Government Shutdown 2013-2014 My Civil Servant Brethern...what you think

[rico x hood]

Correct me if I'm wrong, but don't the American ppl already foot the bill for the uninsured anyways because they go to hospitals and end up with bills they can't pay?

I read somewhere it's around 50 billion in unpaid hospitals bills by the uninsured every yrear, I feel like people who are aganist ObamaCare have overlooked this.

It's not overlooked, I personally just chalked it up to the nature of the beast that is our healthcare system. If they want my support for reform figure out how to keep hard working people from footing the bill for the uninsured.

 

[deuce king]

 

 
Did you not see me highlight the word "NATIONAL" in my statement champ??  Yes, there are 3 branches of government, but of those 3 branches of government only 1 is represented and voted on in a NATIONAL election.  Meaning including all or representing the votes of the entire country. 

if your implication that somehow da "national election" is less important then da non presidential elections is then why obama can't get **** done...?

You got that all backwards champ. 

 

[luckyluchiano]

As long as my pops can have me on his insurance (I turn 25 this month) until next year I don't cAre what happens

 

[Rootin4EverybodyBlack]

It's not overlooked, I personally just chalked it up to the nature of the beast that is our healthcare system. If they want my support for reform figure out how to keep hard working people from footing the bill for the uninsured.

You say this as if the uninsured aren't hard working.

If anything the gov't needs to crack down on these corporations who turn keep turning in larger and larger profits every year but won't provide their employees with insurance.

 

[lyonbc1]

Well there is no public option which is why so many people on the left don't want it. An people on the right don't want it because it gives the government too much power over people's lives. Obama said if you already had health insurance then the law would not effect you. Bold face lie. Studies have shown that people's healthcare premiums might go up...**** that.

There is now a penalty if you decide you don't want health insurance. So as a healthy 23 year old man if I say I want to save more money I just won't get health insurance...the government has taken that choice away from me.

So because of that dumb *** law I now have less freedom and might be losing more money...just so more Americans get have healthcare. Call me selfish but **** is hard out here and I DESERVE to keep MY money.

And you'd be ok paying out the *** for ridiculous costs for medical bills if god forbid something happened and you needed surgery or even just a stint in the hospital? Look I don't make nearly 100k a yr and if they take a little out of my check to cover for some child in Florida or anywhere who has a pre-existing condition and otherwise may die without proper medical care when these crooked insurance companies won't insure them then I'll take that hit. Maybe thats just me. But a business like Papa Johns complaining they may not make as much profit versus the millions of people that the bill will help and allow parents and kids to live to see more of their lives with horrible illnesses.....weighing that I don't see the argument. And those polls are kinda skewed bc there's a portion of people ~10% give or take who don't think the law goes far enough and its too liberal. It's not perfect I agree with that but its a start. and to hold the country hostage--literally, in order to prove a point that is futile and one thats gonna cost me real money as a federal employee? Nah. Congress can't get outta here with that bs. The CBO has also issued reports showing it isn't going to raise costs over the longhaul and in actuality the deficit would be cut by 130billion over the first 10 yrs, and you act like health insurance premiums haven't been SKYROCKETING upward without the law to begin with.

 

[lyonbc1]

Correct me if I'm wrong, but don't the American ppl already foot the bill for the uninsured anyways because they go to hospitals and end up with bills they can't pay?

I read somewhere it's around 50 billion in unpaid hospitals bills by the uninsured every yrear, I feel like people who are aganist ObamaCare have overlooked this.

It's not overlooked, I personally just chalked it up to the nature of the beast that is our healthcare system. If they want my support for reform figure out how to keep hard working people from footing the bill for the uninsured.

Ohhh ok gotcha, so people with pre-existing conditions such as cancer, diabetes who can't get health insurance aren't hardworking? beyond a selfish sentiment.

Some people I've seen and spoken to genuinely care more about a mega corporations complaining they may have to shell out what amounts to pennies more to insure their employees versus fellow human being suffering and born with health conditions beyond their control whose parents/families can't afford the asinine healthcare costs w/o insurance. Makes ZERO sense.

 

[rico x hood]

Ohhh ok gotcha, so people with pre-existing conditions such as cancer, diabetes who can't get health insurance aren't hardworking? beyond a selfish sentiment.

Some people I've seen and spoken to genuinely care more about a mega corporations complaining they may have to shell out what amounts to pennies more to insure their employees versus fellow human being suffering and born with health conditions beyond their control whose parents/families can't afford the asinine healthcare costs w/o insurance. Makes ZERO sense.

Get off your soap box with your demagoguing. You're not going to sway any opinions here by tugging at heart strings. These are the facts: I work hard for my money and I should not have to give a red cent to anyone else for their health care if I do not choose to. That's what this new law will be, and that's what the old system had as well. Money coming out of my pocket to take care of other people who for whatever reason can't take care of themselves. That is not right and it should not be that way. Would it be cool if everyone had health insurance? Yes. But not on my dollar.

