Robert Samuelson's Three Beliefs

Someone said that Robert Samuelson thinks three things are true, deficits are bad, there's a demographic crisis coming, and both parties share the blame for any problem. Based upon these beliefs, he's been writing the same column in one form or another for many years. Notice, for example, how he weaves all three of these points into the opening of his latest column:

Making the Think Tanks Think, by By Robert J. Samuelson, Commentary, Washington Post: Just in case you haven't noticed, the major presidential candidates -- Republican and Democratic -- are dodging one of the thorniest problems they would face if elected: the huge budget costs of aging baby boomers. In last week's CNN-YouTube debate, New Mexico Gov. Bill Richardson cleverly deflected the issue. "The best solution," he said, "is a bipartisan effort to fix it." Brilliant.  There's already a bipartisan consensus: Do nothing. No one plugs cutting retirement benefits or raising taxes, the obvious choices.

End of story? Not exactly. There's also a less-noticed cause for the neglect. Washington's vaunted think tanks -- ... both liberal and conservative -- have tiptoed around the problem. Ideally, think tanks expand the public conversation by saying things too controversial for politicians to say on their own. Here, they've abdicated that role.

The aging of America is not just a population change or, as a budget problem, an accounting exercise. It involves a profound transformation of the nature of government: Commitments to the older population are slowly overwhelming other public goals; the national government is becoming mainly an income-transfer mechanism from younger workers to older retirees. ...

Consider the outlook. ... Social Security, Medicare and Medicaid -- programs that serve older people -- already exceed 40 percent of the $2.7 trillion federal budget. By 2030, their share could hit 75 percent of the present budget, projects the Congressional Budget Office.

These projections are daunting. ... Little wonder politicians stay silent. ... Wrenching honesty might be deeply embarrassing. Liberals might have to concede that government could grow too large and that spending and benefit cuts are needed. Conservatives might have to concede that, even with plausible benefit and spending cuts, tomorrow's government would be bigger than today's. For think-tank scholars, brutal candor might offend friends and political mentors. For the ambitious, it might jeopardize future appointments to top government jobs.

As an antidote to this timidity, I propose that some public-spirited sugar daddy (the MacArthur Foundation? Warren Buffett?) sponsor a short book. A possible title: "Facing Up to an Aging America." Six leading think tanks would be invited to participate: three liberal -- the Brookings Institution, the Center on Budget and Policy Priorities, and the Urban Institute-- and three conservative: the American Enterprise Institute, the Cato Institute, and the Heritage Foundation.

After an introduction describing America's aging, each think tank would receive 35 pages to respond to questions and to present its vision. Are the looming budget changes good for America? If so, how would they be financed? If not, why not? How could adverse consequences be avoided? The think tanks would be expected to be specific. Higher eligibility ages? Well, how much and when? Higher taxes? Which ones and how much? If a think tank rejected the invitation, the publisher would run 35 blank pages and an explanation: "Think tank X declined to participate."

This approach would force think tanks to compete. They'd have to make their vision of the future explicit within the untidy framework of government's past commitments. ... Writing for a general audience, it would favor plain English, not the usual technobabble. If published in April, the book might prod the presidential candidates to address the future. If they didn't, it would demonstrate the magnitude of their evasion.

If we are going to give think tanks an assignment coupled with a threat of bad press if they don't participate, let's have them work on the important part of the problem (there are other choices besides think tanks for such assignments). Social Security is not the problem, it won't take much to get it on solid footing, though the scare stories over the past several years have made many people believe otherwise (and Samuelson has helped to generate this false impression). The problem is not demographics either, though it certainly costs more to serve a larger number of people.

The main problem is rising medical costs, and unlike the misplaced emphasis on Social Security in the last election, there is a lot of focus on health care reform in the political debate this time around. Samuelson seems to have completely missed the connection between health care reform and his pet column peeve, hence his claim that the problem is being ignored in the political debate when that isn't the case. In addition, Samuelson's continual focus on the budget deficit obscures the real problem. It doesn't matter whether health care is in the public domain or the private domain, the costs will be daunting either way if they continue on their present trajectory, so finding ways to hold down health care costs is where the focus needs to be.

