Originally Posted by The Rani

And you have little capacity for intelligent discussion, so you resort to personal attacks.

a fine description of your own behavior, by the way.

Originally Posted by The Rani

Really. Look back and see who opened this exchange with an insult.

uh-huh. says the person who called another poster a "douchebag" the other day.

but then, you could always go back and delete it.

Originally Posted by The Rani

Heh. Nice attempt at diversion.
If you want to call me names (i.e. callous) you can expect snark in return.
Don't expect me to take you seriously.

i'll be watching for those deletions, rani.

Originally Posted by JohnMc82

Shall I remind you that my degree is in Political Economy, ...

I'm pretty sure you have to remind just about everyone you get into an economics discussion of your supposed credentials, over and over again, I'm sure.

The real question is have you ever stop to ponder why that may be?

Originally Posted by the bouncer

but it isn't all about me. it's about the welfare of the entire country.

hell, the entire world.

and that *does* concern me.

The entire world, huh? Even all the dead and soon-to-be-dead brown folks? All concerned about their welfare, are you?

Originally Posted by playwrite

I'm pretty sure you have to remind just about everyone you get into an economics discussion of your supposed credentials, over and over again, I'm sure.

The real question is have you ever stop to ponder why that may be?

Because people who argue against reason and sense tend to be impressed by shiny stuff? Why not use what tools work with them?

Originally Posted by The Rani

So if I call it a disaster, I'm a gloom-and-doomer.
If I dont' call it a disaster, I'm a lousy health care provider.
WTF indeed.

That's pretty silly.

Let me see if I can help you with the use of an analogy

On the one hand, you tell us the house is going to burn down. On the other hand, you tell us that would not be a disaster.

You can certainly be very wrong about both.

In this case (ACA will cause costs to go up and care to go down), you certainly are wrong. It won’t happen; but if it did, it would be a disaster.

Now was that so hard?

Engage that big brain of yours, this is not rocket science.

Originally Posted by playwrite

I'm pretty sure you have to remind just about everyone you get into an economics discussion of your supposed credentials, over and over again, I'm sure.

The real question is have you ever stop to ponder why that may be?

Because 95% of people who think they're knowledgeable about economics on the internet inevitably revert back to "Well, if you took Macro 101 30 years ago, you would know that x causes y!"

Originally Posted by The Rani

In addition to brown folks, "the entire world" would also include non-human animal folks.

Now, now. Let's be reasonable here, little Hindu babe. Cows are food, not friends.

Originally Posted by The Rani

Oh golly I'm so scared!
By the way, are you any relation to a certain french dog?

strange reference.

i guess that was supposed to be an insult.

but whatever.

Originally Posted by Justin '77

The entire world, huh? Even all the dead and soon-to-be-dead brown folks? All concerned about their welfare, are you?

i am, yes.

curious why colour comes into this, though.

Originally Posted by The Rani

In addition to brown folks, "the entire world" would also include non-human animal folks.
Perhaps Monsieur le bouncer is a vegetarian.

the entire biosphere is important, yes.

oh, and i'm not french.

and my diet is none of your business.

Originally Posted by playwrite

On the one hand, you tell us the house is going to burn down. On the other hand, you tell us that would not be a disaster.

You can certainly be very wrong about both.

Unless your house is condemned of course. In that case the house burning down could be considered quite fortunate.

Originally Posted by Copperfield

Unless your house is condemned of course. In that case the house burning down could be considered quite fortunate.

if you want to use that analogy.

i think we're looking more at a renovation, not condemnation.

Originally Posted by JohnMc82

... Federal Reserve responds with stimulus ...

At the heart of it, here is where you guys just don't get it.

What's funny is you believe you know the truth about secret conspiracies (requiring the involvement of thousands of people) over govt economic numbers derived from the most published and scrutinized methodologies of any economic data sets available in the entire world. But then, you fall for the biggest monetary gimmick that central govts use i.e., CBs stimulating by exchanging little-or-no interest bearing securities (i.e. bank reserves) for little-or-no interest bearing securities (i.e., T-Bills or MBSs). Yea, right.

You all are as bought into the fractional reserve lending mythology as any Keynesian. And that is the axel you then get all wound around with your low rates signaling that leads to mal-investments that then crowd out good investment and the need for a depression to wipe the slate clean.

That's not how the real world works.

