Can Obamacare be Fixed?

[itfitzme]

And, Windows has a new fix to Windows 8. The private free market, the one that Microsoft is in, has a routine of fixing software after deployment. It is, the scary part, how drugs are tested.

 

[itfitzme]

The inclusion of a quantity of new customers in the health care market is an increase in the quantity demanded, not a shift in demand.

The establishment of the loan payback program to incentive doctor, nursing and technician education is a shift in supply.

The setting of a floor to insurance company expenditures at 80% is not even directly covered by the ideal micro-economic supply and demand model because the ideal model is based on perfect competition and zero profit. It is, thought, when the theory is expanded to account for it, a shift in the supply curve.

 

[itfitzme]

The health care market includes numerous sub-markets in both horizontal and vertical chains.

It includes the

insurance companies,
hospitals, clinics,
testing laboratories,
doctors,
nurses,
technicians,
colleges and universities,
text book publishers,
the financial markets that provide loans to students,
the general labor pool,
medical device manufactures,
medical equipment manufactures, and
drug companies.

There is the American Medical Association that establishes standards along with the state and federal governments.

It is a huge market covering 4000 miles from sea to shining sea, as well as Hawaii and Alaska. It covers rural, suburban and metropolitan areas. It includes both the private markets as well as Medicare, Medicare Advantage, and Medicaid. It is also impacted by both the minimum wage and OASDI.

None of this makes for a market that is even close to the ideal market of supply and demand in micro-economics.

The PPACA has twelve pages in the Table of Contents. It is a huge bill, some 900+ pages, though keep in mind that the margins are also large. (Apparently, law makers make a lot of notes.)

Not by any stretch of the imagination can simple ideal micro econ 101 theory be applied.

It is absolutely that they managed to come up with a law as comprehensive as the PPACA. Still, it is exactly what Congress is suppose to do. It is called "working".

It would be interesting to go down the table of contents and try to figure out exactly how the models of supply and demand fit.

 

[itfitzme]

HEALTH INSURANCE MARKET REFORMS

Here is an interesting supply curve, the supply curve for a monopoly

Insurance, especially in today's computerized markets, has a supply curve with a negative slope, with diminishing marginal costs. It doesn't take much more energy or labor to service another policy. The capital costs, like the cost of the computer and facilities, is divided by a larger pool of customers.

https://www.e-education.psu.edu/ebf200up/node/139

It is notable that, prior to PPACA, the medical insurance companies were specifically except from federal anti-trust laws. This alone tells us that they are in fact oligopolies. We do, in fact, want efficiency gains from computerization when those saving are shared by customers and businesses alike. Unfortunately, this is not how the free market necessarily functions. It can, depending on the detailed structure of the market.

 

[Bern80]

Todd, I am not going to write a book for you. If you Re intent on chamging the context of statement so that you can fool youself into feeling like you aren't simply ignorant, you are quote welcome.

The facts remain that the S-D model is an ideal that is used to compare the real imperfect markets. It requires numerous constraints such as the assumption of ceterus paribus and perfect competition. The equilibrium point shifts on four changes; demand and supply shifts as well as a chamge in the quantities supplied and demanded. Picking one as "proof" is simple ignorance because it ignores the other three and the reality of the market imperfections an inefficiencies.

Now, go read Dr. Suess, "One Fish Two Fish, Red Fish, Blue Fish" as that seems more your speed that micro and macro econ.

Except now you're backpedaling. Because in your incorrect initial response to me, you tried to use those same curves to prove you were right. Now you're saying, well they don't really apply to the conversation.

I would maintain that they can indeed be used to see what will happen to insurance prices. You simply look at the effect the various policies contained in the bill would have on supply and demand of health insurance policies.

I haven't backpedaled on anything. I presented on graph which applied to your statement because you said to look at that one. There are two basic examples, I didn't present both. Like I said, I'm not going to write a book. You may believe that I made some incorrect response, but you not understanding the material hardly qualifies you to make that determination.

Here are numerous curves

https://www.google.com/search?q=sup...KqsiALx7IG4AQ&ved=0CAcQ_AUoAQ&biw=988&bih=659

I suggested that you might want to review because you were mistaken in your presentation. Somewhere, I also presented the definitions for a change in quantity vs a shift. I get it, it's easy to misunderstand the difference unless it has been specifically highlighted as a common error.

