Cassidy-Graham Implications for Federal Health Spending

Even more draconian than outright repeal.

Source: CBPP.

71 thoughts on “Cassidy-Graham Implications for Federal Health Spending

  1. PeakTrader

    The federal government created an expensive mess in health care and the more it tries to fix it, the worse it gets. Meanwhile, the American people suffer, either from expensive health care or doctors not taking subsidized insurance.

    Obamacare alone added tens of thousands of pages of regulations to an already heavily regulated industry. The politician-lawyers have been very busy, while physicians spend one-third of their time complying with regulations, and lawyers have more opportunities to sue. Government created quite a maze to navigate. It looks worse than the federal tax system.

    1. PeakTrader

      And, over the next 10 years, under current law, budget deficits are projected to increase and the national debt expected to rise.

    2. efcdons

      It’s like you live in some right wing dystopian YA novel. What has given lawyers ” more opportunities to sue”? Certainly not the ACA since torts are a state concern.

      What is it with the right and their apoplectic reaction to anything which might be used to help the people enforce their rights?

      Your post has it all. You hate regulations AND you hate the privately enforced civil justice of the courtroom. It’s almost as if you want people to have no recourse when someone more powerful hurts or takes advantage of them.

      1. PeakTrader

        Efcdons, perhaps, you didn’t notice lawyers work within laws and the more laws there are, the bigger the potential for them to be broken. I don’t know why you’re defending a ridiculous system, including forcing doctors to provide unnecessary procedures to avoid being sued.

        People like you won’t be happy, until you bring everyone down, except in government, even when it means the quality of health care slows dramatically and there’s rationing. Instead, we need a more efficient and cheaper system with less government influence. So, government can afford a stronger safety net.

        1. efcdons

          Because you are so misguided and ignorant about the system you decry it’s physically painful.

          For one, physician’s responses to their perceived liability risk PLUS the cost of malpractice payments, lawyers, etc. are a meaningless percentage of total health care spending. It’s 2.4%

          Physician’s liability for mistakes is based on state laws which the ACA didn’t alter at all.

          Companies may be at risk for legal action if they prevent women from breastfeeding or expressing breast milk (yes, that’s a rule which was included in the ACA) and cut workers hours to prevent them from being eligible for benefits.

          But it doesn’t impact physicians (outside of their role as an employer as the case may be).

          The system is not “ridiculous”. It’s a result of the American health care system and conservatives hatred for government (that doesn’t help the wealthy). Medical malpractice awards are high because the costs of treatment is high. If treatments cost less then the awards would be smaller.

          “Instead, we need a more efficient and cheaper system with less government influence. So, government can afford a stronger safety net.”

          I mean, it’s just a theology at this point, isn’t it? Your views can not be swayed be reason because you didn’t reason yourself into them.

          If the left thought the US health care system could be made cheaper and provide comprehensive coverage to all people via “less government interference” they would jump at the chance. Because, and I know this is hard for you to believe, liberals don’t actually care about the size of government independent of the goals they are looking to achieve using government. Yes, it’s true. Your opponents don’t have the same belief, but opposite to yours, about the size of government.

          But since it’s not actually the case that less government interference will lead to lower prices and universal comprehensive coverage people like me want to increase “government interference” in order to achieve our goals for the US health care system.

          Though the idea the right wants to reduce spending in order to allow government to afford a stronger safety net is so unbelievable it must be that you are being sarcastic.

          1. PeakTrader

            Efcdons, you continue to defend and throw money at an expensive and inefficient system. Unnecessary costs of 2.4% of health care spending is just a drop in the bucket to a big spender like you. If the free market was allowed to work, prices would fall sharply and health care would be a normal good instead of a luxury good. Obviously, you cannot understand lower prices allows government to provide a stronger safety net.

            Here’s what a doctor stated:

            “Malpractice is only a fraction of lawsuits you will encounter in medicine.

            Lawsuits and legal action will include:
            Partnership agreements
            Hospital contract negotiations
            Insurance company contracts
            Medicare fraud investigations
            Competitor lawsuits

            It is insane, there are many days my ENTIRE gross income goes all to big law firms…..”

          2. baffling

            Peak, you seem to be describing the economics of the trump business. Lawsuits and litigation are a proper part of his business plan.