If Samuelson really wants to help, he can quit writing the same misleading and counterproductive column over and over again. Quit saying "cutting retirement benefits or raising taxes" are the "obvious choices" when it's not obvious at all. Cutting retirement benefits or raising taxes will do nothing to reign in health care costs so these measures do not address the main problem. It's time for Samuelson to write a new version of this column and address the core issues, or perhaps better yet, just stop writing about these issues altogether.

Comments

[evagrius]

How old is Samuelson?

[Mike Barrow]

"... programs that serve older people -- already exceed 40 percent of the $2.7 trillion federal budget. By 2030, their share could hit 75 percent of the present budget, projects the Congressional Budget Office..."

Note the words "present budget". So something goes from 40 to 75 over a period of 23 years. That's 2.8% per annum. That's not "daunting", just something to plan for. No big deal.

A misleading use of statistics!

[reason]

Besides which the use of budget here is misleading. Some of the things included have their own separate financing.

[kharris]

Putting Brookings at the same table with Heritage is a stupid idea. Is Samuelson so far inside the Beltway that he cares more about getting the name than he does about getting honest answers? Brookings is hardly even "liberal" anymore, but at least it aims at honesty and quality work. Cato may belong at the same table as Brooking, but neither Heritage nor AEI do.

Telling a think tank "I will dash your reputation to bits if you refuse to do my bidding" also seems an unlikely path to honest intellectual discourse. If these institutions have ducked the question (Brookings has ducked the entitlements issue? Really?), why do we think they will turn in a useful effort under duress? Plenty of room for misdirection and platitudes in Samuelson's little book. Not that Samuelson would notice.

[dchavern]

I am not so negative of the article or Samuelson's basic inclinations -- demographics will have a huge effect on our economy and entitlement reform is beyond needed. I just don't think books or think tanks are a good means to change the debate. There are lots of books and lots of think tank articles -- and absolutely no one outside the beltway cares a wit. It is a hard truth for the "thinkers who lunch" in Washington, but there it is. If you want to change the debate, you need to access popular and alternative media (think an "Inconvenient Truth").

That being said, I do agree with the need to focus on health care costs first and foremost. The now-multi-generational debate about "socialized medicine" is a sideshow compared to the fact that if everyone in society wants/needs/deserves access to every form of possible medical treatment, there is no way we can afford it. Period. We currently "ration" care by cutting out the working poor who can't get insurance. Government insurance schemes ration it by limiting choice and access for all in the system. Neither will be either popular or workable until you can get at the underlying drivers behine sky-rocketing medical costs. THIS really is the issue that no one wants to talk about.

[baileyman]

Ya gotta wonder. Even at recent anemic productivity growth rates, the county becomes on-average twice as rich in, what, 46 years? A guy like Samuelson wants us to believe when we're twice as rich we still won't be able to afford to retire.

[anne]

"The now-multi-generational debate about 'socialized medicine' is a sideshow compared to the fact that if everyone in society wants/needs/deserves access to every form of possible medical treatment, there is no way we can afford it. Period."

Period.... We can afford no health care for no one never. Period.... We can however afford a $624 billion military budget, * we can also afford $18 billion for nuclear armaments, we can also afford $180 for Iraq and Afghanistan. We can however never ever afford health care at all. Period....

* We are even now asking for additional spending for superior much needed armored vehicles for our troops in Iraq.

[anne]

Remember the "daunting" "wrenching" "deeply embarrassing" "brutal candor" that "timidity" and an absence of a "sugar daddy" makes us forever unable to mention that while we evidently cannot afford a billion dollars a year for the health care insurance of 4 million poor children, we can afford $180 billion for the tragic insanity of war and occuaption.

[anne]

Were I to have a "sugar daddy," I could even say the things I say in "plain English, not the usual technobabble," but even with a "sugar daddy" I could never be so "wrenching" not being a, well, plumber. There we have "brutal candor."

[Optimist]

"Neither will be either popular or workable until you can get at the underlying drivers behind sky-rocketing medical costs."

The underlying drivers are two: 1) our amazingly inefficient delivery system, with its huge payoff to insurance companies, and 2) technological progress.

How miserable am I supposed to be at the prospect of actually being able to do something about previously untreatable medical conditions? After food and shelter, what more directly improves human welfare than that?

