The Affordable Health Care for America Act

The Affordable Health Care for America Act

You almost had it described spot on. Let me help you a bit:

The Economically Crippling, Completely Unaffordable, Bureaucratic Boondoggle, Paid On The Backs Of The Next Three Generations Ruining Of Health Care For All Americans Act

There. That's more like it.

I like some of the provisions, such as prohibiting pre-existing condition bans, providing for preventative care coverage, etc.

Having seen how efficient the government is in most other sectors I'm uncertain of the public option, but I am not rigidly opposed. I'd need to see what the final package entiails.

Also, having heard some bloggers around the net talking about how 'the only reason people oppose this is because they are rich and have to pay for it' I would wonder if the reverse question is proper.

IE: If you currently support the proposal but know you won't have to pay anything for it, would your views change if you did have to pay a lot of money out of your pocket ?

Of course any major debate over the provisions is pointless at this junction since we have no way of knowing what, if any, proposal will come out of an eventual conference committee.

I'm uncertain of the public option, but I am not rigidly opposed. I'd need to see what the final package entails.

It entails politicizing medical decisions. Bible thumpers paying for part of your your abortion quite understandably want to prevent it, and I hope no one finds that surprising or unreasonable. Your diet, your smoking, your vaccinations, your contraception, your motorcycling, how much you exercise and so on become matters of legitimate public interest.

Glad to see the Dems are congratulating themselves already. All it takes is one Senate Dem to be annoyed at the take-it-for-granted attitude.

I'm not opposed to several parts of the bill but as a whole all I can say is barf.

Your diet, your smoking, your vaccinations, your contraception, your motorcycling, how much you exercise and so on become matters of legitimate public interest.

Well who cares, if it pasess into law its time to go on an all twinkie diet now that the taxpayer will have to pick up the tab. Personal responsibility was so 1776ish, we need to get with the times.

The benefits side of this bill is OK, the fiscal side is not. By delaying fixing the physician payment SGR formula the Democrats were able to hide some of the costs, a move akin to George Bush hiding the war costs off-budget. This allowed them to crow about the plan reducing the deficit, a claim which is patently false.

At the risk of having the abortion question take over yet another thread:

"The amendment forbids the use even of nonfederal funds to purchase supplementary insurance coverage for abortion services."

Just want to make sure we're clear here: Based on my reading of the amendment, supplementary insurance coverage for abortion services is allowed as long as it is not paid for by federal funds or nonfederal funds that are required to be paid in order to receive federal benefits. What you wrote could be taken to mean that all supplementary abortion coverage is forbidden, which is not true.

As an example, it seems to me that it would still be legal for an insurance company to offer plans that could be subsidized, and then offer optional supplementary insurance for abortion services that could not be subsidized.

Can we agree that that's what it means? I'm not particular interested in debating the merits of the amendment (there are already 2 threads doing that), but at least I'd hope we could agree on the actual meaning of the amendment itself.

As if all that were not already happening and getting worse by the day because of the stratospheric cost of health care increasing astronomically every single day, adding to the $2 trillion dollar deficit -- created by George W. Bush over eight years of war, tax cuts for the rich, war, boondoggles for the defense industry, war, a huge new government bureaucracy (homeland security), war, corporate giveaways, and war -- out of a surplus given to him by Bill Clinton.

If you currently support the proposal but know you won't have to pay anything for it, would your views change if you did have to pay a lot of money out of your pocket ?

Back when my daughter was in grade school in Montclair, NJ, and the Board of Education was trying to justify draconian budget cuts to an extremely popular, national award-winning public pre-kindergarten program, by darkly warning of higher taxes, my little local group of public preK advocates would come to Board meetings with signs saying, "Raise my taxes -- PLEASE!"

And I didn't even have a child in PreK at that time. Maggie was already up several grades. We were one of the lucky families who moved to town before the program was threatened. But I knew how valuable and cost-effective that program was in every way that mattered -- not just pedagogically, but it made Montclair a more desirable town to live in if you had school-age children; it increased property values, etc.

I still feel that way about public spending: Of course, I'm willing to pay, if what I'm paying for is producing something of value. The long-term benefits of a health care system that is affordable for all Americans and that begins to lower the cost of health care -- which is absolutely breaking this country -- are incalculable.

So yes: my views would be the same regarding the House bill if I were still working and paying taxes.

Your diet, your smoking, your vaccinations, your contraception, your motorcycling, how much you exercise and so on become matters of legitimate public interest.

As they already are, and would continue to be, without any public option -- without any health care reform at all.

It has been entertaining reading conservative reactions to all of this.

My message to them...if you voted for Bush twice, you are now reaping what you sowed.

Dems wouldn't have the power to do any of this had you not blindly followed Bush into the abyss.

I think the language is very confusing, to be honest. And to be even more honest, I don't understand what you're saying in your next to last paragraph. Wouldn't supplementary insurance for abortion always be optional? No one is forced to buy supplementary insurance that covers abortion.

The salient point here, for me, is that if the concern is that abortion services should not be funded through the money that's appropriated by this legislation to subsidize insurers on the exchanges, then if federal money is not subsidizing a given insurance company's supplemental policy covering abortion, there should not be an issue. It does not seem to me to be the federal government's place to tell private insurance companies what they may or may not cover with dollars that do not come from the federal government.

adding to the $2 trillion dollar deficit -- created by George W. Bush over eight years of war, tax cuts for the rich, war, boondoggles for the defense industry, war, a huge new government bureaucracy (homeland security), war, corporate giveaways, and war -- out of a surplus given to him by Bill Clinton

Some fact and some partisan drivel there, Kathy. Lets look more closely.



FACT Bush increased the deficit, his wars were costly, agreed.

FACT Almost all democrats approved the war in Iraq, and although he was responsible for it, they certainly contributed and can't deny it.

FACT Democrats controlled Congress since 2008, Congress controls the purse strings, although certainly the President can influence negoations, still Congress has the final say on the budgets passed.

FACT the 2008 deficit under the Bush Presidency and the Democratic Control of Congress was tripled in one year once the Democrats took control of the White House and is projected to also be triple the 2008 deficit next year.

FACT The surplus enjoyed during the Clinton administration was done with a Republican controlled Congress that cut many of the programs Clinton wanted. They get the lions share of the governments portion of the credit for this. Also the tech bubble which was unrelated to the political environment had much to do with this surplus as well.

Rayne at Firedoglake lists the 64 Democrats who, in her words, “ask[ed] for primary opponents.”

Oh please, please, give them primary opponents, the further to the Progressive fringe as possible. And please, please democrats vote for them in the primary. Please make me a happy man.

EDIT: Make an exception for Artur Davis, hes a really good congressman and although I often don't agree with him, he brings a great value to his committees and the American people with his excellent questioning.

But make especially sure you vote out John Spratt my representative in your primary.. Know that I voted for him multiple times, that should be good enough for you.

