General Question

Brian1946's avatar

Will the health care reform bill reduce government expenditures in the long run? If so, how?

Asked by Brian1946 (23719points) March 22nd, 2010

If I remember correctly, according to the CBO it will.

I’m somewhat happy that it passed (I wish it included more coverage for abortions and I favor a single-payer system), but I’d like to know the details on how it will reduce those expenditures.

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39 Answers

missingbite's avatar

No. If you think it does, name one government run program that is under budget.

Fenris's avatar

it’s supposed to even it out by stamping out overspending in some areas and making up the rest through non-taxation revenue generation. I haven’t finished reading the final product, so I couldn’t tell you the post-public option method of generation.

rebbel's avatar

Shit, clicked the Health Care Reform-tab by mistake again…

cockswain's avatar

According to the CBO, it will reduce our annual deficit by $130 billion. I also hear the statement “it will save $1.3 trillion over ten years” which I assume is the deficit savings x10. It has an upfront cost of $940 billion and (I think) won’t start reducing the deficit for at least 5 years. That is a major point of contention since we have such an enormous national debt right now ($10 trillion). The reason it makes economical sense though, is because health care spending is increasing at something like 7–10% per year, and if we do nothing it will be like 40% of GDP in about 30 years (I might have that year wrong, sorry). Currently it is about 16% of GDP. In 1960 it was 5%. This bill is a major first step in tackling this problem. Similar reform needs to happen with social security, because that will begin to owe more than it takes in in the next 7 years, and then will begin depleting a trust fund, and then is predicted to not be able to keep up with promised payments by roughly 2041. So it and health care (and by extension, medicare, which is another big problem) both require substantial reform to prevent us from running annual deficits, the negative balance of which adds to our debt each year. The problem is these are not politically popular topics to tackle, as you’ve seen.

thriftymaid's avatar

No. I just heard there will 100 new beuracracies. I don’t know if that’s inflated—sure hope so. The states are getting hit with increased Medicaid funding which none of them can afford.

josie's avatar

Same way government expenditures decreased with Social Security, Medicare, the EPA, etc. It won’t. They just say it will in order to make it sound good now. Just wait.

galileogirl's avatar

Think of those 30 million going to the Dr when they first get sick instead of the emergency room and hospitalization when the are very sick. By the govt picking up insurance costs, the county hospitals and local taxpayers won’t be paying many thousands.

Think of the loss of productivity and the effect on the economy of an unecessarily sick workforce.

Think of the effect of competition on the insurance oligopoly with a govt option or single payer systrm (coming soon.

missingbite's avatar

@galileogirl Which doctors will they go to? We have a shortage already. Your words “by the govt picking up insurance cost”, you do realize that the government doesn’t have any money except from taxpayers. So I am picking up the cost along with the local taxpayers you seem to think won’t be paying.

galileogirl's avatar

Local govts spend billions on treating uninsured who could have been treated at the beginning of their illness before it became critical. That ‘shortage of Dr’s’ thing is an 11th hour dissimulation. How about nurse practitioners to do the gen’l wellness stuff? How about offering scho;arships and loan rebuctions so medical school is attainable for more people. How about not just thinking how it is but instead how it could be. That’s what made America great

missingbite's avatar

@galileogirl We have a shortage of nurses, Dr’s, PA’s, everything. Who pays for the scholarships and loan reductions? All of those sound great but they cost money. I agree we need to think about how it could be but entitlement programs didn’t make America great. It’s hardworking citizens did.

galileogirl's avatar

Then let’s get more, we’re going to need them as the population ages anyway. The uninsured will get medical care whether it is in a Dr’s office with a bad cough and a prescription or in the emergency room and hospital with pneumonia. Which do you think is more cost effective?

cockswain's avatar

How do you recommend we incentivize people to become doctors, etc… at a faster rate to match the growing demand?

galileogirl's avatar

Like I said, make a medical education more economically attainable and with the use of technology, structuring of responsibilities. Do I need to keep repeating these things or do people enjoy the problems so much they can’t see solutions.

cockswain's avatar

Sorry I made you repeat part of of one of your statements one time. Why are you so cranky?

missingbite's avatar

@galileogirl Please tell us HOW you make the education more economical. If it can be attained great. I don’t see it happening without costing taxpayers more money. Do I need to keep asking?

cockswain's avatar

@missingbite That’s what I was driving at, more specifics. Perhaps there can be loan reductions/forgiveness for working their first 5 years at reduced pay? Perhaps shorter schooling but longer internships? This way they’d at least function at a PA level and could help out.

missingbite's avatar

@cockswain Those sound like good ideas and we need to look into all of them. The problem I see is that loan reductions/forgiveness cost somebody money like the banks who loan. Wait, student loans were part of the health care bill, more government control. See where this leads? I am all for health care reform. Just not in the direction we took it with this health care bill.