An do not draw any false conclusions about my first post. I never once said people with pre-existing conditions and no health insurance were not hard working. I said that I am, and I don't want my hard earned money to go to anyone else if I don't choose to give it to them.

If you want more people to have health insurance, then go add them to your policy. That should be a CHOICE that individuals make and not mandated by the government.

 

[jking0821]

Ohhh ok gotcha, so people with pre-existing conditions such as cancer, diabetes who can't get health insurance aren't hardworking? beyond a selfish sentiment.

Some people I've seen and spoken to genuinely care more about a mega corporations complaining they may have to shell out what amounts to pennies more to insure their employees versus fellow human being suffering and born with health conditions beyond their control whose parents/families can't afford the asinine healthcare costs w/o insurance. Makes ZERO sense.

Get off your soap box with your demagoguing. You're not going to sway any opinions here by tugging at heart strings. These are the facts: I work hard for my money and I should not have to give a red cent to anyone else for their health care if I do not choose to. That's what this new law will be, and that's what the old system had as well. Money coming out of my pocket to take care of other people who for whatever reason can't take care of themselves. That is not right and it should not be that way. Would it be cool if everyone had health insurance? Yes. But not on my dollar.

An do not draw any false conclusions about my first post. I never once said people with pre-existing conditions and no health insurance were not hard working. I said that I am, and I don't want my hard earned money to go to anyone else if I don't choose to give it to them.

If you want more people to have health insurance, then go add them to your policy. That should be a CHOICE that individuals make and not mandated by the government.

 

[sundoobie]

Get off your soap box with your demagoguing. You're not going to sway any opinions here by tugging at heart strings. These are the facts: I work hard for my money and I should not have to give a red cent to anyone else for their health care if I do not choose to. That's what this new law will be, and that's what the old system had as well. Money coming out of my pocket to take care of other people who for whatever reason can't take care of themselves. That is not right and it should not be that way. Would it be cool if everyone had health insurance? Yes. But not on my dollar.

An do not draw any false conclusions about my first post. I never once said people with pre-existing conditions and no health insurance were not hard working. I said that I am, and I don't want my hard earned money to go to anyone else if I don't choose to give it to them.

If you want more people to have health insurance, then go add them to your policy. That should be a CHOICE that individuals make and not mandated by the government.

Stone Face!

So basically you're not ok with our tax dollars paying for American's health care. Bottom line right?

What about all these other Govt programs that do not help Americans at all, are you ok with them? You know like the $2,965,029,000 aid to Pakistan for FY 2012?

Let's see... our own tax dollars to help Americans and our communities here Stateside or help Pakistan fight terrorism? Choices... Choices!

 

[datznasty]

As for the original topic, I have (or get) to work regardless since our contract was paid up front.

 

[sundoobie]

if your implication that somehow da "national election" is less important then da non presidential elections is then why obama can't get **** done...?

oh ok...

obama only controls da executive branch, if he doesn't at least delay his bill THAT ALREADY HAS WAIVERS to other folks then government is

shutting down, and with good reason.

its a bad law and needs to be delayed at MINIMUM....

[h1]Poll: Obamacare remains highly unpopular as implementation looms[/h1]

By Mark Murray, Senior Political Editor, NBC News
A large number of Americans continue to adamantly oppose the nation’s new health-care law and believe it will produce damaging results, according to a new NBC News/Wall Street Journal poll. 
Forty-four percent of respondents call the health-care law a bad idea, while 31 percent believe it's a good idea -- virtually unchanged from July's NBC/WSJ survey.
By a 45 percent to 23 percent margin, Americans say it will have a negative impact on the country's health-care system rather than a positive one. 

http://firstread.nbcnews.com/_news/...highly-unpopular-as-implementation-looms?lite

NO Way!?

The NBC/WSJ poll was conducted Sept. 5-8 of 1,000 adults (including 300 cell phone-only respondents), and it has an overall margin of error of plus-minus 3.1 percentage points.

You mean 440 out of 1,000 adults responded negatively to a law that hasn't been fully implemented? Such an excellent piece of journalism you posted. Thanks for the insight!


Did you forget this part?

Thirty-four percent say they don’t understand the law very well, and another 35 percent say they understand it only “some.”

 

[rico x hood]

Stone Face!

So basically you're not ok with our tax dollars paying for American's health care. Bottom line right?

What about all these other Govt programs that do not help Americans at all, are you ok with them? You know like the $2,965,029,000 aid to Pakistan for FY 2012?

Let's see... our own tax dollars to help Americans and our communities here Stateside or help Pakistan fight terrorism? Choices... Choices!

Nope I don't support them either. I support whatever will allow me to keep as much as MY OWN money as possible. I'm not a rich man and don't have nearly as much savings as I'd like to have at this point in my life. Maybe when I do get to a point in my life when I'm comfortable I'll decide to be a bit more giving with MY money. But at this point in my life I'm not. If that makes me a bad person for wanting to keep my money in my pocket. Then so be it. I'll take that criticism.

