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Posted at 6:40 AM ET, 01/20/2011

Wonkbook: House GOP votes to repeal, but not to replace

By Ezra Klein

PH2011010606173.jpg

The worst portent for health-care reform last night wasn't the repeal vote itself, but what didn't come with it: Any replacement bill that Republicans were committed to passing. The second half of the Republican strategy on health-care reform -- you remember "repeal and replace" right? -- was, in the GOP House's first major initiative, simply dropped. It shouldn't have been. At the moment, neither the Senate nor the White House has any interest in undoing the Patient Protection and Affordable Care Act, and so it'll stay on the books. But going forward, as Republicans continue to try to attack the bill, they need a viable alternative solution for the health-care system that they're trying to push the Democrats to adopt and the country to support. They need something beyond "not this."

After all, even Republicans agree that the status quo is untenable. It leaves too many people uninsured and has no hope of controlling costs. That's why they campaigned on "repeal and replace" rather than just repeal. But "replace" was not what present in anything but Republican rhetoric last night. The closest they came to offering an alternative was asking four committees to come back with some undefined ideas at some unnamed date in the future. And that's a problem. It's perhaps possible to imagine solving our health-care problems if both parties are committed to different versions of reform. The two visions can fight it out, and that process of combat will hopefully improve, rather than dilute, the final product (like this, for instance). But it is very, very difficult to imagine solving our country's health-care problems if one party is committed to reform and the other party's primary interest is in undoing that reform. The real enemy here is the status quo. That, at least, should be a bipartisan sentiment.

Top Stories

The House voted yesterday to repeal health care reform, report Amy Goldstein and N.C. Aizenman: "In the first major act of the new Congress, the Republican-led House voted Wednesday to repeal the Democrats' health-care overhaul, fulfilling a pledge that GOP candidates made during the fall midterm campaigns. Three Democrats sided with a unified GOP in the 245 to 189 vote...Senate Majority Leader Harry M. Reid (D-Nev.) has said he will not allow a similar vote. Republicans vowed to keep pushing to overturn the law. But with no immediate likelihood of that happening, they said they would try to change it by eliminating certain parts of the law, such as a requirement that nearly all Americans obtain health insurance - and working to replace others."

My take: "Boehner's GOP, in deciding against offering the promised replacement for the Affordable Care Act, ducked the hard work and highest responsibilities of governance. Maybe, in the coming months, they'll do better than that. Maybe their committees will report out serious alternatives and they'll be brought to the floor of the House. But this isn't the first time health-care policy has come up in Washington. If the GOP had wanted to offer a plan of their own, there are plenty they could've taken off the shelf. If they'd needed more time, well, there was no hurry. But they didn't take more time, or dust off an existing piece of legislation. Backwards was good enough."

Business leaders used China's state visit to push them to accept more exports, reports Jia Lynn Yang: "Top U.S. business leaders met with President Obama and Chinese President Hu Jintao at the White House on Wednesday to press for increasing U.S. exports to China, a move that could create more American jobs. The show of corporate might - which included Steve Ballmer of Microsoft, Lloyd Blankfein of Goldman Sachs and Jeff Immelt of General Electric - reflected the intense focus during Hu's state visit on the economic relationship between China and the United States. Just before the summit, the White House announced a slew of deals between the United States and China that officials said will increase U.S. exports by $45 billion."

Obama is searching for ideas on fighting unemployment, reports Peter Baker: "Three days before Christmas, President Obama gathered his economic team in the West Wing’s Roosevelt Room to review themes for his State of the Union address. The edge-of-the-cliff crisis he inherited had passed, but with more than 14 million Americans still out of work, he was looking for bold ways to bring down unemployment. The ideas presented to him, though, seemed familiar and uninspired. “You know, guys,” he said, according to someone in the room, 'I’ve told you before, I want you to come to me with ideas that excite me.” Nothing he was hearing excited him. Obama’s frustration could set the tone for the remainder of his term.'

AFL-CIO president Richard Tumka gave his state of working America address: "We have failed to invest in the good-wage growth path that is essential to our survival. We are a big country, not a niche player. We live in a world in which there are two kinds of successful big countries: big, poor countries with low wages that organize themselves for low-cost exports, like China and India, and big developed countries with high-skilled workforces that invest in their infrastructure and in their people, that protect their people's rights on the job and have strong social protections, like Germany and Japan...But too many of our politicians are doing the opposite of what works: destroying our public institutions, crushing working people's rights and living standards, and failing to invest in education. We know this model, and we know where it leads—catastrophe."

Soul cover interlude: J.C. Brooks and the Uptown Sound cover Wilco's "I Am Trying to Break Your Heart".

Got tips, additions, or comments? E-mail me.

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Still to come: Congress gave Chinese leader Hu Jintao an icy greeting; House Republicans are attacking Democratic promises to block health-care reform repeal in the Senate; Karol Rove says the GOP has just begun to fight; Social Security's disability payments program is in fiscal trouble; the White House may cut a deal with major utilities on climate change; and tiny robotic helicopters that can build things.

Economy

Chinese president Hu Jintao receive a cool reaction from the Hill, reports Paul Kane: "The sharpest criticism came from Senate Majority Leader Harry M. Reid (D-Nev.), who called Hu a 'dictator' in an interview with a Las Vegas news station. On Capitol Hill, a top House Republican compared Hu to ancient Chinese emperors. Even before Hu set foot on U.S. soil, several senators reintroduced legislation to push international sanctions against China for alleged currency manipulation. Taken together, these moves suggest a growing and bipartisan view in Congress that China's policies are harmful to the U.S. economy and other interests - or at least that saying so makes for good politics back home, particularly during the current era of high unemployment and mounting federal debt."

The Treasury and Fed say the Consumer Financial Protection Bureau can continue work without a permanent director: http://on.wsj.com/h0fESt

Goldman Sachs' earnings fell by 52 percent in the fourth quarter, reports David Hilzenrath: "For Wall Street powerhouse Goldman Sachs, a year that included a $550 million settlement with federal regulators over fraud charges and a public shaming before a Senate committee ended on a financially humbling note. The firm reported Wednesday that its fourth-quarter earnings declined by 52 percent to $2.4 billion, from $4.9 billion in the comparable period a year earlier. Investors punished Goldman's stock, which fell 4.7 percent...In recent days, J.P. Morgan Chase reported a 47 percent increase, and Citigroup, formerly a major money loser that required a dramatic federal rescue, reported it had swung sharply to a profit."

