46 replies to this topic

[ZaraKitty]

Wearer of Hats, on 10 July 2012 - 10:49 PM, said:

which is much how we do things here in Australia, which is why people like me and Zarakitty can'r quite wrap our heads around the American objection to "socialised medicine".

Thank you!  Haha someone understands my confusion

RavenHawk, on 10 July 2012 - 03:34 PM, said:

Fair enough.  I know what you mean.  I’ve got a lot of replies to make in this thread alone but my work load today will make that prohibitive.  The particular reply is post #318 at: http://www.unexplain...c=228254&st=315.  Now I would also ask that you read the body of my work in this thread if you want to fully understand.  I have repeated myself a few times but you will see how passionate I am on the subject and I think I have been very clear.  In another thread, Karmakazi has said it so eloquently : “Socialist ideals aren't bad, but a socialist government is opressive... this is because the ideals should be held by the people and the people should be freely allowed to share with their fellow countrymen instead of being forced or controlled.”  This is the same concept that Wearer of Hats has expressed with the idea of Socialism at the village level.  This is how we live naturally between each other and that’s the way is should stay.  It doesn’t work when it is dictated from the government level.  That is oppression and enslavement.  Part of American Exceptionalism is our duality.  We are fierce individualists but at the same time willing to go that extra mile for a stranger.  Which basically shoots down what ninjadude was saying and when I find time to thoroughly read his links, I’ll try to expand more on why it is wrong.  Americans are both “The Private” and “The Public”.  But the key here is that it is driven from the people, not the government.

I'll get to reading it It's massive! You are passionate indeed

Aus Der Box Skeptisch, on 10 July 2012 - 09:07 AM, said:

Full fledged socialism doesn't work. Like communism it looks fantastic on paper. Unfortunately people abuse everything for gain or power and in the end neither would work in its entirety. Now to capitalism ... uggh. Capitalism is a great way to begin as a country but it cannot sustain itself long term. IMO. Eventually it begins to divide the haves and the have-nots. As we currently are witnessing in the USA right now. As they say the rich get richer the poor get poorer and middle disappear.

On to the OP lets try a different tactic here. Lets list the things we agree with.
Ill start by saying I agree that preexisting conditions should not disqualify you from insurance.
example:
My step sister was just starting a new job. And benefits would not become available for 90 days then she could get insurance. She was picnicking in Minnesota and afterwards saw a discoloration around a spot on her leg. A few days later the leg became soar and she became somewhat ill. She went to a clinic and was told the spot on her leg was from a tick and she was diagnosed with lymes Disease. She became very ill with pain as she moved and lost her job. She tried getting medical from the state as she was now unemployed and was told due to her recent diagnosis she is now considered to have a preexisting condition and for whatever reason was denied insurance. This seemed odd to me. She called up in tears not knowing what to do. She easily could have died. She was lucky though she found a doctor willing to take her in at no charge. This doctor was specializing in lymes disease and was starting a practice in the twin cities. My sister was lucky. For two months she was told nothing could be done and no one would even look at her. Essentially they were saying please just die quietly your not insured. She wanted to be though and to me this is an important part of this legislation.

Thats.. just awful! I'm so glad that doctor saw her free of charge! What a wonderful man!

[Aus Der Box Skeptisch]

ZaraKitty, on 11 July 2012 - 02:33 AM, said:

Thank you!  Haha someone understands my confusion



I'll get to reading it It's massive! You are passionate indeed



Thats.. just awful! I'm so glad that doctor saw her free of charge! What a wonderful man!

If I recall correctly I think it was a woman. Either way though.... what a wonderful person. And I'd like to add that the effort of the doctor paid off. Its been almost two years without any returning symptoms !! It effected me so much because my sister-in-law had asked my wife and I to take care of her daughters if she passed. My sis in in her twenties and that's just not something you should ever have to consider especially if there is a way to cure the ailment... so I grab on to this legislature with both hands gripping as tight as I can and if I do have to pay a little more then maybe I can take comfort in knowing there will be children out there who still have a mommy because she wasn't denied insurance.

