Wednesday, March 17, 2010
Really Tired, But
I'm also pretty depressed from reading various regulatory stuff. As things get more difficult, our government plans get stranger and stranger.
I found a good blog called Alternative Energy Stocks. This is not light reading, but it provides some good analysis. In the end, it is all about making it pay. If we can make it pay, the investment is good; if we can't, we are in the business of making bad loans yet again. Government bad loan programs make us all poorer, but they certainly are proliferating.
I have been watching CBO for news about their scoring of the phantom health care reform bill in the House. So far, nothing. Once again, all the vote-wrangling and arm-twisting is being done before anyone knows what is in the bill, and before anyone has any sort of external read on what the bill will cost (even over the short-term).
It doesn't matter, though. We now pass legislation based on no information at all. So far I have read almost nothing about the new compromise that would indicate that it won't send health costs sky-high. What is strange and uniquely extraordinary about this proposal is that it manages to deliver almost no help whatsover now, when people so desperately need it.
The CBO analyses I have read are all flawed on several counts. First, they do not estimate the increase in premiums from Medicare cost-shifting. Second, they do not accurately figure the cost of the insurance subsidy. Of course, CBO is limited by what is stated in the legislation, even if we all know that what is stated in the legislation has nothing to do with what will happen. Third, they do not assess the economic effect of choosing a very expensive way to pay for health care in comparison to choosing an inexpensive way to pay for health care.
But regardless, this legislation will pass, because the Democrats are desperate. They have complete control of the government at a time in which they have very little ability to control people's primary concerns, so they have to grab a few flags.
It is not that I am concerned about these policies becoming law. They will never be implemented - they are too expensive and destructive. But I am concerned about the reality that reform is truly needed, and that this great game of "Let's Pretend" will block true reform.
PS: Since we don't have any info on the House bill, let's take another look at the Senate bill. The main page is here. The best way to read this thing is to go through the section-by-section analysis, and then to the text for, shall we say, elaboration.
My favorite bit comes in Part I, Subtitle F, Title 1:
Sec. 5000A. Requirement to maintain minimum essential coverage. Requires individuals to maintain minimum essential coverage beginning in 2014. Failure to maintain coverage will result in a penalty of $95 in 2014, $350 in 2015, $750 in 2016 and indexed thereafter. For those under the age of 18, the applicable penalty will be one-half of the amounts listed above. Exceptions to the individual responsibility requirement to maintain minimum essential coverage are made for religious objectors, individuals not lawfully present, and incarcerated individuals. Exemptions from the penalty will be made for those who cannot afford coverage, taxpayers with income under 100 percent of poverty, members of Indian tribes, those who have received a hardship waiver and those who were not covered for a period of less than three months during the year.Note that this gets charged to the parent or guardian (see page 323 in the bill).
Yes, I remember the fight over this some years back. The CBO is specifically prohibited from using "dynamic scoring"--in other words, they are not allowed to take into account the effect incentives will have on people's behavior. They must estimate costs based on current market realities.
At the time, I think it was Republicans who wanted the CBO to account for the positive effects that some tax rate reductions have on government revenues, and the Democrats who would rather not know.
I think it's a dangerous game, trying to estimate how people will react to changes in the rules, but ignoring those reactions during budget planning is certainly incorrect.
My all-time favorite provision is that kids (yes, those people under 18) will be fined beginning in 2014 for not having health insurance.
Just shoot me now. We have gone insane.
As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year. This scheme is specifically designed to deny you the chance to see a specialist. Each year, the insidious nature of that arbitrary 10 percent rule will make things even worse as 100 percent of doctors try to stay off that list.
Good luck to Medicare patients who need to see SuperDoc!
Thank you very much for that article. It's accurate. Everything in this bill will fail but denial of care.
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