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Posted at 6:41 PM ET, 02/11/2011

Do Republicans really oppose making health-care insurance cheaper?

By Ezra Klein

The health-care debate has a cyclical nature, and I don't want to keep writing the same posts over and over again. So rather than write a whole new piece on the GOP's rediscovery of the Congressional Budget Office's estimate that the health-care law will reduce the labor supply (which they recast as "destroying jobs"), I'll just link to the long post I did on the subject in January.

In case you don't want to click over, though, the short version is this: If you make health-care insurance cheaper and make it harder for insurance companies to deny people coverage, then a certain number of people who would like to leave the labor force but can't afford or access health-care insurance without their job will stop working.

To understand why, imagine a 62-year-old woman who works for IBM and beat breast cancer 10 years ago. She wants to retire. She has the money to retire. But no one will sell her health care under the status quo. Under the health-reform law, she can buy health care in an exchange because insurers can't turn her away due to her history of breast cancer. So she'll retire. Or imagine a 50-year-old single mother who wants to home-school her developmentally disabled child but can't quit her job because they'll lose health care. The subsidies and the protections in the Affordable Care Act will give her the option to stop working for awhile, while under the old system she'd need to stick with her job to keep her family's health-care coverage. That's how health-care reform can reduce the labor supply. If either case counts as a destroyed job, then so does my winning the lottery and moving to Scotland in search of the perfect glass of whiskey.

Moreover, this would happen for any health-care reform that reduced costs and improved access. So when Republicans say that they want a better health-care reform bill that does even more to reduce costs, they're calling for legislation that, according to them, would "destroy" even more jobs than the Affordable Care Act. If they're against all legislation that might destroy jobs in this way, then they're against making health care cheaper. In fact, by that logic, we could just jack the price of health-care insurance up and make it easier for insurers to turn individuals away. Then even more people would have to stick with their employers. Job creation!

By Ezra Klein  | February 11, 2011; 6:41 PM ET
Categories:  Health Reform  
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Comments

I was reading a post at The Daily Caller about this and it was worded in a very tricky way. It was frightening how many commenters did not understand the difference between reducing the labor force and eliminating jobs.

You could tell the article was written by someone who does understand the difference but did not want their readers to understand it.

You could also tell Rep Paul Ryan understands the difference, but he uses tricky wording in his questioning of the CBO to try and create a mish mash that confuses jobs and labor force participation:

“[I]t’s been argued…that the new health care law will create jobs and increase labor force participation,” said House Budget Committee Chairman Paul Ryan. “But if I recall from your analysis, it was quite the opposite. Is that not the case?”

A link to the article is below.

Read more: http://dailycaller.com/2011/02/10/cbo-obamacare-would-reduce-an-estimated-800000-jobs/#ixzz1DhIrxon0

Posted by: DeanofProgress | February 11, 2011 6:56 PM | Report abuse

The argument isn't on the level, as you say.

Give up pretending Republicans are arguing in good faith. They oppose health care because Democrats support it. The end.

Posted by: will12 | February 11, 2011 7:12 PM | Report abuse

One way to see the absurdity of the Republican position is to realize that this "job destruction" *reduces* unemployment, at least in a less-than-full-employment economy like the current one. That is, the number of jobs is (essentially) unaffected, while the number of folks wanting one is decreased. Thus, the number wanting one who don't get one goes down.

Do the Republicans really want higher unemployment?

Posted by: Leon7 | February 11, 2011 7:14 PM | Report abuse

It reduces unemployment if the person leaves the workforce and an unemployed person gets a job. Everybody wins.

Posted by: pjro | February 11, 2011 7:42 PM | Report abuse

If the government can "make health insurance cheaper", I propose it make everything cheaper. How about it starts with rent (my biggest expense)? They it can move on to shelter and clothing.

Posted by: kingstu01 | February 11, 2011 7:43 PM | Report abuse

Are they really that stupid, or, worse, do they think the rest of us are really that stupid? That's not destroying jobs; it's reducing the pool of potential workers, which, in its way, will reduce unemployment by allowing people who don't want to work anymore and can afford, the option to retire, thus making it easier for a younger person, who does want to work (and needs to) to get a job, which will lower the unemployment rate and reduce what the government spends on unemployment payments and welfare.

Following their course will only force people to work who don;t need to or want to, while making it more difficult for people who do want and need to work to find work.

Brilliant.

Posted by: dlk117561 | February 11, 2011 7:46 PM | Report abuse

>>Are they really that stupid, or, worse, do they think the rest of us are really that stupid?>>

Yes

This has been another edition of simple answers to simple questions.

Posted by: fuse | February 11, 2011 7:51 PM | Report abuse

I liked your detailed description of how other people's money will allow some people more freedom to pursue their own goals.

Posted by: kingstu01 | February 11, 2011 7:51 PM | Report abuse

"I liked your detailed description of how other people's money will allow some people more freedom to pursue their own goals."
-kingstu01

Since when did being able to afford and get health care outside of employment become "other peoples money"?
On a side note the whole idea of insurance is that you use other peoples money. People get insurance because they know that they might be some of the unlucky few who are stricken with ill health that would bankrupt them if they didn't have insurance.
On another note the health care reform that passed is projected to reduce total health care spending this is even as it expands health care to 35 million people, saving 35,000 peoples lives each year.
But I guess that kingstu01 would rather we waste more money instead of pooling together to help one another, because helping someone else isn't worth it even if it ends up helping you as well according to people like kingstu01.

Posted by: Hamtree | February 11, 2011 8:20 PM | Report abuse

This is a silly argument. We're talking about people who WANT to stop working. It's like describing someone who retired as "getting fired."

Second, the job itself is not "killed." The position itself will remain. Not only that, it will be vacant, and possibly filled by someone who was previously unemployed.

In short, you go from having a person who wants to retire, but can't and someone who wants to work, but can't, to someone who wants to retire, and can and someone else that wants to work, and can. The second scenario is quite obviously the preferable situation.

We have an unemployment rate around 9+%, even higher in many states. Its not like we're suffering from a lack of willing workers.

Posted by: Nylund154 | February 11, 2011 8:41 PM | Report abuse

Your language is sloppy. There's a difference between health care and health insurance. Anyone can make an appointment with a physician and get care if they choose to pay the physician directly out of their own pocket. Yes, the price may be high (haggling is allowed) but that care is available to anyone, even the many non-citizens amongst us.The IBM'er who had breast cancer could certainly get health care if she were willing to pay for it herself (this may be a problem, but the point is that health care is available)

In contrast, health insurance may be limited or expensive for someone who's older or has had a bout with breast cancer. The ACA (a misnomer) removes many of these barriers to health insurance, but it does little to nothing to reduce the cost of health care.

Posted by: Beagle1 | February 11, 2011 8:43 PM | Report abuse

One thing my wife and I have noticed since moving to a conservative part of the country is that conservatives strongly dislike the idea of helping other people, even if they also gain from it. In fact, they would rather doing something that hurts themselves to prevent someone from getting their help. It manifests itself in strange little ways all the time, including such silly things as lane mergers on a highway. NO ONE is willing to let anyone merge in front of them, so everything just becomes unnecessarily gridlocked. Its as if they think that everything in life is a zero-sum game and that anytime anyone else is gaining, you must be losing something. The idea that cooperation can be mutually beneficial is entirely lost on them.

