Why we cannot trust the CBO on healthcare costs:

hislegacy

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from the Washington post

When Obamacare passed in 2010, the CBO projected a healthy individual market with 23 million people enrolled in exchange plans by this year. The CBO predicted that by 2017, exchange plans would be profitable and annual premium increases low.
The CBO reached these conclusions, in large part, because its model puts significant weight on the individual mandate. The CBO expected millions of relatively young and healthy people to buy exchange plans under government coercion.
But this never happened. Today, there are only 10 million people enrolled in exchange plans — about 60 percent fewer than expected. (Contrary to some claims, this is not because more people have maintained employer plans than the CBO expected; the reduction in employer coverage has been greater than the CBO projected, and overall about 9 million more people are uninsured now than projected.) Absent the projected bounty of young, healthy consumers, health insurers are abandoning the exchanges, leaving a third of American counties with only one insurer to choose from. As insurers continue to flee the exchanges, consumers will face even fewer options next year.​
 
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dannheim

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The way I see it Healthcare costs are rising because of supply and demand. Demand is accentuated by the erroneous notion that health insurance providers have bottomless checkbooks. As such people do not scrutinize their medical bills and demand accountability on the part of the provider to justify the ludicrous amounts they are charging for an aspirin or even a stay in the hospital. The drug industry further complicates the situation by charging enormous prices for prescription drugs all in the name of research which is baloney.

It is the health industry and its greed that is causing this unprecedented rise in the cost of health maintenance. I think we ought to put a cap on these exorbitant fees they are charging. Contrary to its purpose the insurance Industries are actually causing higher fees. The more money hospitals, doctors and drug companies charge the more the insurance company's have to pay and gladly pass on these higher cost on to the consumer and in the process make themselves a lot of money and profit along the way.
 
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camille70

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from the Washington post

When Obamacare passed in 2010, the CBO projected a healthy individual market with 23 million people enrolled in exchange plans by this year. The CBO predicted that by 2017, exchange plans would be profitable and annual premium increases low.
The CBO reached these conclusions, in large part, because its model puts significant weight on the individual mandate. The CBO expected millions of relatively young and healthy people to buy exchange plans under government coercion.
But this never happened. Today, there are only 10 million people enrolled in exchange plans — about 60 percent fewer than expected. (Contrary to some claims, this is not because more people have maintained employer plans than the CBO expected; the reduction in employer coverage has been greater than the CBO projected, and overall about 9 million more people are uninsured now than projected.) Absent the projected bounty of young, healthy consumers, health insurers are abandoning the exchanges, leaving a third of American counties with only one insurer to choose from. As insurers continue to flee the exchanges, consumers will face even fewer options next year.​


Link for anyone who is interested:

Opinion | The fundamental error in the CBO’s health-care projections
 
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HannahT

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We haven't seen any plan or proposal yet that attempts to address the high costs of medical in this country. We get loads of examples of how countries have this, and yet they don't have many of the same workings, regulations, and laws that we do. Sounds like they have simplified things to help it work. lol our country doesn't even know that means, and so YEAH in our dreams something can happen along those lines.

We get constant screams that everyone should have free healthcare, and yet its never free. In our current broken attempt we have the few paying for the many, and everyone else taking a backseat and wont' want to participate at all. Costs go through the roof, and all you hear is we need to do this again yet on a bigger scale...with some magical thinking that costs will work themselves out.

Neither party knows what they are doing, and CBO just adds gas the fire.

All we have a bunch of lip service from both parties. Most of the time its encouraged that they act like children when the other side comes up with proposals that may/may not help the situation. Bills aren't even read, and Congress is already screaming about people DYING!

One side said our system is decent, but of course needs improvement to make it better. Yet, never proposes any improvements...because they are to busy whining about how evil the other side is. Then you have another side that can't agree on anything to help the circumstance, and whines about CBO scores when it really doesn't matter because you don't have the votes anyway.

Notice all the 'government officials' not doing anything fast, because after all they already have awesome healthcare...which won't end, and we pay for. They figure, WHERE'S the FIRE?!

We are a list of people/agencies we can't trust when it comes to healthcare or costs.
 
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dgiharris

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from the Washington post

When Obamacare passed in 2010, the CBO projected a healthy individual market with 23 million people enrolled in exchange plans by this year. The CBO predicted that by 2017, exchange plans would be profitable and annual premium increases low.
The CBO reached these conclusions, in large part, because its model puts significant weight on the individual mandate. The CBO expected millions of relatively young and healthy people to buy exchange plans under government coercion.
But this never happened. Today, there are only 10 million people enrolled in exchange plans — about 60 percent fewer than expected. (Contrary to some claims, this is not because more people have maintained employer plans than the CBO expected; the reduction in employer coverage has been greater than the CBO projected, and overall about 9 million more people are uninsured now than projected.) Absent the projected bounty of young, healthy consumers, health insurers are abandoning the exchanges, leaving a third of American counties with only one insurer to choose from. As insurers continue to flee the exchanges, consumers will face even fewer options next year.​

Believe it or not, what you post actually is a great example of why we can trust the CBO with health care cost projections.