The idea that as we become richer an increasing proportion of income should go to ever-more-effective medical treatment seems to me entirely reasonable. Don't worry, you won't need to give up your big-screen TV.

[reason]

Optimist...
the problem is of course the people who need the treatment and the people who take the "increasing proportion of income" and not necessarily the same - and so we have to way to reconcile that problem. Keeping some people alive will become a net drain on the rest of society. Of course that was always the case, but only for a small privileged elite.

[robertdfeinman]

In every area where technology has been involved since the beginnings of the industrial revolution the long-term outcome has been that costs per unit produced have gone down.

Why shouldn't this be true for health care as well? We already have seen many examples. Take the cost of the polio vaccine vs the cost to society of supporting a person permanently damaged by the disease. Take the cost of a bypass operation which restores a person to full functioning vs having a shortened (mostly unproductive) lifespan spent in bed or hardly able to get around. The list goes on.

The claim is that as people get older their health costs rise. This is true, but the age at which health costs become significant is also going up. This means that people can work or be productive longer which counteracts the aging effect.

Medical expenses have gone up over the past 50 years as the practice went from Marcus Welby to an industrialized enterprise. This means that there was a lot of up front spend on hight tech equipment and new facilities. This is tapering off. We now have an excess of MRI machines in parts of the country.

The second factor which has led to a rapid rise in costs is the transition from an essentially non-profit to a for-profit service delivery model. Previously doctors made a decent wage, insurance companies were non-profit as were hospitals. Now we have doctors making a decent wage, with a few superstars, a for-profit insurance and hospital system. This has raised costs by about 30%, but this percentage won't keep increasing. In fact the push back that is already occurring will probably cause this number to fall.

The third factor has been the use of monopoly power to artificially raise the costs of new drugs and medical devices. This is also a short-term effect. Even the most popular and expensive drug has its patent protection run out in about 20 years. Over the past decade the new drugs that have been released have focused on ever more specific problems. We have not had treatment with the impact of the Salk vaccine for decades. Watch the stock market, the glow is fading on the drug firms.

So medical costs will not continue to rise at the rate that they have done in the past 30 years, in fact they may even fall. Economists (or people pretending to be economists in the popular press) should be the last people to use straight line projections. According to the projections I seem to remember from the 1980's Japan should now have an economy which dwarfs that of the US. Oops...

There is no crisis in Social Security and there is no crisis in Medicare either. The scare tactics are all part of the never-ending attempt to privatize these highly efficient government-administered services. Now that claims that they don't work have been discredited, those who want to destroy the programs are shifting to predictions about the future. These are harder to refute with present data.

[Peter Schaeffer]

Evagrius,

According to Wikipedia, he got his bachelors degree from Harvard in 1967. I would guess he is around 62.

[Gary]

If Samuelson really wants to help . . .

Oh, that's rich. Samuelson is a shill for the GOP, always has been. His punishment for slinging this BS should be forfeiture of his "Moustache of Understanding".

Tom Friedman could use it to create the Van Dyke of Universal Truth.

[op and paine]

mark
wonderful post
we agree with you
one thousand percent

[cm]

anne already beat me to it, but I thought government was an income-transfer mechanism from workers to military equipment and services providers, not retirees. Has the president not seen the lockbox and found that it contains only IOUs?

[Holly W.]

By 2030, their share could hit 75 percent of the present federal budget...

But what does anyone expect the total budget to be in 2030? How much of the 1984 budget do today's SS expenditures represent, if one is going to make these comparisons?

A more honest complaint might be that as SS's treasury bonds are called in for distribution, the harder it will become for presidents and Congress to continue using the Unified Budget to make our annual deficits look lower than they really are. In some ways people like Samuelson seem to have it backwards: SS is in okay shape, because it has a dedicated revenue stream; it's the rest of the budget that's heading up the creek without a paddle.

