Congratulations. You're yet another person who clearly doesn't understand the current situation. The Federal government has consistently been spending substantially more than it takes it.
I'm very aware of the current situation. Which is why I focus on what matters: spending, not debt. Debt is irrelevant. What determines the size and bloat of government is how much spending they're doing today, and I was 100% correct when I said it's at record levels and slated to grow farther still. The 2002 federal budget was 2 trillion. The 2014 federal budget is 3.8 trillion. The handy inflation calculator (http://www.usinflationcalculator.com/) tells me that the dollar has inflated 30% in in that time period. Since 2 trillion is only 2.6 trillion in inflation adjusted dollars, that means the government is spending almost 50% more than it did just a decade ago, TODAY (and that's not even accounting for growth projections). And the interest on past debt is a very small part of that total budget, at just over 200 billion -- so where'd the extra trillion dollars in permanent spending come from? And why do you seem content to ignore it? Moreover, given the fact that we've already had two tax increases (one with Obamacare and one in December), why does Obama still demand tax hikes in any spending cut negotiation when he hasn't cut spending at all!? Why don't we compare current day revenue to 2002 revenue? 2014 revenue projections are 3 trillion (2013 was around 2.7 trillion). 2002 revenue was 1.85 trillion. Going back to that handy 30% inflation number (for an extrapolated 2.4 trillion in adjusted revenue), that means our current revenue is 10-30% higher TODAY than we had then. Yet the only words out of that stubborn president's mouth are "more taxes".
consequently even if we were to take a massive cut to our spending, we'd still be decades away from paying off the debt.
Soooo...what you're advocating is that because it would take a long time to undo the ridiculous level of spending we're at, we should not even try?
any attempt to pay down the debt at a decent rate would invariably require a tax increase along with the substantial spending cuts.
I'm in no hurry to pay down the debt. I'd settle for a balanced budget. GDP growth, revenue increases from a recovering economy, and inflation would pick up the slack just fine. We're not in dire need of new revenue. The deficit is just over 700 billion. If we simply returned the government to the size it was in 2002, we'd have an annual surplus of 500 billion right now.
No. Really, no. Republicans, likely under sway from the Tea Party, were decidedly anti-big government. Republican buy-in to a program that would mandate health insurance or any other way make government somehow further involved in health care was a non-starter.
The Republicans had plenty of ideas that involved govt involvement in healthcare. Vouchers were one. Malpractice reform was another. They even had common ground on a few things that were passed in ACA. Point is, when the Democrats controlled all 3 branches of govt in the founding days of ACA, they didn't even give a nod in the direction of the Republicans.
Further, consider the consistent, lock-step voting by Republicans against ACA. As was repeatedly stated at the time (and later on), Democrats had a majority so didn't need any Republican support
You expect a different response from them when the opposition party pretty much gives them the finger during the entire process? I'm sure they're still pissed about it.
Yet the very fact that *no* Republican supported it is very telling to the idea that their opposition was more hyperpartisan than any real complaint about the merit of the ACA.
At the same time, if Medicare is ACTUALLY a net loss for a provider, they do have the right to accept no medicare. But they don't seem to want to opt out.
Last I heard, they weren't very pleased with the constant "doc fixes" either. However, to be fair, it's still proportionally a very low amount of doctors.
The problem is that there is no market. Nobody publishes prices at all. There's often nobody you can even ask.
I agree this is a problem, and what the government should be spending time/money fixing.
The 'customer' is often in no condition or position to argue. Even for a non emergency, they may not be able to decline the service for long and live to tell about it.
That's not a reasonable stance. Equate a healthcare market with a healthcare insurance market. Current day, do people start shopping in the insurance market when they get sick? Or do they already have a provider lined up? When your car breaks down, do you then start getting mechanic estimates, or do you generally have an affordable mechanic already picked out? That is how the healthcare market would work, if there was one. You'd know which hospitals/doctors are competitive and which ones would rip you off, because those prices would be transparent and exposed, long long before you get sick.
By telling the researchers to "look at 'cyclical' climate change", you are telling them to lock in to a conclusion, that climate changes cyclically, instead of studying and understanding the mechanisms that causes change.
lol, you mean like claiming a "consensus" on a specific conclusion and then continually changing your models to ensure all the non-matching data continues to match your chosen conclusion?
It is probably one of the most blatant and ignorant attempt and controlling science for political motives I have seen.
The Tea Party, to take their name from the Boston Tea Party who acted upon high taxes on tea.... Perhaps if the Tea Party was actually responding to a tax increase instead of preemptive presuming Obama being elected == higher taxes? Or perhaps if they had formed during Bush's years and had given a shit then instead of waiting until Obama
It wasn't until they were co-opted that their agenda shifted to the "general Republican platform" (not at all unlike the Occupy movement and their eventual conversion to the "general Democrat platform").
Perhaps if they called for higher taxes along with less spending instead of less taxes and less spending
Umm, why? The entire point of their argument is that the government is larger than it has ever been, continues to grow, and is tasked way beyond its constitutional reach already. Higher taxes has no place in that argument unless you want to maintain the level of bloat.
And do I begin to point out the absurdity of people who clearly champion less spending even though it could hurt them but are so afraid of tax increases without any thought that if spending can be hypothetically targeted to not hurt them, then so could tax increases?
You do know that governance is more than about just voting for "whatever gets you the most stuff", and that putting others before yourself is a valid method of voting?
Perhaps if less time was spent on decrying the evil of government and electing people who seemed determine to prove them right and more time was spent on actually fixing government and holding politicians accountable? Nah, let's just go for all the extremes we can.
Both sides are to blame here -- we live in hyperpartisan times. Perhaps had the Obama administration worked alongside Republicans when designing ACA instead of giving mere lip service, we wouldn't have had all this fighting over it to date (and maybe it would have actually turned out a decent piece of legislation).
