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Author Topic:   Health Care Policy ( for now) (for the future ) (your best observations )
LamarkNewAge
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Joined: 12-22-2015
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Message 1 of 8 (810385)
05-29-2017 3:53 AM


I was just thinking about "free stuff" and what it means.

The cost to the nation.

The cost to the states.

I thought of Medicaid.

It has historically been "free" in the "free stuff" kind of way.

And it covers over 74 million people (close to 23% I suppose)

COST?

I know that Medicaid costs the federal government $389 billion a year.

But that is only going to be a bit more than 60% of the total cost since states pay about 40%

The total cost ( which I don't know ) will be about $250 billion more.

The number will be around $650 I suppose.

(conservatives claim that the Medicaid payments only cover 89% of the actual costs that the program pays, so that disputed claim complicates matters a bit, so be aware )

(Medicaid payments are ironically higher for the same prescription drug than the insurance companies pay )

We see the total cost now .

NOW THE "FREE STUFF" AT THE STATE LEVEL

I got to thinking about the states that had the most "free stuff".

I already know that West Virginia has the most Medicaid recipients.

29% in West Virginia are on Medicaid.

So how is the tax situation there at the local level?

This link says they are among the lower half. It is The Register Herald of Beckley W. VA.

Www.wvea.org/...ent/wvas-state-tax-rates-ranked-among-lowest

Here is a conservative source.
www.freedominthe50states.org/overall/west-virgina

A quote from the latter

quote:

The Mountaineer State's overall tax burden is about average

My observations are going to be obvious to many .

The state that has about the most unhealthy people - on endless measures - , and the seemingly most poorly endowed finances (low incomes for a tax base ), nevertheless, finds itself able to fund its Medicaid program costs without some bloody apocalyptic blowout of its treasury. With not having too many noteworthy fiscal issues if any (the situation seems very noneventful really ).

I might add that there doesn't seem to be a flood of Virginia emigrants flocking to West Virginia for the "free stuff " fwiw.

( I will work in my FEDERAL GOV OBSERVATIONS now )

Yes the federal government pays its typical 60% as is standard ( a bit more with the Obama expansion ), but this poor state funds its state employed workers insurance plus it's Medicaid receiving legions.

Speaking of which, the federal costs are $389 billion a year.

About 2% of GDP, though state costs bring it up to 3% and some change.

Make it 3.5% if you factor in the conservative claim that it only pays 89%

This means that 23% of the nation on "free stuff" is 3.5% of GDP.

The VA covers another 2-3% so we only have about 74% to go.

The most expensive of the rest are the elderly and they get the vast majority of their bills already covered by Medicare and ( ironically ) Medicaid.

I don't see the scary math here.

I just don't.

Any of your observations? On anything else?


    
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Message 2 of 8 (810399)
05-29-2017 7:51 AM


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LamarkNewAge
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Joined: 12-22-2015
Member Rating: 1.1


Message 3 of 8 (814128)
07-04-2017 4:55 PM


VA has 8 million on "free stuff" while Medicaid is 74.5 million (low price? )
I pointed out that the federal government payments for Medicaid were $389 billion a year (which happens to be no so different an amount as the $71.5 billion increase in annual military spending Congress just proposed added to the Trump tax cut proposals ) but I overstated the states bills a bit.

The current cost from the Federal Government plus the states is just under $600 billion a year (not $650 billion! ).

And the latest news I read has 74.5 million on the program.

The VA has around 8 million on its health care.

So 82 million on free stuff which is about 25% of the population.

One way or another, the government will pay roughly half of the rest of the costs.

Employers pay alot too.

The private insurance companies have a MLR measurement (which they share to get investors )that enables us to see that they add about 25% to the cost of healthcare. Getting rid of the insurance companies will nock almost 20% off of the private insurance portion of the health industry costs. It would be around 10% lower costs for our entire combined national bill. Instead of 17.3% of GDP, we could be at 15.5% with a single payer plan.

