Why we cannot trust the CBO on healthcare costs:

[camille70]

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



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?



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?



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

Marco Rubio happened.

 

[hislegacy]

Marco Rubio happened.

need more than three words to formulate a reply.

 

[hislegacy]

So what happened that caused less people to sign up and why should the CBO have known it was going to happen?

That, my friend is what the CBO should have asked six years ago and then adjusted their projections. (not prognostications)

How can we say that a plan is good or bad based on a methodology that is flawed by 125% and more and has been flawed for almost a decade with no change?

 

[camille70]

need more than three words to formulate a reply.

I actually need just one letter. If you are asking me to expound upon my reply, I'd be happy to:.

I posted this elsewhere but it bears repeating:

The GOP helped cause premiums to rise by preventing health insurance groups from recovering losses that were incurred by participating in the first 10 years of Obamacare.


Now, with hard data on the customers they’re attracting, many insurers are discovering the population is less healthy than they had expected — and more likely to run higher medical bills. At the same time, federal programs designed to cushion insurance company losses are subsiding, partly because the law’s architects intended them to be temporary and partly because Republicans — led by presidential candidate Sen. Marco Rubio (R-Fla.) — forced elimination of one key program in the spending deal Congress enacted last year.


So after two years of premiums that seemed surprisingly low, at least by the standards of private health insurance in the U.S., some insurers are raising prices to adjust. That’s the source of the big hikes that have the attention of Trump and other Affordable Care Act critics. And it’s why, according to ACAsignups.net blogger Charles Gaba, premiums would rise between 12 and 13 percent on average if everybody who currently has insurance simply renewed the same plans for next year.


What Obamacare Opponents Get Wrong -- And Right -- About Insurance Premiums | The Huffington Post


The ACA isn't in a death spiral but the GOP is doing their best to kill it.

 

[hislegacy]

The GOP helped cause premiums to rise by preventing health insurance groups from recovering losses that were incurred by participating in the first 10 years of Obamacare.

?? It this prophetic? The first ten years of OBamacare?

Last I looked it a was six years old, almost seven?

 

[Belk]

That, my friend is what the CBO should have asked six years ago and then adjusted their projections. (not prognostications)

I'm asking you now. Why, in hindsight, did less people then expected sign up and why should the CBO have known about it.

How can we say that a plan is good or bad based on a methodology that is flawed by 125% and more and has been flawed for almost a decade with no change?

Methodologies are not measured in percentages. What is this 125% figure and to what does it pertain?

 

[hislegacy]

I'm asking you now. Why, in hindsight, did less people then expected sign up and why should the CBO have known about it.

I don't have the ability to speak for anyone but myself. When ACA caused my insurance agency to end my coverage and the new coverage went up 130% in the first 14 months I completely dropped medical insurance.

The Congressional Budget Office is responsible for Budget. It's in their name. Over the almost seven years the Budget office has not, to my knowledge, changed their projections.

Someone. Somewhere in six years should have said. "This isn't working"

Profitability is maintained by meeting budget. It's business 101. Companies that do not do Budget reviews are incompetent to the point of negligence.

Methodologies are not measured in percentages. What is this 125% figure and to what does it pertain?

Methodology produces projected budget. If your projected budget doesn't come close to your actual budget you have to rethink how you came to the projected one.

Leaving the projections alone for six years hoping it will change is insanity defined.[/QUOTE]

 

[ThatRobGuy]

Free market economic theory simply does NOT work when you have a mathematical extreme, and health care is a mathematical extreme-- Demand is INFINITE!!!!

Correct...I sort of touched on that in a few other threads as well...

The supply-side model works great in markets where the consumer has ultimate choice...most importantly, and above all else, the choice not to buy the good/service at all and wait for all competitors to lower their price as a result of nobody buying it.

The healthcare model doesn't fit that bill...if you're having chest pains or strokes, "hey, I'll just wait 6 months for their prices to drop" isn't an option like it would be for buying a new gaming console or cell phone.

It's the reason why technology in the realm of consumer electronic is ever-expanding and getting cheaper in comparison to what it used to be...why you can snag food for $1 at any fast food restaurant... yet, getting a CT scan breaks the bank and the technology has been virtually unchanged since the early 80's.

When the consumer doesn't have the option of just not buying it at all, it keeps prices high, and suppliers lazy in terms of innovation.

 

[dgiharris]

Correct...I sort of touched on that in a few other threads as well...

The supply-side model works great in markets where the consumer has ultimate choice...most importantly, and above all else, the choice not to buy the good/service at all and wait for all competitors to lower their price as a result of nobody buying it.

The healthcare model doesn't fit that bill...if you're having chest pains or strokes, "hey, I'll just wait 6 months for their prices to drop" isn't an option like it would be for buying a new gaming console or cell phone.