 

[jjs07]

Well there is no public option which is why so many people on the left don't want it. An people on the right don't want it because it gives the government too much power over people's lives. Obama said if you already had health insurance then the law would not effect you. Bold face lie. Studies have shown that people's healthcare premiums might go up...**** that.

There is now a penalty if you decide you don't want health insurance. So as a healthy 23 year old man if I say I want to save more money I just won't get health insurance...the government has taken that choice away from me.

So because of that dumb *** law I now have less freedom and might be losing more money...just so more Americans get have healthcare. Call me selfish but **** is hard out here and I DESERVE to keep MY money.

While I do agree that health insurance SHOULD be a choice, if you choose not to have it and require a hospital stay for whatever the reason, who is responsible for the bill if you can't pay it?

 

[rico x hood]

NO Way!?
You mean 440 out of 1,000 adults responded negatively to a law that hasn't been fully implemented? Such an excellent piece of journalism you posted. Thanks for the insight!


Did you forget this part?

NOBODY understands this law. The President doesn't fully understand it which is why he's been flip flopping since 2009 about what it will do. Congress doesn't fully understand the law. The CBO doesn't fully understand law which is why there are no concrete numbers about how much it will cost or save. The states that are being forced to implement those exchanges don't understand the law. Of course the American people don't understand it. As I stated in another thread the damn law is a cluster ****...and should have never passed. Obama and the Dems forced that law through Congress even though the majority of Americans didn't want it. That is not the kind of leadership I expected or wanted out Mr. Transparency Obama.

 

[sundoobie]

Nope I don't support them either. I support whatever will allow me to keep as much as MY OWN money as possible. I'm not a rich man and don't have nearly as much savings as I'd like to have at this point in my life. Maybe when I do get to a point in my life when I'm comfortable I'll decide to be a bit more giving with MY money. But at this point in my life I'm not. If that makes me a bad person for wanting to keep my money in my pocket. Then so be it. I'll take that criticism.

And how are you losing money? Are you single with over $200,000 in adjusted gross income for tax year 2013? Do you have over 200,000 in Net Investment Income, you know (Dividends, Interest, Partnership income, Capital Gains) that you have pay the additional 3.8% Net Investment Tax?

Please I seriously want to know why someone in your position is going to lose your own money from this law! The tax penalty for not getting health insurance... Is that what you're complaining about?

 

[ninjahood]

[h5]Pharma & Healthcare[/h5][h6]|[/h6][h6]9/23/2013 @ 8:00AM |432,125 views[/h6][h1]Obamacare Will Increase Health Spending By $7,450 For A Typical Family of Four [Updated][/h1]
Chris Conover, Contributor



398 comments, 210 called-out
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Ron Kirby holds a sign while marching in protest of the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court on March 26, 2012 in Washington, DC. (Image credit: Getty Images North America via @daylife)

Update: At the bottom of this post, the author responds to criticism of his argument. Over at National Journal Avik Roy says the critics are missing the point of Conover’s post.

It was one of candidate Obama’s most vivid and concrete campaign promises. Forget about high minded (some might say high sounding) but gauzy promises of hope and change. This candidate solemnly pledged on June 5, 2008: “In an Obama administration, we’ll lower premiums by up to $2,500 for a typical family per year….. We’ll do it by the end of my first term as President of the United States.”  Unfortunately, the experts working for Medicare’s actuary have (yet again[sup][1][/sup]) reported that in its first 10 years, Obamacare will boost health spending by “roughly $621 billion” above the amounts Americans would have spent without this misguided law.

What this means for a typical family of four

$621 billion is a pretty eye-glazing number. Most readers will find it easier to think about how this number translates to a typical American family—the very family candidate Obama promised would see $2,500 in annual savings as far as the eye could see. So I have taken the latest year-by-year projections, divided by the projected U.S. population to determine the added amount per person and multiplied the result by 4.

Interactive Guide: What Will Obamacare Cost You?

Simplistic? Maybe, but so too was the President’s campaign promise. And this approach allows us to see just how badly that promise fell short of the mark. Between 2014 and 2022, the increase in national health spending (which the Medicare actuaries specifically attribute to the law) amounts to $7,450 per family of 4.



