Score Points!

Absolutely. "Scoring political points" can mean bringing people around to your views.

We're Good, so we never want to engage in Frank Luntz-style Orwelliansisms, but there's nothing wrong with criticizing bad, unpopular ideas to which the GOP is wedded.

It just takes a special kind of rich, complacent asshole to approach America's healthcare problems with a proposal intended to get people into less robust coverage plans.

just to add something to the "unique dementia" of the "permanent pundit class:" it's amazing how little most of them know about most issues.

admittedly, knowing about issues is boring wonkery: it takes time to read and talk to experts and think and understand.

it's much easier to talk about horseraces and pass along cocktail chatter.

just to say something new about this phenomenon, i've started to blame theodore h. white's "the making of the president, 1960," which revealed that there was an audience for political inside baseball.

47 years later, we have a tenured pundit class that is only interested in political insde baseball, and not especially well-informed even about that.

Larger point is important too. There's an excellent piece by Peter Mair in the current New Left Review on the depoliticization of democracy. The notion that partisan conflict is inherently illegitimate, and that government is essentially a matter of administration, is a problem that goes well beyond health care.

Best analysis of the train wreck that is the new plan.

Before yesterday, I never heard that the crisis in health care was not of availability of care but of ultra abundance for some who should therefore be punished.

Bush and the GOP always come up with plans to solve non-existent problems by punishing the not-so-wealthy.

This seems quite Rovian: the only obligation of a party out of power is to get back in power.

This seems quite Ro--

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This seems quite Rovian: the only obligation of a party out of power is to get back in power.

Sure. That's Rovian. Only that's not what Matt wrote. So blow it out your ass.

Best analysis of the train wreck that is the new plan.

Before yesterday, I never heard that the crisis in health care was not of availability of care but of ultra abundance for some who should therefore be punished.

Posted by: gregor

This is not a new theme of Bush's at all, so clearly you didn't listen to the last two or three SOTUs.

I'm jealous.

>others have too little health insurance, and others find >paying for their health insurance to be extremely burdensome. >The Bush administration, by contrast, defines the problem as >many Americans having too much health insurance and therefore > using too many health resources.

Just so that I understand this: can't the Bush people argue that excess (mis)use by some is making health care expensive for everybody ?

Someone educate me...

This seems quite Rovian: the only obligation of a party out of power is to get back in power.

Well, if the GOP wants to regain the power to enact legislation, they should stop fighting popular proposals like raising the minimum wage.

Just so that I understand this: can't the Bush people argue that excess (mis)use by some is making health care expensive for everybody ?

The problem, as the Bushites see it, is that the peasants have any health care at all.

The problem, as the Bushites see it, is that the peasants have any health care at all.

Right. How can a businessman reliably squeeze his workers when those workers aren't afraid from day to day that they'll die?

The only obligation of Al is to be a dick.

Shiv, undoubtedly there are examples of people using health-care resources because they can and not because they need to.

however, in the scheme of things, that is a minor issue.

the big issue is that despite spending much more than other countries as a percentage of gdp, we are neither seeing particularly better health-care outcomes nor are we seeing anything resembling an efficient system, since the many millions without coverage end up using the emergency room and running up costs much higher than the occasional gold-plated user.

PS. now if you want to worry about excessive costs, the place to worry, in my estimation, is the enormous sums we spend to extend lives a few months....

Once upon a time, my mother, then a student nurse, was bewailing the conditions poor people faced when they went to the hospital (crowded wards, substandard care, etc.), and my evil grandmother (rightwinger) argued that poor people deserved NO health care at all. I don't know that Bush would get away with that now, but he's trying. By the way, how much "misuse" of health care is there? Last thing I saw, it wasn't up to me whether or not I got an MRI or an X ray or went to the hospital. It was up to doctors, and they only would do it if it was necessary. Yes, I suppose that there are some fakers, and that there are terrible inefficiencies in the health care market, such as poor people going to the ER for things a doctor's visit should take care of. But one of the reasons they only go to an ER is because they aren't getting ENOUGH health care, and so only go when they get desperate. Good health care isn't really a luxury--not being in excruciating pain or dying is kind of a human necessity.

There have been plenty of studies (perhaps when I have a minute I'll post a cite) showing that people consume health care the same way they consume anything else -- when it's cheaper, they buy more of it. They're not "fakers" and they're not purposefully "misusing" the system. It's common sense -- if you have no idea how much your medical procedures cost, and it hardly affects your out-of-pocket expenses to buy something more expensive, you're not going to be a very efficient consumer. So if Dubya's plan can do something about that, it's good.