[robertdfeinman]

Just for reference as to where the money is going:

Federal Pie Chart

[op]

cm
love the stark take right on

"I thought government was
an income-transfer mechanism
from workers to military equipment
and services providers....."

might i add and t bond holders
which amounts to the same end
since
our federal debt
is about
the compounded size
of bill for
our kold war potlatch
plus
our two sand trap crusades

[evagrius]

If Mr. Samuelson is around 62, it means that he can collect Social Security soon or within 3-4 years. Which also means that he'll be receiving Medicare.
Since he doesn't do back breaking work he is probably in fairly good health which means that he will probably live another 15-20 years or even longer.
Which means that he should be in favor of making sure children receive good health care since they will be young adults entering the work force right at the time he will probably require more medical care. They will have to be healthy workers in order to pay for his care through employment taxes etc;.
Which means he should also be advocating better education for them.
He should also be advocating for better health care access for those entering the work force now since they will be prime earners during his fading years.
Ditto for making sure they too have the opportunity for education and training.
Samuelson should be as greedy as possible by insuring that those much younger than himself can afford his needs as he ages.

[BJ Feng]

Social Security is currently running a surplus (payments vs. receipts) right now so raising taxes wouldn't do anything to help because the government has no mechanism by which it can save. It can't save by buying its own bonds, and buying the debt or equity of corporations or other nations would subject it to management and conflict of interest issues. In the ideal situation, the government could "save" by reducing its debt so that it can borrow later, but that would mean running an overall surplus and good luck with that.

Dealing with Medicare and Medicaid first is definitely the right course of action. Just as the populace would never accept plugging the future shortfall in Social Security with a tax increase alone, the same applies to Medicare and Medicaid. The government must reduce its expenditures.

The unique thing about health care is that, for any given patient, it's doomed to fail. We all will die at some point and no amount of health care spending can prevent that. Yet each individual wants as much health care as possible to try to stave off that eventual reality, especially if it's not his own money. I propose a cap on lifetime health care benefits provided by the government so that, at some point, we can say, "hey, enough is enough you're going to die, we all are going to die, go home". Of course that could be said with greater sympathy, but you get the point.

[cm]

BJ Feng: How does one save anyway? You can either store non-perishables, invest in productive capacity to be used (and usable) when the time comes, or as a subvariety of the former you store valuable means of exchange (i.e. then-valuable, not necessarily now-valuable) to later trade against others' hopefully sufficient then-production that they are then-willing to sell you. Government is not excluded from any of those. One particular thing it can do is invest in future productive capacity, and in people who have the foresight this requires.

[BJ Feng]

What you're proposing is that government enter business for profit. Governments generally have not done well in that arena where they have to figure out what to produce, and then compete against private enterprise. What business should the government enter into? I think this is a bad idea and is almost guaranteed to fail with the government losing most, if not all the capital it employs in this manner. A worse scenario would be if the government were to start passing laws to protect this business from competition, as it would be the only way to ensure its survival. That would cripple or destroy an entire sector.

[BJ Feng]

Another problem with government investment is that it would have to acquire, store, and then sell large inventories of goods, such as silver or gold. Even the best traders would have a problem because the market would know that the government had to buy (under a surplus) and then know when and how much the government would have to sell when the Social Security funds start running a deficit. Plus, the amount of goods that would have to be purchased and then sold would be enormous causing the government to buy high and sell low. There is just no good mechanism for the government to save other than reducing debt and then borrowing later.

[johnchx]

I continue to believe that hand-waving about whopping projected financial problems is simply a pleasing distraction from the annoying issue of getting today's fiscal house in order. It's a lot more fun to pontificate about a problem a few convenient decades away than to face up to tax increases and spending cuts right now.

My answer to the likes of Robert Samuelson has always been: "Well, shouldn't the first step be to bring our current taxes and spending into alignment? And what is your plan for doing that?"

[James Killus]

Governments prepare for the future by investing in physical and social infrastructure, like public health, roads, education, environmental protection and the like.

Governments wreck the future by destroying environmental commons, ignoring educational and public health needs, and by starting wars that sap the wealth of the nation for years, while at the same time alienating all potential foreign allies, making future wars more likely.

An increasing public debt demands future wealth transfers via taxation to pay bond principle and interest. Once upon a time, bond holders were primarily from the monied class; now a substantial portion of the federal debt is held by pension funds (including the Social Security Trust Fund) and foreign governments. The ideology that services the monied class dislikes having great fortunes tied to those of ordinary citizens, to say nothing of foreign governments, so there are many fanciful notions about how best to break these ties, with the destruction of Social Security being high on the list.