Posted by: Nylund154 | February 11, 2011 8:45 PM | Report abuse

Or, imagine a 26 year old single healthy male. Is his insurance cheaper?

Posted by: krazen1211 | February 11, 2011 9:07 PM | Report abuse

"The subsidies and the protections in the Affordable Care Act will give her the option to stop working for awhile, while under the old system she'd need to stick with her job to keep her family's health-care coverage. That's how health-care reform can reduce the labor supply. If either case counts as a destroyed job, then so does my winning the lottery and moving to Scotland in search of the perfect glass of whiskey."


That's not reduced cost. That's transferred cost, from lucky individuals to unlucky ones.

Posted by: krazen1211 | February 11, 2011 9:13 PM | Report abuse

"It reduces unemployment if the person leaves the workforce and an unemployed person gets a job. Everybody wins."

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

Posted by: justin84 | February 11, 2011 10:32 PM | Report abuse

"Since when did being able to afford and get health care outside of employment become "other peoples money"?"

Under the status quo, these individuals couldn't afford health care. Passing a bill does not change this fundamental state of affairs. It can only be papered over with other peoples money.

Each of these individuals would likely be eligible for subsidies, and in addition, young healthy people will be forced to pay higher premiums in order to cover their bills even if no direct subsidies are in play.

"On another note the health care reform that passed is projected to reduce total health care spending this is even as it expands health care to 35 million people, saving 35,000 peoples lives each year."

Each American also gets a free pony.

These people couldn't even guess the enrollment in high risk pools less than a year after the bill passed within a factor of THIRTY.

The original Medicare projections out to 1990 were off by an order of magnitude.

The cost projections are not going to be accurate, and economics suggest the costs will be higher than anticipated.

Posted by: justin84 | February 11, 2011 10:45 PM | Report abuse

"But I guess that kingstu01 would rather we waste more money instead of pooling together to help one another, because helping someone else isn't worth it even if it ends up helping you as well according to people like kingstu01."

People aren't upset about the idea of helping others.

It's theft, Hamtree. The ends don't justify the means.

Posted by: justin84 | February 11, 2011 10:47 PM | Report abuse

--*If you make health-care insurance cheaper and make it harder for insurance companies to deny people coverage*--

You still can't get your premises right, Klein. If you force insurance companies to pay to treat more and sicker people, premiums are not going to go down.

Posted by: msoja | February 11, 2011 10:58 PM | Report abuse

"In case you don't want to click over, though, the short version is this: If you make health-care insurance cheaper and make it harder for insurance companies to deny people coverage, then a certain number of people who would like to leave the labor force but can't afford or access health-care insurance without their job will stop working."

The implicit marginal taxes are also huge. You throw more people into the dead zone.

http://mises.org/daily/3822

Posted by: justin84 | February 11, 2011 11:28 PM | Report abuse

"People get insurance because they know that they might be some of the unlucky few who are stricken with ill health that would bankrupt them if they didn't have insurance."

That idea, of course, is built on the idea of people paying for that insurance on their own, not taking other people's money and doing it.

Posted by: krazen1211 | February 11, 2011 11:35 PM | Report abuse

"People get insurance because they know that they might be some of the unlucky few who are stricken with ill health that would bankrupt them if they didn't have insurance."

That idea, of course, is built on the idea of people paying for that insurance on their own, not taking other people's money and doing it.

Posted by: krazen1211 | February 11, 2011 11:35 PM | Report abuse

You may look at the premium amount and think that there is no way that you can afford it. You cannot afford to be without health insurance! shop around you may find it easy to find an affordable premium, I always find health insurance through wise health insurance network.

Posted by: perelwll | February 12, 2011 12:28 AM | Report abuse

ACA will create jobs. Everybody is already paying for the uninsured, in higher premiums and taxes and in reduced economic efficiency that makes a smaller pie and increases U.S. labor costs, so it's just better to get all the demand into the healthcare system, and reduce all sorts of costs from there. In addition, it must create new jobs. Because providing access to healthcare means increasing the demand for healthcare to its real level, and supply will respond, slowly but surely. It means more jobs not only in the healthcare sector, but also in allied industries such as construction and retail. The ignorance of economics among the anti-reformers has been adumbrated over the months by commentators to Ezra's threads, where their arguments are as suspiciously shortsighted as those of lobbyists: Things like, "If you increase access to healthcare, then there will be a shortage of healthcare" (how ridiculous, that gets a short-term "yes", until supply ramps up). Or: "You are increasing the costs of healthcare" (no, merely treating healthcare problems before they get bad must REDUCE the costs, while shifting the spending from the back door to the front door. But of course they couldn't tell a "cost" from a "price" if it bit 'em in the butt). And remember the old "healthcare demand is infinite" meme? They used this one regularly for months -- but No, of course "health" is what people want; not "healthcare"; no one willingly spends time at the doctor or the hospital, and the demand for healthcare is finite. Never mind asking how people are going to pay for healthcare if they don't have the money for it. Never mind asking why shouldn't we treat healthcare as a growth sector that could provide jobs to help solve that very same problem; which means, again, revealing all hidden demand. You won't read logical, straightforward answers to any of these questions. In fact you wonder why healthcare isn't seen by these people as the growth sector it should be. Always failing these first rebuttals of economics, they shuffle into the "liberty" argument instead, which is entirely arbitrary and cuts both ways. Really it's so pat you'd think it was paid for.

Posted by: Lee_A_Arnold | February 12, 2011 12:40 AM | Report abuse

"Under the status quo, these individuals couldn't afford health care. Passing a bill does not change this fundamental state of affairs. It can only be papered over with other peoples money."

Except for the fact that passing that bill ultimately reduces total health care spending even as it expands health care coverage to 35 million more people. But I'm sure you've no interest in silly facts.
The employer health care tax credit costs the government around 400 billion dollars a year that's considerably more then the 100 billion a year that will be used to help people without employer sponsored health care to get health care. I'm not surprised that a conservatives for government benefits when its for them but against them when they for others.

"young healthy people will be forced to pay higher premiums in order to cover their bills "
Again except for the fact that total health spending will be lower due to the ACA. But you're right young people will never get old, its against physics or something.

"On another note the health care reform that passed is projected to reduce total health care spending this is even as it expands health care to 35 million people, saving 35,000 peoples lives each year."

"Each American also gets a free pony."
No surprise that conservatives deny facts.
Non at all.


Posted by: Hamtree | February 12, 2011 1:32 AM | Report abuse

"But I guess that kingstu01 would rather we waste more money instead of pooling together to help one another, because helping someone else isn't worth it even if it ends up helping you as well according to people like kingstu01."
People aren't upset about the idea of helping others.
It's theft, Hamtree. The ends don't justify the means.

I see so now you've redefined theft as me giving you money. Cool.