    3. 2slugbaits

      PeakTrader Seriously, where do you get this nonsense?

      the American people suffer, either from expensive health care or doctors not taking subsidized insurance.

      So the poor would suffer less if they didn’t have health insurance??? Because that’s the real world alternative. The reason they need a subsidy is because they’re poor.

      Obamacare alone added tens of thousands of pages of regulations to an already heavily regulated industry.

      Heavily regulated? Really? Compared to what? The health insurance industry in this country is far less regulated than it is in just about any OECD country, but yet our medical outcomes are worse than Cuba’s.

      The politician-lawyers have been very busy

      Not nearly as busy as health insurance analysts trying to find ways to exclude bad risks and defraud people. Not nearly as busy as health insurance companies and consortiums of healthcare providers each trying to leverage monopsony and monopoly powers.

      Government created quite a maze to navigate.

      Here I agree. The Republicans have bent over backwards to line the pockets of Big Pharma with ridiculous patent laws. The Republicans have protected doctors’ incomes with all kinds of bizarre rules that limit competition.

      physicians spend one-third of their time complying with regulations

      Hopefully they spend 100 percent of their time complying with regulations. But if you mean they spend a lot of time filling out forms, then that’s just wrong. They do hire clerical staff that spend a lot of time negotiating PPO rates, engaging in price discrimination, setting up unnecessary medical lab procedures with labs that they also have an ownership interest, etc.

      1. PeakTrader

        2slugbaits, not everyone can afford high premiums or deductibles, and many doctors won’t take the government subsidized insurance. You could give out as many insurance policies that you want, but U.S. health care would still be way too expensive.

        I’ve already explained and showed to you when properly adjusted, U.S. medical outcomes are better than almost any country. Yet, you chose to ignore it. And, over 30% of U.S. health care costs goes to “administration.”

        1. 2slugbaits

          PeakTrader not everyone can afford high premiums or deductibles

          And so your solution is to make those premiums and deductibles even less affordable???

          Compare these two statements and ask yourself if isn’t a certain amount of tension between them:

          U.S. health care would still be way too expensive.

          followed by…

          U.S. medical outcomes are better than almost any country

          In any event, the first statement is true; the second one is incorrect and based on special pleading. The bottom line is that we pay more and get less. Healthcare in this country is great if you’re rich. And it is non-existent if you’re poor.

          You keep throwing up this naïve and mythical free market ideology. It’s like you never got past some freshman intro class. We’ve known since Kenneth Arrow’s early days exactly why free market economics is guaranteed to fail and fail miserable when it comes to healthcare. I suggest you try reading his famous paper.

          And once again you seem excessively sensitive to the whiny needs of rich doctors. No one made them go into the medical profession. I’ve seen very few poor doctors struggling to get by on less money than their patients. The main reason healthcare costs in this country are out of line with the rest of the developed world is because doctors and hospitals and Big Pharma have incomes that are out of line with the rest of the world. Doctors in this country are no smarter and no better than doctors in France or Britain or Germany or Japan or Switzerland or Belgium or Sweden or Norway, but they make very close to twice as much.

          And, over 30% of U.S. health care costs goes to “administration.”

          So what? Is that all waste? Administrative costs include stuff like maintaining patient medical records. Is that unnecessary fluff? Admin costs include lab supervision, hospital maintenance, surveillance of controlled substances. Are those things all fluff? The true admin waste is all in the stuff that your political allies want to keep…stuff like high salaries for hospital executives, Big Pharma kickbacks, monopoly rents, etc. And oh by the way, admin costs for private health insurance companies far exceeds the admin costs for Medicare. By a long shot. Not even close.

          1. PeakTrader

            Consumers should know what they’re paying.

            “Prices for routine medical care would plummet, just like they have for cosmetic procedures not covered by insurance. Thanks to competition and technology, LASIK eye surgery cost $2,200 per eye in 1998 but only costs about $300 per eye today.”

          2. baffling

            cosmetic procedures do not need to be treated on a time line, and are requested by the consumer. that is not the same thing as being treated for a heart condition, for which the consumer may know nothing about treatments, symptoms and outcomes.

