Yeah, they will scramble to back away from it, at least until the election’s over. It may be too late, though. There are a lot of Republican’s in the House who voted for it.
If the Republicans really want to privatize it they need to explain how a senior with chronic health issues will be provided health care through the vouchers. Just to give a personal example of how the private healthcare firms are, my oldest son can’t get individual health insurance from a private insurer because he’s diabetic. If they won’t cover him now, why would they cover him when he’s retired and no longer on a company plan? What good will his voucher do him?
Hahah, won by 6 points in a R+6 district. The GOP can’t win an election in New England to save their lives at this point with all the crazy winger infighting. How many of these specials with a breakaway crackpot have they lost now, 4?
It’s complete idiocy and they would realize it if they just thought about it for 12 straight seconds. But they’re too busy repeating “Obama is a Kenyan socialist Muslim” 24/7 to do that.
jeffd
3504
I mentioned this in another thread - but the margin of victory was Hochul by 6%, with Davis (the Tea Partier) taking 9% of the vote. Hochul outperformed expectations even if you give all of Davis’ vote to the Republican candidate.
jeffd
3505
Apologies, I didn’t realize the news had already been posted. I wanted to call it out in this thread as I think it has direct implications for the Ryan plan and it’s support among GOP candidates. From all I’ve read, the big turnaround in pre-election polls was when Hochul began hammering nonstop on her opponent’s stand on Medicare. A petty clear sign of things to come.
That goes back to a point I’ve been making repeatedly. There’s no chance of anything substantial being done on the deficit because the political will in the electorate just isn’t there. It sounds great on the surface, but as soon as you start talking about the hard choices it requires it’s impossible to get elected.
Note: I’m not saying the Rs plan is the right one…just that no substantial debt reduction plan can be pushed through because the voters won’t make the hard choices. That may change someday, but for now the only debt reductions we’ll see are on the fringes and due to higher revenues if/when the economy turns around.
Timex
3508
The problem here is that private insurance doesn’t equate to actually leveraging the market.
Insurance, as it exists today, generally has the same problems that a government system has… People really have no idea what they are “paying” (I put that in quotes, since the insurance company is actually paying it) for a service in healthcare, and as such, the price has no impact on the demand, which thus is pretty much guaranteed to cause the price to skyrocket… and, low and behold, that’s exactly what has happened. And people act surprised.
In most cases, there’s another layer of abstraction that sits on top of this one, which involves people not even really directly paying for their healthcare insurance. Many people get it as part of their job, and only have a fairly abstract knowledge of what they pay. They pay some part of their paycheck to insurance, with their company paying the majority of the cost. While this money, ultimately, comes out of their pocket, they aren’t really that aware of it.
I think this is one of the most critical issues that we’re going to have to address, one way or another. If you want to fix the skyrocketing cost of healthcare, then you need to tie the price to the demand again. You need to make consumers directly aware of the costs of their services. That’s the only way the system will function in a stable manner moving forward.
Damn, Timex. Good post and something we agree upon. There is no market awareness of what things truly cost. The problem is that even if there is awareness, there’s still very little elasticity when it comes to health care. There are few substitutes with an extremely high necessity. That’s why a market system still doesn’t work all that well in with health care.
I’ve argued repeatedly that the cost of employer-paid health care premiums are compensation and that rising health care costs have cut salaries and raises. So many people respond, “my employer pays it so it doesn’t come out of my pocket” when it truly does. If they didn’t pay that money, it would end up in their pocket (at least much of it would). So when health care premiums jump, that’s one major reason why people didn’t get take-home raises - in essence, the rise in health care premiums ate up their raise!
Absolutely agree. Forcing people to put a price on their health simply isn’t going to work, especially when a significant portion of that is time sensitive. Also people have very few ways of evaluating the quality of care they’re receiving and most have no idea what they actually need as far as care and quality level go for a particular situation.
I’ve argued repeatedly that the cost of employer-paid health care premiums are compensation and that rising health care costs have cut salaries and raises. So many people respond, “my employer pays it so it doesn’t come out of my pocket” when it truly does. If they didn’t pay that money, it would end up in their pocket (at least much of it would). So when health care premiums jump, that’s one major reason why people didn’t get take-home raises - in essence, the rise in health care premiums ate up their raise!
I don’t think this would happen or if employer health benefits never existed that salaries would be higher today. Yes, it’s compensation but because people don’t realize how much it costs they don’t know how much they’d lose if it was gone.
jeffd
3511
I believe his actual post is talking about the cost of health insurance. Letting individuals / firms choose insurance plans does not seem to reduce the cost of insurance. This is a separate but related issue to that of health care costs.
