The Preliminary CBO score for HC reform is out

[piasabird]

The big question is where does the tax come from?

So are we going to fine home owners and farmers and companies who dont pay the tax and penalties for the undocumented workers?

Tax em!

High tax leads to lower wages.
Lower wages leads to increases in wages.
Increase in wages leads to inflation.
Inflation leads to devaluation of the dollar.
Deflation of the dollar leads to higher prices.

 

[Patranus]

God. Pelosi must think that every American went to a California public school. She can fool the people of San Francisco but she cannot fool the people of this nation.

10 years of taxes with 6 years of service yet she would like the American people to actually believe that this will lead to long term budget savings? Really?

How exactly do you greatly expand Medicaid and cut doctors payouts by 21% and not have doctors stop taking Medicaid?

Oh, you say that this is only a gimmick to get the legislation "favorably" scored by the CBO and you will "fix" this later? Huh, where will that funding come from and how will it increase the cost of the Medicaid mandates?

 

[Carmen813]

God. Pelosi must think that every American went to a California public school. She can fool the people of San Francisco but she cannot fool the people of this nation.

10 years of taxes with 6 years of service yet she would like the American people to actually believe that this will lead to long term budget savings? Really?

How exactly do you greatly expand Medicaid and cut doctors payouts by 21% and not have doctors stop taking Medicaid?

Oh, you say that this is only a gimmick to get the legislation "favorably" scored by the CBO and you will "fix" this later? Huh, where will that funding come from and how will it increase the cost of the Medicaid mandates?

Patranus, I say this with all due respect, but you really need to get your facts straight.

MediCARE is the program that is having doctors take a 21% pay cut unless the "doc fix" is passed. This "doc fix" would be needed whether or not this bill passes. If this bill doesn't pass, doctors still take a 21% Medicare pay cut. If this bill DOES pass, doctors still take a 21% pay cut. It is a separate issue that has been around for years.

MediCAID is what is going to be used to provide a lot of the expansion of coverage. This bill greatly INCREASES the amount of money doctors get paid to cover MediCAID patients. Doctors who cover MediCAID will now be reimbused at the same rate that doctors receive from MediCARE. That information comes from the American Medical Association.

MediCAID = program for the poor.
MediCARE = program for the elderly.

The 20 year numbers ARE provided by the CBO. Normally the CBO does a 10 year prediction, but due to the fact that this legislation could have such a huge impact Congress has asked them since LAST JUNE to provide 20 year numbers. In addition, the CBO is being EXTRA CONSERVATIVE with its 10-20 year numbers because of how difficult they are to predict.

The whole "6 years of benefits with 10 years of taxes" is a red herring created by Conservatives who refuse to acknowledge the above.

I will continue to tear you apart in the most civil way I possibly can until you start supporting what you have said with some factual analysis. If you can't manage that, then I suggest you troll elsewhere.

 

[Patranus]

Sorry I made a mistake but the substance remains the same.

MediCARE is the program that is having doctors take a 21% pay cut unless the "doc fix" is passed. This "doc fix" would be needed whether or not this bill passes. If this bill doesn't pass, doctors still take a 21% Medicare pay cut. If this bill DOES pass, doctors still take a 21% pay cut. It is a separate issue.

How is it s separate issue?
They claim that the bill saves money yet will pass the "doc fix". You don't think that this would change the results of the CBO score?

The 20 year numbers ARE provided by the CBO. Normally the CBO does a 10 year prediction, but due to the fact that this legislation could have such a huge impact Congress has asked them since LAST JUNE to provide 20 year numbers. In addition, the CBO is being EXTRA CONSERVATIVE with its 10-20 year numbers because of how difficult they are to predict.

Again, garbage in, garbage out. The "doc fix" is one example of this.

The whole "6 years of benefits with 10 years of taxes" is a red herring created by Conservatives who refuse to acknowledge the above.

How so?
Do the taxes no start this year if this legislation is passed?
Does the majority of spending not start after 2014 if not 2016?

I will continue to tear you apart in the most civil way I possibly can until you start supporting what you have said with some factual analysis. If you can't manage that, then I suggest you troll elsewhere.

Huh, your only attack was that I cited Medicaid and not Medicare. I will give you that one.