So here's a serious question... why can so many other countries do it well?
If I had to guess, it's because the other countries are smaller and more homogenous.
So is the US functionally retarded?
Yes -- it's actually a testament as to why more programs should be shoved down to state level. Look at the dysfunction in the EU right now, with each of the member states trying to do it's own thing while Germany tries to order them around. That's what the US is like. I have no idea why half the country is so insistent on telling the other half how to live their lives (both ways...)
The jury is still out on whether it's going to cost more or less. Projections from various agencies put it at a net saving over time.
That's irrelevant. Yes, there's alot of "maybes" and "hopeful projections", but I'm talking facts. Medicaid was expanded: that is a fact. In addition, the "net savings over time" is horseshit since it includes the additional revenue from taxes when making that calculation (namely, if the extra taxes weren't there, it would be losing money) -- this is not a "free program" -- they aren't achieving all the savings from "streamlining the system". It's only claim of "budget neutrality" comes from the fact they're raiding our pockets as taxpayers. Believe it or not, you can make quite a few programs "net budget positive over time" with those kind of shenanigans.
Don't know about torture, though at least officially it has stopped.
So Guantanamo is shut down then?
Holy crap that's some spin.
No, it's not. You can't pretend the tax cuts are some kind of isolated Republican agenda that the Democrats compromised on when the Democrats wanted the tax cuts too. This isn't spin. Both parties wanted the tax cuts. The Dems additionally wanted a modification/repeal of the tax cuts for the rich, whereas the Republicans wanted those made permanent as well. In the end, The Dems got what they wanted when the Republicans caved to the Obama fiscal cliff threat in December.
The taxes you're talking about have been made permanent by a republican House that decided to shut down the government because it didn't get the entire budget it wanted, just a part of it.
Once again, they both wanted permanent extensions of the lower end tax cuts (http://www.bloomberg.com/news/2010-11-11/obama-would-back-extending-tax-cut-for-rich-axelrod-tells-huffington-post.html). The only opposition Obama had was to permanent tax cut extensions for the rich. The permanency of the lower end taxes was a joint operation (and frankly, since it's primarily a Democrat govt, they own more of that than the Republicans).
The taxes still go on
No, Bush's tax cuts have expired, literally. That bill is dead, a new one is in it's place with completely different terms. You can't simply pretend that every subsequent tax package passed is just an "Extension" of the previous one because it shares some semblance of similarity. Otherwise, these are George Washington's tax cuts.
So how does that exactly make him a zero-cost contributor? His tax cuts lived on, and he still never paid for any of his wars.
I said "going forward". I never said he didn't spend a shit-ton of money. In fact, I said exactly that in my previous post: that both of these presidents are huge spenders. The difference is that this president is an even bigger spender when accounting for future projections. Obama is merely masking his spending behind tax hikes.
Obama finally managed to spin down the wars that Bush started and couldn't
Please, next you're going to tell me Obama invented fracking and is the reason we have cheap natural gas. Those wars were already spinning down as Bush was leaving office (the timetable was already set): http://www.politifact.com/truth-o-meter/statements/2011/nov/03/barack-obama/ad-says-obama-reason-iraq-pullout/. What Obama did there was pretty much boilerplate and would largely have been done by any other president in his position. You can't pretend Obama inherited a bunch of nasty stuff from Bush and then also claim that the war drawdown timetable was some kind of crowning individual accomplishment when it was ha
You still haven't answered why in the world the insurance industry would want to inflate the costs of a pill. Certainly Medicaid won't want to inflate that price.
The gods only know. I'm still trying to figure out why negotiated prices are the norm in the first place. How can the same service cost vastly amounts of money in two different locations? It doesn't make any sense.
If I had to wager a guess as to one possible reason non-negotiated prices skyrocket, it could be that they're gouging the people without Medicare to offset the artificially lower payments they're forced to accept from Medicare patients. Or perhaps it's that in a system that pre-determines price via arbitration, uninformed in-the-dark consumers make poor arbiters. Or perhaps it's just economies of scale. When they know 99% of their users will be selecting the same subset of goods, they produce less (or no) goods outside of that subset. So if one of the 1% goes seeking one of those goods, there's a high cost involved since the supply is low. I don't think it's a matter of wanting to inflate the price. It's a matter of dysfunctional market forces driving up the price because of various reasons (inefficiency, arbitrary price assignment, economies of scales, etc, etc). It's funny..."price fixing" is exactly what is occurring with Medicare. If a private company were to behave in that fashion, they'd be charged with anti-competitive behavior under the Sherman Antitrust Act. So we do we allow our government to tamper in the market in such a fashion?
Let me give you a hypothetical example (regarding economies of scale): let's say there's some drug out there that is primarily consumed by the elderly, like an anti-Alzheimer's treatment. Let's say it's supremely expensive. Now, we know that the elderly get the bulk of their healthcare dollars via Medicare, which means the purchasing power of the entire market for that particular drug is dictated by whether or not it's covered by the government. Namely, if they do cover it, it will be affordable enough to market, so the companies will produce it. If they don't cover it, the companies could very easily decide not to produce it at all, because the cost of research & production would outweigh the gains, as very few people would actually be able to afford it. Since that decision then limits the supply, the drug goes even higher in cost than it would have if it were merely "just expensive." The government, through its actions, has priced that drug out of the market.
Even a bunch of bureaucrats making the decision beats the current state of affairs where the cost decisions are made by doctors who don't even know what it costs and don't care.
Ugh, I have higher expectations than "better than nothing". Particularly when going down this road can very easily be "worse than what we have now" if done wrong.
Not during the crucial parts of the Bush administration, where things were radically fucked up the most: the first 3 years or so of his administration, where he lied to the world about the Iraq invasion, let Osama escape in Tora Bora, legitimized torture and set up huge budget-busting tax-cuts and Medicare expansions.