I work in the airlines. I transport people all over the world, even doctors. My education was over 100K. Why don’t I get reduced loans or forgiveness? See where this goes?

Where do we stop with entitlements. And now that the Dems have made it clear that health care is a right, which I disagree with, where do we draw the line? You can’t deny me the doctor I choose, it’s my right! You can’t tell me I can’t have a procedure I ask for, it’s my right! So what if I’m 97 and it’s expensive, I want my knee replacement, it’s my right!

How much will this cost the American taxpayers, which account for less than 60% of the population?

Name one government entitlement program that has come in under budget or reduced cost like it was intended to do. Medicare, broke. Medicade, almost broke. Social Security, broke in a couple of years. Post office, broke. DMV, total cluster at almost every site.

This country is now over 12 Trillion dollars in debt and about to be 14 Trillion in debt. We can’t continue. This is no longer a Republican/Democrat issue. WE ARE BROKE.

This post is not entirely directed at @cockswain so please don’t think I am directing it at you. I just used your name as a response with my first paragraph.

cockswain's avatar

Oh boy. I hear this so much now it’s becoming a cliche: I am all for health care reform. Just not in the direction we took it with this health care bill.. Yet I never hear strong alternatives to this reform. I hear the Republicans claim they weren’t invited to participate, and I hear they added like 200 amendments to the bill. The current bill is way watered down from what I would have preferred, and is hence compromised. Obama tried to work with the right, but they appear to be more interested in regaining power and just unified against the bill, regardless of content. But this could be argued as opinion. Either way, I see this bill as an important first step and will be adjusted, modified, and amended like Soc Sec has been over the years.

Regarding entitlements, it is clear (to me) health care is important enough to warrant gov’t subsidies to stimulate supply of doctors. If you think health care is a privilege, not a right, we have a fundamental difference of philosophy. What else do we actually have in life besides health? I’d rather make $20,000/yr and be able to snowboard than be a billionaire but wheelchair-bound. Because someone is 97 they don’t get to choose to get a new knee? What’s wrong with us paying more taxes to take care of the elderly? I’m fine with losing another $100 a month for that. I view health care as much a gov’t responsibility as I do police and fire. But you’re entitled to believe otherwise.

Assuming your 60% number is correct, that is not the only source of gov’t revenue. Young and retired people alike pay sales tax, and there are plenty of fees and fines out there as well.

The programs you mention I agree are in need of current reform, as I mentioned in my first post. “Broke” isn’t the right description as it implies zero income, but those systems will have promised expenditures exceed income, reducing payouts or increasing debt. No argument here. The post office isn’t a good example as it is self-sustaining.

I hear you on how disgusting our debt is, but where was the outrage during the Bush tax cuts? That was what cranked the debt way up.

galileogirl's avatar

I SAID grants and debt forgiveness if they serve in needed specialties or geographic areas. We’ve done this effectively in the past to get the professionals we need. How to pay for it? Stop supporting the for-profit “tech” schools that can cost $30–40,000 to get a job that pays $12/hr.

Naysayers try opening your minds to possibilities-that’s the true American Way.

missingbite's avatar

@galileogirl Oh boy. I hear this so much it’s becoming cliche: Republicans/Democrats. Bush tax cuts… We inherited… The last 8 years.

I agree, Bush made a bunch of mistakes. Get over it. Obama is making many more larger ones. History will show who is right. You and I will disagree.

“Broke” does not imply zero income. If Imake $100,000.00/year, spend $200,000.00/year and keep spending more with no more income, I’m broke. Unless I have assets to get rid of. What else do we sell China/Japan. Our land? All they are buying right now is our debt. Try living that way and having ANYBODY loan you more money. It is unsustainable and that is what we are doing.

I’m sorry to be the one to break it to you but the ONLY source of income for the government is from the people. You even mentioned it your post. Tax is a tax, fees are a tax, and fines are a tax. My point of the 60% is that is who pay all of the federal income tax. The only way to make the health care bill work will be to add a VAT like Europe. Very costly, mostly to the poor and middle class and it still may not work. It has yet to.