        2. ottnott

          PeakTrader wrote:
          many doctors won’t take the government subsidized insurance

          Doctors won’t know whether or not an insurance policy obtained through an ACA exchange is subsidized. The policies, and the contractural arrangement between the insurance company and the physician are not affected by any subsidy of the insurance premium.

          Now, if you were being sloppy and using “government subsidized insurance” in place of “Medicaid,” the claim that many doctors won’t take Medicaid is both true and a strong point against your anti-ACA position. The doctors who won’t take Medicaid patients will be even less likely to serve those same patients with no insurance.

          1. PeakTrader

            What I meant was many doctors don’t get fully paid, and often have to wait, by the government. They may also be subject to a government investigation.

            Why not allow the free market to determine the doctor-patient relationship, rather than government or insurance companies? Health care insurance should be just for catastrophic care.

          2. baffling

            “What I meant was many doctors don’t get fully paid, and often have to wait, by the government. ”
            that does not apply to folks who buy ACA insurance through the fed or state marketplaces. this is a gripe with medicaid, or medicare. throw your ire at the proper target. this is not a failure of the ACA.

            “Health care insurance should be just for catastrophic care.”
            and the truth comes out. only those with wealth should obtain health care. born poor, tough luck. you should have been born with a silver spoon in your mouth.

    4. sherparick

      I expect a lot of non-sequiters and ad hominems from Peak Trader, when the real pain or unhappiness he feels is that his tax dollars are going to provide health care to “those people.” Also, like most libertarians and so-called conservatives, he is completely ahistorical, because all the current problems in American Health care as far as costs and care, these problems being worse in 2009 and have started to improve the last 8 years since the ACA was enacted. Also, Peak Reveals himself in that all he is concerned about is “costs” and the “deficit” ( a problem that never comes up when the issue is tax cuts for rich people or making war on some poor, benighted 3rd world country), but does not mention all the terrible numbers that make U.S. Health Care closer to the 3rd world standard then to the 1st world standard of Western Europe, Canada, Australia, Taiwan, Singapore, and Japan ( all of which have some form of universal care supported by tax dollars). Peak, Rick Stryker, etc. would shout , “See Obamacare is a disaster” because a law that only started to into effect 7 years ago has not fixed a generation of problems.

      THERE ARE SOME MARKET BASED SOLUTIONS I would like to see: 1) end patent monopoly system for drugs and medical devices and replace it with a prize and royalty system; 2) Encourage immigration of medical professionals to U.S. and 3) encourage U.S. citizens to seek medical care abroad in high quality, low cost foreign medical systems such as Canada, Australia, Singapore, Western Europe, Thailand, India, etc. by authorizing reimbursement for travel to such locations for medical treatment and permitting Medicaid and Medicare to reimburse foreign providers.

      1. PeakTrader

        Sherparick, you’re so wrong. I want to provide more health care to poor people, and everyone else. You’ve been for taxing, borrowing, forcing people to buy expensive insurance, and providing insurance with few or no options. I’m glad you finally acknowledged the system can be improved, which I’ve said all along. Yet, your ideas fall way short how to reduce the tremendous waste and inefficiencies in the current system.

    1. Manfred

      Much more awful will be the times when the bill of the unfunded liabilities come through, and nothing was done today to reign them in. But again, as I say elsewhere, the current culture in Economics and Public Policy schools and in several elite Economics Departments is that stuff is free, opportunity costs are optional, and manna just fall from heaven. I really fret about the current crop of Economics students coming out of such departments.

      1. Menzie Chinn Post author

        Manfred: What schools are the PhD students you are seeing coming from? Our Econ students talk all about costs all the time. One of the most popular classes at the public affairs school here is benefit-cost analysis. You are, frankly speaking, out of touch.

        1. ottnott

          Menzie asks:
          Manfred: What schools are the PhD students you are seeing coming from?

          That’s pretty obvious: Strawman State U.

  2. Manfred

    Yes, and never mind that Medicare and Medicaid are runaway expenditures of the federal budget, with huge unfunded liabilities well into the future. The CBPP does not give a hoot about that, and it seems that in certain “Public Policy” schools they don’t give a hoot either. It is all within a culture that stuff is free, and money just falls from heaven, like manna in the Book of Exodus.
    Draconian will be the times when all the bills come through without having taken action today about it. But, again, stuff is free, and that seems to be the mantra of the new Economics being taught in certain circles and in certain elite universities.