I get one indisputable fact out of all this:

Under Bush, the country went from a surplus to a $2 trillion dollar deficit. All that stuff about Congress approving the budgets is true, but doesn't change the fact that Bush was the president. Plus, as we all know, the unitary executive theory, which was gospel under Bush, says that the president has unlimited authority during war time to get whatever he demands and to do whatever he pleases if it has something to do with national security. And as we all additionally know, not a sparrow fell to the ground from 2000 to 2008 that did not have something to do with national security.

"think the language is very confusing, to be honest."

I agree with you there, but not any more confusing than most legislation I've seen.

In any case, I think we are both referring to this passage: that supplemental insurance can include abortion coverage so long as it's not paid for with federal funds or "other nonfederal funds required to receive a federal payment, including a State's or locality's contribution of Medicaid matching funds".

The word "required" is the key for my interpretation of that. Let's say an insurance company has a plan that costs $1000 a month for which government subsidies apply, and then they tack on a $10 a month abortion coverage plan. If they were to require you to buy the $10 a plan in order to purchase the basic plan, that would be prohibited, which makes sense since in effect it is the same as if they would offer you one plan at $1010. But, as long as the supplemental plan is optional, then it is in effect two separate plans, one of which can be subsidized and the other cannot.

That's my interpretation of what that passage means, but if someone can point to an authoritative interpretation, I would appreciate it. However, all of the summaries I've read, including the one from the NY times that you linked to, have language such as that abortion coverage is restricted "through private insurance that is bought using government subsidies". I don't see a reason why that last part is included if it is restricted entirely from private plans. Also, on the next page there is an entire section about how supplemental coverage for abortions is allowed, which conflicts with your interpretation of the preceding passage.

In fact, I just re-read this passage which pretty much says what I said above regarding optional vs. required: That the supplemental insurance is allowed so long as:

"any nonfederal QHBP offering entity that

16 offers an Exchange-participating health benefits.
17 plan that includes coverage for abortions for which '
18 funding is prohibited under this section also offers
19' an Exchange-participating health benefits plan that
20 is identical in every respect except that it does not
21 cover, abortions for which funding is prohibited
22 under this section."

"that is affordable for all Americans and that begins to lower the cost of health care"

Outside of allowing Medicare part D to negotiate drug prices, nothing else in that bill is meant to realistically reduce costs or improve competition at the provider level. It increases the use of insurance, and prevents people from escaping that cost, other than by eschewing earning money altogether.

And domestically, how is Obama any better?

"The benefits side of this bill is OK, the fiscal side is not."

I agree on that. An interesting find in the CBO report via Greg Mankiw: http://gregmankiw.blogspot.com/2009/11/assuming...

The bill would put into effect (or leave in effect) a number of procedures that might be difficult to maintain over a long period of time. It would leave in place the 21 percent reduction in the payment rates for physicians currently scheduled for 2010. At the same time, the bill includes a number of provisions that would constrain payment rates for other providers of Medicare services. In particular, increases in payment rates for many providers would be held below the rate of inflation (in expectation of ongoing productivity improvements in the delivery of health care). Based on the extrapolation described above, CBO expects that Medicare spending under the bill would increase at an average annual rate of roughly 6 percent during the next two decades—well below the roughly 8 percent annual growth rate of the past two decades, despite a growing number of Medicare beneficiaries as the baby-boom generation retires.

That reads to me like CBO talk for "Our numbers are about as likely to hold up as pigs will fly, but we are prohibited from considering the possibility that pigs won't fly."

Facts are ugly things when they prove you wrong, and these are very ugly to you Kathy, I am sure:

US Deficit Chart

These are the White House's own numbers:

Table 7.1—FEDERAL DEBT AT THE END OF YEAR: 1940–2014—Continued
Gross Federal Debt (Million $)
1995 4,920,586
1996 5,181,465
1997 5,369,206
1998 5,478,189
1999 5,605,523
2000 5,628,700
2001 5,769,881
2002 6,198,401
2003 6,760,014
2004 7,354,657
2005 7,905,300
2006 8,451,350
2007 8,950,744
2008 9,985,757
2009 estimate 12,867,455
2010 estimate 14,456,303
2011 estimate 15,673,873
2012 estimate 16,565,716
2013 estimate 17,440,160
2014 estimate 18,350,010

Here is their 2010 budget tables (information above is on page 128)
THE BUDGET FOR FISCAL YEAR 2010, HISTORICAL TABLES

You are confusing the concept of budget deficits with the national debt, which is the key issue. But if you want, we can show the quintupling of budget deficits in less than a year under Obama. You are letting your love of progressive agendas blind you to the true damage being done to the economy and your daughter's, and any future grandchildren's, financial futures

From the New York Times.

$1.4 Trillion Deficit Complicates Stimulus Plans
http://www.nytimes.com/2009/10/17/us/17deficit....

The Obama administration said Friday that the federal budget deficit for the fiscal year that just ended was $1.4 trillion, nearly a trillion dollars greater than the year before and the largest shortfall relative to the size of the economy since 1945.

The number, while lower than forecast a few months ago, underscored the challenges ahead in shrinking the deficit even as the White House and Congress are considering more steps to stimulate an economy that is making a slow recovery. The political hurdles to finding a solution were evident on Friday as each political party immediately blamed the other for the growth of the deficit.

The shortfall for the fiscal year 2009, which ended Sept. 30, translates to 10 percent of the economy, according to a joint statement from the Treasury secretary, Timothy F. Geithner, and the director of the Office of Management and Budget, Peter R. Orszag. For the 2008 fiscal year, the deficit of $459 billion was 3.2 percent of the economy, as measured by the gross domestic product.

Kathy,

Just so you are aware, health care costs have outpaced inflation since the 1950's. We have long-standing systemic problems in the system that have nothing to do with GWB. There is no tax rate or spending cut that will make the system sustainable when costs are increasing at three time GDP growth. This bill, while it has a few merits, is simply throwing money at a broken system and will only add fuel to fire of financial unsustainability. And I'm sure when the system finally crashes the Partisans will be pointing fingers at GWB or Clinton or Obama or whatever President they like the least.

I get one indisputable fact out of all this:

Under Bush, the country went from a surplus to a $2 trillion dollar deficit.

Absolutely a verifiably false statement Kathy. You really should either do research before you try to quote facts, or stick to generalities.

No annual Bush budget deficit was in excess of about $450B (not that that high number is a good number, mind you). Obama in his first year has hit $2T, and that is BEFORE Health Care Reform, the "Clunker" initiative, or the upcoming attempts to pass the Waxman-Markey Bill in the Senate. That will just make the numbers even worse.

To be fair, I think we should remove the years 2008-2010 from this table since obviously the debt will increase during a recession and its aftermath. So, we see that the deficit was about 500 billion a year under Bush (for which there is no excuse), but after 2010/2011 the deficit is estimated to be about 900 billion under Obama. And I would trust the actual historical number way more than the white house "estimate" of future deficits (see my previous comment on the CBO report) so it's likely the actual deficit post-2010 will be more than 900 billion.

So I think it's fair to say that Obama's policies will at least double the deficit, even when adjusting for the current recession and counting the eventual draw-down of troops in Iraq and Afghanistan that the white house numbers assumed.

