quote:

What they were holding out for was cost reductions, not that it didnt go far enough. And "finally had enough of what they thought they could hold out for" was influenced by Rahmbo's strong arm tactics.

quote:

ORIGINAL: tazzygirl

quote:

What they were holding out for was cost reductions, not that it didnt go far enough. And "finally had enough of what they thought they could hold out for" was influenced by Rahmbo's strong arm tactics.

They held out for far more

quote:

ORIGINAL: slvemike4u

It is highly amusing to see those on the right now championing the Constitution....Where were all you defenders of that document while your boys Bush and Cheney were tearing it to shreds...distorting it at every turn in their mad grab for power?

quote:

ORIGINAL: willbeurdaddy

quote:

ORIGINAL: DomKen

Such a careful editing job. Show me the various speeches and interviews in full.

The Barney Frank quote wasnt edited, it is the entiretly of his response to a question about why the current bill doesnt go all the way to single payer. The Obama speeches are such plain clear words that what would adding the rhetoric around them do. To his union supporters, SEIU and AFL_CIO he was very clear that he supports single payer and that his vision is for employer plans (which ARE the private insurance industry) to be gone in 15 to 20 years.


But, go ahead and ignore the facts and play your childish games as you always do.

quote:

ORIGINAL: willbeurdaddy

quote:

ORIGINAL: tazzygirl

quote:

What they were holding out for was cost reductions, not that it didnt go far enough. And "finally had enough of what they thought they could hold out for" was influenced by Rahmbo's strong arm tactics.

They held out for far more

Cost reductions was still the core of what they were looking for, and didnt get much of. Did you listen to any of their interviews?

Edit: Actually "cost reductions" IS a bit brief, the core of what they were looking for was balancing the program cost with savings in delivery and administration. They rallied behind the CBO study showing that the savings weren't there and turned their focus on cutting costs of the program.

quote:

'Blue Dog' Dems reach health care deal, but Utah's Matheson still balking
Updated: 07/30/2009 07:21:05 AM MDT

Washington » Health reform has a heartbeat in the House again after conservative Democrats struck a deal with party leaders Wednesday that would lower costs and ease requirements on small businesses.

But Rep. Jim Matheson, D-Utah, remains unsatisfied and, unless more changes are adopted, he plans to buck his party and vote against the bill this week in the House Energy and Commerce Committee.

"My most significant concerns," Matheson said, "have not been addressed by the deal."

His list of objections is similar to many Republican concerns. He said the proposal gives the federal government too much power and does too little to reform medical-malpractice claims.

Matheson is a member of the Blue Dog Democrats, a coalition of fiscal conservatives who have threatened to team with Republicans to kill the wide-ranging proposal.

Seven Blue Dogs sit on the commerce committee and four agreed to Wednesday's deal, enough to secure passage out of the panel. A full House vote won't take place until September at the earliest.

President Barack Obama welcomed the news, especially since his signature domestic issue has hit repeated roadblocks recently.

"I'm especially grateful," he said in a statement, "that so many members, including some Blue Dogs on the Energy and Commerce Committee, are working so hard to find common ground."

The accord was reached after House leaders and


White House officials participated in marathon negotiating sessions with members of the Blue Dog coalition. Matheson and others met with Obama at the White House last week.

As part of the deal, House leaders vowed to trim $100 billion from the price tag of the roughly $1 trillion plan. They agreed to allow doctors to negotiate the rates they would be paid by any government-created health-insurance plan instead of tagging the amounts to the lower-paying Medicaid schedule. And they agreed to make it easier for small businesses to avoid penalties if they do not offer health insurance to employees.

quote:

ORIGINAL: Lucylastic

Maverick...Errrrrrrrrrm scuse me but the WHO is still publishing data..
http://www.who.int/whosis/en/index.html
2008 section by section start page
http://www.who.int/whosis/whostat/2008/en/index.html
Now they might have changed some ways of measuring, and even ranking, but the numbers are there to be analyzed
now why should we buy what you are saying???

quote:


Regarding the clips of Obama, they are hardly new, 2003 is the date of one of them, so hes hardly been keeping it a secret.
Have you so little compassion that you dont care about the people who cant afford healthcare beyond using an emergency room? I bet you are one of those that whines about emergency room waits too arent you?

