"An earlier version of a headline accompanying this article on the home page was incorrect. The health law is projected to result in a voluntary reduction in the work force equal to 2.5 million full-time workers, according to the Congressional Budget Office, not two million fewer jobs."
I think it would also be a glaring error to assume these are retirees. What evidence do you have that they are retirees and not 30 year olds that are purposely holding back productivity because of the incentive the government is now giving to not work?
Uh, what? The government isn't really giving an incentive at all. If I were young and didn't have a lifestyle that required a full-time salary, I certainly wouldn't be shackled to a full-time job just to keep insurance. I think that's the case for a ton of people.
You also have to consider the small business case. I can't tell you how many technology workers I know who have health issues and would otherwise be building a startup or working as a consultant, but before the ACA they could never dream of getting or keeping health insurance. I mean I'm a relatively healthy 20-something and was denied health insurance several times, and when I was approved, was paying ridiculous amounts per month because I was 10 pounds overweight.
Putting those prices back in line for most people and not tying health insurance to a full-time job is the whole point. I fail to see how this is government offering an incentive of any sort, unless that's what you meant and it was poorly phrased?
If I were young and didn't have a lifestyle that required a full-time salary, I certainly wouldn't be shackled to a full-time job just to keep insurance. I think that's the case for a ton of people.
So you are saying you might produce less as a result of subsidies given to you if you choose not to have a full time job? You are agreeing with 300bps.
What I'm saying is if, for example, my spouse and I could work enough to pay our bills without working full-time jobs I absolutely would. And that would not require taking advantage of a government subsidy. If I worked 10 hours a week as a consultant at $120/hour, that's over $60k, well out of the realm of any real "subsidy" from the government for insurance.
The government isn't really giving an incentive at all
This statement is incredibly naive and shows a complete lack of knowledge of economics. When the government gives incentives for making less money, then they are giving an incentive to make less money. It's that simple, but let me explain.
To get a bronze family plan on healthcare.gov, I was quoted $12,000 per year with a $12,700 deductible. Basically, I'd be paying $24,000 per year for healthcare.
That's the list price, which is what I have to pay if my wife and I make more than $96,000 per year (1/4 of the income goes toward healthcare). The cost goes down the less I make below $96,000. This is government giving me an incentive to make less money.
* This is government giving me an incentive to make less money.*
Or at least report less income. I bet a lot of people will move into the shadow economy, and get paid in cash. Instead of getting a W2 with 50k on it, I can work a part time job and report 20k, and do some off books work for 30k. I would qualify for the subsidy, and get a chunk of cash that I don't pay taxes on.
"[...] under Obama the average annual number of tax crime prosecutions sought by the Justice Department has been 1,568, versus 1,303 under Bush."
Doesn't sound like that's going to strike fear in the hearts of many. Plus I suspect detecting small fry like in byoung2's example is rather difficult.
That's a list of roles that does nothing to establish that they provide opportunities for $30k and nothing to estimate how many such positions are available.
I'm not arguing that cash jobs are rare or nonexistent. I'm wondering how prevalent "really good ones" actually are.
($30k being a real good cash job is just like my opinion, but whatever)
It would be very difficult to count the number of people doing these jobs for cash since they aren't reporting the income, but it isn't hard to imagine that these jobs could pay 30k if you combine some of the lower paying ones (e.g. $10/hour of gardening and day labor for 60 hours a week), or if you have skills that pay more (I did test prep tutoring for $60/hour in college).
In "the trades", e.g. electrical and plumbing work, LOTS. Don't know about you, but my family pays in cash for that sort of work without asking any questions....
Elsewhere, well, look at e.g. Italy where I've read that the people don't view the central government as legitimate and evading taxes is said to be the national pastime. Read up on the tax police stopping cars in the industrial north and checking trunks.
Our current tax system is truly voluntary in a certain sense, and would seriously break down if we widely adopted such attitudes for whatever reasons.
If that's 100% of the people trying, then it should certainly strike fear in the hearts of those who might try. If it's 0.000001% of the people trying, then it shouldn't phase anyone. I have no idea what the statistics are, though given that there are only 300 million Americans we can put some extremely loose bounds on it (won't be less than one in 200 thousand, about, if my napkin tells the truth). I don't think those bounds are enough to do anything useful, though.
That's a seriously narrow definition of "incentive." It's only an incentive if the amount they're offering you is more than the difference in income, which you and I both know it isn't.
And I have no clue what state you live in or your age obviously, but in Florida, which (previously) had some of the highest health care costs in the country, a family Bronze plan is only like $4k a year. I could get a Platinum plan with $0 deductible for about 30% than the price you're quoting. So, let's not act like those are normative numbers.
Incentive has a very specific meaning, and you don't understand what it means. If I offer you $1 to prance around like a monkey, then I've offered you an incentive to prance around like a monkey. It doesn't matter if you could make $2 slithering around like a snake. I've still given you an incentive to change your behavior, and many people will prefer the offer I am giving and thereby change their behavior.
And beyond that, you have no idea what you're talking about. I just put in my exact family situation into healthcare.gov for Broward County in FL and it is $987 per month with a $12,000 deductible for every Bronze plan. I'm guessing you're entering a ridiculously low income and taking the subsidies into account. Or you're looking at the catastrophic plans and thinking it's bronze, which it's not.
This will be my last response; you are an incredibly naive person and it is not my job to educate you.
I do get what you are saying, I just think it is a weak incentive. If you were making $96k would you forego part of your income in order to get a subsidy?
You need to look at the marginal cost on making that next dollar.
It's a big problem for our official poor, where there are wide ranges of income that cost them more in government benefits than they get in highly repressively taxed income.
And look at the results of supply side tax rate cuts, JFK's from 91%, Reagan's from 50% and 75% as I remember ("earned" and "unearned" (passive) income). Those had major effects, and while I'd gone to college a year before the latter's election I noticed how it changed my parent's economic behavior in ways that were good for the economy.
Again, I'm not necessarily disagreeing with you w/r/t policies outside of the ACA, but weren't we talking about health insurance and a guy that makes $96k? In looking at the tables for Health Insurance Marketplace subsidies, I just don't see the major impact here.
Note the rise from 25% to nearly 50% in the ~ $65K to ~ $85K income range, after which it plateaus to around that $96K threshold; add Obamacare subsidy losses and we're absolutely guaranteed a significant impact, unless people's economic behavior has radically changed since the '80s. Which is of course what the CBO is saying, among many other dire things (0.5% GDP loss, 6-7 million losing their employer health coverage, around the same number uninsured (although a lower percentage because of population growth)).
Note also the > 100% rates around $25K to $45K, and the steep climb that starts around $15K. That's the big effect I was talking about, except we generally don't count people or families in most parts of the country making $45K as "poor".
But, yeah, exactly what's going to happen at that income range is yet to be seen, and at this moment neither of our impressions can be stated to be right or wrong.
This is expected. There is a whole class of people who are working just for insurance because it was prohibitively expensive on the open market for individuals. If you make it affordable for them to purchase healthcare as individuals they'll retire.
Hopefully it means that people who want to work will be able to back fill those jobs.
I think it's a good thing for the economy. It can't be a good thing to force individuals to work when they'd have the means to retire if they were able to purchase healthcare at the same rates as large companies.
Nit: large companies purchase healthcare itself, and have specialist companies administer it, including I'm sure arranging the usual negotiated rates. They're big enough to do their own pooling.
Individuals have to buy insurance, because only a combination of them can form a (large enough) pool.
And I note that your analysis that this is good only holds in a situation like today, where there's a labor surplus. In the future it could be a very bad thing, especially if individuals in otherwise productive parts of their life don't work and therefore don't pay for the Baby Boomers' retirement promises like Social Security and Medicare.
ADDED: one thing we can be very sure about this law: there's going to be a bunch of "UNINTENDED consequences", and some of them will be bad. Some are likely to be very bad; one thing recently remarked on is that VCs are pulling back sharply from funding biomedical ventures, right now due to uncertainty, but things like the medical device tax are a component of that, and of well documented existing company retrenchment.