Obama's 2009 Promise Of Cheaper Healthcare Has Morphed Into 2013 Price Hikes Sally Pipes Contributor

Don't Be Fooled, ObamaCare Will Drive Up Unemployment And Healthcare Costs John Goodman Contributor

The Coming Liberation: Health Care For All Without Obamacare Peter Ferrara Contributor

No, Obamacare Is Not A Good Deal For Young People In The Long Run, Not Even Close Chris Conover Contributor

Let us hope this family hasn’t already spent or borrowed the $22,500 in savings they might have expected over this same period had they taken candidate Obama’s promise at face value. In truth, no well-informed American ever should have believed this absurd promise. At the time, Factcheck.org charitably deemed this claim as “overly optimistic, misleading and, to some extent, contradicted by one of his own advisers.”  The Washington Post less charitably awarded it Two Pinocchios (“Significant omissions or exaggerations”). Yet rather than learn from his mistakes, President Obama on July 16, 2012 essentially doubled-down on his promise, assuring small business owners “your premiums will go down.” He made this assertion notwithstanding the fact that in three separate reports between April 2010 and June 2012, the Medicare actuaries had demonstrated that the ACA would increase health spending. To its credit, the Washington Post dutifully awarded the 2012 claim Three Pinocchios (“Significant factual error and/or obvious contradictions.”)

The past is not prologue: The burden increases ten-fold in 2014

As it turns out, the average family of 4 has only had to face a relatively modest burden from Obamacare over the past four years—a little over $125. Unfortunately, this year’s average burden ($66) will be 10 times as large in 2014 when Obamacare kicks in for earnest. And it will rise for two years after that, after which it hit a steady-state level of just under $800 a year. Of course, all these figures are in nominal dollars. In terms of today’s purchasing power, this annual amount will decline somewhat [corrected as per update 5 below].

But what happened to the spending slowdown?

Some readers may recall that a few months ago, there were widespread reports of a slow-down in health spending. Not surprisingly, the White House has been quick to claim credit for the slowdown in health spending documented in the health spending projections report, arguing that it “is good for families, jobs and the budget.”

On this blog, Avik Roy pointed out that a) since passage of Obamacare, U.S. health spending actually had risen faster than in OECD countries, whereas prior to the law, the opposite was true. Moreover, to the degree that U.S. health spending was slowing down relative to its own recent past, greater cost-sharing was likely to be the principal explanation. Medicare’s actuarial experts confirm that the lion’s share of the slowdown in health spending could be chalked up to slow growth in the economy and greater cost-sharing. As AEI scholar Jim Capretta pithily put it:

An important takeaway from these new projections is that the CMS Office of the Actuary finds no evidence to link the 2010 health care law to the recent slowdown in health care cost escalation. Indeed, the authors of the projections make it clear that the slowdown is not out of line with the historical link between health spending growth and economic conditions (emphasis added).

In the interests of fair and honest reporting, perhaps it is time the mainstream media begin using “Affordable” Care Act whenever reference is made to this terribly misguided law. Anyone obviously is welcome to quarrel with the Medicare actuary about their numbers. I myself am hard-put to challenge their central conclusion: Obamacare will not save Americans one penny now or in the future. Perhaps the next time voters encounter a politician making such grandiose claims, they will learn to watch their wallet. Until then, let’s spare strapped Americans from having to find $657 in spare change between their couch cushions next year. Let’s delay this law for a year so that policymakers have time to fix the poorly designed Rube Goldberg device known as Obamacare. For a nation with the most complicated and expensive health system on the planet, making it even more complicated and even more expensive never was a good idea.

UPDATE 1: Igor Volsky at ThinkProgress has declared this article is “totally wrong.” Center for Budget and Policy Priorities’ Paul Van de Water “described this calculation as one of the stupidest things he’s read in a long time” asserting that I’ve calculated “an average that doesn’t mean anything for anyone.”  To his credit, MIT economist Jonathan Gruber at least concedes my basic point: “The bottom line is that the government has consistently reported that Obamacare will raise national health spending by about 1 to 2 percent.”  But then goes on to say ““This is a small fraction of the typical 5 to 7 percent annual growth rate in health care – and is a small price to pay for insuring 30 million or more Americans.”  Notably absent from Mr. Volsky’s scathing critique is any mention of the person who started this use of a “typical American family:” President Obama.  Most important, Professor Gruber’s point essentially substantiates my own: it was the President’s claim of $2500 premium savings for the “typical” family that was and continues to be totally wrong. It’s simply not possible for national health spending to rise by $621 billion and for the “typical” family to expect a $2500 (per year!!!!) premium reduction. Did Paul Van de Water or anyone else at CBPP call candidate Obama’s promise “one of the stupidest things he’s read in a long time”? If not, why not?

People are welcome to argue that Obamacare is a great deal, that it’s worth all that added spending to get extra coverage for tens of millions of Americans. But of course, that’s not how Obamacare was sold. Rather than tell Americans the truth that they’d have to pay more and that the extra price was worth it, candidate Obama promised the ultimate free lunch: we’ll cover 30 million uninsured AND the typical family will see their premiums go down by $2500 (per year!!!!).  And Jonathan Gruber seems to have changed his tune since the fierce debates about health reform, since as Avik Roy has recounted,   “What we know for sure,” Obamacare architect Jonathan Gruber told  Ezra Klein in 2009, “is that [the bill] will lower the cost of buying non-group health insurance.”   Obamacare was sold on the promise that it would not increase health spending or the deficit or increase taxes on families making less than $250,000 a year  [“I can make a firm pledge under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”]  Every one of these promises/claims/predictions turned out to be totally wrong.  We can start having a productive debate when progressives are willing to concede these simple, easily demonstrable empirical claims. And then perhaps we can move on to junking this unworkable law and replacing it with the world-class patient-centered health system Americans deserve.

