopt behaviors that lead to increased healthcare costs. One study, for example, showed that 93 percent of physician respondents reported engaging in some form of defensive medicine.

Assurance behavior, reported by 92 percent of physician respondents, involves ordering tests (particularly imaging tests), performing diagnostic procedures, and referring patients for consultation. Avoidance behavior, reported by 42 percent of physician respondents, includes restricting their practice, eliminating high-risk procedures and procedures prone to complications, and avoiding patients with complex problems or patients perceived as litigious. A recent unpublished study in Massachusetts showed that 83 percent of physician respondents ordered imaging and laboratory tests or made specialist referrals defensively.




http://www.aaos.org/news/aaosnow/nov08/managing7.asp

 

[PJABBER]

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

Having lots of friends who have gone through med school, residency, then specialization and establishing a practice, I can assure you that you have no idea how many hours they have to work and how many years it takes. Try 80+ hours a week and building up some significant student loans in the process. Starting pay sucks big time. At some point most of them make enough money to overcome the early deficit, but I don't know of a single doc that can say it was easy getting to be one.

Other than someone getting through the Army's Ranger School, I don't know of any profession that stresses their students for as long as they do both physically and mentally as much as med training.

 

[Red Dawn]

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Big deal, we'll just do what Kaiser does, import them from India

 

[Slew Foot]

Originally posted by: Moonbeam

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

Hey dumbshit, physician compensation is 5% of that total cost of US healthcare. Most practicing physicians are putting in 60 hr workweeks.

 

[Red Dawn]

Originally posted by: Moonbeam
Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

I've never met a Dr. that was worthless. Shits heads yes. Of course I've never read a Beamer post that wasn't dripping of sarcasm.

 

[alchemize]

Originally posted by: Moonbeam

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

Doctors work 30 hours a week? Have you ever worked in or near healthcare?

The pediatric heart surgeon that operated on my son was in that damn hospital probably 100 hours a week. I should know as I was there 24/7. But you're right, let's stick some dumbass in there and give him a scalpel and a government paycheck. Gotta get that profit motive out!

 

[Corn]

Moonie doesn't want the most skilled and competent doctors working the system, his only requirement is that the doctor be empathetic and love doctoring. Unlike Moonie, I love myself and my only concern is the skill of the physician, not his motivation for being a doctor.

Why stop at banning private health insurance Moonie (we should also include pharmaceuticals)? Food is far more essential to the immediate needs of the citizenry on a daily basis. All those fuckers earning their evil profits selling us products we cannot live without! Only government owned supermarkets and restaurants will satiate my lust for equality!

 

[shadow9d9]

I don't care about the money. I care about people NOT being denied healthcare or given pre-existing conditions clauses. I care about people not being dropped from coverage when they need it the most, such as cancer.

Let the right wing jerk offs about money commence... you didn't seem to care about 2 endless occupations costing a trillion or the bailouts for corporations last september... Helping our own people? Nah!

You want to save money? You need the complete "socialist" single payer system and the elimination of private insurance. You willing to do that? If not, stfu about the money already.

 

[Hacp]

Originally posted by: shadow9d9
I don't care about the money. I care about people NOT being denied healthcare or given pre-existing conditions clauses. I care about people not being dropped from coverage when they need it the most, such as cancer.

Let the right wing jerk offs about money commence... you didn't seem to care about 2 endless occupations costing a trillion...

If you really don't care about money, then the IRS takes cash, money order, check and credit.

 

[shadow9d9]

Originally posted by: Hacp

Originally posted by: shadow9d9
I don't care about the money. I care about people NOT being denied healthcare or given pre-existing conditions clauses. I care about people not being dropped from coverage when they need it the most, such as cancer.

Let the right wing jerk offs about money commence... you didn't seem to care about 2 endless occupations costing a trillion...

If you really don't care about money, then the IRS takes cash, money order, check and credit.

Do you think you are clever?

We already pay obscene amounts with NOTHING TO SHOW FOR IT! 13k family average in this country and they could cancel you or exempt you, leaving you with no other option. All this while they rake in the profits. Paying the same amount so everyone could get covered and no risk of being dropped is a freakin deal.

 

[SammyJr]

Originally posted by: alchemize

Originally posted by: Moonbeam

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

Doctors work 30 hours a week? Have you ever worked in or near healthcare?

The pediatric heart surgeon that operated on my son was in that damn hospital probably 100 hours a week. I should know as I was there 24/7. But you're right, let's stick some dumbass in there and give him a scalpel and a government paycheck. Gotta get that profit motive out!

You do realize you are replying to Moonbean, right?

I don't think anyone truly believes that doctors put in that few hours.

 

[MrMatt]

Originally posted by: BarrySotero
Ok yours first

hahahhaha "I'm right behind you...I swear"

 

[OrByte]

the current proposals leave lots of ways in which lots of people can sit on the sidelines and lob sticks and stones.... big fucking deal. This is how legislation is created....at least this is how we should EXPECT legislation to be created, not behind closed doors and not ramrodded thru at the 11th hour. People like to talk about the fight between the White house and congress, or between Left and moderate dems...I say LET THEM FIGHT. We should be cheering them on! hash this crap out and hopefully we get a good deal when its all said and done. Thats a whole hell of alot better than the "See no evil, Hear no evil, Speak no evil" congress we've all grown accustomed to.

