Romneycare vs. Obamacare (reprise)

Remember, the Republicans are running against Obamacare, which is basically just warmed-over Massachusetts Romneycare, with the individual mandate and all. 

Via: mittromneycentral.com

RomneyCare was the first significant healthcare reform to happen in the U.S. for decades.

The primary goal of RomneyCare was to provide all citizens in MA with access to affordable health insurance and to eliminate the "free riders" who expected the government or taxpayers to pay for their health care. The plan did an extraordinary job of covering nearly half a million people who were previously uninsured without raising taxes. Under RomneyCare, the citizens of MA can be assured that they will retain their health coverage when they move from job to job, or if they suffer financial hardship.

Highlights of what RomneyCare has accomplished after 5 years of being in affect:

1 - Nearly every Massachusetts citizen is covered. A recent study showed that 98.1% of adults and 99.8% of children now have medical insurance. This is by far the highest rates in the nation. The overall national rate is 83%, with Texas having the worst rates in the nation at 74%. In Texas, one out of every six children is uninsured.

2 - Many more businesses are offering medical insurance to their employees. Now 76% of employers of medical insurance to their employees, compared with 70% just five years ago. The national rate remained at 60%.

3 - The overall costs of the program to the state have not exceeded expectations. At the time of passage, Romney predicted that the new law would add just 1 to 1.5% to the state budget. Last year the additional cost to the state was only 1.2% - precisely where Romney predicted it would be even though the costs to the state would be much lower if the Massachusetts legislature and Governor Patrick (Romney's successor) hadn't added significant costs to the healthcare law. (This is covered more thoroughly in Section 6 - What changes would Romney make to RomneyCare?)

4 - The cost of health care premiums for individuals who buy insurance without the help of an employer have gone down dramatically. According to FactCheck.org, individuals who bought insurance on their own "saw a major drop in premiums, as much as a 40% decline, according to some figures." On average, premiums dropped between 18%-20% for the average individual buying health insurance on their own.

5 - RomneyCare remains exceptionally popular among state residents. Studies repeatedlyconfirm that 67-84% of Massachusetts residents are happy with the plan and would not go back to the old system if given the chance.

The Creation of RomneyCare

Remember that the overall goal of RomneyCare was to provide all citizens with access to affordable health insurance and to eliminate the "free riders" who expected the government or taxpayers to pay for their health care. The plan did an extraordinary job of covering nearly half a million people who were previously uninsured without raising taxes.  [continues here]

See also Massachusetts health care reform - Wikipedia, the free encyclopedia

Life Under Romneycare (Esquire)

The Romney fan site includes the revisions Romney would have made to the law, most overturned by the Democratic Massachusetts legislature.  Most are relatively minor.

For the Republicans to be running “against Obamacare”—instead of saying they’d like to revise it—continues to be one of the most glaring instances of their perversity.  The country could easily be thrown backwards by decades, if not centuries.

Romneycare vs. Obamacare

Via: The Daily Beast

It amazes me that most Americans don’t seem to know this.  Romneycare has resulted in coverage of 98 percent of the citizens of Massachusetts.  Only about one percent of small businesses opt out.  The idea that it’s a states rights thing has been blown away by the Supremes.  That Mitt is running against his own successful health care plan is proof of the moral and intellectual bankruptcy of the Republican platform.  The Republican party stands for nothing other than keeping taxes low on rich people.

Romneycare and Obamacare Differ Only in Inconsequential Ways

by Josh Dzieza Mar 6, 2012 1:16 PM EST

Romney is struggling to distance himself from the health-care law he passed while governor of Massachusetts, and no wonder—the state and federal plans are virtually identical.No other issue--not his wealth, his 15 percent tax rate, or “corporations are people, my friends”--has given Mitt Romney as much trouble as the health care law he passed while governor of Massachusetts. Each of Romney’s opponents has taken a shot at the law Tim Pawlenty dubbed Obamneycare, pointing out again and again that it was the inspiration for President Obama’s reform so loathed by the Republican base. At a town hall rally in Ohio Monday, a Romney supporter pleaded for the candidate to give her something to say to critics. "I understand that Romneycare was good for Massachusetts at the state level, whereas Obamacare is federally mandated," she said. But "I don't know what the fundamental differences between the two [are] and I really would like your assistance with being able to tell others."  [article continues here]

Rational health insurance systems exist—but not in US

Via:  Miller-Mccune  h/t www.patrick.net

Why Should I Buy Health Insurance?

