ObamaCare to Cost More Than Expected? Where Have I Heard This Before?

Today, as Nick Gillespie noted earlier, Washington is shocked, SHOCKED to learn that the Affordable Care Act might not be as easy to pay for as promised. According to an AP summary, a new report "found that the law falls short of the president's twin goal of controlling runaway costs, raising projected spending by about 1 percent over 10 years. That increase could get bigger, since Medicare cuts in the law may be unrealistic and unsustainable, the report warned."

But didn't budget-hottie Peter Orszag warn us not to be swayed by such obviously false charges? After all, ObamaCare is fiscally responsible! What clan of knee-jerk critics could have produced such a report? The libertarians at Cato? The conservatives at Heritage? The neocons at AEI? The socialists at Physicians for a National Health Plan?

Try again: This is the word straight from the Obama administration's Health and Human Services Department, the agency assigned to manage the reforms at the federal level.

Nor did the report's bad news stop there. It also "projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, 'possibly jeopardizing access' to care for seniors."  So when the President told AARP members that "nobody is talking about reducing Medicare benefits," presumably he meant nobody but, um, Medicare's chief actuary. But that doesn't really count, does it?

Of course, at this point, if we discount the claims of any agency or news organization that has expressed caution or concern that the law might not work as promised, we have to throw out the Congressional Research Service, the Joint Committee on Taxation, the New York Times, the L.A. Times, and The Hill, just to name a few. In the days since the Affordable Care Act's passage, reports from government agencies and mainstream news organizations have started to ask many of the same questions—and come to many of the same conclusions—that were asked by critics of the law in the year before it was passed.

Just look at the New York Times. Since the law's passage, the Grey Lady has reported that New York state's efforts to regulate insurance companies drove premiums through the roof and destroyed the market—and an individual mandate, which the state lacked, is a theoretical fix at best. The paper of record also reported that the law may not actually bring down costs for the sick, that the law was hastily and confusingly written (enough that it may deprive Congressional representatives and their staffs of health care coverage), that it may not help all the tough-luck cases it was supposed to resolve, and that health insurers may soon be turned into de facto public utilities.

The details vary somewhat, but cumulative picture is one that's broadly in line with what critics have been arguing since the first legislative drafts became available (at least). Rather than offer true reform for our country's health care system, ObamaCare takes a dysfunctional mess and makes it even more dysfunctional, and at greater cost.

I noted the failure of state regulations here, expressed skepticism about the law's cost estimates here, and looked at the dire fiscal effects of state coverage expansions here.

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  • Valerie Jarrett||

    You'll love it once we've fixed it!

  • ||

    We had to pass the law to find out what's in it!

  • The President||

    The sky didn't fall, the world didn't end...

  • Satan||

    Remember your soul though, Barry. I still have a lease with an option to buy!

  • ||

    Clearly someone is spoofing Satan here.

    If Barry had a soul it is certainly already bought and paid for.

  • Anita Dunn||

    ^What he said.^

  • ||

    The sky didn't fall, the world didn't end...

    The only true criteria by which to judge legislation.

  • Chantor||

    That will make up a nice chant as he is leaving the white house in 2013.

    "The sky didn't fall, the world didn't end ... we're still here, and you're not." (That doesn't rhyme does it. Oh, well.)

  • ||

    OK, maybe the sky has started falling, but it won't actually hit you until after 2012.

  • Brett||

    No but there aren't any organ transplants done in Saskatoon.

  • ||

    That picture of Orszag looks like the top of his skull has been removed and he's waiting for someone to toss some change in there...or something.

  • ||

    Is it just me or does he look like he is wearing a bad wig?

  • ||

    Couldn't look more fake if it had a chinstrap.

  • ||

    Either way, he has one HELL of a punchable face!

  • ||

    It looks more like he finished all of his peas and is waiting for mommy to praise him.

  • cynical||

    It just looks kinda dorky to me, not really the face of a smug asshole.

