Good luck, America.

April 3, 2010 9:07 PM

The New York Times has published an informative graphic realization of projected costs and likely funding sources for the recently enacted Patient Protection and Affordable Care Act (PPACA).

The included 10% tax on tanning salon operators who provide artificial light tanning methods is probably down in the "Other Taxes and Fees" section of "Where the Money Will Come From," but the published graphic doesn't break out any contributions from the recently enacted (via the House/Senate reconciliation bill) $20 billion over 10 year excise tax (beginning in 2013) on implantable devices. On balance, the "Where the Money Will Go" section of the graphic also doesn't seem to include any specific allowances for the possibly hundreds of thousands, if not millions, of expensive artificial joint revisions to be performed in the U.S. in the next decade.

Perhaps, that's because there is presently no central registry for all implanted devices for U.S. patients. But, the PPACA, which was specifically concerned with tanning salon technology, makes no provision for such a registry.

posted by paulsc (40 comments total)

47% of the loot goes to "Premium and cost-sharing subsidies"?---will most of that money be pocketed by private insurers?
posted by Napoleonic Terrier at 9:16 PM on April 3, 2010

WTF!?! An extra $5000 tax if I make between $500,000 and 1 Million annually? That's, like, 10 bottles of Crystal I won't be able to enjoy in my jacuzzi. Damn Obamacare.
posted by HabeasCorpus at 9:27 PM on April 3, 2010 [20 favorites]

I was afraid to look at first, but thank God, my name wasn't there.
posted by StickyCarpet at 9:38 PM on April 3, 2010

I can't help but notice that the graphic quotes 4 Republican politicians and one industry lobbying group. Way to go on the balanced viewpoint there, guys.
posted by deadmessenger at 9:43 PM on April 3, 2010 [22 favorites]

I'm actually fine with this, mainly because I'm sure that once people who have no insurance get it, they won't stomach it being taken away, and the budget will be FORCED to accommodate them, which I sincerely hope will eventually result in the pressure on health insurers I would have liked to see in the first place.
posted by StrikeTheViol at 9:46 PM on April 3, 2010 [1 favorite]

47% of the loot goes to "Premium and cost-sharing subsidies"?---will most of that money be pocketed by private insurers?

Insurance companies will have their "medical loss ratio" capped at 85%, which means (at least) 85¢s; out of every dollar will go to pay medical claims. However, that means they pocket 15%, which a huge amount. Medicare's administrative costs are something like 2%.

Their profits are only about 3%, but remember, that's just the money that would go to their stockholders. The rest gets divided up among their employees, for the most part.

No, it was claimed during the debate that the ratio couldn't be set any higher, because then the CBO would have to have considered them part of the government and it would have massively increased the projected cost (even though the actual costs would be identical, it would just be an accounting change).

Also, looking at these charts. It's interesting how they measure the "10 year cost" yet while you look at the graphs, they're basically going straight up when we hit the 10 year mark. Of course, these are very horizontally squished graphs, making the climb look more steeper then it would on a flatter graph.
posted by delmoi at 9:49 PM on April 3, 2010

I can't help but notice that the graphic quotes 4 Republican politicians and one industry lobbying group. Way to go on the balanced viewpoint there, guys.

That's because the article is about "Questioning" the projections.
posted by delmoi at 9:50 PM on April 3, 2010 [1 favorite]

That's some quality "journalism".
posted by mek at 10:14 PM on April 3, 2010 [1 favorite]

That's because the article is about "Questioning" the projections.

Yeah, maybe so, but what, the only people with the requisite analytical and critical thinking skills needed to look at the projections critically who don't also happen to be Democrats or reform proponents happen to be representatives of the two groups with the most powerful political and economic motivations to create more uncertainty about the projections than might actually be reasonable?

This is an example of one of those blatantly dumb things the media does now to appease it's fragmented and ideologically blinkered viewer-ship under the justification of providing balance--like referring to people who argue against creationists and ID proponents as "evolutionists" instead of just calling them "sane people," or better yet, "people."
posted by saulgoodman at 10:20 PM on April 3, 2010 [12 favorites]

How's that ax coming along? Grind it nice and sharp?
posted by infinitywaltz at 10:44 PM on April 3, 2010 [3 favorites]

It all looks good to me, making the PPACA the most fiscally responsible legislation enacted since the Clinton Deficit Reduction Act of 1993 which, incidentally, not one single Republican voted for just like this one.
posted by JackFlash at 10:54 PM on April 3, 2010 [1 favorite]

Not sharp enough, apparently. Their heads are all still intact.
posted by saulgoodman at 10:56 PM on April 3, 2010

"WTF!?! An extra $5000 tax if I make between $500,000 and 1 Million annually? That's, like, 10 bottles of Crystal I won't be able to enjoy in my jacuzzi. Damn Obamacare."