However, this only applies to people with good insurance. MY is right -- the biggest problem with health care is at the lower end, for people who can't afford it and/or don't have insurance. That doesn't mean Bush is wrong on his diagnosis of one of the smaller problems.

I don't have a problem with the party out of power seeking solely to achieve power, actually. I have a problem with the party in power seeking solely to retain power, because that's a fucked-up way to govern.

Hmmm. Some people consider "Rovian" to be a bad thing. I don't!

Steve writes: I don't have a problem with the party out of power seeking solely to achieve power, actually. I have a problem with the party in power seeking solely to retain power, because that's a fucked-up way to govern.

Well, the Democrats actually have power now. But I guess what Matthew means is the sole aim is to have Democrats get complete control of all branches of government. In any case, I think the point once you are in power is that your priorities should be (a) to stay in power and (b) so long as you are not jeopardizing your chances of staying in power, to do what you can to govern.

"if you have no idea how much your medical procedures cost, and it hardly affects your out-of-pocket expenses to buy something more expensive, you're not going to be a very efficient consumer. So if Dubya's plan can do something about that, it's good"

Your 8-year old just fell out of a tree--looks like he broke his leg. He's crying in pain. What do you do?

(1) Get on the phone, start comparison shopping for affordable ambulances and emergency rooms? In a few hours, you may be have enough information to decide? Or

(2) Call 911, and not even think about money?

Bush is trying to set up a system in which (1) is mandatory, unless you're rich. But in the real world, comparison shopping for medical care is seldom practical.

Show of hands now--who wants their heart transplant peformed by the low bidder?

"The Bush administration, by contrast, defines the problem as many Americans having too much health insurance and therefore using too many health resources."

As do many economists. This is definitely one of the many problems with health care. One that shouldn't be dismissed

rea:

I think the scenario you outline is the exception. My wife and I went through the intertility process a few years back. The Doctor would suggest a drug that would increase our chance of having a baby by a marginal percentage. There was no discussion of cost. What did we care? We weren't paying. There was no cost-benefit discussion. We tried it. And when it didn't work, we tried another drug, and then another, and then another.

The scenario I describe above is the one, of many, that needs to be address.

Sorry for the F*up, I typed "rea" into the name section. My bad.

The Bush administration, by contrast, defines the problem as many Americans having too much health insurance and therefore using too many health resources.

BTW, this line is utterly false.

The Bush Administration defines the problem as consisting of the fact that many Americans have no health insurance, others have too little health insurance, and others find paying for their health insurance to be extremely burdensome.

Which is why the point of the plan is to give people who buy health insurance a tax break (provided the health insurance costs less than $7500). You give them a tax break, and they'll buy more of it. The best thing is that the tax break is greatest for the currently uninsured.

How does giving a tax break on money they already don't make helping anything?

It's not a tax break for buying insurance. They're taking away the tax deduction for insurance, and adding a roughly compensatory amount to the blanket deduction that everyone gets, thus giving people financial incentive to get less health care and save more of this deduction for spending on ice cream.

Until they get sick, and their health care sucks, and they become a drag on the economy and die.

How does giving a tax break on money they already don't make helping anything?

Huh? I don't get what you are saying, Pooh. Under the Bush plan, if a currently uninsured person buys a health insurance policy, he gets a tax break (provided the policy costs less than $7500).

"I think the scenario you outline is the exception. My wife and I went through the intertility process a few years back . . ."

So, is infertility treatment really more common that setting a broken leg in today's medical world? Maybe in your class and circle, but not in mine.

If somebody wants to exclude infertility treatments, viagra, hair transplants, face lifts, etc., from a national health care proposal, that's fine with me.

It's not a tax break for buying insurance. They're taking away the tax deduction for insurance, and adding a roughly compensatory amount to the blanket deduction that everyone gets,

It's not a "roughly compensatory amount". It's $7500. And remember that the tax deduction they are taking away is only for employer-provided health insurance, and it varies by the amount the employer spends.

thus giving people financial incentive to get less health care and save more of this deduction for spending on ice cream.

This is such a typical liberal attitude. If you give people a tax incentive to do the right thing - buy health insurance - that tax incentive money is being spent on ice cream. Not college for the kids. Not retirement. Ice cream. Typical liberal - never trust a person to spend his own money - much better that the government spends the money.

"I don't get what you are saying, Pooh. Under the Bush plan, if a currently uninsured person buys a health insurance policy, he gets a tax break (provided the policy costs less than $7500)."

Al, just out of curiousity, how many people with no health insurance do you think make enough money to pay more than $7500 in federal taxes?

