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Wednesday, August 01, 2012

OTP- August 2012: The Leader Post: New stadium won’t have same appeal, says Bill ‘Spaceman’ Lee

“Building a new stadium down the street does not work unless (Ron) Lancaster spilled some DNA in the lot where they’re going to build the new stadium,” he added. “You have to refurbish (Mosaic Stadium). You’ve got to can all new ideas you might have and use the sacred ground. Fenway did that and that is why Fenway is loved. The new Yankee Stadium isn’t the same as it used to be.”

The former Boston Red Sox and Montreal Expos pitcher will not be running for the vacant mayor’s position in Regina later this year. With his opinion on the new stadium, he wasn’t sure he would garner many votes anyway. But that is nothing new to the former member of the Rhinoceros Party. Lee ran on the Rhino ticket in 1988 for president of the United States. Not surprisingly, he didn’t make the ballot in a single state. He said one of the high-ranking members within the party gave him a six-pack of Molson Canadian and asked him to run for president.

“I adhered to their funny philosophy,” Lee said. “My campaign slogan was ‘No guns, no butter. They’ll both kill you.’ And I only campaigned in federal prisons where I knew they couldn’t vote, and I only accepted a quarter in campaign contributions.”

With it being an election year in the U.S., Lee said he is all in for the re-election of Barack Obama.

“The only time (Mitt) Romney opens his mouth is when he needs to change feet,” Lee said of the Republican nominee. “If Obama does lose this, which I can’t see happening, then it’s because of a lady in Florida who works for Jeb Bush and Diebold, the voting-machine company. If Obama even comes close to losing this election, it’ll be fraud.”

Guess what, its the new OT politics thread!

Tripon Posted: August 01, 2012 at 12:04 AM | 5975 comment(s) Login to Bookmark
  Tags: boston, politics

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   1901. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 05:01 PM (#4207476)
Since when does a person who pays $0 into Social Security "get the same benefit" as someone who pays into the system all his life? You don't seem to understand how S.S. works.


OK, now that's real trollish behavior.*

I apologize to everyone for bringing us down this irrelevant tangent by mentioning payroll taxes. Like most conversations with Joe, he'll ignore 95% of an argument, and latch on to the 5% he thinks he can make some points in, and then continues to lie and obfuscate until 200 posts later, everyone has forgotten what the real point is. So I'll try to go back to where it was more interesting.

From #1851 (Joe's is first, my response in italics)

This seems like class warfare for class warfare's sake. If the notion of rich people living off investments is so offensive, liberals should be arguing for a huge estate tax rather than arguing for higher taxation of investment.



Income is income. I don't see why it should be taxed differently. I just don't see any public good in having one guy making $10,000/month by working 60 hours a week pay income, social security, and medicare taxes while another makes $10,000/month collecting a dividend check pays nothing.


edit: * And before you pretend to get all indignant and pretend to not know what I'm talking about, it's trollish because I was specifically taking not about SS but Medicare, as evidenced by the quote which you omitted.
   1902. zonk Posted: August 13, 2012 at 05:02 PM (#4207477)
And you believe Obamacare's magical system of continually reducing reimbursement rates will solve this?

Arguing about universal coverage is one thing, but a person has to live in fantasyland to believe Obamacare is going to provide more coverage to more people at less cost. It's a pipe dream.



Ummm.... can you show exactly where there is in Obamacare? I'm pretty familiar with the legislation and I'm afraid I've missed this part.

To the best of my knowledge, 'Obamacare' says exactly zilch about reimbursement rates. The only rates it cares about about the insurer's MLRs...


Oh wait, I found it... It's in the same subtitle that established the death panels!
   1903. Joe Kehoskie Posted: August 13, 2012 at 05:05 PM (#4207481)
To the best of my knowledge, 'Obamacare' says exactly zilch about reimbursement rates. The only rates it cares about about the insurer's MLRs...

LOL. How could Obamacare even operate without a system for setting reimbursement rates? Obamacare leaves both the Medicare reimbursement rates in place and tasks IPAB with containing costs.
   1904. zonk Posted: August 13, 2012 at 05:11 PM (#4207485)
LOL. How could Obamacare even operate without a system for setting reimbursement rates? Obamacare leaves both the Medicare reimbursement rates in place and tasks IPAB with containing costs.


It might help here if you explain to me whether we're talking Medicare and specifically, the provisions impacting Medicare or 'Obamacare' generally... The preponderance of 'Obamacare' deals with insurance and insurance access to people ineligible for Medicare. In that realm, 'Obamacare' has very little to say about rates, reimbursement, and actually -- care itself (except for the minimum coverage requirements that translate to care).

You have a habit of moving the goalposts and conflating things when it suits the argument -- so here, we're talking solely about Medicare alone, right?
   1905. Joe Kehoskie Posted: August 13, 2012 at 05:12 PM (#4207486)
OK, now that's real trollish behavior.*

[...]

edit: * And before you pretend to get all indignant and pretend to not know what I'm talking about, it's trollish because I was specifically taking not about SS but Medicare, as evidenced by the quote which you omitted.

What the hell are you talking about? A person who never paid payroll taxes and has substantial income doesn't get Medicare for free; he/she might be qualified to buy Part A coverage. Whether talking about S.S. or Medicare, you were wrong either way.
   1906. Joe Kehoskie Posted: August 13, 2012 at 05:18 PM (#4207491)
You have a habit of moving the goalposts and conflating things when it suits the argument -- so here, we're talking solely about Medicare alone, right?

I'm not moving anything. You and a couple others are claiming Obamacare will address the cost-side problem with healthcare. How will Obamacare do this without a system for setting reimbursement rates? Did the mere passage of Obamacare magically put downward pressure on healthcare costs?
   1907. zonk Posted: August 13, 2012 at 05:20 PM (#4207494)

What the hell are you talking about? A person who never paid payroll taxes and has substantial income doesn't get Medicare for free; he/she might be qualified to buy Part A coverage.


Ummm... no - see 42 CFR Part 406 --

These are the sole exclusions to Part A eligibility (42 CFR 406.11):

(1) Has been convicted of spying, sabotage, or treason, sedition, and subversive action under chapter 37, 105, or 115 of title 18 of the United States Code;

(2) Has been convicted of conspiracy to establish a dictatorship under section 4 of the Internal Security Act of 1950;

(3) On February 16, 1965, was or could have been covered under the Federal Employees Health Benefits Act (FEHBA) of 1959; or

(4) In his or her first month of eligibility;

(i) Is covered by an enrollment under the FEHBA; or

(ii)Could have been covered by an enrollment under that Act if he or she (or any other person who could provide him or her with coverage) was a Federal employee at any time after February 15, 1965, and had enrolled and retained coverage under that Act.
   1908. Joe Kehoskie Posted: August 13, 2012 at 05:28 PM (#4207500)
Ummm... no - see 42 CFR Part 406 --

These are the sole exclusions to Part A eligibility (42 CFR 406.11):

The Medicare eligibility tool plainly asks if a person has "worked 10 years or more in Medicare-covered employment (i.e., paid FICA / Social Security taxes)" and also asks about income, etc.

A person who never paid payroll taxes doesn't "get the same benefit as someone who paid into the system his whole life," as 'Misirlou' claimed.
   1909. zonk Posted: August 13, 2012 at 05:28 PM (#4207501)

I'm not moving anything. You and a couple others are claiming Obamacare will address the cost-side problem with healthcare costs. How will Obamacare do this without a system for setting reimbursement rates? Did the mere passage of Obamacare magically put downward pressure on healthcare costs?


If you're not going to accept the fundamental fact that health care coverage is different for those under 65 vs. those 65 and over, then we're not going to get anywhere...

The coverage solution is already in place for those over 65. It's called Medicare. It does have cost control issues, something that various provisions in the 'Obamacare' took another whack at, but yes - I'm skeptical that the IPAB will have much success just like the '97 BBA which switched from using one formula (MVPS) to another (SGR) simply gets overriden every year by Congress, both Democratic and Republican.

Obamacare's solution for those under 65 is forced insurance buy-in, together with extensive restrictions on insurance discriminatory practices, etc.

You seem to be ignoring the difference between Medicare -- a public insurance program, and the existence of the private insurance market for everyone not eligible for Medicare (or Medicaid, I suppose).

Your argument would only be valid if 'Obamacare' had basically been an 'early Medicare buy-in' option -- something plenty of folks, especially on the left, only wish it could have been.
   1910. zonk Posted: August 13, 2012 at 05:33 PM (#4207503)

Nonsense. The Medicare eligibility tool plainly asks if a person has "worked 10 years or more in Medicare-covered employment (i.e., paid FICA / Social Security taxes)" and also asks about income, etc.

A person who never paid payroll taxes doesn't "get the same benefit as someone who paid into the system his whole life," as 'Misirlou' claimed.


Apparently, we need a quick refresher on the difference between Medicare Part A and Medicare Part B... the eligibility tool you link to is for Part B eligibility.

You might notice that no matter what you plug into the tool -- the answer starts with something like this:


Enrolling in Part B
Medicare Part B helps cover your doctors' services, outpatient hospital care, and some other medical services that Medicare Part A doesn't cover, such as some of the services of physical and occupational therapists, and some home health care. Medicare Part B helps pay for these covered services and supplies when they are medically necessary.


Go ahead and plug whatever criteria you like into the tool -- let me know when you get a result that states you aren't eligible for Part A.
   1911. Joe Kehoskie Posted: August 13, 2012 at 05:35 PM (#4207506)
The coverage solution is already in place for those over 65. It's called Medicare. It does have cost control issues, something that various provisions in the 'Obamacare' took another whack at, but yes - I'm skeptical that the IPAB will have much success just like the '97 BBA which switched from using one formula (MVPS) to another (SGR) simply gets overriden every year by Congress, both Democratic and Republican.

Obamacare's solution for those under 65 is forced insurance buy-in, together with extensive restrictions on insurance discriminatory practices, etc.

Ah, so the same fundamental cost-side problems facing the Medicare program will magically disappear under Obamacare?

Obamacare's "forced insurance buy-in" simply gives everyone access to coverage. It most certainly will not result in more people getting more medical coverage for less cost.
   1912. Joe Kehoskie Posted: August 13, 2012 at 05:38 PM (#4207509)
Apparently, we need a quick refresher on the difference between Medicare Part A and Medicare Part B... the eligibility tool you link to is for Part B eligibility.