The supply and demand model is an ideal model and can't be applied directly to the healthcare markets without actually looking at the details of the health care markets. And, unless the ACA has been examined in detail, the simply ideal model can't be applied either.

Yes, you look at the details of the bill.

On the other hand, I do note that when presented with the actual effect of change to the demand quantity, you went immediately to "well, if you change D to S and S1 to D1 and S2 to D2 then it works", then completely ignore the shifting supply, which is equivalent to saying, "I know what the answer, now I just need to make up the facts that fit it."

Mean while, Todd is over in the corner, drooling on himself and making up every manner of crap, creating some delusional argument that doesn't even exists.

And it is all so stupid, going on for three-four days along with five forum pages without once actually finding and reading the bill. You can't simply imagine what the bill says then apply an ideal micro economic model.

Here is the bill;

http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf

The table of contents covers pages and is a good start.

I made an error in stating quantity demanded rather than simpluy demand. I have admitted that several times now. I used the wrong term for my intent. I'm not ignoring a change in supply. I have simply stated I don't believe there is one. To get back to square one, I have stated that because the government is now subsidizing premium costs to millions of american, this translates into an increase in demand that is a new demand curve pushed to the right. Which, supply staying the same, means price of insurance goes up, when all the Obamacare supporters contend it's going down. That there must be a shift in the demand curve from D1 to D2 should not be up for debate. That's Obama's intent. From the get go his contention was if not but for the cost, more people would get the health care they need. How can you not see that translates into an increase in demand?

Now what I'm perfectly happy to debate and am genuinely curious about is whether the supply curve would indeed shift or not. I maintain it won't. I don't believe there are more policies available, the evidence is they're simply being replaced by 'government approved' policies on the exchange. I can certainly be persuaded by a compelling argument, but this cop out, that 'well it's just too complex an issue to apply supply and demand to' is bullshit. It reeks of the desperation of wanting Obama's policies to work when everything logical in your brain tells you it won't.

 

[itfitzme]

Except now you're backpedaling. Because in your incorrect initial response to me, you tried to use those same curves to prove you were right. Now you're saying, well they don't really apply to the conversation.

I would maintain that they can indeed be used to see what will happen to insurance prices. You simply look at the effect the various policies contained in the bill would have on supply and demand of health insurance policies.

I haven't backpedaled on anything. I presented on graph which applied to your statement because you said to look at that one. There are two basic examples, I didn't present both. Like I said, I'm not going to write a book. You may believe that I made some incorrect response, but you not understanding the material hardly qualifies you to make that determination.

Here are numerous curves

https://www.google.com/search?q=sup...KqsiALx7IG4AQ&ved=0CAcQ_AUoAQ&biw=988&bih=659

I suggested that you might want to review because you were mistaken in your presentation. Somewhere, I also presented the definitions for a change in quantity vs a shift. I get it, it's easy to misunderstand the difference unless it has been specifically highlighted as a common error.

The supply and demand model is an ideal model and can't be applied directly to the healthcare markets without actually looking at the details of the health care markets. And, unless the ACA has been examined in detail, the simply ideal model can't be applied either.

Yes, you look at the details of the bill.

On the other hand, I do note that when presented with the actual effect of change to the demand quantity, you went immediately to "well, if you change D to S and S1 to D1 and S2 to D2 then it works", then completely ignore the shifting supply, which is equivalent to saying, "I know what the answer, now I just need to make up the facts that fit it."

Mean while, Todd is over in the corner, drooling on himself and making up every manner of crap, creating some delusional argument that doesn't even exists.

And it is all so stupid, going on for three-four days along with five forum pages without once actually finding and reading the bill. You can't simply imagine what the bill says then apply an ideal micro economic model.

Here is the bill;

http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf

The table of contents covers pages and is a good start.

I made an error in stating quantity demanded rather than simpluy demand. I have admitted that several times now. I used the wrong term for my intent. I'm not ignoring a change in supply. I have simply stated I don't believe there is one. To get back to square one, I have stated that because the government is now subsidizing premium costs to millions of american, this translates into an increase in demand that is a new demand curve pushed to the right. Which, supply staying the same, means price of insurance goes up, when all the Obamacare supporters contend it's going do. That there must be a shift in the demand curve from D1 to D2 should not be up for debate. That's Obama's intent. From the get go his contention was if not but for the cost, more people would get the health care they need. How can you not see that translates into an increase in demand?