And, here are the key things you miss as a result of you’re going off into magic pony land -

1. The banks will lend when credible and willing borrowers come to them. That would be businesses that see their order books reaching capacity. Businesses DON'T expand, hire, buy new equipment, or borrow until their order books force them to do so. They are not in business for social objectives, they're in business to make money. The CBs exchanging one financial security for another isn’t going to make businesses’ order books somehow get bigger so why would anyone think that this is going to stimulate lending and lead to economic growth???

2. What CBs can do, particularly what our CB is doing, is getting the carrying cost of household borrowing down. As a result of FED actions, carrying cost as a percent of disposable income has dropped like a rock. The reason why they believe they need to do that is because households are carrying an unprecedented level of debt. Until that debt overhang is gone, there is not much hope for anything more than a muddle-through economy at best because households have become net savers (i.e. de-leveraging their debt) rather than net spenders.

3. One man's spending is another man's income; if households are not net spending (because on net they are paying down their unprecedented level of debt) then there are only two places to go to get income. One would be exports, but we are obviously net importers so we are, on net, leaking spending/demand (and thereby income) to overseas’ entities (i.e. China). That leaves only one place for spending to come from that will provide net income to everyone else while the household debt is being paid down. Use your big brain and guess what that is.

4. As stated in '2', keeping borrowing costs down until household debt comes back to sustainable level is, by far, the CBs primary objective. Everything else is, at worst, collateral damage (as well as individually beneficial if you know what is really going on) or at best, provides some "wealth effect" by asset inflation (stocks, houses, gold). The FED is forcing investors to move their money into assets. The FED is not made up of fools, they know its very very unlikely for investor money to go into much of any productive investment because there are very very few businesses willing to borrow right now because their order books are not forcing them to so (see '1' above). The FED is willing to take the risk of asset inflation to get to their primary objective - the lowering of carrying costs for households so they can pay off the unprecedented level of debt. Some folks believe that they are using people, like you, to manipulate the wealth effect ("OMG, hyperinflation is just around the corner!!!! We're all gong to die! Buy gold buy gold!!!). I think they certainly know about you, but in the scheme of things, you all are pretty much nothings - if you all make or lose money, they really don't give a shit, and the same goes for your praxeology-derived hysteria.

The FED knows there’s really not enough demand in the economy to sustain any asset inflation for long. So the FED is willing to risk what little occurs, all the while keeping carrying costs down and household de-leveraging continue at a very rapid clip. Look it up.

Originally Posted by JohnMc82

Oh god, we've been over this before, haven't we?

What does an average number tell us? Not much. Like the CPI headline number, it is reassuring but rather meaningless if we want to understand what is really happening.

Sure, prices are being cut left and right at car dealerships, Best Buy, and resorts around the country, but that is only because massive increases in costs of food, energy, education, and healthcare have drained anything resembling a discretionary budget from most households.

Is new better than old? In science, it typically is, because it actually observes all of the new data. The old books say that monetary policy is a small factor in commodity prices compared to supply and demand. The new research suggests this "conventional wisdom" is part of why we're stuck in this weak economic cycle.

Let's look at the auto manufacturer's point of view:

Sluggish demand causes price cuts and financing deals. Federal Reserve responds with stimulus that only effectively increases the cost of steel and aluminum. Customer has less to spend due to "stimulus" effects on food and energy. Demand falls, manufacturer must cut costs again, jobs are lost.

Repeat vicious cycle until food riots break out in some poorer country/neighborhood. Tell starving people there is no inflation because plasma TVs have never been sharper, bigger, or cheaper.

OK, we're taking about a billion prices here, and the ones you consider sacred have to be included. Let's take the two most common elements that are removed from the adjusted CPI: energy and food. Of the two, energy is actually price sensitive in the cost-push sense of the term. What about food? Well, no. Food, as Americans consume it, is mostly the cost of labor. So labor is the driver, and we know from other sources that labor is sticky. Now that doesn't account for temporary shortages that occur, but those are no more comon than surpluses.

That leaves energy. Do you have some grand plan to alter energy prices? Right now, natural gas is dramatically impacting electricity, and may drive a wedge into liquid fuels. But this is a volitile commodity basket ... just not one that rises continuously. That may change if peak oil is actually achieved, but, for now, increased demand is driving it ... demand mostly from China. that can change in an eye-blink if the Chinese economy slows.