That this would wreck the country is not a very strong argument against the idea; those folks have never liked this country very much, despite all the faux patriotic rhetoric.

[T.R. Elliott]

Just a pointer: Arnold Kling has, in his usual holier than thou manner, dismissed Thoma's points with a scritch-scratch of his rhetorical eraser.

I'd point it out there, but as I love to point out: they banned me on their site because they couldn't stand comments such as this one.

Libertarians and their free markets of ideas. Hah.

[John Doe]

Thoma vigorously deletes comments as well (not for being obscene or irrelevant, just for disagreeing with him). As does DeLong, for that matter. Must be something about economists.

[I don't vigorously delete comments. I have had trouble with one person impersonating others and his comments are deleted. Four were deleted yesterday for this very reason, i.e. for impersonating a regular here. Occasionally others get swept up in the same net. If an email is not provided so that I cannot email you and verify the comment, then I cannot guarantee it won't happen. Thus, anonymous, unsigned, and John Doe emails are more likely to get accidentally caught up in the sweep as I clean out the impersonator. Two others have been banned after repeated warnings. There's one other person recently - must have been you - who posted inappropriate comments, then persisted, and further comments along those lines have been deleted, but the original comment making the point remains, even now. I also occasionally delete comments, though not always, that accuse me of things I didn't say or do, or attribute positions to me that I don't hold, or attack me personally. Almost all of these stay, it's rare to delete one, but there is a line that can be crossed and every so often a comment is deleted for this reason. Essentially, if something irritates me enough, then I unapologetically delete it. I don't need to put up with that here and don't. But nothing said respectfully is ever deleted and there are a wide variety of voices and opinions expressed in comments. One other note - the location of your IP is interesting ... that location comes up quite a bit recently under other names ...

Addendum: It turns out this is the person described above and I deleted the latest attempt to bring up the issue yet again, and will continue to do so. Again, the deletions are the result of the attack on me in the first deleted comment which I did not appreciate or feel was warranted, not the questions that were raised. In any case, I've answered the questions more than once. If you don't like the answers, tough, it's time to move along.]

Anyway: Social Security is not the problem, it won't take much to get it on solid footing, though the scare stories over the past several years have made many people believe otherwise . . . The main problem is rising medical costs,

Says who? Over the next 50 years or so, Social Security might rise by 2.2 percent of GDP (see http://www.cbo.gov/ftpdocs/43xx/doc4380/07-01-SocSecAging.pdf) and Medicare might rise by 7 percent of GDP (see http://aspe.hhs.gov/health/MedicalExpenditures/index.shtml). So yes, projected Medicare costs are higher -- but that doesn't mean that 2.2 percent of GDP can just be swept under the rug as you're attempting to do here.

And in any event, this bit was misleading:

The problem is not demographics either, though it certainly costs more to serve a larger number of people.

The reason generally given for future Medicare increases is none other than . . . demographics. See the Medicare link I posted above, which uses that very word.

[Peter K.]

Mr. Thoma, perfect posting. Whenever I happen to read Samuelson, say in Newsweek at the dentist or doctor's offfice, I want to throw the mag across the room.

Regarding Social Security, I had a fondness for Clinton's surprise (briefly floated/quickly withdrawn) plan for appropriating the means of production via government investing in the stock market. If the market tanks, you just change the rules, a la FDR. Did Samuelson ever write about that idea?

Regarding health care, although America is a great nation, it's not implausible that other countries are doing it better and more efficiently. Why not learn from their experiences?

[BJ Feng]

What's wrong with Libertarian ideas? They are based on the social notions of freedom, individual liberty, and self-determination. Their free market ideas are grounded in solid academic thought and reason with the likes of Ludwig Von Mises and Friedrich Hayek.

Liberals once came from this grand tradition, but the movement has been hijacked by hardcore socialists and libertarians today are generally regarded as conservatives, even though they, and I, are leftist on social policy such as abortion, gay equality, and the decriminalization of drugs. Funny, but this isn't enough to be considered liberal nowadays because libertarians are against state sponsored racism such as affirmative action and race based quotas. Affirmative action might have been necessary in the past, but it has to end at some point; you cannot end racism by promoting racist policies.