We will disagree about tax cuts. You can blame bush if you want too but I believe it has been proven that when you reduce tax, the money collected by government goes up. Here is a link that will explain it to you. Increased taxes stifle growth. Except possible more government jobs.

cockswain's avatar

Obama did not cut taxes to the point of doubling our debt, while funding a debatable war. One could argue reducing taxes may have helped us get out of the minor recession at that time, but not three rounds of tax cuts. The last of which only passed by reconciliation b/c even Republicans thought it was crazy. But tax cuts are good for politics, increases are not. Bush was not an economist, by his own admission.

But I agree, that complaining about it doesn’t help the problem now. I think it is important to be clear on how we got here and not blame Obama. Obama had no choice to sign the stimulus bill, and Bush signed one several months before him. Obviously Obama did not want to ring up the debt, he’s very intelligent.

Regarding our out of control spending, I agree completely with you. We as Americans get to enjoy a lifestyle we have not actually earned. We are funding it with borrowed money, and increasing the borrowing. Further we exploit the hell out of other countries to fund our rampant consumerism because we have the power to do so. Yes, lack of sustainability is a huge problem and it will one day create major environmental and economical problems. But did you personally get in an uproar during the Bush years about this same problem? For some reason conservatives are now attacking the left for doing what they did. That is just a bunch of bs politics.

It’s semantics whether we define fees and fines as taxes or separately. I don’t care about that debate. I’m not so simple-minded as to not know the bulk of gov’t revenue comes from people. I’m sure the gov’t invests too in foreign exchange markets and has other investments, but I know little about that.

I’m also familiar with the tax curve. But do you think we are at the maxima of that curve right now? I don’t.

Overall, I don’t have a problem having my taxes raised to help get us out of this dilemma. Health care reform is non-negotiable to me, regardless of cost. I consider it a moral issue, even though the economic issues are very important to consider as well. But the CBO says this will reduce the deficit, and any comparisons to other gov’t programs, while possibly relevant, aren’t proof this will be the same.

@galileogirl I hope you aren’t calling me a nay-sayer. I’m just trying to get a discussion going about possible ways to improve the incentives for doctors. You keep offering little nuggets of ideas (ideas I like), then sort of insult us in the next sentence. Besides, you did not actually say ”grants and debt forgiveness if they serve in needed specialties or geographic areas”

missingbite's avatar

@cockswain You are both correct and incorrect with your first statement. Bush didn’t cut taxes to the point of doubling our debt. His out of control spending doubled out debt. Something Obama has expanded. His spending.

Heath care is non-negotiable for you and that is fine. We will disagree on whether or not it should be a right or privilege. I will stand by my idea that it is a privilege. If you feel so strongly that it is a right, why do I not have the right to opt out of it? Because this bill is not about health care but about control.

cockswain's avatar

Sure, I’ll agree with that. The out of control spending and reduced tax revenue doubled the debt. But how come you won’t give Obama any slack on signing the stimulus bill? Most economists say we’d have likely entered a depression if not for that. Japan did too little over too long a period of time and suffered what is known as “the lost decade.” I grant that cranking up additional spending for health care isn’t wonderful at this time, but what about the fact that it will start saving us money? Please look at some of my comments in my first paragraph where I talked about how health care with be 40% of GDP if we do nothing. Again, if not this bill, how would you have reformed health care, and when?

Your final point makes sense to the extent that you shouldn’t ever be forced to do something against your will. But isn’t that how it is with all our taxes? It’s just taken out of your paycheck, you don’t get to negotiate. I’d prefer to skip registering my car, but if I don’t DOT loses revenue.

Besides, are you saying you would like to not have health care? What if you break your leg, do you just make a splint and get on with your life? Who doesn’t need health care?

missingbite's avatar

@cockswain I can’t agree with the stimulus for the same reason I didn’t when GB signed one. It was aimed at the wrong thing. Kind of like GM and the auto fiasco. I don’t believe GM was too big to fail. I feel like this country needs some really hard times. The great depression led to our fathers and grandfathers to become savers. They are now frugal while my generation is gimme gimme gimme. I deserve this and that. I don’t think we do.

Some believe “the lost decade” could have been shorter if they did nothing. Why is it that Japan is now doing what we did during Regan? They are freeing up economics while we are going in the opposite direction. Japan is moving toward privatization of the Post office of all things under Junichiro Koizumi. He is getting Japan out of the mess that his country was in.

