World Politics

[Oldman]

The Post Office is withering much like the health care industry would if nobody ever got sick anymore.

USPS posted a $3.8 bil loss this year. I think that's down from years prior because they shed that yellow-clad piece of .....
Considering the economic situation and that USPS is a Federal bureacracy that's probably a stellar performance. United Parcel is paying dividends but don't handle bulk mail, which is mostly junk. Don't know where all that ends up.

 

[Anonymous]

http://money.cnn.com/2009/11/16/news/companies/US_postal_service/index.htm

No, wait a second....

Good thing Lance got his before the downturn.

But there's also this;

http://jec.senate.gov/republicans/public/_files/Are_Health_Care_Reform_Cost_Estimates_Reliable__July_31_2009.pdf



I realize some will look at this and dismiss it because of where the info comes from, but it is either correct, or incorrect. If it is correct then the cost estimates coming from the administration are likely not accurate.

This reads like a bad novel...

Medicare (hospital insurance). In 1965, as Congress considered legislation to establish a national Medicare program, the House Ways and Means Committee estimated that the hospital insurance portion of the program, Part A, would cost about $9 billion annually by 1990.v Actual Part A spending in 1990 was $67 billion. The actuary who provided the original cost estimates acknowledged in 1994 that, even after conservatively discounting for the unexpectedly high inflation rates of the early ‘70s and other factors, “the actual [Part A] experience was 165% higher than the estimate.”

Medicare (entire program). In 1967, the House Ways and Means Committee predicted that the new Medicare program, launched the previous year, would cost about $12 billion in 1990. Actual Medicare spending in 1990 was $110 billion—off by nearly a factor of 10.

Medicaid DSH program. In 1987, Congress estimated that Medicaid’s disproportionate share hospital (DSH) payments—which states use to provide relief to hospitals that serve especially large numbers of Medicaid and uninsured patients—would cost less than $1 billion in 1992. The actual cost that year was a staggering $17 billion. Among other things, federal lawmakers had failed to detect loopholes in the legislation that enabled states to draw significantly more money from the federal treasury than they would otherwise have been entitled to claim under the program’s traditional 50-50 funding scheme.

Medicare home care benefit. When Congress debated changes to Medicare’s home care benefit in 1988, the projected 1993 cost of the benefit was $4 billion. The actual 1993 cost was more than twice that amount, $10 billion.

Medicare catastrophic coverage benefit. In 1988, Congress added a catastrophic coverage benefit to Medicare, to take effect in 1990. In July 1989, the Congressional Budget Office (CBO) doubled its cost estimate for the program, for the four-year period 1990-1993, from $5.7 billion to $11.8 billion. CBO explained that it had received newer data showing it had significantly under-estimated prescription drug cost growth, and it warned Congress that even this revised estimate might be too low. This was a principal reason Congress repealed the program before it could take effect.

SCHIP. In 1997, Congress established the State Children’s Health Insurance Program as a capped grant program to states, and appropriated $40 billion to be doled out to states over 10 years at a rate of roughly $5 billion per year, once implemented. In each year, some states exceeded their allotments, requiring shifts of funds from other states that had not done so. By 2006, unspent reserves from prior years were nearly exhausted. To avert mass disenrollments, Congress decided to appropriate an additional $283 million in FY 2006 and an additional $650 million in FY 2007.


If the cost estimates are off by a factor of 9 (like medicare) with the plan that passed through the house then we a looking at a program that will cost at least 12 trillion dollars (if my math is correct). Perhaps this is not a fair comparison but it seems to me we have been down this road before... like Yogi Berra said, "it's like deja vu all over again."

 

[Alpe d'Huez]

Please point to something this govt does well, efficient, cutting edge and world class. What evidence is there the govt can do this and do it well?

Well done. I'm not ready to conceed regarding NASA and efficiency, but admittedly it would be hard to measure as no one else does what they do.

Any others?

NOAA. GPS. NTSB. FAA. CDC. NPS. USAF. USCG. NRC. etc.