You're just making things up now. This is straight from Medicare.gov:

Who is Eligible for Medicare?

Generally, you are eligible for Medicare if you or your spouse worked for at least 10 years in Medicare-covered employment and you are 65 years or older and a citizen or permanent resident of the United States. If you aren’t yet 65, you might also qualify for coverage if you have a disability or with End-Stage Renal disease (permanent kidney failure requiring dialysis or transplant).

Here are some simple guidelines. You can get Part A at age 65 without having to pay premiums if:

You already get retirement benefits from Social Security or the Railroad Retirement Board.

You are eligible to get Social Security or Railroad benefits but haven't yet filed for them.

Under what reading of this does a person who paid $0 into the program "get the same benefits as someone who paid into the system his whole life"?

Here's the "Quick Estimate of Your Eligibility and Enrollment" tool:

Get a Quick Estimate of Your Eligibility and Enrollment Date

This calculator will provide you with the dates that you'll be eligible to enroll in Medicare. If you're over 65 and/or already enrolled in Medicare, please contact Social Security at 1-800-772-1213 for more information about your Medicare eligibility.

The information you share is confidential. We won't save or share it.

Required Questions
1. Please enter your date of birth:
2. Have you worked 10 years or more in Medicare covered employment (i.e. paid FICA taxes)? (If you are not sure, please refer to your Social Security statement or visit the Social Security calculator.)
3. Are you a U.S. citizen or have you been a legal resident of the U.S. for at least 5 years?


Why would it ask for 10 years of Medicare-covered employment if all comers age 65 and older are entitled to coverage?
   1913. McCoy Posted: August 13, 2012 at 05:39 PM (#4207511)
Go ahead and plug whatever criteria you like into the tool -- let me know when you get a result that states you aren't eligible for Part A.

Grabs some popcorns and sits down. This should be interesting.
   1914. McCoy Posted: August 13, 2012 at 05:43 PM (#4207516)
Who is eligible for Medicare


What it actually says, not the Joe version:

Generally, Medicare is available for people age 65 or older, younger people with disabilities and people with End Stage Renal Disease (permanent kidney failure requiring dialysis or transplant). Medicare has two parts, Part A (Hospital Insurance) and Part B (Medical Insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. You can get Part A at age 65 without having to pay premiums if:
You are receiving retirement benefits from Social Security or the Railroad Retirement Board. You are eligible to receive Social Security or Railroad benefits but you have not yet filed for them. You or your spouse had Medicare-covered government employment.
If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:
You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.) You are a kidney dialysis or kidney transplant patient.
While most people do not have to pay a premium for Part A, everyone must pay for Part B if they want it. This monthly premium is deducted from your Social Security, Railroad Retirement, or Civil Service Retirement check. If you do not get any of these payments, Medicare sends you a bill for your Part B premium every 3 months.
   1915. Joe Kehoskie Posted: August 13, 2012 at 05:47 PM (#4207519)
What it actually says, not the Joe version:

Once again, McCoy posts something that bolsters the other person's point and then claims it's a "gotcha" ...

You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.

[...]

While most people do not have to pay a premium for Part A,

Um, this has been my point all along. You get premium-free Medicare if you paid payroll taxes for at least 10 years. If you didn't pay payroll taxes, such as 'Misirlou's hypothetical person whose income was always derived from interest/capital gains, you have to pay a premium. (Note the last sentence of the quote says that "most people" don't have to pay a premium for Part A, not no people.)
   1916. zonk Posted: August 13, 2012 at 05:48 PM (#4207521)
Ah, so the same fundamental cost-side problems facing the Medicare program will magically disappear under Obamacare?


That depends on whether future congresses will ever have the stones to stand-up to the AMA and AHA. As I said, I have my doubts. However - even if the IPAB does nothing, there ARE two big provisions that WILL save Medicare money even if Congress tells the IPAB to take a hike annually... namely:

1) The reduction in "charity care" payments -- few people realize this, but those 'EMTALA' cases? Medicare actually subsidized this. Medicare reimbursement isn't flat fee -- rather, it's a series of formulas that combine a large number of factors. One of these factors was the volume of 'uninsured' patients a provider treated -- meet a certain threshold, and you got higher reimbursement rates. These rates were radically slashed by Obamacare because in theory, providers will be treating few 'charity care' cases. This is part of the law and will lead to direct savings.

2) Significant reduction in 'Medicare+/MedicareChoice/MedicareAdvantage' (how many times has that been rebranded?) subsidies to private insurance carriers. This was always nothing but a sop to the private insurers anyway -- a way for them to sell to a lucrative market that was largely out of their reach with Uncle Sam footing the actual coverage bill... Again - this is part of the law and leads to direct savings.

Medicare will see savings from Obamacare regardless of whether the IPAB recommendations get accepted by Congress or not.

Obamacare's "forced insurance buy-in" simply gives everyone access to coverage. It most certainly will not result in more people getting more medical coverage for less cost.


It simply does what any insurance scheme - public or private - does... Some people will pay X in insurance costs, but get X + Y in benefits back, others will pay X, but actually get X - Y back in benefits. Since we already established the principle of 'forced care' under Ronald Reagan (i.e., EMTALA), the theory behind Obamacare is simply that whereas providers collectively had to provide care to everyone regardless of ability to pay (whether out of pocket or through their insurance), now "everyone" (accepting that the coverage rate still wouldn't hit 100%) will theoretically have the ability to pay (because "everyone" will have insurance).

In theory, that should smooth out the costs for everyone because the system won't be covering any freeriders.
   1917. Joe Kehoskie Posted: August 13, 2012 at 05:57 PM (#4207526)
That depends on whether future congresses will ever have the stones to stand-up to the AMA and AHA.

LOL. You mean by imposing draconian pay caps on doctors?

This is part of the law and will lead to direct savings.

It's a part of the law just like the Medicare caps are part of the law — and, of course, are waived annually.

In theory, that should smooth out the costs for everyone because the system won't be covering any freeriders.

The idea that Obamacare will result in huge EMTALA savings is just fantasy. Given the choice between paying $10,000 for health insurance under Obamacare or paying the $700 penalty and continuing to use emergency rooms at will, I'm guessing millions of young people and 12 million illegal immigrants will continue operating under the status quo ante. Frankly, they'd be idiots not to.
   1918. McCoy Posted: August 13, 2012 at 05:58 PM (#4207528)
I didn't claim anything as a gotcha.
   1919. Der-K, the bloodied charmer Posted: August 13, 2012 at 06:07 PM (#4207534)
For what it's worth, this discussion involves my industry and, while I'm not willing to discuss it here, zonk has (IMO) the best handle on cost of healthcare fundamentals on the board.
   1920. Joe Kehoskie Posted: August 13, 2012 at 06:13 PM (#4207537)
I didn't claim anything as a gotcha.

No? You posted #1914 as a rebuttal to the "Joe version" of Medicare. Which part of the "Joe version" of Medicare in #1905 or #1908 proved inaccurate?
   1921. Der-K, the bloodied charmer Posted: August 13, 2012 at 06:13 PM (#4207538)
That said I have definite reservations about how o-care was designed and will be implemented.
   1922. tshipman Posted: August 13, 2012 at 06:14 PM (#4207540)
Given the choice between paying $10,000 for health insurance under Obamacare or paying the $700 penalty and continuing to use emergency rooms at will, I'm guessing millions of young people and 12 million illegal immigrants will continue operating under the status quo ante.


Almost no one will be paying $10,000 for health insurance under Obamacare.

For instance, at 150 percent of FPL in 2014, ObamaCare limits the amount that such households must contribute toward their health insurance premium to 4 percent of their annual income. At 400 percent of the FPL, households must contribute 9.5 percent of their income toward insurance premiums.


The Federal Poverty line is $11,170. For someone making four times the FPL, the max they will pay for health insurance is $4,244.60 per year in 2012 dollars ($353 per month or $163.25 per two-week pay period). Also, they get health insurance for that amount.

Someone making $16,755 (150% of the FPL), is limited to paying $55 per month or $670.20 per year. Seems a pretty clear choice, in my opinion. Side note: I'm using a single person, because that's what I think Joe is implying by "millions of young people." The math breaks down even easier for someone with kids or a spouse due to the way the FPL is calculated.

Edit: For someone to pay 10,000 per year for insurance, you would need to have a household of 5 and make $108,040 per year. I don't think if you make more than 100K, you're skipping health insurance.
   1923. STEAGLES is all out of bubblegum Posted: August 13, 2012 at 06:19 PM (#4207541)
LOL. You mean by imposing draconian pay caps on doctors?
i posted this a few pages back, but i think it's worth reposting as a means of furthering this conversation:
also, one thing i'm curious about w/r/t a true universal healthcare environment is the effect it would have on medical malpractice insurance. if all healthcare costs were paid for by the government, wouldn't that significantly limit the long-term liabilities for doctors when an accident occurs, and results in serious medical complications?


   1924. Joe Kehoskie Posted: August 13, 2012 at 06:24 PM (#4207544)
Someone making $16,755 (150% of the FPL), is limited to paying $55 per month or $670.20 per year. Seems a pretty clear choice, in my opinion.

Yeah, it's a pretty clear choice because the alternative is to pay the $700 penalty for no coverage. But I wasn't talking about people at close to the poverty line ...

Side note: I'm using a single person, because that's what I think Joe is implying by "millions of young people."

When Obamacare was being debated, the general claim was that a third of the uninsured were mostly young, healthy people who could afford heath insurance but chose not to buy it. Obamacare does almost nothing to bring those people into the system. No healthy person in his or her right mind is going to pay thousands of dollars for health insurance when they can simply pay a $700 penalty each year and then use the EMTALA safety net and/or buy "insurance" after they get sick (since preexisting conditions will no longer prevent a person from obtaining "insurance").
   1925. tshipman Posted: August 13, 2012 at 06:34 PM (#4207552)
Yeah, it's a pretty clear choice because the alternative is to pay the $700 penalty for no coverage.

When Obamacare was being debated, the general claim was that a third of the uninsured were people who could afford heath insurance but chose not to buy it. Obamacare does almost nothing to bring those people into the system. No healthy person in his or her right mind is going to pay thousands of dollars for health insurance when they can simply pay a $700 penalty each year and then use the EMTALA safety net and/or buy "insurance" after they get sick (since preexisting conditions will no longer prevent a person from obtaining "insurance").


Okay, Joe. This is a good example of why people find it frustrating to argue with you. You're moving the goalposts significantly.