Europe has answered that question to its own satisfaction with a mandatory system that treats health care as a social insurance handled by private firms.

By Michael Scott Moore

As judges around the U.S. weigh the constitutionality of the Affordable Care Act — Obama’s sweeping health care reform law — it’s worth asking how Europe navigated the same questions.

The problem in most state challenges to the new law is the un-American-sounding mandate, the requirement that everyone in the nation must buy health insurance. Europeans have had similar mandates for decades, but you hear very little soul-searching here about fairness or freedom of choice. Is it because Europeans are all a bunch of socialist weenies who don’t mind an overregulated market?

Not quite. The European Union — that garden of overregulation — has fair-competition rules meant to keep markets free, just as the U.S. Constitution has the Commerce Clause. Now, no less than the years after World War II, when Western European countries built their modern health care systems, forcing the public to buy something, whether bowling balls or fire insurance, would seem un-European as well as un-American. It would be an artificial prop for an industry.

But health care, early on, was judged to be different. In the freest European systems — the Swiss, Dutch and German schemes — people can choose from a vast variety of health care providers. But by law they have to choose one. In return for this gift of guaranteed business, the government regulates the companies heavily. The justification for such meddling is that health care is a “social insurance,” a basic service, not a standard sold product.

As Timothy Stoltzfus Jost, a law professor at Washington and Lee University, pointed out in a paper last year, the result is not exactly a market-disciplined health care system. “This [European] understanding of the nature of health insurance is not merely conceptual, but is reflected in the approach that Switzerland and the Netherlands take to financing and regulating health insurance,” he writes. “In both countries, public funding is extensive.”

The German system, intriguingly, reverses the grim “risk-based” equation familiar to every American looking to buy insurance. German citizens pay into a pool for health care according to their income, not their health risks — but the Krankenkasse receives a lump of money back from the pool according to each patient’s risk. That means German insurance companies draw more money for taking on patients with more risk — a built-in reason to cover the old and infirm.

It involves a lot of government fiddling, but what Krankenkassen don’t do under this system is suffer. They do, however, act like insurance companies. When you buy coverage in Europe, you get it.

The incentive structure in America right now pushes companies in the other direction, away from paying coverage wherever they can. That’s the problem Obamacare wants to solve. No purely market-driven system on earth has yet solved it. The systems in Switzerland and the Netherlands were held up for a while as possible free-market models for the U.S., but they’re not strictly market-driven, founded as they are on a notion of health care as a social service.

Legal arguments over the mandates in Obamacare focus on whether the Commerce Clause of the Constitution gives Washington the power to regulate an industry that tends, historically, to be handled by individuals, or by localities and states. It probably does, but the idea of being forced to buy insurance by law will still confuse a lot of Americans when Obamacare kicks into high gear in 2014.

America has to find her own way through this thicket of legal distinctions. There’s no reason to ape the Europeans, because their systems aren’t perfect; in fact it would be nice to watch the American legal process forge something new. But Europeans settled the underlying moral questions — to their own satisfaction — decades ago.

Who ain’t pulling his oar? Joe Lieberman!

Via:  Visualizing Economics 

Income Gap and Marginal Tax Rate 1917-2006 

Thank you, Joe Lieberman!  We wouldn’t want all those rich Republicans you represent in Connecticut to have to pay more taxes!