quote:

The Effects of Health Reform Legislation beyond the Next Decade
In this year’s discussion of health reform, many people have put forth the goals of “bending the curve” of the federal budgetary commitment to health care, the federal budget deficit, or overall national health expenditures. Accordingly, Members of Congress are asking CBO to analyze the extent to which different health reform proposals meet these goals. Last month we wrote to Senator Conrad and Senator Gregg: “CBO does not provide formal cost estimates beyond the 10-year budget window because the uncertainties are simply too great. However, in evaluating proposals to reform health care, the agency will endeavor to offer a qualitative indication of whether they would be more likely to increase or decrease the budget deficit over the long term.” Let me explain our methodology for doing this and the limits of that methodology, beginning with the federal budget and then concluding with national health spending.

The health reform proposals being discussed this year generally include many specific changes to tax and spending policies. Although we and the staff of the Joint Committee on Taxation base our 10-year estimates of the budgetary effects of reform proposals on detailed examination of these changes, we cannot realistically conduct longer-term analysis at that level of detail. Therefore, we group the changes in a reform proposal into several broad categories and evaluate the rate at which the budgetary impact of each of those broad categories is likely to increase over time. Some elements of reform proposals, such as subsidies for people who purchase insurance through exchanges, tend to grow roughly in line with health care costs, although the allocation of those growing costs between enrollees and the government can push the growth rate somewhat higher or lower. Other elements of some proposals, like tax increases unrelated to health care, would generally grow along with increases in taxable incomes, although we aim to take into account specific aspects of legislation that can raise or lower that rate. Still other parts of proposals, such as changes in Medicare and Medicaid payment rates or practices, can have effects that increase at a range of rates at different points in time depending on the nature and extent of the changes. For all of these parts of reform proposals, we evaluate the impact of the legislation as written and do not assess the likelihood that policies will be changed later through subsequent legislation.

After we have developed an estimate of the growth rate of the costs or savings in each broad category, we assess how those costs or savings would evolve from the end of the 10-year budget window through the following decade. The result is a very approximate sense of whether a piece of legislation is increasing or decreasing the federal budgetary commitment to health care or the federal budget deficit during the second decade and at the end of that decade.

We are very reluctant to extend these extrapolations further into the future, because the uncertainties surrounding them magnify considerably. Although we publish projections of the federal budget 75 years ahead, those projections are inherently uncertain and are designed to identify broad trends rather than to reflect specific pieces of legislation. Trying to project several decades ahead not just the evolution of the health care system under current law but also the effects on that system of a particular comprehensive and interacting set of reforms is extremely difficult. One particular challenge is that our long-term projections under current law incorporate changes that we expect would be made by state governments and the private sector in response to the growing burden of health care spending (responses which could occur under current federal law). Because that burden will mount over time, the responses will likely increase in intensity as well; as a result, determining whether reforms proposed in current legislation might ultimately have occurred through the actions of these other agents becomes increasingly complicated as the time horizon lengthens. Indeed, our Panel of Health Advisers has encouraged us to focus on estimating the effects of legislation during the next couple of decades and not to attempt to estimate effects further out.

So, how do we evaluate whether certain health reform proposals “bend the curve” in terms of the federal budgetary commitment to health care or the federal budget deficit? And what does “bend the curve” mean? If the projected budget deficit is lower 20 years from now under a reform proposal than it would be without any policy changes, then that curve is clearly being bent downward, on average, during the next twenty years; if the projected deficit is higher, then that curve is being bent upward. Would those downward or upward trajectories continue indefinitely? That sort of extrapolation might seem natural, but we simply cannot tell whether it is appropriate. Although we think we can provide a rough indication of the level of federal health spending or the budget deficit 20 years ahead, we are not confident that we have an analytic basis for projecting their growth rates at that point, much less for evaluating whether those growth rates will continue in future years. Therefore, we are more confident talking about whether proposals would “lower” or “raise” the curve of the federal budget deficit or budgetary commitment to health care 10 to 20 years from now than we are discussing the shape of the curve in that time period or the level or slope of the curve beyond that period.

