Ray I think you could call the ACA a pragmatic response to the problem. Pragmatic in that its all that the political situation within the US could allow. Some incremental improvements and a "bending" of the medical inflation ...
It isn't likely to be adequate as you point out.
But until the single payer system that has been proven to work better in so many other nations is politically acceptable to a larger group of politicans.... its better than the status quo. And far better than the unproven fantasy that is the Ryan plan.
(I said politicans not voters, because I think if voted on, a national plan would probably be popular with voters.Its politicians who can be bullied by the medical insurance and health care industries, due to the high cost of politics)

Wasn't it Churchill who said,

the USA can always be relied upon to do the right thing, once it has exhausted all other alternatives.

Maybe thats what will eventually happen with healthcare as Freeman says...

rickyp wrote:ant

At first you try to say you aren't just viewing his plan as extreme

Where?
Because I do view it as extreme.
But I point out that one's perception is fueled by one's experiences and knowledge.
The reason The voucher system,( or whatever semantics now chosen for a system that only pays medical costs up to a certain amount,) will seem extreme for those used to Medicare is that people are used to the current system. And like it.
Proposing to change a popular program is going to met with scepticism. Well, it already was met with scepticism when first proposed by Ryan.

Note: Slightly edited the first paragrah sentence to be clearer.

You don't understand what I meant. I meant that you were claiming that not only do you view Ryan's plan as extreme, but that it is extreme. It's not. You simply view it as extreme because you have a limited view of the wide range of policies that can be applied to health care system. And you readily admit that, both in previous posts and in this one.

Ray Jay was discussing how the media/political system unfairly paints politicians and policies as extreme. You disagreed and claimed that Ryan's plan was extreme. I'm telling you that it's not extreme, you only view it as extreme. You are now agreeing with that, so you're proving RJ's point.

super

You don't understand what I meant. I meant that you were claiming that not only do you view Ryan's plan as extreme, but that it is extreme. It's not. You simply view it as extreme because you have a limited view of the wide range of policies that can be applied to health care system. And you readily admit that, both in previous posts and in this one.

You actually think there is objective truth concerning the use of a descriptive term?
In this discussion, my own view that its extreme really doesn't matter. The point is, will the majority of the electorate view the Ryan plan as extreme?
I believe that most seniors who currently enjoy Medicare would resist changes to the program. (The oft quoted "get your government hands off my medicare". )The fact that Ryan plans the changes occurring only to people 55 and younger suggests he understands that Medicare is popular. He apparently thinks that people aged 45-55 won't consider changes that will cost them money when they are ready to take advantage of medicare unacceptable. There are estimates circulating that it will cost about $6,000 a year per senior .... I'm pretty sure that group 45-55 will stand up and listen carefully to these estimates. And they'd probably feel the changes were extreme.
$6000 being a fairly large sum for most voters.
And that backs up my position that extreme depends on one's point of view.

Ray Jay wrote:

Purple wrote:

Ray Jay wrote:What is the pragmatic liberal plan to control health care costs which are now predicted to represent 20% of our economy by the end of the decade?

Wouldn't that be the ACA?

My understanding is that the ACA brought it up from 18% to 20%.

Where do you find that figure? According to testimony by the Congressional Budget Office before the Subcommittee on Health of the House Committee on Energy and Commerce ("CBO's Analysis of the Major Health Care Legislation Enacted in March 2010"), "CBO and JCT [Joint Committee on Taxation] effectively estimated in February [2011] that PPACA and the health-related provisions of the Reconciliation Act will produce a net decrease in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues." This is over the estimates for deficits under prior law. Certainly one could argue that Medicare costs are still too high, indeed potentially a budget buster, but to say that ACA made things worse seems to be a stretch.

Health care reform has been on the agenda for at least a generation, with heretofore no real action (the Clinton administration famously failed to get anything done). I'm not about to argue that ACA is an ideal solution (frankly I don't know enough about its details), but I will say that it is an incontrovertable FACT that it was passed by Congress and signed into law. Those who would argue that the Obama administration has not provided leadership in this area seem to be inexplicably overlooking that point. (If you want to say you don't like where he has led, that's a different argument.)

Rudewalrus wrote:

Ray Jay wrote:

Purple wrote:Wouldn't that be the ACA?

My understanding is that the ACA brought it up from 18% to 20%.

Where do you find that figure? According to testimony by the Congressional Budget Office before the Subcommittee on Health of the House Committee on Energy and Commerce ("CBO's Analysis of the Major Health Care Legislation Enacted in March 2010"), "CBO and JCT [Joint Committee on Taxation] effectively estimated in February [2011] that PPACA and the health-related provisions of the Reconciliation Act will produce a net decrease in federal deficits of $210 billion over the 2012–2021 period as a result of changes in direct spending and revenues." This is over the estimates for deficits under prior law. Certainly one could argue that Medicare costs are still too high, indeed potentially a budget buster, but to say that ACA made things worse seems to be a stretch.

Health care reform has been on the agenda for at least a generation, with heretofore no real action (the Clinton administration famously failed to get anything done). I'm not about to argue that ACA is an ideal solution (frankly I don't know enough about its details), but I will say that it is an incontrovertable FACT that it was passed by Congress and signed into law. Those who would argue that the Obama administration has not provided leadership in this area seem to be inexplicably overlooking that point. (If you want to say you don't like where he has led, that's a different argument.)