  • Ragin Cajun||

    I can clearly see why he is such a hit with the ladies.

  • Ashton Lux||

    I am just SHOCKED! He has been honest this whole time, and now he goes and pulls a stunt like this! He's gonna hafta go onna Idol or something to get back his credibility with his ignoramous constichents.

  • Hank||

    I am just SHOCKED! He has been honest this whole time, and now he goes and pulls a stunt like this! He's gonna hafta go onna Idol or something to get back his credibility celebrity with his ignoramous constichents.

  • ||

    *snort*

    Don't expect any mea culpas.

    Within a week, the meme will be blaming the problems on them eeevuul libertarians.

  • ||

    That's understandable, since we're the ones in charge of the whole thing.

  • ||

    Did you know that libertarians are the closest thing to National Socialists in modern America? Didja?

  • ||

    Sounds like a scam to me.

  • ||

    Yep. The LP, for instance, is actually just a front for Coca-Cola.

  • ||

    So it should be COCA-COLA-TOPUS?

  • ||

    Few realize that the Constitution is a massive fraud perpetrated by Coke in order to cover the fact that it actually rules America. The head of Coke is legally our monarch.

  • ||

    I see. So that is why your line has started the breeding program for the Libertatezits Hadarach, Pro'L Dib.

  • ||

    You remembered! I'm so touched.

  • ||

    Aresen|4.23.10 @ 11:37AM|#
    "*snort*
    Don't expect any mea culpas.
    Within a week, the meme will be blaming the problems on them eeevuul libertarians."

    Oh, no. It'll be a 'failure of the market' requiring new regulations.

  • ||

    Certainly, but doncha no that its them eeevul libertarians who have been promoting the market and supporting big corporashuns?

  • T||

    And we keep pushing deregulation, which causes all of the ills of society.

  • Johnny Longtorso||

    If you were enlightened enough to give us what we wanted, we wouldn't have had to lie to you to get our way. This is all your fault, you anti-government teabagging extremists.

  • ||

    I thought I had read somewhere that Orszag was stepping down soon to spend more time with his families.

  • Drax the Destroyer||

    Hindsight is so bittersweet. Let's see how much bitter it gets when we get to experience the effects of this "landmark" legislation.

  • Tim Cavanaugh||

    So what kind of medicine does Dr. Orszag practice?

  • hurly buerhle||

    I expect to see him in a commercial with Dr. Dre and Gene Simmons any day now.

  • ||

    So what kind of medicine does Dr. Orszag practice?

    Voodoo

    http://en.wikipedia.org/wiki/Peter_Orszag

  • ||

    I'm sure it involves latex gloves.

  • ||

    Tim it involves this handy chart, but alas he himself is no practitioner or medicine.

    If he was an MD/DO, he would be sued for malpractice STAT!

  • ||

    Appropriate in that Orszag looks like he was carved from a giant hunk of bleached shit.

  • hurly buerhle||

    This just in: apparently the laws of economics, logic, and mathematics still hold.

    That is all.

  • The President||

    And we're working hard to correct that.

  • Albert Einstein||

    Apparently you have not heard my quote regarding insanity....

  • ||

    Eventually medicare will have to be cut or restructured. Everyone knows that. Now, the cuts will just be blamed on obamacare. That dumb ass just signed the Democrats up to get blamed for the entitlement train wreck that is coming.

  • ||

    Sorry, that is not the way it works, politically.

    The rubes have been promissed their unicorn and they damn well expect it.

    The Dems will blame "the rich" for preventing every loser receiving his "rights."

    I've seen this movie before.

  • ||

    The Dems promised a unicorn. And they promised one without a single Republican vote for cover. When the unicorn doesn't appear, there will be no ducking the blame.

  • ||

    Logically, you would think it ought to be so.

    But the rubes are not going to listen to "I told you so", they are going to listen to the politician who will promise to "improve it." The Dems will play the "Republicans are trying to cut your medical coverage" card every time.