That's cristal, plebian.
posted by milnak at 10:58 PM on April 3, 2010 [5 favorites]

That's cristal, plebian.

That's plebe, plebe.
posted by Tomorrowful at 11:15 PM on April 3, 2010 [7 favorites]

No, it isn't.
posted by revfitz at 11:52 PM on April 3, 2010

You know, I keep thinking - or wondering. I was a child born during Roosevelt's New Deal, and the government had to spend vast amounts to help pull us out of the depression. And even then the Republicans were moaning what about their children and grandchildren who would have to carry the burden of all that debt. And so, speaking as one of those children, why don't I feel so burdened? I pay taxes and, although I would rather not, they do pay for a lot of the benefits that I enjoy, not least of which is Medicare. So where is this heavy burden? And will my kids and grandkids really feel so heavily burdened when they reach my age? I somehow doubt it. I only hope that they'll be lucky enough to reach my age and still have their good health.
posted by donfactor at 12:04 AM on April 4, 2010 [9 favorites]

...all that debt...

the income tax hikes are exactly:

raising 33% bracket to 36%. (also, Bush's 35% bracket goes back up to 39.5%)

Paired with the somewhat optimistic claim that the government will make matching Medicare savings, this isnt really a sea change of spending or debt.

Conspicuously absent from the debate is any estimate of savings as the war in Iraq is slowly and quietly abandoned.
posted by dongolier at 12:17 AM on April 4, 2010

(...which is the other thing we wanted him to do.)
posted by dongolier at 12:19 AM on April 4, 2010

That's cristal, plebian.

That's Cristal(tm), plebe.
posted by IAmBroom at 1:09 AM on April 4, 2010

So I'm typing this on my iPhone as I jet from one decadent film industry party to the next, and I don't really have time to, like, read and shit. Can someone please just tell me when Obama's gonna cut me a check for my upcoming chin implant and Brazilian butt lift? Are we talking like two months, three months? What's the deal?
posted by ford and the prefects at 1:17 AM on April 4, 2010

I loved the quote about how the bill is using 10 years of taxes to fund 6 years of benefits. Too bad it's not true, since most of the taxes and cuts used in funding this bill don't hit until the benefits do. Most of those that start immediately go to pay for benefits that start immediately, as well as the cost of setting everything up in the first place.
posted by wierdo at 1:33 AM on April 4, 2010

And so, speaking as one of those children, why don't I feel so burdened? I pay taxes and, although I would rather not, they do pay for a lot of the benefits that I enjoy, not least of which is Medicare. So where is this heavy burden?

Well, one reason you may not be feeling this burden is that today's seniors (I'm assuming you're a senior) get back way more in Social Security and Medicare than they put in. Social Security was originally conceived of as a forced savings plan and now is, for better or worse, an income redistribution program from young working people to old people.
posted by shivohum at 1:35 AM on April 4, 2010 [1 favorite]

And reading the whole post..that was pretty axe-grindey paulsc. Bad form.
posted by wierdo at 1:36 AM on April 4, 2010

That article brought to you by Paulsc, Metafilter's resident Tea Bagger.

And so, speaking as one of those children, why don't I feel so burdened? I pay taxes and, although I would rather not, they do pay for a lot of the benefits that I enjoy, not least of which is Medicare. So where is this heavy burden?

Another reason is that the debt added by the Great Society programs and WW2 was paid down decade after decade, such that the bulk of it was eliminated by the Carter administration.

Today, the overwhelming majority of our current debt was added under the Reagan, Bush, and Bush administrations. If you aren't a multi-millionaire who received huge tax cuts or you don't regularly masturbate to looping footage of billion dollar stealth bombers delivering "Shock and Awe" to Iraq, you probably don't have much to show for your share of the trillions of dollars of debt.
posted by Davenhill at 2:02 AM on April 4, 2010 [7 favorites]

Social Security was originally conceived of as a forced savings plan and now is, for better or worse, an income redistribution program from young working people to old people.

When exactly did this change happen? You mean when SS was itself actually implemented with FICA from the get-go, 75 years ago? That's a long time ago for "now" to start.

