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12 July 2012


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You have to take into account the fact that more preventive and primary care promotion will be funded in order to deflect the heavy burden of "chronic" illnesses of the "former youth-buldge", for those that can not afford the care but end up in the ER siphoning up the budgets there.
In stead of looking at this process as ideological, one has to look at it as it is "process management".


Restore the Reagan tax rates and the fiscal situation will quickly improve. What is lost here is that those of us who paid for their own health insurance also paid for those without, when they needed services. That was millions of people.

One of the biggest benefit for the future will be the decoupling of health insurance and employment.



SS and Medicare are essentially insurance and annuity systems that the individual pays into. pl


who isn't driven "mainly by tribal loyalties"?

r whitman

I consider veterans benefits part of my compensation for military service which initially paid me $78/mo as an E-1 and discharged me several years later as an E-5 at $140.40/mo plus flight crew pay of $55 every other month.

r whitman

Tyler, much as I respect your point of view, we live in a social welfare state that is not going to change in your direction. Suck it up and enjoy American life. Bitching does not help.


some medicaid facts


Average state spending on Medicaid as a share of state general fund budgets is actually 16.8 percent, and, just 13.4 percent as a share of spending from all state

Rather than preventing states from spending on other priorities, federal funds coming into a state to pay for Medicaid services actually help states finance other priorities.

In some states with more favorable federal Medicaid matching rates, the different measures can result in dramatically different stories because federal funds can account for as much as two-thirds to three-quarters of total Medicaid spending. For example, using the measure commonly cited, Medicaid accounts for 22.4 percent of total spending in Mississippi, but when only state general funds are counted and federal funds are excluded, Medicaid’s share of the Mississippi budget drops to just 7.8 percent

r whitman

The government leviathan has treated me well all my life. I got 17 years of almost free schooling, lived with good public facilities, had a business that catered 50% to federal, state, local and foreign governments that was sucessful and lived in a relatively crime free environment (except for Wall St types).

This govt asked several things of me. Military service, pay my taxes and stay out of jail.

Hey, its been a good bargain and if they need a few more bucks from me to balance the books then I will give it to them.

TWV you need to take stock of your own dependencies on public programs during your lifetime.


Lars, ACA is going to accomplish just that de-coupling, however the unintended effect, or perhaps the intended effect, is that the quality of business provided coverage is going to drop significantly - while the employee cost for the lower coverage - is going to go up. We are already seeing BCBS Michigan set reimbursement rates based on the Medicare cost tables, not actual costs for services.

Babak Makkinejad

The words "Colored-People" could potentially cover more than just African-Americans.

Babak Makkinejad

That is funny, "Nanny state".

If you are a dental resident doing a post-graduate work in orthodontics, let us say, you get no medical coverage for yourself and your family.

But if you are a prisoner, you do.

If you have been thrifty all your life, you will be obligated to pay your way into poverty in your old age until your money runs out and public funds kick in to cover the old-age expenses.

And the there are things such as this:


What are your recommendations?


This sounds like a lot of economic hoodoo where you expect one thing to happen and then when something else happens your entire model collapses.

Of course the people pushing this are mostly insulated from the fallout, so they get to shrug thier shoulders and say 'Well, it should have worked'.

The Moar You Know

I'm paying for the health care of poor people anyway. Might as well do it in a somewhat more efficient fashion then our current model, which involves the wholesale closure and destruction of hospital emergency services, all to provide the poor marginal health services at what is literally the highest price possible.

As to Romney, well, this won't hurt him with black voters and it won't help him with whites. The end result will be the same. The folks who have real objections to President Obama might want to elbow the clown-car brigade out of the way and try running an electable candidate next time.


True, and they have dedicated tax streams. SS is very close to actuarial balance, Medicare unfortunately is far from balance even in the next decade.


Off topic for which I humbly apologise, but I wondered if the Col. had seen this.


Seems quite odd to me.

Will Reks

This will be a benefit for employers surely. Without Obamacare it would cost a lot more for more families to bear the expense of health insurance on the private market. Those companies will not exchange health care coverage for increased pay. It would otherwise increase the burden for middle class families.



We agree on some things and not others.

It seems to me that whatever was right or wrong in the past, right now the economy and jobs situation is an mess for average and below average people in general; the below average people are having a far worse time than they did, say, in 2000 and the way below average people are in a close to impossible situation that will probably only get worse in the near future.

The wages and jobs just aren't there.

How can you get mad at poor and uneducated citizens for depending on the government when there are so few jobs available for them? Many jobs that they used to do are now held by illegal immigrants.

What are our own poor miserable folks supposed to do about that? The schools and neighborhoods they live in were typically crowded before. Now across America (not just border or coastal states) our own down and outs have had the rug pulled out from under them by the rich people who think it's just dandy that they can give a poor foreign worker a job and save themselves some money at the same time.

I've already written on this page about the terrible changes ahead I see for many whites.

At this point the federal government is forcing people into dependency, as I see it. And those are the lucky ones.

I feel with one thing and the other, many government policies are victimizing our middle class, working class and working poor. Seriously, our own government is acting against our interests and making it more and more impossible for more and more people I know to survive financially.


Nothing is forever.


At least we can agree on that.


Did you realize that Medicare is also greatly subsidized by the taxpayer? I didn't until recently.

In 2010, Medicare received about $205 billion from general revenues out of total expenditures of about $523 billion.

The feeling that people "paid" for their Medicare is only partly correct.

Perhaps even more important, as our population greatly expands and we continue to import poverty, we are setting up future Americans with an enormous healthcare bill that would be overwhelming, I would think, even if managing to bring healthcare spending down to somewhere around what the rest of the First World pays. For what we pay -- around 18% GDP now, expected to reach 20% GDP by 2020, if I recall, it's a recipe for utter financial ruin.



The recipients of Medicare have typically been taxpayers for many years. that is not true of recipients of Meidcaid. pl



The people who run the NAACP are really only interested in African-Americans. Am I wrong in this opinion. pl


Long term care insurance, for one thing.

It seems to me there's a huge split in thought: anybody under 65 is supposed to pay for themselves but after 65 they should not pay much for anything. Many people also believe it's OK if people shift assets to their kids and stick the taxpayer with $70,000 annual nursing home bills.

I think laws should be modified so that the assets can't be hidden but that people can keep high amounts of money to ensure a comfortable living until death. Then the state comes in and gets reimbursed.


Hey Hank, I was glad to see you here.

We are creating a new America by default, one that none of us here would want to live in.

The new America will resemble countries that we now despise, with a rich and criminally indifferent upper class that has its escape routes carefully planned and their passports and visas always ready to go.


Except for end of life care, where many elderly spend down all their money for medical care and living facilities, then go on Medicaid for medical and nursing home care.

When my Mom got sick (and eventually died) the nursing homes laid it out pretty clearly, this is not an unusual situation and is becoming the norm as pension benefits are cut.

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