Umm, you do know Obamacare is a huge Medicare expansion (aside from its own expense?) and Obama also set up huge budget busting tax-cuts as well? (at least Bush's were temporary, Obama's are permanent). Also, Obama's record on stopping torture isn't exactly much better, and don't get me started on the lies...civil liberties, transparency, hello?
Simply put, the mistakes haven't been as numerous or as significant, and the accomplishments have actually been more significant.
Apparently only because you're viewing this through partisan blinders. I see them both as ridiculous spenders, the main difference is that the bulk of Obama's spending is permanent, whereas Bush's was temporary (the wars have spun down and his tax cuts have expired, so going forward he is a zero-cost contributor). Obamacare on the other hand will never die, and Obama's tax cuts are permanent, rather than temporary. From a success/failure perspective, they're both dropping the ball (Iraq/Osama was a train wreck under Bush, just as fiscal discipline/health care reform is a train wreck under Obama)
Meanwhile, keep in mind that this is about what happens if Medicare or similar becomes the single payer. No more kooky insurance industry, just a single government entity that faces constant saber rattling about budget cuts.
But you still have the same problem -- it's just a different entity doing the negotiating at that point. In the end, it's still some other guy artificially increasing the cost of some things while subsidizing/allowing the costs of others.
I see no reason why the conversation couldn't happen with the doctor in that context. It would be about choosing a private option or using the public health system.
Because like I said before, in a system where everyone gets all their healthcare through negotiated prices, non-negotiated prices get jacked (both in the government or the insurance industry negotiation case). The only time the "non-covered" item is allowed to float to a "market rate" is when all items in the system are treated the same (so nothing becomes preferential/favored). Basically, in the negotiated systems, it's not consumer demand/desire/need/want driving the cost, it's a bureaucrat/CEO making arbitrary decisions on what "will become cheap". It's the same as the in-network/out-of-network problem. The same service can be significantly marked up out-of-network (thus somewhat forcing people to use the in-network services). The negotiated prices become a self-fulfilling prophecy -- they end up destroying consumer choice/freedom by ceding cost control to somebody else and consequently eliminating options by pricing them out of the realm of possibility.
You're correct. The insurance system marked the pill up. All the government did was legally mandate that we're all required to use the insurance system for all our healthcare needs.
But that can only happen if you and your doctor actually look at the price and say, woah! That's not sane. If you do, then the $500 pill becomes the $50 pill or even the $15 pill.
This I agree with, except it's never going to happen under the current system because me and my doctor are never the ones talking price, by law in fact.
If you are the sort of patient who can afford to have it served on a cracker with caviar, fine. Tell your doctor and he can give you the $500 pills. It is unconscionable to prescribe it for someone that will have to choose between food and pills yet it happens all the time.
Except our healthcare market (if you can even call it a market) doesn't work that way. Since everything is tied to insurance, anything bought outside of items that insurance companies give the nod to get an insane artificial markup. Namely that $500 pill is $500 if covered by insurance. If not covered by insurance, it's $5,000. So the system in place in fact removes my choice of the $500 pill, because I certainly can't afford $5,000. Basically, the insurance companies (or the government) are the ones determining in the end what will be affordable. If insurance companies weren't in the picture at all, the consumer would be able to decide between the $.50 pill or the $500 on their own.
Dear phantomfive, there is consensus that the we are running an uncontrolled experiment, the/could/ have dire consequences, more mild consequences, or no consequences. If you know anything about risk analysis, then you'd know that that is a serious alarm bell.
Sounds like a pretty straightforward Pascal's Wager. I take it you're a religious man?
I think we should ditch the whole thing and just go single-payer. Doctors would get paid fee-for-service and not have to deal with insurance companies, individuals would be able to use healthcare without worrying about the cost, and things would be better. T
Fuck that, I'm only going single-payer if I get to be the payer. I'll be damned if I'm going to have a government deciding whether or not I/they can afford the care I need. Similarly, I have no interest in subsidizing the pisspoor lifestyles of the rest of the country. I'll be glad to shoulder the cost of keeping them alive, but they damn well better leave the hospital with an even deeper hurt in their wallet (rather than "free of charge")
The NHS is running out of money because there's more people, living longer, wanting the latest, best drugs that cost more, while funding levels are being cut in real terms by the Tory government. That's something that will have to be dealt with, but it's certainly not a reason to kill the NHS. It's one the best things about Britain, and if we have to up our contributions a few percent to pay for it, I for one am glad to do so.
Well maybe that's the difference between Britain and the US. There you talk about upping your contributions to pay for it. Here, a bunch of lazy slugs want to up somebody else's contributions to pay for it. Personally, I believe the personal contribution should scale proportionally to the quality of care you're demanding, but heaven forbid if we actually give "better care" to someone who can actually pay for it.
always cracks me up when people whine about the ACA and "rationing" health care and "death panels" - look around, we already have them and have had them for decades - controlled by corporations out to maximize profit.
And what you don't understand is that the right doesn't want those death panels either. We want our own families to be the "death panel".
Who has more bargaining power? An individual, or a whole government?
Why is "Bargaining power" relevant? I don't bargain with the grocery store when I buy milk. Why is my healthcare done via cost negotiation instead of "oh, i dunno...what the fucking operation costs?"
The free market works for elective surgery because you *can* shop around and take advantage of competition. That isn't where the problems lie. The problems occur in situations where you *cannot* shop around and for which there is no competition, sometimes not even consent (you can't make a deal when you're unconscious).
Except you're wrong and stop spouting this lie. "Emergency care", namely care that is so imminent that you don't have time to react or wait, is a very small portion of our total healthcare bill: http://newsroom.acep.org/download/ACEP+2%25+booklet.pdf
Wake the fuck up.