First you stated that the choice was $10,000 for coverage or $700 for a fine. This, I think I demonstrated in 1922, is not the actual choice.

In general, the choice for someone making 16K is $670.20 for coverage or $700 for a fine. I think that one's pretty easy to say is a win for coverage.

Someone at 200% of the FPL ($22,340) can choose between $1,407.42 for coverage or $700 for a fine. This one is a bit trickier. I still think this is an easy win for coverage, as that is approx $54.13 from your pay check (if you get paid every 2 weeks). I think most people value insurance at that rate.

Someone at 250% of the FPL ($27,925) can choose between $2,247.96 for coverage or $700 for a fine. This breaks down to $86.46 per paycheck. Again, I think most people go for the coverage.

Someone at 300% of the FPL ($33,510) can choose between $3,183.45 for coverage or $700 for a fine. This starts to get steeper at $122 per paycheck. I still think most people go for the coverage, though.


At what point do you think that people prefer to deal with the risk of medical bankruptcy and endless collections calls?
   1926. McCoy Posted: August 13, 2012 at 06:41 PM (#4207556)
Re 1920

It was the entire answer from medicare.
   1927. PreservedFish Posted: August 13, 2012 at 06:42 PM (#4207557)
Someone at 200% of the FPL ($22,340) can choose between $1,407.42 for coverage or $700 for a fine. This one is a bit trickier. I still think this is an easy win for coverage, as that is approx $54.13 from your pay check (if you get paid every 2 weeks). I think most people value insurance at that rate.


As someone that lives in a city full of check cashing stores, I wonder if this is true.
   1928. Joe Kehoskie Posted: August 13, 2012 at 06:51 PM (#4207568)
Okay, Joe. This is a good example of why people find it frustrating to argue with you. You're moving the goalposts significantly.

I didn't move the goalposts one inch.

First you stated that the choice was $10,000 for coverage or $700 for a fine. This, I think I demonstrated in 1922, is not the actual choice.

A run-of-the mill insurance policy for a single person in New York is around $7,000. A family plan is over $20,000. I simply don't believe that comparable plans will magically be available in the exchanges for $1,500 or $2,200 per year. The math simply doesn't add up.

In general, the choice for someone making 16K is $670.20 for coverage or $700 for a fine. I think that one's pretty easy to say is a win for coverage.

Someone at 200% of the FPL ($22,340) can choose between $1,407.42 for coverage or $700 for a fine. This one is a bit trickier. I still think this is an easy win for coverage, as that is approx $54.13 from your pay check (if you get paid every 2 weeks). I think most people value insurance at that rate.

Someone at 250% of the FPL ($27,925) can choose between $2,247.96 for coverage or $700 for a fine. This breaks down to $86.46 per paycheck. Again, I think most people go for the coverage.

Someone at 300% of the FPL ($33,510) can choose between $3,183.45 for coverage or $700 for a fine. This starts to get steeper at $122 per paycheck. I still think most people go for the coverage, though.

Why are you using such low incomes? There are millions of healthy people who make good money and gamble by going without health insurance. Those people have no reason to pay thousands of dollars for Obamacare when they can simply wait until after they're sick to get "insurance."

At what point do you think that people prefer to deal with the risk of medical bankruptcy and endless collections calls?

Apparently, that point is at roughly $1,000 per year, since we know (1) a third of the uninsured, as of 2010, could afford a full health insurance policy but chose not to buy it, and (2) all of those people could have bought a catastrophic-care policy for that $1,000 or less per year but chose to risk it. Obamacare makes it even easier for these people to risk it, since EMTALA still covers emergencies, and preexisting conditions won't prevent people from getting "insurance" after they get sick.
   1929. SteveF Posted: August 13, 2012 at 06:57 PM (#4207571)
Apparently, that point is at roughly $1,000 per year,


So what would you suggest be done differently? Is the penalty simply not high enough? Should the penalty be raised to $1000 a year? The government could, in theory, just take the $1000 and buy him/her a catastrophic care policy.
   1930. tshipman Posted: August 13, 2012 at 06:59 PM (#4207573)
I didn't move the goalposts one inch.


First you stated that the choice was $10,000 for coverage or $700 for a fine. This, I think I demonstrated in 1922, is not the actual choice.


So are people paying 10K or not?

First of all, why are you using such low incomes? There are millions of healthy people who make good money and gamble by going without health insurance. Those people have no reason to pay thousands of dollars for Obamacare when they can simply wait until after they're sick to get "insurance."


Well, because the assumption is that any single person who makes more than 400% of the FPL ($44,680), is extremely likely to have health insurance mostly or partly subsidized by their employer. There are not too many jobs where someone makes more than $21.00 per hour and doesn't have any health insurance. What are these jobs that pay $25.00 per hour with no medical benefits?

Edit: please also note that any business with more than 50 employees will be required to offer health insurance or pay a fine.

Obamacare makes it even easier for these people to risk it, since EMTALA still covers emergencies, and preexisting conditions won't prevent people from getting "insurance" after they get sick.


This assumes that:
a. People behave perfectly rationally.
b. People place zero value on avoiding medical bankruptcy
c. People have comprehensive information on these options.

I think all of these are spectacularly poor assumptions.
   1931. Joe Kehoskie Posted: August 13, 2012 at 07:08 PM (#4207582)
So what would you suggest be done differently? Is the penalty simply not high enough? Should the penalty be raised to $1000 a year? The government could, in theory, just take the $1000 and buy him/her a catastrophic care policy.

The only way Obamacare would work the way Shipman, zonk, et al., claim it will work is if the penalty truly acts as a penalty. If the choice is to pay $670 for insurance or a $700 penalty, then only a fool would forgo the insurance. But if the choice is to pay $2,000 or $5,000 or $10,000 for insurance or pay a $700 penalty, a large percentage of the healthy people who currently forgo insurance will continue to forgo insurance, especially since the biggest risk of not having insurance — a preexisting condition — will disappear under Obamacare.

If your choice is to buy car insurance for $300 or pay a $700 penalty, you buy the insurance. But if the choice is to pay $5,000 for insurance or pay a $700 penalty, knowing full well that you can buy "insurance" after your car is totaled, then only a fool would pay the $5,000.
   1932. SteveF Posted: August 13, 2012 at 07:15 PM (#4207584)
Well, the issue is what is the expected value of the services provided to a person for that $700 penalty, right? The issue is to get that number right. You just seemed to suggest the number was $1000 based on the price for catastrophic coverage.

This sets aside the idea that health care costs as a whole might be reduced if the emergency room stopped being people's primary care. You see some movement by the free market to try and fill that gap (e.g. Walmart).
   1933. Matt Clement of Alexandria Posted: August 13, 2012 at 07:19 PM (#4207586)
The individual mandate has been tested. In Massachusetts, the penalties are actually even lower than nationally.

Austin Frakt: The Individual Mandate is Working
The individual mandate is working in Massachusetts because it is preventing a destabilizing level of adverse selection. Although there are individuals gaming the system in the state—by waiting to purchase insurance until they need it--the overall coverage rate is high (about 96% insured) and the associated degree of adverse selection is very low.

In a recent report released by the Massachusetts Division of Insurance, actuaries estimated that part-year insurance purchasing in Massachusetts' combined individual and small group market increased premiums by 0.5 percent to 1.5 percent. Based on an average individual premium in Massachusetts of about $5,000 per year, that translates into an annual premium increase of $25 to $75, far too low to have a major impact on the market. Insurance companies can pass that level of premium increase on to consumers without many of them dropping coverage.

This is good news for Massachusetts and for the country. The penalty for lack of compliance with the state’s mandate is slightly lower on average than what the fully phased-in penalties will be (in 2016) under the new national health reform law. (I've estimated them to be about $674 per person per year under the national law and $537 under Massachusetts law.) Thus, all else being equal, individual mandate compliance ought to be at least as high under the new law as it is in Massachusetts. The results seen in the state imply that little gaming should be expected nationally.
Frakt notes that it is possible that compliance will be lower in other states, and one positive test is not determinative, but this is not simply a theoretical question, as Joe has approached it to be. The mandate was tried, and it's working.
   1934. Joe Kehoskie Posted: August 13, 2012 at 07:21 PM (#4207589)
So are people paying 10K or not?

Some people are, sure. I just got quoted $7,000/year as a healthy non-smoker in New York.

Well, because the assumption is that any single person who makes more than 400% of the FPL ($44,680), is extremely likely to have health insurance mostly or partly subsidized by their employer. There are not too many jobs where someone makes more than $21.00 per hour and doesn't have any health insurance. What are these jobs that pay $25.00 per hour with no medical benefits?

There aren't? There are millions of self-employed people in the U.S. and millions more who work for small firms that don't offer benefits.

This assumes that:
a. People behave perfectly rationally.
b. People place zero value on avoiding medical bankruptcy
c. People have comprehensive information on these options.

I think all of these are spectacularly poor assumptions.

Then how do you explain the estimated 10 million people, as of 2010, who could afford health insurance but chose not to buy it? Given that catastrophic-care policies have been available for $1,000/year or less for decades, why would anyone above the poverty line not have had insurance as of 2010?
   1935. tshipman Posted: August 13, 2012 at 07:27 PM (#4207591)
The only way Obamacare would work the way Shipman, zonk, et al., claim it will work is if the penalty truly acts as a penalty. If the choice is to pay $670 for insurance or a $700 penalty, then only a fool would forgo the insurance.


Again, this is not how I claim it will work, but how the law is actually written.

But if the choice is to pay $2,000 or $5,000 or $10,000 for insurance or pay a $700 penalty, a large percentage of the healthy people who currently forgo insurance will continue to forgo insurance, especially since the biggest risk of not having insurance — a preexisting condition — will disappear under Obamacare.


So, again, given that all business of more than 50 employees are now going to be required to pay for health insurance (to some extent) or pay a fine, the amount of people who will pay $10,000 per year will be vanishingly small and only impact people making more than $45K as a single person or more than $60-100K as someone with dependents. These are not the people who are struggling to pay for health insurance.
   1936. tshipman Posted: August 13, 2012 at 07:38 PM (#4207595)
Some people are, sure. I just got quoted $7,000/year as a healthy non-smoker in New York.


Good news! If you make less than $44K, you're eligible to receive a subsidy in the exchanges starting in 2014. Also, you can purchase your insurance on the health care exchanges rather than on the individual market, likely resulting in a savings from risk pooling effects!