From the Nation. The top graph shows the average income of the top o.o1% compared to the bottom 90%. The higher the peak the bigger the gap between the two groups. In 2006 you would need an income of over $10 million to make it into the top 0.01% while your income would have to be less than $100,000 to be in the bottom 90. The second graph shows the marginal tax rate over the same time period. Here is graph I created plotting similar data.

What the doctors prescribe: a public option

Via:  Huffington Post  This is amazing.  The AMA doesn’t even represent the doctors!  Who the hell can you believe anymore? 

The Obama presidency is failing.  If the President doesn’t take this study in his hand and demand a public option he is even more of a wimp than he appears.  For a few weeks last fall, I suspended disbelief and gave him time to prove that his political instincts were better than mine, that he was going to clean up Wall Street and get health reform by waiting for the parade before jumping in front of it.  But now it is clear that he is simply cowed, afraid to go up against the oligarchs in finance and health insurance.  Any and all opposition to Beltway business-as-usual is being painted as lunatic fringe (and I wonder how much of it is staged by fifth column agents).  The body politic is very cagily being quartered, using the same old fake polarities of “Republican” and “Democrat,” “liberal” and “conservative,” when the real party in power, the Money Party, is pulling the strings and the people are still dancing to Ronnie Reagan’s Hollywood dream-song, thinking that they will be the ones to win the lottery, and that government is always their enemy…. The American people let this government happen, the American people will have to unseat it.

Majority Of Doctors Back Public Option: New England Journal Of Medicine Study

A new study finds that a majority of physicians support the creation of a public health care option.

A Robert Wood Johnson Foundation (RWJF) study published in Monday's New England Journal of Medicine shows that 63 percent of physicians support a health reform proposal that includes both a public option and traditional private insurance. If the additional 10 percent of doctors who support an entirely public health system are included, then approximately three out of four physicians nationwide support inclusion of a public option. Only 27 percent support a private-only reform that would provide subsidies for low-income individuals to purchase private insurance.

Surveying a nationally representative sample of 2,130 physicians across America, researchers Salomeh Keyhani, M.D., M.P.H., and Alex Federman, M.D., M.P.H., from Mount Sinai School of Medicine in New York City queried physicians about a range of options for expanding health insurance coverage.

"There should be no confusion about where doctors stand in the debate over expanding health insurance coverage: they want reform," said Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation. "This survey reveals important information about the perspective of physicians on issues central to the health reform debate. Policy makers should listen to their doctors."

"We found that no matter how you sliced the data, physicians demonstrated majority support for a public health insurance option, regardless of their type of practice or where they live," said Keyhani.

Among those physicians who identified themselves as members of the American Medical Association, 62.2 percent favored both the public and private options. The AMA has opposed a public option, saying that it "threatens to restrict patient choice by driving out private insurers."

A majority of physicians surveyed (58 percent) also supported expanding Medicare eligibility to those between the ages of 55 and 64.

"These results give voice to individual physicians in the national discussion about health reform," said Federman. "Most often we hear the opinions of special interest groups rather than doctors themselves, but we know that Americans want to hear the opinions of doctors like those who treat them. This study lets us hear the unfiltered views of physicians on key elements of health reform and should be useful for lawmakers."

Read the full study here.

Read more at: http://www.huffingtonpost.com/2009/09/14/majority-of-doctors-back_n_286352.html?view=print

The New York Times on class; Pinochiobama

h/t Mark Thoma

• Interactive graphic (cool)

It is so painful to watch the shredding of our social contract that I’m having trouble posting much.  When I read Mish Shedlock complaining that the healthy will subsidize the sick in a health care program as if this is a proper indictment of “government,” I become very sad that the old right wing meme “government is evil” will be used to complete the neo-feudalization of America.  Much as I admire Peter Schiff for his prescient economic analysis (see for example this) I would be very unhappy to see him in the Senate.  Even Ron Paul has said he would provide health care to the poor and fund it by bringing troops home.

The American people are being snookered again by the right into voting against their own interests.  It is very sad.

