Shocking!

Endurance Man

http://news.bbc.co.uk/1/hi/world/americas/7026454.stm

This is unbelievable, how are the American public letting him get away with this. Is there any doubt in anyone's mind that he is doing this to protect the Tobacco company's :mad: .

mike65

The vetoed bill proposed higher tobacco taxes to provide an extra $35bn (£17bn) to insure some 10 million children.//////

It is directed at families who earn too much to qualify for the Medicaid programme for the poor but cannot afford private health insurance cover.

Mr Bush had said he wanted only a $5bn increase in funding for the scheme.

He argued that expanding its coverage further would encourage people currently covered in the private sector to switch to government coverage - and that the proposal was too costly.

His decision to veto the bill is likely to prove unpopular with many people, however, correspondents say.

Sounds like a money matter rather than protecting cigarette producers per se.

Mike.

Endurance Man

mike65 wrote:

Sounds like a money matter rather than protecting cigarette producers per se.

Mike.

Putting tobacco taxes up isn't going to hurt the tobacco company's profit? Hell it would probably save a few lives in the process.

Manic Moran

As ever, there are two sides to every story. The Democrats love this issue because they can just put up a picture of the poorest, most downtrodden yet cute kid they can find and proclaim "What sort of cruel person can deny this kid?" Yet Bush is not against S-CHIP per se, he's against S-CHIP as expanded into new territory.

See, for example, http://news.yahoo.com/s/csm/20071001/ts_csm/achildhealth_1

The US Department of Health and Human Services estimates that some 794,000 children in these lowest-income families are eligible for S-CHIP and are not currently covered.

Don't you think the US should focus its resources on these kids before attempting to expand the scope of eligibility to higher income levels? Further, once you start expanding into those higher levels ($72,000 a year in New Jersey!?) you're getting to territory where most jobs will have some form of private health coverage as an option. Making the family suddenly available for free public healthcare will result in people opting out of their private coverage and increasing the burden on the public system when it's un-necessary.

NTM

Akrasia

Manic Moran wrote:

As ever, there are two sides to every story. The Democrats love this issue because they can just put up a picture of the poorest, most downtrodden yet cute kid they can find and proclaim "What sort of cruel person can deny this kid?" Yet Bush is not against S-CHIP per se, he's against S-CHIP as expanded into new territory.

See, for example, http://news.yahoo.com/s/csm/20071001/ts_csm/achildhealth_1



Don't you think the US should focus its resources on these kids before attempting to expand the scope of eligibility to higher income levels? Further, once you start expanding into those higher levels ($72,000 a year in New Jersey!?) you're getting to territory where most jobs will have some form of private health coverage as an option. Making the family suddenly available for free public healthcare will result in people opting out of their private coverage and increasing the burden on the public system when it's un-necessary.

NTM

According to Democracy Now, Bush said he vetoed the bill because he it would promote government backed health care

Manic Moran

Akrasia wrote:

According to Democracy Now, Bush said he vetoed the bill because he it would promote government backed health care

Which is correct. It brings government backed healthcare into the range which is currently covered by the lower end of private insurance. Instead of enticing people to switch from (pay for) private to (Near-free) public, it should not provide the option at that level and instead focus on those who do not have a choice in the issue to start with.

NTM

Sir Digby Chicken Caesar

if they want to have smokers pay for MORE of the health bills of these supposedly healthy living ****ers, they should let smokers smoke wherever the hell they want.

why not tax hum vee's, firearms or porn.it's always the smokers.,

Manic Moran

Mordeth wrote:

why not tax hum vee's, firearms or porn.it's always the smokers.,

I don't know about porn, but I had to pay a four-figure "Gas Guzzler" tax (It was actually called that on my receipt) on my Audi (let alone HMMWV) and the amounts on petrol, and believe me, I know how much extra I'm paying for firearms around here.

NTM

Sir Digby Chicken Caesar

well the least you could do is start smoking, clearly your government needs the money

bonkey

Manic Moran wrote:

Don't you think the US should focus its resources on these kids before attempting to expand the scope of eligibility to higher income levels?

Wasn't the bill that he vetoed doing both? Its not like these poor kids were being neglected in order to expand the scope of eligibility....both were being tackled together?

Further, once you start expanding into those higher levels ($72,000 a year in New Jersey!?) you're getting to territory where most jobs will have some form of private health coverage as an option.

Thats the correct place to pitch the cut-off point.

In an ideal world (aks Switzerland ) either you have personal insurance or it is provided for you. Everyone is covered. Aiming to increase cover across the salary brackets where some people cannot afford insurance makes sense. The lower you set your cut-off point, the more people will fall into the gap between "is covered by the state" and "can afford their own insurance". These people are the problem-point and lowering the cutoff point from what was proposed back towards where it currently is only increases the number of people who fall through the net.

Making the family suddenly available for free public healthcare will result in people opting out of their private coverage and increasing the burden on the public system when it's un-necessary.

But its being done in conjunction with increased funding to cover exactly those costs. So its not increasing the burden on the system, its expanding the coverage of the system whilst simultaneously expanding the funding of the sytem to meet this coverage.