There aren't? There are millions of self-employed people in the U.S. and millions more who work for small firms that don't offer benefits.


Good news!
Two years of tax credits will be offered to qualified small businesses. In order to receive the full benefit of a 50% premium subsidy, the small business must have an average payroll per full-time equivalent ("FTE") employee, excluding the owner of the business, of less than $25,000 and have fewer than 11 FTEs. The subsidy is reduced by 6.7% per additional employee and 4% per additional $1,000 of average compensation. As an example, a 16 FTE firm with a $35,000 average salary would be entitled to a 10% premium subsidy


This means that for a small business owner who is a single operator, if you make less than $50k per year, you get a subsidy for the cost of health insurance!

Who runs a small business making more than 50K (and is single) who doesn't have health insurance? Even still--good news as you can still purchase insurance via the exchanges rather than on the market for individuals.

Then how do you explain the estimated 10 million people, as of 2010, who could afford health insurance but chose not to buy it? Given that catastrophic-care policies have been available for $1,000/year or less for decades, why would anyone above the poverty line not have had insurance as of 2010?


According to this study:

88.76% of those making more than 375% of the FPL owned private insurance (compare this to just 35% of those at 125% of the FPL or below). While there are some people who can undoubtedly afford to purchase insurance and do not, they appear to be a minority. In addition, the fine makes it more likely that they will purchase insurance. In Massachusetts for example, the insured rate for the population as a whole is 95% or greater.

So, good news is, of those purported 10 million people, with the passage and implementation of PPACA, their ranks will be cut by more than half!
   1937. Joe Kehoskie Posted: August 13, 2012 at 07:45 PM (#4207596)
So, again, given that all business of more than 50 employees are now going to be required to pay for health insurance (to some extent) or pay a fine, the amount of people who will pay $10,000 per year will be vanishingly small and only impact people making more than $45K as a single person or more than $60-100K as someone with dependents. These are not the people who are struggling to pay for health insurance.

The issue isn't whether they're "struggling" to pay for health insurance, the issue is whether they're willing to pay for health insurance.

According to the CBO (not one of my favorites, but I know you feel otherwise), 47 million people went without health insurance for some or all of 2006. 18 million people (38 percent) made more than $50,000 per year, 10 million of whom made more than $75,000. If these people didn't want to pay even $1,000/year for a catastrophic-care plan, why will they suddenly want to pay $3,000 or $5,000 or more for Obamacare?
   1938. tshipman Posted: August 13, 2012 at 07:59 PM (#4207604)
According to the CBO (not one of my favorites, but I know you feel otherwise), 47 million people went without health insurance for some or all of 2006. 18 million people (38 percent) made more than $50,000 per year, 10 million of whom made more than $75,000. If these people didn't want to pay even $1,000/year for a catastrophic-care plan, why will they suddenly want to pay $3,000 or $5,000 or more for Obamacare?


Good news! We have a test case. The exact same policy was implemented in Massachusetts. The rate of people not purchasing insurance dropped precipitously. Fewer than 2% of the population, in fact.

Why will they suddenly want to pay for insurance now? Because the cost of not paying for it has gone up!
   1939. Joe Kehoskie Posted: August 13, 2012 at 08:28 PM (#4207612)
Good news! We have a test case. The exact same policy was implemented in Massachusetts. The rate of people not purchasing insurance dropped precipitously. Fewer than 2% of the population, in fact.

The rate of people not having insurance clearly dropped, but it's less clear that the rate of people not "purchasing" insurance dropped by a significant amount. From the data I've seen, Massachusetts went from 90 percent insured to 95 percent insured, with a majority of the increase coming not from people who went out and bought insurance but from people who enrolled in Medicaid or became qualified for state-subsidized plans because the eligibility thresholds were lowered. The latter apparently got so costly that some immigrants were summarily dumped from the program in 2009.
   1940. booond Posted: August 13, 2012 at 08:39 PM (#4207614)
From the data I've seen, Massachusetts went from 90 percent insured to 95 percent insured, with a majority of the increase coming not from people who went out and bought insurance but from people who enrolled in Medicaid or became qualified for state-subsidized plans because the eligibility thresholds were lowered.


Link please.
   1941. McCoy Posted: August 13, 2012 at 08:41 PM (#4207617)
Link please.

Keep dreaming,
   1942. Jay Z Posted: August 13, 2012 at 09:00 PM (#4207624)
Having thought about it for a day, this discussion makes apparent what a blunder the Ryan pick is.

Why does Romney want to base his campaign on Medicare elimination? Why would that work any better than Bush's grand tour on the SSI individual accounts, or Obamacare, which was passed but was a compromise and still at considerable political cost? And those were both done POST election and they still met a lot of resistence? Who ties themselves to such specific proposals before an election?

Ryan's sole issue of note is the budget. He has too many proposals, and the show vote on the 2011 budget that meant nothing. He has no plausible deniability. How is he going to explain the need to propose a system where medicare is eliminated so we can have a 0% capital gains tax, which even Romney has derided. But if Romney isn't going to use Ryan's plans, then why is Ryan on the ticket?

The dems don't have to point to Ryan. They can ask Romney about his budget, insinuating that the worst part's of Ryan's plans are going to be Romney's, and forcing Romney to repudiate. Why do you want to waste campaign time on this?

Ryan is a capable if hypocritical pol and no moron. He is just a really poor fit for the job at hand.
   1943. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 09:20 PM (#4207631)
Well, I said I wasn't going to discuss it anymore, but after returning from football practice and seeing that the subject hasn't gone away...

Joe:

Um, this has been my point all along. You get premium-free Medicare if you paid payroll taxes for at least 10 years. If you didn't pay payroll taxes, such as 'Misirlou's hypothetical person whose income was always derived from interest/capital gains, you have to pay a premium. (Note the last sentence of the quote says that "most people" don't have to pay a premium for Part A, not no people.)


I didn't know about the 10 years to be vested clause. My apologies and thanks to those who did the research. However, even assuming this is accurate, my point is still valid. Just take the trust fund baby and have him work 10 years at a minimum wage job for 10 years so he can vest his benefits ( there doesn't seem to be any contribution limit. It just says 10 years and you're in.) Now you've got 2 guys receiving the exact same benefit, one has paid a pittance ( say 3% of $20,000 per year for 10 years, $6,000 total), the other over $150,000 over his working life, and here's the important bit, with both of them having the exact same lifetime income. If this were any other situation, or even this exact situation but in a different context, I know you'd be claiming this as a tax burden on the latter, because that's precisely what it is.

edited to take out the word huge in front of tax burden in the last sentence so as to not start a sub-tangent on what constitutes huge.
   1944. PreservedFish Posted: August 13, 2012 at 09:34 PM (#4207639)
But if Romney isn't going to use Ryan's plans, then why is Ryan on the ticket?

The dems don't have to point to Ryan. They can ask Romney about his budget, insinuating that the worst part's of Ryan's plans are going to be Romney's, and forcing Romney to repudiate. Why do you want to waste campaign time on this?


I agree that these are problems for the Romney/Ryan ticket, but you might be thinking one level deeper than Romney is. He might have thought that Ryan = smart, attractive, young, battleground state, takes care of business.

I'm curious to see what comes of it. Ryan must really be holding his nose to sign onto a ticket with such an absurd and vague fiscal plan - it seems like Romney's nonsense proclamations are exactly the type of thing that piss him off. Do they have some agreement to come up with a unified plan? Is there even time for something like that?
   1945. Dan The Mediocre Posted: August 13, 2012 at 09:37 PM (#4207640)
I'm curious to see what comes of it. Ryan must really be holding his nose to sign onto a ticket with such an absurd and vague fiscal plan - it seems like Romney's nonsense proclamations are exactly the type of thing that piss him off. Do they have some agreement to come up with a unified plan? Is there even time for something like that?


The plans are pretty close to being the same. Ryan's plan is basically nonsense, so he can't be that picky.
   1946. Joe Kehoskie Posted: August 13, 2012 at 10:12 PM (#4207662)
Link please.


This was from 2008, two years into the Mass. law:

Before RomneyCare was enacted, estimates of the number of uninsured in Massachusetts ranged from 372,000 to 618,000. Under the new program, about 219,000 previously uninsured residents have signed up for insurance. Of these, 133,000 are receiving subsidized coverage, proving once again that people are all too happy to accept something "for free," and let others pay the bill. That is in addition to 56,000 people who have been signed up for Medicaid. The bigger the subsidy, the faster people are signing up. Of the 133,000 people who have signed up for insurance since the plan was implemented, slightly more than half have received totally free coverage.

http://www.cato.org/pubs/policy_report/v30n1/cpr30n1-1.html

As for costs, "The universal insurance coverage we adopted in 2006 was projected to cost taxpayers $88 million a year. However, since this program was adopted in 2006, our health-care costs have in total exceeded $4 billion. The cost of Massachusetts' plan has blown a hole in the Commonwealth's budget." (State Treasurer Timothy P. Cahill)

This, despite the fact that:

"The state has been able to shift the majority of the costs to the federal government." The Institute pointed to higher costs of $8.6 billion since the law was implemented. Just $414 million was paid by Massachusetts. Medicaid (federal payments) covered $2.4 billion. Medicare took care of $1.4 billion.

But even more costs, $4.3 billion, have been imposed on the private sector — employers, insurers, and residents. This estimate is in line with an earlier study by the Massachusetts Taxpayers Foundation, which figured that 60% of the new costs fell on individuals and businesses.

As expenses have risen, so have premiums. Noted Kuttner, "because serious cost containment was not part of the original package, premium costs in the commonwealth have risen far faster than nationally — by 10.3%, the most recent year available."

I'm sure the Cato link will get bashed, but I can't find anything that claims more people bought insurance rather than became eligible for "free" or highly subsidized insurance. Story after story talks of "covering" people, not people running out to buy insurance.

Meanwhile, here's a story claiming the penalty for not complying with the Mass. law "can be on the order of $1,200 a year for a 37-year-old single person," which is quite a bit higher than the $670 MCoA mentioned earlier.
   1947. zonk Posted: August 13, 2012 at 10:16 PM (#4207664)
I think the issue with Paul Ryan from a Romney perspective is that I'm not sure he'll be all that good at the 'traditional' role of the veep candidate. Whatever Sarah Palin's limitations at actually governing and setting aside whether she frightened indies into the Obama camp - one thing she excelled at was performing the role of ticket attack dog.