[Aus Der Box Skeptisch]

ZaraKitty, on 11 July 2012 - 02:33 AM, said:

Thank you!  Haha someone understands my confusion



I'll get to reading it It's massive! You are passionate indeed



Thats.. just awful! I'm so glad that doctor saw her free of charge! What a wonderful man!

If I recall correctly I think it was a woman. Either way though.... what a wonderful person. And I'd like to add that the effort of the doctor paid off. Its been almost two years without any returning symptoms !! It effected me so much because my sister-in-law had asked my wife and I to take care of her daughters if she passed. My sis in in her twenties and that's just not something you should ever have to consider especially if there is a way to cure the ailment... so I grab on to this legislature with both hands gripping as tight as I can and if I do have to pay a little more then maybe I can take comfort in knowing there will be children out there who still have a mommy because she wasn't denied insurance.

[Render]

RavenHawk, on 10 July 2012 - 03:49 PM, said:

All I see are the downsides to Socialism.  There is nothing appealing what so ever.  In Capitalism, the rich are suppose to get richer.  That is how it is suppose to work.  But it's not that the rich and poor are going in opposite directions.  They are heading in the same direction just that the rich are rising faster.  And because of that the poor have a higher quality of life.  Even the poor in this nation are better off than 80% of the rest of the world.  That is a direct consequence of the rich in this nation.  Now, it is in your hands as to how far up you can go.  If you are unable or unwilling to climb any further, you still have a better quality of life with the rich getting richer than having no rich at all.  Socialism makes everyone equal in poverty.  You saw this in East Germany and you are seeing it in Europe.

this is probably the most dilusional post i've read in a while

the poor are heading in the same direction of the rich?? oh really? tell that to the next guy you find standing on a bridge cuz he can't pay for the operation of his lil girl

the whole problem with America right now, and the rest of the world, is that the gap between rich and poor is getting BIGGER. Did you not pay attention these last couple of years?

The poor in America are better off than 80% of the rest of the world??????????? OMG this proves yet again you know nothing about the rest of the world, cuz you got that bit of math totally backwards.
Thanks to the social security net in a lot of countries the poor get a chance to bounce back, this is not the case in America...hopefully thanks to Obama it will be.
Socialism in France for example is doing exactly what you think America is like right now, the rich helping the poor .. getting everyone equally well off that is, not equally poor.

words can not express your arrogant blindness. You are one of the reasons ppl say Americans are irrational and don't understand the rest of the world, you don't even understand your own country, not by a long shot. And it's cuz of ppl like you the rest of the world doesn't know who will win the elections, cuz everyone doubts the intelligence of the american ppl, thanks to the backwards logic you are expressing.

[Aus Der Box Skeptisch]

RavenHawk, on 10 July 2012 - 03:49 PM, said:

All I see are the downsides to Socialism.  There is nothing appealing what so ever.  In Capitalism, the rich are suppose to get richer.  That is how it is suppose to work.  But it’s not that the rich and poor are going in opposite directions.  They are heading in the same direction just that the rich are rising faster.  And because of that the poor have a higher quality of life.  Even the poor in this nation are better off than 80% of the rest of the world.  That is a direct consequence of the rich in this nation.  Now, it is in your hands as to how far up you can go.  If you are unable or unwilling to climb any further, you still have a better quality of life with the rich getting richer than having no rich at all.  Socialism makes everyone equal in poverty.  You saw this in East Germany and you are seeing it in Europe.

ah yes remnants of the trickle down economics myth.
The rest of the post was answered quite nicely by the person above me.

[ZaraKitty]

Render, on 11 July 2012 - 05:06 AM, said:

this is probably the most dilusional post i've read in a while

the poor are heading in the same direction of the rich?? oh really? tell that to the next guy you find standing on a bridge cuz he can't pay for the operation of his lil girl

the whole problem with America right now, and the rest of the world, is that the gap between rich and poor is getting BIGGER. Did you not pay attention these last couple of years?

