• Truth and health care

    Krugman wrote it. I’ve taken out all the finger pointing. It’s still the truth (maybe more so) without it.

    What would a serious approach to our fiscal problems involve? I can summarize it in seven words: health care, health care, health care, revenue. […]

    Long-run projections suggest that spending on the major entitlement programs will rise sharply over the decades ahead, but the great bulk of that rise will come from the health insurance programs, not Social Security.

    So anyone who is really serious about the budget should be focusing mainly on health care. And by focusing, I don’t mean writing down a number and expecting someone else to make that number happen — a dodge known in the trade as a “magic asterisk.” I mean getting behind specific actions to rein in costs. […]

    What would real action on health look like? Well, it might include things like giving an independent commission the power to ensure that Medicare only pays for procedures with real medical value; rewarding health care providers for delivering quality care rather than simply paying a fixed sum for every procedure; limiting the tax deductibility of private insurance plans; and so on.

    And what do these things have in common? They’re all in last year’s health reform bill. […]

    This brings me to the seventh word of my summary of the real fiscal issues: if you’re serious about the deficit, you should be willing to consider closing at least part of this gap with higher taxes. True, higher taxes aren’t popular, but neither are cuts in government programs.

    I know some people will object to the notion that the ACA has cost controls in it. That objection is mostly about whether they will work, whether Congress can be trusted not to undo them. I worry about that too. I also know they’re not enough.

    There is a danger of a self-fulfilling prophesy. The cost controls are written into law right now. That’s a fact. By suggesting they are insufficient and anticipating they’ll be weakened are we also telling policymakers to do just that? It’s hard to be cynical and maintain hope. Knowing what we expect, policymakers may deliver it.

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    • By suggesting they are insufficient and anticipating they’ll be weakened are we also telling policymakers to do just that?

      The problem that I see is that this opens politicians, who like to give away goodies not take them away, to open themselves up to demagoging, to be the bad guys. Once people start to complain about a procedure no longer being paid for by medicare the politicians will probably back peddle.

      Right now employers are more and more doing the tough thing that needs to be done, that is raising deductibles and dropping employer sponsored insurance which leads people to choose higher deductible plans or even pay for medical procedures after the deliver of the same. Employers do it because it makes them money, will politicians be willing to do the same when it will cost them votes?

      Considering that politicians cannot even rationally address licensing issues because they do not want to anger providers I have little confidence in them.

      What is happening in Wisconsin and what happened in Greece even brings doubts about weather government monopsony in health care would be a real solution.

    • “Health care, health care, health care, revenue…”

      For once, Krugman is 3/4 right (usually he is 0/4 right). Health care expenditures by government are out of control (although I can’t understand why some liberals object to people spending their own money on health care). Krugman is 100% wrong on revenue.

      GWB grew federal spending by almost 75% during his eight year term. Does that sound like a revenue problem or a “hey I spent to much money on everything” problem? Obama is on track to do even worse on the spending side.

    • Krugman is 100% right. And he’s right more often than this plutocratic shill thinks.

      Health care expenditures by EVERYONE are growing out of control, not just government. We as a country pay more for less per capita when it comes to health care.

      And you are an idiot if you think that we can balance the budget without increasing revenue. GWB increased spending and DECREASED revenue based on a surplus that never materialized because most, if any, of the so-called “jobs created” by the tax cuts were made OVERSEAS. The rest was all hoarded. Large companies are sitting on cash, unwilling to hire people and then they wonder why there is no demand.

      Rocket scientists.