Biden likewise plays that role well (sometimes you have to take the gaffes with the quips). I mean - did anything define Rudy Guiliani as a candidate better than Biden's "A noun, a verb, and 9/11"?

Let's just accept the CW for a moment that Paul Ryan is a substantive, wonky "very serious person" (as Atrios would put it) - that's just not a veep candidate's job during a campaign.

The Ryan budget plan polled extraordinarily poorly - some reputable pollsters even had it underwater among self-described conservatives. Now - I'll grant, policy is extraordinarily tricky to poll... but still - the Republican response when the Ryan plan basically exited stage right was that they didn't "sell" it well, that they let Obama/Democrats "define" the plan.

Well - guess what - it was Ryan's plan. He was given all the microphone he needed to define it, defend it, push it, sell it. Personally - and I say this subjectively as a liberal - the media even helped framing it as a Very Serious Proposal by a Very Serious Person.... and it failed, miserably. Regardless of whether you love the Ryan plan or hate it, it polled even worse than Obamacare by a pretty wide margin.

You have the Romney campaign which is being pummeled by an Obama campaign that at this moment, is succeeding in defining Romney. Just last Friday, Romney asked for a 'truce' about his tax returns and Bain.... If you ask for a truce, you're losing. John McCain admitted during his weekly Sunday TV show, errr... excuse me, whichever Sunday show he was on this week that "I’ve got to give them credit, they have succeeded to a certain degree, of painting — with nothing but attack ads — Mitt Romney into something that’s not an acceptable alternative, because he can’t run on his record". At this point, purely on campaign points, it's a blowout. That doesn't mean Obama will win, much less win in a blowout, but campaigns matter in close elections.

Soooo... how does Team Romney staunch this bleeding? They bring on-board a guy whose visionary plan that crashed and burned. Kathy Hochul won a special election in NY-26 in 2011 (an R+6 district, BTW) wholly on a campaign built upon attacking the Ryan plan and making it her opponent's. I'm sure Steve Israel (DCCC chair) is only too happy to have the Ryan plan back in the news.

   1948. Joe Kehoskie Posted: August 13, 2012 at 10:17 PM (#4207665)
I didn't know about the 10 years to be vested clause. My apologies and thanks to those who did the research. However, even assuming this is accurate, my point is still valid. Just take the trust fund baby and have him work 10 years at a minimum wage job for 10 years so he can vest his benefits ( there doesn't seem to be any contribution limit. It just says 10 years and you're in.) Now you've got 2 guys receiving the exact same benefit, one has paid a pittance ( say 3% of $20,000 per year for 10 years, $6,000 total), the other over $150,000 over his working life, and here's the important bit, with both of them having the exact same lifetime income. If this were any other situation, or even this exact situation but in a different context, I know you'd be claiming this as a tax burden on the latter, because that's precisely what it is.

Your point is only still valid in some hypothetical world where "trust fund babies" go and work minimum-wage jobs for 10 full years just so they can free-ride off other people's payroll taxes. (Frankly, any "trust fund baby" who has the work ethic to do this probably deserves praise rather than scorn.)
   1949. Jay Z Posted: August 13, 2012 at 10:28 PM (#4207670)
I agree that these are problems for the Romney/Ryan ticket, but you might be thinking one level deeper than Romney is. He might have thought that Ryan = smart, attractive, young, battleground state, takes care of business.

I'm curious to see what comes of it. Ryan must really be holding his nose to sign onto a ticket with such an absurd and vague fiscal plan - it seems like Romney's nonsense proclamations are exactly the type of thing that piss him off. Do they have some agreement to come up with a unified plan? Is there even time for something like that?


The problem is not anticipating how things are going to be framed. Ryan has had since 2006 to spitball on the budget since his proposals won't be put in place anyway. At some point the Republicans will again be in position to determine the budget; then they can determine what they want to pursue. I think it's highly likely that the sort of medicare reform that's proposed would hit the same sort of shitstorm that the Clinton plan, Bush SSI tour, Obamacare, etc. have hit. They always think they can explain it rationally, and they never can, and the other side does their best to blow it up. So there's a pretty good chance that the Republicans decide it's not worth it and focus on other things.


So you've got an issue you're not even sure you want to pursue when you get elected. But because of Ryan's spitballing, it's fairly hard to deny that you'd do what he proposed, since they even went so far as to have a show vote on one of his budgets. So now you've got three months to sell medicare reform in a shitstorm, or spend all of this time and capital explaining exactly which of Ryan's proposals he's going to recant. And again, you have a guy that 40% of the American public has no opinion on (because they don't know who he is), and you're immediately telling them that his ideas won't be used.

Meanwhile, the Dems run a bunch of ads in swing states telling voters 50-54 that Romney will take away their Medicare if he's elected. And having a fairly legitimate reason to make that claim.

This is the sort of thing you do after you get elected. Before you talk in broad, general terms, general direction. "I will go to Korea" is about as specific as you get. You can't be Tom Dewey, but controversial, specific proposals are bad news.

If you want Ryan to try and sell Medicare reform once you're in power, that's one thing. You do not try that in a 3 month election time frame when you're running for President.
   1950. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 10:30 PM (#4207671)
(Frankly, any "trust fund baby" who has the work ethic to do this probably deserves praise rather than scorn.)


Well, this reveals a lot.
   1951. Joe Kehoskie Posted: August 13, 2012 at 10:34 PM (#4207673)
Soooo... how does Team Romney staunch this bleeding? They bring on-board a guy whose visionary plan that crashed and burned. Kathy Hochul won a special election in NY-26 in 2011 (an R+6 district, BTW) wholly on a campaign built upon attacking the Ryan plan and making it her opponent's. I'm sure Steve Israel (DCCC chair) is only too happy to have the Ryan plan back in the news.

The Obamacare numbers assume $700 billion in cuts "savings" from Medicare, as Ryan is sure to remind people. While the Ryan Plan is off the table, at least for now, Obamacare is full steam ahead. That ad showing Ryan pushing granny off the cliff now applies more to Obama than it does to Ryan.
   1952. Joe Kehoskie Posted: August 13, 2012 at 10:38 PM (#4207676)
Well, this reveals a lot.

Indeed. Unless you truly believe "trust fund babies" routinely go and work at McDonald's for 10 years just so they can qualify for Medicare a few decades down the road, your position seems rather punitive. If a "trust fund baby" went and worked in a soup kitchen or senior center for 10 years doing menial but important work, would you still want to begrudge him or her the Medicare benefits that everyone else receives after 10 years of working?

Again, if you want Medicare to be an old-age welfare program, why not just say so?
   1953. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 10:43 PM (#4207679)
If a "trust fund baby" went and worked in a soup kitchen or senior center for 10 years doing menial but important work, you'd still want to begrudge him or her the Medicare benefits that everyone else receives after 10 years of working?


Where the hell did I say that? I don't begrudge anyone medicare benefits. This is the second time that I posted a hypothetical example of someone with mostly dividend and interest income having a far lower tax burden than someone with earned income as unfair and you assume it means I must have scorn or disgust for the former. It means nothing of the sort.
   1954. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 10:43 PM (#4207680)
Again, if you want Medicare to be an old-age welfare program, why not just say so?


I want Medicare to be an old age welfare program.

edit: To be more precise, since the health insurance scheme in this country is ###### up, and that almost no one but the super rich can afford adequate middle to old age health insurance outside of an employer plan, I want everyone to have access to Medicare once their working life is over. If you want to call that welfare, so be it. I'm not as hung up on labels as you are.
   1955. The John Wetland Memorial Death (CoB) Posted: August 13, 2012 at 10:44 PM (#4207681)


Under Paul Ryan's plan, Mitt Romney wouldn't pay any taxes for the next ten years -- or any of the years after that. Now, do I know that that's true. Yes, I'm certain.

Well, maybe not quite nothing. In 2010 -- the only year we have seen a full return from him -- Romney would have paid an effective tax rate of around 0.82 percent under the Ryan plan, rather than the 13.9 percent he actually did. How would someone with more than $21 million in taxable income pay so little? Well, the vast majority of Romney's income came from capital gains, interest, and dividends. And Ryan wants to eliminate all taxes on capital gains, interest and dividends.


Romney did earn $593,996 in author and speaking fees in 2010 that would still be taxed under the Ryan plan. Just not much. Ryan would cut the top marginal tax rate from 35 to 25 percent and get rid of the Alternative Minimum Tax -- saving Romney another $292,389 or so on his 2010 tax bill. Now, Romney would still owe self-employment taxes on his author and speaking fees, but that only amounts to $29,151. Add it all up, and Romney would have paid $177,650 out of a taxable income of $21,661,344, for a cool effective rate of 0.82 percent.

But what about corporate taxes? Aren't they a double tax on savings and investment, so Romney's "real" rate is higher than his headline rate? No. As Jared Bernstein of the Center on Budget and Policy Priorities has pointed out, Romney has structured his investments as "pass-throughs" that avoid corporate tax. In other words, the 0.82 percent tax rate is really a 0.82 percent tax rate.


The Atlantic
   1956. zonk Posted: August 13, 2012 at 10:47 PM (#4207683)
Meanwhile, the Dems run a bunch of ads in swing states telling voters 50-54 that Romney will take away their Medicare if he's elected. And having a fairly legitimate reason to make that claim.


One last point the Medicare privatization plan -- while Medicare coverage under the Ryan plan might not change for those 55 and older, it's not quite this simple.

Medicare provides medical insurance, not medical care. There is absolutely no requirement that any physician or provider accept Medicare. In fact, there are significant issues with GP coverage in many areas (general practitioners I do think get shafted by Medicare's reimbursement schema). However, you'd have a tough time finding an inpatient provider (i.e., hospital/hospital system) that doesn't accept Medicare. That's simply a matter of numbers - inpatient services are disproportionately used by the elderly, hence - a hospital that doesn't accept Medicare isn't a hospital likely to do well financially.

However - what happens when Medicare the government insurance program starts to see it's enrollment numbers begin to rapidly fall off as those who get the coupons for private insurance begin to hit eligibility?

Hospitals - even not-for-profits - do plenty of financial modeling. Medicare participation by a provider is no cheap or easy matter - it's no wonder that Medicare beneficiaries love Medicare and it's likewise no wonder Medicare can deliver eye-popping MLRs (even AHIP, the private insurance lobby association, doesn't dispute Medicare has a better MLR, they just argue that it's not as wide as commonly cited): the administrative burden is largely pushed onto the providers. Still - the program pays well enough that at this moment, it makes sense for hospitals to take on that cost.