Paul Volcker is pleased with the implementation so far of the rule bearing his name, reports Aaron Lucchetti: "Former Federal Reserve Chairman Paul Volcker said he supports a study released this week from U.S. regulators implementing the so-called Volcker rule, which seeks to prevent banks from putting their own capital at risk. The study, which discussed how the Volcker rule will be implemented by regulators, gave general direction to regulators, but left specific approaches for defining proprietary trades for later rule proposals. 'My sense is that the Report of the Financial Stability Oversight Council lays out an appropriate approach toward implementing the ban on proprietary trading by banking institutions and limiting their investment in hedge and equity funds,' said Mr. Volcker in a written statement."

Foreclosed upon homeowners should be able to rent their old homes, writes David Kapell: "Here’s how it would work. The borrower would lose ownership of his home, but be allowed to remain as a tenant paying fair rent for a reasonable period after foreclosure, with the requirement that he cooperate in the foreclosure. He’d pay fair market rents as published by the federal government, ensuring a clear, national standard. If the borrower couldn’t afford to pay market rent, existing federal rent-subsidy programs could be extended to help tide him over. At the same time, with borrowers now working with lenders, it would be much easier to gather all the documents necessary to process the foreclosure, unclogging the sort of paperwork roadblocks that have recently encumbered the mortgage industry."

Tim Geithner won't let the US default even if the debt ceiling is not raised, writes Donald Marron: http://bit.ly/g2PERR

The tax deal could pave the way for a individual worker credit, writes Elaine Maag: "One of the few new provisions in that law-the temporary payroll tax holiday-is, in fact, an individual worker credit. And it has, potentially at least, some important long-term consequences. It would provide an individual subsidy to each worker in a couple, as opposed to the Earned Income Tax Credit (EITC) - a prominent support for low-income families - which provides a single subsidy based on joint earnings of married couples. A worker credit could provide substantial assistance to childless individuals who often do not qualify for the EITC, encourage work by secondary earners, and improve equity across all workers."

Amusement park ride that might kill you interlude: A combination merry-go-round and Ferris wheel.

Health Care

The uninsured are curiously absent from much of the Republican Party's health-care rhetoric, writes Ezra Klein: "If all you knew about the Affordable Care Act was what you gleaned from watching the Republicans make their case against it, you probably would not know that the legislation means health-care coverage for more than 30 million Americans. Or, if you did know that, you'd be forgiven for not realizing it's relevant: It almost never gets mentioned (see this congressman's rundown of the bill's contents, for instance), and the repeal legislation the Republicans are pushing does nothing to replace the coverage the Affordable Care Act would give to those people."

House Republicans want an up-or-down vote in the Senate, reports Brian Beutler: "Senate Democrats who want to reform the filibuster may have found an unlikely ally: House Majority Leader Eric Cantor (R-VA). 'I've got a problem with the assumption here that somehow the Senate can be a place for legislation to go into a cul-de-sac or dead end,' Cantor told reporters this morning...Under Democratic control last Congress, the GOP used the Senate as a bulwark against the Democratic agenda. Its supermajority customs allowed Republicans to delay, weaken, or nix most of President Obama's significant priorities. Now that Republicans control the House, priorities have shifted."

Arizona is set to cut 280,000 people from Medicaid: http://wapo.st/h429EQ

The GOP health care offensive is just beginning, writes Karl Rove: "Democrats have traditionally been more trusted than Republicans to deal with health care. They enjoyed a 34-point margin in 1991 and a 25-point margin as recently as 2005. But the most recent ABC News/Washington Post poll shows that Republicans are now tied with Mr. Obama on the issue. It was not just the GOP's strong opposition to ObamaCare that closed the gap, though that was essential. It was also the Republicans' early efforts to sketch out a conservative vision of health-care reform. Democrats are squawking about this week's House vote because it signals the start of a Republican offensive on health care, not the end of one. In 2010, Democrats got their law. In the process, Republicans got their issue."

Obama should offer to cut a deal on health care if the GOP embraces universal coverage, writes Matt Miller: http://wapo.st/g8wvnB

Domestic Policy

Social Security's disability payment program may need reform, reports John Maggs: "The federal government’s entitlement program for disabled workers is threatening to spin out of control, growing much faster than the Social Security retirement system as a whole and on a pace to overwhelm it, according to a study by the Brookings Institution...The disability program was created in 1956, when disability was considered incompatible with work, said Mark Duggan, a co-author of the Brookings study. More workers were disabled for short periods of time, and more disabled people didn’t live very long. But better health care and other societal changes have combined to boost the proportion of working-age people collecting disability income and greatly extend the time that people are disabled."

TV networks are resisting an FCC proposal meant to expand wireless data services: http://wapo.st/hik9Iu

Even large income tax hikes won't put some states into surplus, reports Michael Powell: "In New York, an increase of two percentage points in the state income tax could raise about $9 billion and perhaps tip the state into surplus. In California, a similar action could raise more than $13 billion, which would cover just a portion of that state’s yawning $25 billion deficit. In New Jersey, a jump of two percentage points in each of its income brackets could raise nearly $5 billion, which would probably leave the state with a $4 billion to $7 billion deficit. Under these assumptions, a household with the median income would pay at least $1,000 more a year in each of these states; a family making $200,000 would pay $4,000 more."

Common Cause thinks some Supreme Court justices have conflicts of interest on campaign finance issues: http://nyti.ms/emWhE6

Releasing New York City teacher report cards is good for the public, writes Kyle Spencer: "The city defends the report cards because they are more accurate along the edges than in the middle. Over just a few years, the value-added model can quite reliably document the city's very best and very worst teachers, even though a more average teacher--say, one who should fall in the 63rd percentile based on three years of performance--might actually show up anywhere between the 46th and the 80th percentile (as this study points out)... Meanwhile, one year with a very bad teacher can result in student test scores that are 10 percent below those of similar students with a high-performing teacher, according to a study Harvard's Thomas Kane conducted with researchers Douglas Staiger and Robert Gordon."

Rise of Skynet interlude: Robotic helicopters that can assist in building projects.

Energy

The White House may try to cut a climate deal with utilities companies, reports Darren Samuelsohn: "President Barack Obama scored a landmark environmental victory in May 2009 when his team wrestled the auto industry into agreement on a plan to ratchet down its greenhouse gas emissions. Now, top electric utility officials, think tank leaders, states and key Democratic lawmakers are talking about how to replicate the car companies’ deal for the nation’s power plants...The Clean Air Act -- the primary law governing power plants’ emissions -- doesn’t afford Obama as much flexibility for wheeling and dealing with electric utilities, which contribute a third of the nation’s greenhouse gases and spew emissions that cause premature deaths, asthma and neurological problems."