(of course, if we could just get some inflation going, this debate will be moot)

Rayne at Firedoglake lists the 64 Democrats who, in her words, “ask[ed] for primary opponents.”

Gee, I thought Congressional representatives were supposed to represent their constituents and not party apparatchiks.

KK's grip on logic is as tenuous as her command of facts. According to her, it's ok to plan for one-to-two trillion-dollar deficits as far as the eye can see because GWB regularly presided over deficits on the order of one-fourth that amount. It's the same Escherian world in which it is possible to expand medical care AND reduce costs by having the federal government start running the industry.

"Life-threatening mental health conditions, as well as physical problems that a doctor determines will not result in death but will likely have serious health consequences for a woman if a pregnancy is continued, are not included."

And that seriously doesn't concern anyone? "Congratulations on your new baby, but mommy is dead. We miscalculated slightly and thought she'd just end up as a vegetable. But hey, there was absolutely no chance that Joe Biblethumper might have accidentally somewhere unknowingly and obscurely paid $1 toward saving her life!"

Well, your interpretation may be correct. I don't have much of an interest in trying to figure it out, since from my point of view the amendment is a very bad thing from the get-go, and hopefully (again, from my point of view) the Democrats will be able to strip it out in conference after the Senate bill is voted on.

You can do whatever pleases you, AR. If I were a budgets and spreadsheets wunderkind like Ezra Klein or Marcy Wheeler, I could look at that number dump and see exactly what you've left out and/or what you're distorting or misrepresenting. As it is, I can tell you this with certainty:

The status quo is a non-starter. Doing nothing; leaving things as they are, is not an option. I'm sure this plan is not perfect, because no plan is perfect, and I'm sure there will be problems that need fixing along the way, but I also know that a plan that insures 36 million Americans is a lot better than a plan that leaves 50 million Americans uninsured and their number growing every day. I can also tell you that if you think this plan costs too much, you should be supporting single-payer, because that's the best way to cut costs. Barring that, a robust public option is better than nothing. But if we end up, after the Senate does its work and the two bills are merged into one, with a watered-down proposal without a public option, that is ultimately going to cost all of us much more than spending what it takes to do health care reform right.

Just so you are aware, health care costs have outpaced inflation since the 1950's. We have long-standing systemic problems in the system that have nothing to do with GWB.

Whoaaa. I mean, whaaa? Picture Kathy's jaw dropping. I mean.... reeeaallly? You are serious? Wow! I never knew that!

Okay, snark break. Yes, Andy. I know that, Andy. I am fully aware of that, Andy. I am so very, very aware that the health care crisis has been building for the last 60 years -- almost my entire lifetime, Andy! I know that it was Eisenhower who first tried to solve the health care problem, and I know that various administrations have tried since then without success. This Congress is the first EVER to get a health care reform bill passed. That may be why all these weird little people out here are so thrilled and happy and have some idea that something good has happened.

And yes, you are absolutely correct that we have long-standing systemic problems that predate GWB. GWB did his humble little part, as one mediocre person and very substandard president, to make those systemic problems even worse than they already were, but he did not start the problem. He was only an itty-bitty boy when the problem had its beginnings.

Now, getting to your solution... Oh wait! That's right! You don't have any ideas for a solution. Or, on second thought, maybe that's not fair. You do have a solution. Don't throw money at a broken system. And that makes so much sense, Andy. When a system is broken, it has to be fixed. And you don't fix it by throwing money at it. You fix it by using the faith-based repair program: doing absolutely nothing and hoping the problem goes away. Or better yet: Pretending the problem doesn't even exist anymore! Bush perfected that one. Lord knows nothing ever got fixed or accomplished by spending money. NOT spending money -- now that's the ticket to making everything better.

Thank you for this little discussion, Andy. It's been.... enlightening.

And what was the deficit on the day Obama took office?

Thank you, Almoderate. It's refreshing to read something that makes sense in the midst of all the gaseous nonsense I'd been reading up until the moment I read your comment.

And obviously you're right that no one has any concerns about that, except the two of us, apparently.

You can do whatever pleases you, AR. If I were a budgets and spreadsheets wunderkind like Ezra Klein or Marcy Wheeler, I could look at that number dump and see exactly what you've left out and/or what you're distorting or misrepresenting. As it is, I can tell you this with certainty:

I guess you don't trust the New York Times and their constant right-wing biased figures that these GOP lap dogs posted (and I quoted above) either. They are just another piece of the vast right-wing conspiracy along with the Congressional Budget Office......Did I just break the sarcasm meter?

GWB did his humble little part, as one mediocre person and very substandard president,

So I guess that makes Obama three times as substandard as Bush on the deficit thus far.

also a blast from the past:

"If we confront this crisis without also confronting the deficits that helped cause it, we risk sinking into another crisis down the road," the president warned, promising to cut the yearly deficit in half by the end of his four-year term. "We cannot simply spend as we please and defer the consequences."

--Barrack Obama, February 24 2009.

Oh another snippet somewhat related.

Health Care Reform: Reich Overboard!
http://www.slate.com/blogs/blogs/kausfiles/arch...

Reich's clearly still miffed that President Clinton rejected his stimulus plans in early 1993, choosing instead to lower the budget deficit and interest rates. As a result, Reich declares, "the Clinton years produced few if any major social reforms." Hmm. I can think of one. Actually, two and a half (work-oriented welfare reform coupled with the expansion of the Earned Income Tax Credit and medical care for poor children). Even if Reich perversely won't count that as a "social reform," Clinton's rejection of Reich's advice was followed by the longest economic expansion in our history. The combination lowered the child poverty rate from 22% to 16%. Never trust content from Robert Reich.

I thought Clinton (curbed by a fairly fiscally responsible Republican majority) did on the whole a pretty nice job, He had a more bipartisan approach than the current administration and the economy, and the people benefited.

"Well, your interpretation may be correct. I don't have much of an interest in trying to figure it out, since from my point of view the amendment is a very bad thing from the get-go"

Fair enough. But just to tie up a loose end, if I am right (and at this point I'm pretty sure I am), that significantly counters your argument that poor women will not be able to get abortion covered because of this amendment. They may have to spend an extra few dollars a month for it (which I understand you object to) but it is far from "impossible" as you put it on another thread as well as the arguments that others have put forth on this thread.

I actually agree that I would have preferred to have seen an exception for if the mother's health is significantly at risk. However, your scenario seems to me to be both extremely unlike and entirely preventable.

Any medical condition that could cause someone to become a vegetable almost certainly can also be considered life-threatening. Can you imagine a doctor saying, "Well, you might become a vegetable, but there is absolutely zero chance of death."?

Secondly, the mother could have prevented the situation in several ways:

1) By buying the supplemental insurance, I would think would cost not more than a few dollars a month if that.
2) By not getting pregnant (I understand that birth control is not always entirely effective, which is why option #1 is available)
3) By paying for the abortion out-of-pocket. Even if I were poor, if I were to become a vegetable upon birth I'd find a way to pay. And charities such as planned parenthood are there to help.