    1. efcdons

      Yes, if we look a thousand years into the future Medicare and Medicaid will have a million gazillion dollars of unfunded liabilities! If a specific fund for the program doesn’t exist or isn’t completely funded then obviously there will never be any money to fund the program. Except general revenue. And specifically earmarked taxes. And new taxes. And growth of the economy. And cost savings as we plow through the baby boomers (plus, god willing, a move to universal coverage).

      1. pgl

        The defense department budget strikes me as a yuuuuge unfunded Federal liability – unless one assumes a magic money tree is providing its with tax revenues. Funny thing – I never hear conservatives complaining about this.

    2. pgl

      Stuff is free? WTF? CBPP recognizes the need to pay for health care. Which BTW would exist even if the Federal government abandoned all responsibility here – which is really what Cassidy-Graham does. No – your “elite universities” still teach the long-run government budget constraint even if the Republican Party and its desire to slash taxes are forgotten all about this reality.

      Nice to see the right wing spin machine is alive and well here!

    3. sherparick

      This is just so much BS. Again, the “deficit” right now is not a problem. When real interest rates on the 10-year treasury note rises to 4%, then I will start paying attention to the deficit. People like Manfred and Peak talk about “immense” unfunded liabilities, of Medicare, Social Security, and Medicaid. But the U.S. economy is at a nominal $18 trillion GDP in 2017 and, growing in nominal dollars to $27 Trillion by the end of 2027, with a total amount of (which how all these big Medicare and Medicaid figures are added up) about $260 trillion dollars. That is assuming the same steady 1.5% growth and 2% inflation of the “high” tax and “huge” regulatory burden of the Obama administration. Trump’s return to the late 19th century style regulation and taxes must mean a growth “explosion” right, just like Kansas, Louisiana, and Wisconsin had (or apparently did not have).

      Again, notice how suddenly the “debt” and “deficit” become a mortal threat with Medicare and Medicaid programs needing to be reform, but the topic drops from public discourse when taxes are to be cut or massive interminable wars begun.

  3. joseph

    Obamacare and Medicaid expansion were fully funded by the Obamacare taxes. In fact, according to the CBO, it was budget positive, reducing the debt by over $100 billion over the ten year horizon.

    This is in contrast to the Bush tax cuts and the proposed Trump tax cuts which increase the debt by trillions.

    Republicans claiming concern about the debt is a big lie. What they care about is cutting benefits for the poor and tax cuts for the rich. They have demonstrated repeatedly that they don’t give a damn about the debt.

    1. PeakTrader

      Republicans and Democrats have been consistent. Republicans want tax cuts and a smaller government. Democrats want tax hikes and more spending. Republicans want more defense spending. Democrats want more entitlement spending.

      Income = GDP = output growth has been too low, because the top 40% to 60% pay too much in income taxes, while the bottom 40% receive over $10,000 a year in transfer payments. Incentives matter in work and investment.

      1. PeakTrader

        CBO: Top 40% Paid 106.2% of Income Taxes; Bottom 40% Paid -9.1%, Got Average of $18,950 in ‘Transfers’
        December 9, 2013

        “The top 40 percent of households by before-tax income actually paid 106.2 percent of the nation’s net income taxes in 2010, according to a new study by the Congressional Budget Office.

        At the same time, households in the bottom 40 percent took in an average of $18,950 in what the CBO called “government transfers” in 2010.

        The households in the top 20 percent by income paid 92.9 percent of net income tax revenues taken in by the federal government in 2010, said CBO.”

        1. baffling

          considering the top quarter of income earners reaped all of the income increases in the past decades, i certainly would hope they would have an increase in taxes collected. it would not make any sense for the top 10% to accumulate the additional wealth while letting the bottom half pay more in taxes. but that appears to be what you want peak.