Posted by: Hamtree | February 12, 2011 1:36 AM | Report abuse

--*If you make health-care insurance cheaper and make it harder for insurance companies to deny people coverage*--
---"You still can't get your premises right, Klein. If you force insurance companies to pay to treat more and sicker people, premiums are not going to go down."---

So you're against a health care system treating sick people?
You're right treating more people doesn't make health care costs go down, however expanding preventative care, reducing patent times, eliminating Medicare Advantage, switching to a more bundled payment system, investing in technology, required insurance companies to use more premium dollars on actual benefits and investments in community centers DO lower premium costs.

Posted by: Hamtree | February 12, 2011 1:42 AM | Report abuse

Lee Arnold is a wise person.

Totally eviscerates the competition and the local whiners.

All the problems the naysayers warn us of are ALREADY evident in the prior status quo.

Nowhere to go but up.

Posted by: lauren2010 | February 12, 2011 8:14 AM | Report abuse

--*Except for the fact that passing that bill ultimately reduces total health care spending even as it expands health care coverage to 35 million more people.*--

Sez you. Not even the propagandist Klein has claimed that DeathCare will reduce health care spending. *That* comes later, in some other future "reform" bill, which no one at present can quite visualize.

Posted by: msoja | February 12, 2011 9:50 AM | Report abuse

--*ACA will create jobs.*--

DeathCare sucks nearly a trillion dollars out of the economy over ten years in order to (ostensibly) balance the government's health care books. DeathCare is going to adversely impact the economy as a whole, and that doesn't add up to job creation.

Posted by: msoja | February 12, 2011 10:02 AM | Report abuse

"*That* comes later, in some other future "reform" bill"

No, actually last year the CBO said ACA reduces healthcare spending enough to lower the long-term deficits by 2/3rds, even though their calculation reverted ACA spending, 20 years from now, back to current higher trends, due to lack of analytical evidence -- so total savings could be even far greater. CBO also calculated it the other way around this year, in response to another request: repealing ACA will increase healthcare spending. Of course all this depends on Congress otherwise sticking to "current law" which includes "paygo" -- but we will always have that proviso, even with some Republican "reform" effort, as Lauren above might remind you.

Posted by: Lee_A_Arnold | February 12, 2011 10:20 AM | Report abuse

I guess it comes down to the simple question of do we as a nation want to provide health care to everyone? Put a different way, are we willing to allow a segment of the population to get sick and die if they cannot afford health care? Right now the system is unsustainable since those without coverage get treated at hospitals and do not pay, thus raising the costs for all those who do pay. The fact that they wait till later in the timeline of the illness makes the treatment costs higher. We either figure out a way to cover these folks, or we turn away anyone who cannot pay without treatment.

Are we willing to tell those who cannot pay, that if they get sick, they are on their own?

Posted by: The_Rat | February 12, 2011 10:38 AM | Report abuse

Of course they oppose making health insurance cheaper. They also oppose requring insurance companies to use 80% of each premium dollar for actual health benefits, not for profits and hugh CEO salaries. The GOP wants to go back to the good old days of skyrocketing health care and insurance prices with huge deductibes and exclusions for people who were really sick. To them health care is not a right. It is just another massive profit-making opportunity for their rich billionarie friends.

Posted by: tinyjab40 | February 12, 2011 10:57 AM | Report abuse

No, health care is NOT available to those who cannot afford it. Some hospitals will not treat me if I cannot afford to pay. Some physicians will not treat me if I cannot afford to pay. Sure, credit and payment options exist (often with exorbitant rates or fees) but if I'm poor and already having trouble making ends meet, I will not seek care.

Let's not pretend that the poor among us have equal access to care.

Posted by: knoelle11 | February 12, 2011 11:06 AM | Report abuse

The issue has many factors, but the tough reality is that the costs keep going up. For example, last year a CT scan cost $750. This year, the same scan, on the same machine, at the same clinic, with the same tech, costs $825, or a 10% increase. This has nothing to do with the health care law, since the cost rose 10% the year before.

Then consider the costs of prescription drugs. Medication is second only to major medical expenses, as a portion of health care costs. Right now, many drugs purchased in the US cost nearly 300% more than the same drug, made by the same manufacturer, at a plant in the US, as they do in France. France, like many European countries places price caps on drugs. Now we know that Smith-Klein is not loosing money in France, so why the difference? The drug manufactures tell us it is because of the high R&D costs that they have to incur, in order to develop the drug. But why should the US be the only place that covers those costs, when other nations benefit? Lastly, if the manufacturer wants to make a 10% profit, and sells 50% of the dugs here, and 10% in each of 5 other countries, where the price cap includes only a 5% profit, they make up for the difference by charging at 15% profit in the US. Why? Because we let them.

Lastly, the majority of health coverage in the US is employer (or third party) paid. We have an aging work force, and as we get older, we have more medical problems. This accounts for some of the cost growth, however, the fact that since we don’t pay for the product, we are not savvy consumers. For example, if your doctor treats you and says he has a drug that will help, but you have a choice. You can take one pill a month that costs $500, or one pill a day that costs $50 a month, what would you choose? If you are paying, most people would choose the cheaper pill, and take it every day. Since most of us do not pay however, and our drug co-pay is only $25, no matter what we choose, we opt for the $500 pill, since it is more convenient. The difference in cost is covered in next year’s health insurance premiums, paid by the employer.

The medical cost issue goes far beyond 30 million un-insured, but getting Congress to tackle the big problems, when big donors do not want a change, is the hard first step.

Posted by: The_Rat | February 12, 2011 11:20 AM | Report abuse

The members of the GOP who argue against access to health care for all citizens are just plain immoral and foolish. Good health of the citizens of the U.S. is a good investment. The U.S. the wealthiest nation in the world should provide universal health coverage. There is simply no excuse for the posture the Republicans have taken in regards to this issue.

Posted by: OhMy | February 12, 2011 1:11 PM | Report abuse

--*No, actually last year the CBO said ACA reduces healthcare spending enough to lower the long-term deficits*--

You're talking about cost *to the government*. I'm talking about costs overall, and out of real people's pockets. Try not to conflate the two, especially as it makes you look dishonest.

Posted by: msoja | February 12, 2011 1:12 PM | Report abuse

ezra,


this is a load of crap and you know it.

Or imagine a 50-year-old single mother who wants to home-school her developmentally disabled child but can't quit her job because they'll lose health care

In this instance because of HIPAA this person won't lose their access. They'll be able to keep access. I'd also love to see how you think this will reduce cost. The only way this reduces cost is that in the exchanges people will be subsidized. It doesn't reduce cost necessarily. it just shifts costs. You can say that you think or hope some pilot program reduces costs and hopefully they do but this only helps them with access which is important but you're giving it way too much credit for affecting costs in a positive way. You can't say this will do anything for cost. You can only hope pilot programs will work better than the status quo.


great points by The Rat as well. Your third paragraph explains why HSA's work so well. In an HSA you see those prescription costs to your bottom line so you'll take the generic as opposed to the expensive brand name drug.