The real problem we have is falling incomes in the middle. The CPI has no impact on that.

Originally Posted by The Rani

Oh golly I'm so scared!
By the way, are you any relation to a certain french dog?

Just so you know, there are plenty here who think it that don't actually say so. You rub people the wrong way a lot, which seems odd for someone in your field.

You seem to pursue discussion like a fencing match: thrust and parry. We're not keeping score, you know.

Originally Posted by playwrite

At the heart of it, here is where you guys just don't get it.

What's funny is you believe you know the truth about secret conspiracies (requiring the involvement of thousands of people) over govt economic numbers derived from the most published and scrutinized methodologies of any economic data sets available in the entire world. But then, you fall for the biggest monetary gimmick that central govts use i.e., CBs stimulating by exchanging little-or-no interest bearing securities (i.e. bank reserves) for little-or-no interest bearing securities (i.e., T-Bills or MBSs). Yea, right.

Sigh, back to the magic ad-hom. I'm sure tearing down two dimensional characters is useful on stage, but it doesn't teach you economics. Assuming you did pay attention in Macro 101 you'd know that lower interest rates are generally considered to be stimulating via Keynesian interpretations of the Great Depression.

Good start, I'm sure you can follow along this far. Except it is different this time. See, the 1930s was the last time all commodity classes hit a low trough in the supercycle. Grain was so cheap that a lot of product rotted because it wasn't worth taking to market.

This time, commodity classes are approaching relative peaks of a commodity super cycle. The last time that happened in the U.S. was during the Civil War. Prices got so high the red states thought they could walk off with all the cotton and grain and let the cities starve. Then, of course, a bunch of Union soldiers stomping through all the farms didn't exactly help prices come back down right away either.

You all are as bought into the fractional reserve lending mythology as any Keynesian. And that is the axel you then get all wound around with your low rates signaling that leads to mal-investments that then crowd out good investment and the need for a depression to wipe the slate clean.

That's not how the real world works.

Are there a lot of bad investments? Yeah! Do they need to be unwound? Uh... yeah! I'm not saying this is going to happen someday, I'm saying it already did. The Fed recognizes that and they're working to clean 'em up and get the system back in order. There's nothing particularly controversial about this...

The problem is that the Federal Reserve's actions aren't living up to the textbook model's expectations. Hell, Bernanke wrote the damn textbook with his research.

He wrote it in 1982, when we had about 10 years worth of data on free-floating fiat currencies. Based on that limited data-set, you get a lot of weird results like commodity price assymetry - where the decrease of energy prices doesn't increase economic gains proportionately to the losses of energy price increases. The new research that looks at the whole forty year floating currency period finds that symmetry again and a macro incentive to drop commodity prices.

So the Federal Reserve is actually going the wrong way, because that is exactly what the textbooks say they should do.

Congress is going the wrong way too, but that has something to do with the idiots we keep electing thanks to a seriously limited spectrum of choice and a loud chorus of paid fools claiming they're opposite extremists.

And, here are the key things you miss as a result of you’re going off into magic pony land -

1. The banks will lend when credible and willing borrowers come to them. That would be businesses that see their order books reaching capacity. Businesses DON'T expand, hire, buy new equipment, or borrow until their order books force them to do so. They are not in business for social objectives, they're in business to make money. The CBs exchanging one financial security for another isn’t going to make businesses’ order books somehow get bigger so why would anyone think that this is going to stimulate lending and lead to economic growth???

2. What CBs can do, particularly what our CB is doing, is getting the carrying cost of household borrowing down. As a result of FED actions, carrying cost as a percent of disposable income has dropped like a rock. The reason why they believe they need to do that is because households are carrying an unprecedented level of debt. Until that debt overhang is gone, there is not much hope for anything more than a muddle-through economy at best because households have become net savers (i.e. de-leveraging their debt) rather than net spenders.

3. One man's spending is another man's income; if households are not net spending (because on net they are paying down their unprecedented level of debt) then there are only two places to go to get income. One would be exports, but we are obviously net importers so we are, on net, leaking spending/demand (and thereby income) to overseas’ entities (i.e. China). That leaves only one place for spending to come from that will provide net income to everyone else while the household debt is being paid down. Use your big brain and guess what that is.