        2. 2slugbaits

          Sounds like another whiny complaint from some rag like Forbes. Cry an ocean of tears for the plutocrats and not a drop for “those” people. Apparently federal income taxes are all that count in your world. Never mind that lower incomes fund a helluva lot of those transfer payments through FICA taxes and Medicare taxes. And why don’t you talk about how upper incomes have their health insurance subsidized with huge tax breaks, which shifts the tax incidence on the poor. BTW, do you know the difference between a tax impact and a tax incidence? I’ve seen enough of your posts to conclude that you don’t. I’ve also seen enough of your posts to believe that you don’t know the difference between earned income and rent-seeking.

          Also, where did you get your off the wall estimates of the labor elasticity of supply? Lowering the top marginal tax rate would have almost zilch effect on the amount of labor supplied. And to the extent that our captains of industry worked less, that would be a good thing because they’d do less opportunity to do further damage…especially those executives in the banking and finance area.

          1. PeakTrader

            2slugbaits, you’ve shown you discount incentives. In the real world, people actually will not work or invest, because of higher taxes on marginal income earned.

            And, you shouldn’t complain about too many poor people when you’ve allowed tens of millions of low skilled people with little wealth, from much poorer countries, in the U.S., and their subsequent children, who also drive down wages for the domestic poor.

          2. baffling

            “In the real world, people actually will not work or invest, because of higher taxes on marginal income earned.”
            That is a great talking point, but it is not true. A rich guy has a million dollars, he would rather leave it in a 1% savings account than earn 7% plus in the S&P?

            I will quit my job, or cut back my hours, because of higher marginal taxes that are still capped at around 35%? And if i were dumb enough to do so, you don’t think there is somebody below me who will eagerly take the pay raise accompanied by the additional work that is now available?

            I have no problem letting the wealthy work to get wealthier. But it is foolish to promote a system that allows wealth to accumulate easier as you get wealthy. It promotes economic inequality. You are free to pursue the greater wealth, but i want it to be competitive. That is better for the overall economy, rather than wealth concentration.

          3. PeakTrader

            Baffling, even you wouldn’t trade your labor for diminishing income. At some point, the trade off won’t be worth it to you. Don’t be a hypocrite.

          4. baffling

            peak, if i don’t do it, then somebody else will come along and do it in my place, probably at a cheaper rate as well. the economy will still continue to grow, but more efficiently. why do you want to promote inefficiency? you have a strange view of entitlements for the wealthy.

          5. PeakTrader

            Many people don’t work more hours to avoid losing government benefits, which keeps them poor.

            And, there’s less risk taking, to expand the economy, because of diminishing marginal returns from high marginal taxes.

          6. baffling

            “Many people don’t work more hours to avoid losing government benefits, which keeps them poor.”
            but it is not high marginal tax rates that are doing this. lets stick to the subject at hand. your complaint is the higher marginal tax rates on high income is a disincentive.

            “And, there’s less risk taking, to expand the economy, because of diminishing marginal returns from high marginal taxes.”
            actually this is not true. there are folks making less than the high earners who will be willing to take on the risk. why protect the privileged class? give them some competition for acquiring their wealth. they are replaceable, just like any other worker, and should not be afforded protected status because they are already wealthy. if they don’t want to work harder, then retire.

            so peak, you are completely wrong on both counts.

          7. PeakTrader

            Baffling, also, many people refuse overtime, because of marginal taxes.

            When the after tax return is lower, there’s less risk taking, to expand the economy. For example, all big firms were once small firms.

          8. baffling

            “Baffling, also, many people refuse overtime, because of marginal taxes.”
            there are not many people subject to overtime wages who also have to worry about marginal taxes. most higher earners are salary rather than hourly wage. your arguments are on very thin ice here. you are simply repeating an ideology which does not really have a place in reality. and you can use higher bracket marginal rates to understand how overpaid some of these folks actually are. but from a practical perspective, i would rather have an economy with fewer overtime hours and more people working a steady full time job instead.

      2. sherparick

        Actually, taxes have been cut repeatedly since 1981 and there is evidence in that tax cuts for the rich actually hurt growth and productivity. If the average investment banker will only work a half day if he is taxed at a 45% rate on his marginal income over $1 million, I can live with that. Apparently the economy of the 1940s, 50s, and 60s could live with it to.