Why is the care in the US 2.5x as expensive as the "too expensive" NHS (per person per PPP normalized GDP/capita) if the free market system works so well?
Because we don't have a free market!!!! I evaluate insurance plans, not medical costs.
You're nuts if you think that eye surgeries are anything but an outlier.
It isn't just eye surgery. Most elective surgery has seen cost declines, such as plastic surgery. Namely, most everything that isn't handled through insurance has seen cost declines. Notice the correlation?
Surely you didn't miss the obvious answer, doctors shouldn't tick every box on the lab form and prescribe $500 pills when a $0.50 pill will do the same thing. Is it really so hard for them to be professional?
I'd argue it's rarely that simple. Normally there's a $500 pill that's 90% effective and a $.50 pill that's ~75% effective. The doctors are just trying to avoid malpractice suits, so they probably go with whatever is the most effective. Neither situation is ideal. If I personally could afford the $500 pill, why should I get substandard care just because my doctor is trying to be cost effective? Which brings us inevitably back to the free market debate and why consumers should be in control of their own healthcare choices, not anybody else (I should be making that cost analysis decision, not somebody else).
That's actually a very common thread with him actually. Just look at any of his budget proposals. Spending never goes down. He pretends to claim financial discipline via using tax hikes and retribution of dollars (by cutting programs he doesn't like) to account for added spending.
However, while I concede that there is perhaps not enough of a focus on cutting spending, you can't simply ignore the issue of taxation, even if only for the reasons I mention previously.
That alone is 1.6 trillion dollars in new revenue over 10 years. Now show me a drop in the budget anywhere near that. Here's the last 6 budgets (over his total time in office, he has added 700 billion in spending to the budget -- and keep in mind, this is accounting for the savings in winding down Iraq/Afghanistan spending + TARP paying for itself...so even with those windfalls, we're at +700 billion):
2014 United States federal budget â" $3.8 trillion (submitted 2013 by President Obama)
2013 United States federal budget â" $3.8 trillion (submitted 2012 by President Obama)
2012 United States federal budget â" $3.7 trillion (submitted 2011 by President Obama)
2011 United States federal budget â" $3.8 trillion (submitted 2010 by President Obama)
2010 United States federal budget â" $3.6 trillion (submitted 2009 by President Obama)
2009 United States federal budget â" $3.1 trillion (submitted 2008 by President Bush)
You'll note that spending hasn't changed at all. At best, it's petered out at "unchanged" (and this is in an environment with very little inflation). So once again, you'll have to pardon me if I don't scoff at the demands for more taxes by the Democrats (or at the demands for more spending for "stimulus"). I find it particularly insulting that Obama has the gall to demand a "balanced" (i.e. "1-to-1") composition of tax hikes and spending cuts after he just permanently added 700 billion (20% more spending) to our total spending picture
The states had a good couple decades, centuries in some cases, to get this shit straightened out. Nothing happened.
Actually, I'm fairly certain the states dodge most of these issues because they assume mother government is going to handle it on the federal level. Otherwise, why haven't all the Democratic states adopted single payer programs as they've been clamoring for so incessantly?
I hear a lot of talk about reform. I have yet to hear any coherent plan to provide t
Yes, like sailors on shore leave, unlike the preceding administration's fiscal responsibility with things like the Iraq and Afghanistan wars, the "Bush tax cuts", Medicare Part D, which make the current "spending spree" seem like austerity.
Expenses that are all already gone. The current budget no longer has a significant Iraq/Afghan expense. The Bush temporary tax cuts have expired. So no, I'm afraid you're incorrect. The current administration's permanent tax cuts plus permanent Obamacare/entitlement expansion are way more damaging to our budget, and have contributed far more to the deficit to date. And I never recall supporting the previous administration either. Two wrongs don't make a right.
Much like Democrats have been asking for single payer healthcare, a significant reduction in military spending, and a repeal of the second amendment
The Dems couldn't even get their own party behind single payer, so you lose there.
Military spending has already seen a significant reduction. The wars have been wound down, the sequester has hit them hard, and projected growth is flat. On top of that, defense spending is at an all time low: https://en.wikipedia.org/wiki/File:U.S._Defense_Spending_-_percent_to_Outlays.png
You guys really need to learn to get your news from someone other than Stewart/Colbert.
Regarding the repeal of the 2nd amendment, please -- like that's in any way comparable to requests for entitlement reform?
I got news for you: it's not happening, and simply asking for the same thing over and over again isn't going to make it any more palatable to the voting public.
Between people who want "major change" in the program or a "complete rebuild", a plurality of the nation wants substantial change to those programs Once again, get out of your echo chamber. The only people it isn't palatable to are liberals afraid of losing votes.
So the solution is not to actually enforce the tax code, or to get rid of loopholes, but instead to simply lower taxes?
Actually, closing the loopholes is a far more noble (and fruitful) cause than simply jacking up the rates. Sadly, no Democrats are willing to engage that concept in any serious fashion.
Some of us are unwilling to bend to the will of the rich and don't feel that giving up on taxing them is the optimal solution here.
Define "giving up" -- the rich have already seen substantial tax hikes in the past 4 years -- why do you pretend as if nothing has been done? When is enough enough? When they're out of money? As I said before, they're already paying a historically massive sum of total taxes.
According to the Center for Budget and Policy Priorities, "in 2007, the share of after-tax income going to the top 1 percent hit its highest level (17.1 percent) since 1979". That means that that the income of the top 1% accounts for roughly 17% of GDP. Are you suggesting that federal spending is greater than 17% of GDP? Where are you getting these numbers?