UPDATE 2: Wonkette is the latest to weigh in on the purported  stupidity of my post: “In other words, this is incredibly stupid. Sure, the latest Center for Medicare & Medicaid Services report [PDF]  says that “Obamacare” will lead to “roughly $621 billion” in additional health spending over the next ten years. But that emphatically does not mean that you, me, and the other two members of our typical family will be paying this money out of pocket. Most of it will be paid out by insurance companies, who will have a whole bunch of new policyholders because of Obamacare. Much of it will be paid by the government in subsidies and increased Medicaid enrollment. And yes, some of it will be paid by healthy (for now), well-off (for now) young (for now!) people who would otherwise forgo insurance and roll the dice on not ever being carted to the hospital in an ambulance” (emphasis added).

Wonkette’s attitude about the $621B illustrates precisely the attitude that has led to the mess we’re in (both related to Obamacare specifically, and entitlements more generally). “Don’t worry. Families won’t have to pay the tab. We’ll stick it to greedy insurance companies or Uncle Sam will cover it. No problem!”  But of course, we can be pretty certain that insurance companies (especially if they are greedy!) are unlikely to be paying for any tab without turning around and passing that cost along to (gasp!) American families. Similarly, Uncle Sam has nowhere else but American families to keep replenishing tax coffers. In short, American families manifestly WILL be absorbing every single penny of the $621B in added health spending created by Obamacare and it is intellectually disingenuous (and certainly no contribution to informed public debate) to pretend otherwise.

UPDATE 3: Avik Roy at NRO has done a splendid job of explaining the genesis of President Obama’s original estimate of $2500 savings for the “typical family.” It’s essentially identical to the method used for my own calculation. Avik’s post also includes a very entertaining montage of the number of times President Obama made this claim. I encouraged anyone interested in actually understanding this issue to read his piece.

UPDATE 4: Reader Thomas Rudder makes the following comments (submitted on 2013/09/24 at 4:53 pm  for anyone who cares to read his comment in its entirety): ”Authors presentation of CMS report is not accurate.” “ACA is summed up in the final sentence of the CMS Major Findings, ***it is still slower growth than over the longer-term history*** ACA Saves according to this report.”  I’m not trying to single out Mr. Rudder, but his is the clearest articulation of an apparent misunderstanding of the CMS report that I’ve observed in quite a number of comments I’ve received.

To be sure, there has been a slowdown in the growth of health spending. But it is manifestly NOT due to Obamacare. The whole point of Tables 2 and 2a in that report was to compare a set of projections assuming ACA was in place to an alternative set of projections in which ACA was assumed NOT to be implemented, i.e., that the pre-Obamacare world had simply continued forward until 2022, inclusive of slightly rising numbers of uninsured etc. The critical point Mr. Rudder and other readers seemed to have missed is that the recent slowdown in health spending happens in both scenarios. Why? Because the slowdown in spending relates principally to the slowdown in the economy and to more cost-sharing such as the growing number of Americans who have jumped into high deductible health plans. The reason we know for certain is not the cause of the observed slowdown in spending is because in every single year from 2010-2022, health spending is higher in the set of projections that assumes ACA is implemented than in the scenario in which it is not (readers can examine the tables themselves if they have any doubt on this fundamental point).  If Obamacare truly slowed down health spending more than in the counterfactual world without it, then it obviously would make no sense that spending would be $621B higher under Obamacare than without it. In short, the CMS report manifestly is NOT drawing the conclusion Mr. Rudder erroneously attributes to it.

Once Obamacare proponents reluctantly reach the conclusion that Obamacare will increase national health spending, many seem to want to switch to the argument that of course spending rose since we’re covering more people. I agree, it is pretty obvious we should have expected that to happen, but unfortunately, that’s not the way candidate Obama and his advisors saw it. They were convinced their plan–notwithstanding its expansion of coverage for tens of millions of uninsured–would SAVE $200 billion in health spending a year, which translated into roughly $2500 a year. And candidate Obama’s claim that he could pull this astonishing feat off before the end of his first term was not some off-script overenthusiastic bit of puffery that occurred during a campaign speech. As Kevin Sacks at the NYT reported: “Mr. Obama’s economic policy director, Jason Furman, said the campaign’s estimates were conservative and asserted that much of the savings would come quickly. “We think we could get to $2,500 in savings by the end of the first term, or be very close to it,” Mr. Furman said.”  Thus, the savings was not some long-term aspiration to “bend the cost curve” that would happen down the road outside of the range of the latest CMS projection (as many other readers have claimed).