So, in the end, the scenario you outlined is about as likely to happen as the CBO's numbers are likely to hold up.

"You can do whatever pleases you, AR. If I were a budgets and spreadsheets wunderkind like Ezra Klein or Marcy Wheeler, I could look at that number dump and see exactly what you've left out and/or what you're distorting or misrepresenting."

I respect you Kathy, but I have to call you out on this one. These are the numbers from the white house. If anytime you are shown evidence that disproves your point you are going to assume there is some misrepresentation and you are really right, then you are not debating in good faith.

"also know that a plan that insures 36 million Americans is a lot better than a plan that leaves 50 million Americans uninsured and their number growing every day"

Should the cost of the two plans be factored into the comparison, or do you believe a plan that insures more people is always better than a plan that insures less, regardless of the cost?

Kathy,

Touche' on your patronizing response! So my apologies for assuming you didn't the fiscal reality, but you are actually one of the few. Most people simply don't know that health costs have always risen faster than inflation and I made a wrong assumption based on your laying so much blame at the feet of one President.

Now, getting to your solution... Oh wait! That's right! You don't have any ideas for a solution. Or, on second thought, maybe that's not fair. You do have a solution. Don't throw money at a broken system. And that makes so much sense, Andy. When a system is broken, it has to be fixed. And you don't fix it by throwing money at it. You fix it by using the faith-based repair program: doing absolutely nothing and hoping the problem goes away. Or better yet: Pretending the problem doesn't even exist anymore!

I do actually have ideas, if you cared enough to ask. Unfortunately, the established political parties aren't interested in the kind of systemic reform I advocate for because they each have powerful vested interests. Yes, that includes the party that you seem to identify with. The Democratic plan which you support does nothing to change the existing system - its the equivalent of rearranging deck chairs. Since, as you've now said, you're completely cognizant of the systemic fiscal problems and the unsustainability of the system, one wonders why you support a bill that ignores those problems and the problem of unsustainability and, indeed, is likely to make those problems worse. It would be interesting to hear your defense on that score.

Just so you're clear on where I stand, here is a short list of general reform principles I think are necessary:

1. Get employers out of the health care business. Employer-provided health care favors corporations over small business and is one of the primary factors of wage depression over the last couple of decades.
2. Get rid of the fee-for-service system.
3. Change incentives and increase transparency within the system so that the consumers of health care better understand what they are getting and how much it costs.

Once that is done I would favor a government sponsored national catastrophic insurance plan where government would pay medical costs over a set amount (let's say $100k a year, adjusted yearly, as an example). This would effectively set a cap on what private insurance would pay out and make health insurance operate more like auto and property insurance (ie. your property insurer knows that your house and belongings are worth X amount and know they won't have to pay more than that. For health insurance, there currently is no limit, raising risks and premiums). Then individuals could buy private insurance to cover whatever they'd like and government could assist those with low income to enable them to purchase insurance.

Of course, that's just one idea and one that has flaws, as any plan would. There are other plans that could work, obviously. The bill that was recently passed in the house is not one of those.

And what was the deficit on the day Obama took office?

The 2008 budget deficit was just under $500B.

The question you forgot:

And what is the deficit the first year since Obama took office?

The 2009 budget deficit is $1.4T

Almoderate,

The standard today, for medicare/medicaid at least, is that "life of the mother" means abortion is permissible when a threat to the mother includes "physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself." I would like to see where, exactly, the specific language you quoted exists in the bill.

Since, as you've now said, you're completely cognizant of the systemic fiscal problems and the unsustainability of the system, one wonders why you support a bill that ignores those problems and the problem of unsustainability and, indeed, is likely to make those problems worse.

Kathy is hardly alone here, indeed her viewpoint is shared by the majority of Democrats and especially the ones in Congress. It's pretty clear all the left's moaning about Bush's fiscal irresponsibility was just so much hogwash geared towards getting Obama elected. Just as the GOP was happy to embrace big government if it meant getting a pet program, Democrats are happy to embrace dishonest budgeting and huge spending increases if they get their pet programs.

As they already are, and would continue to be, without any public option -- without any health care reform at all.

True to an extent, which is one reason the system needs reform that increases individual responsibility. Moving it in the other direction not only robs us of freedom in the abstract, it doesn't work well in practice. "Collective responsibility" is usually realized as "no responsibility at all."

I'm pro-choice, which means I think women should get to choose about having abortions themselves rather than the choice being made by some religious lobby group. I also don't really think your weight or how much you exercised last week should be any of my business, and I would rather not have a financial obligation to inquire or to manage those figures on your behalf.

I suppose it depends on how you define "a few dollars." The women who will be denied coverage because of this amendment (if it remains) are the same women who have the fewest extra dollars to spend.

These are the numbers from the white house.

I apologize for the tone of my reply. I am allergic to long lists of numbers, presented in isolation regardless of their origin, in a situation where numbers do not tell the whole story. Indeed, in the instance of health care reform in general and the House bill in particular, the flat numbers do not provide a lot of insight into the merits of the legislation. You also have to ask what the status quo would cost, and in addition you have to ask if the legislation in question is likely to appropriate the money in effective ways. We're not talking about whether the numbers justify purchasing a bigger house or whether we should stay in the perfectly fine but a bit too snug smaller house. We're talking about, literally, an existential crisis that must be addressed effectively. Therefore, the questions, Does this bill lower the cost of health care over time and insure most if not all uninsured Americans? are at least as important as the question, What does this bill cost, and does this huge number on a piece of paper scare me?

I think the mind-set that is illustrated by AR's long list of numbers in isolation with no context and no reference to the larger problem is very short-sighted. I will also admit that, in general, I am at a disadvantage with policy arguments that rely SOLELY on numbers-crunching. It's just not my forte. So I suppose I became a bit too defensive at the way AR framed his argument -- this is too expensive and here are the numbers to prove it. It boxed me into a corner where the only counter-argument would be more numbers or different numbers, and (a) my mind does not work that way; and (b) I think that argument, in this instance, fundamentally misses the point.

Should the cost of the two plans be factored into the comparison, or do you believe a plan that insures more people is always better than a plan that insures less, regardless of the cost?

Not necessarily, no. And yes, the cost of the two plans should be factored into the comparison -- but it's not enough to judge the merits of the two plans just based on the comparative costs. You have to also weigh what the two plans will respectively do. A plan that costs less money but does not solve the problem, or effectively address the problem, is much, much more expensive in the long run than a plan that costs more money at the start line but *does* effectively address the problem and thus will lower costs over time. That's why I hate arguments based purely on arbitrary bottom lines, as AR's argument was. They are short-sighted.

We'll have to wait and see how much sanity drives a push-back in the Senate toward realism.

The most intriguing question will be what happens if the Senate removes the public option. The lib Dems in the House really want it (the federal takeover effort's core), but (the intriguing question is) will they feel ultimately it's to their relative advantage to pass legislation with much else in it, anyway, rather than pass nothing eventually?