Yes, that is what I'm suggesting. 2013 US GDP was a hair above 15 trillion. 17% of that is about 2.5 trillion. The 2013 federal budget had 3.8 trillion dollars in outlays. That's the kind of spending we're talking about. Even if you account for the fact that payroll taxes cover part of that sum, you're still nowhere near where you need to be. And that spending is expected to spike in a big way down the road as well as Medicare and Social Security balloon. So that's exactly why this conversation should be about the spending and not about the revenue.
Reform... what does that even mean? Let's say we give $X/year in entitlements to recipients of Social Security, Medicare, Medicaid, and other social programs that need "reform". Surely you'll agree that this will cost at least $X/year, plus overhead costs. By "reform", are you talking about cutting the already-nominal overhead costs?
If you're talking about me personally, I want a complete overhaul (as in privatizing part of Social Security and/or changing it to more of a pre-funded forced retirement w/ a smaller supporting safety net rather than the pyramid scheme it is today). But there's a great deal of smaller things that could be done which would still put a significant dent into it such as means testing.
You mean you want to gut these social programs, to pay out less to the recipients.
No, benefit changes are the last thing I want. I want a well designed program that isn't susceptible to govt raiding of the funds, a shrinking workforce, or a declining population.
You want to screw people that have spent their entire lives paying into the system, allowing "the market" to "take care" of them.
Had the social security lockbox been in the stock market for the duration of its existence, rather than being borrowed upon and wasted by the government, we wouldn't even have a deficit right now. But go ahead and keep mindlessly bashing the free market -- you guys are good for that.
At least be honest and say you don't think it's the government's business to take care of those in need
It is a task better suited for the state government, where the majority of these programs should be implemented. I disagree with the unconstitutional nature of the federal programs. But I believe that such safety net programs should exist.
Thankfully enough, sociopaths like you aren't a majority in our society.
And sadly enough, shortsighted people like you are a majority of our society. You'll gladly praise any dollar the govt is throwing at a problem, no matter how poorly designed or horribly implemented. You stand ignorantly in the f
Yes, for funding the government, as has been done many times before in the past w/ respect to increasing the debt limit. It's particularly relevant considering the Dems spent the past half decade spending like sailors on shore leave (including on their beloved Obamacare, and Obama's tax cuts, and entitlements, which are all the primary drivers of our current debt).
Or are you saying that it would only really be a compromise on the part of Democrats, or basically that the Republicans should get what they want without any real concessions?
I'm saying that the Republicans never get concessions, and frankly are due. They've been asking for entitlement reform for forever, for instance. When Obama did the exact same budget bravado in December, the Republicans caved on their #1 "golden cow" and allowed tax hikes. Yet the promised entitlement conversation never followed.
The Dems are remarkably good at steering public dialogue to make it appear that the Republicans are "getting something, but just whining about not getting enough", when in reality the Dems are pretty much getting practically everything they want, while refusing to put anything on the table of actual relevance (as an example: the Dems get a new massive entitlement program not seen since the New Deal, and the Republicans in return get "some piddly discretionary cuts that don't even dent the deficit"). That's the problem.
Slashdot Mirror
I'm very aware of the current situation. Which is why I focus on what matters: spending, not debt. Debt is irrelevant. What determines the size and bloat of government is how much spending they're doing today, and I was 100% correct when I said it's at record levels and slated to grow farther still. The 2002 federal budget was 2 trillion. The 2014 federal budget is 3.8 trillion. The handy inflation calculator (http://www.usinflationcalculator.com/) tells me that the dollar has inflated 30% in in that time period. Since 2 trillion is only 2.6 trillion in inflation adjusted dollars, that means the government is spending almost 50% more than it did just a decade ago, TODAY (and that's not even accounting for growth projections). And the interest on past debt is a very small part of that total budget, at just over 200 billion -- so where'd the extra trillion dollars in permanent spending come from? And why do you seem content to ignore it? Moreover, given the fact that we've already had two tax increases (one with Obamacare and one in December), why does Obama still demand tax hikes in any spending cut negotiation when he hasn't cut spending at all!? Why don't we compare current day revenue to 2002 revenue? 2014 revenue projections are 3 trillion (2013 was around 2.7 trillion). 2002 revenue was 1.85 trillion. Going back to that handy 30% inflation number (for an extrapolated 2.4 trillion in adjusted revenue), that means our current revenue is 10-30% higher TODAY than we had then. Yet the only words out of that stubborn president's mouth are "more taxes".
Soooo...what you're advocating is that because it would take a long time to undo the ridiculous level of spending we're at, we should not even try?
I'm in no hurry to pay down the debt. I'd settle for a balanced budget. GDP growth, revenue increases from a recovering economy, and inflation would pick up the slack just fine. We're not in dire need of new revenue. The deficit is just over 700 billion. If we simply returned the government to the size it was in 2002, we'd have an annual surplus of 500 billion right now.
The Republicans had plenty of ideas that involved govt involvement in healthcare. Vouchers were one. Malpractice reform was another. They even had common ground on a few things that were passed in ACA. Point is, when the Democrats controlled all 3 branches of govt in the founding days of ACA, they didn't even give a nod in the direction of the Republicans.
You expect a different response from them when the opposition party pretty much gives them the finger during the entire process? I'm sure they're still pissed about it.
Actually, in my opinion, that's very telling abo
The number of doctors not accepting Medicare patients has tripled: http://www.healthcaretechnologyonline.com/doc/doctors-refuse-to-accept-medicare-patients-0001
Last I heard, they weren't very pleased with the constant "doc fixes" either. However, to be fair, it's still proportionally a very low amount of doctors.
I agree this is a problem, and what the government should be spending time/money fixing.