Posted by: visionbrkr | February 12, 2011 1:23 PM | Report abuse

--*Right now the system is unsustainable since those without coverage get treated at hospitals and do not pay, thus raising the costs for all those who do pay.*--

Having the government "give" insurance to people who can't pay for it doesn't change what you say one iota. Poor people still can't pay for their health care. Other people still have to pay to treat poor people. Except, since, under DeathCare, poor people won't have to worry about paying for care, they are all the more likely to use a lot of it, which will still have to paid for by other people. Contrary to popular belief, promoted by propagandists like Klein, DeathCare does not ameliorate the free rider problem, but exacerbates it.

Posted by: msoja | February 12, 2011 1:25 PM | Report abuse

I have two examples of paying for other people's lack of health care coverage. A number of years ago, I worked w/ a mother w/ two children. She had no coverage for her children. She told me when her kids get sick, she always took them to X hospital, where it would be written off, b/c she could not pay. And, in my current city, a young mother I know became pregnant. When I asked about her coverage, she said, "I don't have insurance. I go to X hospital, and as long as I pay on my bill for a year, the hospital will write off the rest". I frequently re-visit these stories, and understand how the uninsured cause everyone's medical bills to be so high. And, then I think of my sister and her family, who face medical bankruptcy b/c they try to do the right thing by paying down their debt while trying to put food on the table for a family of five. The question is, whose story is right? The mother and mother to be? Or, my sister and her family? Should my sister continue to pay her bills and sacrifice
her family (and dignity), or should she 'right if off' like the other mothers? Change has to come.

Posted by: sage1332003 | February 12, 2011 1:32 PM | Report abuse

"You're talking about cost *to the government*. I'm talking about costs overall, and out of real people's pockets. "

No, total costs out of real people's pockets go down. Just taking care of the needy before they get more costly ensures that by arithmetic.

Now it may only just mean a lesser rate of price growth. In other worlds, cost reduction shows up when real prices climb not so fast as before the reform.

In addition, this also reduces the trajectory of the long-run public debt, which is one of the Tea Party's main concerns.

Posted by: Lee_A_Arnold | February 12, 2011 2:13 PM | Report abuse

--*Good health of the citizens of the U.S. is a good investment.*--

Then I suggest *you* "invest" in it, and leave me free to invest in whatever I value. Unless you're tired of living in a free country, of course, and then I guess we'll have to see who has the bigger mob.

Posted by: msoja | February 12, 2011 2:16 PM | Report abuse

--*Just taking care of the needy before they get more costly ensures that by arithmetic.*--

Now you're talking about a *theory* which is more along the lines of wishful thinking.

Hey, do you know *why* we *still* have poor people who can't afford health insurance after fifty years of throwing money at them and giving them health care? It's because there is always a more or less given percentage of people whose nature it is to be poor, and no matter what you do, including trying to make them healthier by encouraging them to eat right and brush their teeth three times a day and see their government-provided doctor twice a year, they are still going to neglect themselves and make all the poor choices that add up to being poor and hating rich people for not giving them stuff.

--*Now it may only just mean a lesser rate of price growth.*--

Oh, now it could mean a lesser rate of growth, how cute. Not a reduction, like you said before. Just a teensy bending of the cost curve.
And that's only a socialist theory, too, and not likely to be born out in practice.

Yeesh.

Posted by: msoja | February 12, 2011 3:05 PM | Report abuse

“Having the government "give" insurance to people who can't pay for it doesn't change what you say one iota. Poor people still can't pay for their health care. Other people still have to pay to treat poor people. Except, since, under DeathCare, poor people won't have to worry about paying for care, they are all the more likely to use a lot of it, which will still have to paid for by other people. Contrary to popular belief, promoted by propagandists like Klein, DeathCare does not ameliorate the free rider problem, but exacerbates it.”

So MSOJA, if I read this right, you are a proponent of letting those without health care insurance, or the ability to pay for health care, suffer the symptoms of their illness, up to and including death, without society lifting a finger to help them?

Posted by: The_Rat | February 12, 2011 3:34 PM | Report abuse

I'll bet msoja has employer-provided health care, which is tax deductible. So big guvmint subsidizes msoja to the tune of about $2,000 a year. Gee, isn't that THEFT?

Posted by: GreenDreams | February 12, 2011 5:01 PM | Report abuse

"I'll bet msoja has employer-provided health care, which is tax deductible. So big guvmint subsidizes msoja to the tune of about $2,000 a year. Gee, isn't that THEFT?"

Are you kidding me? Of course not. He's keeping his own money.

Posted by: justin84 | February 12, 2011 5:46 PM | Report abuse

"ACA will create jobs."

Possible in the short run, but so would outlawing computers. Both would make the country poorer.

"Everybody is already paying for the uninsured, in higher premiums and taxes and in reduced economic efficiency"

Then end the social insurance programs and mandates to provide provision. Charity care does not reduce economic efficiency. More people will take care of themselves, there will be more wealth for charity due to less deadweight loss of taxation, and prices will be lower.

"In addition, it must create new jobs. Because providing access to healthcare means increasing the demand for healthcare to its real level, and supply will respond, slowly but surely."

Only if prices respond, Lee. If demand increases and prices go down (or even are unchanged), you'll get shortages instead. But for some reason, you think health care spending will also go down. Increased quantity of health care demanded and supplied at higher prices equals higher total costs.

"It means more jobs not only in the healthcare sector, but also in allied industries such as construction and retail."

And it will mean fewer jobs in other sectors. Over the long run, the economy will tend to drift back towards full employment (which varies depending on supply constraints).

"their arguments are as suspiciously shortsighted as those of lobbyists: Things like, "If you increase access to healthcare, then there will be a shortage of healthcare" (how ridiculous, that gets a short-term "yes", until supply ramps up)."

What drives that ramp up? *Higher prices*

"You are increasing the costs of healthcare" (no, merely treating healthcare problems before they get bad must REDUCE the costs, while shifting the spending from the back door to the front door. But of course they couldn't tell a "cost" from a "price" if it bit 'em in the butt).

Yes, the person who would have died of cancer at age 60 will now get cancer treatment at age 60 and now also at 80, after twenty years of health care price inflation. It will be far far more expensive.

"And remember the old "healthcare demand is infinite" meme? They used this one regularly for months -- but No, of course "health" is what people want; not "healthcare"; no one willingly spends time at the doctor or the hospital, and the demand for healthcare is finite."

Well then why the hell are the pols spending all this time reforming "health care" when the people don't even want it? Why didn't you just outlaw bad food and inactivity? It would be a lot cheaper and give people quite a bit more health than hospitals (hospitals directly kill far more people than lack of health insurance is alleged to).

And all the liberals keep telling us that supply in health care creates its own demand. How they hell does that happen? If Ford doubled supply, those cars would sit unsold on the lots. I'll give you a hint: comprehensive insurance makes demand very price inelastic. Ponder that for a bit.

Posted by: justin84 | February 12, 2011 6:16 PM | Report abuse

Providing healthcare is like outlawing computers, in that both would increase the jobs market? Not necessary to read any further.

Posted by: Lee_A_Arnold | February 12, 2011 6:43 PM | Report abuse

"Never mind asking how people are going to pay for healthcare if they don't have the money for it."

Price discrimination by providers (in favor of low income customers) and charity.

"Never mind asking why shouldn't we treat healthcare as a growth sector that could provide jobs to help solve that very same problem; which means, again, revealing all hidden demand."

