The Barack W. Backlash Begins

[Winstonm]

I hope that the real truth is that the American people are going to start demanding fiscal accountability from all levels of government and aren't going to let social issues wedge how we vote in elections.

 

If you are so impassioned about fiscal responsibility then you must surely be in favor of reducing the outrageious amount spent on defense spending when there is no U.S.S.R. to defend against.

[Al_U_Card]

Seems like, in the "good" old days, you'd have your major conflict, prosperity and then economic bust (repeat as required).

 

Then a bunch of reformers stepped in and regulated the crap out of the speculators and there was 1945 to 2000......

 

Returning to "traditional" values has allowed us to exchange prosperity for debt.

 

That Obama is talking about banking regulation and reform belies his actions to date. It will be interesting to see what diversion arises to scuttle that ship of state.

[PassedOut]

Yes, this is another good example. The assertion is that it will reduce the deficit; most people are in favor of deficit reduction, so the conclusion is that people just aren't well-informed about the bill. Alternate hypothesis: They don't believe it.

There are people who believe that tax cuts will reduce the deficit. Not kidding.

[helene_t]

The 23% actually is, I guess, 61.5% on the explanation that 23 comes from 61.5 minus 38.5. Or anyway it comes from something minus something. It's not to be taken straight up.

 

I think there are a lot of problems with making any sense out of these numbers.

Nah, net favorability is a good measure for the popularity of something if one wants to report a single number. If you want more details you might be able to get them from the source.

 

As for the guys who where against reducing the deficit, I think a number of reasons could be given. We never have an anonymous poll here on BBF either. Most likely they just read it as "increase the deficit", since that is the obvious consequence of the bill. Alternatively they understood the q but refused to accept the premise. Or maybe just some random error, like the interviewer misclicking.

 

I think you are too negative, Ken. This poll is probably not more nonsensical than so many other polls.

[kenberg]

 

Don't you find it a little suspicious that this bill purportedly is going to extend coverage to tens of millions of people, keep current insurance holders and Medicare recipients at the same level of coverage and reduce the deficit?

 

Yes, very.

 

I'll get to that, but first another few words about the poll. When 1 in 5 say that reducing the deficit would make them less likely to favor the bill I think that the clear conclusion is that people often answer a question that is different from the one that was asked. Either that or 1 in 5 Amercians are deranged.

 

Now, about being suspicious. As with so many things, we have to ask exactly what is being said. I acknowledge uncertainty, but here is what I think is meant.: Suppose that without the bill the cost to the government for medical care would be x and suppose that with the bill it would be y, which is larger than x. The bill also raises money through various taxes, call the amount raised z. I think the assertion is that z is larger than y minus x. Those who know the details better than I can correct me if this is wrong. For the moment, let's explore it.

 

If z is larger than y minus x that is certainly better than if it were smaller (as was the case, I gather, for the prescription drug reform bill). But paying for increased costs is certainly different from reducing costs. In particular, there are many things that need doing and only so many sources for new revenue, so using new tax sources to cover the costs restricts our ability to act elsewhere. Maybe it's worth it, maybe not, but describing it as a deficit reduction plan invites skepticism, probably well-founded even if one cannot be exactly sure what's funny about it.

 

Some posts back I mentioned that I had two hopes for healthcare reform, helpong those in need and bringing spiraling costs under control. Well, covering spiraling costs by raising taxes is better than not covering spiraling costs, but it's not exactly what many of us were hoping for.

[Aberlour10]

There are people who believe that tax cuts will reduce the deficit. Not kidding.

More than the half of the new german parliement belives this nonsense at the moment. Shall be a kind of "excuse" for the tax gifts they made for their clients...like hotel owners etc..

[kenberg]

The 23% actually is, I guess, 61.5% on the explanation that 23 comes from 61.5 minus 38.5. Or anyway it comes from something minus something. It's not to be taken straight up.

 

I think there are a lot of problems with making any sense out of these numbers.

Nah, net favorability is a good measure for the popularity of something if one wants to report a single number. If you want more details you might be able to get them from the source.

 

As for the guys who where against reducing the deficit, I think a number of reasons could be given. We never have an anonymous poll here on BBF either. Most likely they just read it as "increase the deficit", since that is the obvious consequence of the bill. Alternatively they understood the q but refused to accept the premise. Or maybe just some random error, like the interviewer misclicking.

 

I think you are too negative, Ken. This poll is probably not more nonsensical than so many other polls.

I agree, sort of, with the last sentence. At various times I have been polled. I usually find the questions inane.