 

[Carmen813]

Sorry I made a mistake but the substance remains the same.



How is it s separate issue?
They claim that the bill saves money yet will pass the "doc fix". You don't think that this would change the results of the CBO score?




Again, garbage in, garbage out. The "doc fix" is one example of this.



How so?
Do the taxes no start this year if this legislation is passed?
Does the majority of spending not start after 2014 if not 2016?



Huh, your only attack was that I cited Medicaid and not Medicare. I will give you that one.

That "mistake" has gigantic repercussions for what you said. It's important for people to understand the differences between these two programs.

Yes, benefits do start this year, but you ignore them. Within 90 days of passage high risk insurance pools are setup for people with pre-existing conditions. Within 90 days children will be able to stay on their parents insurance until age 26. Within 90 days there are no longer lifetime limits on insurance benefits. Within 90 days the insurance practice of rescission becomes illegal. Within 180 days children can no longer be denied insurance for pre-existing conditions. Beginning in January 2011 Medicare patients are able to be covered for "wellness visits." This will all happen before the 2010 elections if this bill passes within the next month or so.

As I said, the idea that benefits don't kick in for "years" is a red herring created by people who don't know or don't care what is in the bill. In 2014 the exchanges are setup and pre-existing conditions are banned for good. It takes time to set up those reforms in a responsible manner. If you were to simply ban pre-existing conditions the moment the bill was signed into law, premiums would SKYROCKET because there would not yet be additional people in the insurance pool to offset those costs.

What's even more ridiculous is that you guys are tripping on your own arguments. "Wait and slow down" we keep hearing. Well, this bill is deliberately staged so that it is rolled out in a responsible manner. Just like with the stimulus bill, Republicans are screaming that the government should try to do all this spending within one year if they are going to do it. You know that would doom it to failure, so in reality all that bitching is only about securing political points and not doing what is right for the country if the bill passes. As Hayabusa Rider has discussed, trying to roll this out immediately would cause utter disaster for patients and providers.

The "doc fix" is a problem that has existed for a very long time. It isn't cheap, it costs around $400 billion over 10 years to get the rates the doctors want. There are three ways you can fix this, either deficit spend, cut spending else, or raise additional taxes. Find me some information about what the Republican proposal is to fix this issue and we'll talk. If you were to implement the doc fix it in this bill it would require deficit spending to cover these costs. I think there is a better way to fix this problem. The 20 year deficit reduction numbers provide a way that this can be paid for in the future. You are presenting it as if it is a new problem created by this bill, and that is simply factually inaccurate.

 

[Patranus]

That "mistake" has gigantic repercussions for what you said. It's important for people to understand the differences between these two programs.

Yes, benefits do start this year, but you ignore them. Within 90 days of passage high risk insurance pools are setup for people with pre-existing conditions. Within 90 days children will be able to stay on their parents insurance until age 26. Within 90 days there are no longer lifetime limits. Within 90 days the insurance practice of rescission becomes illegal. Within 180 days children can no longer be denied insurance for pre-existing conditions. Beginning in January 2011 Medicare patients are able to be covered for "wellness visits." This will all happen before the 2010 elections if this bill passes within the next month or so.

Intellectually dishonest argument.
Ok, yes, *some* programs start immediately so let me rephrase.

10 years of taxes - 6 years of spending = long term savings.

 

[Carmen813]

Intellectually dishonest argument.
Ok, yes, *some* programs start immediately so let me rephrase.

10 years of taxes - 6 years of spending = long term savings.

Care to explain how I am in anyway being dishonest? From what I'm reading of your statement, you are essentially saying that no benefits will kick in for four years. I think I've pretty honestly addressed that.

Let's assume you are right though for years 1-10. How do you excuse the deficit savings from years 10 - 20? Or the CBO's statement that:

CBO has not extrapolated estimates further into the future because the uncertainties surrounding them are magnified even more. However, in view of the projected net savings during the decade following the 10-year budget window, CBO anticipates that
the reconciliation proposal would probably continue to reduce budget deficits relative to
those under current law in subsequent decades, assuming that all of its provisions would
continue to be fully implemented.

The CBO is not a democrat organization. It is not a biased organization. It is non-partisan in the extreme, and it's entire reputation rests on whether or not it can deliver unbiased information to Congress. I don't think they are perfect, and I'm sure their analysis is flawed in some way, but when I see independent studies that use their own models backing them up, and others continue to spout the same talking points, I begin to question their motives.