Plenty more, at least when reasonably well funded. There may be flaws with many, but not all government departments buy $400 hammers, and have employees sitting around doing nothing.

Thus, the friendly, though vastly underpaid and undermanned, staff at Minuteman National Historic Park, counts as well in my book as running very well. Same with most similar places.

Frequently it isn't so much the problem with the government departments themselves, it's how the money is appropriated by Congress, often under pressure from lobbyists who help craft bills. It's not so much the people working there that's the waste. The four biggest costs in the Federal budget are Social Security, Medicare/Medicaid, Defense, and interest on the debt. The departments I list above are teeny tiny by comparison, pennies on your tax dollar, and not that wasteful at all - comparable to the private sector.

Is Medicare/Medicaid wasteful, as a whole? Compared to the private sector? In some ways, definitely (Part D). But let's also keep an eye on the alternatives. You seem to be thinking it should all be cut, all of it. What a nightmare world that would be.

Thus, this cuts both ways. I can also point to plenty of private companies that have been completely run into the ground, and ripped a lot of innocent people off. So can you. Would you want Georgia Pacific in full control over the US forest and national park systems? How about ValuJet/Sabertech in charge of airline safety? Jeffery Skilling heading the NYSE with no SEC oversight? Tyler Hamilton heading up a private version of USADA?

 

[usedtobefast]

i do believe the feds built the Federal Highway System.
they also run FAA.
also FDA.
I do not want private companies involved anywhere in public safety regulation
and enforcement.
the government does things in a not for profit manner. here in the usa you would be squashed like a bug if private industry was like it used to be.

 

[Anonymous]

NOAA. GPS. NTSB. FAA. CDC. NPS. USAF. USCG. NRC. etc.

Plenty more, at least when reasonably well funded. There may be flaws with many, but not all government departments buy $400 hammers, and have employees sitting around doing nothing.

Thus, the friendly, though vastly underpaid and undermanned, staff at Minuteman National Historic Park, counts as well in my book as running very well. Same with most similar places.

Frequently it isn't so much the problem with the government departments themselves, it's how the money is appropriated by Congress, often under pressure from lobbyists who help craft bills. It's not so much the people working there that's the waste. The four biggest costs in the Federal budget are Social Security, Medicare/Medicaid, Defense, and interest on the debt. The departments I list above are teeny tiny by comparison, pennies on your tax dollar, and not that wasteful at all - comparable to the private sector.

Is Medicare/Medicaid wasteful, as a whole? Compared to the private sector? In some ways, definitely (Part D). But let's also keep an eye on the alternatives. You seem to be thinking it should all be cut, all of it. What a nightmare world that would be.

Thus, this cuts both ways. I can also point to plenty of private companies that have been completely run into the ground, and ripped a lot of innocent people off. So can you. Would you want Georgia Pacific in full control over the US forest and national park systems? How about ValuJet/Sabertech in charge of airline safety? Jeffery Skilling heading the NYSE with no SEC oversight? Tyler Hamilton heading up a private version of USADA?

That's not my position, although I sincerely believe private industry is a better fit for some things the govt is involved in (education for example). What I'm asking is why in the heck would we want to nationalize something as massive as our healthcare when we there are mulitple examples of how ineffiecient it will be (ala medicare)? By your own admission it would be a "nightmare" to cut these massive govt entitlements so why create yet another one?

I've never stated private industry has all the answers and is perfect. But I do believe there are free market solutions that will address the cost and access issues without creating a massive new bureaucratic apparatus. I also believe they will never see the light of day because a better system is not this administrations goal. A public system is, for better or worse.

 

[Alpe d'Huez]

Cost is indeed a huge issue. And I think that's where you and I agree. About 20 pages ago you lamented the size of the cost of all this, when we already have a massive debt load we can't pay for dragging things down. That is the one area where all this really concerns me.