Manic Moran

bonkey wrote:

Wasn't the bill that he vetoed doing both? Its not like these poor kids were being neglected in order to expand the scope of eligibility....both were being tackled together?

No. S-CHIP is being renewed and expanded by this bill, not introduced for the first time. Indeed, it seems that in the bill as presented, it reduces this effect.

By stripping out a requirement that S-CHIP cover 95 percent of the neediest children before extending it to higher-income children, Congress is undermining a key intent of the program, Mr. Fratto says.

Thats the correct place to pitch the cut-off point.
<snip>
either you have personal insurance or it is provided for you. Everyone is covered.

This is reasonable, but does Switzerland do it in the same generic manner of a base salary level cut-off? I'll wager that even if it does, that the cost of living difference across the country is far less than the difference between, say, San Francisco and Fresno, or New York City and Buffalo, yet the programme as billed applies state-wide standards.

But its being done in conjunction with increased funding to cover exactly those costs. So its not increasing the burden on the system, its expanding the coverage of the system whilst simultaneously expanding the funding of the sytem to meet this coverage.

Just because more money is coming in does not mean that the money is being spent efficiently.

NTM

bonkey

Manic Moran wrote:

No. S-CHIP is being renewed and expanded by this bill, not introduced for the first time. Indeed, it seems that in the bill as presented, it reduces this effect.

My mistake. Thats a serious flaw in the bill alright.

This is reasonable, but does Switzerland do it in the same generic manner of a base salary level cut-off?

Nope...but that's slightly beside the point, surely? Your argument was that people at the proposed salary level generally already had cover. I'm saying thats a good place to pitch such a cut-off, not that this is the ideal method of implementing things.

I'll wager that even if it does, that the cost of living difference across the country is far less than the difference between, say, San Francisco and Fresno, or New York City and Buffalo, yet the programme as billed applies state-wide standards.

This would be relevant if 75K was too low a mark for people in the more expensive areas....meaning that they would be cut out.

No method of assessment is perfect. No matter how granular you implement it, someone will win, someone will lose, someone will be able to game the system. Also, the more granular you go, the more it costs you to implement some form of fair assessment. In such a case it may be that a simple salary-based implementation is the cheapest.

Just because more money is coming in does not mean that the money is being spent efficiently.

No, it certainly doesn't...but is it inefficient to include more people in the net?

I agree that it seems wrong that requirement to cover the neediest has been dropped, but I note with interest that this is not reason the President offered for his veto, but rather went along the lines that too many people would be covered.

Manic Moran

bonkey wrote:

No method of assessment is perfect. No matter how granular you implement it, someone will win, someone will lose, someone will be able to game the system. Also, the more granular you go, the more it costs you to implement some form of fair assessment. In such a case it may be that a simple salary-based implementation is the cheapest.

Nail on head.

I have yet to see any argument stating that this is the case. The big brouhaha has been on the emotional argument of 'anyone who is against this is against healthcare for children', yet nobody has come out and said "This is why we think it is better for X proportion of persons to be eligible to switch from private to public and this is the most efficient way of doing it" Given that the US healthcare system functions primarily on the private healthcare market, I think it is a reasonable question to ensure the greatest potential proportion of 'currently uncovered' to 'currently covered'

No, it certainly doesn't...but is it inefficient to include more people in the net?

The wider the net goes, the more chance it will cover persons who already have private healthcare. The trick is to try to make sure that those people are not covered, whilst those who would otherwise not be covered are. That would be efficient in terms of coverage.

but rather went along the lines that too many people would be covered.

Given that there's a finite amount of money involved (Which is another argument entirely), he could well be right. You want to get the (Number out of posterior) 2 million currently uncovered kids coveraged. If the proposed legislation covers 3million kids, even if it would cover all 2 million currently uncovered, that's too many. You want to concentrate those funds on the neediest, not spread it around too much.

NTM

bonkey

Manic Moran wrote:

Given that there's a finite amount of money involved (Which is another argument entirely), he could well be right.

I'm not actually ruling it out...I just consider it unlikely

You want to get the (Number out of posterior) 2 million currently uncovered kids coveraged. If the proposed legislation covers 3million kids, even if it would cover all 2 million currently uncovered, that's too many.

That depends on whether or not you can include all 2 million of those kids by targetting a smaller group, for a start. Also, its possible that while the aim was to cover 2 mill, that somewhere along the line someone figured out that it wasn't enough. Now, that raises the thorny issue of whether or not its acceptable to include more people who deserve or need to be included, but who didn't form part of the original "mission scope", sure, but I tend to lean along the lines that the original mission scope is less important than the right solution. If teh right solution is found to involve a larger mission scope, then enlarge it if its feasible.

At a perfunctory level, Bush's argument seems to be that the extra people shouldn't be included because some of them don't need to be, and all of the extra are beyond the original scope of the project. He doesn't seem to address those who should be / need to be included, who were outside the original mission scope, but inside the expanded scope.

You want to concentrate those funds on the neediest, not spread it around too much.

But the funds were grown in accordance with the expanded scope. I'm pretty certain that Bush's position isn't that if the bill were resubmitted tomorrow with the same increase in funding but only the original scope of people that he wouldn't veto it....if the overuse of negatives isn't too confusing.