It can be a growth sector, but you don't get to point guns at other peoples' heads in order to fund your preferred growth sector.

"Always failing these first rebuttals of economics, they shuffle into the "liberty" argument instead, which is entirely arbitrary and cuts both ways."

This is hilarious, given all the inconsistent economics you applied, but also backwards - natural rights come first.

That is, even if socialism were to "work", it wouldn't matter. It just makes it easier that socialism doesn't work as well as capitalism.

You can get a nice high speed train network by indiscriminately bulldozing homes that are in the way, but it would be wrong the bulldoze those homes.

The economic arguments are mainly there to convince utilitarians, who don't really believe in right or wrong. In the train example, you point out how much subsidies most train systems need to continue to operate at even modest ridership levels.

Say seven people in a hospital need various organs, and there is one man in the waiting room with healthy examples of them all. Is it right to butcher him in order to save the lives of the other seven?

When talking to a utilitarian, I might emphasize that a society in which you could be randomly butchered for the benefit of others would more or less collapse, or at the very least be a poorer, scarier world to live in.

That argument isn't where I'd rest my case. At the end of the day, the guy in the waiting room owns his own life, and can do whatever he wants with it, regardless of the wants and needs of others.

Posted by: justin84 | February 12, 2011 6:46 PM | Report abuse

"Providing healthcare is like outlawing computers, in that both would increase the jobs market? Not necessary to read any further."

I'm sorry it's so tough for you to grasp - it requires thinking instead of merely dismissing what you are confused by - but you can create jobs by making the economy less efficient. The ACA reduces economic efficiency, as would outlawing computers. Total output is down, but more people are slaving away to produce that lower level of output.

There is no unemployment in a subsistence farming society, at least not amongst the able bodied. Everyone needs to work in order to stay alive.

Posted by: justin84 | February 12, 2011 6:53 PM | Report abuse

So basically, more affordable health care encourages some people to retire, freeing up jobs. Unemployed people can then apply for those jobs. So health care reform CREATES jobs, which is the opposite of what Republicans are saying.

Posted by: skylights | February 12, 2011 6:53 PM | Report abuse

Msoja: "It's because there is always a more or less given percentage of people whose nature it is to be poor"

Oh here it is again, the big sneer about the undeserving wretches. Which doesn't explain why good workers lose their jobs and their coverage, or why insurers rescind coverage, etc. Much less would it explain the 80/20 rule in the distribution of income, which precedes personal motivation or biological or social organization of any type. Can you guess the true reason for it?

Posted by: Lee_A_Arnold | February 12, 2011 6:53 PM | Report abuse

"The ACA reduces economic efficiency"

How, exactly?

Posted by: Lee_A_Arnold | February 12, 2011 7:13 PM | Report abuse

Ezzy Ezzy Ezzy.... You just dont understand the Congressional Budget Office... They are required to work with the BS guidelines/numbers/assumptions they are given...... (by the Dummycrats) Come on... you cant be that stupid!!!!!!!!


Posted by: 2010Rout | February 12, 2011 7:30 PM | Report abuse

So to the righties here...

We spend 17% of our GNP on health care compared to about half that of our competitors and we are not only rationing health care now but we are not all that healthy either...

Now we've heard ya'll say what you don't like but seems that ya'll never quite get around to telling *US* what you do like...

Is it too much to ask before you fire up yet another meaningless/toothless "Obamacare" rant to ask what your plan is???

I mean, we've had 2 years of ya'll tellin' us what you don't like and 2 years of complete silence on what you have to offer...

But I guess that is way over ya'll's heads...

Bob

Posted by: bobnpvine | February 12, 2011 8:49 PM | Report abuse

When someone calls a program "deathcare" when in fact it provides care to 32 million more people who didn't have it, it just shows how out of touch with reality they are.

Logic and facts means nothing to these people.

Posted by: lauren2010 | February 12, 2011 10:08 PM | Report abuse

2010Rout, 2010Rout, 2010Rout..............
Your party has always trusted that office before. Just happens to be inconvenient to you now. But that's how you seem to roll. Always.

Posted by: amazedone | February 12, 2011 11:24 PM | Report abuse

So sick of Republican drama..........
"Deathcare"? Get a grip.

Posted by: amazedone | February 12, 2011 11:30 PM | Report abuse

Republican drama and fear mongering and sabotage of the American government is nothing new. As Robert Reich writes, it has been their playbook for a very long time. Here, he outlines how Hooverish and bereft of ideas today's Republicans still are.

http://robertreich.org/post/3243257446

Posted by: lauren2010 | February 13, 2011 6:29 AM | Report abuse

The 62 year old woman can afford to be in the healthcare system because her employer carries her insurance costs in the company group health plan. The new law makes it possible to shift the high cost of her coverage to another plan not supported by the employer. By my accounting, this law benefits the woman, the employer and its stakeholders and the potential new hire. On the downside, the members of the insurance plan the woman joins will all see a small increase in premium.

In my view, the impact of the law in this case is a net positive. What would be even better, however, is a phase out of all employer paid health care. Let the healthcare consumer identify the best coverage available for their situation in a manner similar to how we purchase auto insurance today. In this way, an artificial barrier to co-mingling of insurance risk is eliminated. The cost of the coverage is shared more equitably among all parties.

Employer paid health care is skewing the health care market at a cost to everyone. Employer paid health care is a drag on the economy and worker mobility.

Posted by: Zpilot | February 13, 2011 9:01 AM | Report abuse

--*So MSOJA, if I read this right, you are a proponent of letting those without health care insurance, or the ability to pay for health care, suffer the symptoms of their illness, up to and including death, without society lifting a finger to help them?*--

Ah, "society", the great vague euphemism used to group the great undefinable masses into a single agent of whichever moral rectitude its invoker is pushing. There is no such thing as "society". Try substituting "your fellow man" for "society" and see how ridiculous your statement is. You invoke "society" as if it were a big fluffy pillow of voluntary collective action, but what you're really mean is that the government should step in and impose arbitrary values via threats of force and violence. Your "society" is nothing but government force, otherwise you wouldn't invoke it as you have.

Here's another way to look at it: Since we live in an ostensibly free country, our basic operating precept ought to be that if "society" wants something, "society" will act of its own free will in said regards.

Posted by: msoja | February 13, 2011 10:27 AM | Report abuse

--*I'll bet msoja has employer-provided health care*--

How much will you bet? $1000? Let me know.

Posted by: msoja | February 13, 2011 10:30 AM | Report abuse

--*Oh here it is again, the big sneer about the undeserving wretches.*--

A fact of life is not a sneer, but thanks for continuing to show your dishonesty.

That "undeserving" is cute, too. If some stranger "deserves" a slice out of *my* assets, what do I "deserve"? To be thankful your collective gang didn't vote to put me to death?

Posted by: msoja | February 13, 2011 10:38 AM | Report abuse

"A fact of life is not a sneer"

Your "fact" is that there is a percentage of people "whose nature it is to be poor". A ridiculous explanation that wouldn't cover all cases anyway. Do you know the real reason for the 80/20 rule?