The poor in America are better off than 80% of the rest of the world??????????? OMG this proves yet again you know nothing about the rest of the world, cuz you got that bit of math totally backwards.
Thanks to the social security net in a lot of countries the poor get a chance to bounce back, this is not the case in America...hopefully thanks to Obama it will be.
Socialism in France for example is doing exactly what you think America is like right now, the rich helping the poor .. getting everyone equally well off that is, not equally poor.

words can not express your arrogant blindness. You are one of the reasons ppl say Americans are irrational and don't understand the rest of the world, you don't even understand your own country, not by a long shot. And it's cuz of ppl like you the rest of the world doesn't know who will win the elections, cuz everyone doubts the intelligence of the american ppl, thanks to the backwards logic you are expressing.

You sir are right on so many levels.
The poor Americans are dying on the streets, the poor Australians are getting free health care and a place to live and money in the bank. I wonder who has the better quality of life?
They scream to be individuals, but in the adult world it really gets you nowhere, it get's you begging for money on the street to see a doctor, it gets you squatting in an abandoned house to keep out of the rain. I'd rather let the government help me out, my pride would be better served allowing someone to help me, rather than dying a beggar.

[RavenHawk]

Render, on 11 July 2012 - 05:06 AM, said:

this is probably the most dilusional post i've read in a while

What’s delusional is seeing how you are championing Socialism.  You are truly brainwashed.  If things stay on the course they are now, I’ll be saying I told you so but you’ll be in a state of denial that you wouldn’t be able to see your nose in front of your face.

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the poor are heading in the same direction of the rich?? oh really? tell that to the next guy you find standing on a bridge cuz he can't pay for the operation of his lil girl

Life is unfair, get use to it.  How ‘bout the guy standing on the street that decided to stop feeling sorry for himself and figured a way to get that operation…

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the whole problem with America right now, and the rest of the world, is that the gap between rich and poor is getting BIGGER. Did you not pay attention these last couple of years?

Yes, I paid attention.  Yes, I noticed how the Democrats have brought down our economy to turn it into a Socialist European Utopia.  But in 116 days that will stop.  You haven’t happened to notice the collapse in Greece, Portugal, Italy, Spain, etc?  The lack of austerity?  This is unsustainable.  You do realize that?  Do not pass go – do not collect $100.  The wealth is slowly flowing away.

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The poor in America are better off than 80% of the rest of the world??????????? OMG this proves yet again you know nothing about the rest of the world, cuz you got that bit of math totally backwards.

Look at the poverty levels in India, China, Africa, Middle East.  Then look at our poor that squander the wealth they do have access to.  The Wealthy here have created a level of quality that these other nations cannot match.  These other nations cannot help their populations as we can here.  Despite the wealth redistribution that does occur here our poor have a better time making ends meet at a sustaining level.

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Thanks to the social security net in a lot of countries the poor get a chance to bounce back, this is not the case in America...hopefully thanks to Obama it will be.

How many nations actually have a “SS net”?  Most of it is just wealth redistribution which only helps short term and ends up throwing that wealth down the toilet.  Wealth redistribution only shows that people that pass out dole do not understand the meaning of money and its importance.  Money is not something to just throw at a problem.

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Socialism in France for example is doing exactly what you think America is like right now, the rich helping the poor .. getting everyone equally well off that is, not equally poor.

Are you talking about the rich that give to charities or how the government dictates and steels wealth from the rich to give to the poor?  One reason the poor are poor is because they can’t manage what they do have.  Giving them more is just funneling that wealth down a drain.  So taxing the rich more is just depleting their wealth and dispersing it.  And that makes us all poorer.  To make a difference, wealth needs to be concentrated, not redistributed.  Dole is just a means to diffuse the wealth and that is unsustainable because this process does not recycle or generate more wealth.  SS here is going to be broke by 2033 (est).  That’s not quite a hundred years.  What do you think Obamacare will look like in a hundred years?  Have you been paying attention to what is going on in Europe?  Countries are going broke and people don’t want to give up their Entitlements.  France just upped the tax rate on the rich to 70%.  All that will accomplish is to chase off business and those that stay are going to hunker down at a level in which the rich will get richer but no one else will.  In hard times the rich are willing and capable of living at a certain level and still be content and not worry about anyone else.  Jobs with good salaries will not exist.  Eventually, this tap will run dry.