A federal report urges regulators to let Wall Street participate in carbon trading: http://bit.ly/fbVPLb

The House Energy and Commerce committee is focused on blocking EPA climate rules, report Andrew Restuccia and Ben Geman: "House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) plans to take dead aim at the Environmental Protection Agency’s climate change regulations this year, according to a document obtained by The Hill laying out the panel’s 2011 agenda. 'We believe it critical that the Obama administration 'stop' imposing its new global warming regulatory regime, which will undermine economic growth and U.S. competitiveness for no significant benefit,' says the document...The committee will focus much of its attention this year on EPA’s regulatory 'chokehold,' as the document calls it. And the document underscores the extent to which Upton will argue that EPA's agenda collides with economic recovery."

EPA regulations won't perform as well as cap and trade would have, writes Joshua Green: "The cap-and-trade bill that passed the House aimed to reduce emissions 17 percent by 2020 from their 2005 levels. A World Resources Institute study found that the most aggressive implementation of EPA regulations would only reduce emissions by 12 percent in that time frame. Scientists say reductions of 36-48 percent would be necessary to halt global warming. 'Having EPA set carbon-pollution reductions was everyone's second choice for slowing global warming,' said Daniel J. Weiss, director of climate strategy at the Center for American Progress Action Fund. 'It was like 'In Case of Congressional Gridlock Break Glass.''"

Closing credits: Wonkbook is compiled and produced with help from Dylan Matthews, Mike Shepard, and Michelle Williams. Photo credit: Bill O'leary/the Washington Post Photo

By Ezra Klein  | January 20, 2011; 6:40 AM ET
Categories:  Wonkbook  
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Next: If Obama wants to be bold, he should be bold

Comments

read the NYT article this morning about what Common Cause is doing and that's a very slippery slope they're treading down. While I disagree with Citizens United in general, questioning the ability of SC judges of recusing themselves when warranted goes too far. If liberal judges had ever attending functions for liberal leaning causes should we force them to recuse themselves? How long before we have a filibuster type problem with the SCOTUS?


Also unsurprising that the Teachers Unions will push back hard against publishing of "teacher report cards". They seem to be taking every reasonable precaution to make sure teachers aren't unfairly graded and if they're concerned about the truth about poor teachers getting out they're proving once again that they're not there for the students but for themselves. Interested to see how this plays out.

Posted by: visionbrkr | January 20, 2011 7:58 AM | Report abuse

RE: 'Repeal' of Health Care Reform

Is anyone truly surprised that the Congressional bomb-throwers would vote to repeal but offer no suggestions of their own?

They are behaving precisely as they promised they would during the fall campaign because 'that is what the voters want'.

Buyers' remorse is a powerful corrective.

The only problem is that it generally comes too late!

Posted by: bloommarko4 | January 20, 2011 8:09 AM | Report abuse

Hawaii Gov. Neil Abercrombie is now suggesting that a long-form, hospital-generated birth certificate for Barack Obama may not exist within the vital records maintained by the Hawaii Department of Health.
If no birth certificate exists in Hawaii is the birth certificate Obama presented for venting a fake as claimed by experts? This is now a valid question, is Obama a fake President???? Let's ask the questions of Obama a Democrat we would ask of any Republican President.

Posted by: Richie5 | January 20, 2011 8:10 AM | Report abuse

Hawaii Gov. Neil Abercrombie is now suggesting that a long-form, hospital-generated birth certificate for Barack Obama may not exist within the vital records maintained by the Hawaii Department of Health.
If no birth certificate exists in Hawaii is the birth certificate Obama presented for venting a fake as claimed by experts? This is now a valid question, is Obama a fake President???? Let's ask the questions of Obama a Democrat we would ask of any Republican President.

Posted by: Richie5 | January 20, 2011 8:11 AM | Report abuse

--*But going forward, as Republicans continue to try to attack the bill, they need a viable alternative solution for the health-care system*--

How about something called The Free Market?

It costs nothing, manages itself automatically, and runs rings around everything else ever tried.

Posted by: msoja | January 20, 2011 8:13 AM | Report abuse

WOW!!--the Republicans have decided to go down in history as the party that took health care away from the poor--And the really stupid part is most Republicans have some money--and it is THEY who are already paying for the poor's health care--In America everybody has health insurance--it is just an odd sort where those who can pay PAY FOR EVERYONE. And the Republicans seem to want to keep right on doing it--Talk about shooting yourself in the foot. Were everyone to pay--and that is the intent of the new law--THEN THE PRICE of heath care could began to approach the COST of health care--instead of being TEN TIMES the cost (So that the poor, and those who maliciously refuse to take responsibility for themselves can be cared for.--Likewise insurance costs would be wildly reduced--of course the providers would move heaven and earth to keep right on charging what they are today--Jail 'em

Posted by: Skerns0301 | January 20, 2011 8:17 AM | Report abuse

Good point on the bill replacement.

The J.C. Brooks covering Wilco is kinda old though.

Posted by: guidedbynoises | January 20, 2011 8:27 AM | Report abuse

--*Obama should offer to cut a deal on health care if the GOP embraces universal coverage*--

That's what passes for compromise in Klein's claustrophobic marxist outhouse. If the conservatives agree to embrace socialism, Obama should be big enough to welcome them into the big red Comrade Club. Win win!

Posted by: msoja | January 20, 2011 8:28 AM | Report abuse

--*Likewise insurance costs would be wildly reduced*--

Not even the propagandist Klein has made such claims. DeathCare is going to accelerate price rises and will eventually lead to shortages.

--*Jail 'em*--

Scratch a progressive, find a Nazi.

Posted by: msoja | January 20, 2011 8:34 AM | Report abuse

Can citizens go too far in using "protected liberties" to criticize or hold gvmt officials, even SC Justices, accountable for horrible decisions or actions?

I think not. Freedom of Speech, baby. And to say citizens can't criticise justices or ask them to recuse themselves means you don' believe in FoS.

We are a nation of free thinkers, and what free thinkers do best is propose new ideas, and asking for recusal is a very modest idea--certainly far more modest than impeachment (which ought be on the table in this case).

Posted by: lauren2010 | January 20, 2011 9:04 AM | Report abuse

lauren,

Sure you can criticize all you want (and you sure get your 2 cents worth in the FOS dept) but criticizing is one thing, and forcing the Justice Dept's hand as they're doing is another. If they do this then don't be surprised when conservatives follow the same tact when wanting to get rid of a liberal SC justice and then where does it lead?


Should conservatives have asked for liberals to disqualify themselves from Roe v Wade type cases if there was similar instances happening there? As I said a very slippery slope and you may not like where it ends up.

Posted by: visionbrkr | January 20, 2011 9:12 AM | Report abuse

--*[T]o say citizens can't criticise justices or ask them to recuse themselves means you don' believe in FoS.*--

You're free to make an fool of yourself all day long.