Posted by: Lee_A_Arnold | February 13, 2011 10:52 AM | Report abuse

--*When someone calls a program "deathcare" when in fact it provides care to 32 million more people who didn't have it, it just shows how out of touch with reality they are.*--

You're confused again. DeathCare seeks to provide insurance, not care. Your "32 million" already had care.

Also, I call the recent legislation DeathCare because the word embodies the long term effects of this further government imposition. The law sucks nearly a trillion out of the economy over ten years, it burdens small and large businesses, it further burdens businesses that produce medical devices, etc., it further ties the hands of the insurers, it will dampen research and innovation in the pharmaceutical industry, and it will discourage people from entering the medical field. In the long run, the government run program will reduce availability of care services and devices and medicines to *everyone*, and what remains available will be of a lower quality, and that means earlier deaths for more people. Hence: DeathCare.

Posted by: msoja | February 13, 2011 10:53 AM | Report abuse

--*Your "fact" is that there is a percentage of people "whose nature it is to be poor". A ridiculous explanation that wouldn't cover all cases anyway.*--

I didn't *say* it covered all cases, dummy. My statement stands.

Posted by: msoja | February 13, 2011 11:20 AM | Report abuse

Wrong

The vast majority of those 32 million do not have care and would never be able to afford care needed for a catastrophic event.

You are simply making things up.

Also, please provide a detailed enumeration of the trillion you claim is being sucked out of the economy and I will explain why most or all of it currently is simply ending up in the bank accounts of wealthy execs or corporate coffers with little benefit to average people.

That's just another baseless lie that the CBO makes clear that the economy will improve and less debt will be created under ACA than if we just continue to funnel that trillion to corporations and wealthy execs.

Posted by: lauren2010 | February 13, 2011 11:30 AM | Report abuse

I challenge msoja to show us an excerpt of any CBO report that implies a trillion is being sucked from the economy and that the economy is expected to be worse off for ACA.

I also want him to explain what economic education or experience he has in assuming he can reasonably claim things that the highly educated, experienced and OBJECTIVE CBO team are not saying and in fact are disagreeing with him about.

I confess I am not educated and trained in these matters, but that's why I base my opinions on the most honest and objective and credible sources, and right now, the CBO is the only such player in town, though I would agree their analysis is not always perfect.

Posted by: lauren2010 | February 13, 2011 11:41 AM | Report abuse

Ezra, you write like someone who has never shopped for his own insurance. Clearly, you've spent your adulthood as the beneficiary of subsidized insurance, in your case, subsidized by your employer, who gets a tax break from the government.

When do ACA subsidies kick in? I recently returned to self-employment after a year or so at a small business. Health insurance is NOT affordable yet for people looking for non-employer sponsored insurance, I can tell you from my experience. Don't really understand why I have to wait until 2014 for the benefits of the bill to kick in...

And this example that you cite is wrong for many reasons: "... imagine a 50-year-old single mother who wants to home-school her developmentally disabled child but can't quit her job because they'll lose health care. The subsidies and the protections in the Affordable Care Act will give her the option to stop working for awhile, while under the old system she'd need to stick with her job to keep her family's health-care coverage."

If she voluntarily leaves the job market to care for her child, what income will she use to pay for her health insurance - and her mortgage? Or is the ACA providing unemployed people with the money for premiums? Are you also saying that ACA will no longer allow insurance companies to rate people based on the healthcare they need? That a young, healthy adult will pay the same rates as an obese smoker? That the services required for a developmentally disabled child will be covered at the same premium as billed for a "normal" child? Would like to know more about that dramatic shift in rating insurance premiums.

ACA should NOT be used as a reason to drop out of employment all together. It should help those who want to work OUTSIDE of a company (entrepreneurs, self-employed, etc.) obtain decent, affordable health insurance. Quite frankly, as someone who's been self-employed and self-insured for the better part of a decade, I'm eager for affordable health insurance, but that doesn't exist for me right now - despite the fact that the ACA was passed with great fanfare.

Posted by: MainStreetMuse | February 13, 2011 12:18 PM | Report abuse

"My statement stands."

You forgot the ridiculous part. There is no "nature" to be poor.

Posted by: Lee_A_Arnold | February 13, 2011 12:37 PM | Report abuse

The particularly egregious distortion is that what will actually happen is that, rather than reducing jobs by 160,000, it will reduce *unemployment* by that amount.

Note that the phenomenon being described doesn't reduce a single job - but, by making people able to leave the work force, it creates 160,000 fewer people vying for the same number of jobs and, as long as there are the unemployed seeking employment, it creates 160,000 openings that now need to be filled but that otherwise wouldn't have existed.

Posted by: mikerose2 | February 13, 2011 3:12 PM | Report abuse

The particularly egregious distortion is that what will actually happen is that, rather than reducing jobs by 160,000, it will reduce *unemployment* by that amount.

Note that the phenomenon being described doesn't reduce a single job - but, by making people able to leave the work force, it creates 160,000 fewer people vying for the same number of jobs and, as long as there are the unemployed seeking employment, it creates 160,000 openings that now need to be filled but that otherwise wouldn't have existed.

Posted by: mikerose2 | February 13, 2011 3:12 PM | Report abuse

The particularly egregious distortion is that what will actually happen is that, rather than reducing jobs by 160,000, it will reduce *unemployment* by that amount.

Note that the phenomenon being described doesn't reduce a single job - but, by making people able to leave the work force, it creates 160,000 fewer people vying for the same number of jobs and, as long as there are the unemployed seeking employment, it creates 160,000 openings that now need to be filled but that otherwise wouldn't have existed.

Posted by: mikerose2 | February 13, 2011 3:13 PM | Report abuse

"That's just another baseless lie that the CBO makes clear that the economy will improve and less debt will be created under ACA than if we just continue to funnel that trillion to corporations and wealthy execs."

The CBO has no idea how to forecast the economy, whatsoever.

On the verge of the Great Recession, they projected years of budget surpluses beginning about now, and thought 2010 GDP would be $16 trillion (we actually saw ~$14.6 trillion).

The CBO expected with 90% confidence that the budget deficit in 2009 would have been between less than 5% of GDP. Oops.

They also expected 5.2% unemployment from 2008-2011.

www.cbo.gov/ftpdocs/70xx/doc7027/01-26-BudgetOutlook.pdf

The CBO also expects unemployment to come back to 5% or so sometime in the future, and the current budget assumptions assume, quite remarkably, no recessions from 2009-2020.

Many economists think that the U.S. will have a tough time getting unemployment down below 6% or 7% in the future.

http://www.businessweek.com/magazine/content/10_24/b4182012718823.htm

Not only structural factors from the recession are at play, but the big European welfare states we are seeking to emulate (France, Germany, Italy, Spain) tend to have unemployment consistently over 7%, even at the peak of their expansions.

Posted by: justin84 | February 14, 2011 1:51 AM | Report abuse

This statement is laughable:

"Herbert Hoover, you may remember, didn’t have a sterling record when it came to the economy. As president, he presided over the Great Crash of 1929 and ushered in the Great Depression. He had no idea for what to do to help the nation out of the Depression except to balance the federal budget."