In my post, I have avoided trying to speculate on whether the President was delusional. lying or simply mistaken in his forecast (readers can view below the many instances in which he made this claim and draw their own conclusions).  The indisputable truth is he was dead wrong–not even close to hitting the mark. That was the simple take-home message I’d hope to deliver in my piece, but which way too many readers appear to be furiously shutting their eyes to see.  It’s hard to have a productive debate about what to do about this terribly misguided law without agreeing on some pretty indisputable facts.

UPDATE 5: Regrettably, in its eagerness to defend Obamacare, Andrew Lazarus  at DailyKos has made a flagrant misstatement of fact:  ”The $7450 figure is calculated as a mean, what we colloquially call an average. By “typical”, Obama is evoking the median  family.” Unfortunately, Kevin Sacks at NYT (known to many as a newspaper of record) has put on the record exactly how candidate Obama and his advisors came up with their figure of $2500 in premium savings for the “typical family:”

The original arithmetic was somewhat basic. In May 2007, three Harvard professors who are unpaid advisers to the Obama campaign — Mr. Cutler, David Blumenthal and Jeffrey Liebman — produced a memorandum offering their “best guess” that a menu of changes would produce savings of at least $200 billion a year (it has since been revised to $214 billion). That would amount to about 8 percent of the $2.5 trillion in health care spending projected for 2009, when the next president takes office…..The total savings were then divided by the country’s population, multiplied for a family of four, and rounded down slightly to a number that was easy to grasp: $2,500.”

If that calculation sounds familiar, it’s because it’s precisely  the one I did in my post–the only difference being that unlike President Obama, I manifestly did NOT characterize the result as the expected change in premiums. It’s the total change in health spending, which will end up being borne in a variety of forms, higher premiums, higher out-of-pocket costs, higher taxes etc. If Obamacare were financed honestly and transparently, we actually could say how much of an increase would be faced by any given family. Because it’s quite the opposite, we have to resort to talking about “average” effects recognizing that some will pay more, some will pay less than this average. Perhaps Mr. Lazarus will do his homework a little better in the future.

I did make an error that Mr. Lazarus was correct to point out and now have deleted this original sentence: “Of course, all these figures are in nominal dollars. In terms of today’s purchasing power, this annual amount will rise steadily.”  It was a goof, pure and simple, for which I apologize. It does not materially affect my central conclusion–that Obamacare increases health spending by many thousands of dollars for the average family of 4–but for wonks who are interested, the $7,450 in present value terms (using the GDP deflator as projected by CBO) is $6,777 in today’s dollars. Somehow I don’t think most Americans will be comforted to learn that the Obamacare hit on their pocketbooks will amount to only $6,777 per family of 4.  Perhaps this will pave the way for Mr. Lazarus to apologize for his own mistake.

UPDATE 6: In “Conservative Accidentally Reveals that Obamacare Slashes Cost Increases,” Mary Noble erroneously claims “The growth in health care costs for four people is half as much in Obamacare’s first nine years as it was under Bush.”  She reaches this conclusion by pointing out that my figure of $7450/family of 4 over 9 years equals an average increase of $207 per person per year. She then demonstrates that per capita health spending grew by $385 per person per year during the G.W. Bush administration, ergo growth in health spending was only half as great under Obama compared to Bush. Sounds pretty bulletproof except for one thing. Ms. Noble evidently doesn’t understand that my $7450 increase in spending only represents the additional health spending attributable to Obamacare, i.e., above and beyond “normal” growth in health spending that would have happened anyway. Total health spending is not increasing only $207/person/year during the 9 years I referenced. It is growing by $605 per person per year.  That would be 57% higher than under GWB.  Whoops!

Update 7: Brad DeLong in a post titled “PREMIUMS, NATIONAL HEALTH SPENDING, AND THE AFFORDABLE CARE ACT: NO. NOTHING COMING OUT OF THE AMERICAN ENTERPRISE INSTITUTE SHOULD BE TRUSTED BEFORE IT IS CAREFULLY VETTED AND VERIFIED. WHY DO YOU ASK?” declares “AEI’s Chris Conover claims that….it is not possible for the premiums paid by those who purchase health insurance to be going down as a result of the ACA.” Of course, that’s not what I said, but then again Mr. DeLong’s characterizes his blog as “Brad DeLong’s Semi-Daily Journal–Fair, Balanced, and Reality-Based 99.4% of the Time,” so perhaps I’ve inadvertently caught him during the 0.6% of the time he is unfair, unbalanced and unreality-based.  What I actually said (in Update 1) was “it was the President’s claim of $2500 premium savings for the “typical” family that was and continues to be totally wrong. It’s simply not possible for national health spending to rise by $621 billion and for the “typical” family to expect a $2500 (per year!!!!) premium reduction.”   There’s a fairly sizable gulf between claiming it’s impossible for there to be ANY premium reduction and claiming it impossible for the average family of 4 to be saving $2500 annually in premiums even as annual health spending is rising an additional $621 billion due to Obamacare. If Mr. DeLong doesn’t see the distinction, perhaps he has less grasp on reality than he realizes.