You won't find the actual statistic that ACA brought health care spending up from 18% to 20%. I was being a bit toungue in cheek. Purple already pointed out that demographics are probably the primary driver to increased health care costs. I have seen a forecast that health care spending as a % of the economy is rising to 20% within the decade.

All that being said, I am positive that ACA will increase health care costs. That is a different question than whether it is increases or decreases the federal deficit. (It does substantially increase the deficit, but that is a different question. Just look at the faulty assumptions of the CBO.) It will increase health care costs because it increases the number of people who are on medicare, it strongly motivates (through tax/penalty) people to have insurance, and it mandates that insurance companies do not refuse them.

I think it is great that some people will now have health coverage where they did not before. However, Obama promised to bend the cost curve down by taking the best ideas from both parties. He did not. He bent the cost curve up. Yes, he made it financially worse. That's not a stretch at all. It's a slam dunk.

Obama did provide "leadership". But it was leadership in the wrong fiscal direction.And as far as I can tell, there is no follow up plan.

Of course, a fair amount of the mandated coverage is preventive healthcare, which may actually bring down total costs if it is taken up. I believe a fair number of those provisions kicked in a couple of weeks ago, so it's way too early to tell, but would be intersting to see (if the ACA lasts long enough for study)

danivon wrote:Of course, a fair amount of the mandated coverage is preventive healthcare, which may actually bring down total costs if it is taken up. I believe a fair number of those provisions kicked in a couple of weeks ago, so it's way too early to tell, but would be intersting to see (if the ACA lasts long enough for study)

I wish that preventive care saved health care dollars. I used to think that was the case. However, the reality is the opposite. Preventive care often finds stuff that needs to be investigated. This involves more tests, follow ups, and often a visit with a specialist. Yes, sometimes the preventive care is cheaper than ignoring the problem. It does result in better health care. However, the evidence that I've seen is that more preventive care drives costs up because you find more stuff to investigate.

It will be interesting to see what happens in my state since we are a few years in to mandated coverage.

ray

I wish that preventive care saved health care dollars. I used to think that was the case. However, the reality is the opposite. Preventive care often finds stuff that needs to be investigated. This involves more tests, follow ups, and often a visit with a specialist. Yes, sometimes the preventive care is cheaper than ignoring the problem. It does result in better health care. However, the evidence that I've seen is that more preventive care drives costs up because you find more stuff to investigate.

I'm pretty sure that the cost of vacinnation for polio and many other communicable diseases prove to be saving over all health costs.
Although it is true that some "preventative health measures" have proven to be not worth the money, good epidemiology applied to a public health program can adjust as we learn.
I don't know if this applies elsewhere, but recently guidelines for women for preventative measures for cervical cancer changed in Canada. A lot of the preventative measures for women under 30 were dropped because they were proven not to have mattered.
The difference might be that in a health care system where profit is a driving motive is that many of these "preventative measures" might be great profit centres for health care providers and pharmeceutical companies...

Yes, sometime preventive care does save $s ... but in totality it doesn't under the current US system. Let's get back to the basic point: what is the Democratic plan to manage health care costs in this country?

I'm liking the Ryan pick more and more. At least we are talking about the issues. I'm not sure it helps Romney for 2012. However, the Republicans are now running on something. If the Republicans win they have a mandate. If the Democrats win, and we have more of the same (high health care costs and the large federal deficit and a lackluster economy) then the Repulbicans can run on issues againt in 2016.

Ray Jay wrote:Obama did provide "leadership". But it was leadership in the wrong fiscal direction.And as far as I can tell, there is no follow up plan.

Hmm, yet you intend to vote for him.

Intriguing.

I'm still in the 5% undecided ... i'm terribly washy-wishy

Ray Jay wrote:I'm still in the 5% undecided ... i'm terribly washy-wishy

I think that number is understated. I believe there will be more of a change. I think we will see polls in which either Romney or Obama are very near 40%. I suspect it will be the President, but we will see. He may actually come up with something to run on, other than the "boogeyman strategy" he's employing now.

Wow rj...it's great that all these people got covered but not if it costs anything. ...and the solution to Medicare is simply have seniors pay for it (assuming vouchers don't work,a pretty safe assumption)...if that appeals to you then you should vote for Romney
And btw I assume that you have read the articles indicating that it was Republican strategy not to work with Obama (starting with a meeting on the night of his first day in office), yet it was Obama who wouldn't use Republican ideas? And speaking of costs Romney will have tax cuts and increased mlilitary spending that is not paid for--that is not bothersome?

freeman2 wrote:And btw I assume that you have read the articles indicating that it was Republican strategy not to work with Obama (starting with a meeting on the night of his first day in office) . . .

Is that true?

Why did Republicans vote for the Stimulus? Why did a Republican break the stalemate on Obamacare in the Senate?

Please, do detail the President's outreach to the GOP. That should be easy--since it doesn't exist.

. . . .yet it was Obama who wouldn't use Republican ideas? And speaking of costs Romney will have tax cuts and increased mlilitary spending that is not paid for--that is not bothersome?

Better to cut the military, increase taxes, and STILL have massive deficits as far as the eye can see?

How many Democrats voted for the Presidents budget? (Shhh. The answer is zero...)