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DOGE's only public ledger is riddled with mistakes

nytimes.com

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Re: DOGE's only public ledger is riddled with mistakes

#361

Post by yadaeno »

silvestrov wrote: post #314
firejake308 wrote: post #298

Earlier quoted context omitted.

I know of at least one source arguing that in fact, population health (mainly obesity and gun violence) explain upwards of 70% of the difference in healthcare spending between the US and other developed nations.[1] To me, this seems like the most likely explanation because I believe we have pretty similar diagnostics and treatments to other developed countries, and I don't feel like a British doctor would give me any…

It is very expensive to run the insurance companies, plus all the time the hospitals need to spend to talk/plead with the insurance companies. When you have the state as a single payer then all those expenses just vanishes.

Even the various single payer models in Europe and asia still have insurance companies.

The difference is that in these systems the government has some stake — whether it’s providing the public insurance fund, or owning the company itself — so that the government is financially incentivized to reduce costs.

In the US case everything is private so all parties are incentivized to increase costs as much as possible.

We really should to copy the Bismarck model. Public owned “public fund”, heavily regulated private insurance and care.

Re: DOGE's only public ledger is riddled with mistakes

#362

Post by unclebucknasty »

rayiner wrote: post #211
munchler wrote: post #186

Earlier quoted context omitted.

"We spend too much" is a political opinion, rather than a statement of fact. Only Congress can change the amount of money spent by the government, so the executive branch's actions are unconstitutional, no matter how large the crowd cheering it on. This is exactly the sort of mob rule that the Founders wanted to prevent.

It’s quite debatable what the founders intended here. Congress has the power to appropriate funds, it’s not clear as a constitutional matter it has the power to compel the executive to use all the appropriated funds. Even as a legal matter, the impoundment act only requires rescission notification once it’s clear that the executive won’t use all the money appropriated for a “program.” When Congress is appropriating s…

>cancel a lot of individual contracts before it needs to invoke recession

This is not correct.

The recission process requires that the Executive branch notify Congress upon appropriation that it will not use appropriated funds. Congress can then decide to accept or reject the recission notice. If rejected, the funds remain appropriated, with whatever conditions Congress set.

The argument could be made that this is a new administration with different priorities, so does not intend to use the previously appropriated funds. But, even then, the spirit of the law (and the Constitution) is such that the new administration would engage in the recission process as if the funds had just been appropriated. So, they would submit a recission notice before taking action.

That is, they would not just do whatever they wanted and inform Congress afterwards.

Re: DOGE's only public ledger is riddled with mistakes

#364

Post by hnmullany »

heartbreak wrote: post #354
balderdash wrote: post #347

Earlier quoted context omitted.

The social security administration estimates ~$60b a year in fraud on ~$400b budget! [1] [2]. People can have a rational discussion as to where and how fraud and abuse are rooted out, but I have trouble understanding how people don’t think it’s an issue? [1] https://blog.ssa.gov/medicare-fraud-prevention-week/ [2] https://www.usaspending.gov/explorer/budget_function

You linked to a blog post about Medicare fraud, not Social Security fraud.

That's because the original responder's data was about medicare fraud although the estimate was provided by the Social Security Administration

Re: DOGE's only public ledger is riddled with mistakes

#365

Post by dboreham »

pclmulqdq wrote: post #179
JeremyNT wrote: post #129

Earlier quoted context omitted.

2) is questionable. Most of the budget is spent maintaining global hegemony through military dominance. Whatever inefficiencies that exist on the civil side are nearly irrelevant.

You should look at the CBO's reports on this. Most of the budget is spent maintaining Medicare/Medicaid and Social Security. The sleight of hand involved in the idea that the military budget is "most" of the spending is by calling large parts of the government's spending (but none of its military spending) "mandatory," and then slicing up the "discretionary" portion only, most of which is the military. However, the d…

Because people have been gasslit into believing that social security and medicare are funded by the same-named payroll withholding contributions.

Re: DOGE's only public ledger is riddled with mistakes

#366

Post by harry8 »

qgin wrote: post #277
sxyuan wrote: post #248

For those who want to have a substantive discussion on the federal budget and believe these cuts are justified, I have a few questions (putting aside questions of constitutionality for this thread): 1. There are claims that federal spending is out of control. How do you square that with the fact that spending as a percentage of GDP is only slightly elevated compared to the historical average going back to at least th…

Number 3 can’t be overstated. Healthcare costs for the exact same care are 2x-3x what they are in Europe. Global health insurance plans usually come in two flavors: 1. Global coverage 2. Global coverage excluding United States (for half the monthly premium of the first plan) The United States in an extreme outlier in terms of cost. This is separate from rationing care. This is separate from even population health (ex…

20 years ago I read a story about an obstetrician in the USA.

His premiums at that time for professional negligence were $1m per year. He would have to keep paying those premiums for 18 years after his retirement.

Same for every obstetrician.

Professional fees then must be set to cover those insurance premiums.

Has that changed for the better in the USA? Seems very unlikely to be the same in Europe.

Obstetrics is obviously a illustrative case. How are the professional negligence premiums across the other specialties?

Why does the effect of the US legal system never seem to come up much in the “US healthcare is insanely expensive” discussion? Is the effect of it really not significant?

Re: DOGE's only public ledger is riddled with mistakes

#367

Post by thrance »

JackYoustra wrote: post #299

Rule of law is what allows us to grow. Acemoglu won a nobel prize showing that institutions cause growth. Destroy institutions and you'll undershoot potential.

Pet peeve: there is no Nobel prize of economics, Alfred Nobel didn't include "economy" in his will. Instead there is a "Nobel Memorial Prize in Economic Sciences" whose purpose is to give credibility to the unscientific field of economics. The prize itself is mostly awarded to neoliberalists economists and does not often represent the majority views in the field.

Re: DOGE's only public ledger is riddled with mistakes

#368

Post by forrestthewoods »

sxyuan wrote: post #248

For those who want to have a substantive discussion on the federal budget and believe these cuts are justified, I have a few questions (putting aside questions of constitutionality for this thread): 1. There are claims that federal spending is out of control. How do you square that with the fact that spending as a percentage of GDP is only slightly elevated compared to the historical average going back to at least th…

1. But debt as percent of GDP has been growing. