Paul Krugman Recommends 'Death Panels' and 'VAT Tax' to Help Balance Budget

Quote from Epiphyte : Is there really all that substantial a difference between Medicare premiums and a tax if you're forced to pay them both?

Perhaps not, but I can see why people would think that a system that doesn't allow them to opt out shouldn't declare some people not worth spending treatment money on.

It's the same way that parents of children with severe learning disabilities demand that the schools pay $100,000 a year to try to educate their children, even though many of them cannot be educated.

Quote from tbuccaneer : Perhaps not, but I can see why people would think that a system that doesn't allow them to opt out shouldn't declare some people not worth spending treatment money on. It's the same way that parents of children with severe learning disabilities demand that the schools pay $100,000 a year to try to educate their children, even though many of them cannot be educated.

Right, I can understand how paying that second tax (premiums) could unnerve some.

With all the talk about debt, it's critical to engage the greatest contributor, which is Medicare, and make it more efficient using cost-cutting practices that are regularly implemented in private industry. We might be better off with no Medicare at all, but I don't foresee it disappearing any time soon and we can't afford to wait for that to happen before taking action.

On a side note: This has been a pretty enjoyable exchange. I appreciate the reasoned views you and others have offered up.

Quote from Epiphyte : Right, I can understand how paying that second tax (premiums) could unnerve some. With all the talk about debt, it's critical to engage the greatest contributor, which is Medicare, and make it more efficient using cost-cutting practices that are regularly implemented in private industry. We might be better off with no Medicare at all, but I don't foresee it disappearing any time soon and we can't afford to wait for that to happen before taking action. On a side note: This has been a pretty enjoyable exchange. I appreciate the reasoned views you and others have offered up.

Thank you Same to you.

I agree that something has to be done about Medicare. But notice that people don't complain when Medicaid forbids certain procedures. I think it's because people recognize that Medicaid is in essence provides a basic level of support for which the beneficiaries have not paid for. Medicare, people see as something they've paid into their whole lives and should not be limited by some evil panel now. Of course you and I know that most people on Medicare today draw far more out then they ever contributed, even adjusting for inflation and investment returns.

But that's the key difference.

Quote from smegalicious : Would this same logic apply to other govt-funded "systems" and benefits? In other words, since no poor person would deny themselves additional SNAP benefits or additional Section 8 benefits, does it make sense that the govt that represents them would deny it?

If you look at the trends in gov't provided housing, one of the lastest and greatest ideas (in the northeast anyway) is 'mixed income' housing. Pairing Section 8 receipients with young professionals in the same type of units in new construction. Essentially providing 'premium' housing to the poorest members of our society.

One thing you can always tell in government is it will almost always cost more to do something next year than it does this year. One might think over time people get more efficient at things, whether it's preventing crime, teaching students, providing food and shelter, etc., but when it's government running the show, that is more the exception than the rule.

Quote from Epiphyte : But, why such high expectations for Medicare, but not for other programs we're forced to pay for, yet often choose not to utilize? I don't expect every public school to offer the resources of Exeter.

If you think the current drive isn't for more public schools to be more like elite schools, your crazy. Small class sizes, special attention to students who are slow or falling behind, more diverse educational programs, and virually anything else you can think of that costs money is being used in our public school system.

In fact, I bet there are school systems today that have a single teacher earning $90,000 (in salary and bene's) to help a few disadvantaged students.

Schools in this country are getting anything except more efficient.

Quote from Epiphyte : Also, it's curious that most of the people who deride the so-called "death panels" seem to be conservatives.

Just so we're on the same page, I'm against all those entitlements. SS, Medicare, & Medicaid are all giant slush funds wasting my money as far as I'm concerned. And the only reason I use the term 'death panels' as a discripter for those who make the decisions between what procedures are selected is because I don't believe they have the tools needed (that the market process provides) to efficiently make decisions to improve the lives of citizens.

It's by no means their fault, it's just inherent in the nature of their position. They won't be able to make as good of a decision because if they fail at their job they don't go out of business. In fact if they fail, they'll probably get more money shifted their way.

Perhaps the level of care we provide to our own citizens would be less of an issue, were we to stop providing health care to those that are not citizens without reimbursement.

Quote from JackHandey : Perhaps the level of care we provide to our own citizens would be less of an issue, were we to stop providing health care to those that are not citizens without reimbursement.

Less of an issue, sure. But, would that make more than a small dent in the problem? I'd like to see some numbers.

Quote from Epiphyte : Less of an issue, sure. But, would that make more than a small dent in the problem? I'd like to see some numbers.

Well if we're talking solely about emergency room costs, Medicaid patients use the ER with twice the frequency of the uninsured, and only a subset of the uninsured patients are non-citizens.

Quote from Tony_Danza : Well if we're talking solely about emergency room costs, Medicaid patients use the ER with twice the frequency of the uninsured, and only a subset of the uninsured patients are non-citizens.

Yup, it wouldn't make that enormous a dent, just like removing earmarks wouldn't. But it's symbolic, and it's important.

Many people on the government teet, either through Medicare, Medicaid, food stamps, Social Security, unemployment, or whatever, say things like "Cut all the waste and then we can talk about cutting my benefits" or "Stop providing tons of services to illegals first."

I don't think people will be willing to take the necessary drastic cutbacks that will be required in the entitlement programs until after the most egregious of wasteful expenditures are eliminated.

Quote from Epiphyte : Less of an issue, sure. But, would that make more than a small dent in the problem? I'd like to see some numbers.