Now what I'm perfectly happy to debate and am genuinely curious about is whether the supply curve would indeed shift or not. I maintain it won't. I don't believe there are more policies available, the evidence is they're simply being replaced by 'government approved' policies on the exchange. I can certainly be persuaded by a compelling argument, but this cop out, that 'well it's just too complex an issue to apply supply and demand to' is bullshit. It reeks of the desperation of wanting Obama's policies to work when everything logical in your brain tells you it won't.

It wasn't you so much as Todd. He been a dick for about three days running.

Adding more individuals to the market is an increase in the quantity demanded. Really, it is. That's the easy one.

Now, that isn't to say that there isn't also some other part, like the tax credits (or whatever they are) that shifts demand. On the other hand, the capping of insurance companies "profit" to 20% is a shift in supply, at least for that specific market.

It is too complex to apply the simple perfect market supply and demand model. As soon as market imperfections become part of it, the simple "perfect competition" model is out the window. Frankly, there are very few, if any, markets that are the perfect competition, simple supply and demand model markets.

I don't know if I got this up here,

LINK: Supply and Demand

What were gonna see is more like

or

where the equilibrium point moves as all four changes occur simultaneously, quantity demanded, quantity supplied, supply shift and demand shift. It is what almost entirely happens. This fact actually sucks because we can't determine the curves from just watching the price/quantities in the markets.

If we pick through the PPACA, we can probably assign some expectation to each of the line items in the TOC. I doubt that even the CBO can predict the exact balance of all of it.

I've looked at the TOC of PPACA a number of times, imagining going through and line item assigning expectations. The very thought is exhausting. Still, it is clear that it attempts at market reform in the right ways, not like the silliness of the 70's.

 

[itfitzme]

One thing to keep in mind is that the ideal supply and demand curves are boundary conditions, what supplier and consumer would charge and pay in a perfectly competitive markets.

Fact is, most are not perfectly competitive and have imbalances in the market forces that lean either towards the supplier or the consumer. Usually the supplier, but not always.

The supply and demand curves really put upper and lower limits on the supplier and customer prices. Customer's will happily pay less and suppliers will happily take more, if the market will bear this out. The supplier cost is an obvious lower bound. Suppliers can't sell below cost for very long.

The only thing that restricts the demand curve is the other markets, how much we have to spread around. I'll happily pay less, but at some point I have to have enough for food, housing, gasoline, etc. And property management companies know what minimum wage and Social Security pays. So, COLA goes up, up goes rents.

Still, say for instance the local service stations, act as oligopolies. I talked to one owner who said, "We don't get into price wars. That's just tacky." They price as high as the market will bear. They don't compete for the most customer's and don't price at rock bottom cost. They don't talk to each other, but they do watch each others prices. Those price signs aren't just for you and I. The advertisements that say, "will beat any price in town" aren't for you and me. Those are for the competition. The owner of the Shell station knows that the owner of the Arco knows that the Shell station owner knows that the Arco owner is watching Shell prices.

When insurance becomes part of it, the whole thing is up for grabs. Dentists typically charge different prices for insured than non-insured. The difference is that out of pocket is the same, they just get more when insurance is picking up a portion. A 50% deductible and I pay $1000 for a root canal and my insurance picks up $1000. No insurance and I get half off, so I pay $1000. And, frankly, that's the game and no-one can to otherwise because if they do, they get buried in the market.

As far as ACA goes, it is a hugely complex bill and if anyone says they know what is going to happen, they are fooling you, me and themselves.

Put in incentives like loan repayment programs to medical students and tuition costs will rise. Typically, the difference gets split. Like the Cash For Clunkers program... A $1000 rebate and price of autos went up. Depending on the elasticity of the supply and demand curves, it got split between buyer and seller. Depending on how many students take advantage of the loan repayment, the demand for professionals in the hard to fill geographic areas, and the increase in monies gets split up between saving students money and increasing profits to medical schools.

Having insurance companies capping operating expenses and profits to 20% keeps them from being a bottomless well for the rest of the industry. Still, that isn't going to be enough.

Medical device manufactures make bank. So implementing a medical device tax isn't going to increase the price of a $350 hip joint from $35,000 to $45,000. It won't happen.

Medicare is a huge player in the health care markets. So whatever Medicare does, it holds prices down. In a free market system, someone gets less for a lower price. The price of a McDonald's cheeseburger from the $1 menu keeps the price of a Wendy's hamburger down. Union wages at Safeway increase wages at the non-union Raley's.