That's not a reasonable stance. Equate a healthcare market with a healthcare insurance market. Current day, do people start shopping in the insurance market when they get sick? Or do they already have a provider lined up? When your car breaks down, do you then start getting mechanic estimates, or do you generally have an affordable mechanic already picked out? That is how the healthcare market would work, if there was one. You'd know which hospitals/doctors are competitive and which ones would rip you off, because those prices would be transparent and exposed, long long before you get sick.
lol, you mean like claiming a "consensus" on a specific conclusion and then continually changing your models to ensure all the non-matching data continues to match your chosen conclusion?
I agree.
Hello straw man.
They did, and they did. The Tea Party started as a response to the bank bailouts, specifically to TARP: https://en.wikipedia.org/wiki/Tea_Party_protests
It wasn't until they were co-opted that their agenda shifted to the "general Republican platform" (not at all unlike the Occupy movement and their eventual conversion to the "general Democrat platform").
Umm, why? The entire point of their argument is that the government is larger than it has ever been, continues to grow, and is tasked way beyond its constitutional reach already. Higher taxes has no place in that argument unless you want to maintain the level of bloat.
You do know that governance is more than about just voting for "whatever gets you the most stuff", and that putting others before yourself is a valid method of voting?
Both sides are to blame here -- we live in hyperpartisan times. Perhaps had the Obama administration worked alongside Republicans when designing ACA instead of giving mere lip service, we wouldn't have had all this fighting over it to date (and maybe it would have actually turned out a decent piece of legislation).
If I had to guess, it's because the other countries are smaller and more homogenous.
Yes -- it's actually a testament as to why more programs should be shoved down to state level. Look at the dysfunction in the EU right now, with each of the member states trying to do it's own thing while Germany tries to order them around. That's what the US is like. I have no idea why half the country is so insistent on telling the other half how to live their lives (both ways...)
Only true of the government offerings. You can sign up for private health insurance anytime you damn well please. And none of them can turn you down.
That's irrelevant. Yes, there's alot of "maybes" and "hopeful projections", but I'm talking facts. Medicaid was expanded: that is a fact. In addition, the "net savings over time" is horseshit since it includes the additional revenue from taxes when making that calculation (namely, if the extra taxes weren't there, it would be losing money) -- this is not a "free program" -- they aren't achieving all the savings from "streamlining the system". It's only claim of "budget neutrality" comes from the fact they're raiding our pockets as taxpayers. Believe it or not, you can make quite a few programs "net budget positive over time" with those kind of shenanigans.
So Guantanamo is shut down then?
No, it's not. You can't pretend the tax cuts are some kind of isolated Republican agenda that the Democrats compromised on when the Democrats wanted the tax cuts too. This isn't spin. Both parties wanted the tax cuts. The Dems additionally wanted a modification/repeal of the tax cuts for the rich, whereas the Republicans wanted those made permanent as well. In the end, The Dems got what they wanted when the Republicans caved to the Obama fiscal cliff threat in December.
Once again, they both wanted permanent extensions of the lower end tax cuts (http://www.bloomberg.com/news/2010-11-11/obama-would-back-extending-tax-cut-for-rich-axelrod-tells-huffington-post.html). The only opposition Obama had was to permanent tax cut extensions for the rich. The permanency of the lower end taxes was a joint operation (and frankly, since it's primarily a Democrat govt, they own more of that than the Republicans).
No, Bush's tax cuts have expired, literally. That bill is dead, a new one is in it's place with completely different terms. You can't simply pretend that every subsequent tax package passed is just an "Extension" of the previous one because it shares some semblance of similarity. Otherwise, these are George Washington's tax cuts.
I said "going forward". I never said he didn't spend a shit-ton of money. In fact, I said exactly that in my previous post: that both of these presidents are huge spenders. The difference is that this president is an even bigger spender when accounting for future projections. Obama is merely masking his spending behind tax hikes.
Please, next you're going to tell me Obama invented fracking and is the reason we have cheap natural gas. Those wars were already spinning down as Bush was leaving office (the timetable was already set): http://www.politifact.com/truth-o-meter/statements/2011/nov/03/barack-obama/ad-says-obama-reason-iraq-pullout/. What Obama did there was pretty much boilerplate and would largely have been done by any other president in his position. You can't pretend Obama inherited a bunch of nasty stuff from Bush and then also claim that the war drawdown timetable was some kind of crowning individual accomplishment when it was ha
The gods only know. I'm still trying to figure out why negotiated prices are the norm in the first place. How can the same service cost vastly amounts of money in two different locations? It doesn't make any sense.
If I had to wager a guess as to one possible reason non-negotiated prices skyrocket, it could be that they're gouging the people without Medicare to offset the artificially lower payments they're forced to accept from Medicare patients. Or perhaps it's that in a system that pre-determines price via arbitration, uninformed in-the-dark consumers make poor arbiters. Or perhaps it's just economies of scale. When they know 99% of their users will be selecting the same subset of goods, they produce less (or no) goods outside of that subset. So if one of the 1% goes seeking one of those goods, there's a high cost involved since the supply is low. I don't think it's a matter of wanting to inflate the price. It's a matter of dysfunctional market forces driving up the price because of various reasons (inefficiency, arbitrary price assignment, economies of scales, etc, etc). It's funny..."price fixing" is exactly what is occurring with Medicare. If a private company were to behave in that fashion, they'd be charged with anti-competitive behavior under the Sherman Antitrust Act. So we do we allow our government to tamper in the market in such a fashion?
Let me give you a hypothetical example (regarding economies of scale): let's say there's some drug out there that is primarily consumed by the elderly, like an anti-Alzheimer's treatment. Let's say it's supremely expensive. Now, we know that the elderly get the bulk of their healthcare dollars via Medicare, which means the purchasing power of the entire market for that particular drug is dictated by whether or not it's covered by the government. Namely, if they do cover it, it will be affordable enough to market, so the companies will produce it. If they don't cover it, the companies could very easily decide not to produce it at all, because the cost of research & production would outweigh the gains, as very few people would actually be able to afford it. Since that decision then limits the supply, the drug goes even higher in cost than it would have if it were merely "just expensive." The government, through its actions, has priced that drug out of the market.