    I know this because, as a Canadian, I have watched the same sort of thing happen here for the last 30 years.

  • ||

    We are not Canadians. Seriously, the US is not Canada. And we are not going to go quietly into the socialist night the way Canada and the UK did.

  • melman||

    yes, you will

  • ||

    Right.

    Tell me who in the US is actively pursuing a serious reform of Social Security. Obamacare will be just as much a sacred steer. (I'd say 'sacred cow', but you can get milk from a cow and 'sacred bull' would imply that there are balls present.)

    United Statesians are no different from anybody else when it comes to demanding that their unicorns shit rainbows.

  • ||

    I'm reluctantly with Aresen on this one. We're less inclined to socialism than our Canadian and European friends, but we're well down the path. I think the chances of us turning things a different direction are pretty small.

    Still, we do have a hard core of opposition to big government here, which may save us from things getting much more ridiculous. I honestly don't know.

  • ||

    Time will tell. But there are few things that bug me more than defeatism. And further, I think it is a grave mistake to underestimate this country. I guess that is why I think we will turn it around. I refuse to believe that Americans are as a group a bunch of lazy welfare queen communists. And I can't understand how any Libertarian could honestly believe such a thing.

  • ||

    A significant portion of this country either doesn't care, wants the government to solve all possible problems, or wants to force people to act a certain way, regardless of silly ideas like rights. That's a serious obstacle to stopping the madness.

  • ||

    Drink!

  • Bertha Lewis||

    Tell it, brother John! Tell it! TELL IT!!!

  • ||

    Obamacare will not be a sacred cow. It has gotten more unpopular since its passage. And unlike Social Security, it doesn't hand out any checks to anyone. It does the opposite, it just screws people.

    Stop whining and feeling sorry for yourself.

  • ||

    Social Security screws people too. But it's presented as a wonderful program that gives people money, and to get past that illusion requires a willingness to look a gift horse in the mouth that most people understandably don't have.

  • ||

    Social Security is loved because the middle class rightfully see it as the only thing standing between them and having to care for their parents. Social Security and Medicare are middle class entitlements. That is why they are so popular and hard to tame. Obamacare is nothing of the sort. It screws the middle class in both the short term and long term. That is why it is politically doomed. Who is going to love it? Insurance companies? The poor who don't get the free care they thought they were going to get? Seriously, who?

  • Mike Laursen||

    Good point. It's important to distinguish between entitlements for the poor (vulnerable) and entitlements for the middle class (invulnerable).

    In the case of Obamacare, the Democrats' fatal mistake may be putting off many of its provisions until 2014. That's four years before any of the middle class starts viewing themselves as being dependent on it.

  • ||

    They had to do that to get a decent CBO score. Ten years of taxes paying for six years of benefits.

  • LibertyGal||

    John, don't you think the insurance cos' are going to love receiving 30 million more premiums each and every month than they do now?
    Also, the pharmaceuticals are going to love it because they (as well as the insurance cos.) are at the price-fixing table, rather than taxpayers (who are not special interests beneficiaries), or patients, or doctors. You watch, the expensive chemo treatments will be approved @ 100% of market price, while other payments, like office visits, pap smears, labs and non-profitable drugs (like antibiotics) will not. Chemo sales make up 85% of BigPharma revenues.

  • ||

    Social Security screws people too. But it's presented as a wonderful program that gives people money

    It does give most people money. It just borrows it from future generations, and can only be paid for with a constantly expanding population of young workers.

    That it reduces the incentive to have kids (since one reason to do so is to have someone to care for you in your dotage) is extra icing on top of the silliness.

  • Mike Laursen||

    Social Security basically provides time-shifted income to middle-class people of retirement age. This libertarian could live with such a system, if the money were actually invested, or at least if the government would stop raiding the fund for other purposes.

  • ||

    Americans are a bunch of fat docile cyrbabies looking for a handout. End of story. Don't fool yourself, the sponges (and their collaborators) are now the majority and they call the shots.