4. As stated in '2', keeping borrowing costs down until household debt comes back to sustainable level is, by far, the CBs primary objective. Everything else is, at worst, collateral damage (as well as individually beneficial if you know what is really going on) or at best, provides some "wealth effect" by asset inflation (stocks, houses, gold). The FED is forcing investors to move their money into assets. The FED is not made up of fools, they know its very very unlikely for investor money to go into much of any productive investment because there are very very few businesses willing to borrow right now because their order books are not forcing them to so (see '1' above). The FED is willing to take the risk of asset inflation to get to their primary objective - the lowering of carrying costs for households so they can pay off the unprecedented level of debt. Some folks believe that they are using people, like you, to manipulate the wealth effect ("OMG, hyperinflation is just around the corner!!!! We're all gong to die! Buy gold buy gold!!!). I think they certainly know about you, but in the scheme of things, you all are pretty much nothings - if you all make or lose money, they really don't give a shit, and the same goes for your praxeology-derived hysteria.

The FED knows there’s really not enough demand in the economy to sustain any asset inflation for long. So the FED is willing to risk what little occurs, all the while keeping carrying costs down and household de-leveraging continue at a very rapid clip. Look it up.

Yes, and almost all of the deleveraging is in the mortgage sector, correlating to the rapid rise in defaults and foreclosures. Student loan debt is at record highs while credit, auto, and other revolving debt levels are average for the ten year period.

Maybe some malinvestment being wiped clean?

Originally Posted by Marx & Lennon

OK, we're taking about a billion prices here, and the ones you consider sacred have to be included. Let's take the two most common elements that are removed from the adjusted CPI: energy and food. Of the two, energy is actually price sensitive in the cost-push sense of the term.

The real problem we have is falling incomes in the middle. The CPI has no impact on that.

The headline CPI number that matches the BPP does include energy and food, although I can't find real data on the BPP website except to a consulting firm who wants to sell it to me. The CPI is fine, it tells us exactly what is happening to consumer households: the cost of necessities is rising, the cost of luxuries and long term purchases is declining, and based on relative budgets of consumers in 2007 and 2008 it balances out to a low inflation rate.

You mentioned another important point: wages are declining.

So, what happens when wages decline and the cost of necessities goes up? Cut back spending. What happens when people cut back? Sales drop, jobs get terminated. It's a cycle.

Food, as Americans consume it, is mostly the cost of labor. So labor is the driver, and we know from other sources that labor is sticky. Now that doesn't account for temporary shortages that occur, but those are no more comon than surpluses.

That leaves energy. Do you have some grand plan to alter energy prices? Right now, natural gas is dramatically impacting electricity, and may drive a wedge into liquid fuels. But this is a volitile commodity basket ... just not one that rises continuously. That may change if peak oil is actually achieved, but, for now, increased demand is driving it ... demand mostly from China. that can change in an eye-blink if the Chinese economy slows.

A) labor isn't the primary cost of food these days. Maybe 30% when transportation is included. Oil isn't the primary cost either, maybe 10% when its half of transportation is included.

B) Supply and demand and peak oil fears aren't the primary factor driving fuel prices, either. We know this because over the last 40 years of free floating currency exchange, most fluctuations are not global but rather national. Even global supply shocks ripple through individual nations in a very different way as currency markets declare winners and losers in all of the latest developments. Europe has seen slower energy and food increases not because taxes already increased the retail prices, but because their currency has declined less in real terms.

C) We can control this cost with appropriate monetary policy that reflects the best research of the last 10 years, and it is in our interest to do so as a net importer who relies so much on turning raw materials in to value added products.

D) The trade deficit isn't a problem, it's a benefit of empire. As was noted in Rome, ships enter the capital's port loaded with treasure and delicacies and return to the colonies empty or with the most basic supplies. We load our empty ships up with green slips of paper and that's a damn good deal while it lasts.

Why Most other countries see health care costs rise less than they do here.

Originally Posted by Wonkbook

We have a lot of examples to look at where governments have successfully held down the rate of health-care cost inflation. Most of them do that through some version of price controls, where the government sets the rates that doctors can charge for various services...

...It turns out that we don’t even have to look internationally to find an example of success at holding down health cost inflation: Maryland has been quite successful at this for about four decades now. It is the only state that uses rate-setting for hospitals, meaning that the state government decides what all Maryland hospitals can charge for a given procedure.