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words can not express your arrogant blindness. You are one of the reasons ppl say Americans are irrational and don't understand the rest of the world, you don't even understand your own country, not by a long shot. And it's cuz of ppl like you the rest of the world doesn't know who will win the elections, cuz everyone doubts the intelligence of the american ppl, thanks to the backwards logic you are expressing.

I hit your little Socialist buttons didn’t I?  Walked all over your toes because I threaten your dole.  I don’t know how old you are but you sound like a product of our current educational system.  That teaches that the world owes you everything.  That’s not real life.  Just because teachers are not failing students (when they have failed) is creating an arrogant blindness that you seem to be in.

[RavenHawk]

ZaraKitty, on 11 July 2012 - 08:26 AM, said:

The poor Americans are dying on the streets,

No, the poor are not dying in the streets.  No more than anywhere else.  Now, with a larger population than most anywhere else we would have more but no more than what one would consider “normal”.

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the poor Australians are getting free health care and a place to live and money in the bank.

And what do you think will happen when the government can no longer support this habit?

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I wonder who has the better quality of life?

There are many ways to look at it.  I look at it long term.  What’s sustainable and what isn’t.

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They scream to be individuals, but in the adult world it really gets you nowhere, it get's you begging for money on the street to see a doctor, it gets you squatting in an abandoned house to keep out of the rain.

That is the real world.  The individual against the world.  The sooner you learn that, the better you can survive.  This is something that we build on and then thrive.  We’re not waiting around for someone to take care of us.

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I'd rather let the government help me out, my pride would be better served allowing someone to help me, rather than dying a beggar.

I’d rather be a dying beggar than a kept gigolo or prostitute.  This is the core of what it is to be human.  You are either your own person or you belong to someone else.  I’ve been in that position of being a beggar on the street.  It was not of my doing.  It was from layoffs during Clinton’s 2nd term.  I did not like it one bit.  But I got my act together and got back into the game.  I now have a good job, great wife, and a home.  I did pretty well under Bush and now struggling again under Obama, but I’m in a better position than before.  My wife has gone back to school and she can’t get loans because I make too much yet we are scraping by living paycheck to paycheck.  A lot of good Entitlements are doing me.  I pay taxes and I can’t get government help.  If I spelled my name right or my wife was an illegal single mom then we probably could get more money than I make now.  This shouldn’t last too much longer then we’ll have her salary too to live on.  We work our butts off and we don’t need anyone else.  We don’t need the government to come around with its hands out if in the end, it isn’t going to help us.  And that’s where government should be in the first place, out of the way.  It is not the business of the government to pass out dole.

Sorry for the rant but you people are pissing me off now.

[RavenHawk]

Startraveler, on 09 July 2012 - 10:04 PM, said:

I'd rather this thread not turn into pages of defining ideological terms or constant tit-for-tats. That's what the other thread seems to be for.

Just the facts, ma'am.

Obamacare IS ideological (not tit-for-tat).  That’s the facts.  Your answers are ideological.  I was looking for hard answers as advertised.

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That's a political question but there are any number of reasons opponents don't like it. It has a requirement for people who can afford it to carry health insurance (the law's least popular provision). The Supreme Court has upheld that as constitutional but many folks still feel that's an inappropriate use of federal power.

That’s incorrect.  Roberts said that the individual mandate was unConstitutional.  It was upheld because Congress has the Right to regulate commerce.  But that is only for those that currently carry health insurance.  Congress does not have the Right to compel someone to purchase it.  So by the anti Injunction Act, in 2014 when someone is forced to buy insurance, they can sue for a refund at which time, it’ll go through the courts again.  This time being shot down.  It’s very clever as to what Roberts did but a lot can happen between now and then.  It can certainly backfire.

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The law does effectively create a new entitlement, which some fear is too expensive in the long run. Some folks fear they're going to lose some choices or otherwise be negatively impacted personally by the law. Others wanted more radical changes (either to the right or the left) in our health system and so are dissatisfied with the reform law.

There’s no fear about it.  What Entitlement established by this government has not lost money?  This is not a rhetorical question.

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And others could benefit from seeking more information on what the reform law is intended to do and how it approaches those goals.