One other thing we can be very sure about this law: there's going to be a bunch of "unintended consequences", and some of them will be good. Some are likely to be very good.
Yes. Any moderately intelligent and informed person could look at a government program and identify both positive and negative impacts.
As an example, the entire Silicon Valley ecosystem started from the confluence of government programs, such as one where private investor dollars were matched by government dollars to create the very first valley VCs. I don't think anybody inside or outside of the government, projected the immensity of the impact of those programs.
Or y'know... about 90% of the stuff that spun out from NASA.
Anyway... I get it: you're a closed-minded ideologue and you weren't REALLY asking a question, you were just being snarky. So I'll stop pretending that I respect you now. And I'll stop pretending that we're having a conversation.
I don't think you've answered the question. In your response you cite a program that enjoyed the effects that were intended, but to an even greater degree than had been expected (and aside from the effects being expected, it's also not a large and complex program). Another example of a program that successfully achieved its goal, but surpassed expectations, would be the Eisenhower Interstate Highway system (which is probably the most successful large program I can think of).
What's the NASA spinoff you allude to? I expect it's, again, what had been promised. Part of the plan was to bring about technological innovations. The development of velcro, or things like it, was part of the plan.
What I actually asked for is any example of what you claimed to be a certainty: a large, complex government program having unintended positive results.
I wasn't being snarky, I was trying to demonstrate that the record here is nearly, if not entirely, on the downside. History shows us governmental programs failing in a myriad of ways, but this isn't balanced on the upside. I honestly can't think of a counterexample within my parameters (large size and complexity, and having unintended positive results).
EDIT: A better way to state my question occurred to me. What I'm looking for is not quantitatively unexpected results, but qualitatively unexpected results, because I think that's what is implied in the above back-and-forth about these qualitatively unintended bad results versus a certainty of unintended good results.
Give me a break. I guarantee that when NASA was proposed, nobody had a presentation which showed all the companies that would result, nor all the side effects of the engineering talent that would be accreted in industry and universities, nor all the innovations that would occur not just from items listed in the RFPs but from items inspired by those items and so on.
You're pretending that if something good happens after a government action it was all intentional and thus there were never any unintended positive impacts of anything, ever. Because government is full of far-sighted individuals who totally grokked that ARPAnet would eventually be used for every conceivable form of communication, entertainment, and commerce.
The world is complex. Governmental programs aren't all good or all bad. Reality isn't compatible with your small-minded ideology. Deal with it.
You're pretending that if something good happens after a government action it was all planned
I'll admit that I'm walking a dangerous line with the "no true Scotsman" fallacy. I stand by my judgment of the examples cited, but agree there is some room for debate.
I think the NASA example fails not because I'm being too narrow, but because the initial stated objectives were so fuzzy and broad. More importantly, these stated objectives were probably just secondary, a rationalization to enable the true objective - the nationalistic desire to win the "space race" against the Soviets. JFK, who initially got the whole ball rolling, actually wanted nothing to do with space exploration. His backing of it was really just a political ploy. (of course, in pointing this out, I'm making your point to a certain degree: JFK set out to score political points, and in the end he wound up bringing us velcro and ICBMs - yes, I'm being snarky there)
That said, you've also given me the best reply to my question: ARPAnet. While it wasn't large at the time, it was certainly complex (beyond my ability to understand all of its technology, anyway). And since it was developed for defense purposes, the end positive consequences are in a whole different ballpark than what was originally planned.
Anyway, what really drives my questioning here is a Megan McArdle post from yesterday [1] about a political science class at John Hopkins about policy failures. She quotes the prof. as talking about opening minds to critical thinking about the endless ways in which the best-laid plans can go awry.
"nationalistic desire" implies an inward looking reason, right?
As I read it, it was part of the fight for the hearts and minds of the 3rd world, the "Western" 1st World's approach to things vs. the Communist's 2nd World approach. Eisenhower let the Soviets orbit the first satellite to de facto establish his Open Skies policy, which the Soviets were mightily objecting to (the principle that outer space overflights were beyond territorial claims like those for airspace) ... but that the usual internal infighting led to our being visibly behind the Soviets in the most visible form of high technology. Which severely weakened our sales proposition to the 3rd World....
One explicit objective that developed, especially after LBJ took over, was uplifting the South with high tech. The opportunity of spending an extra billion in Texas is why we didn't build any infrastructure in space....
If you're going to stand by your judgment, you should do so on both sides.
Actors within government are generally aware that their actions have some negative consequences. They have a lot of smart people who tell them about problems that can (and will) occur, along with some likelihoods of the magnitude and frequencies of those problems. So under your classification scheme, there really aren't many unintended downsides of governmental action.
You seem to be conflating the public marketing of a policy (it will be sunshine and rainbows) with the internal understanding of a policy (it will solve a few problems, create a few different problems, and hopefully net positive).
You seem to be conflating the public marketing of a policy with the internal understanding of a policy
Yes. I'm doing that consciously, because I think it's appropriate. The very nature of the question is that when it's presented to the public, only the public marketing is on display. At the time we're debating a policy, we can guess at the internal agenda but we never really know for sure until later (if at all).
So if we're trying to learn from history and apply it to today's policy debate, of what use is a history that separates the hidden agenda - a factor that we are unable to know and make use of at the time the decision is being made?
It's in no way appropriate. You're purposefully conflating completely different arguments to try to score cheap political points.
And it's almost comic that you're essentially pretending that nobody talked about potential problems and failure modes for various healthcare reforms prior to the passing of Obamacare.
It saddens me that you seem to be an otherwise intelligent person, but you're so blinded by your ideology that you don't realize what intellectually dishonest nonsense you're spewing.
I respond poorly to people accusing me of intellectual dishonesty without demonstrating in what way I'm being dishonest. In my defense, if you look back through this thread, when specifically confronted about the arguments, I directly addressed the "no true Scotsman" issue, for example.
It's true that I'm not impartial here, but there's every indication that you're not either, yet you're trying to pin it all on me.
Of course problems and potential failure modes were debated; that was part of the public marketing. But there clearly was a hidden agenda that we still don't know. Why else would they have worked so hard to pass something overnight -- as if it were an emergency -- and including language making it so far from what anyone wanted and containing provisions contradicting what had been promised (and with every indication that (at the outset, anyway) those promises were sincere?
But where in the debate do you see any discourse about the hidden agendas of either side? How in the world can we include this in today's discussion when even now it can only be speculation? And how can I be intellectually dishonest with it, then, if we can't know what it is?
Sidebar:
The debate we had included raging dishonesty on both sides. On the pro side we had misdirection about the problems the bill was putatively intended to solve (preexisting conditions were already significantly addressed by HIPAA; uninsured could already get catastrophic care at hospitals, financed by the government) and funding (expenditure estimates were cooked by showing a runtime starting years before actual outlays began, in order to minimize the deficit impact). On the anti side we had hyperbole about "death panels" and about the government taking over the industry, etc.
I directly addressed the "no true Scotsman" issue, for example.
No, you didn't. You simply asserted that you weren't committing that fallacy.
Similarly, you simply asserted that when evaluating unexpected positive and negative consequences of an action, it is acceptable to dismiss nearly all of the positive ones while including nearly all of the negative ones. This is obvious nonsense, but you couldn't see the problem because you're blinded by your ideology.
And after that you engaged in the always fun sport of moving the goalposts. You switched your argument from 'there are no unintended positive consequences' to a completely unrelated set of complaints about public discourse.
You were intellectually dishonest. If you can't see this, it is only because you do not wish to see it. Your cognitive dissonance will not change reality.
I respond poorly to people accusing me of intellectual dishonesty without demonstrating in what way I'm being dishonest.
* You simply asserted that you weren't committing that fallacy.*
I acknowledged that there was room for debate, yet you offered none. I explained why I thought that I was on the correct side of the line (because the NASA case had objectives too fuzzy to judge), despite it being a close call.
I also acknowledged that a further example you gave (ARPAnet) was, in fact, a pretty good response to my initial question. You didn't pursue this point, yet I think it demonstrates that I'm not dishonestly throwing out all counterarguments.
