A deal on the insurance tax

The White House and the unions seem to have a deal. This was the last big hurdle to finding a bill that could get 218 votes in the House, as provided in the Constitution, and 60 votes in the Senate, as not provided in the Constitution Now if the Mass. Senate election doesn’t blow it up, the biggest piece of social legislation since the Great Society seems set to become law.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

17 thoughts on “A deal on the insurance tax”

  1. I live in Massachusetts. Coakley, a fine public servant, is a dud campaigner. She will lose. As for Democrats having a Plan B, I've been a Democrat for 40 years, and they seldom have a Plan A.

  2. It seems the Democrats have gotten complacent for this Election in MA! Pres. Obama was not going to campaign and now he will! The same thing happened in GA! This whole Health Reform has been a farce from the start! Obama let it get away by not having any Backbone! If they lose it it will be the Democrats fault! They cow tailed to Lieberman the idiot! if it doesn't get 60 votes he should be booted from the caucus and the chairmanship!

  3. "Now if the Mass. Senate election doesn’t blow it up, the biggest piece of social legislation since the Great Society seems set to become law."

    And if a couple of Senators (who shall remain nameless, but you know their names) don't suddenly scream about the conference bill being Evul Librul, and refuse to vote for cloture. I'm really expecting that; it'd be a great election year backstab.

  4. JMG,

    I live in MA also, and agree that Coakley has run one of the worst campaigns imaginable. Brown is a cookie-cutter right-wing Republican, and should have had zero chance. I still think Coakley will win, but I'm not wildly confident. Maybe the possibility of Brown actually winning will help turnout.

  5. Wow. Government employees and unionized employees don't have to pay the excise tax, and everyone else does. Way to pay off your supporters, Democrats!

  6. The New York Times has an editorial today (Saturday) that supports the Senate bill's excise tax. They admit that the cost control mechanism is to reduce coverage (and/or increase co-pays and deductibles) and that "[requiring] workers to pay more out of pocket would force them and their doctors to think a lot more carefully about whether an expensive test or treatment is really necessary."

    That's the McCain plan, premised on the notion that the main problem with health care is that people just get too damn much of it. Of course, if you are seriously ill and opt for only the most conventional of treatment programs, you're going to also be "paying more out of pocket", which you may or may not be able to do. Even if you can pay, that's a threat to one's fiscal status. If you can't? Well, the mortician is waiting for you.

    The Times admits this, and writes: "There is some risk — nobody knows how large — that higher deductibles and co-payments would discourage some people, especially the chronically ill, from seeking medical care that they need. Congress can avoid this tragic outcome by setting up a monitoring system to detect any emergence of harm …"

    Nobody knows! Hasn't there been program like the Senate's that been tried anywhere on earth before now? Or is this a big experiment?

    And how about that "monitoring system to detect any emergence of harm". Is that political gold for Republicans or what?

    The Senate bill is geared for reducing EXPENDITURES. Expenditures, not the PRICES of drugs or services. But Obama supporters like to use the word "COSTS", which is dual use (can refer to expenses or prices) in order to fool the people.

  7. That's all it's been about from the beginning. All those "shovel ready" projects may have left construction industry unemployment rates over 20%, but I hear government employee unemployment rates are hovering up around 3%.

  8. Duane: "They cow tailed to Lieberman the idiot!" I think I share the sentiment, but where does "cow tailed" come from? An amalgam of "kowtowed" and "pigtailed"?

    Brett: I'll follow your double red herring. What do you think the construction industry unemployment rate would have been without the stimulus?

  9. James Wimberley says:

    "Brett: I’ll follow your double red herring. What do you think the construction industry unemployment rate would have been without the stimulus?"

    Don't bother, James – Brett has a long history here.

  10. Well, based on administration behavior to date, they'll just adjust their predictions retroactively to say that it would have been 105%. Falsifiability having gone out the window, and all. The point is that the freaking stimulus package was never aimed at boosting private sector employment; It could have been spent having people in the private sector dig holes and fill them, and done THAT better. It's aimed almost exclusively at benefiting the strongest Democratic constituency, government employees.

    Problem is, the government sector is parasitic on the private sector. The more the former is boosted at the latter's expense, the more unsustainable the situation becomes. The predator/prey ratio has gotten too high now, and we're going to be lucky if we just grind along in a recession, a crash seems more likely to me.

  11. "Problem is, the government sector is parasitic on the private sector. The more the former is boosted at the latter’s expense, the more unsustainable the situation becomes. The predator/prey ratio has gotten too high now, and we’re going to be lucky if we just grind along in a recession, a crash seems more likely to me."

    Glibertarianism 101.

  12. There is something very wrong with funding this "reform" on the backs of people who have deliberately chosen employers that provide decent health insurance, often at the cost of accepting a lower salary. What is "fair" about suddenly reducing our (often lower middle class) incomes to pay for health care for all? Why us? Why not let those who can actually afford it pay for this? Coupled with the TARP and the banker bonuses, this amounts to a royal screwing.

    Furthermore, why should everyone be forced to do business with corporations? This is NOT like the requirement for automobile insurance, since no one is forced to own an automobile. Without a public option of some sort, this "plan" makes our payments to large corporations mandatory, with no corresponding requirement for a minimum percentage of premiums going to fund actual health care. The ginormous CEO salaries will, no doubt, continue or even grow.

    The corporations have gotten everything they wanted, and more–mandatory coverage is their dream come true! Yes, it's good that previously uninsured would get coverage, but at what cost, and to whom? It is unbelievable how cowed our representatives are, how unwilling they were to fight for single-payer, medicare-for-all, or even a public option of any kind. Believing that this is a "first step" to a better plan is, I think, very naive. Compared to the health plans of every advanced nation on earth, this plan is garbage. We've been had.

    – kathleen, a disillusioned Obama supporter

  13. Barry, do you live on Bizzaro Earth, where production all occurs in the government sector, while the private sector is entirely funded by government handouts? On THIS planet, production occurs in the private sector, which has to produce enough to keep itself running, AND produce enough surplus to fund the government that's taxing it. And to increase the amount of government, and hence the amount of production the government drains from the private sector, right at the time when the private sector is in trouble, most certainly does have predator/prey ratio issues. If the government's drain on the private sector exceeds that sector's excess production, the economy can do nothing but shrink.

  14. Brett, I live on Earth, where the places with the least government tend to have rather minimal production, and life can be summarized as 'nasty, brutish and short'.

    " And to increase the amount of government, and hence the amount of production the government drains from the private sector, right at the time when the private sector is in trouble, most certainly does have predator/prey ratio issues. "

    Here's a hint – don't lean history from UCLA, and don't learn your economics from Chicago. Or GMU, or Joe Blow Austrian, or libertarian websites.

  15. I see even Open Left now thinks that we're screwed & Coakley is toast. I foresee a testing time – we are about to find out just how good a President Obama is.

  16. Barry, government is overhead. It may be necessary overhead, some of it, but it's overhead. It's not the part of the economy that produces. Hence the private sector has to produce enough to keep it self perpetuated, AND fund government. If the private sector is shrinking, and the government sector growing, eventually that becomes impossible.

    The "stimulus" was directed almost entirely into the government sector, spent on overhead. Spending on overhead CAN promote production, indirectly, but we do not appear to be that short on overhead spending.

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