... the unique dementia of the permanent pundit class in Washington ...

That's a damn fine phrase, Matt. Seriously.

Al, just out of curiousity, how many people with no health insurance do you think make enough money to pay more than $7500 in federal taxes?

This was, in fact, my point, perhaps I should have showed my work better, but there it is.

Al, what it's called is "R E A L I T Y."

"Typical liberal - never trust a person to spend his own money - much better that the government spends the money."

Y'know, there are areas of the economy where it really is better "that the government spends the money."

To make sure old folks have a basic pension and kids have basic schooling, it really does make more sense "that the government spends the money". To make sure we have a national defense, it really does make more sense "that the government spends the money".

And to make sure that everyone has basic health care, it really does make more sense "that the government spends the money".

rea, you're looking at the wrong amounts. The $7500 is a deduction, not a credit. And, moreover, it applies to both income AND payroll taxes. So anybody who is uninsured and who works will get a tax break.

I suggest that rea (and Pooh) familiarize themselves with this Overview of the Uninsured in the United States. It states that 27% of the uninsured have incomes of at least 300% of poverty. For a family of 4, that's about $56,000. As the White House fact sheet points out, an uninsured family of 4 making about the same amount ($60,000) would get about a $4500 tax break to buy health insurance. So I think that a LOT of uninsured people would get VERY significant tax breaks to buy health insurance.

Ruth Marcus wants to be the next David Broder. Which means bipartisanship must always be the end goal, even when it is advancing bad policies. In her mind this shows she is a "serious", "responsible" columnist, not like that shrill Paul Krugman.

BTW, this reminds me, how come there are no good female columnists?

I can't think of a single female columnist worth reading. Most of them come across as silly, snarky, wishy washy.

There are female writers who write about politics worth reading, like Joan Didion. But no columnists.

Al, surely you're not under the impression that $4500 a year is anywhere close to enough money to insure a family of 4, right?

According to the WH, the average policy for a family of 4 is $6100. So the tax break would be reducing the cost of health insurance by about 75%.

I don't know where the $6100 figure comes from. Do you have an info as to the average cost of a policy?

rea:

I didn't mean to compare infertility treatment to a broken leg. I only used it to help highlight one of health care's core problems: how Doctor's prescribe medication that has marginal benefit and we patients take them without caring, or even inquiring, about the cost.

By they way... love the "class" comment.

1) This does not deal at all with people being uninsurable because of pre-existing conditions. That factor alone destroys an Econ 101 approach to this. Make the practice illegal, and then maybe we'll talk.

2) You'd better hope these numbers are on a slidung scale--because with costs rising the way thet are, in five years these numbers will be a joke.

3) For vast numbers of people, the insurance process itself is hideously disfunctional. You get sick; your doctor trears you; the insurance compsny refuses to pay; you go broke. I've said it before: a liberal is a conservative who's dealt with a health insurance company.

4) After seeking to destroy your Socisl Security, the Republicans now want to destroy your health care. That's a message that will give the Democrats the Presidency even if they run an Al Sharpton/Dennis Kucinich ticket.

Nice stats Al, what's your PER...

Seriously though how many of those folks are in the fairly well-documented group which can't buy insurance at any price? How does offering a tax break they'll never be able to use help exactly?

Re: It just takes a special kind of rich, complacent asshole to approach America's healthcare problems with a proposal intended to get people into less robust coverage plans.

Oh, good grief. The limitations proposed only affect very munificent policies, and probably no more than 1% of the population (that's a guess) has those sorts of policies. No one seemed to mind when Clinton raised taxes on 1% of the population (and yes, that was right thing to do) so why should Bush doing so in this context be so wrong? For the sake of reality in this discussion my own emnployer-provieed healthcare policy (which is a truly excellent policy relative to what many working people have) costs about 450/mo (that's the total premium and includes the dental coverage as well, of which the company pays $390 and I pay the rest). That's well under the deductibility limit.

Re: They're taking away the tax deduction

??!!? Where do you see that? There's a very high deductibility limit, but certainly there is no loss of the tax break in total. The limit will only affect CEOs and a few other high-rollers with gold-plated coverage, whiel benefitting (albeit only marginally) the self-employed and those paying for COBRA who get little or no break now.

"Democrats -- if they care more about addressing health-care needs than scoring political points -- ought to be finding ways to improve and build on the Bush proposal, not condemning and mischaracterizing it."

One more reason it's false is that, even as newly energized as they are, there's a limit to how much time and energy the Dems have. And it's a waste of time to start with a bad proposal and try to improve it, when it would be far easier to come up with a pretty good one (on health insurance, or anything else, for that matter) straight from scratch.