You accuse me of "purposefully conflating completely different arguments to try to score cheap political points." Yet in my remarks about JFK and the space race, which in the sequence of the conversation seems to be what you're referring to, I was quite explicit in admitting "in pointing this out, I'm making your point to a certain degree".
I don't believe that your claim that I'm moving the goalpost has merit. I was pretty explicit in that I was looking for positive results that were qualitatively unexpected. The examples cited to me (with the exception of ARPAnet) were positive ones, but they were quantitatively unexpected. Saying "that worked better than we thought" is very different from saying "that had benefits that we didn't foresee".
Turning this around, now, and looking back on your own claims... your initial statement was "One other thing we can be very sure about this law: there's going to be a bunch of 'unintended consequences'", i.e., with certainty there will be positive consequences that weren't intended. Based on the context (that we're discussing employment effects of a sort that I don't recall ever seeing discussed in the PPACA debating), and the connotations of the word "intended" (as contrasted to the word "expected"; to me, the latter might have referred to quantitative differences but this doesn't work so well for the former), I interpret this to mean that there is a certainty of positive consequences that were qualitatively unintended.
You were intellectually dishonest.
It seems to me that -- as you're accusing me -- you're making brash and unfounded ideological pronouncements. That's what I intended to challenge, because it sounds preposterous to me. If the outcome you promise is certain, then there must be such a laundry list of them from past endeavors that you'll be able to rattle off a list in no time. I couldn't think of a single one (although, as noted above, ARPAnet is one example). So I challenged for examples.
And only one of the examples met the conditions that I believe were implied by your original statement (or how I interpreted it, anyway), that is, positive qualitatively unintended consequences to a large, complex governmental program.
You may disagree with me, but I think the fact that we've only come up with a single example (in between the name-calling) pretty well shows that such outcomes are far from a certainty.
I was pretty explicit in that I was looking for positive results that were qualitatively unexpected.
Jumpin Jesus on a pogo stick, you truly are a ridiculously dishonest asshole. This waste of time and energy started because you snarked "Can you name other government programs -- particularly any of this scope and complexity -- that have had unintended positive consequences?"
And now you're moving the goalposts again. Now you're claiming that if an achievement has dramatically different magnitude than expected that it doesn't count as unexpected. But this is clearly some of the purest manure ever seen on HN.
If you believed that bullshit argument, you'd also have to dismiss almost all of the unintended negative consequences of governmental actions, because most of those are ALSO problems of magnitude, where policy makers think there will only be a very marginal issue with X or Y, but the problems end up being material, at least for some stakeholders.
Magnitude matters. It is grossly dishonest of you to pretend otherwise.
I acknowledged that there was room for debate, yet you offered none.
That's because it's only debatable in your mind. You were completely in the wrong. There's no point in arguing with you on this point.
If you think you have plausible deniability, you're wrong.
You accuse me of "purposefully conflating completely different arguments to try to score cheap political points."
Because you're a dishonest asshole who switched arguments the moment I found an example that clearly falsified your bullshit.
only come up with a single example
Why, on God's green earth, would I bother coming up with more examples for a pathologically dishonest waste of oxygen who moves the goalposts whenever I say something? When you declared that Silicon Valley was an intentional benefit of government programs you made it CRYSTAL clear that you're not interested in anything even remotely resembling an honest conversation.
It also had plenty of unintended negative consequences. See suburban sprawl, oil dependency, the health impacts of commuting, and a ton of other negative impacts.
A lot of very large-scale military and space research, which has provided a lot of the technological basis on which modern Silicon Valley is build.
Most basic research, whether in natural sciences, mathematics or the humanities.
The equation 'large-scale government endeavour = bad' is so simplistic, it is painful to hear otherwise smart people repeat it over and over. The real world is way to complex for this kind of black-and-white armchair economics.
Ah, yes. All the abject failures have resulted in an increased distrust in big, "unlimited" government, making it harder for that government to do more damage. In this particular case, look at how Obamacare passed by a whisker, and how votes for it have sent so many politicians home to spend more time with their families.
Or how the "stimulus" produced a counter-reaction that's got the establishment utterly terrified, and using the full force of the state to repress. Which doesn't tend to end well, per Pareto "history is a graveyard of aristocracies".
It won't be a good thing for the economy, more people on the dole is never a good solution. The ACA was only going to "work" if it had enough healthy workers paying into it, having larger numbers of unsubsidized players.
With so many dropping into the clearly subsidized roles this will push the costs of the program up. With the guarantees to the insurance companies built into the law the public will end up footing an even larger bill which requires increase taxes and health care costs for those working putting a bigger drag on the economy.
Having more part time jobs which is what will happen when the employer side of this kick is not better that keeping full timers.
The hope is that we will observe an increase in real wages at the bottom end of the scale, which will have a very positive effect on the economy. This is evidence that people have been effectively trapped in jobs just for the healthcare.
I actually worked with someone (who knows python, JavaScript, c#, t/sql, etc.) who had to work loading boxes at UPS on the night shift while he was between jobs because, while he could afford to quit and look for a new job, he couldn't afford a gap in his insurance. It's not that he was sucking down tons of services either - just having a gap would have been bad news.
Now I hear that jobs at Whole Foods and Starbucks are pretty good all around, but there are others that I think will rightly need to pay more going forward.
Well, take my wife (please): she was working as an employee, taking a job that could have been done by someone else (teaching orchestra at a school), and then we moved and she started a business (private violin studio). While she makes more as a private teacher, prior to the ACA she was previously unable to purchase health insurance on the private market due to a food allergy (a precondition).
We had to move for other reasons than her job, but consider that there are many people doing work that other people do, who are motivated to do things like start a business, but who are otherwise unable to do so because of the US healthcare system.
Additionally, consider my parents, who are also working not because they need the income per se-- they could retire and live well-- except for the costs and difficulties of purchasing health insurance on a private market.
So it isn't the case that people are just universally "going on the dole"... making private insurance closer to the same cost to purchase health insurance regardless of your status as an employee shouldn't affect the overall bottom line of the leeches who provide insurance.
Curious that every insurance firm would rather not have you as a customer at all than simply offer to charge a higher premium or offer to exempt the consequences of a food allergy.
If it is any consolation to you, we could have gotten into our state's high risk pool, at about a third of collective our monthly income (to have just her in it, with a very limited selection of providers/services).
So, like about 1 in 4 folks in Texas, we went without.
It wasn't always a good idea, even. If they "exempt the consequences of" any particular condition, then they'll fight tooth and nail to assure that anything that does happen can be blamed on it.
prior to the ACA she was previously unable to purchase health insurance on the private market due to a food allergy (a precondition).
This is a common misunderstanding. For most people in this situation, the laws on the books already took care of the problem. If she already had healthcare insurance at her previous employer, if she could show continuous coverage, she would be able to continue to purchase healthcare insurance privately, despite her preexisting condition.
Whether the private insurance would be affordable to you is a different question, but it's not true that a preexisting condition was, before Obamacare, a complete roadblock to acquiring coverage privately.
The two preconditions you state explain exactly why preexisting conditions often were complete roadblocks to insurance. If you didn't have previous employer-sponsored insurance, or you had ever become financially unable to afford to maintain continuous coverage, you were SOL.
Yes, you are correct. Yes, she did have a lapse in coverage occurred.
And you're right; I believe that there were options open to her, specifically our state's high risk pool, which wasn't a viable option due to price.
But, heck, if price isn't a factor, why do we need insurance at all :D ? I mean, we always have the option to just purchase healthcare directly; whether that will be financially feasible, is, of course, "a different question".
I believe you may be oversimplifying the continuous coverage rules.
Under HIPAA, continuous coverage ensures acceptance into group health care plans (for instance, employer-provided coverage) regardless of preexisting conditions.
Further, continuous coverage ensures acceptance into some form of individual coverage, of a kind determined by the specific state you're in.
I do not believe it is the case that continuous coverage guarantees acceptance into individual health care plans.