 

[Patranus]

Care to explain how I am in anyway being dishonest? From what I'm reading of your statement, you are essentially saying that no benefits will kick in for four years. I think I've pretty honestly addressed that.

The programs that cost next to nothing for the government to implement are being implemented first. The remainder show a reduction in spending over 6 years of the program with 10 years of income.

If the benefits that require significant amounts of spending were implemented on a year of taxes for a year of spending basis there is no way this legislation would show a decrease in spending.[/quote]

I never said the CBO was a Democrat (big D) organization.

What I said was garbage in, garbage out.
One example of this is the "doctor fix" which recent internal memos from the Democrats even admit the outlook is not so good when you include this.

 

[Carmen813]

The programs that cost next to nothing for the government to implement are being implemented first. The remainder show a reduction in spending over 6 years of the program with 10 years of income.

If the benefits that require significant amounts of spending were implemented on a year of taxes for a year of spending basis there is no way this legislation would show a decrease in spending.
I never said the CBO was a Democrat (big D) organization.

What I said was garbage in, garbage out.
One example of this is the "doctor fix" which recent internal memos from the Democrats even admit the outlook is not so good when you include this.

I was making a broad statement that the CBO is independent and non-partisan. You still haven't accounted for the second 10 years, which obviously has a full 10 years of spending/savings in it. Even if you factored in the doc fix, there would still be a deficit reduction of around 800 billion using the CBO numbers.

The only way you could implement this bill immediately is to utilize deficit spending. It takes time (and yes, money) to implement these changes in a responsible manner. If we didn't, I believe we'd end up with substantial problems at the provider level.

The only way you could get the money to do these reforms without raising taxes (which will generate revenue starting next year, not this year) is to utilize deficit spending. Assuming for a minute that you were pro-reform, do you think that would be a better solution?

 

[shira]

Patranus, I say this with all due respect, . . . [snip]

No, no, no, no, no. Don't say anything to Patranus with any quantity of due respect, a little, a lot, or [heaven forbid] all. He is not worthy.

 

[woolfe9999]

Care to explain how I am in anyway being dishonest? From what I'm reading of your statement, you are essentially saying that no benefits will kick in for four years. I think I've pretty honestly addressed that.

Let's assume you are right though for years 1-10. How do you excuse the deficit savings from years 10 - 20? Or the CBO's statement that:

I am going to interject briefly into your discussion with Patranus. His point about 10 years of taxes for 6 years of benefits is very frustrating to me, because I have pointed this out before linking the CBO reports and the assertion just keeps getting made. The fact is, the bill collects virtually NOTHING in tax revenues prior to 2013. The taxes thereafter ramp up and are BACKLOADED to the latter part of the decade. Take a look at Table 2 under "Changes in Revenues."

http://www.cbo.gov/ftpdocs/113xx/doc11307/Reid_Letter_HR3590.pdf

The reason for the delay in the primary fiscal benefits is exactly what you said, that it takes time to implement these measures responsibly. The actual fiscal impact of the bill will be virtually nil either way prior to 2013. This is not a trick to make the bill look better on the deficits. The bill doesn't even become deficit positve until 2016. Prior to that it is slightly deficit negative. If this were front loaded on taxes, it would be entirely the other way around. This is pretty much 6 years of benefits for 6 years of taxes.

- wolf

 

[GuitarDaddy]

I am going to interject briefly into your discussion with Patranus. His point about 10 years of taxes for 6 years of benefits is very frustrating to me, because I have pointed this out before linking the CBO reports and the assertion just keeps getting made. The fact is, the bill collects virtually NOTHING in tax revenues prior to 2013. The taxes thereafter ramp up and are BACKLOADED to the latter part of the decade. Take a look at Table 2 under "Changes in Revenues."

http://www.cbo.gov/ftpdocs/113xx/doc11307/Reid_Letter_HR3590.pdf

The reason for the delay in the primary fiscal benefits is exactly what you said, that it takes time to implement these measures responsibly. The actual fiscal impact of the bill will be virtually nil either way prior to 2013. This is not a trick to make the bill look better on the deficits. The bill doesn't even become deficit positve until 2016. Prior to that it is slightly deficit negative. If this were front loaded on taxes, it would be entirely the other way around. This is pretty much 6 years of benefits for 6 years of taxes.