Employers and the government already pay for over 75% of the 17.3% already so that is 13% of GDP in costs.

Californian is going to need $400 billion dollars to fund a free stuff single payer system but $200 billion can be taken from existing state and federal government programs to place in a big pot, so that requires $200 billion new funding to fill the void or close the gap. Employers pay alot already. Individuals pay alot just in premiums already.

California is just about 1/8 of the population of the country so $200 billion times 8 would be $1.6 trillion for the whole nation to pay for a giant single payer system ( and one that doesn't have ruinous price controls ).

We need to see what the average employer pays then ask what the total dollar amount nationwide is in employer costs.

What is it that the average person spends on premiums then what is the total national dollar amount individuals spend total just in premiums.

I wonder what that would be compared to the $1.6 trillion in new funding needed.

Then the co pays and deductibles need to be looked at for all Americans.

I know that the end number would be 17.3% of GDP verses 15.5% but I still wonder how close we would come in the steps before the last one above. Before the co pays and deductibles, I wonder how much lower than 15.5% it really is.


    
LamarkNewAge
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Member Rating: 1.1


(1)
Message 4 of 8 (814253)
07-05-2017 12:07 PM


Beware of the anti Medicaid propaganda (like Committee for Responsible Federal Budget
Marc Goldwein heads this fiscal watchdog group.

He says that Medicaid is unststainable as do most commentators.

But I should point out that Medicaid is only 2% of GDP if you look at the federal government spending (which is fair enough to look at absent the additional 1% of GDP that the states spending adds BECAUSE the states portion is mostly optional spending that the respective states have decided on via much deliberation ).

Federal Medicare spending is 3.1% of GDP.

Now look at the 30 year projections that all sides agree as an accurate analysis of 2047 spending projections.

Medicare will go from 3.1% of GDP to 6.1% of GDP spending funded by the Federal Government.

Medicaid cost will be up to 2.7% from the 2.0% today.

So this program will cost (2017 dollars are the index I use ) another $140 billion per year in 2047.

And the people covered will actually be around 100 million as opposed to 74 million today. Infact by 2026 ,Medicaid is projected to cover over 85 million. Interesting that over two decades later, the cost will be in a pretty manageable condition.

Remember that the Congress just proposed a $72.5 billion increase to yearly military spending ($71.5 was an incorrect amount I posted above ) and that says nothing of the endless increases that will likely be proposed in addition over the next 29 years.

If Federal Medicaid costs are so out of control (according to popular propaganda ) with a $140 billionyearly increase gradually reached by 2047, then a sudden $72.5 billion military increase should really make us talk about the need to make defense cuts to get control of an out of control spending situation.

BUT THERE IS MORE

Check out the June 27, 2017 USA Today article by Dhruv Khullar and Anupam Jena

Medicaid cuts would hurt more than help

The article mentioned a 2015 study that compared poor children both covered AND not covered by Medicaid, then found that the benefits of children covered (verses not being covered ) would, by the time they reached 60, would bring back half the Medicaid cost just in higher tax payments alone.

Plus a new Commonwealth Fund study shows that the Congress bill cuts would cause 1 million jobs to be lost by 2026, with Gross State Products decreasing by $93 million each, and business output dropping by $148 billion. 47 states would suffer lost jobs.

A 2014 study showed that Medicaid children have a 4%-6% lower dropout rate in highschool and a 3% higher four years college graduation rate.

The studies understate the benefits of the FREE STUFF healthcare benefit. Medicaid is pretty difficult to remain on and requires lots of endless signing up and difficult eligibility examinations. A Canadian style single payer (with no signups and absent the difficult eligibility requirements ) would multiply benefits many times the Medicaid program offers ( plus the approved coverage in the Canadian system doesn't become worthless once a state border is crossed ).


