Category Archives: GDP

If US is Serious About Debt, There’s a Single-Payer Solution

St. Louis Post-Dispatch Editorial

August 14th, 2011

If America truly is serious about dealing with its deficit problems, there’s a fairly simple solution. But you’re probably not going to like it: Enact a single-payer health care plan.

See, we told you weren’t going to like it.

But the fact is that everyone who has studied the deficit problem has agreed that it’s actually a health care problem — more specifically, the cost of providing Medicare benefits to an aging and longer-living population. The bipartisan National Commission on Fiscal Responsibility and Reform reported last December: “The Congressional Budget Office (CBO) projects if we continue on our current course, deficits will remain high throughout the rest of this decade and beyond, and debt will spiral ever higher, reaching 90 percent of GDP in 2020.

“Over the long run, as the baby boomers retire and health care costs continue to grow, the situation will become far worse. By 2025 revenue will be able to finance only interest payments, Medicare, Medicaid, and Social Security. Every other federal government activity — from national defense and homeland security to transportation and energy — will have to be paid for with borrowed money.”

That being the case — and nobody argues that it isn’t — there are two broad ways for the government to address its spiraling health care costs. One, shift more of those costs to recipients, by trimming benefits and/or extending eligibility ages and indexing eligibility to personal income. This is politically unpalatable, particularly to most Democrats, President Barack Obama being a conspicuous exception.

The second way for government to address its health costs is not to shift them, but to reduce them. This is what a single-payer health care system would do, largely by taking the for-profit players (insurance companies for the most part) out of the loop.

The advocacy group Physicians for a National Health Program estimates that “private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.”

Once everyone is covered, the government would have the clout to bring discipline into the wild west of health care spending. It could insist that providers be paid for quality of service, not quantity. Health facilities and equipment could be managed by regional boards. Medical services could be “bundled” — rather than paying hospitals and doctors and laboratories separately, there would be fixed prices for treatments. And so on.

The Patient Protection and Affordable Care Act passed in 2009 contains many pilot programs designed to test cost-reduction strategies. Most of them won’t kick in for another six to eight years, by which time health care costs will be approaching 20 percent of U.S. gross domestic product. The combined state and federal share of that will be 49 percent, up from 45 percent today.

Indeed, a study published this month in the journal Health Affairs estimates that while the Affordable Care Act will pay for itself by 2020, it won’t actually “bend the cost curve,” as the Obama administration had hoped. But the study, done by the Actuary Centers for Medicare and Medicaid Services, says the ACA will significantly slow the rise of health care costs to state and local governments.

But consider those two findings: In effect, they say that if reducing overall health care costs is the goal, then the ACA didn’t go far enough. Thirty million more people will be insured and government costs will grow more slowly. But overall health care costs will continue to explode.

Sooner or later, a nation serious about controlling spending must take broad control of the health care system.

It surely won’t be sooner. Compared to the political fight that would erupt over a single-payer plan, the congressional battle over the Affordable Care Act would seem as tame as resolution praising mom, the flag and apple pie.

The ACA was a compromise. Mr. Obama brought everyone to the table — doctors, insurance companies, drug companies, hospitals — and came away with a “best we can get” kind of bill. Many of those at the table turned around and lobbied against it or sought special favors once the bill came before Congress.

It passed by narrow margins, and Congress is decidedly more conservative now. Indeed, the new House majority has voted to repeal the ACA and challenges to its constitutionality continue to work their way toward the Supreme Court.

But now, like a baby discovering its toes, Congress has discovered the deficit. And the plain fact is that unless you want to commit political suicide and cut Medicare to the bone — as Rep. Paul Ryan’s, R-Wis., budget plan would do — the best way to seriously address long-term deficits is to get control of health care costs through a single-payer plan.

In 2008, when health care costs amounted to “only” 16 percent of U.S. gross domestic product, Great Britain was spending 8.7 percent of its GDP on health care, and Canada was spending 10.4 percent. Both nations have single-payer plans. Quality of care scores in both nations are at least comparable, and in most cases, better.

Eventually, the United States will have a single-payer plan. But we’ll waste a lot of money and time getting there.