And it's good to see you exercising that freedom so vociferously.

Posted by: msoja | January 20, 2011 9:13 AM | Report abuse

P.S. What I meant to imply in my last post, was that as long as people don't break the law, then they aren't gong too far. Obviously, people can go too far, just like Loughner did.

Posted by: lauren2010 | January 20, 2011 9:14 AM | Report abuse

Stupid Republicans, WHERE ARE THE JOBS!!!???
Nobody voted you in to waste my time and tax money jerking around with a law that you WILL NEVER REPEAL.
JOBS, Republicans, and NOTHING ELSE!

You @*#% got elected by crying about a lack of effort on jobs by Democrats, and that is it. Now you’re in office and the absolutely only thing I want to hear out of your lying mouths is how you are working on JOBS.
Because you promised to deliver us from people (Dems) who you claim are purposely trying not to create jobs.
WHERE ARE THE JOBS!!!???

Time to take your medicine toolbags, because that is the only thing you’re going to hear all day every day for the next two years:
WHERE ARE THE JOBS!!!???

Stop crying about healthcare. The Dems pulled it off, and they’ll rightly get the credit.
YOU FAILED. You failed to even mention reform for eight solid years while you spent my tax money on bombs and bonuses for millionaires. So the Dems get credit. So what?
MOVE ON. You just sound like a bunch of petulant sore losers. Which is of course what you are.
Get over yourselves and get those jobs back that you promised
WHERE ARE THE JOBS!!!???


See you tomorrow, for more of the same.

Posted by: DAMNEDGENTLEMEN | January 20, 2011 9:18 AM | Report abuse

vision

There should be ethics rules for Justices.

It is not a alien idea to have Justices recuse themselves in some cases. In fact, it has happened before.

There is absolutely no harm for citizens groups to demand that Justices recuse themselves. The Justices in question are free to decide for themselves, and almost always if they do recuse themselves it is because it is warranted.

And when Justices have strategy sessions on how to get a certain ruling, then that to me sounds like an ethical breach and quite possibly a criminal breach of due process.

Justices are appointed for life terms. It is essential they maintain the people's faith in the institution, and when it appears they are making decisions because of ideology and are changing the laws as opposed to upholding the existing law, then they are undermining the institution.

Posted by: lauren2010 | January 20, 2011 9:31 AM | Report abuse

According to Tumka, the U.S. is somehow "failing to invest in education".

The government alone spends over $900 billion on education. If the results aren't to his liking, the problem is *return on investment* (or lack of it), not a failure to invest.

Posted by: justin84 | January 20, 2011 9:31 AM | Report abuse

lauren,

i have no problem with justices recusing themselves and think its important but when "think tanks" force the justice Dept's hand like that its taking it to an entirely new level.


justin,

well said. But then again Trumka would never stoop so low as to think tenure or accountability is the problem. if he was talking about corporations, YES. Teachers unions, NO. More hypocrisy and less accountability. Why would I expect different from him.

Posted by: visionbrkr | January 20, 2011 9:35 AM | Report abuse

"How about something called The Free Market?"

We have the freest market in the history of the world and US health insurers and providers have succeeded only in creating one of the worst health care systems in the civilized world.

If you don't believe me, ask the 32 million uinsured and the 1000s of deaths due to lack of care and the half million bankrupted every year due to medical related issue, and check out the stats showing that life expectancy and survival rates for various illnesses are falling behind other western countries, and that 10000s US citizens now leave the US annually to get needed care in other countries because they can't afford it here.

Posted by: lauren2010 | January 20, 2011 9:40 AM | Report abuse

vision

no one is "Forcing" anyone's hand. If a Justice recuses him/herself it is because they personally feel obligated to do so. There is a reason we give justices lifetime appts, i.e. so they aren't forced into anything they don't want to be forced into and instead are able to make decisions based on their wisdom and experience and education.

Posted by: lauren2010 | January 20, 2011 9:42 AM | Report abuse

justin

do you have a piechart of how that $900 billion is spent? Perhaps we are spending it in the wrong ways.

Posted by: lauren2010 | January 20, 2011 9:44 AM | Report abuse

"Arizona is set to cut 280,000 people from Medicaid"

That's the risk you take when you become dependent on government - capricious politicians might just pull the rug right out from under your feet.

Posted by: justin84 | January 20, 2011 9:46 AM | Report abuse

"DeathCare is going to accelerate price rises and will eventually lead to shortages."

Oh, OK. We'll believe you instead of the professionals at the CBO who say otherwise. But then, you probably think they are propagandists too?

And the 32 million to receive new insurance means more people will die instead of less, right?

And the new ban on insurance recissions (insurance companies dropping sick people) will also mean they will die more quickly because now they get to keep their insurance?

Is there anyone here who agrees with msoja that ObamaCare = DeathCare?

Vision?

Justin?

Posted by: lauren2010 | January 20, 2011 9:51 AM | Report abuse

"...capricious politicians might just pull the rug right out from under your feet. "

Which is why I, as a real American, given a choice insist on having the rug pulled out from under my feet by a publicly-traded corporation every time.

It's my patriotic duty.

Posted by: davis_x_machina | January 20, 2011 9:52 AM | Report abuse

Seriously, are you surprized? There is a winner in the health care status quo, and it's the people and industries that contribute to the Republican Party. Everybody else realizes that the status quo is rotten, so you can't say out loud that it works, you have to promise reform...down the road somewhere.

Posted by: ciocia1 | January 20, 2011 9:56 AM | Report abuse

lauren,

did you read the NYT piece? they're not suggesting recusal. Per the piece they are asking to:

move for their disqualification from the landmark Citizens United case.

That's a whole other ballgame as I said.


If i agreed with msoja you'd know it. I've got issues with it but not what he suggests. You can't cover 32 million people and actually think its going to cost less or the same. there's not that much inefficiency in the system, not even close. You're going to raise taxes on many to pay for it and then their actions when taxed are not taken into account. Liberals love to state that when the ARRA funding for states dried up that those people put money into the economy. So do the people that are being taxed in the healthcare bill. Insurance companies when they lose however many billions they lose in the subsidy aren't going to just say oh well. They're going to have to increase their prices in other markets where they can.


Posted by: visionbrkr | January 20, 2011 10:10 AM | Report abuse

--*We have the freest market in the history of the world*--

Not any more we don't, and especially not in health care. It's regulated from top to bottom, inside and out. For heaven's sake, the *government* is directly "responsible" for half the health care dollars in the country. The other half is just the tattered remains of what *was* the free market.

You're loony if you think the current state owes to some failure of the free market. The free market is what's keeping the thing from complete collapse.