In 19 years of working, and (more relevantly) 15 years of marriage, I have never had a lapse of health care coverage for myself or my family. When we started Matasano, I had just previously left a full-time, full-benefits job at a larger company where I'd been working for 4 years. I elected COBRA when I left, and started shopping for individual coverage.
We were unable to get family coverage at any price in Illinois because of preexisting condition concerns for two members of my family. In both cases, the rejection cause was a total surprise, because the "condition" wasn't an ongoing health problem, but rather a piece of medical trivia that caused underwriters concern that there might have been more significant issues down the road.
I shopped for insurance myself, and then with a professional broker who I paid to deal with the problem, and who could not find a way around it.
We solved the problem first by my wife taking a full-time job outside Matasano, which got us group coverage, and then by starting group coverage at Matasano.
>With the guarantees to the insurance companies built into the law the public will end up footing an even larger bill which requires increase taxes and health care costs for those working putting a bigger drag on the economy.
I don't get it. If we are footing the bill, then it will make higher taxes, but if the insurance companies foot the bill then health care costs increase. There's no reason for both to rise (unless we subsidize the insurance companies through taxes on the insurance companies...)
The "visible foot of the government" is quite enough. 2,000 pages of unread "law" can force all sorts of negative changes, and then there's the electronic health record (EHR) requirements in the "stimulus" bill, including the single sentence on requiring "meaningful use" which expanded into 700 pages of regulations, a lot of well paid consulting, and what looks like so far worse medical care as healthcare workers have to focus on the computer instead of the patient to avoid losing their jobs.
There's also the host of taxes in Obamacare; just the medical device tax alone will obviously raise the cost of care.
Ah, sorry, I didn't read what you were quoting carefully enough, although aren't there 3 or so "guarantees", 2 in addition to the risk corridors?
Risk corridors by themselves, obviously not. Except if you ignore the fungibility of money aren't they ostensibly paid for by taxes on policies??
On the other hand "guarantees" will put less pressure on insurance companies to put pressure on suppliers of health care, resulting in less displacement to other customers.
This title will be read by people and a lot will interpret it as 'less jobs'. But the exact opposite will happen: Some people will work less, so more people will need to be hired. Plus wages will have to go up to account for the shortage.
In a way, the ACA is creating jobs. Or at the very least, it'll increase wages. That's a selling point.
EDIT: I thought I wrote the "increasing jobs" in a "wouldn't it be funny if this were true" sort of sense, guess I didn't.
I thought that was the case. They phrased it so badly i actually quit reading it in the middle because it was giving me a headache.
Loss of working hours for businesses does not mean loss of jobs it means finally people can work decent hours and employers can't take advantage of them as easily.
This is unclear to me. The company needs to pay what what costs? As far as I can see, they are indeed paying hourly workers for the hours that are worked, so this can't be what you're referring to. What is the cost that they're not paying?
he might be referring to the fact that a lot of large retail outfits or fast food outfits basically pay such low wages that employees have to apply for things like food stamps (meaning the gov't is effectively subsidizing these jobs for the companies).
People who will continue to want to work more are, ipso facto, not part of the voluntary reduction in labor force participation projected in the CBO study. In fact, that reduction would reduce the number of people competing for those hours, making it more likely that those who want them will get them.
Your interpretation of the article is not supported by the body. If the CBO believed in the effect you postulate, they would not predict fewer jobs (more precisely, reduced effort equivalent to fewer jobs).
According to the body, hours worked and full time employment will drop. This is a straightforward supply shock, along the same lines as the oil shortage of the 70's (assuming of course you believe in reducing the entire economy to 2 graphs, as the Keynesians often do).
Also, increasing wages in a recession is a big no-no if you believe in Keynesian economics. Assuming this effect is not taken into account by the CBO's headline number, it means there will be further job losses.
> If the CBO believed in the effect you postulate, they would not predict fewer jobs.
They're predicting a smaller labor force (non-institutionalized population of working age working or actively seeking work) resulting from the reduced health insecurity from the ACA, not fewer jobs. [1]
To see where that fits into the unemployment picture, understand that the unemployment rate is (1 - (Filled Jobs / Labor Force)).
> Also, increasing wages in a recession is a big no-no if you believe in Keynesian economics
We're not in a recession. We're in an expansion in which both wages and employment rates have recovered slower than normal -- which was also true in the last expansion between the 2001 recession and the Great Recession -- which is why it feels like we've been in a 13 year recession to many people who aren't major capitalists, though there have only been 26 months of official recession in that period.
[1] The ACA effect is described on p. 14 of the report [2], which is linked from the NYTimes article, in the section under the heading "Labor Force Participation" (heading on p. 13).
I think you're missing the point about changes to the labor market.
The unemployment rate you cite is correct, but it's just as you said - a rate, not an absolute total.
What the report states is that the total number of jobs will decrease. Together with the fact that we know that hours per job is not going to increase (and may actually be decreasing, thanks to other PPACA regulations), simple algebra tells us that there will be fewer hours worked overall.
Barring an external development that causes productivity per hour to increase, we can expect lower total production. Bottom line, then, is lower GDP as a result of this. That is the opposite of a good thing for the economy.
considering that one of the measures of production (and GDP) is salaries, your argument is a bit iffy (salaries could rise proportionately due to the labor shortage, thus increasing GDP anyways, but that goes to show the uselessness of GDP in measuring "real" production).
One argument for better healthcare is people end up less sick. These guys(http://www.forbes.com/sites/brucejapsen/2012/09/12/u-s-workf...) seem to think that productivity decreases in the US account for almost 10% of spending on salaries and whatnot. There are 120 million or so people in the workforce, so 2 million jobs is something like 1%.
So if we make people "10%" more health , it would end up with us saving the same 1% (thus on the long-term allowing more investment later). We could get people to do the same amount of work for less, thus we are more productive.
I do not vouch for the validity of the numbers, just for the idea behind it (healthier people means more productive people).
"One argument for better healthcare is people end up less sick."
Indeed. Unfortunately, it is entirely unproven that Obamacare, which focuses on health insurance, is going to result in better health care.
For reasons we can go into if you want, Obamacare compliant polices tend to have extremely narrow networks of doctors and hospitals. E.g. look at all the fuss the Seattle Children's Hospital is raising, and there's a lot of individual cases where people are losing their doctors who've been treating their conditions for a long time, this is just the latest report to pop up: http://www.latimes.com/business/la-fi-obamacare-patients-201...
There's a reason Reagan got a lot of mileage with his joke "The nine most terrifying words in the English language are 'I'm from the government, and I'm here to help.'"
Obamacare compliant polices tend to have extremely narrow networks of doctors and hospitals
This is a good point.
The narrower networks can, I think, be expected to result in more time off work. I'll have to drive a farther distance to see my doctor, or I'll have to settle for an appointment in the middle of the day. Either way, it's a hit to my time that wouldn't exist under "traditional" schemes.
it is entirely unproven that Obamacare, which focuses on health insurance, is going to result in better health care.
So the fact that you're insured doesn't necessarily mean that you're going to get better faster. The doctor can't do anything for you if you've got a cold or the flu; you've just got to ride it out. I suspect that it's cases like this that make up the lion's share of health-related lost productivity.
And even when healthcare can have an impact on your health, I don't believe that the positive effects on worker productivity could be that great. Most employers already provide healthcare insurance, so there's no improvement to the situation there. The only positive effect will be toward those who are already employed but without health insurance, which is a minority.
They're predicting a smaller labor force (non-institutionalized population of working age working or actively seeking work) resulting from the reduced health insecurity from the ACA, not fewer jobs.
According to the CBO, the difference between actual and potential GDP will decline to 0.5% by 2017. At that point (and possibly before) a reduced labor force is reduced jobs and (more importantly) reduced production.
It could result in reduced jobs/production even before that if workers who choose to reduce output are not interchangeable with unemployed [1] workers willing to take those jobs at the same wage.
We're not in a recession. We're in an expansion in which both wages and employment rates have recovered slower than normal
Either we need fiscal/monetary stimulus or not. If we need stimulus, increasing wages is a bad idea according to all mainstream economic theories (Keynesian, Monetarist, Structuralist). Which is it?