Instead of offering a shred of empirical evidence that Obamacare actually has reduced premiums by $2500 a year for the typical family of 4, Mr. DeLong offers this logic: “Right now the premiums of those who buy insurance pay for a lot of the uninsured’s medical care. If you broaden the base by insuring more people, you lower the rates that those who are insured and pay for the system pay.”  This is understandable logic, but the claim that those with private insurance pay for “a lot” of the uninsured’s medical care is dead wrong. A careful study by Jack Hadley and John Holahan completed well before Obamacare became law showed that uncompensated care averaged no more than $970 per person who was uninsured on a typical day. This is less than half the $2,067 in annual health spending for such individuals. More importantly, fully three quarters of uncompensated care was paid by taxpayers (federal, state and local), leaving only $245 per capita uninsured to be paid by those with private coverage. That’s 12% of uninsured spending. Does that sound like “a lot” to you?

These are in 2008 dollars, so we can inflate them to 2013 using the increase in national health spending per person over that period (which grew from $7922 to 9216) yielding a maximum of $285 per capita uninsured that apparently is “cost-shifted” to privately insured families. In the MEPS data used in Hadley and Holahan’s analysis, there were 2.66 individuals insured full-year with private-only coverage (e.g., excluding Medicare recipients who buy private supplemental coverage, for example). If we conservatively assume that the uninsured uncompensated care burden not borne already by taxpayers (i.e., the $285) is shifted onto these full-year private-only insured plan members, then it means that the average person with private health insurance in 2013 is only paying $107 more in premiums as a consequence of the uninsured. Thus, a family of four is paying $428 extra. This amounts to 2.6% of the $16,531  average family premium for employer-sponsored health coverage in 2013 (as reported in the latest Kaiser/HRET annual survey).

It’s not worth quibbling over whether this is “a lot.”  What should be clear is that no one in their right mind should have expected $2500 in annual premium savings for the average family of 4 as a consequence of covering the uninsured. This is especially true given that when fully implemented, Obamacare will cover less than half the uninsured, meaning that such a family might have hoped to obtain $214 in annual savings at most–less than 1/10 of President Obama’s flagrantly erroneous projection.

By the way, the Kaiser survey allows us to directly measure the accuracy of candidate Obama’s ridiculous and unbelievable campaign promise. Since average premiums for family coverage for employer-sponsored insurance (i.e., the kind of private coverage the “typical” family has) were $13,375 in 2009, average premiums for family coverage grew by $2,976 by the end of his first term. Thus, we can accurately say that both in direction and magnitude reality turned out to be literally the opposite of what the president pledged. Rather than concede this simple and rather obvious point, defenders of Obamacare like Mr. DeLong instead appear to prefer to spin as fast and furiously as possible to avoid having the public see the truth.

Mr. DeLong further snarks “Of course, nobody at the AEI will point out that Conover is either–at best–confused, or is simply saying things he knows are not true. Obedience to their political masters, after all, rules on 17th St. Informing the public and raising the level of the policy debate doesn’t.”   Readers can judge for themselves which of us is more accurately informing the public and raising the level of the policy debate.


English: Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)

Footnotes

[1] The Medicare actuary first issued a report carefully estimating the cost impact of Obamacare on April 22, 2010. Its annual national health expenditure projections reports for 2010, 2011 and 2012 all have contained tabulations showing that Obamacare will increase health spending over the next 10 years compared to a counterfactual scenario in which the law was never enacted.

http://www.forbes.com/sites/theapot...pending-by-7450-for-a-typical-family-of-four/

 

[rico x hood]

While I do agree that health insurance SHOULD be a choice, if you choose not to have it and require a hospital stay for whatever the reason, who is responsible for the bill if you can't pay it?

In a perfect world I would be assed out. Deciding not to have health insurance requires a risk/benefit analysis. God forbid something did happen to me and I needed medical attention but had chose not have health care. I would probably have to appeal to better angels of my family and friends to try and scratch up that money. An if I was unable to get it...I'd be assed out.

Now for people who don't have it threw any fault of their own just bad luck and circumstance, I feel for them, I really do. But ****, you can't save everybody.

 

[sundoobie]

NOBODY understands this law. The President doesn't fully understand it which is why he's been flip flopping since 2009 about what it will do. Congress doesn't fully understand the law. The CBO doesn't fully understand law which is why there are no concrete numbers about how much it will cost or save. The states that are being forced to implement those exchanges don't understand the law. Of course the American people don't understand it. As I stated in another thread the damn law is a cluster ****...and should have never passed. Obama and the Dems forced that law through Congress even though the majority of Americans didn't want it. That is not the kind of leadership I expected or wanted out Mr. Transparency Obama.