  • ||

    There are important differences between the US and Canada/UK, but I fear they won't be enough to stop creeping socialism. The main obstacles present here that were not present in those countries are the existence of a Constitution written (unlike UK) by people who were skeptical of govt power (unlike Canada), and the more decentralized nature of our federal structure. Unfortunately these safeguards are being continually eaten away at by those in power with complicity on the part of the people in general.

  • Lock & Load||

    "There are important differences between the US and Canada/UK, but I fear they won't be enough to stop creeping socialism."

    We respectfully disagree.

  • LibertyGal||

    Obamacare is really corporatism disguised as socialism. With the insurance cos. and BigPharma on the price-fixing Advisory Committee, those industries' prices will be more advantageous to them than the 'free' market is now.

  • ||

    John Edwards was right when he said there were "two Americas"--just not in the way he meant. I don't know which one will win the fight but it's going to get ugly.

  • ||

    Who the fuck is talking to who in this thread within a thread within a thread?

    Ye gods, I hate this damned system.

  • ||

    Sounds like a scam to me.

  • ||

    It's scams all the way down.

  • Mike Laursen||

    Ooh, that is so quotable.

  • ||

    You can usually figure it out from the timestamps, actually.

  • ||

    Dude, I'm at work. I don't have time to do such things.

  • ||


    Pro Libertate|4.23.10 @ 12:53PM|#
    Dude, I'm at work. I don't have time to do such things.

    Nominally at work, anyways. ;P

  • ||

    I'm very efficient.

  • ||

    Who the fuck is talking to who in this thread within a thread within a thread?

    It's not that hard to figure out. The system just has a maximum number of indentations it allows.

    More people could blockquote if they wanted, of course.

  • Pip||

    "More people could blockquote if they wanted, of course."

    Takes too long.

  • ||

    And blockquoting can be abused in horrific ways.

  • ||

    Who the fuck is talking to who in this thread within a thread within a thread?


    It's not that hard to figure out. The system just has a maximum number of indentations it allows.

    More people could blockquote if they wanted, of course.


    "More people could blockquote if they wanted, of course."

    Takes too long.


    And blockquoting can be abused in horrific ways.

    Such as?

  • ||

    The rich? You mean the people who pay all the taxes for this stuff? Screw 'em.

  • Drax the Destroyer||

    "That dumb ass just signed the Democrats up to get blamed for the entitlement train wreck that is coming."

    They were playing Russian Roulette with the Republicans for the blame. Either way, someone gets shot in the head.

  • ||

    Usually the taxpayers.

  • ||

    That dumb ass just signed the Democrats up to get blamed for the entitlement train wreck that is coming.

    This is a game of musical chairs, where each party hopes to avoid having to do anything unpopular about the entitlement catastrophe while it is in power. We will see the can kicked down the road until the system well and truly collapses into a fiscal black hole.

    Whichever party has the bad luck to be in power at that point in time will get the blame.

  • ||

    Obama hasn't yet been blamed for any of the economic problems that have occurred during his term.

  • ||

    Really? Then how is his approval rating so low? He is in the 40s right now. What will he be if people start blaming him for something? The teens? I think people are starting to blame him for his ineffectiveness. Every day that goes by, he owns the economy just a little bit more.

  • Gilbert Martin||

    "Just look at the New York Times. Since the law's passage, the Grey Lady has reported that New York state's efforts to regulate insurance companies drove premiums through the roof and destroyed the market—and an individual mandate, which the state lacked, is a theoretical fix at best."

    Since the law's passage, eh?

    Gee, I wonder why the NTY just couldn't find the time to do this kind of reporting BEFORE the law was passed.

  • NY Times||

    Oopsie!

  • ||

    I'm fluent in three sections!

  • Jamie Kelly||

    I have the death penalty in five systems.

  • ||

    It's death sentence in 12 systems.

  • ||

    You'll be dead!

