Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 OK, let's look at that. What are some proposals for how to do that?I really should bookmark this, because this will be the fifth time....But okay. What you're trying to stop is the gaming -- people who have the ability to get insurance but would deliberately wait until they got sick. That means you can bar pre-existing exclusions for everyone else, namely, those who didn't have insurance previously because they were unemployed, and those who did have insurance but are changing jobs. Barring the exclusion in those cases won't jack up rates because you won't have the gamers. Now, for the gamers -- the people who have a job with an employer who offers insurance, but they have declined it previously, the exclusion would still apply. People have the right to be decide to take that risk themselves, and tough noogies for them if they gamble wrong. There are other proposals based on the creation of new groups, but I like that one the best.And if there are good options, why wouldn't the Democrats choose one of them instead of the mandate?Because without the mandate, they can't claim that everyone will be covered. And, they actually do wnat to play the daddy role a bit more heavily and cover even those people -- many of whom are the young "I'm an immortal" types, who choose deliberately not to be covered. And I don't. I don't have much financial sympathy for someone who rolled the dice and just gambled that they wouldn't get sick. However, I do see a virtue in not penalizing people who only just got a job, or are trying to change jobs. Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 I'm tired of the health care dead horse, so moving on....Saw an article today about the serious financial woes facing a lot of states. California just declared a budget emergency, http://www.cnbc.com/id/41189521and some states may be trying to figure out if they can legally declare bankruptcy. The NYT thinks Illinois might try for a "GM-type" of bankruptcy.http://www.nytimes.com/2011/01/21/business/economy/21bankruptcy.html?_r=1&src=buslnSince liquidation isn't an option, it's got to be restructuring. That may mean defaulting out on a bunch of debts, including massively underfunded pension plans for state workers. And there's a hint in there that some states may seek a Congressional bailout to help them restructure. I don't think they'll get it, but they have to do something.So what do you guys think? I personally think that each state -- and the voters of each states -- had complete control over its own taxes and budget, so they should be solely responsible for whatever messes they may find themselves in. But it is going to get ugly.... Link to comment Share on other sites More sharing options...
awesome possum Posted January 21, 2011 Share Posted January 21, 2011 How about this: Now that the GOP has "repealed" health care, some of them are ready to move on to screwing up other stuff, like energy and pollution regulationsThe Environmental Protection Agency in December said it would draw up performance standards that would help cut heat-trapping gases produced by refineries and coal-fired power plants...."Standing up for American workers and addressing EPA's rampant regulations is a top priority, Rep. Fred Upton, R-Mich., said Thursday. "We will be active and aggressive using every tool in the toolbox to protect American jobs and our economy by rolling back the job-destroying (greenhouse gas) regulations."...The House legislation, the Free Industry Act, introduced by Rep. Marsha Blackburn, R-Tenn., has 96 co-sponsors — all Republicans except Rep. Dan Boren, a Democrat from Oklahoma.The bill would change the law so that greenhouse gases couldn't be considered air pollution and it would tell the EPA that nothing in the law empowers the agency to regulate the pollutants that cause climate change.Nice to see that their priorities are straight. And that apparently the only debate tactic they need for legislation now is to label whatever they're against as "job-destroying." Link to comment Share on other sites More sharing options...
TerraPrime Posted January 21, 2011 Author Share Posted January 21, 2011 Pensions are an ugly situation. It's a bit like cutting Medicare. You're making a cut to something that people expected to have. But it's very difficult not to do given the situation.It's more than that. Pensions are part of the agreed-on compensation package between employer and employee. Fortunately for civic servants in Illinois at least, pensions are in the state constitution and the government can't touch it. They can furlough us and they can even fire some people, and they can hire new people at a lower pension rate, but they can't reduce pension pay-outs that have already been promised. Link to comment Share on other sites More sharing options...
The Progressive Posted January 21, 2011 Share Posted January 21, 2011 I really should bookmark this, because this will be the fifth time....But okay. What you're trying to stop is the gaming -- people who have the ability to get insurance but would deliberately wait until they got sick. The number of deliberate "system gamers" are so low that focusing on this issue is about as dumb as claiming that tort-reform would significantly lower health care cost. What is most often the cases are people who became unemployed and couldn't afford cobra payment, and the horde of employees from low-wage service sectors who aren't provided with health insurance by their employers. Link to comment Share on other sites More sharing options...