Robert Reich apparently doesn't know much about economic history, or he's just a propagandist. I could easily write the same thing for Obama:

"Barack Obama, you may remember, didn’t have a sterling record when it came to the economy. As president, he entered office in the wake of Great Crash of 2008 and ushered in many years of high unemployment. He had no idea for what to do to help the nation out of the Depression except to run large federal budget deficits."

Or for that matter, you could hit FDR with this charge too - unemployment was double digits for more or less his entire first two terms.

Go check out this link, and you'll see Hoover wasn't exactly a do nothing President.

http://mises.org/rothbard/agd/chapter11.asp

If you care to look, you'll note important parallels between ARRA and Hoover's economic program.

If you decide to read up on the Depression of 1920-1921 - which most people today have never heard about, and for good reason - you'll see that Harding had no idea what to do then either except balance the budget while slashing taxes. That Depression was sharp, but in 1923 unemployment was lower than it has been at anytime in the post war era.

Posted by: justin84 | February 14, 2011 2:09 AM | Report abuse

"How, exactly? [does the ACA reduce economic efficiency]"

- High implicit marginal taxes on labor created by the subsidies, will reduce labor supply, more so in the long run

- Wealth effect will also reduce labor supply

- Further entrenches comprehensive insurance, and replaces the price mechanism with top down directives, most of which will not work as expected

- Will try to control costs while expanding access in a sector that will account for 1/5th of the economy upon implementation

- Increases taxes on investment

- Increases taxes on medical product suppliers

- Will make it difficult for employers that continue to offer health insurance as health care will be more expensive (new care mandates plus higher prices due to higher demand)

- Increases the cost of hiring a new worker at medium sized businesses which don't offer insurance by $2,000

In general, the government doesn't have the knowledge to get involved in any sector and redesign it to make it more efficient. It can accomplish several specific goals, to be sure, but it will create dead weight loss in the process.

Posted by: justin84 | February 14, 2011 2:28 AM | Report abuse

"Is it too much to ask before you fire up yet another meaningless/toothless "Obamacare" rant to ask what your plan is???"

There shouldn't be any national "plan" in the first place.

Posted by: justin84 | February 14, 2011 2:31 AM | Report abuse

Yeah justin

Hoover is an economic god to you

And McCarthy was your hero

And Obama caused the recession

And doubling the DoD budget in recent years doesn't appear on your radar as you bemoan and whine about even the littlest of taxes.

And redirecting ANY money from wasteful programs to health reform, or instead washing it down the drain in a vast sea of DoD related spending and foreign wars is the death of us all.

And having the lowest taxes in the western world after we gave the wealthiest even more money (recent tax deal) to send overseas is just not good enough.

And you are smarter than Dr Reich and about 99% of economists who have concluded that hoover indeed was an economic dolt and ushered in the Great Depression and that FDR/WWII ended it.

You are naive to think the US will thrive in a laissez faire business model where taxes and gvmt regulation are a historic remnant. There's no historic precedent for your belief, and indeed, everytime we or anyone else have tried that, we have been predated on by the wealthy elite and suffered terrible economic shocks. And that includes the Great Depression, the Great Recession, and several shocks in the 19th century that few Americans have ever heard about except in vague terms of Robber Barons and the like.

Every time we lower taxes on the wealthy, almost half that money disappears into overseas investments or tax shelters. That's the giant sucking sound you hear, and msoja mistakenly believed was ACA.

I'm all for low taxes, but not for gutting them mindlessly. Clinton era high end tax rates were reasonable and helped balance the budget, and anything lower IMO is destructive to our economy and std of living.

I'm all for for smart elimination of regulation, but not for mindless gutting them.

As a 12 year USAF vet, I'm all for strong defense, but not the current wars and not the doubling of the DoD budget as BushJr did.

Evaluating whether a program has a NET negative or positive effect on the economy involves a fair assessment of all variables, something freeloaders like you aren't capable of doing. Some of the variables you enumerate would indeed be problems, except that you forgot to mention the variables in the package that outweigh your negatives. For example, ensuring that 32 million people have affordable care and won't go bankrupt or die are positive factors that HELP the economy and outweigh your variables.

And your blatant hatred of the CBO process also shows you are a wingnut whose opinions are distorted by ideology.

You fail to cite that GOP predictions are even worse than CBO predictions, and that the main reason CBO predictions are often wrong is that the underlying assumptions of those predictions change as a result of partisan actions by later Congresses and admins.

I am no longer a Republican because I came to learn that they engage in the biggest lies of all. You are the kind of propagandist that caused me to abandon that party--the party of debt, fear and big lies

Posted by: lauren2010 | February 14, 2011 6:48 AM | Report abuse

The fewer people in the workforce the higher wages are, due to supply and demand. If legislation has the effect of reducing the workforce, it will, by definition, increase wages. Therefore, conservatives oppose legislation that will reduce the workforce because if they dont, wages for workers will rise and their core constituency, the top 1 percent of wage earners, will lose wealth.

Posted by: sposito1 | February 14, 2011 7:03 AM | Report abuse

Oh, there is much wailing and gnashing of teeth about "theft" by the government on this thread. Wow, gang. The government "robbed" us all to bail out fraudulent banksters and put it on our "collective, socialist" credit card. It's not the banksters who will pay that back. It's "us." The government "theives" away dollars to build airports and roads, which benefit us all collectively (and socialistically)...at least till the government "sells" them off to private corporations so that we can pay the fraudulent tolls and essentially be doubled taxed on the things. My husband and I have no children, but we have paid property taxes for years and years to pay for public schools. Is that theft, too? And why should I pay for the court system and jails for those sorry criminals and murderers out there? I, of course, am the ONLY person I should be concerned with. Makes me think of John Donne: "No man is an island." Think about it, conservatives.

Posted by: beth-wade | February 14, 2011 7:11 AM | Report abuse

Ezra .. as usual you miss the real issue with the Pelosi-Reid-Obama healthcare legislation....the financing scheme is a mess..it is impracticable and cannot accomplish the job, meaning large and continuous tax increases will be required in the future.

The new healthcare system creates too much costly and guranteed to be inefficient bureaucracies (for no real purpose).

The new financing scheme shifts $500 billion from the Medicare system to help pay for this monster. Medicare will thus have to REDUCE coverage and benefits or greatly increase the costs paid by Medicare participants - most of whom are on fixed-income budgets right now and can't afford increases.

The new financing scheme assumes that the government will save $60 billion a year by more strict controls over fraud - purely nonsense ... can't be done...it takes years and lots of $$ to investigate and put together fraud cases ...

Obama and Congress may have fooled the majority of their "base" into believing their B-S, but anyone with an operating brain can easily see through this mess.

Posted by: Hazmat77 | February 14, 2011 7:45 AM | Report abuse

Republicans do not oppose making health care cheaper. What they oppose is the lie that if we insure 30+ million more people and increase coverage (i.e. eliminating preexsiting conditions) the cost of health care will decline. Anyone who believes that nonsense is delusional.

Posted by: acahorvath | February 14, 2011 8:42 AM | Report abuse


Using the standards that the health care industry has used for over 30 years, the new health care program should reduce the total cost of individual health care in this country.