As we are in an expansion, we don't really need stimulus, we need retraction of the policy changes of the last 35, and particularly the last 15, years that redirected more of the gains from private sector expansion to the capital and the very upper end of non-capital income earners, at the expense of everyone else; stimulus in these conditions doesn't really address the fundamental problem. At best, it provides a short-term backstop against the fundamental weakness of a poorly-distributed expansion crashing back into recession, but even that is hampered by the same distributional problems when using traditional monetary and fiscal stimulus levers.
Sure, from the POV of much of the workforce the economic. car isn't going anywhere, but stimulus is like trying to give it a jump start when the engine is runnin but the transmission is in neutral.
People who would otherwise spend time with their families, friends, hobbies and side projects will no longer be forced to work more hours at their jobs. Others who don't have full-time jobs will have an easier time getting them. Some good news for once.
These are houly people that need the hours to make ends meet. They are being forced into part time so that they aren't eligible. This is definitely a net negative, but not the least bit surprising.
With a deadline of the end of this year, I suspect we've only seen a fraction of what'll happen when the employer mandate goes into effect. Especially since a bunch of regulations for big companies, the ones that self-insure, haven't been finished yet, so it's probably up in the air if such maneuvers will help (i.e. would D.C. pass up such an opportunity to squeeze more cash out of them?)
The economy is a measurement of the productivity of the workers. By cutting 2 million man/hours, or whatever metric they use, you are cutting the economic productivity that much. So, it will hurt the economy no matter how you spin it.
Further, it is not like they are getting health care due to an efficiency in the system. The government is taking resources from the productive (taxes) and giving it to the unproductive (subsidies) in order to purchase insurance. This will further erode economic productivity.
Few or none. The economic effect that the study is showing is not an increase in unemployment.
What they're expecting is that fewer people will be motivated to work (or to work a second job, perhaps). Imagine someone self-employed who also works part time to get medical insurance benefits; with PPACA he wouldn't need to do this any longer. On the other hand, imagine someone who was working just to supplement the spouse's income. With PPACA's subsidies, the extra income (within certain ranges) becomes a liability, and it makes more sense for that person to stay home without the earned income, enjoying the healthcare subsidy instead.
So this doesn't say anything about unemployment (as it's commonly defined).
What they're expecting is that fewer people will be motivated to work (or to work a second job, perhaps)
They should also expect that some people will appear to reduce their hours or quit that second job, when in fact they trade it for some off the books work. For example, the musician who used to work part time at Applebees might just teach guitar lessons for cash in his spare time instead. The person supplementing the spouse's income is not going to just stay home and watch TV...they might run an unlicensed daycare or become a basement hairstylist or freelance web designer for cash.
This reflects a misunderstanding of the study, the article written about the study, the words "productivity", "economics" and the phrase "economic productivity". Jesus christ.
Correction: February 4, 2014
An earlier version of a headline accompanying this article on the home page was incorrect. The health law is projected to result in a voluntary reduction in the work force equal to 2.5 million full-time workers, according to the Congressional Budget Office, not two million fewer jobs.
If true, this is a good thing. We, as a society, don't need "jobs" or hours worked. We need stuff made. Voluntary attrition of the least productive 5-billion person-hours per year won't hurt us much, but that will cause wages to rise (which will, over time, improve what is produced).
We're already producing a lot of stuff. What we need now is a qualitative focus, serious consideration of sustainability and, above all, better leadership. Taking some pressure off the lower and middle classes (i.e. peeling back the wage serfdom that gives power to feudal strongmen) is a start.
There used to be a Fordist connection between general prosperity and the well-being of businesses, rippling up to the very rich. But the consumer credit boom killed that (sort of). Instead of letting wages rise or prices fall, the poors could be pumped full of loans they couldn't afford to repay. We saw, in 2008, how well that works out, but the fundamental structure of society hasn't changed.
Obama has made many tactical mistakes with the PPACA, and I wish he had started at single-payer to make public-option the compromise, but if "Obamacare" is bringing us back toward a more cooperative, progressive society, then that's a good thing.
The whole discussion is baffling. The US health care system consumes almost 20% of GDP. That is twice as much as any other developed country - without seeing better health care results.
Making changes to a system that corresponds to one fifth of the annual economic output will obviously have massive consequences. However, it is hard to see how you could possible make the economics of US health care worse. ACA gives more people the ability to individually choose their health care insurance, thus increasing competition and hopefully giving the health care buy side more incentive to drive down prices.
One simple way to make health care more expensive with minimal improvements to outcomes would be to devote even more resources to extraordinary measures.
The U.S. healthcare system is not set up to maximize outcomes. I guess I agree that is a problem, but it makes efficiency comparisons less interesting.
91 comments
[ 2.8 ms ] story [ 166 ms ] thread"An earlier version of a headline accompanying this article on the home page was incorrect. The health law is projected to result in a voluntary reduction in the work force equal to 2.5 million full-time workers, according to the Congressional Budget Office, not two million fewer jobs."
You also have to consider the small business case. I can't tell you how many technology workers I know who have health issues and would otherwise be building a startup or working as a consultant, but before the ACA they could never dream of getting or keeping health insurance. I mean I'm a relatively healthy 20-something and was denied health insurance several times, and when I was approved, was paying ridiculous amounts per month because I was 10 pounds overweight.
Putting those prices back in line for most people and not tying health insurance to a full-time job is the whole point. I fail to see how this is government offering an incentive of any sort, unless that's what you meant and it was poorly phrased?
So you are saying you might produce less as a result of subsidies given to you if you choose not to have a full time job? You are agreeing with 300bps.
So, no, I do not agree with him.
You agree with his claims, just not his tone.
This statement is incredibly naive and shows a complete lack of knowledge of economics. When the government gives incentives for making less money, then they are giving an incentive to make less money. It's that simple, but let me explain.
To get a bronze family plan on healthcare.gov, I was quoted $12,000 per year with a $12,700 deductible. Basically, I'd be paying $24,000 per year for healthcare.
That's the list price, which is what I have to pay if my wife and I make more than $96,000 per year (1/4 of the income goes toward healthcare). The cost goes down the less I make below $96,000. This is government giving me an incentive to make less money.
Or at least report less income. I bet a lot of people will move into the shadow economy, and get paid in cash. Instead of getting a W2 with 50k on it, I can work a part time job and report 20k, and do some off books work for 30k. I would qualify for the subsidy, and get a chunk of cash that I don't pay taxes on.
"[...] under Obama the average annual number of tax crime prosecutions sought by the Justice Department has been 1,568, versus 1,303 under Bush."
Doesn't sound like that's going to strike fear in the hearts of many. Plus I suspect detecting small fry like in byoung2's example is rather difficult.
I'm sure there are lots of them, but I wonder if there are so many that it is something to worry about.
Given the audience of this site, web design would be the obvious choice. But here are some more:
http://livesafely.org/financial-freedom/67-jobs-that-pay-und...
I'm not arguing that cash jobs are rare or nonexistent. I'm wondering how prevalent "really good ones" actually are.
($30k being a real good cash job is just like my opinion, but whatever)
Elsewhere, well, look at e.g. Italy where I've read that the people don't view the central government as legitimate and evading taxes is said to be the national pastime. Read up on the tax police stopping cars in the industrial north and checking trunks.
Our current tax system is truly voluntary in a certain sense, and would seriously break down if we widely adopted such attitudes for whatever reasons.
And I have no clue what state you live in or your age obviously, but in Florida, which (previously) had some of the highest health care costs in the country, a family Bronze plan is only like $4k a year. I could get a Platinum plan with $0 deductible for about 30% than the price you're quoting. So, let's not act like those are normative numbers.
And beyond that, you have no idea what you're talking about. I just put in my exact family situation into healthcare.gov for Broward County in FL and it is $987 per month with a $12,000 deductible for every Bronze plan. I'm guessing you're entering a ridiculously low income and taking the subsidies into account. Or you're looking at the catastrophic plans and thinking it's bronze, which it's not.
This will be my last response; you are an incredibly naive person and it is not my job to educate you.