The Progressive Posted January 21, 2011 Share Posted January 21, 2011 typo Link to comment Share on other sites More sharing options...
ljkeane Posted January 21, 2011 Share Posted January 21, 2011 So what do you guys think? I personally think that each state -- and the voters of each states -- had complete control over its own taxes and budget, so they should be solely responsible for whatever messes they may find themselves in. But it is going to get ugly....I think the current problems of the Eurozone are a good example why that isn't a good idea beyond a certain point. The US is a far more integrated economy but too much fiscal divergence could present similar issues. Link to comment Share on other sites More sharing options...
alguien Posted January 21, 2011 Share Posted January 21, 2011 So what do you guys think? I personally think that each state -- and the voters of each states -- had complete control over its own taxes and budget, so they should be solely responsible for whatever messes they may find themselves in. But it is going to get ugly....I agree. I fucking love Chicago. I just looked out my office window to a beautiful city and with great architecture, clean streets, a river, and a lake. CTA works generally well. The parks along Lake Michigan are amazing. I've taken the sort-of unpopular view that if I'm OK with a (reasonable) tax increase to keep paying to keep them in good condition. As a Detroit native, I've seen how cities can go bad.ETA: that might be more of a city thing though, tax-wise Link to comment Share on other sites More sharing options...
The Progressive Posted January 21, 2011 Share Posted January 21, 2011 Do you know what percentage of the state's general fund goes into paying for pension obligation, TP? Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 I think the current problems of the Eurozone are a good example why that isn't a good idea beyond a certain point. The US is a far more integrated economy but too much fiscal divergence could present similar issues.Most of our states have some constitutional limits on borrowing. It can get to a certain point, and then hard limits kick in. So the choice really comes down to either cutting spending, increasing taxes, or both. I don't think there's nearly as much potential for sort of a domino-effect as there is in Europe.I think most of those states will solve those issues via a combination of significant cuts and perhaps even more significant tax increases. The problem is that is going to make them much less attractive for businesses, who have the option to flee (over time) to much more tax/business friendly states. That's a big reason why the industrial midwest is hurting. And if that flight happens, then you're going to see a greater erosion of the tax base, which will make the problem even worse.Not a pleasant scenario by any stretch. Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 Pensions are an ugly situation. It's a bit like cutting Medicare. You're making a cut to something that people expected to have. But it's very difficult not to do given the situation.People with pensions in the private sector face the same risks. If pensions go belly-up in the private sector, all those folks get is 50% from PBGC. I mean, how many private-sector employees took it in the shorts when the market crashed and killed their 401(k) plans? It may come down to a political tug-of-war between state employees wanting their full pensions, and private sector taxpayers being unwilling to subsidize that. You might even see some state constitutional amendments on those issues if it becomes bad enough.I'm not saying it's right, or fair. But given the size of some of those unfunded pension obligations, there may not be an alternative. Link to comment Share on other sites More sharing options...
Altherion Posted January 21, 2011 Share Posted January 21, 2011 People with pensions in the private sector face the same risks. If pensions go belly-up in the private sector, all those folks get is 50% from PBGC. I mean, how many private-sector employees took it in the shorts when the market crashed and killed their 401(k) plans?It's not the same. The 401(k) plans are subject to the same risks as any other investment whereas the pensions are guaranteed. Of course, the state can break the contract it made a long time ago and there is precious little the senior citizens can do about it, but this amounts to outright confiscation of property. If we're going to go that path, there are other people to whom it can be applied who can afford it more than the retirees. Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 It's not the same. The 401(k) plans are subject to the same risks as any other investment whereas the pensions are guaranteed. Of course, the state can break the contract it made a long time ago and there is precious little the senior citizens can do about it, but this amounts to outright confiscation of property. If we're going to go that path, there are other people to whom it can be applied who can afford it more than the retirees.Again, it may not be "the same". I'm simply talking about the political realities of asking private sector employees who lost much of their own retirement to pay higher taxes to ensure that public sector employees get their full pensions. The shortfalls we're talking about here are not minor -- they're well in excess of $1T and growing, and not distributed evenly by state. So regardless of how "right or wrong" it may be, the question is how that shortfall is going to be met.http://www.reuters.com/article/idUSTRE61H13X20100218 Link to comment Share on other sites More sharing options...
Swordfish Posted January 21, 2011 Share Posted January 21, 2011 David Frum touches on the health care dilemma for Republican candidates.I think the article more or less falls apart because it's based on this false dichotomy:In other words, candidly shrugging off the uninsured will rub many voting Americans very much the wrong way. On the other hand, answering affirmatively carries other risks for a Republican.Those are hardly the only two ways to 'answer' that question.It's like Frum has never watched a political debate before or something.And then he falls back on this gem:The trouble with that position, as Romney himself used to argue, is that we’re not a harsh-enough society to live up to it. We are willing to allow people to go without insurance. We are not willing to allow them to go without care. Result: They get care — but very late, and often at unnecessarily enormous cost and with unnecessarily poor results. For lack of $300 in insured prenatal care, we spend $300,000 in charity emergency care to rescue a premature baby.Which is basically the tired, disproven notion that preventative care saves the system money, which we know is no true. Link to comment Share on other sites More sharing options...