        If anything, it is the cut in Government investment over the last 35 years, reducing spending on infrastructure, R&D, public education, etc. and reduction in aggregate demand as more and more income and wealth goes to the top 1% with a low propensity to spend which has likely cause some of the drop in growth. Most of it is a work force that is not growing at the pace it grew in the 1970s, 80s, and 90s as both boomers and women of all generation joined the labor force. To get similar growth now would need a liberal immigration policy and more Government assistance to families with dependent children or caring for dependent adults.

      3. baffling

        “Republicans want tax cuts and a smaller government…Republicans want more defense spending.”

        So you want smaller government and more defense spending. Hey genius, more defense spending is not smaller government, it is bigger government. So to be clear, republicans are advocates for bigger government.

  4. 2slugbaits

    So here we have PeakTrader and Manfred on the same side of the issue but making completely contradictory arguments. PeakTrader is all upset about high income taxes needed to pay for Medicare and Medicaid. And then we have Manfred complaining that Medicare and Medicaid are all unfunded and unpaid for freebies. So with PeakTrader the problem is that taxes are too high. With Manfred the problem is that taxes are too low. Both cannot be right, but both can be wrong. And they are both wrong.

    1. PeakTrader

      2slugbaits, again, you miss the point. Income growth is too low, because income taxes are too high and incentives matter.

      1. pgl

        I guess who have Art Laffer winning the Nobel Prize. The slowing of income growth has nothing to do with higher taxes. If you do not realize this – then may I suggest you actually what is posted on these economist blogs?

      2. ottnott

        PeakTrader sez:
        2slugbaits, again, you miss the point. Income growth is too low, because income taxes are too high and incentives matter.

        And yet, study after study shows that most of the country’s income gains over the past few decades have gone to those who have the highest marginal tax rates.

        We’ve allowed the extremely wealthy in this country to accumulate absolutely massive amounts of wealth. If putting more money in the hands of the investor class and in the hands of those who start businesses really was the secret to growing employment and the economy, we would have been in hog heaven for the past 20-30 years.

        1. PeakTrader

          And, yet, in the real world, national income growth is too low.

          I suspect, most successful small business owners earn well over $100,000 a year.

          They’re too rich for you. I’ve been for a big middle class tax cut, at least to offset Obamacare.

          And, when you pay people not to work or work little, guess what?

        2. PeakTrader

          Ottnott says: “We’ve allowed the extremely wealthy in this country to accumulate absolutely massive amounts of wealth.”

          Spoken like a true communist. We need to severely limit people to accumulate massive amounts of wealth, like:

          Bill Gates: $75 billion.
          Warren Buffett: $60.8 billion.
          Jeff Bezos: $45.2 billion.
          Mark Zuckerberg: $44.6 billion.
          Larry Ellison: $43.6 billion.
          Michael Bloomberg: $40 billion.

          1. PeakTrader

            I’m a supporter of capitalism. Should the government limit wealth to say $1 billion, $100 million, $10 million? Then, for example, Microsoft would’ve been a much smaller company and wouldn’t have made over 10,000 of its employees millionaires. Technology, and productivity growth, would’ve been much smaller, and slower, and stockholders would’ve made much less money.

            Should the government have limited Tiger Woods to only a few tournament wins, because he’s making too much money? After all, we need to be fair.

          2. baffling

            peak, should your last dollar be easier to make than your first dollar? how does that improve competition. capitalism only works with competition. do you have a problem with a monopoly?

    2. Manfred

      “With Manfred the problem is that taxes are too low.”

      I never said that – that is you putting words in my mouth.
      It is perfectly possible that expenditures may be too high, and promises made to future generations too high, given the income generation of the economy. Thus, maybe, just maybe, we need to pair down the expenditures and the promises.

      1. sherparick

        The economy will generate $260 trillion dollars of GDP over the next 10 years, but we won’t be able to take care of the sick and disable and old because it may cost an extra $10 trillion? (And the spending of course is income for someone else, hence the debt is something we owe to ourselves and pay to ourselves. As least Peak Trader may appreciate, if abhor, the State (in this case the Federal Government), is Leviathan, and such compared to mortal men and women, immortal, something Alexander Hamilton well understood.