It’s not important what this law was intended to do.  What’s important is what this law *WILL* do!

I’m sorry, I guess I wasn’t clear.  I was expecting answers not double talk.

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In the long run, the primary source of funding is additional tax revenue that comes from ending the currently limitless tax subsidy for employer-sponsored group plans. That one also has the benefit of slowing long-term health spending.

Please speak English.  I thought you were going to clearly explain things not espouse a Leftist commercial.  So it sounds like you’re saying that Medicare will be raided.  Ok, so where is the rest of the money coming from?  So what happens if people can’t afford the premiums?

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In the meantime (i.e the first decade or so of implementation), about half it comes from savings achieved by limiting the growth rate of certain Medicare reimbursements over the next decade. The other half comes from a hodgepodge of miscellaneous revenue raisers (an excise tax on medical device manufacturers and indoor tanning services, a fee on pharmaceutical manufacturers, a fee on health insurers, raising the hospital insurance tax on high-income earners, etc).

Enough of the euphemisms.  You’re taking from Medicare in the same way SS has been raided in the past.  Does a “hodgepodge of miscellaneous revenue raisers” include bake sales?  How ‘bout the penalty tax?

[ZaraKitty]

RavenHawk, on 12 July 2012 - 06:20 PM, said:

No, the poor are not dying in the streets.  No more than anywhere else.  Now, with a larger population than most anywhere else we would have more but no more than what one would consider "normal".


And what do you think will happen when the government can no longer support this habit?


There are many ways to look at it.  I look at it long term.  What's sustainable and what isn't.


That is the real world.  The individual against the world.  The sooner you learn that, the better you can survive.  This is something that we build on and then thrive.  We're not waiting around for someone to take care of us.


I'd rather be a dying beggar than a kept gigolo or prostitute.  This is the core of what it is to be human.  You are either your own person or you belong to someone else.  I've been in that position of being a beggar on the street.  It was not of my doing.  It was from layoffs during Clinton's 2nd term.  I did not like it one bit.  But I got my act together and got back into the game.  I now have a good job, great wife, and a home.  I did pretty well under Bush and now struggling again under Obama, but I'm in a better position than before.  My wife has gone back to school and she can't get loans because I make too much yet we are scraping by living paycheck to paycheck.  A lot of good Entitlements are doing me.  I pay taxes and I can't get government help.  If I spelled my name right or my wife was an illegal single mom then we probably could get more money than I make now.  This shouldn't last too much longer then we'll have her salary too to live on.  We work our butts off and we don't need anyone else.  We don't need the government to come around with its hands out if in the end, it isn't going to help us.  And that's where government should be in the first place, out of the way.  It is not the business of the government to pass out dole.

Sorry for the rant but you people are pissing me off now.

Less normal than here, we have people living in the streets because they choose to, absurd I know but they're often drunks and druggies. Never simply have no money, as the government gives something around 400 a fortnight for every single adult who can't find a home to live, more if they have children and more if they're disabled.

Australia will never abandon it's people. I will never abandon my fellow people and I'm glad our government can help us. I am thankful.

[Startraveler]

RavenHawk, on 12 July 2012 - 08:43 PM, said:

That's incorrect.  Roberts said that the individual mandate was unConstitutional.  It was upheld because Congress has the Right to regulate commerce.

It was upheld as constitutional because Chief Justice Roberts felt it fell under Congress's power of taxation:

"The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax.  Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness."

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Please speak English.  I thought you were going to clearly explain things not espouse a Leftist commercial.  So it sounds like you're saying that Medicare will be raided.  Ok, so where is the rest of the money coming from?  So what happens if people can't afford the premiums?

You have many questions. Good!

The Medicare savings come through two primary avenues: 1) reductions in subsidies to privatized Medicare plans (i.e. Medicare Advantage) and 2) by slowing the growth rate of reimbursements for services under the public component of Medicare.

Prior to the ACA, government payments to the private plans in Medicare Advantage (which were originally conceptualized as being more efficient and less costly than the traditional, public Medicare fee-for-service program) had crept up, to the point that the government was spending 14% more for private plans than on traditional Medicare, with very little value coming out on the other end for beneficiaries. In other words, private insurance companies were getting a sizable public subsidy and offering very little in return for it. Those subsidies are being dialed down under the law.