The Progressive Posted January 21, 2011 Share Posted January 21, 2011 Obviously not ALL forms of preventive care is cost-saving, which is altogether quite different from being cost-effective.Briefly, preventive care that decreases costs is cost-saving. For example, many childhood immunizations are cost-saving. If the benefitsare sufficiently large compared to the costs, the intervention is “cost-effective” even if it does not save money. Cost-effective preventive care, however, do not slow the growth in spending but provide important health benefits and are still be worthwhile. Cost-effectiveness analysis compares an intervention’s benefits and costs and therefore helps identify services that provide health benefits sufficiently large to justify their costs.The key here is that whether any preventive measure saves money or is a reasonable investment despite adding to costs depends entirely on the particular intervention and the specific population in question. For example, drugs used to treat high cholesterol yield much greater value for the money if the targeted population is at high risk for coronary heart disease, and the efficiency of cancer screening can depend heavily on both the frequency of the screening and the level of cancer risk in the screened population.So while it's true that the exclusive focus on prevention as a key to cost savings is a fool's errand, but then again nobody is saying that must be the only thing to do (except for rightwing hacks who loves strawmen, lol). Rather, it is essential to analyze the costs and benefits of specific preventive measure separately.Some helpful literature:http://www.rwjf.org/pr/product.jsp?id=48508 Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 I think the article more or less falls apart because it's based on this false dichotomy:Frum is the type of guy who believes that winning elections is more important that actually accomplishing anything.The biggest problem I see with Frum's article, which at least deserved to be addressed by him, is that the survey was taken at some undisclosed point during "the George W. Bush years". Well, shit. Since "the Bush years", we had a financial near-collapes, epic recession, and exploding deficits. I have little doubt that the population in general would have been feeling more generous, and more likely supported more government spending, back then. Polls on all sorts of other economic issues have shot up and down during that stretch. So why assume that this poll's results are still valid? Yet Frum simply assumes, without explanation or justification, that those results would be the same today.That's just strange. And it's even stranger that he doesn't even cite the year of the poll, which certainly would have been more useful than the 8 year span of "The George W. Bush years". Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 Interestingly, I've heard him say in an interview something like "The purpose of winning elections is to do stuff." Meaning govern/accomplish things. Just because he said that doesn't mean it disproves what you said, but it's still worth pointing out.Frum essentially advocates, on a pretty consistent basis, that the GOP move to the left so as to capture enough of the electorate to win. Now I do believe in measuring your rhetoric to try to appeal to as broad a spectrum as possible, but in this case, he's essentialy suggesting that the GOP abandon the substantive positions that just resulted in a big-time win. Based on a poll that (I think) is 4 years old.It's really, really odd to me. Link to comment Share on other sites More sharing options...
Shryke Posted January 21, 2011 Share Posted January 21, 2011 Morbid Curiosity Leading Many Voters To Support Palin: A recent poll shows 62% of Americans say they don't want to vote for Palin, but kinda just have to see what would happen. Link to comment Share on other sites More sharing options...
Shryke Posted January 21, 2011 Share Posted January 21, 2011 Frum advocates for moving to the left from where the GOP is now. So he's not saying move to the centre, he's saying go from the Extreme Right to the Right.And most polling in the election showed that while people voted GOP, the GOP wasn't well liked. It's a bad economy and a mid-term and that means the party in power always loses. Link to comment Share on other sites More sharing options...
Former Lord of Winterfell Posted January 21, 2011 Share Posted January 21, 2011 Frum advocates for moving to the left from where the GOP is now. So he's not saying move to the centre, he's saying go from the Extreme Right to the Right.That's just a labelling issue. You can toss around right and left all day, but the terms are meaningless without the context of where you view the center. So leaving the labels out of it, there has never been majority support in the GOP for making health care an entitlement. If there was, such a bill would have passed a long time ago. So what Frum is really doing is arguing that the GOP should adopt positions further to the left (on whatever absolute scale) than what it has ever espoused in the past, solely for the purpose of gaining power.And the question I have is what is the point of surrending core principles just to get elected, other than power for it's own sake? Link to comment Share on other sites More sharing options...
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