- wolf

But, But that's the truth, and the truth doesn't support the rightwing outrage! Baldfaced lies work much better, and they are so fun. And there is a virtual army of braindead parrots waiting to repeat it thousands of times regardless of how ridiculous it is

 

[Patranus]

woolfe9999, you provide a compelling argument back by facts.

Thank you for bringing facts to the table.

I rescind my opposition to this legislation based on 6 years of services/10 years of taxes.

 

[Carmen813]

woolfe9999, you provide a compelling argument back by facts.

Thank you for bringing facts to the table.

I rescind my opposition to this legislation based on 6 years of services/10 years of taxes.

I apologize if I offended you earlier, I honestly didn't think you would change your mind on this particular issue. I did actually try to find similar info by reading through the bill, but I was struggling to understand legalease

Good info Woolfe.

 

[Fern]

I am going to interject briefly into your discussion with Patranus. His point about 10 years of taxes for 6 years of benefits is very frustrating to me, because I have pointed this out before linking the CBO reports and the assertion just keeps getting made. The fact is, the bill collects virtually NOTHING in tax revenues prior to 2013.
-snip-
wolf

No need to get so frustrated, that change was just published yesterday.

Anyway (or moreover), it's (the House buill to fix the Senate bill) about 150 some pages of law that's going to take a while to sort out and understand.

I think people are focusing too hard on this preliminary report. Just read the cover page to Pelosi and you'll find some elements are omitted (waiting for the Joint Committee of Taxation), others need to be reviewed etc. Might be prudent to wait for the final. Along those lines the Dems are being arguably deceptive by pointing to this thing knowing full it's incomplete and hasn't been adequately reviewed yet.

I'll say the same for much of the MSM, which is touting this as though it's a final.

Yes, the CBO is nonpartisan, nobody should argue that point. However, they are given much of the parameters and assumptions by Congress (the Dems in this case) to perform these calculations. Now we have 25 pages of financial summaries likely backed by scads of detailed calcualtions etc. It'll take a while before that data can be sifted through. Looking at the summary is only a part of the story, and may be only a small part. The assumptions/parameters that are (1) provided by Congress, and (2) those developed by the CBO itself need to be identified and analyized before the quality of these projections can be determined.

I'm begining to suspect Congress is back to 'full speed ahead' before final data is known.

As CPA who does a lot of projections I recognize that they are just 'fiction', but hopefully based upon good faith/realistic assumptions. Fact of the matter is if projections end up with good future estimates it's a wild coincidence, likely every assumption/parameter was wrong by a certain factor yet the actual data just so happened to coincided 'magically' to arrive at the same, or close result. But because we lack any better tool, this is what we are stuck with. But they are useful and necessary.

Cliffs: Wait for the 'real' CBO report, and then let non-partisan competent professionals analyize it.

Fern

 

[Fern]

But, But that's the truth, and the truth doesn't support the rightwing outrage! Baldfaced lies work much better, and they are so fun. And there is a virtual army of braindead parrots waiting to repeat it thousands of times regardless of how ridiculous it is

Whoa whoa, this change was just published yesterday. The claim of front-loading revenue was accurate until then. Might still be too depending upon what the Senate does. Essential we're looking at a new proposal to get rid of that front-loading.

Fern

 

[woolfe9999]

No need to get so frustrated, that change was just published yesterday.

The reason I am frustrated is because this allegation was made months ago when the CBO reports came out for the Senate bill which ultimately passed on Christmas eve, and I linked the CBO reports at the time. There have been many iterations of this bill, and multiple CBO reports, with corrections, etc. for each iteration. The fact is, in every version, the pattern of revenue inflow and outflow is very similar, with only small differences in individual numbers. In every version, the taxes are backloaded toward the end of the decade and the bill is shown to run a slight deficit early and reduce the deficit much later, precisely because the taxes are so back loaded. It is really very much the reverse of what is being alleged.

- wolf

 

[shira]

I apologize if I offended you earlier, I honestly didn't think you would change your mind on this particular issue. I did actually try to find similar info by reading through the bill, but I was struggling to understand legalease

Good info Woolfe.