 

[Toddsterpatriot]

This whole conversation is three days and five pages old.
It began with


To which I replied,

To which you replied



I said, "left" when I meant "right" in "the demand shifts to the left, to higher quantity," which is clear from the context as I followed it with "then the equilibrium price follows the supply curve, such that the quantity supplied increases"

Then we get three days and five forum pages of you and Todd busy going on and on about every manner of what not. Three days and five pages later, I really don't care.

I said, "left" when I meant "right" in "the demand shifts to the left, to higher quantity,"

Yes, the demand curve shifts to the right.
You posted the supply curve shifting to the right, idjit.

Todd, I am not going to write a book for you. If you Re intent on chamging the context of statement so that you can fool youself into feeling like you aren't simply ignorant, you are quote welcome.

The facts remain that the S-D model is an ideal that is used to compare the real imperfect markets. It requires numerous constraints such as the assumption of ceterus paribus and perfect competition. The equilibrium point shifts on four changes; demand and supply shifts as well as a chamge in the quantities supplied and demanded. Picking one as "proof" is simple ignorance because it ignores the other three and the reality of the market imperfections an inefficiencies.

Now, go read Dr. Suess, "One Fish Two Fish, Red Fish, Blue Fish" as that seems more your speed that micro and macro econ.

Todd, I am not going to write a book for you.

That's good, because you're wrong from page one on.

Show me how an increased demand for oil will reduce the price of oil.
Be sure to use the correct chart.

 

[itfitzme]

The ideal supply and demand curves are based on "ceterus paribus", all other things being equal. The reason that a market typically has increasing costs is because they are demanding it from a limited pool of resources, like the labor pool. But, that doesn't mean that the real markets actually have a limited supply. And, there are economies of scale, especially these days.

The medical markets have moved a lot of tasks over to technicians. More techs, like phlebotomists, etc, means fewer high paying nurses and doctors are needed to supply the demand. More customers means that the demand can be supplied more efficiently. Doctors have become more like medical managers than anything else. Nurse don't do so much of the paperwork. Specialization means greater efficiency and greater quantity drives efficiency. I wouldn't be surprised if, in a decade or so, we see computer aided diagnosis. Oh, wait, actually the nursing staff does have protocols for doing over the phone diagnosis. I know someone that has been diagnosed with sinus infections four times a year without ever seeing the doctor's office.

And, with less demand for manufacturing, we have a larger supply of labor that is available to fill medical jobs. We've been stuck at about 7.5% for some time now.

I'm not copping out in saying "well it's just too complex an issue to apply supply and demand to'. It is too complex to apply simple ideal supply and demand models to. It isn't the simple supply and demand market. We can poke at it here and there. It is a good exercise to go through it and see what we can make out of it. But the reality is that even when we can tell the general direction that things will go with something simple like "Cash For Clunkers", there is no way we are going to even guess if the rebate will get split 25:75, 50:50 or 75:25.

Can we say exactly how much savings will occur, given all the other market changes, with insurance companies putting 80% of premium revenues into patient care costs?

Can we easily determine what "Sec. 4205. Nutrition labeling of standard menu items at chain restaurants" will do? (Not shit for a half generation if at all, I suspect).

How about "Sec. 2501. Prescription drug rebates"? Will that shift demand and supply simultaneously?

Can we say exactly how many more doctors and nurses will be added to the supply in two to four years due to "TITLE V—HEALTH CARE WORKFORCE"?

The most fundamental tenant of micro economics is ceterus paribus. There is nothing, "all other things being equal" about this.

I'm not copping out. I have to be realistic. The very nature of the ACA is that nothing is being held equal.

 

[itfitzme]

I said, "left" when I meant "right" in "the demand shifts to the left, to higher quantity,"

Yes, the demand curve shifts to the right.
You posted the supply curve shifting to the right, idjit.

Todd, I am not going to write a book for you. If you Re intent on chamging the context of statement so that you can fool youself into feeling like you aren't simply ignorant, you are quote welcome.

The facts remain that the S-D model is an ideal that is used to compare the real imperfect markets. It requires numerous constraints such as the assumption of ceterus paribus and perfect competition. The equilibrium point shifts on four changes; demand and supply shifts as well as a chamge in the quantities supplied and demanded. Picking one as "proof" is simple ignorance because it ignores the other three and the reality of the market imperfections an inefficiencies.