Fact of the matter is, any solution is going to be expensive. Obama shot himself in the foot when he said that UHC will save money.

He should have said its going to cost money but the status quo will cost MORE.

Also, I like how on the one hand alot of people are all doom and gloom about the COST of UFC, and on the other they turn around and complain that there is not enough data on the proposals to tell whether its good or not.

Basically we have had up to this point alot of dipshits in the media pull you all by the noserings and tell you what you wanted to hear.

congrats.

 

[Moonbeam]

Originally posted by: Red Dawn

Originally posted by: Moonbeam
Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

I've never met a Dr. that was worthless. Shits heads yes. Of course I've never read a Beamer post that wasn't dripping of sarcasm.

That one was dripping with hyperbole. We have all these market freaks that tell us about supply and demand and that tells me there aren't more doctors because their numbers are artificially limited. It really matters little how hard they work or how long, the important point is that more doctors means more competition and yes, bringing millions of them from India will bring health care costs down. Kaiser has lots of Indian doctors and they are great.

 

[Moonbeam]

Originally posted by: SammyJr

Originally posted by: alchemize

Originally posted by: Moonbeam

Originally posted by: PJABBER

Originally posted by: Moonbeam
I am not smart enough to know what the answer to health care is or why Obama is in such a rush.

All I know is that I want it done right with cost well considered and factored in. I am also of perhaps the naive opinion that it can't or shouldn't be rushed, that is is way to complicated for that and too much needs to be changed to make it better.

I want the strangle hold doctors hold on medicine broken. Nursed and med techs could do 90% of medicine. I want the limit on the number of places in college for doctors massively expanded. They limit the supply to up their income the worthless assholes. I want for profit out of medicine all together. Let it be government funded bases and rewards paid out on savings.

So many things wrong with how things are, so much that needs to be changed. Automatic health coverage for all politicians should be suspended till it's universal and they get only that too.

The Complexities of Physician Supply and Demand: Projections Through 2025

AAMC projects growing shortage of physicians
November 24, 2008

A new report from the Association of American Medical Colleges projects the U.S. will face a shortage of 124,000 physicians by 2025, citing population growth, aging and other factors. "Simply educating and training more physicians will not be enough to address these shortages," the report states. "Complex changes such as improving efficiency, reconfiguring the way some services are delivered and making better use of our physicians will also be needed." In 2006, the association recommended a 30% increase in U.S. medical school enrollment and expanding Graduate Medical Education positions to accommodate an anticipated shortage of physicians.

Yup those worthless shit-heads also don't like being overworked. They want just enough doctors, not too few and not too many, so they can get rich in a 30 hour week.

Doctors work 30 hours a week? Have you ever worked in or near healthcare?

The pediatric heart surgeon that operated on my son was in that damn hospital probably 100 hours a week. I should know as I was there 24/7. But you're right, let's stick some dumbass in there and give him a scalpel and a government paycheck. Gotta get that profit motive out!

You do realize you are replying to Moonbean, right?

I don't think anyone truly believes that doctors put in that few hours.

I should be ashamed of my self, I know, but when you hang around here very long you get a real ear full of how the really good people, conservatives especially, work so hard to obtain what they have and they are so proud of what they achieve and puff their egos to such magnificent air bags heights that you just naturally want to walk around with a pin and stick it in their hot air balloons. I have to admit that I know that 30 hr a week line would cause a bunch of the usuals to jump off roofs and out window. When your in a giant button shop with all color of buttons around, you just can't help pushing some to see what they do.

 

[BarrySotero]

Originally posted by: shadow9d9
I don't care about the money. I care about people NOT being denied healthcare or given pre-existing conditions clauses. I care about people not being dropped from coverage when they need it the most, such as cancer.

Let the right wing jerk offs about money commence... you didn't seem to care about 2 endless occupations costing a trillion or the bailouts for corporations last september... Helping our own people? Nah!

You want to save money? You need the complete "socialist" single payer system and the elimination of private insurance. You willing to do that? If not, stfu about the money already.

Obamcare will deny and delay lots of people health-care - all the big socialist health-care systems do.

The agency to gauge the ratios was established with the "stimulus" bill and it's called the Federal Coordinating Council for Comparative Effectiveness Research.. Gov bureaucrats will use their info to decide who gets what health-care. George WIll decribed them like this in Jan

"The stimulus legislation would create a council for Comparative Effectiveness Research. This is about medicine but not about healing the economy. The CER would identify (this is language from the draft report on the legislation) medical "items, procedures, and interventions" that it deems insufficiently effective or excessively expensive. They "will no longer be prescribed" by federal health programs. The next secretary of health and human services, Tom Daschle, has advocated a "Federal Health Board" similar to the CER, whose recommendations "would have teeth": Congress could restrict the tax exclusion for private health insurance to "insurance that complies with the Board's recommendation." The CER, which would dramatically advance government control -- and rationing -- of health care, should be thoroughly debated, not stealthily created in the name of "stimulus."


http://www.washingtonpost.com/...8/AR2009012802939.html

Here is CER site

http://www.hhs.gov/recovery/programs/cer/index.html