It's the reason why technology in the realm of consumer electronic is ever-expanding and getting cheaper in comparison to what it used to be...why you can snag food for $1 at any fast food restaurant... yet, getting a CT scan breaks the bank and the technology has been virtually unchanged since the early 80's.

When the consumer doesn't have the option of just not buying it at all, it keeps prices high, and suppliers lazy in terms of innovation.

Absolutely correct.

then there is a dark side to 'for profit' health care model. If you are a Health Care Insurance Provider, your profit comes from figuring out creative ways to deny coverage and to deny medical procedures that are costly and repetitive. If you are a Pharmaceutical Company, your biggest profits come from treatment not cures. Imagine a Pharma company produces pill XYZ which must be taken 3 times per day, at $1 per pill resulting in a nice $1,000 annual profit per person (yes profit margin is that insane with pills). Their R&D department stumbles onto a pill QRS that in 2 weeks completely cures the ailment XYZ treats. What do you think the Pharmaceutical companies do?

They either:
#1) Shelve pill QRS for as long as possible (i.e. they wait / hope their competitors don't develop it) or...
#2) They reduce the effectiveness of the pill, develop a lesser version JKL that does eventually cure the condition but only after years of taking JKL, and they make sure that the money spent on JKL equals or exceeds the money that XYZ makes.

Every single time GOP types bang the "all regulations are bad" drum I want to tear my hair out and scream. The average person has no idea what it is like to be in a high level board meeting at the top echelon of these soulless corporations. They are as soulless as an African Warlord recruiting child soldiers... All decisions are made by bean counters obsessed about next quarter's stock price.

In the for profit health care model, you pit the health and well being of John Q Public against next quarter's stock price... and it just never works out well for John Q Public as evident by our current health care crisis in America.

 

[Belk]

I don't have the ability to speak for anyone but myself. When ACA caused my insurance agency to end my coverage and the new coverage went up 130% in the first 14 months I completely dropped medical insurance.

I am sorry it affected you in such a manor. However it seems you do not know the reasons why others did not sign up for insurance. This makes it difficult to say that the CBO should have known it was going to happen.

The Congressional Budget Office is responsible for Budget. It's in their name. Over the almost seven years the Budget office has not, to my knowledge, changed their projections.

Why would they? The do projections on things they do not have real world data for. Once the law is passed you use the data instead of a projection.

Someone. Somewhere in six years should have said. "This isn't working"

Profitability is maintained by meeting budget. It's business 101. Companies that do not do Budget reviews are incompetent to the point of negligence.

You don't think the CBO is doing budget reviews?

Methodology produces projected budget. If your projected budget doesn't come close to your actual budget you have to rethink how you came to the projected one.

Leaving the projections alone for six years hoping it will change is insanity defined.

Exactly how much do you know about what the CBO does?

 

[hislegacy]

[QUOTE="Belk, post: 71518039,

I am sorry it affected you in such a manor. However it seems you do not know the reasons why others did not sign up for insurance. This makes it difficult to say that the CBO should have known it was going to happen.

I never said they should have known, I have stated repeatedly, they should have reviewed the numbers - that is part of budget
forecasting

Why would they? The do projections on things they do not have real world data for. Once the law is passed you use the data instead of a projection.

Once again, let me reiterate I am questioning if they ever did budjet reviews? If they had, they could alter their numbers and forecast to real life numbers, not just stay with a six year old forecast


You don't think the CBO is doing budget reviews?

No clue


Exactly how much do you know about what the CBO does?

Exactly as much as you, at least I think so

Warm Regards
hislegacy
Joe

 

[Belk]

I never said they should have known, I have stated repeatedly, they should have reviewed the numbers - that is part of budget
forecasting

I think I must be missing what you are stating then. Do you feel that the CBO should have had a good estimate of how many people would sign up for the ACA? If not then I am not understanding your complaint.

Once again, let me reiterate I am questioning if they ever did budjet reviews? If they had, they could alter their numbers and forecast to real life numbers, not just stay with a six year old forecast



No clue




Exactly as much as you, at least I think so

Warm Regards
hislegacy
Joe

My knowledge is somewhat sparse as far as the CBO is concerned. Given my paucity of information I would hesitate to claim people should not listen to those considered to be an expert on the subject.

 

[RocksInMyHead]

The GOP's Mind-Blowing Hypocrisy on the CBO

This is an older piece dating back to the initial healthcare debates in March, but it's still worth consideration. There are several important points to be gleaned from it:

1. The current head of the CBO (selected in 2015 by a Republican-majority congress) is a conservative economist who worked in the Bush administration. He has been critical of the ACA and is vocal in his support for deregulation and reduced government spending. This is not the same man who presided over the office when the ACA was scored.