 

Here is another aspect to this particular poll. Suppose that the pollster approaches Joe Schmoe and says "Joe, if the bill included a provision for free beer for all Joes, would you be more likely to support it?". Suppose also that Joe already is an ardent supporter of the bill. What is his honest answer? If the question were "would you be even more enthusiastic?" the answer could be yes, but that wasn't the question. How can a person who already supports the bill become more likely to support it? It's like asking if a person who just fell from a thirty story building would be more likely to die if he took poison on the way down.

 

 

Now one could say that this example just shows that I am picky (or negative). And I wouldn't make too big a deal out of it. But getting a response showing that 20% are opposed to reducing the deficit indicates to me that the people who designed this poll need to learn how to ask questions that accurately get at the matter they are investigating.

 

Put otherwise, when a poll produces such results, I would be wary of making any decisions based on it's data.

[Lobowolf]

Those numbers say 1 in 5 people either are against deficit reduction, or think it's MORE likely the deficit increases if the CBO says it will decrease than otherwise

My guess would be that some are ignorant of the claim that it will reduce the deficit, and other think it's more likely the bill increases the deficit regardless of what the CBO says.

 

As a first point, regardless of whether they're right or wrong, I think it's certainly not a case of:

1) The CBO claims the bill will reduce the deficit.

2) People are in favor of a reduced deficit.

3) There isn't strong support of the bill.

4) Therefore, people just must not know what the bill is going to do.

 

That presumes a "CBO said it, I believe it, that settles it" mentality.

 

As a second point, I think it's nuts to believe that it's more likely than not that it would be deficit-neutral or better. That doesn't mean that it shouldn't be done.

[jdonn]

Those numbers say 1 in 5 people either are against deficit reduction, or think it's MORE likely the deficit increases if the CBO says it will decrease than otherwise

My guess would be that some are ignorant of the claim that it will reduce the deficit, and other think it's more likely the bill increases the deficit regardless of what the CBO says.

I understood the 20% as supposedly people who would otherwise support the bill but choose not to because the CBO says it will reduce the deficit. You seem to be referring to people who wouldn't support the bill either way.

[helene_t]

this "makes you more likely to support the bill" is poorly phrased. What they want to know is whether you support a particular item or not.

 

I doubt that many responders have said "indifferent" to lots of items just because they made their mind up already and that particular item won't change their position. Maybe some have.

 

I hate those interviewers. Once I was asked "Do you think the Social Democrats should change their stand on Christiania?". I answered that I don't care. It's their choice. If they change their positions on lots of issues I might consider voting for them. Otherwise I just vote for some other party, no big deal. Then she rephrased it to "But would it make you more likely to vote for them?". Well to be honest I probably won't vote for them anyway. Then she rephrased "but do you think their position on Christiania is too soft?". Oh boy. Now she tried with three different questions but no matter which of the three I answer, I will get coded in the same field. Arghhhh.

[Lobowolf]

Sorry; I'm articulating this badly. I think there is some "misunderstanding the question" or "mind is already made up" going on; otherwise, a bill that would reduce the deficit should be 100% agreed better than one that wouldn't.

 

But it seems that the point being made is that an increase in awareness of the bill's selling points would lead to an increase in support for the bill. I'm sure that's true to some extent, but I think it's greatly reduced by suspicion as to the claims. Making 100% of people aware of the claims to be deficit-favorable will only increase support for the bill to the extent that people believe the claims, and to the extent that that factor is a tipping point.

[jdonn]

But it seems that the point being made is that an increase in awareness of the bill's selling points would lead to an increase in support for the bill. I'm sure that's true to some extent, but I think it's greatly reduced by suspicion as to the claims. Making 100% of people aware of the claims to be deficit-favorable will only increase support for the bill to the extent that people believe the claims, and to the extent that that factor is a tipping point.

I understand your point, but I also think there is a correlation between how much you say something and how likely it is to be believed by any individual person. In other words it's not so much to make sure everyone hears your points at least once, it's to drill your points into the heads of as many people as possible until they finally start to believe they must be true.

[kenberg]

Speculating on how others think is of course risky, but symbols count for a lot.

 

Current application: A senator from Nebraska says "Helping those in need of medical care is really a fine idea and this is so important that as soon as you put in a special deal for the people of Nebraska I'll be right there with my vote". People say "That's a senator doing his senator thing". Then the president says "OK, done". People say "I guess everything is for sale, where's my payoff?"

 

 

An important feature of the healthcare bill is that many of us don't need it. My medical care is fine, I don't expect anything in the bill to improve it. That doesn't mean I oppose it, I don't. Not in principle anyway. But life teaches that those who speak much about helping others are often busy helping themselves. I was brought up to understand that if a guest starts talking about morality you should lock up the good silver and keep a close watch on your daughter. Or maybe the other way around.