Posted by: msoja | January 20, 2011 10:11 AM | Report abuse

"do you have a piechart of how that $900 billion is spent? Perhaps we are spending it in the wrong ways."

Lauren,

Most of that $900 billion goes towards school employee compensation.

There isn't a lot of detail - data is pulled from Census and GPO, extrapolations for state/local are done for FY2010 and FY2011 (assumption appears to be 1.37% growth/yr).

The Census data for State and Local governments show capital outlays to account for 11.8% of spending back in 2008. I'd imagine something like 80%+ of the remainder goes to pay employee compensation.

http://www.usgovernmentspending.com/numbers#usgs302

Posted by: justin84 | January 20, 2011 10:17 AM | Report abuse

"Stupid Republicans, WHERE ARE THE JOBS!!!???
Nobody voted you in to waste my time and tax money jerking around with a law that you WILL NEVER REPEAL.
JOBS, Republicans, and NOTHING ELSE!"

When jobs results for January 2011 come out you leftists will be eating crow!

Posted by: krazen1211 | January 20, 2011 10:19 AM | Report abuse

msoja

At the time Obama took office, the US health care system was an ABJECT failure. And it failed during history's freest market in the world.

Get over it.

Things have slightly improved since then.

Posted by: lauren2010 | January 20, 2011 10:35 AM | Report abuse

lauren,

I will say that msoja has a point that there hasn't been a true idealogical free market in healthcare in a long time. The regulations requiring everything under the sun to be covered blunts the free market. The taxes on insurers to pay for government's pet projects blunts the free market just to name a few.

It was a failure during the time you mention but that doesn't mean it was a free market.

Posted by: visionbrkr | January 20, 2011 10:47 AM | Report abuse

"Is there anyone here who agrees with msoja that ObamaCare = DeathCare?"

Lauren,

I agree with his general contention that either prices must rise or access will fall, and it will probably be a combination of both.

Now, for the newly insured access should rise, but since the bill doesn't do much to push up supply, access will fall for people who already have coverage (probably via longer waits). If prices rise sufficiently, enough supply should be brought online over time to offset new demand from the newly insured, but it will take time and it will be expensive.

Enrolling millions of more people with Medicaid is probably going to make it more difficult for the average Medicaid enrollee to find a provider on a timely basis, which could have adverse consequences for some (e.g. Ezra's story yesterday about the kid who couldn't find a dentist to take out his tooth because so few dentists accepted Medicaid patients and died as result).

On net, the bill spends $1 trillion on health care so yes, I would expect that fewer people die on net, relative to the status quo. Obvious examples would be those with chronic conditions that require expensive care over the long haul. On the other hand, reduced access to care for those with insurance might end up killing a few people who might otherwise have lived (more Deamonte Driver stories), and it's going to cost more.

Over the long term, I share msoja's view that more top down interference in the health care sector is likely to reduce innovation, leading to some more deaths in the future that otherwise wouldn't have occurred. I also would agree that the status quo isn't a free market, as we've discussed before - the status quo we have today exists because of the direct and indirect effects of policy decisions made over most of the past century.

Posted by: justin84 | January 20, 2011 10:53 AM | Report abuse

"At the time Obama took office, the US health care system was an ABJECT failure. And it failed during history's freest market in the world."

How do you measure free vs. unfree? Pages of regulation? Units of currency spent by government?

Even assuming your assertion is correct, calling the slave who gets a one hour break from his master the "freest" slave may be technically correct but quite misleading at the same time. He might be less productive than the other slaves, but that is not an argument for taking away his break - would anyone doubt that he would be even more productive working on his own behalf?

Health care provision in the United States is not an abject failure. The results are more or less world class, though outcomes could be even better and health care is difficult to access for many due to cost. Of course, we disagree on why costs are so high and access so difficult in the first place.

Posted by: justin84 | January 20, 2011 11:15 AM | Report abuse

"Top U.S. business leaders met with President Obama and Chinese President Hu Jintao at the White House on Wednesday to press for increasing U.S. exports to China, a move that could create more American jobs"

Not really, our exports are in very limited areas where we're already pushing the edge of the envelope. We're not going to greatly increase exports in other areas because we're very far away from being cost effective on a global scale. For instance nothing that happened yesterday is going to increase our market share in manufactured goods, where the big trade deficit lies.

We are also weak in the area where gains are at least theoretically possible because of a ravenous world market, namely commodities.

When it come to finance and business, the President really has no idea what he talking about, and so far neither have his advisors.

Posted by: johnmarshall5446 | January 20, 2011 11:27 AM | Report abuse

I was wondering how David Kapell could come up with such a ridiculously unworkable solution, (apparently he doesn't realize that there is a whole body of law devoted to renting in every state). Then I saw that he is a former small town mayore and it all makes sense.

Posted by: johnmarshall5446 | January 20, 2011 11:34 AM | Report abuse

richie:

Birthers, you gotta love 'em! Hey wasn't that you as an on camera expert on "Ancient Aliens" the other night?

Posted by: johnmarshall5446 | January 20, 2011 11:41 AM | Report abuse

Ezra says: "The closest [Republicans] came to offering an alternative was asking four committees to come back with some undefined ideas at some unnamed date in the future.]

Huh, this sort of sounds like Obama's tactic in addressing one of the single largest drivers of spiraling health care costs, malpractice lawsuits.

In spite of Obama's promise to consider malpractice lawsuit reform, to date neither he nor Democrats have offered a single concrete proposal to put any limits on malpractice lawsuits.

I'm really befuddled as to why this 800 lb gorilla has been ignored by Democrats, since Democrats are so compassionate and caring that they seek to remove every obstacle from people getting health care. Threats of unlimited malpractice suits have led to early retirements of many doctors, which creates LESS health care access.

I suppose if I were to start googling all the campaign donation filings of Democrats, perhaps I would discover why they are so averse to addressing this huge hurdle to bringing down the cost of health care?

Posted by: dbw1 | January 20, 2011 11:48 AM | Report abuse

justin84:
"I agree with the general contention that either prices must rise or access will fall, and it will probably be a combination of both."

A couple of your comments this morning reminded me of something I remember hearing C. Everett Koop say 20 years ago, and I never forgot it. (I paraphrase)

"The goal of any health care system is to be 1) affordable, 2) easy to access, and 3) of highest quality. Unfortunately, it will be impossible to ever have more than two of the three."

Liberal-progressives seem to prioritize #1 and #2. No shame in that. But they must realize something will have to give, namely #3 (high quality) if they prioritize the other two. And, in fact, in the all out pursuit of #2 (making the same health care equally accessible to everyone, which they claim is the goal of the ACA), we are likely to sacrifice BOTH #1 (affordability) and #3 (quality).