Those who voted for Obama thinking they were going to get real change rather than a executive facsimile of Alan Greenspan (I used to irritate liberal friends in the ‘Nineties by calling Alan “The Great Accommodator”—liberals can be so blind to the persuasions of money, too—easy money was good for the people, no?) those who voted for Obama are perhaps the most devastated by the way things are going, now that we see that Obama is just a puppet, an appeaser of Wall Street, a politician who knows his place. 

True or False: “Consumption is 70 percent of GDP”?

Via:  Business Week via CR

An article in Business Week declares that “consumption is not 70 percent of GDP.”

Yes, 70 percent of GDP in recent years has been “consumption” as the government defines it.  And yes, if the saving rate out of disposable income goes up four to eight percent, the consumption part of “consumption” (or some part of “consumption,” anyway, could be discretionary health care spending) will go down. 

So the point has no material bearing on the collapse of consumption spending.

Obama’s deal with big pharma

The United States government has agreed not to negotiate prices with Big Pharma in exchange for support of a health bill.

Here’s what Robert Reich, a Democratic team player, has to say about that.

…

We’ve got a liberal friend from Minnesota visiting who is still arguing that it’s going to be better under Obama because he’s not a Republican.  And I do agree that Bill Clinton and a Republican Congress did the best job in recent memory of managing the economy.

I keep trying to tell her there’s only one party in American politics, the Money Party, and it always wins because it owns the government. 

Sadly, it wasn’t enough that Obama could beat the system (and he really did, and beat the Clintons, too) by raising his own money over the Internet.  What must the man be feeling, if he actually believes anything like his campaign rhetoric?  He’s gone back on what he represented as his basic values, ramping up a stupid war and providing massive welfare for the rich and now caving in to Big Pharma.  Or was it all an act?  I don’t think so.

Head’s up people:  you got to support Congressional candidates with money who will honor your will.  

First, we have to figure out how to get them on the ballot…. I still like the idea of voting out all incumbents until they get the idea….

Will rising “animal spirits” lead to ruin?

With the decline in the unemployment rate this morning, “animal spirits” improved.  We should see improvement in the Michigan Consumer Sentiment Index going forward, although it has slipped a bit recently.  There is noise in all economic series.

Click on chart for larger image in new window.

Even with unemployment climbing to about 11 percent over the next year, confidence will improve until the A metric (reference) actually becomes positive in time for the election, barring a currency crisis or other catastrophe in the meanwhile.  Confidence is one of the primary drivers of the business cycle.  However, given the double-whammy to consumption I noted yesterday from falling wages and salaries and increased saving, and the collapse of investment demand, growth is likely to be very, very slow.

This is bad news, in my view, as it affords the opportunity for the fiscal and monetary authorities to continue to pile up debt on the backs of American taxpayers.  Bernanke and Geithner will continue to bail out the bad debts of some big banks at taxpayer expense, and Congress will continue to rack up world-war-like deficits.

America can not service the debt load it has now.  Credit market debt is about 375 percent of GDP, higher than it was in 1929 according to reliable estimates.  Consumer and business debt is charging off at high rates likely to get worse.  As government crowds out private borrowing, private defaults can be expected to rise even more.  Since a lot of bad private debt of Wall Street firms is being converted into “good,” “risk-free” U.S. Treasury debt, this amounts to a continuation of the greatest expropriation of the ordinary Americans by the rich interests in American history.  Almost none of the high-rolling Wall Street speculators or their institutions have paid any price whatsoever for their trillions of dollars of bad bets.  (There was Lehman, but that was personal, Hank Paulson’s pet revenge project.)  At some point, demand for the dollar will collapse and rising import prices will drive the standard of living of the average American down even further.

We are watching an empire self-destruct in slow motion.  At the end of this process America will truly be a banana republic, with income and wealth inequality far worse than they are now, a hollowed-out state.  As McKinsey notes in a recent study, the human capital of the American labor force is subpar.  How will we climb back out?  The rich are free to invest their money anywhere in the world.