* * *

"They are short-sighted."

Yes, the proponents of a new federal entitlement, and federal takeover of health care truly and obviously are. I wonder how many of them (you) will be agitated and throw tantrums to no short end if legislation ultimately is passed that doesn't include the public option in it, as I stated already, which is unnecessary insofar as any true "reform" is honestly concerned.

And I have no expectation that proponents (you) will yet note, much less act or want the Dems to act, on reforming and rescuing Social Security and Medicare in their current, unsustainable forms they're in now. (The most sensible acts are the farthest away from what such people want, and what they do.)

"I think women should get to choose about having abortions themselves rather than the choice being made by some religious lobby group"

Actually, that's the mainstream position. Few are absolute (100%) prohibitionists, and of course few want their religious views encoded into the US (federal) legal code. This always has been a straw man.

What the mainstream also isn't, either is 100% absolute accepting and defending of all abortions, of all kinds, and the mainstream is not insistent on creating a new federal entitlement to abortion (the mainstream is against it, if this is the question of the moment).

This always should have remained in its correct federal constitutional place, as a state and local issue.

If state laws are not what you want, work to get them changed by your legislators, or by initiative or referendum, if your states have these devices.

You say, "Here is a short list of general reform principles," then after you list them you say, "Once that is done," without ever telling us *how* they would get done. And you give no specifics at all about how you would lower the cost of health care so 50 million uninsured Americans could afford it.

Your "government-sponsored catastrophic insurance plan" is a hoary chestnut by now. It completely ignores what the problem is to begin with -- that health care costs are catastrophically out of control, getting higher every day, and totally out of the reach of most Americans. The 50 million Americans who are uninsured cannot afford private insurance. That is the point.

The argument that compares health insurance to car insurance is specious, and has been debunked many times before. The value of human life and health is not analogous to a car. A car is optional; my life is not. And it's a good thing that cars are optional, because I can't afford the cost of automobile insurance in my state anyway. I'm glad I can live w/o a car. I can't live w/o my life.

You do not provide sources here, and I am not an accountant or an economist, so I will rely on credible sources:

This is FactCheck.org fact-checking Bush after his 2007 State of the Union address. Under Federal Deficit and Fiscal Discipline:

Bush inherited a budget with a comfortable surplus, and then ran up enormous deficits that continue to the present. Under Bush, the national debt (debt held by the public) has increased by more than $1.5 trillion. The annual deficits peaked at $413 billion in fiscal year 2004, and has declined since then.

We don't know how much health care reform will increase the deficit for 2009, because we don't have a bill yet. But to say that the House version will increase the deficit by $1 trillion, or whatever number is being claimed, is misleading. The more important issue is whether and to what extent health care reform will lower the national debt over time.

The "deficit" is the budget gap for one year, right? And the national debt is the accumulated total of yearly deficits, right? So which is more important -- "This bill will increase the deficit by $1 trillion!" or "This bill will decrease the national debt over 10 years"?

If you want to make numbers the sole measure of benefit for public policy, then at least apply the numbers in a way that makes sense.

Andy, Almoderate was quoting from my comment about the language that IS in the amendment and the language that ISN'T in the amendment. The language "physical disorder, physical injury, or physical illness, including a life-endangering physical condition caused by or arising from the pregnancy itself" IS in the amendment. The language *I* described and Almoderate quoted is NOT in the amendment. And that is the point.

"Individual responsibility" is not the problem. Corporate responsibility is the problem. Freedom is not lost by knowing you will not drop dead of a heart attack or succumb to cancer because you could not afford health care and didn't have insurance to pay for it.

We -- all of us who are citizens of the U.S. -- ARE, collectively, the American people. We are not just individuals running around unconnected to and unaffected by and unresponsible for anyone but ourselves. We all -- and that includes you -- pay the price for ignoring that reality (a price that is very, very real). You derive benefit from being part of a human, societal, economic, governmental system that includes 300 million people other than yourself. Every single day, you take from the system and derive good stuff from the fact that you are one person in a larger society where what happens to others affects the entire system and everyone in it. Yet, when it comes to paying into the system, you declare there is no system.You want the benefits of living in an organized political and social collective system without the costs. It doesn't work that way.

"The 50 million Americans who are uninsured cannot afford private insurance. That is the point."

But the act barely addresses that affordability (allowing Medicare part D to negotiate drug prices is the only attempt), other than to subsides our current outrageous prices. Again, our costs are going up because employers and states are unnecessarily involved when they shouldn't be. I've stated my ideas several times, and will again if you've forgotten them. As it stands, lobbyists are by far bigger winners than the people, which is why no administration has been able to make meaningful reform, and this one isn't either.

Again, our costs are going up because employers and states are unnecessarily involved when they shouldn't be.

I'm not sure what you mean by states being unnecessarily involved -- unless you're referring to state regulation of insurance companies, which is rather important to prevent insurers from selling policies that have huge coverage gaps. With regard to employers, I might need to research this to know for sure, but if memory serves the reason employers started offering health insurance coverage as an employee benefit was precisely because the cost of purchasing insurance privately was so high even then. In other words, it was a response to rising costs, not the cause of them.

Kathy,

You say, "Here is a short list of general reform principles," then after you list them you say, "Once that is done," without ever telling us *how* they would get done.

I thought I made it pretty clear that I don't think my ideas are possible at present since neither the Democrats nor the Republicans are interested in real reform. Here's the sentence you seem to have missed: "Unfortunately, the established political parties aren't interested in the kind of systemic reform I advocate for because they each have powerful vested interests." You originally - and speciously - claimed I didn't have any solutions - I think I do, but they are not politically possible given the vested interests that support your party and the GoP. I'm actually quite cynical on that score and believe that the system will, at a minimum, have to stand the precipice before real reform occurs, but I think it's much more likely we'll go the way of Argentina first. Our Congress too often doesn't act until after a crisis occurs.

So go ahead and criticize my politically impossible ideas all you want, but you should at least acknowledge that your solution doesn't solve any of the fundamental problems in the system either. It's quite amazing for you to lecture me about costs - the drum I constantly beat - on one hand while the other hand supports a bill that is likely to affect costs in the wrong direction. If you want to engage in wishful thinking and believe this bill you support will somehow reduce costs or even the rate of cost growth, then don't let me stop you. Maybe you'll get lucky and the train will somehow derail before it hits us - or at least those of us who will still be around to bear the brunt and clean up the mess.

And you give no specifics at all about how you would lower the cost of health care so 50 million uninsured Americans could afford it.

Actually I did - I listed the three general principles I think are necessary. Those are changes that would really be structural change. If you were expecting a thesis or detailed explanation, sorry to disappoint you, but this is just a comment thread after all.

Your "government-sponsored catastrophic insurance plan" is a hoary chestnut by now. It completely ignores what the problem is to begin with -- that health care costs are catastrophically out of control, getting higher every day, and totally out of the reach of most Americans. The 50 million Americans who are uninsured cannot afford private insurance. That is the point.