I didn’t say I don’t want health care. I am saying that I will do anything in my power to have it at my own will. I have seen with my own eyes homeless people who have no health insurance talking on cell phones. College kids doing the same thing. Not everyone is like that and we need to take care of the ones who aren’t. However, why do my taxes go up to cover the ones that can and choose to spend their money in other ways. Responsibility is huge with me. Entitlement programs lead to more entitlements. That is what the word means. I am entitled to it. I believe you earn it. If I didn’t have health care, I wouldn’t be typing on a computer that I couldn’t afford.

cockswain's avatar

But you realize without reform even you won’t eventually be able to afford your premiums. And most plans have a $1 million lifetime maximum. So if you need heart surgery and there are complications, you’ll probably hit $1 million quick. What then? What about everyone with that problem? I just assume everyone is SOMEONE’s loved one and feel they should be treated with the same way I treat my loved ones. It isn’t exactly entitlement to help those people, just like we wouldn’t say they aren’t worthy of police intervention when someone is kicking the crap out of them.

I’ll have to research the Lost Decade more, I’m no expert. I agree with your first paragraph in principle, and try to live similarly. However had the credit markets froze, we both know what would have happened.

I’ll ask again though, how do you recommend health care reform should look? That’s why I’m sick of the cliche: I like reform, but not this bill. No one has actually stepped up and provided a rational alternative to getting the ball rolling on reform.

missingbite's avatar

@cockswain I don’t think I said I didn’t want reform. I do. I will list a few ways to start the reform by copy/pasting something I wrote in another thread. Here goes:

As for the fixes because I know someone will say all I can do is say the bill is bad and not offer solutions so here goes. Why didn’t we start with zero cost items to see where it led? Open up state lines and let insurance companies compete. (0 cost) Pass real tort reform. This will keep doctors from running sometimes unnecessary tests just to cover their butts from a law suit. (0 cost) Pass legislation that allows people to group together for group benefits. (0 cost) These are just three things that have at least little or no cost to taxpayers. Another idea is to sell bonds like we did during WWII. I know that sounds a little crazy but try it and see where it leads. We have to think outside of the box. Look at the money we as Americans sent to Haiti. Anyone who thinks the golden rule is dead hasn’t looked at the Charities we give to in this country. (feel the link to responsibility coming?)

I know that people are going to say none of these will work. I know people will say, those greedy rich people who make huge profits won’t donate. I disagree. Bill Gates is giving away his entire fortune. Most Americans who can afford it, donate some of their income. Set it up to see if we can change health care like this before we start another entitlement program that really is more about control over the people than it is about health care.

Someone will read my post and think, Republican/Democrat! Drop that thinking. Both parties have failed us. Think FISCAL RESPONSIBILITY FOR OUR COUNTRY. We can’t afford to keep giving people things regardless of their income level. That sounds harsh I know. But, it’s like most of our parents taught us, we all take care of things we have a vested interest in. That is why kids who buy their own first car usually take care of it more than the spoiled rich kid who gets a BMW for their 16th birthday. I know that is a generalization but it typically applies.

On top of that let me point out what is wrong with parts of this bill that in theory sound good. All of these cost the taxpayer money.

The first thing that comes to mind is the “Children until 26” part. What this does is extend the amount of time for a “Child” to face the real world. How does that hurt you ask? Well, I’m 22 and have my own apartment. I get my first job, and I can either have that new iPhone and also a new computer with high speed internet access. Total cost $175.00/month. Or I can get health insurance. Oh wait, I can stay on my parents until 26. I might as well get that new car now because In 4 years it will be paid for and I can then buy health insurance. What this provision will do for some people, not all, is help them get to a point that by the time they are 26, they will be in debt and need the government for help. I mean, why not? It is a right to have medical care. Just don’t take my iPhone.

The second, If you own a business and you employ 50 full time people, you must offer healthcare or we will have 16,000 shinny new IRS people fine you. My family is in this position. The business does not make them “rich” and their income is below $200,000.00/year. We will either start losing money, or close. Wait, we have a better idea. We create another company, channel 49 people under one and 49 under the other. The customer doesn’t even know it happened. To them it’s all one company. Now we have 98 full time employees instead of the 109 we used to have. Where did the other 11 go? Unemployment. Please don’t hate us it was the lesser of two evils. And don’t think this not going to happen to a lot of companies. If we only had 62 employees, we would lose 13.

The US needs health care reform. No doubt. This bill is not health care reform. It a control bill.