Imo, the biggest difference between what the Dems proposed vs the GOP is that with the Dems, the math works out and it makes sense.

With what you posted, the CBO expected X which would yield Y. WHen X didn't happen then Y was not as expected.

This is mathematically sound. It is logical. It makes sense.

What GOP healthcare proposes does not mathematically add up. It is a lot of hand waving a trickle down economics and "just trust us everything will be fine we will fix it later..." GOP is saying things that are just not true in regards to health care, premiums, coverage, etc.

So I will trust the CBO numbers a thousand times more than I trust anything from the GOP on healthcare.

The CBO is a non-partisan board that is trusted for making projections about everything. If you don't trust them on this, then you can't trust them on anything and where does that leave us?

Here is how and why I would not trust the CBO.

If the CBO expected that if X happened and Y happened then Z would happen and cost would be Q.
Then, if X did happen, and Y then happened and Z happened BUT costs ended up being J instead of Q "then" that would be a reason to not trust the CBO.

Do you follow me?

So yeah, based on what you posted, that actually is an argument for why we CAN trust the CBO's projections and numbers...
 
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hislegacy

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No I don't follow you at all.

The CBO did not get one cost projection correct in seven years.

Obamacare is a complete failure.

We were told cost would go down 2,500 a year. - it has gone up 200% and more in some cases

We were told if we like our medical plan, we could keep it. Obamacare regulation eliminated most plans completely forcing people to go into other more expensive ones.

We were told 23,000,000 additional people would be covered, 9,000,000 chose the plans.

We were told our employer plans would not change. It was a lie

The CBO agreed to just about everything that came out of the White House and it is an abismal failure

So why should we put our trust in an organization that hasn't been right in almost a decade??
 
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Belk

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No I don't follow you at all.

The CBO did not get one cost projection correct in seven years.

Obamacare is a complete failure.

We were told cost would go down 2,500 a year. - it has gone up 200% and more in some cases

We were told if we like our medical plan, we could keep it. Obamacare regulation eliminated most plans completely forcing people to go into other more expensive ones.

We were told 23,000,000 additional people would be covered, 9,000,000 chose the plans.

We were told our employer plans would not change. It was a lie

The CBO agreed to just about everything that came out of the White House and it is an abismal failure

So why should we put our trust in an organization that hasn't been right in almost a decade??

Where were their projections wrong? Don't tell me about how they predicted X but got Y, I want to know where in their calculations they were fundamentally wrong. So far the only thing I am seeing is people complaining because they are not prognosticators.
 
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FenderTL5

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Original CBO estimates didn't account for states opting out of Medicaid expansion. The CBO didn't consider that state governments would throw their own citizenry under the bus the way that they did.
 
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Desk trauma

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Ignore the news.

Ignore the polls.

Ignore the CBO.

Ignore anything embarrassing or ignorant from the president.

Did I miss anything?
 
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hislegacy

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Where were their projections wrong? Don't tell me about how they predicted X but got Y, I want to know where in their calculations they were fundamentally wrong. So far the only thing I am seeing is people complaining because they are not prognosticators.

I am unsure how I can help you here.

If the CBO states fees will go down and they go up, that is getting wrong.

If the CBO bases its findings on 23,000,000 people signing up for Obamacare and only 9,000,000 sign up. That is getting it wrong.

While certainly not prognosticators, budget forecasting is used across the board. If your budget forecasts are not accurate, then you have failed and have to look at different methodology in forecasting. Using the same methods again will not produce more accurate results.

I am at a loss as to how to express that concept in plainer language to help your understanding. I apologize for not being able to do better.
 
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Allandavid

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Ignore the news.

Ignore the polls.

Ignore the CBO.

Ignore anything embarrassing or ignorant from the president.

Did I miss anything?

Don't like military decisions?
"I know more than the generals"

Don't agree with the FBI?
"I've fired that nut job Comey"

Don't like when the press outs your lies?
"Fake news!"

Don't like your party's progress with legislation?
"It's the Democrats obstructing!"

Don't like the numbers?
"The CBO can't be trusted"

Ho hum.....
 
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dysert

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If the CBO expected that if X happened and Y happened then Z would happen and cost would be Q.
Then, if X did happen, and Y then happened and Z happened BUT costs ended up being J instead of Q "then" that would be a reason to not trust the CBO.

Do you follow me?
I follow you. You make perfect sense. The problem is that the CBO must start with some initial assumptions. In this example, the assumption is that "X happened". Well, if X doesn't happen, the whole rest of the analysis is out the window. CBO can't predict things out of thin air. They start with assumptions and follow them. The problem is that many of the assumptions they start with have proven wrong. So their analyses are way off.
 
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Maren

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I am unsure how I can help you here.

If the CBO states fees will go down and they go up, that is getting wrong.