  • Jamie Kelly||

    Come now. My little cock is not worth it. Now let me finger-fuck your mother.

  • ||

    Your days of finger fucking me through my pretty pink panties, are over!

  • ||

    That's "finger-banging", puke. Now drop and give me twenty.

  • Jamie Kelly||

    One more for the corps! ... I guess the corps don't get theirs.

  • ||


    Star Wars Pedant|4.23.10 @ 12:05PM|#
    It's death sentence in 12 systems.

    Death by immersion in bantha poop is the only fitting punishment for Star Wars Pedants.

  • ||

    May you be frozen with Nancy Pelosi in carbonite while receiving fellatio from her Sarlaac vagina, you horrid Canuck!

  • ||

    Cspan's Washington Journal waited until after the bill passed to have a segment on the state of Massachusetts' failing model for Obamacare.

  • Pip||

    Of course they did. That way, they get ObamaCare AND take out Romney.

  • creech||

    This government report is obviously seditionist. Arrest those who don't tow the party lion.

  • ||

    So it may increase a whopping 1% over 10 years?

    Holy Cow! Let's all jump off a building.

  • ||

    Go ahead. It will save the cost of keeping you alive.

  • ||

    "So it may increase a whopping 1% over 10 years?

    Holy Cow! Let's all jump off a building."

    He's just pointing out that there's a leak in the argument there--by their own admission. Nobody saying that's the end of the argument...

    "Nor did the report's bad news stop there. It also "projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, 'possibly jeopardizing access' to care for seniors."

    That's also in addition to...

    And the argument doesn't stop there either. There's a lot of trees he can point to. And when you put all those trees together?

    That's called "a forest".

  • Warty||

    “Faavrogg!” Smith cried out, “See if you can stabilize that asternatium by vogalizing the tyricnal klinbirators!”

  • ||

    This, oddly enough, is very similar to weaning a child off of breast milk.

  • ||

    So it may increase a whopping 1% over 10 years?

    That's the best case scenario, which also assumes (among other things) pretty steep Medicare cuts.

  • ||

    Which is why now is the time to get out of CMS. I feel very sorry for future med school grads.

  • ||

    Duh!

  • ¢||

    I'm sure it involves latex gloves.

    He makes a show of putting the gloves on, but you don't have eyes where he's going.

  • Brian||

    This is all going exactly according to plan.

    Next up, Price Caps

  • melman||

    surprisingly, paying all the medical expenses of tens of millions of people costs money

    it is rather shocking

  • ||

    "Nor did the report's bad news stop there. It also "projected that Medicare cuts could drive about 15 percent of hospitals and other institutional providers into the red, 'possibly jeopardizing access' to care for seniors."

    Just for the record?

    I think this is what some of us were talking about in that thread a few weeks ago, about the losses inherent in Medicare and Medicaid not being evenly distributed among providers.

    And since that's the case, I wouldn't expect Seniors to be the biggest losers of access, especially if they live in an area where a relatively large percentage of the population has private insurance...

    The biggest losers of access to healthcare that way will be poor people in poor neighborhoods, where relatively few have insurance through their employers.

    Hospitals that go into the red because of Medicare and Medicaid reimbursement determinations must be the ones who are most vulnerable because they have so few private insurance patients, isn't that so?

  • ||

    I wouldn't expect Seniors to be the biggest losers of access, especially if they live in an area where a relatively large percentage of the population has private insurance...

    Though a LOT fewer seniors are going to have private insurance as well, thanks to cuts making Medicare Advantage a fool's game.

  • Paul||

    And since that's the case, I wouldn't expect Seniors to be the biggest losers of access

    No one will lose access. They will just lose healthcare. Or more accurately, they won't get healthcare.

  • ||

    I worked at a private hospital as it was shut down in the '90s. It's a lock down psych ward now.

    It went under because there weren't enough people in that neighborhood with private insurance to make up for all the money we lost treating people on Medicaid.