Maybe you missed the part where I said that would come after the necessary structural reform, which I believe should be the priority above all else - a priority the current legislation ignores. Of course if we simply adopted the model I suggested without those structural changes then it would fail - just as this current legislation will fail should it become law. At the risk of repeating myself, we need systemic reform, not the window-dressing that both political parties advocate.

The argument that compares health insurance to car insurance is specious, and has been debunked many times before. The value of human life and health is not analogous to a car. A car is optional; my life is not. And it's a good thing that cars are optional, because I can't afford the cost of automobile insurance in my state anyway. I'm glad I can live w/o a car. I can't live w/o my life.

Of course, but you completely missed what I was saying which related to the fiscal aspect of health care coverage. If you can't understand the financial implications of unlimited liability vs capped liability then I don't know what to tell you. Capping liability by requiring government to cover costs above that cap would tend to reduce premium costs. I'm not sure how you got the impression that I was comparing the value of life to the value of a car or a house, but whatever.

Every single day, you take from the system and derive good stuff from the fact that you are one person in a larger society.

And I derive a lot of bad stuff too, to the extent the system delivers people worse outcomes than people could achieve on their own. Which is, from my observations, at least half the time.

You want the benefits of living in an organized political and social collective system without the costs. It doesn't work that way.

It works precisely that way, at least the part of it the government subsidizes. You know subsidies, those things you're always screaming for more of but lack the means to pay for?

Everyone wants the benefits without the costs, so government programs that decouple the two create a dangerous moral hazard. When you offer people entitlement programs and "free" services, by and large they're happy to avail themselves of them. We Californians have the empty coffers to prove it.

Sadly, that doesn't make the cost go away, it just passes it on to some schmuck who may or may not be better able to bear it.

What I'm trying to determine is if this new law will use the same standard as the hyde amendment. The language I quoted is from that.

First, your constant need for 'cites' simply says you think everyone is a liar. That offends me.

Second, your inability to find the simplest of available data implies either laziness or inability. You tell me which it is.

Third, your constant reliance on incorrect analysis simply because it comes from an organization you trust, rather than going to source documents, speaks to the same likely causes as my second complaint.

So, as anyone who might have spent the LEAST amount of time actually learning about what they are trying to shoot their mouth out about knows, the United States has been free of a national debt for only two years, 1834 and 1835. (page 2)

Again, you are confusing and mixing the concepts of National Debt with Budget Deficits.

So, for the second time in a few days, from the 2010 White House Budget Historical Tables (page 128), put out by the Obama Administration, which I hope meets your exacting standards for 'credible sources':

Now, when Bush took office, the National Debt was $3.410T ($5.629T gross - $2.219T held in government accounts), and when he left office it was $5.802T ($9.986T gross - $4.183T held in government accounts), a difference of $2.392T. Divided by 8 years in office, that is an average of $299B per year. Nothing to be proud of, certainly.

Now, In Obama's first year the WH's own estimates (same chart) show a national debt of $8.531T, or a ONE YEAR INCREASE of $2.279T! By the end of his first (and hopefully only) term, the national debt is estimated to have grown to $11.468T, an increase of $5.666T (which is more than than double what it was when he took office). That is an average increase of $1.417T per year, and that is before Health Care Reform or Waxman-Markey, and the lower than projected tax revenues as the recession (depression) is exacerbated by this insane spending spree, all of which will add multiple trillions of dollars more.

Now, to your other point of confusion, budget deficits, i.e., the amount in any given budget year that government spending exceeds revenues. On that matter, indeed at the end of the Clinton years there were four years of budget surpluses. But look at the annual budget deficits under Bush, and the WH and CBO projections for Obama.

Here is the source document for this chart, again, prior to Health Care Reform or Waxman-Markey, and the lower than projected tax revenues.

I thought I made it pretty clear that I don't think my ideas are possible at present since neither the Democrats nor the Republicans are interested in real reform.

Uh-huh. So. If your ideas were possible at present, how would they get done? What specific steps would you take to implement them? How would this look in terms of actual policy?

Actually I did - I listed the three general principles I think are necessary.

Uh-huh. But how would they serve to deliver health care to uninsured Americans at a lower cost? What makes you believe that setting a payout cap at $100,000 for private insurance companies would induce them to sell policies with lower premiums that provide comprehensive coverage? How would your principles help uninsured Americans to purchase insurance on the private market? I mean, I see your general principles and they are very nice, but I can't say if I think they are good or bad ideas if I don't know how they will change anything.

Uh-huh. But, um, how would they

It works precisely that way, at least the part of it the government subsidizes. You know subsidies, those things you're always screaming for more of but lack the means to pay for?

You're missing my point. I'm not talking about subsidies. I'm talking about how you -- and all Americans -- are affected in all sorts of ways good and bad -- in your daily life from the fact that you live in a society governed by law, custom, and policy -- as opposed to say, if you lived in a cave in the mountains of Afghanistan, or if you lived on a small island alone in the Pacific Ocean somewhere. I'm talking about more than just police and fire protection, garbage pickup and streets without huge potholes. I'm talking about every single thing you do from the moment you get up till the moment you go to sleep at night -- your food, your job, your commutation method, your home, your relationships, everything. Let's give an even better example. Let's suppose you live in San Francisco -- alone. You are the only person in San Francisco. There is no government, no human infrastructure at all for making things happen. How long do you suppose you would survive, and be able to do all the many humdrum things you do every day that you flatter yourself are entirely your doing and do not depend on anyone or anything else?

I'm guessing -- maybe -- two weeks.

First, your constant need for 'cites' simply says you think everyone is a liar.

Oh, no, AR, that's not it at all. It's just that I've had it drummed into me over 12 years of public education, four years of college, two years of graduate school, two years of specialized professional training, and oodles and oodles of books and other information on research methods over the years, that when you make a specific claim of fact, you must back it up with proof if you want to be taken seriously -- and, in addition, that when you are drawing conclusions from facts, stating opinions, or arguing against or for a position on a given subject, you must provide sources, cites, references, etc., to support your arguments. Not all of those necessarily at one time, but I've been taught that if you draw conclusions from a list of numbers or otherwise without any supporting documentation at all, then you will not be taken seriously. I try to stick to that rule as much as I can. It's not that I think you're lying. It's just that assertions and claims of fact and opinion have to be independently confirmable by parties other than yourself. That's all it is, really.

That offends me.

I am truly sorry that this offends you. I apologize that this is what I need from those who would try to convince me that they are right and I am wrong.

Kathy, I certainly am missing your point. While I acknowledge the principle that society is interconnected, I don't see its usefulness in deciding which parts of your life I should stick my nose into. As you can see I have a mighty one.

OK, I have given you all the facts and figures and cites to show you were mis-characterizing the difference between budget deficits and national debt, and that Obama is spending us into oblivion. Other than some lame 'but he HAS to because of Bush' excuse, care to comment on fact he is crippling us, our children and our future grandchildren under an unprecedented debt load that will take generations to overcome? I don't see WW III coming to pull his ass out the economic fire like WW II did for Roosevelt, either.