Now, go read Dr. Suess, "One Fish Two Fish, Red Fish, Blue Fish" as that seems more your speed that micro and macro econ.

Todd, I am not going to write a book for you.

That's good, because you're wrong from page one on.

Show me how an increased demand for oil will reduce the price of oil.
Be sure to use the correct chart.

Todd, blow it out your ass. You are being a dick.

 

[Toddsterpatriot]

Todd, I am not going to write a book for you. If you Re intent on chamging the context of statement so that you can fool youself into feeling like you aren't simply ignorant, you are quote welcome.

The facts remain that the S-D model is an ideal that is used to compare the real imperfect markets. It requires numerous constraints such as the assumption of ceterus paribus and perfect competition. The equilibrium point shifts on four changes; demand and supply shifts as well as a chamge in the quantities supplied and demanded. Picking one as "proof" is simple ignorance because it ignores the other three and the reality of the market imperfections an inefficiencies.

Now, go read Dr. Suess, "One Fish Two Fish, Red Fish, Blue Fish" as that seems more your speed that micro and macro econ.

Todd, I am not going to write a book for you.

That's good, because you're wrong from page one on.

Show me how an increased demand for oil will reduce the price of oil.
Be sure to use the correct chart.

Todd, blow it out your ass. You are being a dick.

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

 

[PMZ]

Todd, I am not going to write a book for you.

That's good, because you're wrong from page one on.

Show me how an increased demand for oil will reduce the price of oil.
Be sure to use the correct chart.

Todd, blow it out your ass. You are being a dick.

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Todd, you are a legend in your own mind. Out here, a legendary asshole.

 

[PMZ]

You said it does;



So which is it? Is, is not, congress capable of passing laws that are unconstitutional?

Congress is certainly capable of passing unconstitutional laws and has. Congress, like you or I, is not the Constitutional authority. The Federal Courts will, however, overturn any law, that's challenged, that they judge to be prohibited by the Constitution.

Didn't you learn any of this in school?

Nope. Just confused because you said they could then you said they couldn't.

No. I said they could pass an unconstitutional law, because they can. The law can't be enforced by the executive branch, if someone challenges the Constitutionality of it, unless the federal courts rule it is Constitutional. Remember the Republican ACA massacre?

 

[Toddsterpatriot]

Todd, blow it out your ass. You are being a dick.

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Todd, you are a legend in your own mind. Out here, a legendary asshole.

 

[KissMy]

 

[freedombecki]

Todd, blow it out your ass. You are being a dick.

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Todd, you are a legend in your own mind. Out here, a legendary asshole.

Yes, your being called to admit your mistakes is so uncomfortable that rather than admitting them, you have to smear the messenger.

That will get you nowhere fast, motormouth.

 

[PMZ]

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Todd, you are a legend in your own mind. Out here, a legendary asshole.

Yes, your being called to admit your mistakes is so uncomfortable that rather than admitting them, you have to smear the messenger.

That will get you nowhere fast, motormouth.

Point out a mistake.

 

[freedombecki]

Quote: Originally Posted by Toddsterpatriot

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Todd, you are a legend in your own mind. Out here, a legendary asshole.

Yes, your being called to admit your mistakes is so uncomfortable that rather than admitting them, you have to smear the messenger.

That will get you nowhere fast, motormouth.

Point out a mistake.

Which one?

 

[PMZ]

Quote: Originally Posted by Toddsterpatriot

Yeah, it hurts when I make you defend your stupid error for pages and pages.

I notice you haven't bothered to defend your claim that when green mandates raise the cost of everything, that it costs nothing.

Yes, your being called to admit your mistakes is so uncomfortable that rather than admitting them, you have to smear the messenger.

That will get you nowhere fast, motormouth.

Point out a mistake.

Which one?

Any.

 

[freedombecki]

Todd, you are a legend in your own mind. Out here, a legendary asshole.

Yes, your being called to admit your mistakes is so uncomfortable that rather than admitting them, you have to smear the messenger.

That will get you nowhere fast, motormouth.

Point out a mistake.

We do know one thing though. When all of the carbon that's been sequestered in fossil fuels was last in the atmosphere, the climate was inhospitable to life.

http://www.usmessageboard.com/envir...should-listen-to-the-97-a-33.html#post7815379

There you go.