CBO does not analyze national health expenditures (NHE) as closely as we analyze the federal budget (although we are working to enhance our capabilities in this area). Accordingly, we cannot provide precise quantitative estimates of the effect of health reform proposals on NHE even within the first 10 years. However, we will try to offer a qualitative indication of whether proposals would be more likely to raise or lower NHE during the next couple of decades. Expanding insurance coverage would raise NHE, because insured people generally receive more medical care than do uninsured people (see CBO’s Key Issues in Analyzing Major Health Insurance Proposals, December 2008, pages 71-76). Yet, the increase in NHE would be much smaller than the increase in federal spending because some of that additional spending represents a shift in costs from other payers to the government (for example, new subsidies for people who would have purchased insurance anyway). At the same time, changes in Medicare or Medicaid that reduce federal spending and do not merely shift health costs to other payers would generally reduce NHE. For specific pieces of legislation, we will try our best to provide a very approximate sense of balance between these two opposing forces.

In sum, as health reform legislation is considered by the Congress, CBO will endeavor to offer a qualitative indication of whether certain legislation would be more likely to increase or decrease the federal budgetary commitment to health care, the federal budget deficit, and national health expenditures in the decade beyond the 10-year budget window. Whether these effects would persist in more-distant decades is not clear, and that uncertainty is an inherent feature of policy changes that could have substantial effects on such a large and growing share of the U.S. economy.

quote:

Saturday, July 25th, 2009 at 3:19 pm
CBO and IMAC
Peter R. Orszag, Director

This morning, the Congressional Budget Office (CBO) analyzed proposals to shift more decision-making out of politics and toward a body like the Independent Medicare Advisory Council (IMAC) put forward by the Administration. CBO noted that this type of approach could lead to significant long-term savings in federal spending on health care and that the available evidence implies that a substantial share of spending on health care contributes little, if anything, to the overall health of the nation. This supports what President Obama has said all along: we can reduce waste and unnecessary spending without reducing quality of care and benefits.

In part because legislation under consideration already includes substantial savings in Medicare over the next decade, CBO found modest additional medium-term savings from this proposal -- $2 billion over 10 years. The point of the proposal, however, was never to generate savings over the next decade. (Indeed, under the Administration’s approach, the IMAC system would not even begin to make recommendations until 2015.) Instead, the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term. In other words, in the terminology of our belt-and-suspenders approach to a fiscally responsible health reform, the IMAC is a game changer not a scoreable offset.

With regard to the long-term impact, CBO suggested that the proposal, with several specific tweaks that would strengthen its operations, could generate significant savings. (The potential modifications included items such as providing mandatory funding for the council, rather than having the council rely on the annual appropriations cycle, and requiring independent verification of the expected reductions in program spending rather than relying only on the Medicare actuaries for such verification, along with other suggestions, such as including an across-the-board reduction in payments as a fallback mechanism if the council did not produce proposals that generated adequate savings.) And if you look back at recent history, one can see why an empowered advisory council would be useful. For example, for the better part of this decade, MedPAC has recommended reducing overpayments to insurance companies for Medicare Advantage plans – to equate those payments with the cost of covering the same beneficiary under traditional Medicare. Yet, nothing happened, costing taxpayers tens of billions of dollars. We can’t afford that type of inertia.

The bottom line is that it is very rare for CBO to conclude that a specific legislative proposal would generate significant long-term savings so it is noteworthy that, with some modifications, CBO reached such a conclusion with regard to the IMAC concept.

A final note is worth underscoring. As a former CBO director, I can attest that CBO is sometimes accused of a bias toward exaggerating costs and underestimating savings. Unfortunately, parts of today’s analysis from CBO could feed that perception. For example, and without specifying precisely how the various modifications would work, CBO somehow concluded that the council could "eventually achieve annual savings equal to several percent of Medicare spending...[which] would amount to tens of billions of dollars per year after 2019." Such savings are welcome (and rare!), but it is also the case that (for good reason) CBO has restricted itself to qualitative, not quantitative, analyses of long-term effects from legislative proposals. In providing a quantitative estimate of long-term effects without any analytical basis for doing so, CBO seems to have overstepped.

quote:

The U.S. Census Bureau tells us that in 2007, the last year for which it has data, the number of people with health insurance increased to 253.4 million, and the number without health insurance dropped to 45.7 million, or 15.3 percent. Given the current economic situation, more people now don't have insurance.