I think we are clearly on the same side, and I enjoy your comments....keep them coming; there appear to be a precious few of us willing to hold Ezra's feet to the fire when he continues pushing ACA propaganda that wilts under even modest scrutiny.

Posted by: dbw1 | January 20, 2011 12:03 PM | Report abuse

Justin

I asked if you agree with mdoja saying obamacare = deathcare.

Regarding health care free market, insurers are allowed in former years to drop sick people, raise rates at will, reject preex, while paying 100s millions in CEO pay.

As I said, there has never been a freer market for them in the history of the world. The gvmt even civers tne neediest: the elderly. Yet the insurers claim they can not profit unless they continue with banning preex, and dropping the sick, etc.

Also , the CBO disagrees with msojas claim obamacare will raise rates.

Blue cross tried raising rates in CA by mote than 39% BEFORE ACA was passed and when its defeat seemed likely.

Posted by: lauren2010 | January 20, 2011 12:04 PM | Report abuse

lauren,

insurers DO NOT claim that they can not prfit unless they continue banning pre-ex. Just a suggestion if you don't know something don't blurt out whatever "NONSENSICAL" statement comes to mind. Insurers were at the forefront of banning pre-ex as long as it came with a requirement that everyone be covered so they weren't adversely selected against as happens all the time which btw is why rates are so high.

It wasn't Blue Cross that raised rates UP TO 39% (not 39% for all) it was Wellpoint. You're mixing your talking points. Blue Cross is currently needing to raise rates up to 59% (while the average was 14%). If costs and utilization increase and those healthy people don't continue to be covered then YES costs will go up.

Posted by: visionbrkr | January 20, 2011 12:15 PM | Report abuse

It's funny that that was Christie's exact plan for dealing with teacher tenure:

let's remove tenure, and replace it with a merit based system using...well, we'll form a committee someday to look into that someday.

How many republicans does it take to replace a light bulb?

1 to remove the light bulb, 5 on the committee looking at options of what to replace it with, but at the end of the day you know they'll conclude that a tax cut for the rich will result in the most light. How are they a national party again?

Posted by: eggnogfool | January 20, 2011 12:42 PM | Report abuse

lauren,

oh and as an FYI. Insurers haven't "dropped th sick" since HIPAA went into effect in 1996 so you may want to revise that talking point and understand what the facts of the HIPAA law are.

Here's a good starter for you.

http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act


Check Title 1 for your answer on pre-ex.

Posted by: visionbrkr | January 20, 2011 12:45 PM | Report abuse

eggnogfool,

so you're a proponent of the status quo that's failing out students? Good to know who's side your own.

Posted by: visionbrkr | January 20, 2011 12:53 PM | Report abuse

"I asked if you agree with mdoja saying obamacare = deathcare."

DeathCare is just a label. It depends on what one means by using it. Given that, I moved past the label and focused on the substance of msoja's arguments, which in large part I do agree with.

"Regarding health care free market, insurers are allowed in former years to drop sick people, raise rates at will, reject preex, while paying 100s millions in CEO pay."

That does not a free market make. A free market is defined by voluntary transactions. Our market - what's left of it - is heavily distorted by taxes, tax incentives, government spending, regulators, etc. That someone gets rich in the process does not mean he was operating in a free market - the nomenklatura were rich, too.

"Also , the CBO disagrees with msojas claim obamacare will raise rates."

The CBO is already appears to be wildly off on several aspects of Obamacare, including the employer tax credits and the high risk pools.

I don't trust the CBO numbers any more than you would trust Moody's ratings on a mortgage backed security. In each case, complexity makes accurate analysis largely impossible - an accurate number or rating largely comes to down to a lucky guess.

No matter what the CBO says, the economic logic is inescapable. If you increase demand without increasing supply, either prices rise or you face shortages.

Posted by: justin84 | January 20, 2011 12:55 PM | Report abuse

http://articles.latimes.com/2010/feb/09/business/la-fi-anthem-obama9-2010feb09

No, it was blue cross (anthem), as I said.

I'll respond to all the other silliness later when I have time.

Posted by: lauren2010 | January 20, 2011 1:11 PM | Report abuse

lauren,

actually I was somewhat wrong, it was Anthem which is a subsidiary of Wellpoint which is a national BC carrier based out of Indianapolis. As far as the other "silliness" well, whatever. I guess I can't make you understand the laws if you don't want to.

The current increase in CA being attacked by liberals is Blue Shield.

Posted by: visionbrkr | January 20, 2011 1:26 PM | Report abuse

@Justin84:
"The CBO is already appears to be wildly off on several aspects of Obamacare, including the employer tax credits and the high risk pools."

This is wrong. The CBO was exactly right on the high risk pools, to 12 decimal places. It wasn't hard, because the bill allocated exactly 5 billion, so the CBO's estimate basically said that every allocated penny would be spent. The CBO also pointed out it would only be enough to last a year or so if access to the pools wasn't limited.

I'm not sure what employer tax credit inaccuracy is referred to, but it's probably wrong as well.

Posted by: eggnogfool | January 20, 2011 1:43 PM | Report abuse

--*At the time Obama took office, the US health care system was an ABJECT failure. And it failed during history's freest market in the world.*--

At the time Obama took office, government was already accounting for 50% of health care expenditures in the country. (That "involvement" has undoubtedly crept higher since then.) The "crisis" in health care is largely in that 50%, though the effect of the government's machinations at such a large scale has undeniable and unavoidable impact on what's left of the other half.

Think about what Medicare/Medicaid did to the free market. It's not as though old people and those in poverty weren't getting health care before 1965. The free market was providing that care. But since then, the government has steadily intruded and increased its "take".

Read about the HMO Act of 1973...

http://www.capitalismmagazine.com/index.php?news=2819

... for the second act in the government's health care takeover.

ALL OF IT is an illegitimate usurpation of private property and endeavor.

And, despite those huge takeovers, and the myriad little ones, you think the private market is at fault? You're a joke.

Posted by: msoja | January 20, 2011 2:05 PM | Report abuse

Ezra said, " House GOP votes to repeal, but not to replace"
-----------------------------------------
Why would they replace something that the congress has no authority to do in the 1st place. That's just INSANE.

Posted by: illogicbuster | January 20, 2011 2:20 PM | Report abuse

"This is wrong. The CBO was exactly right on the high risk pools, to 12 decimal places. It wasn't hard, because the bill allocated exactly 5 billion, so the CBO's estimate basically said that every allocated penny would be spent. The CBO also pointed out it would only be enough to last a year or so if access to the pools wasn't limited."

Fair enough eggnogfool - we can blame that bad estimate on Congress rather than the CBO. That said, your comment raises an interesting question - what happens if Congress doesn't accept a limit on access to the high risk pools?