Currently, the are massive shortages of organs in this country.
The Bush plan is just using the market to correct this problem.

The Bush administration, by contrast, defines the problem as many Americans having too much health insurance and therefore using too many health resources.

This is rather facile. I'm sure the wonks who came up with the proposal don't actually think that Americans have too much much health insurance. I'm also sure they don't think it would be peachy keen for most Americans to be languishing in TB wards while folks who live in gated communities get their care from the Mayo clinic (all those sick middle class people would surely not be good for the economy).

More likely, the Bush's wonks think that some Americans buy too much health insurance (and some buy too little), and this makes the system as whole less efficient and more costly than it would be otherwise (which means the burden on people who really do need more robust healthcare -- or those who pay for it, like governments and firms -- is greater).

In the Bushtopia, buying health insurance would be just like buying life insurance. You'd probably just get a quote on the web. Your company might well provide you with an insurance benefit, but it would most likely just take the form of extra pay -- a portable cash voucher -- and it would be up to you to decide which of the thousands of vendors to choose, and which offering to buy. Competition for these millions of consumers would keep prices low. Any of the extra voucher cash you didn't spend on premiums you'd be able to pocket and buy stuff. Like a new IPod. Likewise if you wanted a more robust health insurance policy -- if you didn't want to share a hospital room, or didn't want to worry about deductibles (or whatever) you'd be free to top dig into your own pocket as deeply as you wanted to for additional coverage. If you're too poor to buy your own policy the government would still pay for your healthcare (as it does now) or perhaps for a portion of your premium. Being insured would likely be mandatory, so we'd have universal coverage. My guess is the government would ultimately have to do a few additional things to make the whole scheme work. Like mandating community rating. And heavily getting into reinsurance (a great idea proposed by Kerry, but also by Eisenhower and Nixon, of all people). I think it would work. I think single payer would, too. The problem is one party isn't serious about universality and equity, and the other party is terrified of following its instincts on the issue. The other party is also, needless to say, insufficiently skilled in the art of politics to seize the president's hunger for bipartisanesque deals as the opportunity it is (to paint the GOP into a corner and get some much needed reforms done).

"There have been plenty of studies (perhaps when I have a minute I'll post a cite) showing that people consume health care the same way they consume anything else -- when it's cheaper, they buy more of it. They're not "fakers" and they're not purposefully "misusing" the system. It's common sense -- if you have no idea how much your medical procedures cost, and it hardly affects your out-of-pocket expenses to buy something more expensive, you're not going to be a very efficient consumer. So if Dubya's plan can do something about that, it's good."

And there have been plenty of studies that show that when consumers pay directly for healthcare, people don't become efficient consumers. In fact, they "misuse" the system even more. They skip flu shots and tetanus shots and and pap smears and they don't go to the doctor for that pain in their chest because, hey, maybe it's just indigestion and do you have any idea how MUCH it costs to see a cardiologist?

But when they get pneumonia from the flu, lockjaw from a rusty nail, cervical cancer, or they collapse from a heart attack, you bet your sweet bippy they get to the doctor.

So, Dubya's plan is bad. Not only does it fail to fix the problem, but it actually creates a whole new set of problems.

Still, it's not surprising from this administration. Sure, some may call them penny-wise and pound foolish, but they're just not looking at how MANY pennies we'll amass! We'll have easily 10 times as many pennies as we'll have pounds!

Matt, aren't you on your way to becoming part of the "permanent pundit class in Washington?"

According to the WH, the average policy for a family of 4 is $6100.

According to the National Coalition on Health Care, "The annual premium that a health insurer charges an employer for a health plan covering a family of four averaged $11,500 in 2006." And that's employers, some of whom have significant bargaining power, as opposed to a family of 4 purchasing their own coverage.

I'd be interested to see a link to Al's source, not to mention an explanation of the discrepancy.

Kaiser Family Foundation (August 2004):

The premiums that people pay for individual health insurance are much lower than the total average premiums for group health insurance ($1,786 for single individually-purchased coverage v. $3,383 for single employer-based coverage, and $3,331 for family individually purchased coverage v. $9,068 for family employer-based coverage). This substantial difference likely reflects the relatively younger ages of individual health insurance purchasers and less generous individual coverage which may or may not reflect the purchasers’ health care needs. It also may reflect the choices that people make when buying health insurance for themselves, paying only for the benefits they believe they will need and use, while employer-based coverage may provide benefits the policyholders do not use.