However, consider that among those without coverage 9.2 million are in households earning $75,000 or more, 9.7 million are illegal aliens and non-citizens, and many don't have coverage for three months a year, or less. At worst, the number is closer to 30 million, about 10 percent of the actual citizen population. The United States government should not concern itself with whether people who are not citizens have health insurance, nor be concerned whether citizens with the means to purchase insurance decide not to.

quote:

ORIGINAL: DomKen

quote:

ORIGINAL: willbeurdaddy

quote:

ORIGINAL: DomKen

Such a careful editing job. Show me the various speeches and interviews in full.

The Barney Frank quote wasnt edited, it is the entiretly of his response to a question about why the current bill doesnt go all the way to single payer. The Obama speeches are such plain clear words that what would adding the rhetoric around them do. To his union supporters, SEIU and AFL_CIO he was very clear that he supports single payer and that his vision is for employer plans (which ARE the private insurance industry) to be gone in 15 to 20 years.


But, go ahead and ignore the facts and play your childish games as you always do.

So it's his vision? How precisely is that a plan to eliminate privatehealth insurance? Nice attempt at goal post moving but not good enough.

BTW were you similiarly outraged over McCain's plan which was to intentionally eliminate employer provided coverage and force everyone into the market for individual plans?
http://www.businessweek.com/bwdaily/dnflash/content/apr2008/db20080429_854428.htm
http://www.factcheck.org/mccains_5000_promise.html

quote:

ORIGINAL: tazzygirl

Now, lets talk about the CBO....

The first is a report issued by the CBO on its web site. The Second by the former CBO.

quote:

The Effects of Health Reform Legislation beyond the Next Decade
In this year’s discussion of health reform, many people have put forth the goals of “bending the curve” of the federal budgetary commitment to health care, the federal budget deficit, or overall national health expenditures. Accordingly, Members of Congress are asking CBO to analyze the extent to which different health reform proposals meet these goals. Last month we wrote to Senator Conrad and Senator Gregg: “CBO does not provide formal cost estimates beyond the 10-year budget window because the uncertainties are simply too great. However, in evaluating proposals to reform health care, the agency will endeavor to offer a qualitative indication of whether they would be more likely to increase or decrease the budget deficit over the long term.” Let me explain our methodology for doing this and the limits of that methodology, beginning with the federal budget and then concluding with national health spending.

The health reform proposals being discussed this year generally include many specific changes to tax and spending policies. Although we and the staff of the Joint Committee on Taxation base our 10-year estimates of the budgetary effects of reform proposals on detailed examination of these changes, we cannot realistically conduct longer-term analysis at that level of detail. Therefore, we group the changes in a reform proposal into several broad categories and evaluate the rate at which the budgetary impact of each of those broad categories is likely to increase over time. Some elements of reform proposals, such as subsidies for people who purchase insurance through exchanges, tend to grow roughly in line with health care costs, although the allocation of those growing costs between enrollees and the government can push the growth rate somewhat higher or lower. Other elements of some proposals, like tax increases unrelated to health care, would generally grow along with increases in taxable incomes, although we aim to take into account specific aspects of legislation that can raise or lower that rate. Still other parts of proposals, such as changes in Medicare and Medicaid payment rates or practices, can have effects that increase at a range of rates at different points in time depending on the nature and extent of the changes. For all of these parts of reform proposals, we evaluate the impact of the legislation as written and do not assess the likelihood that policies will be changed later through subsequent legislation.

After we have developed an estimate of the growth rate of the costs or savings in each broad category, we assess how those costs or savings would evolve from the end of the 10-year budget window through the following decade. The result is a very approximate sense of whether a piece of legislation is increasing or decreasing the federal budgetary commitment to health care or the federal budget deficit during the second decade and at the end of that decade.