Over ten years ago now, twice actually, the Balanced Budget Amendment came close to passing, and I fully supported (and still support) such a bill. It's a shame it came so close to passing, and now, there seems like no chance. Both parties are just so used to spending money they don't have. Whether that's for health care, bailouts, contracts to KBR/Haliburton, or even small perks. etc.

 

[Anonymous]

Cost is indeed a huge issue. And I think that's where you and I agree. About 20 pages ago you lamented the size of the cost of all this, when we already have a massive debt load we can't pay for dragging things down. That is the one area where all this really concerns me.

Over ten years ago now, twice actually, the Balanced Budget Amendment came close to passing, and I fully supported (and still support) such a bill. It's a shame it came so close to passing, and now, there seems like no chance. Both parties are just so used to spending money they don't have. Whether that's for health care, bailouts, contracts to KBR/Haliburton, or even small perks. etc.

I'll drink to that. Cheers

 

[Laszlo]

Well done. I'm not ready to conceed regarding NASA and efficiency, but admittedly it would be hard to measure as no one else does what they do.

Any others?

national security; building of roads and highways ( contracted out, but unlikely to be done as extensively by private business concerns )

 

[Laszlo]

justice system....there is no way you can do that privately; it is world class that a person be he homeless be able to force a government to concede a point on rule of law; the lawyers and judges might be overpaid; there certainly is corruption amongst local police etc. but the FBI has fought and took down mafia bosses, governors, senators etc etc; they are part of the justice system and justice is something we all rely on to keep our society from going "postal".

 

[scribe]

Speaking of judicial system. US is set to try Kahlid Shek Muhammed (too lazy to look up the spelling) and a few others as criminals. Thank god! What a revelation. And they are doing it blocks from the WTC site.

 

[CentralCaliBike]

justice system....there is no way you can do that privately; it is world class that a person be he homeless be able to force a government to concede a point on rule of law; the lawyers and judges might be overpaid; there certainly is corruption amongst local police etc. but the FBI has fought and took down mafia bosses, governors, senators etc etc; they are part of the justice system and justice is something we all rely on to keep our society from going "postal".

Agreed, I do believe we have the best system in the world today. Not sure about the overpayment part (I know a lot of defense attorneys that do much better economically than the local judges and certainly the prosecutors), but for the most part the jury system gets it right.

 

[CentralCaliBike]

Speaking of judicial system. US is set to try Kahlid Shek Muhammed (too lazy to look up the spelling) and a few others as criminals. Thank god! What a revelation. And they are doing it blocks from the WTC site.

I have to ask, should we appoint attorneys for every prisoner of war who commits war crimes and set trial within the normal 60 day time limit? The judicial system is designed to deal with criminals acting within the national borders, it is not designed to prosecute active war criminals during the course of war.

 

[Anonymous]

Speaking of judicial system. US is set to try Kahlid Shek Muhammed (too lazy to look up the spelling) and a few others as criminals. Thank god! What a revelation. And they are doing it blocks from the WTC site.

I sure hope you are joking. If not, a pitiful comment.

 

[scribe]

No I am not kidding. Better than letting them be tried in the various countries from which they belong. Better than keeping them in detention indefinitely without trial. They might seem like enemy combatants, but that is not so easy to define and assign jurisdiction, seeing as they subscribe to a twisted ideology as opposed to a sovereign state.

Might as well do this right here and issue punishment. Hopefully, life behind bars in a very very quiet place from which they are never seen nor heard from again.

 

[CentralCaliBike]

Might as well do this right here and issue punishment. Hopefully, life behind bars in a very very quiet place from which they are never seen nor heard from again.

You do not seem to know how the judicial system works - just because there is a trial does not mean the defendants will automatically be found guilty. Their statements will be inadmissible since they were not given attorneys before questioning. And, if they follow all the other constitutional guarantees, it is possible that most of the other evidence would be suppressed as obtained without warrant or probable cause.