That system went into effect in 1976, when Maryland had hospital costs 26 percent higher than the rest of the the country. Just over three decades later, in 2008, the average cost for a hospital admission in Maryland was down to national levels. ”From 1997 through 2008, Maryland hospitals experienced the lowest cumulative growth in cost per adjusted admission of any state in the nation,” the state concluded in a 2010 report.

Also allowing large agencies like Medicare to negioate costs, including for perscriptions, would help.
But then the lobbyists would not earn the big bucks anymore.

Originally Posted by The Rani

So here's the horrible and callous comment that started the firestorm:



Can anyone provide a reasonable argument why hospitals would NOT do either or both of the things that I describe in the first sentence?
No, of course not.

So instead, let's all pick on The Rani. Yeah, that's a great idea. It will make her feel bad, so she'll shut the hell up.
And really she's only saying that stuff because she is Ayn Rand reincarnated.
Phew! That explains it. Now we can all believe in Obamacare again and sleep well at night.

If that's really what you guys want to believe, wonderful. Good luck with that.

in answer to your question: i would rather see people spend an extra day or two in the hospital instead of having to re-admit them later on. wouldn't starting the admission process all over again be more inefficient than just keeping the person longer in the first place?

you actually asked a good question *before* you went back and added the snark. *you* stepped on your own message.

"it's a good time to be healthy." that is right out of romney's script.

sorta reminds me of that old doonesbury musical:

it's the right time to be rich
it's the right time to scratch that itch
and what do you care
if you dirty the air
palm springs is always clean
i'll meet you on the third green
it's a bad time for the dole
when the rich are on a roll.

ol' gary trudeau saw where all this was going

by the way, if justin '77 is still around, i'd still like some clarification on the relevancy of that "brown people" remark.

The thing about discharging hospital patients sooner was pushed upon the industry as an effort to reign in spiraling health care costs in the 1980's. At the time this was referred to as creating DRG's(Diagnostic Related Groupings), over which both Medicare and private insurers were only going to pay so much for different types of medical conditions. Hospitals and doctors would actually receive recognition for speedier discharging of patients. This may have run counter to the prevailing medicial opinions of the day--I don't know. This was the beginning of the efforts at healthcaare reform. I was one of those who lost a job because of this at a time when I felt that a hospital would be the safest place to have a job at because there would always be sick people that needed care. Fast forward a quarter century and more procedures that used to require inpatient stays can now be done on an outpatient basis much more efficiently--sometimes in a time frame of two hours or so. I don't expect either Medicare of SS to be dismantled at least not while this generation of seniors is still alive, as a considerable portion of them are older, wealthier and more established than the younger gens, and also vote in heavier numbers. The flip side of this is that the majority of them are skeptical of government programs which means that true national healthcare probably will not pass within my lifetime(Am 67).

Originally Posted by The Rani

So here's the horrible and callous comment that started the firestorm:



Can anyone provide a reasonable argument why hospitals would NOT do either or both of the things that I describe in the first sentence?
No, of course not.

Well, let's break down what you actually wrote -

They will either keep patients longer during the first admission

This is just your conjecture. Do you have any data? Surely, you must know of some state or local govt or even a hospital policy that penalizes re-admissions and the data shows this has lead to keeping patients longer on first admission. Or, are you just blowing this out your ass?

(increasing costs)

Let's say you do have data on lengthier admissions and obviously leading to more cost, but relative to what; or, more specifically, relative to the costs of two admissions? Again, is this just about you being a little bit windy?

or refuse to readmit them (decreasing level of care.)

- same questions about examples, data, and, well, your possible windiness.

Now let's compare that to the real world example I provided as part of my post that engendered your apparent need for some GasX -

In Northern Virginia, the Inova health system has spent $2.4 million to hire eight health coaches and four case managers to coordinate and keep track of patients after discharge, said Vera Dvorak, vice president for transitional care. The company also opened two special clinics where doctors see Inova patients who can’t get appointments with their regular providers within a week after discharge. Inova’s five hospitals will get paid about $250,000 less from Medicare this coming year because of the penalties, officials said.

You see the difference? Your stuff stinks, mine doesn't - so you get "the treatment" because you’re obviously undergoing some weird GI tract distress.

It’s not that we’re picking on you, it’s because we care.

Originally Posted by The Rani

..., I seriously don't give a shit.

That just may be what's giving you all that gas.

I do feel bad for you, but it does stink up the place.