[ken melvin]

Samuelson is a bit of a Manchurian Candidate. Obviously he doesn't have a mind of his own, and he feels duty bound to tell the rest of us what to think. As to whether this happened at Harvard or is an accident of birth, your guess is as good as mine. The real questions are: Who's behind the screen? Who is telling him what tell the rest of us what to think about this and that. And, where is the money coming from to pay them? As Jonah and Mitch well know, free speech depends on the ability to spend whatever money necessary to offset uncontrolled public opinion. They know that in a free arena of ideas they lose, so the ability to argue needs be controlled. No equal time. No siree, bob. Free speech is having the money to put your ideas afore the public all the time while keeping the other guys off the air, out of print and off the tube (even if the nation should somehow recover and survive, the death of equal time will haunt us many a year). To have the masses have their own thoughts about terror, credit, healthcare, economics, taxes, … is truly horrifying. And, think how bad it would be if they, the public, thought that their government sold them out on Oxycontin, the tobacco settlement, the Microsoft settlement? Why, they might even want to know who made the phone call and who did they make it to, …. and for how much money?

[James Killus]

Well, BJ Feng, to take one example, if you follow Hayek's reasoning (that restrictions on economic freedom inevitably lead to restrictions on other liberties) to its logical conclusion, Sweden should now be a totalitarian state.

Some libertarians have accepted the principle that, if one of your ideas do not stand the test of time, you should try to come up with some different ideas. Others have not. The latter are responsible for "what is wrong with libertarian ideas."

[run75441]

Anyone ever look at what are the major costs of healthcare beyond Admin? By that I mean the illnesses or conditions . . .

heart disease,

mental disorders (stroke, etc.),

pulmonary disorders,

cancer

trauma

hypertension

cardiovascular disease

arthritis

diabetes

back problems

skin disorders

pneumonia

infectious disease

endocrine

kidney

These 15 conditions increased the cost of healthcare by ~56% since 1987.

Five percent of the population accounts for almost half (49 percent) of total health care expenses. The 15 most expensive health conditions account for 44 percent of total health care expenses in 2004. Patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition.

Now if you were going to attack the rising cost of healthcare, why not attack what contribute the most to the rising cost? I have yet to hear a politician address these as issues other than to condemn the rising cost of healthcare and the lack of insurance for some 40+ million of the population.

as taken from:

http://www.ahrq.gov/research/ria19/expendria.htm#diff1 The High Concentration of US Healthcare Expenditures

http://content.healthaffairs.org/cgi/reprint/hlthaff.w4.437v1 Which Medical Conditions Account for the Rise in Healthcare Spending?

[kaleberg]

As a contrarian and a fan of Douglas Adams, I'm expecting that forcing old people to retire will send the productivity of the remaining workforce soaring. With more expensive labor, businesses will have to invest to stay competitive. Of course, there is the issue of political will.

[Lafayette]

kb: I'm expecting that forcing old people to retire will send the productivity of the remaining workforce soaring.

Then why, pray tell, are companies so keen to convince them to stay?

[Lafayette]

run: These 15 conditions increased the cost of healthcare by ~56% since 1987.

Yes, it is clear that anyone with an illness that you cite on your list should be shot. In this manner health care services will be reserved only for the healthy.

The cost of health care is far too much because of infrastructural over-pricing of HC practitioners. Meaning there is not enough of them to establish an equilibrium market price for their services.

So, when such prices get out of hand, instead of simply passing the cost on to the dupes, the state (read "federal government") has every right to mandate them in a service as strategically important to the general population. This is a plausible alternative for only as long as the state has a solution to the long-term problem of infrastructural costs, that is, bringing more heath care practitioners to the service.

This is NOT being considered anywhere that I can note. If you have "secret information" regarding the significant enhancement of health care training/education across the US - please do share it with us.

Once again, in its idiotic notion that "markets should regulate themselves", America is leaving the destiny of health care in the hands of the wrong people, that is, it's practitioners and their Washington lobbyists (the AMA).

A parallel HC infrastructure that provides care for the poor and less-poor could be run to assure that those without the means are covered. The cost structure would be mandated (at about half of private health care) and the government would be charged with both training and staffing the clinics involved in the program.