 

Obama, the other night, spoke of a deficit in trust. He has that right. I hope he understands that some of that lack of trust applies to him. Most people, probably including many of the senators and representatives who will be casting votes, have not thoroughly studied all aspects of the health care bill(s). We understand that lobbyists get paid to tweak the bill to the advantage of their clients. The president is supposed to control this tweaking. I think there is declining confidence in his ability or willingness to do this. Once people understand that you are desperate to get something passed, they are in a strong position to grab some goodies.

 

If the plan is to ram a bill through by buying votes, it's really best if you do it quickly before people catch on. Otherwise you might, for example, piss people off and lose a senate seat to the other party.

 

 

It's always possible that republicans, a group of them, will come in with some sensible suggestions that would make this a better bill, one that they could vote for. Hope springs eternal... But I won't be holding my breath.

[PassedOut]

An important feature of the healthcare bill is that many of us don't need it. My medical care is fine, I don't expect anything in the bill to improve it. That doesn't mean I oppose it, I don't. Not in principle anyway. But life teaches that those who speak much about helping others are often busy helping themselves.

I definitely have a self-interested view of health care reform. Like you, I'm not personally at risk of losing good medical care. However, our family's businesses, like very many others, deal regularly with out-of-control increases in insurance premiums for employees. This has been going on for years. Most recently, this October, our premiums rose yet another 25.13%.

 

Of course we always have the option of reducing or eliminating insurance benefits, but that has other negative consequences, both for our businesses and our employees. Or we could simply say, "the hell with it," and close down. But we'd much rather not.

 

If you look at the chart that Richard mentioned earlier, it's clear that at least half of the money spent on health care in the US is pure waste. We're paying for that waste and so is everyone else. This is not going to fix itself, and there is no reason that the US government cannot do as good a job as other governments do in bringing sanity to a hopelessly broken system. Even cutting down on the waste a bit at a time will be a huge improvement.

 

The present bills passed by the house and the senate don't do everything needed, but you have to start somewhere.

[kenberg]

On the chart the US is represented by a steeply descending purle line. The purple indicates we don't have universal health care, I got that, but I cannot figure out the meaning of the descent. Taking a point on the line as having two coordinates, what are they?

 

 

But my greater interest is in the business about your business. I assume there are many replicas of your situation. We don't seem to have heard much from them, one way or the other. It's a little weird. Traditionally, dems were there for the guys drawing a paycheck, reps for the business guys. I often relect on the dems losing touch with the wage earner, and perhaps the republicans have lost touch with the business people.

 

Maybe small and medium sized business owners could find common ground with wage earners and kick some ass.

[hrothgar]

On the chart the US is represented by a steeply descending purle line. The purple indicates we don't have universal health care, I got that, but I cannot figure out the meaning of the descent. Taking a point on the line as having two coordinates, what are they?

 

 

But my greater interest is in the business about your business. I assume there are many replicas of your situation. We don't seem to have heard much from them, one way or the other. It's a little weird. Traditionally, dems were there for the guys drawing a paycheck, reps for the business guys. I often relect on the dems losing touch with the wage earner, and perhaps the republicans have lost touch with the business people.

 

Maybe small and medium sized business owners could find common ground with wage earners and kick some ass.

The first coordinate shows per capita health care spending: (One significant input into the system)

The second shows life expectancy: (One possible proxy for the effectiveness of the system)

 

In theory, the slope of the line provides useful information about how effective the system is at transforming the input into the output.

 

In practice, there are a lot of other important issues beyond per capita health care spending that impact life expectancy (diet, poverty levels, smoking...). The diagram undoubtedly overstates its case.

 

Still, it provides some interesting perspective...

[PassedOut]

On the chart the US is represented by a steeply descending purple line. The purple indicates we don't have universal health care, I got that, but I cannot figure out the meaning of the descent. Taking a point on the line as having two coordinates, what are they?

I originally tried to see a meaning in the slope of the line also, but the line exists mainly to connect two data points on the chart.

 

The interesting facts are the per capita costs vs. the results. The values on the right of the chart could be replaced by just about any measurable medical outcome you can choose, such as infant mortality, with the same unfavorable comparisons for the US. By necessity, people who run businesses are much into performance measurements, and a chart like that absolutely screams waste to any business person who looks at it.

 

For a number of reasons, smaller businesses and startups do not have the lobbyists and financial impact that larger corporations do to influence (or buy) favorable legislation.

[kenberg]

Sorry if I am being dense here but I still don't get it. First coordinate = per capital spending, second coordinate=life expectancy.

 

I would expect the US to have one pair of such numbers, making a dot on the graph. But the US gets a whole line (as does everyone). This would have to represent many different pairs, each with its own spending and life expectancy numbers. From where? Evolving over the years? And both the linearity and the negative slope are suspicious. Increased per capita spending delivers decreased life expectancy in diorect proportion to the increase?

 

Not trying to be either difficult or dense but I really can't make head nor tail of it.