2. The CBO uses a different budgeting model than it did when the ACA was scored, called "dynamic scoring". This method is favored by GOP lawmakers because it tends to reduce the impacts of tax cuts on overall revenue.

3. The CBO in the past paved the way for the Bush-era tax cuts and criticized Obama for his handling of future debt, and has received plenty of praise from Republicans over the years. That has only changed recently when their proposals have gotten poor scores.

In short, current criticism of the CBO by Republicans is ridiculous, and complaints about the accuracy of their predictions based on the ACA score are irrelevant.

Edit: also, it's important to note that the Op-Ed in the OP was co-written by Trump's Director of Legislative Affairs (Marc Short) and a conservative economist from the Heritage Foundation. It's got quite a bit of in-built bias.

 

[RocksInMyHead]

Another Op-Ed, this one from a former director of the CBO, that's worth reading: Don't blame the CBO for problems in the House healthcare bill

 

[bhsmte]

Absolutely correct.

then there is a dark side to 'for profit' health care model. If you are a Health Care Insurance Provider, your profit comes from figuring out creative ways to deny coverage and to deny medical procedures that are costly and repetitive. If you are a Pharmaceutical Company, your biggest profits come from treatment not cures. Imagine a Pharma company produces pill XYZ which must be taken 3 times per day, at $1 per pill resulting in a nice $1,000 annual profit per person (yes profit margin is that insane with pills). Their R&D department stumbles onto a pill QRS that in 2 weeks completely cures the ailment XYZ treats. What do you think the Pharmaceutical companies do?

They either:
#1) Shelve pill QRS for as long as possible (i.e. they wait / hope their competitors don't develop it) or...
#2) They reduce the effectiveness of the pill, develop a lesser version JKL that does eventually cure the condition but only after years of taking JKL, and they make sure that the money spent on JKL equals or exceeds the money that XYZ makes.

Every single time GOP types bang the "all regulations are bad" drum I want to tear my hair out and scream. The average person has no idea what it is like to be in a high level board meeting at the top echelon of these soulless corporations. They are as soulless as an African Warlord recruiting child soldiers... All decisions are made by bean counters obsessed about next quarter's stock price.

In the for profit health care model, you pit the health and well being of John Q Public against next quarter's stock price... and it just never works out well for John Q Public as evident by our current health care crisis in America.

I agree with your for profit take on the insurance side, as i have dealt with payors and the games they play for decades. On the actual health care provider side, for profit providers tend to fair quite well, when it comes to quality and being efficiant. The big non profits, tend to be cumbersome, top heavy with management and some of those CEOs are making millions a year. Also, non profit in healthcare is misleading. Non profits want to make a profit and take in more money than they spend, they just have to put the money back into the organization. This is why the large non profit hospitals, are erecting new facilities every five minutes. With the pharma companies, there are few complete cures of disease in healthcare in general. What you most often see, is disease being managed or controlled.

 

[hislegacy]

I think I must be missing what you are stating then. Do you feel that the CBO should have had a good estimate of how many people would sign up for the ACA? If not then I am not understanding your complaint.



My knowledge is somewhat sparse as far as the CBO is concerned. Given my paucity of information I would hesitate to claim people should not listen to those considered to be an expert on the subject.

While I sincerely appreciate all the personal attention you were giving me in that of all the posters on this thread you chose to ask me all these personal questions, I find that once a position is stated and then reiterated three times it does very little good to state it a fourth.

I apologize that I was not clear in stating in my position to help you understand what I'm saying and I do hope in the future That I get better in my posting style I hope you have a very good day

Warmest regards

His legacy

 

[Belk]

While I sincerely appreciate all the personal attention you were giving me in that of all the posters on this thread you chose to ask me all these personal questions, I find that once a position is stated and then reiterated three times it does very little good to state it a fourth.

I am trying ascertain the level of credibility I should give to your idea that we should not believe the CBO's reports. No offense but you do not seem to know very much about the subject. It makes it hard to take your position as having merit.

I apologize that I was not clear is a saint in my position to help you understand what I'm saying and I do hope in the future That I get better in my posting style I hope you have a very good day

Warmest regards

His legacy

I wish you the best of luck in your endeavors His legacy.

 

[Allandavid]

While I sincerely appreciate all the personal attention you were giving me in that of all the posters on this thread you chose to ask me all these personal questions, I find that once a position is stated and then reiterated three times it does very little good to state it a fourth.

I apologize that I was not clear in stating in my position to help you understand what I'm saying and I do hope in the future That I get better in my posting style I hope you have a very good day

Warmest regards

His legacy

You do a lot of that kind of apologising...

 

[hislegacy]

You do a lot of that kind of apologising...

Thank you. I do my best to be honest.

Best regards,

Hislegacy
Joe

 

[TLK Valentine]

need more than three words to formulate a reply.

According to...?