Don't understand the law? I am a CPA and have taken courses for the Affordable Care Act. That's what I am paid to do, so guess what, if a professional like myself needs to take courses to understand the law and it's tax implications then you don't think other PROFESSIONALS, oh you know like the CBO, President of the United States and Congress would have to know the law? Seriously stop BELIEVING everything you read on the news. Some of you guys are posting by verbatim everything you read, things that aren't even FACTUAL!

The reason why I laugh at that article was because 1/3 of Americans POLLED did not know the LAW so how is that poll conclusively?

 

[011781]

 
and Washington Heights favorite

 

[sundoobie]

[h5]Pharma & Healthcare[/h5]

[h6]|[/h6]

[h6]9/23/2013 @ 8:00AM |432,125 views[/h6]

[h1]Obamacare Will Increase Health Spending By $7,450 For A Typical Family of Four [Updated][/h1]

Per the article...

So I have taken the latest year-by-year projections, divided by the projected U.S. population to determine the added amount per person and multiplied the result by 4.

How does this simple math calculation not make you laugh!

 

[rico x hood]

If the President, our elected officials, or anyone for that matter truly understood that law then SOMEONE would be able to get on TV or write some kind of op-ed explaining what it's enactment will mean with hard numbers. I'm happy to hear you are ahead of the curve. But what your class probably taught you is what is understood about the law on the surface. There is a whole bunch of other **** in that law that can't be explained until AFTER it's implementation. At this point all anyone can do is make educated guesses. An that is what's so scary about the law.

"You have to pass the law to find out what's in it." -Nancy Pelosi-

 

[011781]

These are the facts: I work hard for my money and I should not have to give a red cent to anyone else for their health care if I do not choose to.

Here's another fact. YOU DO IT EVERY DAY.

You already pay taxes that fund programs to help those that can't handle various financial burdens.

So I'm finding it hard to understand what you're so upset about all of a sudden.

Secondly, a healthier workforce is better for America. That's the bottom line. The debate should be HOW we make the system better, not "**** these broke mutha****as that can't afford chemo or preventative care".  The ACA is a step in the right direction.

 

[011781]

NOBODY understands this law. The President doesn't fully understand it which is why he's been flip flopping since 2009 about what it will do. Congress doesn't fully understand the law. The CBO doesn't fully understand law which is why there are no concrete numbers about how much it will cost or save. The states that are being forced to implement those exchanges don't understand the law. Of course the American people don't understand it. As I stated in another thread the damn law is a cluster ****...and should have never passed. Obama and the Dems forced that law through Congress even though the majority of Americans didn't want it. That is not the kind of leadership I expected or wanted out Mr. Transparency Obama.

Son, you're all over the place.

You don't live in this country alone, nor does anyone in this country become successful alone.

Your "me, me, and mine" attitude is why **** can't get done.

I don't understand why people don't get that we're better off as a nation if everybody eats.

 

[cparkfresh]

if your implication that somehow da "national election" is less important then da non presidential elections is then why obama can't get **** done...?

oh ok...

obama only controls da executive branch, if he doesn't at least delay his bill THAT ALREADY HAS WAIVERS to other folks then government is

shutting down, and with good reason.

its a bad law and needs to be delayed at MINIMUM....

[h1]Poll: Obamacare remains highly unpopular as implementation looms[/h1]

By Mark Murray, Senior Political Editor, NBC News
A large number of Americans continue to adamantly oppose the nation’s new health-care law and believe it will produce damaging results, according to a new NBC News/Wall Street Journal poll. 
Forty-four percent of respondents call the health-care law a bad idea, while 31 percent believe it's a good idea -- virtually unchanged from July's NBC/WSJ survey.
By a 45 percent to 23 percent margin, Americans say it will have a negative impact on the country's health-care system rather than a positive one. 

http://firstread.nbcnews.com/_news/...highly-unpopular-as-implementation-looms?lite

Here in lies the problem. The majority of Americans do not know the difference between ACA and Obamacare. Polling also shows that the majority of Americans support the majority of the provisions of the ACA when they are asked about each element individually (minus the spin)

[COLOR=#red]Bottom line: If the ACA is as bad as Republicans would lead us the believe then they should let it fail. If it where to fail they would stand the most to gain. The problem is they are afraid that once it is implemented people will like it. So they are trying their best to derail it. They have passed numerous continuing resolutions since the laws implementation. The only difference between now and then is tomorrow people begin to be able to sign up for more affordable insurance. [/COLOR]

 

[ninjahood]

If the President, our elected officials, or anyone for that matter truly understood that law then SOMEONE would be able to get on TV or write some kind of op-ed explaining what it's enactment will mean with hard numbers. I'm happy to hear you are ahead of the curve. But what your class probably taught you is what is understood about the law on the surface. There is a whole bunch of other **** in that law that can't be explained until AFTER it's implementation. At this point all anyone can do is make educated guesses. An that is what's so scary about the law.

"You have to pass the law to find out what's in it." -Nancy Pelosi-

basically...fleeced from jump street.