It's a big problem for our official poor, where there are wide ranges of income that cost them more in government benefits than they get in highly repressively taxed income.
And look at the results of supply side tax rate cuts, JFK's from 91%, Reagan's from 50% and 75% as I remember ("earned" and "unearned" (passive) income). Those had major effects, and while I'd gone to college a year before the latter's election I noticed how it changed my parent's economic behavior in ways that were good for the economy.
Note the rise from 25% to nearly 50% in the ~ $65K to ~ $85K income range, after which it plateaus to around that $96K threshold; add Obamacare subsidy losses and we're absolutely guaranteed a significant impact, unless people's economic behavior has radically changed since the '80s. Which is of course what the CBO is saying, among many other dire things (0.5% GDP loss, 6-7 million losing their employer health coverage, around the same number uninsured (although a lower percentage because of population growth)).
Note also the > 100% rates around $25K to $45K, and the steep climb that starts around $15K. That's the big effect I was talking about, except we generally don't count people or families in most parts of the country making $45K as "poor".
But, yeah, exactly what's going to happen at that income range is yet to be seen, and at this moment neither of our impressions can be stated to be right or wrong.
Hopefully it means that people who want to work will be able to back fill those jobs.
I think it's a good thing for the economy. It can't be a good thing to force individuals to work when they'd have the means to retire if they were able to purchase healthcare at the same rates as large companies.
Individuals have to buy insurance, because only a combination of them can form a (large enough) pool.
And I note that your analysis that this is good only holds in a situation like today, where there's a labor surplus. In the future it could be a very bad thing, especially if individuals in otherwise productive parts of their life don't work and therefore don't pay for the Baby Boomers' retirement promises like Social Security and Medicare.
ADDED: one thing we can be very sure about this law: there's going to be a bunch of "UNINTENDED consequences", and some of them will be bad. Some are likely to be very bad; one thing recently remarked on is that VCs are pulling back sharply from funding biomedical ventures, right now due to uncertainty, but things like the medical device tax are a component of that, and of well documented existing company retrenchment.
As an example, the entire Silicon Valley ecosystem started from the confluence of government programs, such as one where private investor dollars were matched by government dollars to create the very first valley VCs. I don't think anybody inside or outside of the government, projected the immensity of the impact of those programs.
Or y'know... about 90% of the stuff that spun out from NASA.
Anyway... I get it: you're a closed-minded ideologue and you weren't REALLY asking a question, you were just being snarky. So I'll stop pretending that I respect you now. And I'll stop pretending that we're having a conversation.
What's the NASA spinoff you allude to? I expect it's, again, what had been promised. Part of the plan was to bring about technological innovations. The development of velcro, or things like it, was part of the plan.
What I actually asked for is any example of what you claimed to be a certainty: a large, complex government program having unintended positive results.
I wasn't being snarky, I was trying to demonstrate that the record here is nearly, if not entirely, on the downside. History shows us governmental programs failing in a myriad of ways, but this isn't balanced on the upside. I honestly can't think of a counterexample within my parameters (large size and complexity, and having unintended positive results).
EDIT: A better way to state my question occurred to me. What I'm looking for is not quantitatively unexpected results, but qualitatively unexpected results, because I think that's what is implied in the above back-and-forth about these qualitatively unintended bad results versus a certainty of unintended good results.
You're pretending that if something good happens after a government action it was all intentional and thus there were never any unintended positive impacts of anything, ever. Because government is full of far-sighted individuals who totally grokked that ARPAnet would eventually be used for every conceivable form of communication, entertainment, and commerce.
The world is complex. Governmental programs aren't all good or all bad. Reality isn't compatible with your small-minded ideology. Deal with it.
I'll admit that I'm walking a dangerous line with the "no true Scotsman" fallacy. I stand by my judgment of the examples cited, but agree there is some room for debate.
I think the NASA example fails not because I'm being too narrow, but because the initial stated objectives were so fuzzy and broad. More importantly, these stated objectives were probably just secondary, a rationalization to enable the true objective - the nationalistic desire to win the "space race" against the Soviets. JFK, who initially got the whole ball rolling, actually wanted nothing to do with space exploration. His backing of it was really just a political ploy. (of course, in pointing this out, I'm making your point to a certain degree: JFK set out to score political points, and in the end he wound up bringing us velcro and ICBMs - yes, I'm being snarky there)
That said, you've also given me the best reply to my question: ARPAnet. While it wasn't large at the time, it was certainly complex (beyond my ability to understand all of its technology, anyway). And since it was developed for defense purposes, the end positive consequences are in a whole different ballpark than what was originally planned.
Anyway, what really drives my questioning here is a Megan McArdle post from yesterday [1] about a political science class at John Hopkins about policy failures. She quotes the prof. as talking about opening minds to critical thinking about the endless ways in which the best-laid plans can go awry.
[1] http://www.bloomberg.com/news/2014-02-04/learning-from-iraq-...
As I read it, it was part of the fight for the hearts and minds of the 3rd world, the "Western" 1st World's approach to things vs. the Communist's 2nd World approach. Eisenhower let the Soviets orbit the first satellite to de facto establish his Open Skies policy, which the Soviets were mightily objecting to (the principle that outer space overflights were beyond territorial claims like those for airspace) ... but that the usual internal infighting led to our being visibly behind the Soviets in the most visible form of high technology. Which severely weakened our sales proposition to the 3rd World....
One explicit objective that developed, especially after LBJ took over, was uplifting the South with high tech. The opportunity of spending an extra billion in Texas is why we didn't build any infrastructure in space....
Actors within government are generally aware that their actions have some negative consequences. They have a lot of smart people who tell them about problems that can (and will) occur, along with some likelihoods of the magnitude and frequencies of those problems. So under your classification scheme, there really aren't many unintended downsides of governmental action.
You seem to be conflating the public marketing of a policy (it will be sunshine and rainbows) with the internal understanding of a policy (it will solve a few problems, create a few different problems, and hopefully net positive).
Yes. I'm doing that consciously, because I think it's appropriate. The very nature of the question is that when it's presented to the public, only the public marketing is on display. At the time we're debating a policy, we can guess at the internal agenda but we never really know for sure until later (if at all).
So if we're trying to learn from history and apply it to today's policy debate, of what use is a history that separates the hidden agenda - a factor that we are unable to know and make use of at the time the decision is being made?
And it's almost comic that you're essentially pretending that nobody talked about potential problems and failure modes for various healthcare reforms prior to the passing of Obamacare.
It saddens me that you seem to be an otherwise intelligent person, but you're so blinded by your ideology that you don't realize what intellectually dishonest nonsense you're spewing.
It's true that I'm not impartial here, but there's every indication that you're not either, yet you're trying to pin it all on me.
Of course problems and potential failure modes were debated; that was part of the public marketing. But there clearly was a hidden agenda that we still don't know. Why else would they have worked so hard to pass something overnight -- as if it were an emergency -- and including language making it so far from what anyone wanted and containing provisions contradicting what had been promised (and with every indication that (at the outset, anyway) those promises were sincere?
But where in the debate do you see any discourse about the hidden agendas of either side? How in the world can we include this in today's discussion when even now it can only be speculation? And how can I be intellectually dishonest with it, then, if we can't know what it is?
Sidebar: The debate we had included raging dishonesty on both sides. On the pro side we had misdirection about the problems the bill was putatively intended to solve (preexisting conditions were already significantly addressed by HIPAA; uninsured could already get catastrophic care at hospitals, financed by the government) and funding (expenditure estimates were cooked by showing a runtime starting years before actual outlays began, in order to minimize the deficit impact). On the anti side we had hyperbole about "death panels" and about the government taking over the industry, etc.
No, you didn't. You simply asserted that you weren't committing that fallacy.
Similarly, you simply asserted that when evaluating unexpected positive and negative consequences of an action, it is acceptable to dismiss nearly all of the positive ones while including nearly all of the negative ones. This is obvious nonsense, but you couldn't see the problem because you're blinded by your ideology.
And after that you engaged in the always fun sport of moving the goalposts. You switched your argument from 'there are no unintended positive consequences' to a completely unrelated set of complaints about public discourse.