Ugh, I have higher expectations than "better than nothing". Particularly when going down this road can very easily be "worse than what we have now" if done wrong.
Umm, you do know Obamacare is a huge Medicare expansion (aside from its own expense?) and Obama also set up huge budget busting tax-cuts as well? (at least Bush's were temporary, Obama's are permanent). Also, Obama's record on stopping torture isn't exactly much better, and don't get me started on the lies...civil liberties, transparency, hello?
Apparently only because you're viewing this through partisan blinders. I see them both as ridiculous spenders, the main difference is that the bulk of Obama's spending is permanent, whereas Bush's was temporary (the wars have spun down and his tax cuts have expired, so going forward he is a zero-cost contributor). Obamacare on the other hand will never die, and Obama's tax cuts are permanent, rather than temporary. From a success/failure perspective, they're both dropping the ball (Iraq/Osama was a train wreck under Bush, just as fiscal discipline/health care reform is a train wreck under Obama)
But you still have the same problem -- it's just a different entity doing the negotiating at that point. In the end, it's still some other guy artificially increasing the cost of some things while subsidizing/allowing the costs of others.
Because like I said before, in a system where everyone gets all their healthcare through negotiated prices, non-negotiated prices get jacked (both in the government or the insurance industry negotiation case). The only time the "non-covered" item is allowed to float to a "market rate" is when all items in the system are treated the same (so nothing becomes preferential/favored). Basically, in the negotiated systems, it's not consumer demand/desire/need/want driving the cost, it's a bureaucrat/CEO making arbitrary decisions on what "will become cheap". It's the same as the in-network/out-of-network problem. The same service can be significantly marked up out-of-network (thus somewhat forcing people to use the in-network services). The negotiated prices become a self-fulfilling prophecy -- they end up destroying consumer choice/freedom by ceding cost control to somebody else and consequently eliminating options by pricing them out of the realm of possibility.
You're correct. The insurance system marked the pill up. All the government did was legally mandate that we're all required to use the insurance system for all our healthcare needs.
This I agree with, except it's never going to happen under the current system because me and my doctor are never the ones talking price, by law in fact.
Except our healthcare market (if you can even call it a market) doesn't work that way. Since everything is tied to insurance, anything bought outside of items that insurance companies give the nod to get an insane artificial markup. Namely that $500 pill is $500 if covered by insurance. If not covered by insurance, it's $5,000. So the system in place in fact removes my choice of the $500 pill, because I certainly can't afford $5,000. Basically, the insurance companies (or the government) are the ones determining in the end what will be affordable. If insurance companies weren't in the picture at all, the consumer would be able to decide between the $.50 pill or the $500 on their own.
Sounds like a pretty straightforward Pascal's Wager. I take it you're a religious man?
Fuck that, I'm only going single-payer if I get to be the payer. I'll be damned if I'm going to have a government deciding whether or not I/they can afford the care I need. Similarly, I have no interest in subsidizing the pisspoor lifestyles of the rest of the country. I'll be glad to shoulder the cost of keeping them alive, but they damn well better leave the hospital with an even deeper hurt in their wallet (rather than "free of charge")
Well maybe that's the difference between Britain and the US. There you talk about upping your contributions to pay for it. Here, a bunch of lazy slugs want to up somebody else's contributions to pay for it. Personally, I believe the personal contribution should scale proportionally to the quality of care you're demanding, but heaven forbid if we actually give "better care" to someone who can actually pay for it.
And what you don't understand is that the right doesn't want those death panels either. We want our own families to be the "death panel".
Why is "Bargaining power" relevant? I don't bargain with the grocery store when I buy milk. Why is my healthcare done via cost negotiation instead of "oh, i dunno...what the fucking operation costs?"
Except you're wrong and stop spouting this lie. "Emergency care", namely care that is so imminent that you don't have time to react or wait, is a very small portion of our total healthcare bill: http://newsroom.acep.org/download/ACEP+2%25+booklet.pdf
Wake the fuck up.
Because we don't have a free market!!!! I evaluate insurance plans, not medical costs.
It isn't just eye surgery. Most elective surgery has seen cost declines, such as plastic surgery. Namely, most everything that isn't handled through insurance has seen cost declines. Notice the correlation?
I'd argue it's rarely that simple. Normally there's a $500 pill that's 90% effective and a $.50 pill that's ~75% effective. The doctors are just trying to avoid malpractice suits, so they probably go with whatever is the most effective. Neither situation is ideal. If I personally could afford the $500 pill, why should I get substandard care just because my doctor is trying to be cost effective? Which brings us inevitably back to the free market debate and why consumers should be in control of their own healthcare choices, not anybody else (I should be making that cost analysis decision, not somebody else).
It's been a mainstay request of Republicans for some time now. And do you know what Obama's counter proposal has been? He'll entertain the idea if he gets to spend the money saved from the reform: http://www.bloomberg.com/news/2013-07-30/obama-tax-plan-tackles-budget-issue-with-political-hurdle.html
That's actually a very common thread with him actually. Just look at any of his budget proposals. Spending never goes down. He pretends to claim financial discipline via using tax hikes and retribution of dollars (by cutting programs he doesn't like) to account for added spending.