If the CBO bases its findings on 23,000,000 people signing up for Obamacare and only 9,000,000 sign up. That is getting it wrong.

While certainly not prognosticators, budget forecasting is used across the board. If your budget forecasts are not accurate, then you have failed and have to look at different methodology in forecasting. Using the same methods again will not produce more accurate results.

I am at a loss as to how to express that concept in plainer language to help your understanding. I apologize for not being able to do better.

The problem is, the CBO is only evaluating what is in the bill, then basing their projections on what the bill states. In the case you mention, the law would required everyone, in all states, to sign up for health plans; with states having various obligations in expanding Medicare and helping their low income citizens. What made the CBO projections wrong was some states going to the courts to block portions of the law. Since the CBO based their projections on what the law required, but with many states getting courts to block some of the requirements, and then not participating as the law required -- this lowered the numbers of people that had the opportunity to sign up. The requirements changed after the CBO evaluation -- therefore the old evaluation was no longer relevant.
 
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ThatRobGuy

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The projections, based on the information they had, were completely reasonable.

If I'm making a projection about how a game is going to end, and someone changes the rules of the game after I've made my projection, you can't knock my projection when the game finishes with an unexpected result.

That's essentially what happened. The CBO made reasonable projections, individual states complained to the courts and found a way to circumnavigate laws (that they were expected to follow at the time the projections were made), and therefore the end result deviated from the projections.


To me, this "don't trust the CBO" shtick just seems like a way to discredit the entity that's giving some very sound warnings about the potential outcome of the GOP healthcare bill.
 
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dgiharris

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To me, this "don't trust the CBO" shtick just seems like a way to discredit the entity that's giving some very sound warnings about the potential outcome of the GOP healthcare bill.
\

It is part of the "discredit the source" logical fallacy narrative being pushed by the GOP.

As near as I can tell, there is only one side in this health care debate that is putting forth actual tangible demonstrable costs vs effects.

The other side is putting forth "nebulous" claims and assertions that have no actual hard number backing of any kind. It's a form of "fuzzy math" that uses a bunch of theory to hand wave away the problems we experience today.

Essentially, GOP plan is "hey, trust us, and health care will be better..." and yet they do not tell you exactly how or show you mathematically how. They say stuff like, "The free market will lower health care costs..." and that is just not true.

I will make this point in every health care debate I engage in. Free market economic theory simply does NOT work when you have a mathematical extreme, and health care is a mathematical extreme-- Demand is INFINITE!!!!

When your daughter has cancer, how much are you willing to spend to treat her? EVERYTHING. Similarly, you won't be in a position to shop your daughter's cancer around as if you are shopping for the best widget.

There are plenty of things a for profit model is the best fit for... Unfortunately, Health Care is not one of them, and that is why using the "Free market" to magically lower prices is a pipe dream. If the free market was so great handling health care we wouldn't have the problems we have now.
 
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jayem

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So why should we put our trust in an organization that hasn't been right in almost a decade??

CBO projections are required by federal law for certain spending legislation. Though it's up to Congress to decide what to do with the findings. You must know that the private sector does the same thing. Don't large companies hire consulting firms to run financial projections before undertaking major expenses? I haven't researched it, but I strongly doubt that the private sector's record for accuracy is significantly better.

Do you have an alternative?
 
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Belk

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I am unsure how I can help you here.

Let me see if I can illustrate what I am looking for.

If the CBO states fees will go down and they go up, that is getting wrong.

Except the CBO did not state this. According to your quote in the OP the CBO stated that the rate of increase would slow. Which as I recall it did for the first couple of years until something caused the rate of increase to speed up. What I am looking for is what assumption did the CBO use that you feel was incorrect and why should they not have assumed that. What caused the rate of increase and why should they have foreseen it in their models?

If the CBO bases its findings on 23,000,000 people signing up for Obamacare and only 9,000,000 sign up. That is getting it wrong.

I disagree. That is the projection not following along with the assumptions. Again these are estimates not prognistications. So what happened that caused less people to sign up and why should the CBO have known it was going to happen?

While certainly not prognosticators, budget forecasting is used across the board. If your budget forecasts are not accurate, then you have failed and have to look at different methodology in forecasting. Using the same methods again will not produce more accurate results.

There is a difference between accuracy and applicability. There projections were accurate for the assumptions they used. If you are going to complain that they used the wrong assumptions then I want to know why you feel they were incorrect? I want specifics of which assumptions you feel were not correct to use and why.

I am at a loss as to how to express that concept in plainer language to help your understanding. I apologize for not being able to do better.

I think it is fairly simple. I am looking for specifics on what you feel the CBO did incorrectly.
 
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hislegacy

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When we had cost projections they were reviewed quarterly and adjusted for variances.

The CBO has been off by over 125% off for years.

In the private sector, upper level management would have lost their jobs.

A definition of insanity is doing things the same way and expecting different results.

The CBO, in my opinion, needs to seriously look at their methodology
 
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