        “…Persuaded as the Secretary is that the proper funding of the present debt will render it a national blessing, yet he is so far from acceding to the position, in the latitude in which it is sometimes laid down, that “public debts are public benefits,” a position inviting to prodigality and liable to dangerous abuse, that he ardently wishes to see it incorporated as a fundamental maxim in the system of public credit of the United States, that the creation of debt should always be accompanied with the means of extinguishment. This he regards as the true secret for rendering public credit immortal…”

        Of course, Libertarians and Neo-Confederates, who would like to see the National Government ham strung, if not destroyed, do want to limit the means of its extinguishment by limiting the taxing power.

        1. PeakTrader

          Why pay $25 for an aspirin, just because the country is so rich? And, if you don’t know it costs $25 and you can make some other fool pay for it, that’s even better.

      2. pgl

        We can easily fund these Trust Funds with very modest increases in tax rates. So what you are actually saying is simply fact free rants.

  5. joseph

    Trump “economic adviser” Stephen Moore defending Graham-Cassidy: “People want insurance for their own families, not for other people’s families.”

    Yet more evidence that Republicans are without a doubt the dumbest people on the planet. Stephen Moore literally does not know what insurance is.

    Moore: “I want insurance for my house if it burns down. I don’t want insurance that pays for other people’s houses that burn down.”

  6. joseph

    Oh, it gets better.

    Here is Republican Chuck Grassley explaining why Graham-Cassidy should pass — or maybe not pass — or whatever:

    “You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Grassley said. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

    Damn the substance! Full speed ahead!

    1. baffling

      we had rick stryker crying because he felt the ACA was passed without sufficient input and discussion from the republicans. now we have a wide reaching legislation about to be passed with absolutely no knowledge on what is in it, its full impact on the country, and its cost. and silence from comrade rick.

  7. joseph

    Manfred: “But again, as I say elsewhere, the current culture in Economics and Public Policy schools and in several elite Economics Departments is that stuff is free, opportunity costs are optional, and manna just fall from heaven. I really fret about the current crop of Economics students coming out of such departments.”

    Interesting you should bring costs up because in the Trump administration, literally, costs are counted while benefits are ignored. You should feel proud.

    The HHS this month produced a report on the economic impact of refugees over the last 10 years. The report documented that immigrants contributed $269 billion in tax revenues and received $206 billion in services, a net positive effect of $63 billion.

    Yet the report was censored by Trump’s senior policy adviser Stephen Miller. He edited the final report to include the costs but exclude the benefits.

    In an email from September 5, “Miller personally intervened in the discussions on the refugee cap to ensure that only the costs — not any fiscal benefit — of the program were considered.”

    Gee, I wonder what “elite Economics Department”, as you put it, Miller graduated from. Oops, none. He has a bachelor’s degree in political science. Yet he feels qualified to weigh in on economic cost/benefit analyses.

    Yet another example of Republican idiocracy.

  8. PeakTrader

    I heard, there are no cuts, just smaller increases.

    And, the block grants will result in a much better system.

    1. ottnott

      PeakTrader sez:
      I heard, there are no cuts, just smaller increases.

      You are one of the gullible who fell for the Cassidy’s con job. Cassidy-Graham results in massive cuts in funding for healthcare.

      What Cassidy and Graham have been doing to mislead people is to talk about how the block grants to each state grow every year under the bill.

      What makes it so misleading is that the first year of Cassidy-Graham funding is far below what the ACA provides, and the gap grows each year until it explodes in 2027 with the end of the block grants.

      Peak Trader adds:
      And, the block grants will result in a much better system.

      The block grants ends after 2026, so it is a much better system if you plan to die before 2027.

      1. PeakTrader

        I bet the block grants will slow the skyrocketing costs of health care. So, the slower rate of government spending will not worsen the system and result in huge government savings. Of course, there still needs to be massive and real cuts in regulations to allow the free market to work, including getting big insurance, big pharma, etc., and all the other crony-capitalists out of the way. Moreover, a big Trump tax cut can offset the Obamacare taxes.

  9. PeakTrader

    In further response to a prior comment (from the New York Times in 2016: “Sorry, We Don’t Take Obamacare”)

    “AMY MOSES and her circle of self-employed small-business owners were supporters of President Obama and the Affordable Care Act. They bought policies on the newly created New York State exchange. But when they called doctors and hospitals in Manhattan to schedule appointments, they were dismayed to be turned away again and again with a common refrain: “We don’t take Obamacare.””

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