The more controversial savings--or at least the part folks try to make controversial--come from slowing the growth rate in Medicare's rates for hospitals and certain other providers (not physicians). The key to understanding these reductions is to realize that they're not simply an edict or a baseless assumption. The ACA contains a number of reforms to the way Medicare  and health care providers do business. These are what make that slowed growth possible over the next decade or so.


In other words, to make that goal of slowed cost growth attainable, the law included a great deal of Medicare reform underlying the future slower growth rates required and assumed by the ACA. And there's some evidence that providers are already beginning to change the way they do business in response to it.

Here are some observations from earlier this year: Slower Growth in Medicare Spending — Is This the New Normal?

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But there are indications that Medicare spending growth has slowed. One highly visible gauge of Medicare spending trends is the standard monthly Part B premium, which is set by the Medicare actuary to cover one quarter of total Part B spending. In August 2011, the actuary projected that the Part B premium for 2012 would be $106.60, but the actual premium was set in November at only $99.90. A much broader indicator of a slowing trend is the fact that growth in Medicare outlays per enrollee in 2010 and 2011 was roughly in line with growth in the economy (see graphExcess Medicare Spending Growth.). And in January 2012, the Congressional Budget Office (CBO) made a $69 billion downward revision to its 10-year Medicare spending projection — a technical correction that reflects emerging data showing surprisingly slow growth in outlays. Similar slowing trends have led to positive earnings surprises for publicly traded insurers.

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The framers of the ACA perceived broad provider-payment reform as the best prospect for slowing the long-term spending trend. But they needed scoreable savings, and they could ill afford to alienate backers by forcing through major payment reforms at the same time. The ACA planted the seeds for accountable care organizations (ACOs), bundled payment for episodes of care, patient-centered medical homes, and incentives for reducing readmissions. Now those seeds offer a way forward.

In site visits and interviews conducted for our ongoing qualitative research, the Center for Studying Health System Change found strong provider interest in payment reform and efforts to prepare for it, with the prospect of increasing constraint on Medicare payment rates cited as motivation. We see a combination of reformed delivery of care and broader units of payment as having the potential to allow providers to generate savings through steps that are less threatening to quality of care and access than are cuts in payment rates. More concretely, payment on the basis of shared savings or partial capitation can reward providers for delivering care more efficiently. This approach is preferable to merely paying providers less and less for business as usual.

There is a historical precedent for harsh, simple-minded cuts setting the stage for broad-based payment reform. Up until the early 1980s, Medicare reimbursed hospitals for costs incurred, subject to ceilings. The Tax Equity and Fiscal Responsibility Act of 1982 substantially tightened those limits, leaving hospitals with no upside — they could not earn a profit by reducing costs — and a growing downside for those whose costs exceeded the limits. The next year, legislation was passed, with the support of the hospital industry, replacing cost reimbursement with the inpatient prospective payment system (IPPS), with rates initially calibrated to leave Medicare outlays unchanged. Hospitals then had the opportunity to reduce costs per admission by shortening lengths of stay and to earn a positive margin in the process.

The IPPS is generally viewed as a major policy success: it encouraged hospitals to seek efficiencies, and when they found those efficiencies, it allowed the federal government to share in the savings. Should ACOs and other reforms prove effective, they will provide broader opportunities to increase the efficiency of delivery beyond shortening lengths of stay, such as managing chronic disease more effectively so as to keep beneficiaries out of the hospital in the first place. But our current challenge is more complex than the one faced in the early 1980s. Broadening the unit of payment will require reaching across different types of providers and helping to stitch together real delivery systems in places where now there are none.

The Medicare and Medicaid reforms in the ACA offered carrots for these improvements and, through Medicare, the looming threat of some big sticks on the horizon is encouraging hospitals to seek efficiencies.

Medicare spending in surprising slowdown | UPI.com

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U.S. Medicare spending growth has slowed even as enrollment rises, and could remain below targets set by Congress for the next 10 years, experts said.