 

[Anonymous]

Who would have thought a sitting US President would be having this kind of discussion with (communist) China?

http://blogs.reuters.com/james-pethokoukis/2009/11/16/china-questions-costs-of-us-healthcare-reform/


"Guess what? It turns out the Chinese are kind of curious about how President Barack Obama’s healthcare reform plans would impact America’s huge fiscal deficit. Government officials are using his Asian trip as an opportunity to ask the White House questions. Detailed questions.

Boilerplate assurances that America won’t default on its debt or inflate the shortfall away are apparently not cutting it. Nor should they, when one owns nearly $2 trillion in assets denominated in the currency of a country about to double its national debt over the next decade.

Nothing happening in Washington today should give Beijing any comfort or confidence about what may happen tomorrow. Healthcare reform was originally promoted as a way to “bend the curve” on escalating entitlement costs, the major part of which is financing Medicare and Medicaid. That is looking more and more like an overpromised deliverable."

Imangine a scenario where China stops loaning the US govt money?

Furthermore, imagine a scenario where China continues to loan the US govt money?

Now, imagine the drastic reduction in the quality of life for future generations that are paying ridiculous amounts of US GDP in debt service. Imagine what the effective rates of taxation will be. Change we can believe in? Not so much.

 

[Bala Verde]

You do not seem to know how the judicial system works - just because there is a trial does not mean the defendants will automatically be found guilty. Their statements will be inadmissible since they were not given attorneys before questioning. And, if they follow all the other constitutional guarantees, it is possible that most of the other evidence would be suppressed as obtained without warrant or probable cause.

yeah, wouldn't it be ironic that if due to the previous government's legal erring to an extent that seems humanly impossible this criminal could potentially get a pass on many charges, because certain fair trial requirements have been violated. Very scary...

Well I guess that's what could be in the barrel when you mess with rule of law. (The system is so good that some do-gooders felt compelled to export it to other countries, in lieu of WMDs).

I see a headline: "Bush/Cheney allow murderers to have weekend passes"

On the other hand, have some faith in the judicial system, which is after all the greatest in the world.

 

[Cobblestones]

That's just wrong. Legitimate claims are paid (per insurance contract) or insurance co's are shut down. Every state has a department of insurance (or an equal) who investigate claims made against insurance co's every day. Insurance co's don't make a profit by only paying as few claims as possible. But let's assume you are correct. Exactly how will this change when you insert the federal govt into the equasion? Do you really see big payouts for litigation when there is a federal single payer system in place? Where will the cost containment come from and where is there any evidence that govt can do this?

There are some problems between insurers and defensive medicine practices. When insurers know tests and procedures were redundant for appearance reasons then they have a problem. But, who forces defensive medicine? Tort reform a small issue? Bullocks.

Federally funded research is hardly federal run anything. Federal apparatus is medicare, social security, veterans admin, etc. Problems with any of those?

The military is many things, but efficient? Nope.

Read this blog. It's by a Princeton economics, published by the NYT. Excerpt:

One thing Americans do buy with this extra spending is an administrative overhead load that is huge by international standards. The McKinsey Global Institute estimated that excess spending on “health administration and insurance” accounted for as much as 21 percent of the estimated total excess spending ($477 billion in 2003). Brought forward, that 21 percent of excess spending on administration would amount to about $120 billion in 2006 and about $150 billion in 2008. It would have been more than enough to finance universal health insurance this year.

It was part of a series of 7 entries, published about 1 year ago. The last part is about reigning in physicians. Not surprisingly:

on average, physicians who have a direct financial interest in the use of imaging services, like CAT scans or M.R.I. scans, recommend far more such services for their patients than do physicians without such financial interest.

Tort reform is small compared to this, but by all means, let's do tort reform as well. I'm not opposed.

 

[CentralCaliBike]

yeah, wouldn't it be ironic that if due to the previous government's legal erring to an extent that seems humanly impossible this criminal could potentially get a pass on many charges, because certain fair trial requirements have been violated. Very scary...