We are very reluctant to extend these extrapolations further into the future, because the uncertainties surrounding them magnify considerably. Although we publish projections of the federal budget 75 years ahead, those projections are inherently uncertain and are designed to identify broad trends rather than to reflect specific pieces of legislation. Trying to project several decades ahead not just the evolution of the health care system under current law but also the effects on that system of a particular comprehensive and interacting set of reforms is extremely difficult. One particular challenge is that our long-term projections under current law incorporate changes that we expect would be made by state governments and the private sector in response to the growing burden of health care spending (responses which could occur under current federal law). Because that burden will mount over time, the responses will likely increase in intensity as well; as a result, determining whether reforms proposed in current legislation might ultimately have occurred through the actions of these other agents becomes increasingly complicated as the time horizon lengthens. Indeed, our Panel of Health Advisers has encouraged us to focus on estimating the effects of legislation during the next couple of decades and not to attempt to estimate effects further out.

So, how do we evaluate whether certain health reform proposals “bend the curve” in terms of the federal budgetary commitment to health care or the federal budget deficit? And what does “bend the curve” mean? If the projected budget deficit is lower 20 years from now under a reform proposal than it would be without any policy changes, then that curve is clearly being bent downward, on average, during the next twenty years; if the projected deficit is higher, then that curve is being bent upward. Would those downward or upward trajectories continue indefinitely? That sort of extrapolation might seem natural, but we simply cannot tell whether it is appropriate. Although we think we can provide a rough indication of the level of federal health spending or the budget deficit 20 years ahead, we are not confident that we have an analytic basis for projecting their growth rates at that point, much less for evaluating whether those growth rates will continue in future years. Therefore, we are more confident talking about whether proposals would “lower” or “raise” the curve of the federal budget deficit or budgetary commitment to health care 10 to 20 years from now than we are discussing the shape of the curve in that time period or the level or slope of the curve beyond that period.

CBO does not analyze national health expenditures (NHE) as closely as we analyze the federal budget (although we are working to enhance our capabilities in this area). Accordingly, we cannot provide precise quantitative estimates of the effect of health reform proposals on NHE even within the first 10 years. However, we will try to offer a qualitative indication of whether proposals would be more likely to raise or lower NHE during the next couple of decades. Expanding insurance coverage would raise NHE, because insured people generally receive more medical care than do uninsured people (see CBO’s Key Issues in Analyzing Major Health Insurance Proposals, December 2008, pages 71-76). Yet, the increase in NHE would be much smaller than the increase in federal spending because some of that additional spending represents a shift in costs from other payers to the government (for example, new subsidies for people who would have purchased insurance anyway). At the same time, changes in Medicare or Medicaid that reduce federal spending and do not merely shift health costs to other payers would generally reduce NHE. For specific pieces of legislation, we will try our best to provide a very approximate sense of balance between these two opposing forces.

In sum, as health reform legislation is considered by the Congress, CBO will endeavor to offer a qualitative indication of whether certain legislation would be more likely to increase or decrease the federal budgetary commitment to health care, the federal budget deficit, and national health expenditures in the decade beyond the 10-year budget window. Whether these effects would persist in more-distant decades is not clear, and that uncertainty is an inherent feature of policy changes that could have substantial effects on such a large and growing share of the U.S. economy.

http://cboblog.cbo.gov/?p=336

This entry was posted on Friday, July 24th, 2009 at 3:59 pm and is filed under Budget Projections, Health, Long-Term Budgetary Issues.

quote:

Saturday, July 25th, 2009 at 3:19 pm
CBO and IMAC
Peter R. Orszag, Director

This morning, the Congressional Budget Office (CBO) analyzed proposals to shift more decision-making out of politics and toward a body like the Independent Medicare Advisory Council (IMAC) put forward by the Administration. CBO noted that this type of approach could lead to significant long-term savings in federal spending on health care and that the available evidence implies that a substantial share of spending on health care contributes little, if anything, to the overall health of the nation. This supports what President Obama has said all along: we can reduce waste and unnecessary spending without reducing quality of care and benefits.

In part because legislation under consideration already includes substantial savings in Medicare over the next decade, CBO found modest additional medium-term savings from this proposal -- $2 billion over 10 years. The point of the proposal, however, was never to generate savings over the next decade. (Indeed, under the Administration’s approach, the IMAC system would not even begin to make recommendations until 2015.) Instead, the goal is to provide a mechanism for improving quality of care for beneficiaries and reducing costs over the long term. In other words, in the terminology of our belt-and-suspenders approach to a fiscally responsible health reform, the IMAC is a game changer not a scoreable offset.