Medicare recorded a sharp drop in the volume of doctor visits and other outpatient services early in 2010, from an annual growth rate of 4 percent growth to less than 2 percent.


"We thought, 'Wow, what's happening?'" chief Medicare actuary Rick Foster told The Washington Post in an interview. "Part B cost growth has slowed down so much, we're seeing virtually the lowest rates ever."

Washington Stuck Fighting Wrong Health-Care Battle | Bloomberg

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This brings us back to the progress being made beyond the Beltway toward a better combination of cost and quality in health care. Consistent with other evidence that points to a deceleration in cost pressures is a Congressional Budget Office report earlier this month showing that Medicare spending has risen less than 3 percent over the past year.

Bending The Health Care Cost Curve: More Than Meets The Eye? | Health Affairs Blog

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During the past months, a number of important articles have appeared in the healthcare literature on the subject of the recent slowing of health-spending growth in the U.S. In an article in January’s Health Affairs, economists at the Centers for Medicare and Medicaid Services suggest that the recession, even though officially ending in mid-2009, was the major factor in “extraordinarily slow” spending growth of 4.7 percent in 2008 and 3.9 percent in 2010, down from 7.5 percent in 2007 and double-digit growth in the 1980s and 1990s. Also citing recessionary causes, a report from the McKinsey Center for U.S. Health System Reform specifies declines in the rate of overall spending growth for eight consecutive years, from 9.2 percent in 2002 to 4.0 percent in 2009.

The purpose of this commentary is to suggest—through observations and data analyses—that independent of the recession, other fundamental and structural changes are likely contributing to the flattening of the cost curve, and further, that these changes have the potential to significantly alter the curve’s path into the future. Two independent analyses support this premise.

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Does a "hodgepodge of miscellaneous revenue raisers" include bake sales?  How 'bout the penalty tax?

You may have missed it, but the major revenue provisions in the law were listed immediately after what you just quoted.

The mandate penalty isn't a revenue raiser (the CBO scored it as bringing in less than $4 billion a year once the exchanges are up and running). Its purpose is to prevent adverse selection in the new markets the law establishes--it largely replaces medical underwriting, in which insurers use your medical history to decide whether or not to deny you coverage and whether to charge you a higher premium.

[Michelle]

ZaraKitty, on 12 July 2012 - 10:45 PM, said:

Less normal than here, we have people living in the streets because they choose to, absurd I know but they're often drunks and druggies. Never simply have no money, as the government gives something around 400 a fortnight for every single adult who can't find a home to live, more if they have children and more if they're disabled.

Australia will never abandon it's people. I will never abandon my fellow people and I'm glad our government can help us. I am thankful.

I don't know where you get your misinformation, but you really need to look into some of these things before you announce how they are there or in the US. Australia has lots of homeless that are definitely not doing it by choice

.http://www.actnow.co..._Australia.aspx

Australia isn't the utopia you make it out to be and the US isn't the hellhole you have been led to believe by some misguided source.

[ZaraKitty]

Michelle, on 13 July 2012 - 01:29 AM, said:

I don't know where you get your misinformation, but you really need to look into some of these things before you announce how they are there or in the US. Australia has lots of homeless that are definitely not doing it by choice

.http://www.actnow.co..._Australia.aspx

Australia isn't the utopia you make it out to be and the US isn't the hellhole you have been led to believe by some misguided source.

It's not a utopia, but we give homeless money to help them eat and find shelter. I live here, they have money we just have a shortage of places to live.

[Sir Wearer of Hats]

ZaraKitty, on 13 July 2012 - 03:20 AM, said:

It's not a utopia, but we give homeless money to help them eat and find shelter. I live here, they have money we just have a shortage of places to live.

actually, it's less a shortage of places to live, and mre landoords being incrddibly selective as to whom they rent property.

[ZaraKitty]

Wearer of Hats, on 13 July 2012 - 07:50 AM, said:

actually, it's less a shortage of places to live, and mre landoords being incrddibly selective as to whom they rent property.

It is rather hard to find a place to rent, I'm still trying to no avail. However I'm never short of food in my belly, thanks to the money from the government as I live in an area with a high 90s percent unemployment. It does get hard, but I don't feel disadvantaged.