Sure, AR. Here is my comment. It's a question, actually. What would you have him do? Assuming you agree the health care delivery system is in crisis, people are not spending money because the unemployment picture is still so bad, climate change is nearing a point of no return, and... well, I guess that's enough for a start. Do you think Obama should stop all spending until the economy gets better, Americans become able to afford insurance, and climate change fixes itself? What would you have him do, precisely?

Of course, if you don't agree with my premises, then you will probably say "do nothing," which would make sense if none of these issues are actually serious problems. But assuming you agree that they are, how would you solve them w/o spending money?

Forget it, then. I don't know how better to explain it.

I mean “a few dollars” literally. I don’t know the exact numbers, but I imagine that the cost of abortions makes up a very small fraction of total health care expenses, and therefore the cost of the supplemental abortion insurance would be a very small fraction of the cost of the basic insurance plan. I understand you find it morally objectionable to make poor women pay even a few extra dollars toward abortion coverage, but it seems like a reasonable compromise considering those who oppose abortion also find it morally objectionable that their tax dollars would go to such a procedure. Just to cut down on the back and forth, if you are going to counter with "but abortion is legal", I would counter with "and the law says that federal dollars can't go toward abortion".

"I apologize for the tone of my reply. I am allergic to long lists of numbers, presented in isolation regardless of their origin, in a situation where numbers do not tell the whole story."

OK. I know not everyone is a numbers person, and since you are AR are in a somewhat heated debate I won't hold your tone against you.

I tried to lay out the numbers in prose form in my response to AR. As I said, I don’t think it’s useful to talk about numbers from 2008-2010/2011ish, since those are recession numbers. Of course the deficit will be higher during those years both because of decreased tax receipts and some degree of stimulus. We could debate whether short-term stimulus and bail-outs are justified during a recession, but that’s a different discussion. If we want to talk about long-term deficit spending, we have to look at Bush’s numbers pre-2008, and Obama’s estimates post-2011ish. If you look at those numbers, it is simple math to see that Obama’s deficits are about twice as large as Bush’s numbers (and yes, I checked and those numbers do include spending for the Bush wars).

So which is more important -- "This bill will increase the deficit by $1 trillion!" or "This bill will decrease the national debt over 10 years"?

Republicans (at least the non-crazy ones) aren't saying that the bill be increase the deficit by 1 trillion. They are saying that it will increase the debt over the next few decades. So yes, the question of over-all debt is more important than any single year's deficit, but we are talking about the former. Maybe it's confusing because in order to talk about the effect of the policy on the overall debt, you have to look at the individual years' deficits over that period of time. (ie. The sum of the deficits for all tens years = the increase in the debt over those tens years).

"What would you have him do, precisely?"

I know your asking AR, but if you don't mind this is what I'd have him do:

#1) Don't promise that you're going to cut the annual deficit (and I'm not talking about 1 year, I'm talking about the average annual deficit) in half when you are actually going to multiply it by at least 2.

#2) Pass a stimulus bill that is cut down to stimulus only, not unfunded long-term spending. As an exercise, I found $112 billion dollars that could have been taken out of the stimulus while only decreasing short-term spending by 20 billion, and I explain in my post how that is only the tip of the iceburg: http://sovereignmind.wordpress.com/2009/02/02/w...

#3) Produce health care reform that prioritizes lowering the cost of health care, instead of just shuffling it around. I've said before that I support efforts to improve the fairness of our health care system, but if cost is not also controlled then it will be for naught as far as our economy and debt are concerned. There have been numerous previous threads where conservatives vs. liberal ideas on how to decrease costs have been debated, so I won't get into that for now.

However, I will agree with you (and disagree with AR) in terms of the short-term spending. I'm not as upset about the 2009 deficit as I am about the 2014 one and beyond.

This is not how it would work at all, AD. Did you read the article by Jessica Arons at The Huffington Post that I linked to earlier? Here is the link again, and here is a quote from it:

It effectively bans coverage for most abortions from all public and private health plans in the Exchange: In addition to prohibiting direct government funding for abortion, it also prohibits public money from being spent on any plan that covers abortion even if paid for entirely with private premiums. Therefore, no plan that covers abortion services can operate in the Exchange unless its subscribers can afford to pay 100% of their premiums with no assistance from government "affordability credits." As the vast majority of Americans in the Exchange will need to use some of these credits, it is highly unlikely any plan will want to offer abortion coverage (unless they decide to use it as a convenient proxy to discriminate against low- and moderate-income Americans who tend to have more health care needs and incur higher costs).

"Forget it, then. I don't know how better to explain it."

This is actually something I've thought quite a bit about. This is going to sound a little crazy and off topic, but I can't resist the chance to actually agree with Kathy on something: I picture the human race as living on a huge 3-dimensional spider-web suspended high in the trees (OK, I know you think I'm crazy). Our society has built this web and we live our entire lives on it and we have become so accustomed to it that if we were to fall off of it and land on the ground we would shrivel up and die in seconds, unable to even walk on the foreign material known as "dirt". I have thought about the "you wake up and everyone is gone" scenario. I am fortunate enough to have sufficient money to live in a comfortable home, drive a reliable car, etc. But if I had to build my own home, raise my own food, etc, my standard of living would be a small fraction of what it is today. I do my small part to keep up the web, which in part is my job where I help produce something that is worthless by itself but adds value to our lives when used in conjunction with everyone else's work (now you see where I get the "web" metaphor, as every individual strand is worthless by itself).

We all depend on each other to keep up the integrity of the web. Occasionally something happens (natural disasters, planes flying into buildings, wars, etc.) to blow holes in our web that causes devastation and a hurry to fix the hole and reinforce it so that such holes are more difficult to happen in the future.

So, I know what you mean Kathy. However, I think it has more to do with our society than our government. We have social interaction when that social interaction benefits both parties (ie. I'll build you a home if you will feed my family). The metaphor starts to break down, in my opinion, when we are talking about government imposing policies to force us to have those social interactions (ie. you'll pay for my health care whether you like it or not). The line is not necessarily always clear, however, so I take your point.

(I'm resume my normal relatively sane commenting now)

"Did you read the article by Jessica Arons at The Huffington Post that I linked to earlier?"

No, but I did now. The author reaches that conclusion only be completely dismissing the supplemental abortion coverage aspect which is the heart of my argument. This is how the article dismisses it:

"Stupak and his allies claim his Amendment doesn't ban abortion from the Exchange because it allows plans to offer and women to purchase extra, stand-alone insurance known as a rider to cover abortion services. Hopefully the irony of this is immediately apparent: Stupak wants women to plan for a completely unexpected event."

Yes, that's part of what health insurance is: planning for unexpected events. And an insurance company has an incentive to make it as easy as possible to opt for the supplemental insurance. I imagine it would be as simple as checking a box on an application form.

#1, you don't know that that's true. You are projecting into the future not knowing what other factors will come into play.