    The people in that community lost an emergency room to go to. Doesn't matter what the price of care was, they no longer have access to that resource at any price.

    They lost access.

    As we expand Medicaid to cover millions of more people who don't pay for care, hospital losses will expand proportionately. If ObamaCare goes as it's presently constructed, urban neighborhoods will lose more emergency rooms the same way. People will lose more access.

    It won't happen in Orange County. But it will happen in Central Los Angeles.

  • ||

    Hospitals that go into the red because of Medicare and Medicaid reimbursement determinations must be the ones who are most vulnerable because they have so few private insurance patients, isn't that so?

    That's one part of it Ken. The other, which is why this fool's dream was even started, is cost shifting from indigent patients, especially those that use the ER as their primary source of care.

  • Pip||

    So when some poor person without insurance loses a few toes in a lawnmower accident, will they be going to the limp-in Walmart clinic or the ER?

  • ||

    Good news: Whereever they go, it will have plenty of Bactine.

    Bad news: don't expect your toes sewn back on.

  • ||

    Pip, there's a difference between a legitimate emergency and using the ER as a primary care physician.

  • ||

    I'm sure it will soon be revealed that the HHS numbers were ginned up by Bush-era appointees.

  • MP||

    2016 - Obamacare is in full effect, SS is running a deficit, Medicare is running a deficit. Guess the Mayans were off by four years.

  • ||

    LOL, surely no one is surprised by this latest discovery LOL

    Lou
    www.anonymous-vpn.tk

  • ||

    I guess this makes Lou Anonbot smarter than every lefty in the country

  • Mike M.||

    Everybody notice how MNG and the other left-wing douchebags are nowhere to be seen now that this "news" has come out?

  • Pip||

    MNG can't talk right now. His mouth is stuffed full with my cock.

  • ||

    " So when the President told AARP members that "nobody is talking about reducing Medicare benefits,"

    Well, nobody in his administration was TALKING about it. And nobody denied that they were going to de facto REDUCE medicare benefits.
    Geez, you guyz are dumb...

  • Jesse Jackson||

    Don't end it, mend it.

  • Paul||

    This is what happens when you leave healthcare up to the market.

  • ||

    Reason Magazine has the best reader comments on the Internet. So freaking funny but unfortunately 99.9% correct. Thanks to all who contribute, you've eased my pain.

  • .||

    Lefty sites are populated with thin-skinned, angry and utterly clueless big-government apologists. That kind of worldview is not conducive to wit.

  • Paul||

    "This world is a comedy to those that think, a tragedy to those that feel" -- Horace Walpole.

  • Forrest||

    You're welcome.

  • tim in vermont||

    Obviously the answer to not having enough general practitioners or PCPs is to cut their reimbursements even more, then open the med schools to the level of students who now become journalists and teachers.

  • Sam||

    Frustration with this constant deception will reach the point where the 'i' word will surface sooner than later. I challange anyone to substantiate a past president who has been as deceitful and maligning as this president has been in only his first 18 months in office.

  • ||

    Plain and simple: Obama is either a liar or a fool. My money is on both.

  • bcl||

    The Democrats never cared about the cost at all. They can say that they enacted universal health care--their holy grail for decades. Hospitals will go under and access will decline gradually, so it will be hard to pin it on them. Even if it can be pinned on them, it will be years down the road, and the universal health care toothpaste won't go back into the tube.

  • ||

    George W. Bush is the worst person in the world for making the cost of this bill exceed our dear leader's promises.

  • EscapedWestOfTheBigMuddy||

    Love the alt texts.

  • ||

    Health care reform is failing. But that isn't because the bill was wrong, you libertarian fanatics, it just didn't go far enough. The dems will cure everything with another reform bill, probably single payer. Simple dem program, pass a bill enormously expanding government, then when it fails, propose a cure, involving yet more government.

  • Dave K||

    Maybe the chief actuary's nickname is "Nobody".

  • replica watches||

    good post

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