[hrothgar]

Sorry if I am being dense here but I still don't get it. First coordinate = per capital spending, second coordinate=life expectancy.

 

I would expect the US to have one pair of such numbers, making a dot on the graph. But the US gets a whole line (as does everyone).  This would have to represent many different pairs, each with its own spending and life expectancy numbers.

Hi Ken

 

There's more than one way to skin a cat (or in this case, to draw a graph)

 

I think that most people would display the information as a 2D scatter plot with per capita spending as the X coordinate and average life expectancy as the Y coordinate (just as you recommend). You could then use the size of the dot to represent number of doctor's visits per year. This chart displays the same information. It just uses a different visualization technique.

 

I suspect that it would have been better to use the scatter plot, as you suspect, just because its more familiar to folks.

[hrothgar]

And both the linearity and the negative slope are suspicious. Increased per capita spending delivers decreased life expectancy in diorect proportion to the increase?

 

Not trying to be either difficult or dense but I really can't make head nor tail of it.

The linearity is meaningless. In this case, a line doesn't mean anything other than "the shortest path between two points".

 

The slope of the line, on the other hand, has a lot of meaning...

 

In theory, the slope of the line might have some explanatory power describing the efficiency of the health care system in transforming dollars spend into life expectancy...

[jdonn]

Sorry if I am being dense here but I still don't get it. First coordinate = per capital spending, second coordinate=life expectancy.

 

I would expect the US to have one pair of such numbers, making a dot on the graph. But the US gets a whole line (as does everyone). This would have to represent many different pairs, each with its own spending and life expectancy numbers. From where? Evolving over the years? And both the linearity and the negative slope are suspicious. Increased per capita spending delivers decreased life expectancy in diorect proportion to the increase?

 

Not trying to be either difficult or dense but I really can't make head nor tail of it.

Forget X and Y coordinates. There is a line drawn from the left edge to the right edge for each country. The higher the line touches on the left edge, the higher spending is. The higher the line touches on the right edge, the higher life expectancy is. So a large positive slope means high life expectancy per amount spent, and a large negative slope (like the US has) means low life expectancy per amount spent.

[kenberg]

Ah!! The line just connects the two pieces of data. Thanks to all! The US graph was clearly some sort of outlier, but I was missing the point.

[kenberg]

Another question, now that I understand that graph.

 

 

Under the proposed health care plan, does the cbo expect the per capita expenditure to be more or less than what it would be without the plan? You can see where I am going. Asking whether it will reduce the deficit is a somewhat tricky question because it involves revenue as well as government expenditure. The graph makes a strong case for reducing per capita expenditure, no matter who pays the freight. Would the bill help on that?

 

Except maybe for some Hollywood plastic surgeons it doesn't seem to me that doctors are particularly overpaid. They make good money, but they do important work, and at least often they do it well. I don't think that I would want to try reducing costs by reducing doctor's incomes.

 

I have been lucky with my health and so I have very little first hand experience with how this all goes. I had a recent problem with a kidney stone (I'll spare you the details) but everything that was done was well-judged and first rate, as near as I can tell. I can't escape the feeling though that a good part of the problem is that no one has any motivation at all in trying to keep costs down.

 

I think that some of the worry with the current bill is that it may lock in a number of entitlements, again without adequate regard for the costs. We know how this goes. If I get a prescription filled, it's really very cheap. I don't know why. Medicare? My supplementary insurance? The Bush program? I dunno. But now I expect it. Someone wants to modify it so that I have to pay more? What, they hate old people? Call AARP.

 

 

I really wish more attention had been paid, both in design and presentation, to this business of controlling costs. If this had happened, I think we would be in a better position. I favor doing the right thing, but when push comes to shove I don't feel that I have a serious stake in the outcome of this bill.

[Al_U_Card]

Who should control expenditures? (In the sense of defining billing amounts/procedure and supply/demand of goods and services.)

 

Patients (taxpayers)?

Health care service providers?

Pharmaceutical/medical item suppliers?

Para-public body?

Government?

 

The current situation seems to be a sort of interplay between 2 and 3 above. This explains the "line" in the graph for the US.

[Winstonm]

Obama, to me, has a curious interpretation of leadership. His idea seems to be in forming coalitions which he helps form and then he stands aside and lets them come up with agenda and ideas.

 

The latest clash with the Republicans is a case in point. Obama is still railing that he is getting no Republican support. Does the man not realize he still has a Democratic majority? If he wants to whip someone into shape, it should be the members of his own party. Why beg for Republican support when it is blue-dog Democrats holding the party hostage?

 

IMO Obama needs to learn a simple lesson - you cannot lead well if you do not know where you are going or how you plan on getting there. It's not enough to wave the baton and form a choir - you also have to tell them what they are singing and in what key.