You were intellectually dishonest. If you can't see this, it is only because you do not wish to see it. Your cognitive dissonance will not change reality.
I respond poorly to people accusing me of intellectual dishonesty without demonstrating in what way I'm being dishonest.
Grow up.
I acknowledged that there was room for debate, yet you offered none. I explained why I thought that I was on the correct side of the line (because the NASA case had objectives too fuzzy to judge), despite it being a close call.
I also acknowledged that a further example you gave (ARPAnet) was, in fact, a pretty good response to my initial question. You didn't pursue this point, yet I think it demonstrates that I'm not dishonestly throwing out all counterarguments.
You accuse me of "purposefully conflating completely different arguments to try to score cheap political points." Yet in my remarks about JFK and the space race, which in the sequence of the conversation seems to be what you're referring to, I was quite explicit in admitting "in pointing this out, I'm making your point to a certain degree".
I don't believe that your claim that I'm moving the goalpost has merit. I was pretty explicit in that I was looking for positive results that were qualitatively unexpected. The examples cited to me (with the exception of ARPAnet) were positive ones, but they were quantitatively unexpected. Saying "that worked better than we thought" is very different from saying "that had benefits that we didn't foresee".
Turning this around, now, and looking back on your own claims... your initial statement was "One other thing we can be very sure about this law: there's going to be a bunch of 'unintended consequences'", i.e., with certainty there will be positive consequences that weren't intended. Based on the context (that we're discussing employment effects of a sort that I don't recall ever seeing discussed in the PPACA debating), and the connotations of the word "intended" (as contrasted to the word "expected"; to me, the latter might have referred to quantitative differences but this doesn't work so well for the former), I interpret this to mean that there is a certainty of positive consequences that were qualitatively unintended.
You were intellectually dishonest.
It seems to me that -- as you're accusing me -- you're making brash and unfounded ideological pronouncements. That's what I intended to challenge, because it sounds preposterous to me. If the outcome you promise is certain, then there must be such a laundry list of them from past endeavors that you'll be able to rattle off a list in no time. I couldn't think of a single one (although, as noted above, ARPAnet is one example). So I challenged for examples.
And only one of the examples met the conditions that I believe were implied by your original statement (or how I interpreted it, anyway), that is, positive qualitatively unintended consequences to a large, complex governmental program.
You may disagree with me, but I think the fact that we've only come up with a single example (in between the name-calling) pretty well shows that such outcomes are far from a certainty.
Jumpin Jesus on a pogo stick, you truly are a ridiculously dishonest asshole. This waste of time and energy started because you snarked "Can you name other government programs -- particularly any of this scope and complexity -- that have had unintended positive consequences?"
And now you're moving the goalposts again. Now you're claiming that if an achievement has dramatically different magnitude than expected that it doesn't count as unexpected. But this is clearly some of the purest manure ever seen on HN.
If you believed that bullshit argument, you'd also have to dismiss almost all of the unintended negative consequences of governmental actions, because most of those are ALSO problems of magnitude, where policy makers think there will only be a very marginal issue with X or Y, but the problems end up being material, at least for some stakeholders.
Magnitude matters. It is grossly dishonest of you to pretend otherwise.
I acknowledged that there was room for debate, yet you offered none.
That's because it's only debatable in your mind. You were completely in the wrong. There's no point in arguing with you on this point.
If you think you have plausible deniability, you're wrong.
You accuse me of "purposefully conflating completely different arguments to try to score cheap political points."
Because you're a dishonest asshole who switched arguments the moment I found an example that clearly falsified your bullshit.
only come up with a single example
Why, on God's green earth, would I bother coming up with more examples for a pathologically dishonest waste of oxygen who moves the goalposts whenever I say something? When you declared that Silicon Valley was an intentional benefit of government programs you made it CRYSTAL clear that you're not interested in anything even remotely resembling an honest conversation.
DIAGF.
(I'll concede that it depends on what you want to measure, but it's hard to argue that cheap trucking has only been a negative)
Most basic research, whether in natural sciences, mathematics or the humanities.
The equation 'large-scale government endeavour = bad' is so simplistic, it is painful to hear otherwise smart people repeat it over and over. The real world is way to complex for this kind of black-and-white armchair economics.
Or how the "stimulus" produced a counter-reaction that's got the establishment utterly terrified, and using the full force of the state to repress. Which doesn't tend to end well, per Pareto "history is a graveyard of aristocracies".
With so many dropping into the clearly subsidized roles this will push the costs of the program up. With the guarantees to the insurance companies built into the law the public will end up footing an even larger bill which requires increase taxes and health care costs for those working putting a bigger drag on the economy.
Having more part time jobs which is what will happen when the employer side of this kick is not better that keeping full timers.
I actually worked with someone (who knows python, JavaScript, c#, t/sql, etc.) who had to work loading boxes at UPS on the night shift while he was between jobs because, while he could afford to quit and look for a new job, he couldn't afford a gap in his insurance. It's not that he was sucking down tons of services either - just having a gap would have been bad news.
Now I hear that jobs at Whole Foods and Starbucks are pretty good all around, but there are others that I think will rightly need to pay more going forward.
We had to move for other reasons than her job, but consider that there are many people doing work that other people do, who are motivated to do things like start a business, but who are otherwise unable to do so because of the US healthcare system.
Additionally, consider my parents, who are also working not because they need the income per se-- they could retire and live well-- except for the costs and difficulties of purchasing health insurance on a private market.
So it isn't the case that people are just universally "going on the dole"... making private insurance closer to the same cost to purchase health insurance regardless of your status as an employee shouldn't affect the overall bottom line of the leeches who provide insurance.
So, like about 1 in 4 folks in Texas, we went without.
This is a common misunderstanding. For most people in this situation, the laws on the books already took care of the problem. If she already had healthcare insurance at her previous employer, if she could show continuous coverage, she would be able to continue to purchase healthcare insurance privately, despite her preexisting condition.
Whether the private insurance would be affordable to you is a different question, but it's not true that a preexisting condition was, before Obamacare, a complete roadblock to acquiring coverage privately.
And you're right; I believe that there were options open to her, specifically our state's high risk pool, which wasn't a viable option due to price.
But, heck, if price isn't a factor, why do we need insurance at all :D ? I mean, we always have the option to just purchase healthcare directly; whether that will be financially feasible, is, of course, "a different question".
Under HIPAA, continuous coverage ensures acceptance into group health care plans (for instance, employer-provided coverage) regardless of preexisting conditions.
Further, continuous coverage ensures acceptance into some form of individual coverage, of a kind determined by the specific state you're in.
I do not believe it is the case that continuous coverage guarantees acceptance into individual health care plans.
In 19 years of working, and (more relevantly) 15 years of marriage, I have never had a lapse of health care coverage for myself or my family. When we started Matasano, I had just previously left a full-time, full-benefits job at a larger company where I'd been working for 4 years. I elected COBRA when I left, and started shopping for individual coverage.
We were unable to get family coverage at any price in Illinois because of preexisting condition concerns for two members of my family. In both cases, the rejection cause was a total surprise, because the "condition" wasn't an ongoing health problem, but rather a piece of medical trivia that caused underwriters concern that there might have been more significant issues down the road.
I shopped for insurance myself, and then with a professional broker who I paid to deal with the problem, and who could not find a way around it.
We solved the problem first by my wife taking a full-time job outside Matasano, which got us group coverage, and then by starting group coverage at Matasano.
I don't get it. If we are footing the bill, then it will make higher taxes, but if the insurance companies foot the bill then health care costs increase. There's no reason for both to rise (unless we subsidize the insurance companies through taxes on the insurance companies...)
The "visible foot of the government" is quite enough. 2,000 pages of unread "law" can force all sorts of negative changes, and then there's the electronic health record (EHR) requirements in the "stimulus" bill, including the single sentence on requiring "meaningful use" which expanded into 700 pages of regulations, a lot of well paid consulting, and what looks like so far worse medical care as healthcare workers have to focus on the computer instead of the patient to avoid losing their jobs.