Where's the tipping point? When does a hospital see enough of these 'transition cases' - people getting the "Medicare" coupons to buy private insurance that it no longer makes sense to be a Medicare participant?

I guarantee you that day would come well before the last Medicare beneficiary dies off... so you'll have people who will have 'Medicare', but few facilities that accept classic Medicare because it's no longer cost effective to do so.

   1957. zonk Posted: August 13, 2012 at 10:53 PM (#4207692)

The Obamacare numbers assume $700 billion in cuts "savings" from Medicare, as Ryan is sure to remind people. While the Ryan Plan is off the table, at least for now, Obamacare is full steam ahead. That ad showing Ryan pushing granny off the cliff now applies more to Obama than it does to Ryan.


Can you please make up your mind about whether the Obamacare savings to Medicare are illusory or not?

So now, apparently, the savings are valid... as I explained upthread, the three primary savings methods are:

1) Elimination of the charity care reimbursement factor. This has absolutely no impact on what constitutes a covered service under Medicare.

2) Gutting of MedicareAdvantage/Gap/Choice/whatever. I suppose technically, this may very lead to some seniors losing Medicare supplemental insurance - but again, all currently covered services under Medicare proper remain covered services.

3) Undefined plans* that IPAB submits which essentially require congressional approval, just like the '97 changes essentially require congressional approval.

There's a huge gap between trimming some accouterments of Medicare, but keeping the core, well-liked plan in place and eliminating Medicare in favor of vouchers.

EDIT: *Wanted to re-check to be sure, but per the IPAB definitions in Sec 3403 of PPACA - IPAB's plan cannot "The proposal shall not include recommendations to ration health care, raise revenues or premiums, increase beneficiary cost-sharing, or restrict benefits, or modify eligibility criteria."

In other words, IPAB can't cut benefits either... They can recommend cutting rates for certain services, but cannot eliminate benefits. Medicare participation isn't ala carte - though, certainly, if say... ESRD reimbursement rates are cut, some hospitals might well determine it's an area to cut services entirely.
   1958. Joe Kehoskie Posted: August 13, 2012 at 11:00 PM (#4207697)
Where the hell did I say that? I don't begrudge anyone medicare benefits. This is the second time that I posted a hypothetical example of someone with mostly dividend and interest income having a far lower tax burden than someone with earned income as unfair and you assume it means I must have scorn or disgust for the former. It means nothing of the sort.

Eligibility for Medicare requires 10 years of Medicare-covered employment. Unlike varying the size of Social Security checks, it's hard to vary the quality of healthcare, so your hypothetical "trust fund baby" qualifying for Medicare by working a minimum-wage job is just an inevitable loophole.

I can understand arguing for a huge estate tax. I can understand wanting all cap gains to be taxed, or no cap gains to be taxed. But allowing people to sell homes tax-free while gleefully plotting higher cap gains taxes for "the rich" seems like little more than an exercise in class warfare. If you make $200,000 selling your house and I make $200,000 selling Apple stock, why should your tax bill be $0 while mine is $50,000 to $80,000?
   1959. Bitter Mouse Posted: August 13, 2012 at 11:08 PM (#4207705)
Not only does it cost more to not have insurance under ObamaCare, but the insurance is worth more*. Preventative services, covering children older than before, and so on. On one hand it cost more to not do it, on the other it is worth more to do it, and it is a societal expectation now to get insurance. It is the law, mandated even.

I think that variety of factors will lead more people to become insured than before - how could it not? More people with insurance and thus preventative care will lead to better health outcomes.

How much better? How many more? How much does it cost? Well I guess we will find out. LOL all you want, it is the law and we will find out. Pretty much every industrialized nation on earth has some form of universal care, and now we do to.

* Some of these ideas were promised to us by insurance companies who claimed they would keep them no matter what. If you believe these benefits would not have happened without ObamaCare I have a lovely bridge to sell you.
   1960. Misirlou is on hiding to nowhere Posted: August 13, 2012 at 11:09 PM (#4207708)
Eligibility for Medicare requires 10 years of Medicare-covered employment. Unlike varying the size of Social Security checks, it's hard to vary the quality of healthcare, so your hypothetical "trust fund baby" qualifying for Medicare by working a minimum-wage job is just an inevitable loophole.


And that was only done to illustrate the folly of denying that payroll taxes are like some sort of insurance premium and not like real taxes.

I can understand arguing for a huge estate tax. I can understand wanting all cap gains to be taxed, or no cap gains to be taxed. But allowing people to sell homes tax-free while gleefully plotting higher cap gains taxes for "the rich" seems like little more than an exercise in class warfare. If you make $200,000 selling your house and I make $200,000 selling Apple stock, why should your tax bill be $0 while mine is $50,000 to $80,000?


Well, the next time I argue for the latter will be the fist. This gets back to my "This explains a lot" comment from earlier. You are assuming way too much about the agenda of the posters you are arguing with, as if we are all speaking as a cartoon version of some liberal spin meister on cable TV. I've said numerous times that I feel that equal income, no matter the source, should be taxed equally. Generally speaking. In the case of your home example, I would have no problem going back to where we were before. Cap gains on the sale of a house can be deferred as long as you buy a residence of equal or greater value. This has a societal benefit that outweighs fairness.

   1961. zonk Posted: August 13, 2012 at 11:13 PM (#4207711)
If you make $200,000 selling your house and I make $200,000 selling Apple stock, why should your tax bill be $0 while mine is $50,000 to $80,000?


Who makes $200k selling their home besides the very rich? The median home price in the US is $221k - at the height of the housing bubble, it was $246k. You'd have to buy your theoretical median home back in 1966 to get the median price down to $21k and make the 200K in capital gains for selling your house.

But hey, you want to exempt the first $50k/tax the first $50k in capital gains at 0%, I'd be game... without even doing the math or looking it up, I'd be willing to bet that covers huge swaths of gains people make on selling their home to retire to Florida, buy up, or whatever.
   1962. tshipman Posted: August 13, 2012 at 11:26 PM (#4207719)
The Obamacare numbers assume $700 billion in cuts "savings" from Medicare, as Ryan is sure to remind people. While the Ryan Plan is off the table, at least for now, Obamacare is full steam ahead. That ad showing Ryan pushing granny off the cliff now applies more to Obama than it does to Ryan.


Here's the deeply cynical part about this statement: The Ryan plan has those exact same cuts also!
   1963. Joe Kehoskie Posted: August 13, 2012 at 11:48 PM (#4207734)
If you believe these benefits would not have happened without ObamaCare I have a lovely bridge to sell you.

Likewise if you believed Obama when he said, "If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what."

***
In the case of your home example, I would have no problem going back to where we were before. Cap gains on the sale of a house can be deferred as long as you buy a residence of equal or greater value. This has a societal benefit that outweighs fairness.

It does? The "societal benefit" of the boom/bust nature of the housing market seems dubious, as does the sprawl that has resulted. Regardless, it's unclear to me why buying a house should be seen as preferable or even more noble than investing in a business.

***
Who makes $200k selling their home besides the very rich? The median home price in the US is $221k - at the height of the housing bubble, it was $246k. You'd have to buy your theoretical median home back in 1966 to get the median price down to $21k and make the 200K in capital gains for selling your house.

$200,000 was just a random number, but people make that selling homes in big cities all the time.

But hey, you want to exempt the first $50k/tax the first $50k in capital gains at 0%, I'd be game... without even doing the math or looking it up, I'd be willing to bet that covers huge swaths of gains people make on selling their home to retire to Florida, buy up, or whatever.

Now we're talking ...
   1964. Joe Kehoskie Posted: August 13, 2012 at 11:53 PM (#4207738)
Here's the deeply cynical part about this statement: The Ryan plan has those exact same cuts also!

I know. But since Romney has made it clear that they're campaigning based on his plan rather than the Ryan Plan, Obama's $700 billion in Medicare cuts is more of a threat to seniors than the shelved Ryan Plan.

It's both absurd and fair at the same time. In a perfect world, such nonsense would have no place in a presidential campaign, but in the real world, unilateral disarmament is practiced only by fools. If the Dems are going to blame Romney for Soptic's wife and claim Ryan wants to "end Medicare" and "kill granny," then turnabout is fair play.
   1965. Misirlou is on hiding to nowhere Posted: August 14, 2012 at 12:07 AM (#4207750)
Regardless, it's unclear to me why buying a house should be seen as preferable or even more noble than investing in a business.


At the risk of taking us down another irrelevant tangent... When you buy Apple stock, you are not investing in a business. You are speculating. Unless the stock you bought was from an IPO, Apple receives no money from your transaction. You bought the stock from someone who bought the stock from someone who bought the stock from someone who bought the stock from someone..... It's an investment to be sure, but don't pretend your investment has anything to do with helping Apple prosper. Apple's going to sell the same number of iPads today whether AAPL volume was 1 million or 20 million shares.

Now that's how Joe Kehoskie would argue this point, focusing on the specific throwaway example instead of the larger point. Why is it more noble to buy a house than invest in a company? Well, it's not, and I never said it was. The greater societal benefit I referred to has to do with upgrading the size of your residence as you move through life and your family needs change, at minimal penalty from the government. If a young couple buys a 1 bedroom apartment after getting married, and 5 years later find themselves with 2 kids and no way to upgrade to a 2 or 3 bedroom because their cap gain minus taxes won't allow them to afford the down payment on the equally inflated price of the 3 bedroom, that's a societal negative IMO. A home, a primary residence, is, or should be, treated different from financial investments. As you stated earlier WRT Medicare, it's an inevitable loophole. Those who see things in only black and white may disagree.
   1966. The Yankee Clapper Posted: August 14, 2012 at 12:14 AM (#4207756)
Who makes $200k selling their home besides the very rich?

Lots of folks in high cost cities and their suburbs if they held on to their home for 20 to 30 years.
   1967. bobm Posted: August 14, 2012 at 12:15 AM (#4207758)
When you buy Apple stock, you are not investing in a business. You are speculating. Unless the stock you bought was from an IPO, Apple receives no money from your transaction. You bought the stock from someone who bought the stock from someone who bought the stock from someone who bought the stock from someone..... It's an investment to be sure, but don't pretend your investment has anything to do with helping Apple prosper.