Only a radical reordering of American priorities in the next couple of years will prevent this.  There is no one who believes the Bush-Obama deficits projected over the next ten years are sustainable.  Ron Paul is the only elected politician who is addressing the scope of the change needed.  Everyone else appears to be playing politics as usual, acting as servants to the rich.  Even a five percent surtax on incomes over $1 million to provide health coverage to the poor has been fought tooth-and-nail by our greedy over-class.  The rich in this country have lost all sense of fiscal fairness in the worst crisis in three generations.  Ron Paul is the only politician of any standing who correctly diagnoses the problem, imperial over-reach inevitably leading to ruin.  As a physician, he has even moderated his libertarian positions to support government-sponsored health insurance for the poor, paid for by ending our futile wars.  I would add to that livable workfare for the unemployed to see them through the crisis, which is likely to last a decade or more.

Finally, is the unemployment report real?  Many would say not.  See TrimTabs’ research (here and here) and ShadowStats.  The Labor Department itself shows a decrease in the labor force of over four million in this decade.  Do you believe none of these folks want jobs?  All they have to do, reputedly, is to stop looking for a month and they’re out of the labor force.  The employment-to-population ratio is dropping sharply.  The government is aware of the psychological impact of the unemployment rate number so they manipulate it to keep it down.  The true unemployment rate is already in the teens.  A growing awareness of this reality may undercut the forecasted rise in confidence levels.

Click on chart for larger image in new window.

The middle way: reprise

Arianna Huffington got a naked capitalism citation for saying that a middle way reflecting neither all-Republican nor all-Democratic boilerplate positions is gaining ground in Washington (after >3 min I can’t find the link; sorry).

Here’s the problem I have with the libertarians: most of them don’t seem bothered by the financial catastrophe impending upon us (and yes, I will address that in the next “animal spirits” update).  From this I infer that they’re relatively well-off for the most part, traders and other rich folk who’d like to keep their taxes low and who don’t give much of a fig for the suffering of the unemployed.  Even Ron Paul has come out recently saying that it would be irresponsible not to provide health care for these folks.  He suggests paying for it by ending our wars.

Here’s the problem I have with the Keynesians like Paul Krugman:  they don’t look at the aggregate debt problem.  They’re advocating more debt to solve a problem of too much debt.  It will sink us.  It’s not just the ratio of federal debt to GDP; it’s the ratio of all nonfinancial debt to GDP that is at record levels of ~375 percent.  The Blue Dog Democrats share this concern.  My position is that we offer (1) health care and (2) a livable dole to the involuntarily unemployed.  These are the best stimulus dollars we can spend; they will be spent wisely.  Let the economy self-organize at the local level.  It’s going to take a long time to reconfigure the economy toward more saving and investment, away from consumption.  Also, helping people out will make them feel better about being Americans, rather than becoming radicalized.

Here’s the problem I have with the Monetarists:  see the above.  Ben Bernanke thinks that lowering interest rates, stimulating credit expansion, and adding to nonfinancial credit market debt is going to help!  When he and Alan (Not-Potty-Trained) Greenspan worried about deflation, didn’t they wonder why they were worrying about deflation?  Deflation happens when asset values get bid out of range by excessive credit creation, and people stop servicing the debt.  Banks reasonably tighten credit standards, and prices decline.  But no!  Greenspan and Bernanke think more credit creation is the answer.  Meanwhile, by keeping interest rates near zero (especially for well-connected borrowers like Goldman Sachs who not only get near-zero interest rates but FDIC guarantees on their debt) the Fed is creating a carry trade that will further distort asset prices and relative values.

Republicans exist to keep taxes low on rich people.  Democrats exist for much the same reason, because of the way elections are funded, but are willing to go a little higher on marginal tax rates on rich people.  It used to be that Democrats were the proven budget-busters, but after George W. Bush, that label no longer applies.  Most of Obama’s deficit is inherited.