Some states actually have spent double their allotment in several months, despite enrollment falling far short of projections.

Look at New Hampshire. In several months, 80 people have spent somewhere in the ballpark of $1.2 million. Annualize that, and you're looking at $60,000/yr. If you spend that much over a three year period, you can only cover 27,778 people in the high risk pools. Even if the average is only a quarter of that amount, you can barely cover 100,000 people - less than a third of the number originally expected to be enrolled by the end of the year.

Let's say that enrollment actually heads up to sizable levels, and the money runs out. What does Congress do? Even with a Republican House, there's a decent chance the program is allocated more money.

"In the spring, the Medicare program's chief actuary predicted that 375,000 people would sign up for the pool plans by the end of the year. Early last month, the Health and Human Services Department reported that just 8,000 people had enrolled."

"Montana is one of a few states in which the medical bills from those who have joined are huge. New Hampshire's plan has only about 80 members, but they already have spent nearly double the $650,000 the state was allotted in federal money to help run the program, said J. Michael Degnan, its director."

http://www.washingtonpost.com/wp-dyn/content/article/2010/12/27/AR2010122702343_2.html?sid=ST2010122702477

Posted by: justin84 | January 20, 2011 3:13 PM | Report abuse

"I'm not sure what employer tax credit inaccuracy is referred to, but it's probably wrong as well."

Eggnogfool, read dbw1's comments.

CBO expected the employer tax credits to cost $2 billion in the first year. Over 4 million small businesses are going to take advantage per Ezra's link, which works out to $1,250 per business (not per employee) on a tax credit that offsets up to 35% of health insurance costs (and 1.2 million businesses qualified for the full credit).

http://voices.washingtonpost.com/ezra-klein/2011/01/the_first_12_million_is_always.html#comments

Maybe there is an offset that we're missing, but it isn't obvious to me.

Posted by: justin84 | January 20, 2011 3:19 PM | Report abuse

@Justin84:

Ezra's link doesn't say 4 million businesses will take advantage, it says there are 4 million businesses with few enough employees to qualify. They are unlikely to start providing health care in order to take advantage of the credit.

Posted by: eggnogfool | January 20, 2011 4:21 PM | Report abuse

"And, despite those huge takeovers, and the myriad little ones, you think the private market is at fault? You're a joke."

Hmmm. Let's see.

- We have the gvmt providing care for society's most expensive segment: the elderly. This means the insurers don't have to squander profits on them.

- We provide care for millions of the poorest via medicaid.

- And everyone else, in the middle (those young and employed, i.e. healthy) get insurance. Yes indeed. We have private insurers that increasingly insure only the healthy. They routinely reject applicants with pre-ex conditions, and they drop sick people in huge numbers (if memory serves, CEOs testified that over 1.6% of policy holders get dropped when they get sick, and considering the sick represent only a small percentage of their clients, that is a damning statistic).

I didn't say we have the most laissez faire market possible. I said we have the freest market in history. And we clearly did when Obama took office.

And even Republicans at that time admitted we had to reform the health care system.

It's worth repeating: When Obama took office, we had the freest market economy in the history of the world and had the worst health care system in the civilized world.

That means private markets can't always solve all problems. That's because their goals are to increase profits for their share holders and not to provide complete health care services to all Americans, whether or not they are sick or elderly, or are rich or poor.

Posted by: lauren2010 | January 20, 2011 5:23 PM | Report abuse

"Ezra's link doesn't say 4 million businesses will take advantage, it says there are 4 million businesses with few enough employees to qualify."

Then it was a bit misleading of Khimm to make it sound like all of those businesses were actually benefitting from ACA, wasn't it?

Still, let's run some numbers.

According to the article, 46% of businesses with 3-9 employees provide coverage, and 72% of businesses with 10-24 workers provide coverage.

Let's assume the average 1-10 employee business employs 3 workers, and spends $4,000 on behalf of the workers. Let's assume the average 10-24 employee business employs 14 workers, also spending $4,000 on their behalf, and receive an average tax credit of 10%.

That's 1.656 million workers for the very small businesses (1.2 x 3 x 46%) and 28.224 million workers for larger small businesses (2.8 x 14 x 72%).

The 1.656 million workers get a $1,400 tax credit (35% x $4,000), or $2.318 billion. The 28.224 million workers get a $400 tax credit, or $11.29 billion. That's $13.608 billion total, using workers who already have coverage.

There are a few offsets left, such as the wage thresholds ($50,000), but given that the median wage is much lower than $50,000, I'd imagine most elligible businesses wouldn't be affected - certainly not enough to bring the total costs down to $2 billion or anything close to it. Furthermore, there are offsets in the other direction, such as the fact that employers might cover a bit more than $4,000 per worker, or that the average tax credit might be worth 12% or 14% for the larger businesses, some businesses might begin offering coverage, etc.

Think of it another way - if the average tax credit is only worth $200 (including for those employees who get the full 35% credit), that implies only 10 million workers have coverage which qualifies for the credit out of a likely population closer to 30 million.

Using even extremely conservative assumptions, I see the CBO being off by a factor of 3, and potentially off by more than an order of magnitude using more aggressive ones.

Posted by: justin84 | January 20, 2011 5:55 PM | Report abuse

vision

You weren't just a little wrong to challenge my assertion that Blue Cross tried to raise rates in CA by 39%

You were completely wrong to do so, as I proved with my earlier link.

And then in your apology where you said you were a "little wrong", you used "BC" instead of "Blue Cross", as if you were trying to hide the very same words I had used.

Still, thanks for the admission, as partial as it is. It's a first from you, as far as I can tell.

P.S. You are also wrong about insurers not dropping the sick. Indeed, how can you dare to say that given that insurance CEOs have admitted before Congress that they engage in the practice of recision, and when there is much written about that practice and that it is estimated that 10000s Americans are dropped each year?

Posted by: lauren2010 | January 20, 2011 5:57 PM | Report abuse

http://www.consumerwatchdog.org/story/health-insurers-refuse-limit-rescission-coverage

This link refers to testimony by insurance CEOs who admitted to recission practices (dropping sick people).

Vision claims that this never happens in America.

Posted by: lauren2010 | January 20, 2011 6:01 PM | Report abuse

"They are unlikely to start providing health care in order to take advantage of the credit"

Then what's the point of having the credit? As much as I am in favor of companies being allowed to keep their own money, it seems awfully pointless to include such a thing from the perspective of a Democratic politician.

If the average tax credit is only $200 (which would still probably generate a tax credit cost closer to $6 billion than $2 billion), I think you're right that very few businesses are going to decide to offer health insurance on account of it. Basically, you're just cutting taxes ever so slightly ($3,000 for a company with 15 employees) without even getting the desired action (increased coverage).