I would agree with this statement only if taxation wasn't already addressed while spending has been completely overlooked. Obamacare hiked taxes by about 1 trillion over 10 years: http://www.washingtonpost.com/blogs/fact-checker/post/does-obamacare-have-1-trillion-in-tax-hikes-aimed-at-the-middle-class/2013/03/11/1e685f4c-8a9b-11e2-8d72-dc76641cb8d4_blog.html
The December tax hike on the upper income bracket resulted in 600 billion in new revenue over 10 years: https://en.wikipedia.org/wiki/American_Taxpayer_Relief_Act_of_2012
That alone is 1.6 trillion dollars in new revenue over 10 years. Now show me a drop in the budget anywhere near that. Here's the last 6 budgets (over his total time in office, he has added 700 billion in spending to the budget -- and keep in mind, this is accounting for the savings in winding down Iraq/Afghanistan spending + TARP paying for itself...so even with those windfalls, we're at +700 billion):
2014 United States federal budget â" $3.8 trillion (submitted 2013 by President Obama)
2013 United States federal budget â" $3.8 trillion (submitted 2012 by President Obama)
2012 United States federal budget â" $3.7 trillion (submitted 2011 by President Obama)
2011 United States federal budget â" $3.8 trillion (submitted 2010 by President Obama)
2010 United States federal budget â" $3.6 trillion (submitted 2009 by President Obama)
2009 United States federal budget â" $3.1 trillion (submitted 2008 by President Bush)
You'll note that spending hasn't changed at all. At best, it's petered out at "unchanged" (and this is in an environment with very little inflation). So once again, you'll have to pardon me if I don't scoff at the demands for more taxes by the Democrats (or at the demands for more spending for "stimulus"). I find it particularly insulting that Obama has the gall to demand a "balanced" (i.e. "1-to-1") composition of tax hikes and spending cuts after he just permanently added 700 billion (20% more spending) to our total spending picture
Actually, I'm fairly certain the states dodge most of these issues because they assume mother government is going to handle it on the federal level. Otherwise, why haven't all the Democratic states adopted single payer programs as they've been clamoring for so incessantly?
Expenses that are all already gone. The current budget no longer has a significant Iraq/Afghan expense. The Bush temporary tax cuts have expired. So no, I'm afraid you're incorrect. The current administration's permanent tax cuts plus permanent Obamacare/entitlement expansion are way more damaging to our budget, and have contributed far more to the deficit to date. And I never recall supporting the previous administration either. Two wrongs don't make a right.
The Dems couldn't even get their own party behind single payer, so you lose there.
Military spending has already seen a significant reduction. The wars have been wound down, the sequester has hit them hard, and projected growth is flat. On top of that, defense spending is at an all time low: https://en.wikipedia.org/wiki/File:U.S._Defense_Spending_-_percent_to_Outlays.png
You guys really need to learn to get your news from someone other than Stewart/Colbert.
Regarding the repeal of the 2nd amendment, please -- like that's in any way comparable to requests for entitlement reform?
Incorrect, the voting public wants entitlement reform: http://www.people-press.org/2011/07/07/public-wants-changes-in-entitlements-not-change-in-benefits/
Between people who want "major change" in the program or a "complete rebuild", a plurality of the nation wants substantial change to those programs Once again, get out of your echo chamber. The only people it isn't palatable to are liberals afraid of losing votes.
Still not a fix. The only options are "shaft the doctors" or "pay the exorbitant fees". Neither is good for a functioning healthcare system.
Actually, closing the loopholes is a far more noble (and fruitful) cause than simply jacking up the rates. Sadly, no Democrats are willing to engage that concept in any serious fashion.
Define "giving up" -- the rich have already seen substantial tax hikes in the past 4 years -- why do you pretend as if nothing has been done? When is enough enough? When they're out of money? As I said before, they're already paying a historically massive sum of total taxes.
Yes, that is what I'm suggesting. 2013 US GDP was a hair above 15 trillion. 17% of that is about 2.5 trillion. The 2013 federal budget had 3.8 trillion dollars in outlays. That's the kind of spending we're talking about. Even if you account for the fact that payroll taxes cover part of that sum, you're still nowhere near where you need to be. And that spending is expected to spike in a big way down the road as well as Medicare and Social Security balloon. So that's exactly why this conversation should be about the spending and not about the revenue.
If you're talking about me personally, I want a complete overhaul (as in privatizing part of Social Security and/or changing it to more of a pre-funded forced retirement w/ a smaller supporting safety net rather than the pyramid scheme it is today). But there's a great deal of smaller things that could be done which would still put a significant dent into it such as means testing.
No, benefit changes are the last thing I want. I want a well designed program that isn't susceptible to govt raiding of the funds, a shrinking workforce, or a declining population.
Had the social security lockbox been in the stock market for the duration of its existence, rather than being borrowed upon and wasted by the government, we wouldn't even have a deficit right now. But go ahead and keep mindlessly bashing the free market -- you guys are good for that.
It is a task better suited for the state government, where the majority of these programs should be implemented. I disagree with the unconstitutional nature of the federal programs. But I believe that such safety net programs should exist.
And sadly enough, shortsighted people like you are a majority of our society. You'll gladly praise any dollar the govt is throwing at a problem, no matter how poorly designed or horribly implemented. You stand ignorantly in the f
Yes, for funding the government, as has been done many times before in the past w/ respect to increasing the debt limit. It's particularly relevant considering the Dems spent the past half decade spending like sailors on shore leave (including on their beloved Obamacare, and Obama's tax cuts, and entitlements, which are all the primary drivers of our current debt).
I'm saying that the Republicans never get concessions, and frankly are due. They've been asking for entitlement reform for forever, for instance. When Obama did the exact same budget bravado in December, the Republicans caved on their #1 "golden cow" and allowed tax hikes. Yet the promised entitlement conversation never followed.
The Dems are remarkably good at steering public dialogue to make it appear that the Republicans are "getting something, but just whining about not getting enough", when in reality the Dems are pretty much getting practically everything they want, while refusing to put anything on the table of actual relevance (as an example: the Dems get a new massive entitlement program not seen since the New Deal, and the Republicans in return get "some piddly discretionary cuts that don't even dent the deficit"). That's the problem.