All that would cost that of about a year's DOD budget. That is not Mission Impossible. It is, seemingly, Mission Improbable.

[cm]

Lafayette: Compelling your experienced hands to stay is more expedient, when the time comes, than realizing you have neglected to train or bring in their successors, and taking more expensive steps to "fixing" that. Quite as much as squeezing more overtime out of your existing workforce is more expedient than troubling yourself with backfilling the ranks.

[Cyrille]

My understanding was that the implicit solution was more preventive care, although death penalty for being sick definetely helps solvency.

says...

Lafayette says: "Once again, in its idiotic notion that "markets should regulate themselves", America is leaving the destiny of health care in the hands of the wrong people, that is, it's practitioners and their Washington lobbyists (the AMA)."

And this is the crux of the "free market" health care nonsense. Regulations prevent any marginal alternative from guiding HC costs. Without competition on the margins, HC providers are free to set prices as high as they'd like, since people have no alternative. Since we can't have quacks working on the margins, I would agree with the common sentiment here that getting to the bottom of health care costs and working a solution from there is the next necessary step.

[ken melvin]

What do we do with them once they are used up? Medicare, like social security, is such a waste of resources.

[run75441]

Lafayette:

Shooting them is little different than applyimng the treatment to either sustain or heal them. This issue is to eatablish better life styles which will minimize the need for treatment and hence doctors. I cited a couple of sources for the cause of increased healthcare.

If one works to improve the health of the people, then costs should decrease. While not all can be prevented, many can be through early lifestyle changes. Hasn't it been cited recently that this group of children suffers from obesity and will not live as long as there parents? Why should they be allowed to get fat? Attack the initial cause of the problem before it becomes a problem.

[Anon]

Mark said: "Social Security is not the problem, it won't take much to get it on solid footing, though the scare stories over the past several years have made many people believe otherwise..."

While granting Medicare is a bigger issue, Mark's statement is odd considering the hue and cry over Pres Bush's proposals a couple years ago. (Some of which was likely on this blog.) Bush proposed solving roughly half the 75-year solvency problem through progressive reductions in benefit growth. (He also would not rule out raising the tax cap, which also focused on higher earners.)

So it was only about half the 'pain' of fixing Social Security, and this pain was focused on high earners, yet a lot of folks went bananas. If we can't process that amount of pain, how will we tackle health care?

[run75441]

Anon:

Google Bruce Webb sometime. SS TF is not bankrupct. They use consevative growth numbers which skew the TF downward

[Lafayette]

run: This issue is to eatablish better life styles

Your “typo” indicates more than you intended perhaps.

Many of the ills that befall a modern society revolve around eating habits. That obesity has become declared a “pandemic” in the US indicates only slight the enormous proportions of the problems.

Why not ban all food advertising, as has been done for cigarettes ... and "freedom of expression" be damned.

If we seek “better life styles”, then I suggest we look at how Pavlovian reflexes of television advertising impact not only the quality of what we eat but its quantity.

Therein, I suggest, perhaps lies the root to much of health care service that is so costly today.

[reason]

That obesity has become declared a “pandemic” in the US indicates only slight the enormous proportions of the problems.

No pun intended?

[ken melvin]

While back, a commentor from Canada noted that Canadians get commercial free for, I think it was, $2.40/mo. Someone else noted that the UK is so for $8/mo. What a deal. To hell with the market system. There's no net on commercial tv.

[Lafayette]

reason: No pun intended?

How more subtle could I get ... ? :^)

[Weston]

If we didn't have a military to defend our nation and the freedoms that "we the people" enjoy, you wouldn't even be feeling the need to share your thoughts with the enlightened masses...because you wouldn't exist. Try to see beyond yourself at the bigger picture - it's staring you right in the face. If our nation ceased to exist because we have enemies - lots of enemies - who want to annihilate us, the problems would be solved. Presto! You and your ideas are wiped from the face of the earth. Let me be so bold as to suggest that you (first) begin working to change what you can - a sarcastic, mean-spirited attitude - and then move on to more constructive areas such as actually contributing to the betterment of society. Bashing and bullying only make you out a fool and earn you a black eye. Get on with offering ideas that are useful and could actually work...what a novel idea.