Not exactly. Apple cannot raise money from an IPO or secondary offerings without a functioning stock market where its shares can be traded. The "speculators" do serve a useful function.
   1968. Misirlou is on hiding to nowhere Posted: August 14, 2012 at 12:23 AM (#4207761)
Not exactly. Apple cannot raise money from an IPO or secondary offerings without a functioning stock market where its shares can be traded. The "speculators" do serve a useful function.


Agreed, but that's investing in the process, not the business. AAPL traded 10 mil shares today (a light day). At $630/share, that's $6.3 billion. How much of that large sum was actually invested in Apple, the company?

edit: Aw jeeze, I'm helping perpetuate the irrelevant tangent. It's easy to do. I'll shut up about AAPL now and stand by my second paragraph in 1965.
   1969. Dan Szymborski Posted: August 14, 2012 at 12:24 AM (#4207762)

At the risk of taking us down another irrelevant tangent... When you buy Apple stock, you are not investing in a business. You are speculating. Unless the stock you bought was from an IPO, Apple receives no money from your transaction. You bought the stock from someone who bought the stock from someone who bought the stock from someone who bought the stock from someone..... It's an investment to be sure, but don't pretend your investment has anything to do with helping Apple prosper. Apple's going to sell the same number of iPads today whether AAPL volume was 1 million or 20 million shares.


Correct me if I'm wrong, but did you just essentially say that companies don't care about their market cap or access to capital? Apple doesn't care who specifically owns that one little share, but they sure as hell care that someone does and values it highly. Companies certainly don't give dividends out of sheer generosity, either.
   1970. Misirlou is on hiding to nowhere Posted: August 14, 2012 at 12:31 AM (#4207769)
Correct me if I'm wrong, but did you just essentially say that companies don't care about their market cap or access to capital?


I gave that impression yes, and I regret doing so, as it really has nothing to do with the discussion.
   1971. McCoy Posted: August 14, 2012 at 12:35 AM (#4207772)
Who makes $200k selling their home besides the very rich?

Hell, "poor" people in DC make more than that in profit and they need to just to stay in the area. Housing prices in DC are insane but not unique to this area. I have a bunch of older family members and even friends that bought houses years ago, even decades ago, and never took out second mortgages and the like. There homes have doubles, tripled, quadrupled, and more since they bought it but if they were to ever sell their home they would not be able to buy a house of similar size or even close to it in their area. For instance a little over a decade ago my Aunt and Uncle sold their home in the LA area that they had lived in for about 20 years. They sold for a very nice chunk of change but they had to move out of the area because they couldn't afford to buy a house in the area.
   1972. SteveF Posted: August 14, 2012 at 12:48 AM (#4207774)
How much of that large sum was actually invested in Apple, the company?


I sort of get what you are saying, here. You wouldn't, however, get any initial investment if stock prices had no chance of increasing. So the possibility that the stock price can increase is integral to the motive behind the initial investment. Further, that initial investor couldn't actually receive some part of the benefit (some of it would have been returned via dividends -- well, Apple might be a bad example here) from that initial investment if there was nobody to buy his stock. So the second+ owners of the stock are doing something to facilitate the initial investment.

Whether all that merits capital gains treatment for stocks held for 1 year... That's certainly a matter for debate.

Obviously the housing exemption has nothing to do with capital gains, as buying a house isn't an investment (well, not the same kind of investment as buying into a business). I'm sure it's entirely about mobility (we live in a big country where changing jobs often necessitates moving) and subsidizing home ownership. It's all ultimately reflected in the home prices anyway.
   1973. SteveF Posted: August 14, 2012 at 01:01 AM (#4207778)
Note: I'm not saying selling a house wouldn't be treated as a capital gain. I realize it would. But the exemption really isn't about encouraging investment, but is meant to do precisely what McCoy mentioned (essentially encouraging home ownership).
   1974. McCoy Posted: August 14, 2012 at 01:17 AM (#4207786)
Taxes and tax breaks are ways the government gets you to do something. They want people to own homes. It is good for the economy and it is good for stability. People who own their own home don't rebel, they don't start a revolution, they don't riot in the street. They can't, they have to be at work in the morning so they can pay their mortgage. Plus it ties you down to one easily locatable spot and thus they can plan and budget around you and your fellow home owners fixed spots. To get people to buy homes, which for 99% of citizens will be the biggest investment they ever make, the government does a lot of things to entice you as compared to doing virtually nothing to entice you to rent.

The theory behind not taxing investments and such is that it turns assets more readily into liquid assets and pumps the economy with cash. Trickle down all over again.
   1975. Joe Kehoskie Posted: August 14, 2012 at 01:20 AM (#4207788)
But the exemption really isn't about encouraging investment, but is meant to do precisely what McCoy mentioned (essentially encouraging home ownership).

I think encouraging home ownership was just the window dressing on a plan that was designed to encourage investment. Telling people they'll owe $0 in cap gains taxes after owning a home for just 2 years created a nation of trader-uppers. Combine the promise of tax-free gains with the lure of easy credit and it was no wonder the housing market ballooned and then went bust.
   1976. McCoy Posted: August 14, 2012 at 01:27 AM (#4207791)
0 capital gains certainly didn't help but I think it played an extremely small part in what happened to the housing market last decade. Cheap money is pretty much what causes a bubble 99% of the time and the globe was swimming in cheap money.
   1977. SteveF Posted: August 14, 2012 at 01:42 AM (#4207795)
Taxes and tax breaks are ways the government gets you to do something.


There's a legitimate question about how well that works in various contexts. To what extent are high home prices a product of the tax deductibiliity of mortgage interest? Is the deduction simply priced in? And if so, does it really have any impact on the ease with which people can own a home?

You can make the same argument in the context of financial aid and the tax deductibility of loan payments. Do they just get priced into tuition? Hell, even Obama thinks that's happening.

Edit: There was a time when I thought that if the CPI still included home prices, it's possible the housing bubble would have been avoided. But then, it's not like home prices aren't tracked.
   1978. BurlyBuehrle Posted: August 14, 2012 at 02:15 AM (#4207801)
H/T to 1789 and 1970 for understanding the need to occasionally step back from a misstatement/incorrect assertion/unintentional error and just say "I was wrong, can we move on?"

That is pretty much the most important thing I've taken away from this thread.
   1979. OCF Posted: August 14, 2012 at 02:19 AM (#4207802)
One idea I've seen floated (and I've seen it floated a long time ago) concerning the home interest deduction would be to place a dollar cap on how much interest any individual or couple could deduct, with that cap set at a level where a typical middle class homeowner would still get nearly the whole amount deducted. There are practical problems with this, including that the cap would probably have to be adjusted faster than the political system is capable of moving, and areas of the country with different housing costs would see unequal effects. This might, during boom times, have slowed the upward pressure on prices. Or it might not have.
   1980. McCoy Posted: August 14, 2012 at 02:22 AM (#4207803)
As an aside, I finally got my tax rebate from the state of VA today. My employer had never stopped paying taxes to VA despite the fact that I had moved to DC. So I had to pay all of my 2011 taxes due to DC in one go. Meanwhile it took VA 6 months to give me my money back.
   1981. Swoboda is freedom Posted: August 14, 2012 at 07:59 AM (#4207822)
If you make $200,000 selling your house and I make $200,000 selling Apple stock, why should your tax bill be $0 while mine is $50,000 to $80,000?

First of all the tax would be $30-$40k (15-20%) depending on how long you held it. Secondly, losses from selling your home cannot be written off. If I lose money on Apple (not easy to do right now) I can write it off against other gains, or $3000 against my other income. Losses on houses are gone. Not that I agree with all the tax breaks with home ownership (mortgage and property tax deductions).

My recommendation is taxing all income at the same rate (including capital gains and dividends), but not to tax corporations on any income that they pay out in dividends. Eliminate the double taxation and encourage companies to pay out the money that sits around in corporate treasuries.
   1982. CrosbyBird Posted: August 14, 2012 at 09:57 AM (#4207879)
That's odd, since the "Obama" in "Obamacare" still adamantly denies that the mandate is a tax at all.

This just in: politicians don't always tell the truth.

If you'll recall, several posters here have criticized the dishonesty of this denial. If you're relying on the Supreme Court decision, it's a tax.
   1983. Shredder Posted: August 14, 2012 at 09:58 AM (#4207880)
However, you'd have a tough time finding an inpatient provider (i.e., hospital/hospital system) that doesn't accept Medicare. That's simply a matter of numbers - inpatient services are disproportionately used by the elderly, hence - a hospital that doesn't accept Medicare isn't a hospital likely to do well financially.
Which is, of course, a perfect explanation of why single payer is so much more cost effective than the current model. People love to claim "Competition will bring prices down!!", then they go shop at Wal-Mart which has used its tremendous bargaining power to bully suppliers into lower prices, without ever noting the similarity.
   1984. zonk Posted: August 14, 2012 at 10:16 AM (#4207894)
Which is, of course, a perfect explanation of why single payer is so much more cost effective than the current model. People love to claim "Competition will bring prices down!!", then they go shop at Wal-Mart which has used its tremendous bargaining power to bully suppliers into lower prices, without ever noting the similarity.


Indeed - when private insurers negotiate reimbursement rates with their provider networks, the rates Medicare pays for procedures (minus the numerous reimbursement factors like geographic adjustments, case mix indices, CAH/DSH disposition, educational reimbursement -- another little thing that Medicare foots the bill for -- roughly 85-90% of all medical internship costs are borne directly by Medicare... so it's Medicare, not the hospital, not the AMA that pays for the final apprenticeship step for all US physicians) are generally the starting point. Japan actually sets the rates for all providers -- their "public option" and private insurers.

Except (I think) for certain LTC/SNF (Longterm Care and Skilled Nursing Facility) situations - private insurers always have higher reimbursement rates than Medicare.

   1985. STEAGLES is all out of bubblegum Posted: August 14, 2012 at 10:18 AM (#4207896)
That's odd, since the "Obama" in "Obamacare" still adamantly denies that the mandate is a tax at all.
that doesn't seem like an entirely fair criticism, since, well, noone's taxes have actually gone up yet as a result of the legislation.

and i believe it's also important to note that, while you are criticizing the law because of a theoretical tax increase that hasn't yet cost anyone a dime, over $1 billion has already been paid back to policy holders in the form of a insurance rebate as a result of a mandate made in the ACA that stipulated that 80% of a health insurance company's premiums be spent on actual health care, with any shortfall paid back to its policy holders in the form of the aforementioned rebate.