With regard to the long-term impact, CBO suggested that the proposal, with several specific tweaks that would strengthen its operations, could generate significant savings. (The potential modifications included items such as providing mandatory funding for the council, rather than having the council rely on the annual appropriations cycle, and requiring independent verification of the expected reductions in program spending rather than relying only on the Medicare actuaries for such verification, along with other suggestions, such as including an across-the-board reduction in payments as a fallback mechanism if the council did not produce proposals that generated adequate savings.) And if you look back at recent history, one can see why an empowered advisory council would be useful. For example, for the better part of this decade, MedPAC has recommended reducing overpayments to insurance companies for Medicare Advantage plans – to equate those payments with the cost of covering the same beneficiary under traditional Medicare. Yet, nothing happened, costing taxpayers tens of billions of dollars. We can’t afford that type of inertia.

The bottom line is that it is very rare for CBO to conclude that a specific legislative proposal would generate significant long-term savings so it is noteworthy that, with some modifications, CBO reached such a conclusion with regard to the IMAC concept.

A final note is worth underscoring. As a former CBO director, I can attest that CBO is sometimes accused of a bias toward exaggerating costs and underestimating savings. Unfortunately, parts of today’s analysis from CBO could feed that perception. For example, and without specifying precisely how the various modifications would work, CBO somehow concluded that the council could "eventually achieve annual savings equal to several percent of Medicare spending...[which] would amount to tens of billions of dollars per year after 2019." Such savings are welcome (and rare!), but it is also the case that (for good reason) CBO has restricted itself to qualitative, not quantitative, analyses of long-term effects from legislative proposals. In providing a quantitative estimate of long-term effects without any analytical basis for doing so, CBO seems to have overstepped.

http://www.whitehouse.gov/omb/blog/09/07/25/CBOandIMAC/

i offered these on another thread. i offer them again here for comment since you brought up the subject.

quote:

ORIGINAL: tazzygirl

Being forced to take two part time jobs instead of one full time so the companies can save money while they offer, for the most part, only sick insurance and not preventative insurance, isnt the answer. nor should it be acceptable. i worked two jobs, 70 hours a week. two insurance plans, 75 dollars a week just to cover myself.. one Starbridge... sick coverage.. which means it only pays when im sick. it wont cover check ups. the other was beechcreek... and its the same.

30 million people, thats taking out the illegal aliens and those who refuse to pay, who have no insurance.

quote:

The U.S. Census Bureau tells us that in 2007, the last year for which it has data, the number of people with health insurance increased to 253.4 million, and the number without health insurance dropped to 45.7 million, or 15.3 percent. Given the current economic situation, more people now don't have insurance.

However, consider that among those without coverage 9.2 million are in households earning $75,000 or more, 9.7 million are illegal aliens and non-citizens, and many don't have coverage for three months a year, or less. At worst, the number is closer to 30 million, about 10 percent of the actual citizen population. The United States government should not concern itself with whether people who are not citizens have health insurance, nor be concerned whether citizens with the means to purchase insurance decide not to.

http://zogby.com/Soundbites/ReadClips.cfm?ID=18994

quote:

However, consider that among those without coverage 9.2 million are in households earning $75,000 or more

quote:

ORIGINAL: tazzygirl

quote:

However, consider that among those without coverage 9.2 million are in households earning $75,000 or more

Those are the ones who opt not to buy

quote:

ORIGINAL: tazzygirl

cite your source

quote:

ORIGINAL: Mercnbeth

quote:

the White House there has been a rise of hate crimes, hate speech from mainstream politicians,

Much of it coming from the White House. Profits - BAD! Success - EVIL! Law enforcement - Acting "Stupid"!

quote:

ORIGINAL: Brain

he needs more time to fix this mess

I've heard this illegitimate excuse for too long. Under the current politic make up of Congress-Why?

quote:

Why does he need more time? Because the American health care budget is as big and as complicated as the German economy. That's just one reason. I'm sure there are many others.