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Filed under America’s Affordable Health Choices Act, baby boomers, Congressional Budget Office, GDP, health care reform, Medicaid, Medicare, single-payer system, Social Security, St. Louis Post-Dispatch

President Obama’s Weekly Address: 10/31/09 Milestones on the Economy and the Recovery Act

While there is nothing to celebrate until job numbers turn around, the President cites the recent dramatic turnaround in gross domestic product as a sign of better things to come. He also applauds the fact that the Recovery Act has now created or saved more than a million jobs

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Filed under American Recovery and Reinvestment Plan, GDP, President Obama, Recession, weekly address

President Obama’s Weekly Address: 8/01/09

This Economic Storm Will Pass

The President discusses the state of the economy amidst positive signs from the GDP. Making clear that this is little comfort to those struggling, he notes that we appear to have averted an even worse disaster and offers hope for the time ahead.

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Filed under business investmentsest, Economic Assistance and Recovery Plan, GDP, Jobs, President Obama, weekly address

Open Letter to President Obama on Consumer Protection

I am no fan of Ralph Nader, but today he posted an open letter to President Obama on the CommonDreams.org  website which makes perfect sense to me. In his letter, Nader expresses his concerns over the economy and the need for consumer protections against fraud and deceit:

Dear President Obama:

Underneath many of our country’s economic problems is the thirty-year collapse of consumer protection-both of the regulatory kind and of the self-help kind known as proper access to justice.

Last month major consumer groups sent you a letter proposing action to rein in exploitation of consumers as debtors, as buyers of oil, gas and electricity, as patients needing health insurance and as eaters wanting safe goods.

Under the Bush regime, the words “consumer protection” were rarely uttered and the Bush administration almost never initiated any pro-consumer efforts, even with massive evidence before it, such as predatory lending and credit card abuses.

You need to recognize and elevate the GDP significance of fair consumer policies along with their moral and just attributes at a time of worsening recession.

I suggest you focus on the state of the poorest consumers in the urban and rural ghettos. As you know from your days with the New York Public Interest Group (NYPIRG) and as a community organizer in Chicago, the consumers in these areas are the most gouged and least protected. That the “poor pay more” has been extensively documented by civic, official and academic studies, and numerous local newspaper and television news reports.

Unfortunately, neither Congress nor the Executive branch have paid adequate attention to the tens of millions of people who lose at least 25 percent of their consumer dollars to multiple frauds and shoddy merchandise. You should establish special task forces in the Justice Department and the Federal Trade Commission on their plight and on the many proven but unused remedies to assure a fair marketplace with effective enforcement and grievance procedures.

Working with and galvanizing local and state agencies to enlarge their capacity and staff-with stimulus monies-can produce a triple-header-making the federal effort more effective, providing valuable jobs and freeing up billions of consumer dollars from the financial sink-hole of commercial crimes.

It requires the visibility and eloquence of your personal leadership to launch this long-overdue defense of poor people.

A second area of action is simply to update major areas of regulatory health and safety that have been frozen for thirty years. These include modernizing standards for auto and tire safety, food safety, aviation and railroad safety and occupational health and trauma protection.

New knowledge, new marketing forays, and new technologies have accumulated during this period without application. It is the obsolescence of so many safety standards hailing from the fifties, sixties and seventies that permits the tricky, corporate advertising claims that products “exceed federal safety standards.”

Note for example that the SEC has never come close to regulating the recent explosion of myriad collateralized debt obligations (CDOs). The massive speculation in this area is destabilizing the national and world economies.

Third, you need to articulate and provide a high profile to what western Europeans have long called “social consumerism.” Citizens are consumers of government services for which they pay as taxpayers. In return they are entitled to prompt, accurate and courteous responses to their inquiries and to their perceived needs as embraced by the authorizing statutes.

To begin with, Americans need to be able to get through to their government agencies and departments. Being put on hold interminably with automated messages to nowhere, not receiving replies of any kind to their letters, and generally getting the brush-off even with the deadlines explicated in the Freedom of Information Act have been a bi-partisan failure.

However, under the Bush regime, not answering serious letters from dedicated individuals and groups on time-sensitive matters of policy and action-as with the Iraq war and occupation-became standard operating procedure-starting with President Bush himself.