   1986. Dan Szymborski Posted: August 14, 2012 at 10:47 AM (#4207914)
My recommendation is taxing all income at the same rate (including capital gains and dividends), but not to tax corporations on any income that they pay out in dividends. Eliminate the double taxation and encourage companies to pay out the money that sits around in corporate treasuries.

I would tax all income at the same rate as other income, however, income from investments should be treated in constant dollars (which is part of the reason long-term capital gains rates are different than short-term capital gains rates, it's not just a carrot). If I buy a house for $150,000 in 1990 and sell it for $160,000 in 2012, I lost money, I didn't make $10,000.
   1987. Dan Szymborski Posted: August 14, 2012 at 10:52 AM (#4207919)
that doesn't seem like an entirely fair criticism, since, well, noone's taxes have actually gone up yet as a result of the legislation.

Well, then, it's not fair to criticize Ryan's plan until 2023.

and i believe it's also important to note that, while you are criticizing the law because of a theoretical tax increase that hasn't yet cost anyone a dime, over $1 billion has already been paid back to policy holders in the form of a insurance rebate as a result of a mandate made in the ACA that stipulated that 80% of a health insurance company's premiums be spent on actual health care, with any shortfall paid back to its policy holders in the form of the aforementioned rebate.

That $1 billion didn't just magically come out of a Scrooge McDuck vault of gold coins just sitting there.
   1988. tshipman Posted: August 14, 2012 at 10:56 AM (#4207922)
I would tax all income at the same rate as other income, however, income from investments should be treated in constant dollars (which is part of the reason long-term capital gains rates are different than short-term capital gains rates, it's not just a carrot). If I buy a house for $150,000 in 1990 and sell it for $160,000 in 2012, I lost money, I didn't make $10,000.


This is, of course, completely sensible and something that I think most people agree on. You want to incentivize buy and hold behavior when you can do so.

Edit: I have legitimate conflict about whether or not to "do something" about high frequency trading. I hate introducing market distortions (no, really), but I am concerned about how we now have apparent flash crashes that no one can explain because of an algo freaking out.


Well, then, it's not fair to criticize Ryan's plan until 2023.


Doesn't it blow up the deficit much before then?

That $1 billion didn't just magically come out of a Scrooge McDuck vault of gold coins just sitting there.


Yes ... it came from insurance companies over-charging their customers for services. Not sure where you're going with this.
   1989. Shredder Posted: August 14, 2012 at 10:58 AM (#4207924)
That $1 billion didn't just magically come out of a Scrooge McDuck vault of gold coins just sitting there.
No, it came out of insurance company bank accounts, which were originally filled with premiums paid by private citizens. What's your point?
   1990. zonk Posted: August 14, 2012 at 10:59 AM (#4207928)
that doesn't seem like an entirely fair criticism, since, well, noone's taxes have actually gone up yet as a result of the legislation.


Well, then, it's not fair to criticize Ryan's plan until 2023.


Except for the fact that my payroll taxes which would have formerly been funding a public retiree health insurance system which I support and wish to enroll would no longer be going towards that, but instead, towards some coupon that may or may not meet my potential health care needs.
   1991. Swoboda is freedom Posted: August 14, 2012 at 11:00 AM (#4207929)
This is, of course, completely sensible and something that I think most people agree on.

Which of course means it will never become law.
   1992. Dan Szymborski Posted: August 14, 2012 at 11:06 AM (#4207934)
No, it came out of insurance company bank accounts, which were originally filled with premiums paid by private citizens. What's your point?

It's not a net gain as being implied - that billion is coming from somewhere, either directly from the people getting the rebates, the people employed by the company, or the shareholders of the company.

If the health industry as a whole raises prices by a billion to pay for the billion in rebates (which they can do if it's a built-in cost that the entire industry has to pay and there aren't large differences among the companies in administrative costs), it's the equivalent of playing "Got Your Nose" with a toddler.
   1993. Dan Szymborski Posted: August 14, 2012 at 11:08 AM (#4207937)
Except for the fact that my payroll taxes which would have formerly been funding a public retiree health insurance system which I support and wish to enroll would no longer be going towards that, but instead, towards some coupon that may or may not meet my potential health care needs.

Except you're not funding a public retiree health insurance option. You're providing general tax revenue to the Treasury. Didn't you guys above just scold Joe for arguing that Medicare taxes were some magic taxes that were different? None of your money is set aside in a special place, specifically to pay for public retiree health insurance. If it's politically popular, the government can simply use that money to buy jetskis, invade Portugal, or hire every senior citizen a private cowboy poet.

Simply put, if you can't talk about a tax existing until someone's been taxed, you can't talk about a cut in benefits existing until someone's actually received that cut in benefits. Which will be in 2023.

I, of course, think that's ridiculous, but that's what STEAGLES said, that we can't call something tax until someone is actually taxed.
   1994. zonk Posted: August 14, 2012 at 11:09 AM (#4207938)
One other thing on the Ryan's plan sunset of Medicare --

I think most people would be surprised how little 'it would won't affect you if you're under 55' resonates with many seniors... I get weary of the whole 'greatest generation' stuff, too -- but when the Ryan plan, and specifically, the Medicare provisions came up at a family gathering last year, I and a cousin were arguing about it. My debate opponent made sure to point out -- specifically for my 83 yo grandmother -- that it won't impact her Medicare.

Without any prompting from me, she immediately jumped into the fray and pointed to all of her grandkids sitting around the room and said quite angrily - "what about them? So I've got reliable healthcare and you want to stick them with a theory that sure as hell didn't work for my own parents?"

I don't know if it's a generational thing or what - and sure, we joke about seniors voting in their own self-interests, but I think that there are a good number of seniors who view issues around Social Security and Medicare more than just out of pure self-interest, but because they've (especially those older seniors who had parents and grandparents that lived out their 'golden years' before these programs) experienced firsthand the differences these programs have made.
   1995. tshipman Posted: August 14, 2012 at 11:11 AM (#4207941)
It's not a net gain as being implied - that billion is coming from somewhere, either directly from the people getting the rebates, the people employed by the company, or the shareholders of the company.

If the health industry as a whole raises prices by a billion to pay for the billion in rebates (which they can do if it's a built-in cost that the entire industry has to pay and there aren't large differences among the companies in administrative costs), it's the equivalent of playing "Got Your Nose" with a toddler.


The health insurance industry cannot raise prices by a billion to pay for the billion in rebates because the law prohibits them from having more than 20% of the cost of insurance not go to patient care, and all rate hikes of more than 10% are reviewed by a board.

Do you seriously not know about this?

Yes, it comes from shareholders, I suppose. Let me cry in my sleep for Aetna shareholders.
   1996. Ray (RDP) Posted: August 14, 2012 at 11:14 AM (#4207945)
Who makes $200k selling their home besides the very rich?


This is an incredibly obtuse statement. Many, many "non-rich" people make 200K selling their homes.

For example, in the housing market I live in (Manhattan), if you bought a one BR co-op apartment for 90K in the mid-1990s it may well be upwards of 400K now. And people just out of school were able to... afford... those apartments -- i.e., people who were not "rich" by any stretch of that term. I know a number of such people myself. (Regrettably, I am not one of them, as I bought in the peak of the market in 2005 and given closing costs/etc I'd be lucky to break even if I sold now.)

And a great many people, in a great many housing markets across the country made 200K or more over the past two or three decades selling their home.

The premise that only the "very rich" make 200K on a housing sale is silly and childish.
   1997. STEAGLES is all out of bubblegum Posted: August 14, 2012 at 11:14 AM (#4207946)
It's not a net gain as being implied - that billion is coming from somewhere, either directly from the people getting the rebates, the people employed by the company, or the shareholders of the company.

If the health industry as a whole raises prices by a billion to pay for the billion in rebates (which they can do if it's a built-in cost that the entire industry has to pay and there aren't large differences among the companies in administrative costs), it's the equivalent of playing "Got Your Nose" with a toddler.
but that's not true. the rebates are tied directly the proportion of premiums that are spent on actual healthcare. if insurance companies only raised the amount of money that they charge without actually increasing the amount of money they spend on healhcare, the added revenue from premium increases would just be paid back out in the form of more rebates.
   1998. Dan Szymborski Posted: August 14, 2012 at 11:15 AM (#4207947)
I think most people would be surprised how little 'it would won't affect you if you're under 55' resonates with many seniors... I get weary of the whole 'greatest generation' stuff, too -- but when the Ryan plan, and specifically, the Medicare provisions came up at a family gathering last year, I and a cousin were arguing about it. My debate opponent made sure to point out -- specifically for my 83 yo grandmother -- that it won't impact her Medicare.


Since you guys criticizing Joe for relying on his memory for 32 years ago as a source for data, surely, you have polling data to show that there are no changes in polls when the age limit is mentioned. Surely, someone interested in data, wouldn't rely on an anecdote revolving their cousin.
   1999. Shredder Posted: August 14, 2012 at 11:19 AM (#4207949)
The health insurance industry cannot raise prices by a billion to pay for the billion in rebates because the law prohibits them from having more than 20% of the cost of insurance not go to patient care, and all rate hikes of more than 10% are reviewed by a board.
I assume he thinks that doctors and hospitals will just raise their prices by $1B cumulative dollars, but I'm not sure that makes much sense. Obviously insurance companies can't just raise premiums to make up the shortfall, because they'd still be in the same predicament. So I'm not really sure I understand Dan's point.

I pay health insurance premiums. My expectation is that my premiums will be used primarily for health related services, and if they aren't spending the money I'm paying them to provide health related services on actual health related services, I shouldn't be paying them so much. I suppose the counter argument is "who cares what they spend it on?" which doesn't make that much sense to me, but that seems to be the position Dan is taking. I guess I don't really get the argument against the 80% rule that doesn't amount to "it's not fair to lower their profits!", which I suppose brings us back to the question of why the profit motive in health insurance exists in the first place.
   2000. Dan Szymborski Posted: August 14, 2012 at 11:20 AM (#4207950)
but that's not true. the rebates are tied directly the proportion of premiums that are spent on actual healthcare. if insurance companies only raised the amount of money that they charge without actually increasing the amount of money they spend on healhcare, the added revenue from premium increases would just be paid back out in the form of more rebates.

Unless, of course, they simply raise the cost and just agree to pay providers more, essentially splitting premium increases from the consumer with providers, without actually providing any additional healthcare or administrative costs.

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