On a side note, and only my closest friends know this about me, I help others pay for health care for a 13 y/o girl b/c her family can’t do it. So please don’t think I am some heartless person with no morals. No one on here has accused me of that but I’m sure some think it. No one on here knows me so I don’t care but…Not all Conservatives are bad people who hate the poor and want to neglect people. Most of us just wish more Americans took care of their own responsibilities before looking to the government. For those that can’t, Most Americans will help. Trust me, if this girls family had flat screen tv’s and cell phones, she may not be getting her insurance either.

galileogirl's avatar

@missingbite This entire answer was about you and your personal experience. I am not at all surprised that you are 22 based on the callowness of your post. So your parents make less than $200,000. You do realize that most people your age have families making less than $60,000 and they are trying to make it through public colleges that are so overcrowded and understaffed that it is nearly impossible to graduate in 4 years. It is made more difficult when tuition and fees are going up 2½ times the cost of living so that you only have the choice of getting into debt up your eyeballs or work 30 hours a week. Then you find the BS or BA is not enough because you are competing against people with advanced degrees.

Listen, Junior, the age of 21 or 22 wasn’t just pulled from the air. That was the average for completing one’s education. That no longer is true. You might find it worthwhile to observe and understand how most people live with incomes under 6 figures before you announce you expertise.

missingbite's avatar

@galileogirl Wow, you know everything. For your info. I’m not 22. That was a hypothetical. I’m 39. I went to school. Got out $42,000 in debt and am now debt free. I have not lived under my parents since I was 17 when I moved out to live on my own. I have worked since I was 14 and saved a portion of my income since the first paycheck. (mowing lawns) I currently make about $55,000.00/year and save about 35% of that per year. I’m debt free except a mortgage and live well within my means.

You may want to “learn” that you don’t know everything. Nor can you read a post and know much about me or anyone else. My entire post was not about my experience. It also gave ways to reduce the cost of health care that are cost neutral.

You don’t like what I say so you talk down to me? “Listen, Junior”? How dare you? Your ignorance is unbelievable. Please show me where I have talked down to anyone on here. I have stated opposite opinions, and that is it. So you attack me thinking (incorrectly) that I’m 22 and must be callow? I would be willing to bet I do more for the underprivileged both monetarily and physically then you could possibly fathom. But I disagree with your view so I must need “to observe and understand how most people live with incomes under 6 figures”. Been there, done that, still doing that.

That’s right…..you have the expertise. Whatever your age, grow up.

missingbite's avatar

@galileogirl One more thing to clarify. I don’t work for my family either. If you search Fluther you will see I am in the airline field. Just because I am related to people who own a business, it doesn’t mean I slack off living under them. So before you go off on another rant explaining to me how my job isn’t real because I must work for my mommy and daddy, I don’t. It’s not even my parents company.

cockswain's avatar

easy, buddy. She’s a crusty old barnacle but she makes great points sometimes.

missingbite's avatar

@cockswain I think you make great point too. I’m sure she may. You and I were having a great debate. I actually had to stop and rethink some of my ideas from your points. I didn’t change my mind, but that is what make this country, and Fluther, great. I’m not even sure she read my whole post. I’ll calm down. Thanks for the reminder. And GA.

cockswain's avatar

It is a good debate. You’re way more reasonable than a lot of conservative-minded people on this site. We’re of like mind on many points. I’ll get back to it tomorrow, I’m reading a biography about Paul Volcker.

missingbite's avatar

Sounds great. I’m off to sleep. And thanks for the compliment. I try to be open minded as you seem to be too.

galileogirl's avatar

@missingbite Then I guess you are a fibber. From your post “Well, I’m 22 and have my own apartment” “My family is in this position. The business does not make them “rich” and their income is below $200,000.00/year” Is anything you write true? Since you don’t respect the t5ruth, how can we respect you or your ideas?

@cockswain Is that one of my good points?

missingbite's avatar

@galileogirl If you have never heard of examples, i’m sorry. They aren’t “fibbing”. That is what it was. My point of you flaming me was that you can’t read a persons intent. The example of a hypothetical 22 y/o stands. Some 22 year olds will think that way.

The example of my family was real. They are family members, not me specifically. Again, hard to decipher on anonymous forum. Ask questions before you flame.

You have no idea if I “respect the truth” or not. You read one post and assumed something about me. (incorrectly) Don’t assume. I don’t.

BTW, as a “dedicated, caring Teacher”, do you speak down to your students the way you did me when you thought I was 22? If so, maybe that is the reason our education system is almost last in the world.

Amazing.

galileogirl's avatar

My students know the difference between “I’m 22” “If someone was 22” In fact you didn’t sound as mature as my students who are more honest and thoughtful than the imaginary you. Occasionally, I run into a 17 yo libertarian. I treat him (always him) kindly because I have faith he will outgrow it by 22.

missingbite's avatar

@galileogirl Apparently you’re not very bright so I hope you’re students are.

galileogirl's avatar

Ooh, namecalling!! lol

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