There's also the host of taxes in Obamacare; just the medical device tax alone will obviously raise the cost of care.
Risk corridors by themselves, obviously not. Except if you ignore the fungibility of money aren't they ostensibly paid for by taxes on policies??
On the other hand "guarantees" will put less pressure on insurance companies to put pressure on suppliers of health care, resulting in less displacement to other customers.
In a way, the ACA is creating jobs. Or at the very least, it'll increase wages. That's a selling point.
EDIT: I thought I wrote the "increasing jobs" in a "wouldn't it be funny if this were true" sort of sense, guess I didn't.
As for the wage increase, Business insider seems to think so at least (http://www.businessinsider.com/the-buried-lede-in-the-cbo-re...).
Loss of working hours for businesses does not mean loss of jobs it means finally people can work decent hours and employers can't take advantage of them as easily.
A company needs to pay what that costs or their not worth being a company.
This is unclear to me. The company needs to pay what what costs? As far as I can see, they are indeed paying hourly workers for the hours that are worked, so this can't be what you're referring to. What is the cost that they're not paying?
According to the body, hours worked and full time employment will drop. This is a straightforward supply shock, along the same lines as the oil shortage of the 70's (assuming of course you believe in reducing the entire economy to 2 graphs, as the Keynesians often do).
Also, increasing wages in a recession is a big no-no if you believe in Keynesian economics. Assuming this effect is not taken into account by the CBO's headline number, it means there will be further job losses.
They're predicting a smaller labor force (non-institutionalized population of working age working or actively seeking work) resulting from the reduced health insecurity from the ACA, not fewer jobs. [1]
To see where that fits into the unemployment picture, understand that the unemployment rate is (1 - (Filled Jobs / Labor Force)).
> Also, increasing wages in a recession is a big no-no if you believe in Keynesian economics
We're not in a recession. We're in an expansion in which both wages and employment rates have recovered slower than normal -- which was also true in the last expansion between the 2001 recession and the Great Recession -- which is why it feels like we've been in a 13 year recession to many people who aren't major capitalists, though there have only been 26 months of official recession in that period.
[1] The ACA effect is described on p. 14 of the report [2], which is linked from the NYTimes article, in the section under the heading "Labor Force Participation" (heading on p. 13).
[2] https://www.cbo.gov/sites/default/files/cbofiles/attachments...
The unemployment rate you cite is correct, but it's just as you said - a rate, not an absolute total.
What the report states is that the total number of jobs will decrease. Together with the fact that we know that hours per job is not going to increase (and may actually be decreasing, thanks to other PPACA regulations), simple algebra tells us that there will be fewer hours worked overall.
Barring an external development that causes productivity per hour to increase, we can expect lower total production. Bottom line, then, is lower GDP as a result of this. That is the opposite of a good thing for the economy.
One argument for better healthcare is people end up less sick. These guys(http://www.forbes.com/sites/brucejapsen/2012/09/12/u-s-workf...) seem to think that productivity decreases in the US account for almost 10% of spending on salaries and whatnot. There are 120 million or so people in the workforce, so 2 million jobs is something like 1%.
So if we make people "10%" more health , it would end up with us saving the same 1% (thus on the long-term allowing more investment later). We could get people to do the same amount of work for less, thus we are more productive.
I do not vouch for the validity of the numbers, just for the idea behind it (healthier people means more productive people).
Indeed. Unfortunately, it is entirely unproven that Obamacare, which focuses on health insurance, is going to result in better health care.
For reasons we can go into if you want, Obamacare compliant polices tend to have extremely narrow networks of doctors and hospitals. E.g. look at all the fuss the Seattle Children's Hospital is raising, and there's a lot of individual cases where people are losing their doctors who've been treating their conditions for a long time, this is just the latest report to pop up: http://www.latimes.com/business/la-fi-obamacare-patients-201...
There's a reason Reagan got a lot of mileage with his joke "The nine most terrifying words in the English language are 'I'm from the government, and I'm here to help.'"
This is a good point.
The narrower networks can, I think, be expected to result in more time off work. I'll have to drive a farther distance to see my doctor, or I'll have to settle for an appointment in the middle of the day. Either way, it's a hit to my time that wouldn't exist under "traditional" schemes.
it is entirely unproven that Obamacare, which focuses on health insurance, is going to result in better health care.
So the fact that you're insured doesn't necessarily mean that you're going to get better faster. The doctor can't do anything for you if you've got a cold or the flu; you've just got to ride it out. I suspect that it's cases like this that make up the lion's share of health-related lost productivity.
And even when healthcare can have an impact on your health, I don't believe that the positive effects on worker productivity could be that great. Most employers already provide healthcare insurance, so there's no improvement to the situation there. The only positive effect will be toward those who are already employed but without health insurance, which is a minority.
According to the CBO, the difference between actual and potential GDP will decline to 0.5% by 2017. At that point (and possibly before) a reduced labor force is reduced jobs and (more importantly) reduced production.
It could result in reduced jobs/production even before that if workers who choose to reduce output are not interchangeable with unemployed [1] workers willing to take those jobs at the same wage.
We're not in a recession. We're in an expansion in which both wages and employment rates have recovered slower than normal
Either we need fiscal/monetary stimulus or not. If we need stimulus, increasing wages is a bad idea according to all mainstream economic theories (Keynesian, Monetarist, Structuralist). Which is it?
Here is the report, btw: https://www.cbo.gov/sites/default/files/cbofiles/attachments...
[1] Including discouraged, at least if employers can find the discouraged workers.
Sure, from the POV of much of the workforce the economic. car isn't going anywhere, but stimulus is like trying to give it a jump start when the engine is runnin but the transmission is in neutral.
Further, it is not like they are getting health care due to an efficiency in the system. The government is taking resources from the productive (taxes) and giving it to the unproductive (subsidies) in order to purchase insurance. This will further erode economic productivity.
What they're expecting is that fewer people will be motivated to work (or to work a second job, perhaps). Imagine someone self-employed who also works part time to get medical insurance benefits; with PPACA he wouldn't need to do this any longer. On the other hand, imagine someone who was working just to supplement the spouse's income. With PPACA's subsidies, the extra income (within certain ranges) becomes a liability, and it makes more sense for that person to stay home without the earned income, enjoying the healthcare subsidy instead.
So this doesn't say anything about unemployment (as it's commonly defined).
They should also expect that some people will appear to reduce their hours or quit that second job, when in fact they trade it for some off the books work. For example, the musician who used to work part time at Applebees might just teach guitar lessons for cash in his spare time instead. The person supplementing the spouse's income is not going to just stay home and watch TV...they might run an unlicensed daycare or become a basement hairstylist or freelance web designer for cash.
If true, this is a good thing. We, as a society, don't need "jobs" or hours worked. We need stuff made. Voluntary attrition of the least productive 5-billion person-hours per year won't hurt us much, but that will cause wages to rise (which will, over time, improve what is produced).
We're already producing a lot of stuff. What we need now is a qualitative focus, serious consideration of sustainability and, above all, better leadership. Taking some pressure off the lower and middle classes (i.e. peeling back the wage serfdom that gives power to feudal strongmen) is a start.
There used to be a Fordist connection between general prosperity and the well-being of businesses, rippling up to the very rich. But the consumer credit boom killed that (sort of). Instead of letting wages rise or prices fall, the poors could be pumped full of loans they couldn't afford to repay. We saw, in 2008, how well that works out, but the fundamental structure of society hasn't changed.
Obama has made many tactical mistakes with the PPACA, and I wish he had started at single-payer to make public-option the compromise, but if "Obamacare" is bringing us back toward a more cooperative, progressive society, then that's a good thing.
Making changes to a system that corresponds to one fifth of the annual economic output will obviously have massive consequences. However, it is hard to see how you could possible make the economics of US health care worse. ACA gives more people the ability to individually choose their health care insurance, thus increasing competition and hopefully giving the health care buy side more incentive to drive down prices.
The U.S. healthcare system is not set up to maximize outcomes. I guess I agree that is a problem, but it makes efficiency comparisons less interesting.