Remember that the uninsured are more likely to be young (per my link above, 63% are under age 34), so it is likely that the uninsured population would have access to cheaper insurance than average.

It also may reflect the choices that people make when buying health insurance for themselves, paying only for the benefits they believe they will need and use, while employer-based coverage may provide benefits the policyholders do not use.

Yeah, I'd guess this is the case.

Last time I checked, high-deductible plans were not particularly common on the job (I've never been offered this sort of coverage as an employee, although perhaps they're now becoming more common). But lots of self-employed people purchase them because they're well, cheaper. I suspect this difference in breadth and depth of coverage between employer-based plans and self-purchased plans accounts for the bulk of the difference in cost. Bush's plan, sensibly in my opinion, would nudge consumption of health insurance downward for younger and healthier people. Less sensibly, it would, over the long term, make more comprehensive forms of coverage more expensive as lots of younger and healthier people withdraw from the risk pool. I think this would trend would completely obviate any savings we'd otherwise derive from a slowdown in medical inflation. That's the main reason it's a political non-starter, as much as the basic concept (making consumers out of health insurance users) makes sense in a lot of ways.

Some actual cost effects. I finished my 2006 taxes already, so I printed off some extra forms and played some what-if games with this new proposed formula.

Annual values:

Actual cash income: $46,000
Health benefit value: $ 8,250
Current before-tax cont: $ 150
Filing status: Single, no deps
No crazy deductions. This is standard deds only using 1040-EZ.

Under Bush's plan:

* I pay $573 less in payroll taxes (the first $7500 in income is exempt). This gives me more spending money per month now, but it will have a significant effect on my future Social Security withdrawals when I reach retirement age in 35-40 years or so.

* I pay federal income taxes at 25% on an additional $750 in income. (This is my benefits value, minus my $7500 individual deduction.) This adds $187.50 to my annual tax liability.

* I also lose the "deduction" for my employee contribution of $150 per year. This is actually a deduction that happens before you even get your W2, since pre-tax contributions don't show up in your total income line. I saved $37.50 this year in taxes by making my employee contribution in pre-tax dollars. I will have to pay that amount next year.

* I will end up with an additional $348.00 per year in spending money ($29.00 per month), at the cost of $573.00 less going into my Social Security account.

In essence, I'm getting $348 per month in present tax breaks, at the cost of $573 per year less building into my Social Security account. In order to protect my retirement income in the future (as you can see from my income, I'm hardly independently wealthy), I would need to invest all of that money in some good mutual funds and hope like crazy that the market returns over 35 years can make up the $225 gap between my "tax break" and my Social Security reduction.

This isn't a health care plan. This is George Bush's social security privatization plan dressed up in Health Care clothing.

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Oyun oyunlar oyun oyna gibi kelimeler toner kartuş konuları yer almakta bedava oyunlar
2 Oyunculu Oyunlar - Yetenek Oyunları - Dövüş Oyunları - Aksiyon Macera Oyunları - Nişancılık Oyunları - Spor Oyunları - Yarış Oyunları - Zeka Hafıza Oyunları - oyun çocukta doğuştan gelen bir tabiat ve Allah'ın onda yarattığı bir içgüdüdür. Bunun temelinde çocuğun fiziksel gelişiminin mükemmel bir tarzda gelişimdirMotor Oyunları - Mario Oyunları - Savaş Oyunları - Strateji Taktik Oyunları - Yemek Pişirme Oyunları - Dekor Oyunları - Boyama Kitabı Oyunları - 3 Boyutlu Oyunlar - Hugo Oyunları - Sonic Oyunları - Webcam Oyunları - Peri Güzellik Oyunları - Battleon Oyunları - Süper Oyunlar - İlizyon Oyunları - Komik Oyunlar - Teletabi Oyunları - Giysi Giydirme oyunları - Makyaj yapma oyunları -çocuğun en özenli işidir. Yetişkin için iş ve kazanç ne ise onun için de oyun odur... Dış dünyanın kavranılması öğrenilmesi ve hayata hazırlanmanın en ... Kız oyunları - Çocuk Oyunları - işletme oyunları - varmısın yokmusun - Bebek Oyunları - Oyun - Animasyon - Oyun Oyna - Oyunlar - Oyun Cambazı - Bedava Oyunlar - motosiklet dergisi - animasyon - renkli toner tozları - fotokopi toneri - kartuş - toner - boş toner - boş kartuş - toner dram - toner chip - toner tozu - toner dolumu - kartuş dolumu - kartuş dolum malzemeleri - kartuş dolum makinesi - renkli toner dolumu - Bedava Oyun - Kral oyun

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