Don't get giddy here. Patranus didn't say he rescinds his opposition to the legislation. He said merely that he rescinds "6 years of services/10 years of taxes" as a reason for opposition. But he continues to oppose the legislation for plenty of other bogus reasons, you can be sure.

 

[woolfe9999]

Don't get giddy here. Patranus didn't say he rescinds his opposition to the legislation. He said merely that he rescinds "6 years of services/10 years of taxes" as a reason for opposition. But he continues to oppose the legislation for plenty of other bogus reasons, you can be sure.

True, but I'll give him props for acknowledging the facts and backing off on the point. It isn't that common an occurence on P&N.

And strange as it may seem, I actually agree with him on the "doc fix" issue, for the most part.

- wolf

 

[cubby1223]

I still don't "get it"

How does this bill save money? Taxing more than it spends is *not* savings. It's taxing.

Why don't the Dems just add on another 1% tax on everything, then they can claim their health care plan is saving $2 trillion!

And even what they are taxing in this plan, doesn't make any damn sense. They're taxing insurance companies and drug companies and medical supplies makers. Many of the taxes they are using to fund this legislation, will be directly increasing the cost of health care! So what is the point? The bill is self-defeating from the get-go!

 

[boomerang]

I still don't "get it"

How does this bill save money? Taxing more than it spends is *not* savings. It's taxing.

Why don't the Dems just add on another 1% tax on everything, then they can claim their health care plan is saving $2 trillion!

And even what they are taxing in this plan, doesn't make any damn sense. They're taxing insurance companies and drug companies and medical supplies makers. Many of the taxes they are using to fund this legislation, will be directly increasing the cost of health care! So what is the point? The bill is self-defeating from the get-go!

Many of us have been trying to get the point across for the last year that the primary reason for this bill is not health care, it's control and power.

"We're Going To Control The Insurance Companies" Once again, Joe Biden lets the cat out of the bag.

 

[Fern]

The reason I am frustrated is because this allegation was made months ago when the CBO reports came out for the Senate bill which ultimately passed on Christmas eve, and I linked the CBO reports at the time. There have been many iterations of this bill, and multiple CBO reports, with corrections, etc. for each iteration. The fact is, in every version, the pattern of revenue inflow and outflow is very similar, with only small differences in individual numbers. In every version, the taxes are backloaded toward the end of the decade and the bill is shown to run a slight deficit early and reduce the deficit much later, precisely because the taxes are so back loaded. It is really very much the reverse of what is being alleged.

- wolf

The existing Senate version has taxes frontloaded. This can be confirmed by looking at the Dem reconcilliation fix published just a few days ago; a lot of the Revenue section is them "striking after 2010 and inserting after 2014". I'm not sure what interations you're referring to, the details of the bill seem to have been unknown for quite sometime. IIRC, Obama himself said he didn't know what was in it during the interview.

I'm gonna go ahead and say I still don't think we know what's exactly in the bill to be voted on tomorrow, looked to me like a lot of work being done today by the Dems in Congress. Pelosi was right, we'll only know what's in after it passes.

BTW: I think it's a shrewd maneuever to frontload some bennies and backload taxes. Looks like they made up for the cost problem by throwing student loans in it and coming up with some extra revenue to pad the numbers.

Fern

 

[piasabird]

One problem we have in the USA is we have no national standards for health insurance and no national standards for licensing doctors. Every state has their own standard. So doctors and insurance companies move easily from state to state if they get in trouble.

 

[Fern]

One problem we have in the USA is we have no national standards for health insurance and no national standards for licensing doctors. Every state has their own standard. So doctors and insurance companies move easily from state to state if they get in trouble.

That's true.

I don't see how their profession can get away with it. They need to brought into modern times.

Well, maybe they're not 'getting away with it'. Once they figure their lack of standards opens them to lawsuits they'll reform.

Fern

 

[Carmen813]

That's true.

I don't see how their profession can get away with it. They need to brought into modern times.

Well, maybe they're not 'getting away with it'. Once they figure their lack of standards opens them to lawsuits they'll reform.

Fern

It's like this for mental health professionals as well. In fact, one state doesn't even have Mental Health Counselor licensing. It's part of the problem my profession faces.