The issue of exposing consumers more directly to health care costs is colloquially known as skin in the game. From what I recall, the evidence for increasing skin in the game leading to decreased health care spending is pretty mixed. The problem is that when your doctor tells you that you need some treatment you will generally get that treatment. There are some exceptions around the margins, but they end up not being a significant chunk of overall health care costs. When I’m done with class I will try to dig up some links. Or you can just go search the incidental economist blog, they talked about it a couple of weeks ago.
You’re probably correct, but this isn’t evidence of this point, because the Ryan plan isn’t a serious plan. Further, some of the “hard choices” are a lot easier than others. Letting the Bush tax cuts expire isn’t really that hard a choice.
They haven’t been asked. Also, again, for the thousandth time, the only long-term deficit problem is in Medicaid and Medicare.
Some analysis of the special election from the always excellent Nate Silver 538. He’s been talking about this election for a while now, and lays out quite a bit of detail. Generally speaking, he’s in agreement that this does indicate a significant shift, largely due to the Ryan plan, even considering the effects of the 3rd candidate in the race.
Well, much of it is. We do still have a deficit problem even if Medicaid/Medicare were fixed today, but it’s much easier to tackle. Eliminate the Bush tax cuts, hold spending at par for a couple of years, end the wars and slightly drop defense spending and we’re pretty much there.
But we just saw what happened to the GOP candidate who backed the Ryan Plan and I truly believe that the same will happen to any candidate who backs any kind of similar reduction in benefits regardless of party affiliation. It’s just too easy for the opposition candidate to counter with, “he/she wants to take Grandma’s health care away” and that’s the end of the discussion. Let’s face it, much of the electorate is comprised of morons who are unable to understand the facts and those type of one-liners win elections. You must have more faith in the general electorate than I do to think that asking would do any good.
I think our current state of Eternal War is a pretty significant long-term deficit problem as well.
Ezra Klein agrees with you.
Ezra Klein sez you’re wrong because there was already a period where lower health-care costs led to higher wages.
The current deficit is mostly due to the terrible economy, with the tax/spending mismatch opened up in the Bush years as the next major issue. That’s easily resolvable when the economy recovers by slightly increasing taxes or reducing spending.
The long-term deficit projections, by contrast, are entirely Medicaid and Medicare, because the growth in those programs are projected to outrun economic growth by a large margin, forever.
Not really.
Reductions in benefits (defined in terms of actual value delivered) are probably not required to solve the problem. Ryan got hammered because his plan was a straightforward “cap payouts to seniors, sucks to be you beyond that, no other attempts to fix the health care market.” The AFHCA was chiefly a coverage bill with some reform aspects, but since Clinton 1993 (I think?) no one’s really taken a crack at a heavy reform bill.
Except healthcosts are a shared cost (by the entire employee pool).
Say you get a heart attack. Choices are:
-
Go home, take aspirin and come back in two weeks to do a simple treadmill stress test ($250)
-
Go do a cath, angioplasty, stent replacement. (~$20,000)
You are scared. So much more you could do, the stent could give you better quality of life in the little time you have left. PS money is not coming out of your pocket anyway. If you’re retired, you’ve already “paid into the system” by working your whole life.
The only way to cut costs is well, to not cover expensive shit.
I’m a big proponent of administrative efficiency via single payer but it still leaves out regulatory capture, and also political difficulties with cutting health benefits to seniors. The magic is going to be how to cut benefits without taking the blame for cutting benefits.
I guess that was the point of medicare HMO’s (advantage plans), except their ended up being no reduction in costs… Rather each spends about the same (no figures?) plus the 20-30% overhead the insurance companies used up. It’s not a bad set of ideas, tiering medications and preauthorization on procedures. The problem is competition and fragmented markets makes admistration for the physician a nightmare. Nevermind the senior citizens who routinely got bamboozled (I’ve heard THOUSANDS of stories, they basically get pressured into a plan the same way those long distance salesmen used to do.)
This is reasonable, but this is cost-sharing. Maybe cost-sharing 10% up to a cap of $5000 sounds reasonable. It can discourage the use of some services. How is this supposed to work thought, at what point are the providers supposed to change their billed amounts or negotiated prices?
Say EVERY single person in an area is in this new plan, and demand for chest x-rays drops 20%. Then in theory the hospital says oh ok, times are tough, we’ll renegotiate lower fees for next year? This implies that insurers do need stronger market share. I don’t like the idea thought, yet another private corporation that gets both money and lobbies government for more expenses :(
I thought the current set of wars (Iraq, Afghanistan) weren’t included in that?