    
LamarkNewAge
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Posts: 1247
Joined: 12-22-2015
Member Rating: 1.1


Message 5 of 8 (840023)
09-22-2018 6:33 AM


Colorado gets 31,074 jobs (1% of workforce) from Medicaid expansion. True or false?
Go to:

www.bing.com

(and)

www.google.com

(and)

every other search engine

Then type these search words:

31,074 JOBS COLORADO

I will spare you my usual (large) pastes of search engine hits. But there is good discussion on reddit.com plus lots of good analysis.

Tell me what you think.

Is this the type of policy that matters when it comes to JOBS, JOBS, JOBS? Or, is anti-immigration blather the way to (somehow) create jobs? Never mind the fact that jobs are SUBTRACTED from the economy when immigration is curtailed. Just never mind that. I suppose the anti-immigration crowd feels that less people in the workforce helps those who remain (even if there are fewer jobs in a smaller workforce economy). The CBO says that overall unemployment remains the same if we grant amnesty to all the "illegal immigrants", but the unemployment for the poorest workers will rise 0.1% (with average wages, among this same group, 15 to 25 cents an hour lower).

(In the long term, I feel that unemployment will be lower for pretty much everybody, but a constant immigration-flow of poorer workers could create the slightest most miniscule increase in unemployment for the overall-workforce-of-the-poorest-workers due to the slight lag in newer workers spending what they make RIGHT BACK INTO THE ECONOMY and thus ultimately creating as many jobs as taken)

So we have unchanged unemployment with "amnesty for illegals" as a policy.
(0.1% for some but not most)

But 1% lower unemployment due to Medicaid expansion.

Perhaps Democrats need some candidates that get it?

Perhaps Democrats need to make it clear, to those who find anti-immigration "solutions" seductive, that they (to steal a line from a, perhaps insincere, Democratic candidate of past decades) "feel your pain", but then offer real unemployment-busting alternatives? An alternative to bad prescriptions is nice enough, if for no other reason than to offer those suffering a diagnosis that resembles the pain they are (constantly?) going through.


Replies to this message:
 Message 6 by Phat, posted 09-22-2018 6:47 AM LamarkNewAge has responded

    
Phat
Member
Posts: 11300
From: Denver,Colorado USA
Joined: 12-30-2003
Member Rating: 1.1


Message 6 of 8 (840024)
09-22-2018 6:47 AM
Reply to: Message 5 by LamarkNewAge
09-22-2018 6:33 AM


Re: Colorado gets 31,074 jobs (1% of workforce) from Medicaid expansion. True or false?
I typed in your search term exactly and this is what I got: 31,074 JOBS COLORADO

Not exactly what you wanted to say and another good reason why you need to abandon this silly search engine type of learning.


Chance as a real force is a myth. It has no basis in reality and no place in scientific inquiry. For science and philosophy to continue to advance in knowledge, chance must be demythologized once and for all. –RC Sproul
"A lie can travel half way around the world while the truth is putting on its shoes." –Mark Twain "
~"If that's not sufficient for you go soak your head."~Faith
You can "get answers" by watching the ducks. That doesn't mean the answers are coming from them.~Ringo

This message is a reply to:
 Message 5 by LamarkNewAge, posted 09-22-2018 6:33 AM LamarkNewAge has responded

Replies to this message:
 Message 7 by LamarkNewAge, posted 09-22-2018 9:53 AM Phat has responded

  
LamarkNewAge
Member
Posts: 1247
Joined: 12-22-2015
Member Rating: 1.1


Message 7 of 8 (840028)
09-22-2018 9:53 AM
Reply to: Message 6 by Phat
09-22-2018 6:47 AM


Re: Colorado gets 31,074 jobs (1% of workforce) from Medicaid expansion. True or false?
It does seem that the Google engine picks up less relevant hits than Bing.

But there were several relevant hits.

Here is the first.