This is what I am able to find... Bear in mind that we have more illegal aliens now than when this was written, so the costs are most likely higher.

Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status. In California, a 2004 study by the Federation for American Immigration Reform put the state's annual cost at $1.4 billion. Similar studies in Colorado and Minnesota in 2005 came up with much smaller estimates: $31 million and $17 million, respectively. Texas estimated its 2006 costs at $1.3 billion. Because most illegal immigrants are relatively young and healthy, they generally don't need as much health care treatment as U.S. citizens.

The Immigration and Naturalization Service (INS) continues to bring injured and ill illegal immigrants to hospital emergency rooms without taking financial responsibility for their medical care. Almost $190 million or about 25 percent of the uncompensated costs southwest border county hospitals incurred resulted from emergency medical treatment provided to illegal immigrants.

That's $2.748 BILLION dollars. In just 4 states.

They are also using the hell out of our SW ER's.

That isn't even considering the impact upon our educational system...

California $3,220,200,000
Texas $1,645,400,000
New York $1,306,300,000
Illinois $834,000,000
New Jersey $620,200,000
For all 50 states $11,919,900,000

http://en.wikipedia.org/wiki/Econ...ted_States

That's right, we spend almost 12 BILLION dollars educating illegal immigrants. If we just took care of our own, we would not be spread so thin.

Quote from JackHandey : This is what I am able to find... Bear in mind that we have more illegal aliens now than when this was written, so the costs are most likely higher. Data on health care costs for illegal immigrants are sketchy because hospitals and community health centers don't ask about patients' legal status. In California, a 2004 study by the Federation for American Immigration Reform put the state's annual cost at $1.4 billion. Similar studies in Colorado and Minnesota in 2005 came up with much smaller estimates: $31 million and $17 million, respectively. Texas estimated its 2006 costs at $1.3 billion. Because most illegal immigrants are relatively young and healthy, they generally don't need as much health care treatment as U.S. citizens. The Immigration and Naturalization Service (INS) continues to bring injured and ill illegal immigrants to hospital emergency rooms without taking financial responsibility for their medical care. Almost $190 million or about 25 percent of the uncompensated costs southwest border county hospitals incurred resulted from emergency medical treatment provided to illegal immigrants. That's $2.748 BILLION dollars. In just 4 states. They are also using the hell out of our SW ER's. That isn't even considering the impact upon our educational system... California $3,220,200,000 Texas $1,645,400,000 New York $1,306,300,000 Illinois $834,000,000 New Jersey $620,200,000 For all 50 states $11,919,900,000 http://en.wikipedia.org/wiki/Econ...ted_States That's right, we spend almost 12 BILLION dollars educating illegal immigrants. If we just took care of our own, we would not be spread so thin.

Thanks for the research. $2.748 billion for a few large states with large illegal immigrant populations is still a very small part of medicare/medicaid spending. So it would make a small dent, but in no way comes close to solving the problem.

Quote from Epiphyte : Thanks for the research. $2.748 billion for a few large states with large illegal immigrant populations is still a very small part of medicare/medicaid spending. So it would make a small dent, but in no way comes close to solving the problem.

To place it in perspective, it's equivalent to 30,000 of those prostate cancer treatments that you thought were outrageous enough to create a thread about.

Quote from JackHandey : To place it in perspective, it's equivalent to 30,000 of those prostate cancer treatments that you thought were outrageous enough to create a thread about.

Right, still a drop in the bucket as far as overall expenditures. Of course, if restrictions were expanded to many other procedures that cost too much to do too little, then we could be approaching an actual solution.

Edit: If we want to do something about the debt, healthcare spending needs to be reduced. If we're going to reduce health care spending, we're going to have to do a lot more than restrict illegal's access and implement malpractice reform because those two solutions are small in scale compared to the overall beast.

Quote from Epiphyte : Right, still a drop in the bucket as far as overall expenditures. Of course, if restrictions were expanded to many other procedures that cost too much to do too little, then we could be approaching an actual solution.

Kind of the point... All of these "drops in the bucket" add up. If we cracked down on the illegal aliens, and government aid fraud, we would have more money available to take care of the things that are a concern for our citizens. I would feel much better about providing 30K citizens an extra 4 months of life, than allowing illegal aliens to steal that money from us.

Quote from Danman114 : The problem with government "death panels" is inherant in the nature of Government. As a citizen, you make up a part of your government and paying taxes into it is mandatory. We perceive it as immoral for government (which we consider representing the people, including the sick needing treatment) to deny treatment because we force individuals to pay into the 'system', we consider the 'system' as being run on behalf of those who pay into it, and considering no one would deny themselves access to the medical needs, it doesn't make sense that the government that represents them would deny it. Private insurance is different in this because private insurance is a completely seperate entity that you enter into an agreement with (it's voluntary) and part of the agreement you recognize that the insurance company has the final say in what treatments you receive.

Have to completely disagree, Dan. The 'problem' with government "death panels" is simply the fact that dishonest propagandists are using the term to describe what is an utterly reasonable and proper thing to do.

Government-provided health care is an attempt to mitigate the effects of inequities that exist in our societies (because of a free market economy) that are, most often, not the fault of an individual and (therefore) unjust. Since it is impossible to make a determination about each individual -- whether or not his circumstances are his fault or 'bad luck' -- we've created some basic structure to provide basic services to those we think are likely to need it.

It is the moral thing to do, in a nation so rich with resources. And, to make sure that this service is available to the citizens, a judicious use of available resources is also the right/moral thing to do. There is nothing improper, let alone immoral about judicious use of resources.