The politicians need to come down off their ideological high horses and start taking care of the people. 

A simple outlines of my plan is here, in a letter I sent to my elected representatives:

Dear -----:

America already has more debt than it can handle.  The deficits will sink
the economy into a debt-deflation.

The stimulus, like the banking bailouts, is likely to go to the richest
Americans.  The government is broken.  The stimulus will not help the
people.  It is pork that will go to the well-connected.

America is a basket case.  Here's what we need:

1.  Health care for all, especially the unemployed, and a livable dole for
the unemployed to see them through the long crisis to come.  They will
spend the money taking care of their families and finding new jobs in time.

2.  Higher (much higher) marginal tax rates on the rich who have
manipulated the system to their advantage for so long.  I suggest 75%
rates on income over $1 million.  The rich need to learn to share, to give
back to the country that has treated them so well.

3.  An aggressive FDIC campaign to recognize and charge off bad debt in
the banking system.  Making rich investors whole on the taxpayers' backs
only exacerbates the debt-deflation, and risks turning America into a
neo-feudal society.  Reverse the banking bailouts.  Make Goldman Sachs pay
up—their profits were made with taxpayer money.

4.  Fiscal discipline.  The deficits need to be brought down under 5% of
GDP immediately, and to balance within 5 years.

America is a rich country.  The problem is not the amount of GDP, it's how
it's distributed.  America is now the greatest debtor country.  The
Keynesianism that worked in the thirties will sink us now. The government
is broken and can not be trusted to spend the public's money wisely.

These recommendations don't fit into either Republican or Democratic
molds.  As I used to tell my students, "make the adjustment."  A far worse
depression awaits us if we don't.

It's time for triage.  America is a basket case.

“Keep It Simple, Stupid” would seem to be a good way to go in the current environment.  So many mistakes were made during the Panic of 2008… and opportunistic Beltway insiders stand ready to spin every event to their own advantage.

Stop the bailouts.  Cut the pork.  Take care of the people.  Let the economy self-organize.

Ron Paul: End wars to fund health care

Via:  Raw Story  Ron Paul scores again.  Do it, Congress!

Ron Paul: End wars to fund health care

By David Edwards and Daniel Tencer
Published: July 22, 2009
Updated 2 hours ago

House Rep. Ron Paul may be America’s most famous libertarian these days, but he’s making a surprising concession to progressives when it comes to the debate about public health care.

Though the house representative from the 14th District of Texas still insists that government should get out of the health care trade altogether, he told CNN’s Kiran Chetry on Wednesday that “you don’t want to cut under these [economic] conditions medical care from poor people who have been dependent, or the elderly.

“Even though I have my ideal system I would like to see, with the government out completely — because that would be a much better system — that’s not going to happen. I’m realistic.”

But, the House rep said, “one thing we shouldn’t do is pay for it with money out of thin air,” referring to the federal government’s ballooning deficit.

“So what i would do in a transition … is cut spending somewhere and take care of the people were talking about.”

And to finance health reform, Paul would like to see the US end its overseas military engagements. “I would cut from overseas spending, I would cut from these trillions and trillions of dollars that we have spent over the years and bring our troops home so that we can finance it [health care].”

Paul said that President Obama’s decision to cancel the F-22 fighter jet program was “a first very very minor step … and I applaud Obama for that. But we don’t need one [defense project] removed, we need to change our foreign policy, then we could afford the health care that is necessary to tide us over until we come to our senses and believe that freedom can deliver medical care much better than a bureaucracy.”

‘MAKE LOVE NOT WAR’

Paul continued his anti-war theme when CNN host Kiran Chetry asked him about RonPaulSingles.com (”We put the ‘love’ in revolution”), a dating website for Ron Paul followers.

“It sort of fits a famous slogan that I sort of liked, which says ‘Make love not war,’ so maybe that’s what they’re thinking about doing,” Paul said.

Click through link on headline for video at Raw Story.