I found this hit on the Google page.

quote:

By DAVID OLINGER | dolinger@denverpost.com |
March 10, 2016 at 12:54 pm

A new Colorado Health Foundation report says state expansion of the Medicaid program has created 31,074 new jobs and added $3.8 billion in economic activity.

The report concludes that “in the two years since implementation, expansion in the state has had a significant positive effect on the economy at no expense to the general fund” in the state budget.

Its findings:

• Medicaid expansion, largely funded by the federal government, is already affecting and will continue to affect the state economy positively.

• The number of jobs created by giving more people access to Medicaid will continue to grow. The report predicts a total of 43,018 jobs created in Colorado by the 2034 fiscal year.

• The state’s economy is 1.14 percent larger because of Medicaid expansion. By fiscal year 2034, that will grow to 1.38 percent of the total economy, or an $8.5 billion increase.

• Average household earnings are $643 higher as a result of Medicaid expansion.

• The general fund will not incur any expenses associated with Medicaid expansion.

Kevin Lundberg, the Republican who chairs the state Senate Health and Human Services Committee, laughed at the notion that Medicaid expansion is not costing the state anything.

He said, “What we’ve been doing is pulling down federal debt dollars” to bring more money into the state. But, he said, the $9.9 billion being spent on Medicaid “has an immediate, direct impact on the state budget as well.”

The study was commissioned by the health foundation and prepared by the Colorado Futures Center at Colorado State University.

Center director Charles Brown said its analysis showed more positive economic impacts than the center had previously predicted.

At the foundation, president Karen McNeil-Miller heralded its results.

“The impact of Medicaid expansion in the state is broad-reaching and demonstrates how health is more than just what happens at the doctor’s office,” she said. “In addition to providing health insurance to nearly 400,000 Coloradans, expanding Medicaid has proven to be a fiscally sound decision.”

https://www.denverpost.com/...ion-is-a-boon-to-state-economy


The Republican's attack seems to be limited to the federal cost of the Medicaid expansion.

The $9.9 billion is the federal payments to Colorado over a 10 year period.

Let us say $1 billion a year to Colorado, an average size state.

So $50 billion a year nationwide.

But 1.5 million jobs will bring a lot of revenue back.

They always forget the dynamic scoring!

Trump said his $1.5 trillion in tax cuts should only be scored at $1 trillion over 10 years because of dynamic growth.

Why can't this be considered economic dynamite?

Make the $50 billion say no more than $33 billion a year!

(and the military increases are way more than $72.5 billion a year)

(now about $167 billion a year military increases)


This message is a reply to:
 Message 6 by Phat, posted 09-22-2018 6:47 AM Phat has responded

Replies to this message:
 Message 8 by Phat, posted 09-22-2018 4:11 PM LamarkNewAge has not yet responded

    
Phat
Member
Posts: 11300
From: Denver,Colorado USA
Joined: 12-30-2003
Member Rating: 1.1


Message 8 of 8 (840046)
09-22-2018 4:11 PM
Reply to: Message 7 by LamarkNewAge
09-22-2018 9:53 AM


Re: Colorado gets 31,074 jobs (1% of workforce) from Medicaid expansion. True or false?
Again...STOP with the search engine thing! ANY learning expert will tell you that this is not the way to teach any concept. I don't know where you picked up this bad habit but it is annoying. If you can't make a point in your own words without a search engine, you really are not teaching anyone anything...you are simply providing links for them to read.

Chance as a real force is a myth. It has no basis in reality and no place in scientific inquiry. For science and philosophy to continue to advance in knowledge, chance must be demythologized once and for all. –RC Sproul
"A lie can travel half way around the world while the truth is putting on its shoes." –Mark Twain "
~"If that's not sufficient for you go soak your head."~Faith
You can "get answers" by watching the ducks. That doesn't mean the answers are coming from them.~Ringo

This message is a reply to:
 Message 7 by LamarkNewAge, posted 09-22-2018 9:53 AM LamarkNewAge has not yet responded

  
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