Well I guess that's what could be in the barrel when you mess with rule of law. (The system is so good that some do-gooders felt compelled to export it to other countries, in lieu of WMDs).

I see a headline: "Bush/Cheney allow murderers to have weekend passes"

On the other hand, have some faith in the judicial system, which is after all the greatest in the world.

That is the reason you do not have the judicial system involved in trying war criminals - and why we do not appoint attorneys and have a trial when holding prisoners of war.

I mentioned earlier we have the best legal system, however, it is designed to handle criminals with the borders for individualized, and occasionally small group, crimes.

 

[Cobblestones]

This is what I really wanted to post today:

Can our legislators be bought? A case study. I say it again, this is the cancer which destroys America. Legislators need money to get re-elected. Interest groups provide the money. Legislators are more beholden to interest groups than their constituents.

 

[Anonymous]

Read this blog. It's by a Princeton economics, published by the NYT. Excerpt:

It was part of a series of 7 entries, published about 1 year ago. The last part is about reigning in physicians. Not surprisingly:

Tort reform is small compared to this, but by all means, let's do tort reform as well. I'm not opposed.

I'm not arguing some (many?) physicians are corruptable. Defensive medicine is practiced as a business strategy to combat potential future litigation. This is a circular argument.

As a side note, I'm not sure accuracy or truthfulness is absolute when relying on information from the NY Times.

 

[Anonymous]

This is what I really wanted to post today:

Can our legislators be bought? A case study. I say it again, this is the cancer which destroys America. Legislators need money to get re-elected. Interest groups provide the money. Legislators are more beholden to interest groups than their constituents.

Yes. This system is broken, and has been made worse by McCain/Feingold.

 

[Laszlo]

I have to ask, should we appoint attorneys for every prisoner of war who commits war crimes and set trial within the normal 60 day time limit? The judicial system is designed to deal with criminals acting within the national borders, it is not designed to prosecute active war criminals during the course of war.

They are not prisoners of war; no formal war between nations was declared where al queada was concerned. a uniformed soldier is accorded some rights when they are captured or surrender; not to be tortured, to be humanily housed, clothed, fed, no forced labour- it is a minimum that is expected of both sides in a conflict between nations. Spies and soldiers operating not in a recognizable uniform have no such rights- it has been this way since at least the napoleonic wars. These terrorists ( barring specific circumstances ) are in a legal limbo of their own making- they are quite lucky to have recieved such fairness as they have already; and they will be given fair trials with excellent defense lawyers; something their victims did not, including soldiers, security personel and civilians who surrendered were later tortured and killed with utmost barbarity. It is the laws of the United States that forced the bush administration to keep al queada prisoners off american soil- again a real testiment to the strength and power of the american constition, american bill of rights, and the authorities that enforce it.

 

[Laszlo]

Yes. This system is broken, and has been made worse by McCain/Feingold.

we can argue that greed alone is the fly in the ointment of free-marketeers; principled people are the ones who help keep our society functioning

 

[CentralCaliBike]

They are not prisoners of war; no formal war between nations was declared where al queada was concerned. a uniformed soldier is accorded some rights when they are captured or surrender; not to be tortured, to be humanily housed, clothed, fed, no forced labour- it is a minimum that is expected of both sides in a conflict between nations. Spies and soldiers operating not in a recognizable uniform have no such rights- it has been this way since at least the napoleonic wars. These terrorists ( barring specific circumstances ) are in a legal limbo of their own making- they are quite lucky to have recieved such fairness as they have already; and they will be given fair trials with excellent defense lawyers; something their victims did not, including soldiers, security personel and civilians who surrendered were later tortured and killed with utmost barbarity. It is the laws of the United States that forced the bush administration to keep al queada prisoners off american soil- again a real testiment to the strength and power of the american constition, american bill of rights, and the authorities that enforce it.

I don;t disagree, except to say that it is a huge mistake to have these cases set for trial in the criminal courts - they are not designed for this type of prosecution (specifically the rules of court).