This stonewalling has turned people off so much that they do not even bother to “ask their government” for assistance and that includes an astonishingly unresponsive Congress (other than for ministerial requests such as locating lost VA or social security checks.)

As you shape the Obama White House, bear in mind that the “change you can believe in” is one of kind, not just degree.

Sincerely yours,

Ralph Nader

 

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Filed under CommonDreams.org, Congress, consumer protection, deception, fraud, GDP, open letter, President Obama, Ralph Nader, Securities and Exchange Commission

>Open Letter to President Obama on Consumer Protection

>

I am no fan of Ralph Nader, but today he posted an open letter to President Obama on the CommonDreams.org  website which makes perfect sense to me. In his letter, Nader expresses his concerns over the economy and the need for consumer protections against fraud and deceit:

Dear President Obama:

Underneath many of our country’s economic problems is the thirty-year collapse of consumer protection-both of the regulatory kind and of the self-help kind known as proper access to justice.

Last month major consumer groups sent you a letter proposing action to rein in exploitation of consumers as debtors, as buyers of oil, gas and electricity, as patients needing health insurance and as eaters wanting safe goods.

Under the Bush regime, the words “consumer protection” were rarely uttered and the Bush administration almost never initiated any pro-consumer efforts, even with massive evidence before it, such as predatory lending and credit card abuses.

You need to recognize and elevate the GDP significance of fair consumer policies along with their moral and just attributes at a time of worsening recession.

I suggest you focus on the state of the poorest consumers in the urban and rural ghettos. As you know from your days with the New York Public Interest Group (NYPIRG) and as a community organizer in Chicago, the consumers in these areas are the most gouged and least protected. That the “poor pay more” has been extensively documented by civic, official and academic studies, and numerous local newspaper and television news reports.

Unfortunately, neither Congress nor the Executive branch have paid adequate attention to the tens of millions of people who lose at least 25 percent of their consumer dollars to multiple frauds and shoddy merchandise. You should establish special task forces in the Justice Department and the Federal Trade Commission on their plight and on the many proven but unused remedies to assure a fair marketplace with effective enforcement and grievance procedures.

Working with and galvanizing local and state agencies to enlarge their capacity and staff-with stimulus monies-can produce a triple-header-making the federal effort more effective, providing valuable jobs and freeing up billions of consumer dollars from the financial sink-hole of commercial crimes.

It requires the visibility and eloquence of your personal leadership to launch this long-overdue defense of poor people.

A second area of action is simply to update major areas of regulatory health and safety that have been frozen for thirty years. These include modernizing standards for auto and tire safety, food safety, aviation and railroad safety and occupational health and trauma protection.

New knowledge, new marketing forays, and new technologies have accumulated during this period without application. It is the obsolescence of so many safety standards hailing from the fifties, sixties and seventies that permits the tricky, corporate advertising claims that products “exceed federal safety standards.”

Note for example that the SEC has never come close to regulating the recent explosion of myriad collateralized debt obligations (CDOs). The massive speculation in this area is destabilizing the national and world economies.

Third, you need to articulate and provide a high profile to what western Europeans have long called “social consumerism.” Citizens are consumers of government services for which they pay as taxpayers. In return they are entitled to prompt, accurate and courteous responses to their inquiries and to their perceived needs as embraced by the authorizing statutes.

To begin with, Americans need to be able to get through to their government agencies and departments. Being put on hold interminably with automated messages to nowhere, not receiving replies of any kind to their letters, and generally getting the brush-off even with the deadlines explicated in the Freedom of Information Act have been a bi-partisan failure.

However, under the Bush regime, not answering serious letters from dedicated individuals and groups on time-sensitive matters of policy and action-as with the Iraq war and occupation-became standard operating procedure-starting with President Bush himself.

This stonewalling has turned people off so much that they do not even bother to “ask their government” for assistance and that includes an astonishingly unresponsive Congress (other than for ministerial requests such as locating lost VA or social security checks.)

As you shape the Obama White House, bear in mind that the “change you can believe in” is one of kind, not just degree.

Sincerely yours,

Ralph Nader

 

Leave a comment

Filed under CommonDreams.org, Congress, consumer protection, deception, fraud, GDP, open letter, President Obama, Ralph Nader, Securities and Exchange Commission