The standard pricing policies, used by the major not for profit health care insurance companies for each individual covered by a policy, will reduce per individual because of the major increased number of individuals that will become covered/insured in the health care delivery system.

Since insurance companies depend on spreading the risk of paying claims by the number of individuals they cover, the larger the number of people covered, the lower the risk of a claim per person.

The new plan will be a major increase in the number of individuals elgible to receive a specific benefit and will also increase the total amount of contributions-money-that is contributed to the plan.

This will automatically result in a lower risk to the insurance carrier and should lower the cost per individual covered by the plan.

In simple terms, the more people covered by the plan, the lower the individual cost per person.

In addition, it will also cover current signifiant costs that are incured when patients do not have health insurance coverage and can not pay their bill for the care they received. This will reduce the losses the health care industry will incure and just pass on their other policy holders through increased premiums.

The new health care plan will be less expensive per person in future years than a current health care plans because of the increasing of the number of individuals covered by the plan and the reduced costs to the insurance industry.

The prime objection to the governments plan are the major for profit health care companies. They like the current system and do not what major elements changed. Many of these carriers compensate their exectives EXTREMELY well and do not want to face the possiblity of future reductions in income in either through savings of expenses or in compensation.

When the say it is "NOT ABOUT THE MONEY...YOU KNOW IT IS ALL ABOUT THE MONEY"

Posted by: meyer390 | February 14, 2011 9:19 AM | Report abuse

"What they oppose is the lie that if we insure 30+ million more people and increase coverage (i.e. eliminating preexsiting conditions) the cost of health care will decline. Anyone who believes that nonsense is delusional."

Of course, your premise is inaccurate and lacks details.

This is a corrected version of your lament:

If we insure 30+ million more people and increase coverage (i.e. eliminating preexsiting conditions), and the insurers get 30+ million new customers and all their business, and we eliminate existing corporate welfare programs such as medicare-D ($100s and $100s billions in waste in itself), and regulate an industry that till now has utterly failed and force them to engage in private market health exchanges that the GOP once favored and which exemplify American-style private-oriented traditions, the cost of health care will decline.

Of course, ACA is full of kinks that need to be worked out. But repealing ACA means NOTHING to controlling costs or providing a functioning care/insurance system.

If you don't believe ACA can be a foundation upon which to build on, then you simply don't believe in the ability of private enterprise to innovate and make profits AND provide care/insurance in the health care market.

You yourself seemed to imply they cant profit without excluding 10s millions or people and excluding sick people. What worth is having a care/insurance industry that succeeds only at providing profits to execs while providing illusory benefits to more and more Americans.

Posted by: lauren2010 | February 14, 2011 9:44 AM | Report abuse

Health care costs doubled under the Bush/Cheney watch, and I didn't hear Republicans complaining about that. What's "cheaper" about that? The insurance companies made a bundle thanks to Bush and the GOP. For those of you who have a company subsized insurance plan, you are lucky but naive about the true cost of insurance premiums. Only when you lose that benefit will you understand. Using the new health care law to raise premiums and scare employers is just another ruse by insurance companies to fleece America.

Posted by: lddoyle2002 | February 14, 2011 10:25 AM | Report abuse

Justin84: "- High implicit marginal taxes on labor [etc]"

Your list won't do it. In the old system, there are plenty of separate conditions which ALSO reduce economic efficiency. You have to cost-benefit the whole thing together, in other words do all the tradeoffs. The question is how will ACA reduce economic efficiency overall. If you are against universal coverage for resentment reasons, just say so. Misapplying economics to buttress your position doesn't help.

Posted by: Lee_A_Arnold | February 14, 2011 11:42 AM | Report abuse

Ezra.....a significant point in your piece about health insurance neglects the fact that most conservatives feel that the wifes place is in the home, and if wives are only working to maintain employer provided insurance, doesn't it stand to reason that if less mothers with young children were in the work force, more single women and the unemployed of both genders would be able to take those vacated jobs, thus decreasing the high unemployment rolls. Conservatives should be eating this up, if only they weren't more concerned with destroying this health care bill in order to damage the democrats chances in 2012.

Posted by: bobncar | February 14, 2011 11:54 AM | Report abuse

Acahorvath: "Republicans do not oppose making health care cheaper. What they oppose is the lie that if we insure 30+ million more people and increase coverage (i.e. eliminating preexsiting conditions) the cost of health care will decline. Anyone who believes that nonsense is delusional."

No. At the present time we end up paying for everybody anyhow, in higher premiums and taxes. We "pay" for it additionally, in reduced worker output. So we aren't increasing the total price there, by much if anything at all -- we may end up saving a little.

Also, in the healthcare debate, "cost" is different than "price", and this appears to confuse a lot of critics. If we treat people earlier because they have access, instead of them being afraid to seek help until until they are forced when it is serious, the system saves on cost (i.e., price per unit of good health outcome). Demand won't explode upward, because the demand for healthcare is finite (e.g., people really don't want to spend more time at the doctor or in the hospital).

Romneycare in Massachusetts is already demonstrating a little of these possibilities: There was some increase in requests for doctor appointments, yet no extra demand for inpatient treatment, plus a reduced growth in the rate of hospital costs, compared to the rest of the U.S.

There could be other savings effects: saving the 5-10 cents on every dollar lost to excess administrative costs charged by insurers (for no value-added on their part); better job portability helping workers maintain incomes; lower business-startup costs for entrepreneurs; and lower U.S. labor costs in international trade, thus making U.S. exports more competitive while using less dollar devaluation.

From all of these, the size of the economic pie would increase a little, reducing the share of healthcare, even as a properly growing sector of the U.S. economy.

Posted by: Lee_A_Arnold | February 14, 2011 1:04 PM | Report abuse

This republican isn't against lower health care costs. What I'm against is the unconstitutionality of the Afordable Care Act.

Posted by: gfafblifr | February 14, 2011 1:09 PM | Report abuse

Some may quit because they will lose the huge percentage for brokering,but if they quit there will many inline for those jobs.and it will increase those jobs at a lower pay rate with more people insured.

lose jobs ,but gain more jobs

REPUBLICAN BACKERS DON'T WANT REFORM IT WILL COST them MONEY AND THEN IT WILL COST REPUBLICANS

my grandchildren need health care

Posted by: theoldmansays | February 14, 2011 10:17 PM | Report abuse

Some may quit because they will lose the huge percentage for brokering,but if they quit there will many inline for those jobs.and it will increase those jobs at a lower pay rate with more people insured.

lose jobs ,but gain more jobs

REPUBLICAN BACKERS DON'T WANT REFORM IT WILL COST them MONEY AND THEN IT WILL COST REPUBLICANS

my grandchildren need health care

Posted by: theoldmansays | February 14, 2011 10:27 PM | Report abuse

Yes, they do not want it to become cheaper. According to them, they are a private company that can do whatever they want, however they want, whenever they want

And if the government puts any laws for consumers in? STOP!!!!!

If the government makes any laws forcing the company to fix any spills that were their fault? SHAKEDOWN!!!!1

Posted by: Bious | February 15, 2011 11:01 PM | Report abuse

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