This leaves ACA with another problem - if costs come in as expected for the high risk pools and the employer tax credits, then very few people will end up benefiting in terms of expanded coverage, meaning that these things are more or less useless gimmicks.

However, if these initiatives are more substantial, then it is quite likely they will cost far more than anticipated.

Posted by: justin84 | January 20, 2011 6:10 PM | Report abuse

"You are also wrong about insurers not dropping the sick. Indeed, how can you dare to say that given that insurance CEOs have admitted before Congress that they engage in the practice of recision, and when there is much written about that practice and that it is estimated that 10000s Americans are dropped each year?"

Lauren,

While I understand it can be hard to tell the difference between fraud and an honest mistake, some of the examples are pretty egregious. I wouldn't want to do business with those guys either, and thankfully I don't have to.

My health insurance company is a mutual, and it doesn't have much in the way of incentives to cherry pick policies for recission - outright and obvious fraud being the exception.

I've always wondered why liberals who complain about insurance company abuses never started their own insurance company. If 50,000 people who subscribe to MoveOn each invested $2,000 of start up capital, you'd have $100 million to get a company off the ground. As owners, they'd control the whole show. I might even sign up if the details look good.

People used to do such things, though now they just lobby the government to do it for them, despite their plans never making it through the government meat grinder intact. An informative post on one of those historical examples from The Unbroken Window: http://theunbrokenwindow.com/2011/01/20/the-organized-medicine-cartel-a-love-story/

That all said, recission doesn't appear to have been a huge problem. If you assume those three insurance comapnies represent 5% of the insurance market and are fairly typical, then over five years insurance companies used recission to avoid paying $6 billion in claims. Since U.S. health care spending over that time was ~$10 trillion, recission impacted 0.06% of total spending, suggesting to me that the vast majority of the very sick had no problems (since the sickest portion usually account for the vast majority of the claims). Using just the data from the linked article, the amount saved per person from recission was less than $3,000 per person per year ($300 million / 20,000+ / 5 years). And of course, some of that - probably much of it - was related to obvious fraud on the part of the customer.

Still, the thought of being told my $5,000 claim was denied because I forgot to mention a routine (and unrelated) dermatologist appointment from five years before on my application is bothersome, and I'd like to reduce the risk of it.

Just so it's clear, I don't think private businesses are always the 'good guys'. Some can be managed/staffed by downright awful people. However, if the service is bad I can always tell a business "you're fired!" I don't have the same option for bad government service.

Posted by: justin84 | January 20, 2011 7:16 PM | Report abuse

"I didn't say we have the most laissez faire market possible. I said we have the freest market in history. And we clearly did when Obama took office."

Well no, the freest market in history was America several generations ago. Still not completely free, but more so than today.

However, the health care industry was far different back then, and America wasn't quite as rich in those days, so we don't have much to directly compare.

An ironic takeaway from the SBA story I link to above, is that government policy (Revenue Act of 1942 & regulators) mortally wounded the mutuals and fraternal aid societies, leading to dominance of the for-profit health insurance company model we have today. Of course, I should note that the AMA was also a villian in this story, though the AMA got quite a lot of help from the government.

Posted by: justin84 | January 20, 2011 7:35 PM | Report abuse

Justin

Prior to medicare and Medicaid, private health insurers had a hard time making profits. Now that they no longer have to care for the sick and elderly, their profit margins are much more lucrative. They even have gvmt helping them with welfare via Medicare-d.

In essence , several generations ago gvmt did not actively try to increase their profits the way it does now.

Posted by: lauren2010 | January 20, 2011 11:02 PM | Report abuse


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Posted by: clararico123 | January 21, 2011 3:33 AM | Report abuse

lauren you are an idiot of the highest degree. Your example of recission happens .00011 percent of the time (175 million covered by private insurers divided by approx 20,000 cases annually). Should it happen at all, NO. But you also routinely (much more than 20,000) have people GAME the insurance companies to make their deals better with them. But do we feel badly for anyone there? NO. All we do is pay higher premiums (those of us that don't game the system).

Should it happen, NO. Should you base all your judgements on them, well only if you're nonsensical. So there you go.


By your continued twisted logic Ezra should not be able to do what he does (you know he made a mistake about the Constitution or something), government workers should all be fired because i'm sure that .00011% of them must be doing something wrong. Well you get my point I hope.

I won't bother to go into your rant about me shortening the name of Blue Cross to BC. If you think its meant to "hide" anything you're crazier than I've always thought.

Posted by: visionbrkr | January 21, 2011 7:47 AM | Report abuse

lauren you are an idiot of the highest degree. Your example of recission happens .00011 percent of the time (175 million covered by private insurers divided by approx 20,000 cases annually). Should it happen at all, NO. But you also routinely (much more than 20,000) have people GAME the insurance companies to make their deals better with them. But do we feel badly for anyone there? NO. All we do is pay higher premiums (those of us that don't game the system).

Should it happen, NO. Should you base all your judgements on them, well only if you're nonsensical. So there you go.


By your continued twisted logic Ezra should not be able to do what he does (you know he made a mistake about the Constitution or something), government workers should all be fired because i'm sure that .00011% of them must be doing something wrong. Well you get my point I hope.

I won't bother to go into your rant about me shortening the name of Blue Cross to BC. If you think its meant to "hide" anything you're crazier than I've always thought.

Posted by: visionbrkr | January 21, 2011 7:47 AM | Report abuse

you've also made a mistake ( i suspect) above when you mentioned


In essence , several generations ago gvmt did not actively try to increase their profits the way it does now.

Posted by: lauren2010 | January 20, 2011 11:02 PM | Report abuse

I believe you meant to say private insurers so since you've made a mistake then you obviously don't have the right to post here anymore.


Also when Ezra posted that horrible story the other day about Medicaid failing the 12 year old child its obvious that Medicaid is a failure and needs to be scrapped. The government can't do it right so they need to have it taken from them.

Posted by: visionbrkr | January 21, 2011 7:50 AM | Report abuse

"Prior to medicare and Medicaid, private health insurers had a hard time making profits. Now that they no longer have to care for the sick and elderly, their profit margins are much more lucrative."

But government policy and regulation gave those private health insurers a competitive edge against the nonprofit fraternal associations in the first place.

And a 4.4% profit margin isn't lucrative.

http://biz.yahoo.com/p/522qpmd.html

Domino's Pizza manages 4.8% (and McDonalds is at 22.02%!)

http://biz.yahoo.com/p/712qpmd.html

Posted by: justin84 | January 21, 2011 3:47 PM | Report abuse

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