I doubt a forced savings plan would have lasted all this time, anyway. If politicians had not wiped it out, then the private sector would have feasted on the savings—leaving us with just as many poor old people.
posted by fleacircus at 5:05 AM on April 4, 2010 [1 favorite]

Conservative groups . . . argue that taxing the investment income of those with the highest incomes will depress economic growth. (from the graphic)

Why would this be true? Wealthy people won't just stop investing. It's not like they are going to pout and go home with their money, like some kid on a playground. They won't make as much but they aren't dumb enough to stop investing altogether.

And it's not like the taxed income won't be spent. The government isn't just going to keep it under a mattress. The wealthy won't be spending it on luxury items but the government will be spending it on health care. The benefit to the economy should be mostly the same, no? It might be a it better actually, many of the luxury goods that the wealth would purchase are imported. So the money spent on these items leaves the country. While insurance companies are all domestic with domestic employees, rents, etc.
posted by oddman at 5:44 AM on April 4, 2010 [2 favorites]

Just to keep things in some perspective, here's a handy infographic that offers a time line of changes and benefits for the consumer.
posted by madamjujujive at 6:18 AM on April 4, 2010 [3 favorites]

The title of this post pretty much negates any possible claim the poster might have to this not being an axe-grindy editorial.
posted by octothorpe at 6:19 AM on April 4, 2010 [3 favorites]

Perhaps the tax on tanning will somehow offset the cost of the UV-B treatments for psoriasis that I don't think I can afford with my current insurance.
posted by sciencegeek at 7:25 AM on April 4, 2010

I always thought it was pleb.
posted by djgh at 7:47 AM on April 4, 2010

It's plebians vs. patricians. A plebe is a first year cadet at a second rate military school.

FWIW, a fish is a first year cadet at a first rate military school.
posted by Xoebe at 7:58 AM on April 4, 2010

When exactly did this change happen? You mean when SS was itself actually implemented with FICA from the get-go, 75 years ago? That's a long time ago for "now" to start.

It was imprecise wording -- better to say that it's always been sold as a forced savings plan but is in fact a simple transfer -- but the point remains that today's seniors have benefited greatly from particular demographic facts that are not likely to be in place for today's children. It's a little too simplistic to say, "Hey, it worked out great for us, and I'm sure it'll work out great for you, too!"
posted by palliser at 8:05 AM on April 4, 2010

And I'm not arguing against the PPACA on those grounds, by the way -- my problem is with non-means-tested transfers, and the PPACA is not that.
posted by palliser at 8:08 AM on April 4, 2010

menzie chinn helps put the PPACA impact on budget balance in context, cf. EGTRRA & JGTRRA
posted by kliuless at 8:08 AM on April 4, 2010 [1 favorite]

Social Security was originally conceived of as a forced savings plan and now is, for better or worse, an income redistribution program from young working people to old people.

It was originally conceived and promoted as "self-supporting," which to three generations of profligate and despicable Washington politicians has meant "tax-supported":

"In the important field of security for our old people, it seems necessary to adopt three principles: First, non-contributory old-age pensions for those who are now too old to build up their own insurance. It is, of course, clear that for perhaps thirty years to come funds will have to be provided by the States and the Federal Government to meet these pensions. Second, compulsory contributory annuities which in time will establish a self-supporting system for those now young and for future generations. Third, voluntary contributory annuities by which individual initiative can increase the annual amounts received in old age. It is proposed that the Federal Government assume one-half of the cost of the old-age pension plan, which ought ultimately to be supplanted by self-supporting annuity plans."

--Franklin Roosevelt, MESSAGE TO CONGRESS ON SOCIAL SECURITY. JANUARY 17,1935
posted by geeyore at 8:25 AM on April 4, 2010 [1 favorite]

I'll support any healthcare plan that pays for itself by eliminating social security before the baby boomers get any. :)
posted by jeffburdges at 8:41 AM on April 4, 2010

I've just always been saving (and assuming) that I won't ever see social security. I'm 23. There's no way this system will endure without radical changes for another 50 years.
posted by msbutah at 8:51 AM on April 4, 2010

Where does it show when the apocalypse starts?
posted by T.D. Strange at 9:01 AM on April 4, 2010

I've just always been saving (and assuming) that I won't ever see social security. I'm 23. There's no way this system will endure without radical changes for another 50 years.

Soylent Green is people.
posted by mecran01 at 9:09 AM on April 4, 2010

This argument against healthcare funding is about as well-grounded as an airplane on a treadmill.
posted by five fresh fish at 10:20 AM on April 4, 2010 [1 favorite]