Bow Before the Limbaugh!

[Naked Gents Rut]

How exactly are you going to control costs if the federal government doesn't become responsible for the vast majority of health-care expenses in the U.S.?

[Ramo]

You realize that isn't what you wrote, right? Vast majority != all.

[Imran Siddiqui]

And not only are they covered in the budget, they make our long term fiscal situation far more tenable.

This is bull****, by the way. It's a good talking point and Obama has been hitting it pretty hard, but even he doesn't actually believe it.

QFT

Specifically, which spending cuts don't you think are realistic?

Any intended cuts to federal agencies will never or barely happen. Like wages, federal agency budgets tend to be sticky.

[Ramo]

QFT

You really think the long term finances of our health care system is anything but absurd?

Any intended cuts to federal agencies will never or barely happen. Like wages, federal agency budgets tend to be sticky.

Give me numbers.

[Imran Siddiqui]

Hell, why not, I'll link to Douthat again, responding to Ramo like objections:

http://rossdouthat.theatlantic.com/archives/2009/03/barack_obama_deficitcutter.php

Ramesh Ponnuru isn't convinced, and neither am I. That deceptive baseline makes all the difference in the world; take it away, and what you have is Obama reducing the deficit from recession-era highs created by TARP and the stimulus package - which are both designed to be temporary anyway - to recovery-era lows that are no lower, as a percentage of GDP, than the deficits Bush ran during his administration's years of economic growth.

Now it's true that some voices within the Obama Administration wanted to run a higher deficit still, and the President apparently sided against them. But that doesn't change the fact that the projected post-recession deficits are in the same range as Bush's pre-recession deficits, if not slightly higher.

This isn't a point "in spirit" - it's a point in fact. When the recession is over, and the stimulus spending has finished running through the economy, Barack Obama's budget projects the same level of deficit spending that the United States experienced from 2000 to 2007. The difference is that whereas Bush ran deficits in part as an attempt to establish a lower baseline for tax rates, Obama would run deficits in part as an attempt to establish a higher baseline for government spending. His accounting may more honest than Bush's, as Chait argues in a follow-up post, but that doesn't change the basic reality of what this administration is proposing: Its budgets would use substantial deficit spending to finance an expansion of government, while putting off the tax increases that would be required to pay for it. And I think it's fair to call that "starve the beast" in reverse.

[Naked Gents Rut]

You realize that isn't what you wrote, right? Vast majority != all.

I don't see the functional difference. The federal budget is going to balloon whether Obama brings all health-care under federal control or just the vast majority of it. My point was that this huge increase in the federal budget will be a disaster unless the Dems can get the American people to accept cuts in services, which I'm extremely skeptical of.

[Ramo]

About the deceptive baseline, I agree. That's why I said >$500 billion in savings, rather than $2 trillion. That's still savings.

And we weren't dealing with a brutal world recession in the Bush years. It's pretty silly to compare the deficits. And he's not addressing my basic points: this is about reducing long-term deficits, and the social programs themselves are financed.

[Imran Siddiqui]

And I think the contrary argument is that Bush like deficits because of increases in social programs is going to require the middle class to pony up some. SOME social programs are financed by raising taxes on the top 2% and some spending cuts, but there is a ton still unfinanced.

[Ramo]

I don't see the functional difference. The federal budget is going to balloon whether Obama brings all health-care under federal control or just the vast majority of it.

No. You are clearly not at all familiar with the proposals on the table. The consensus proposal is not direct federal control of even the vast majority of health care. It's standardizing the private market, providing public competition, and subsidizing insurance for those with low incomes. The actual change in federal appropriations would be in the $100 billion/year range.

My point was that this huge increase in the federal budget will be a disaster unless the Dems can get the American people to accept cuts in services, which I'm extremely skeptical of.

Since you're clearly ignorant about policy, I'm not sure why I should be paying attention to your predictions of supposedly disastrous lower services.

The Brits, for example, spend ~40% of what we do as a percentage of their GDP, with roughly the same outcomes. We probably won't have a system that efficient (it's associated with more "socialism" than is politically viable), but there's a ton of room for improvement.

Seriously, read up on health care. You can do better than this ignorant propaganda.

[Ramo]

SOME social programs are financed by raising taxes on the top 2% and some spending cuts, but there is a ton still unfinanced.

According to the budget document that we have, that is simply not true. The changes in social programs are all financed by spending cuts and tax increases. If you believe some of the spending cuts are unviable, specify them, and we'll compare numbers.

[Naked Gents Rut]

The consensus proposal is not direct federal control of even the vast majority of health care.

So you have no chance of controlling costs, then. Great. Obama wants to toss $634 billion into the money hole...

[Ramo]

Quite the detailed analysis, there.

[Naked Gents Rut]

Why would a detailed analysis be necessary? You can't control costs in the health care industry if you don't actually control the health care industry. Obama's just going to make the fiscal problems of the U.S. government worse if he expands the government's insurance responsibilities without putting the government in a position to at least attempt to restrict services.

[Jon Miller]

The problem with the health care industry isn't that services are too available.

JM

[Kidlicious]

The consensus proposal is not direct federal control of even the vast majority of health care. It's standardizing the private market, providing public competition, and subsidizing insurance for those with low incomes. The actual change in federal appropriations would be in the $100 billion/year range.

I guess if they don't actually control costs then they still can't be held accountable for not cutting them. It's hard to believe that any of the proposals you mentioned will have a significant effect. There's just no will to do anything.