#2 I don't share your definition of what is "stimulus spending" and what is "unfunded long-term spending." There were millions of dollars cut from the stimulus bill that were in fact, stimulative and should have been kept in. Almost all public spending stimulates the economy in a no-spending recession. The bill should have been double the size it was, and the fact it is not is one reason it's not working as well as it should be.

#3 There is no way to "prioritize" cost-cutting without (a) increasing the number of Americans who have coverage; and (b) creating *real* competition to the private insurance industry. If you want more cost-cutting, then you should be hoping the Senate retains the strong public option that's in the House bill. Even better yet, you should be calling for single-payer. But obviously that's not on the menu right now. But the conservadems and Republicans who refuse to vote for health care reform if the public option is in it, are either hypocritical or uninformed, because the moment you take the public option out, the cost goes up. So we could actually end up with a bill that covers fewer people, does not provide real competition for the private insurance industry, and costs *more* than the just-passed House bill would. There is no way to have serious cost-cutting without a public option, and the more people it covers, the more it will cut costs.

Wow, AD. I love this. If this is crazy, I think you should stay here.

And of course now I am insanely curious to know what that something is that you help produce that is worthless in itself but adds value when used with everyone else's work. How intriguing! Is it a secret? Or can you tell?

"I'm not sure what you mean by states being unnecessarily involved -- unless you're referring to state regulation of insurance companies, which is rather important to prevent insurers from selling policies that have huge coverage gaps."

Yes, I'm back to McCarran-Ferguson again. As long as people are given complete information, I would far rather be given the chance to determine if a policy has a "gap" or just something I don't want or need. Single men, for instance don't need maternity coverage, but it's mandated in some states anyway. To me, it's elitism to think that the state is going to be able to make better purchasing decisions than I can. It also allows for lobbyists to force favoritism to their industry, which is the driver behind these kinds of mandates.

"With regard to employers, I might need to research this to know for sure, but if memory serves the reason employers started offering health insurance coverage as an employee benefit was precisely because the cost of purchasing insurance privately was so high even then. In other words, it was a response to rising costs, not the cause of them."
No. No. No. Medicals costs were far lower back then, in both real and inflation adjusted dollars. Medical insurance was uncommon and medical care was much cheaper, and less regulated. As I've stated several times before, it was tied to employment because wages were fixed, but employers wanted a way to attract better employees. Rather than lift the wage limits, congress allowed employers to offer additional benefits, and made health insurance non-taxable when offered through the employer. Unfortunately, when WW II ended, and the wage limits were lifted, the tax benefit wasn't lifted.

#1: Again, I'm using Obama's own estimates, which I take as a best-case scenario since the CBO's deficit estimates are higher. If Obama can beat his own estimates so much that he can actually make good on his promise (which would mean deficits around 500/2 = 250 billion rather than 1 trillion), and also all of his other promises, we should probably elect him to be king.

#2: We probably don't want to get into a debate on the stimulus right now. My rough definition of "unfunded long-term spending" was spending that was set to happen 2 years or more after the stimulus took effect. The CBO broke down those numbers so it was quite easy to distinguish between the two.

#3: Like I said, we've debated conservative vs. liberal ideas on how to cut costs many times before. All I can say is that the CBO estimated that the Republican alternative (which is pretty impotent as well, I have to admit. We could have done much better on the conservative side just as you think single payer would have been better on the liberal side) would reduce costs 5-10% or so while the CBO made no such claim about the Democrats bill. I'm not sure that the Democrats even asked the CBO that question, which is telling.

"And of course now I am insanely curious to know what that something is that you help produce that is worthless in itself but adds value when used with everyone else's work. How intriguing! Is it a secret? Or can you tell?"

It's really not that interesting, Kathy. My point is that we could all say this about the things we do. Very few professions (education, medicine, etc.) can actually point to specific one-on-one interaction that directly benefits the lives of individuals. The rest of us are inclined to look at what we do and think, "Am I really making a difference in the world?" We are taught to idolize famous people who do great things. We tell our children that if they put their mind to it they can become President, even though the vast majority of them will not even if they DO put their mind to it. Certainly we should strive to be the best we can, but I believe an over-emphasis on this type of thinking can be destructive. More collective good has been done in our society by ordinary people doing their work well (in or out of their job, I mean) than by the occasional exception that goes above and beyond.

I produce software. Or, to put it more accurately, I produce lines of code that, when mingled with millions of other lines of code, results in a piece of software that makes other professionals more efficient, thus allowing them more time to give their services to individuals that need them. So, my work has value within society, but by myself (without customers who can use the software to do things that i can't, and without suppliers like computer manufacturers) my talent for programming would be useless.

Assuming you agree the health care delivery system is in crisis

No, I do not share that view.

Do you think Obama should stop all spending until the economy gets better

Of course not. That cannot be done. I do however think he, and to be fair, Congress, should stop creating so many new $T+ spending programs. I opposed TARP, the Porkulus bill, the car bailouts, etc. I WOULD have supported a stimulus bill that wasn't just the Democrats funding all their pet projects, i.e., a TRUE infrastructure and jobs creation bill (not one that 'saved' 935 jobs in a department that only has 508 total employees).

Unemployment has gotten significantly worse than either the 'no stimulus' or 'with stimulus' projections. Why? Simple. Actions have consequences. When business owners, especially small business owners, are fearful of what is going to happen with inflation, taxes, energy costs (and the government has flat out stated their goal is to make energy costs go up to 'force' people to conserve, and make alt energy more cost viable by comparison), and the government forcing a HUGE increase on their health care costs, they stop hiring, put off expansion, and even let people go.

The business community, large and small, are showing they feel no confidence the government is currently concerned abut their problems, and is instead focused on passing these wide-ranging, expensive programs that will hurt their businesses, and crush the economy for years to come.

So, yes, unless they want to focus on actually helping the economy instead of pushing the 'progressive agenda', I certainly do think we would be better off if they did nothing.

So I suppose I became a bit too defensive at the way AR framed his argument -- this is too expensive and here are the numbers to prove it

Wow. I had missed that reply.

What am I supposed to say? Sorry for using facts to support my contentions?

Facts that YOU forced me to cite, as you kept harping that I wasn't providing the source for the one-line figures I talked about?

If you are willing to accept the fact that I do not make up numbers out of thin air, I will stop throwing long, complex source documents at you, and we can debate the underlying assumptions.

But as long as you keep implying I am a liar and making numbers up, or using 'unreliable sources', hell yes I am going to keep showing your lack of knowledge.

Here is the link again, and here is a quote from it:

OK. my turn to call you out. The Huffington Post as a 'reliable and unbiased source'? Get real.

Wow, AR, talk about selective quoting.

I did not force you to do anything, AR. Neither did I imply you were a liar or that you made numbers up. And in fact, you can do as you please with regard to citing sources, or with regard to political argumentation, or with regard to any other aspect of intellectual approach, philosophy, or standards.

Thank you for discussing these issues with me, AR. It's been interesting.

Yes, so much easier to walk away when you are called out on your BS. Typical Liberal response - I am losing this argument, so I will pretend that the other side is being unreasonable.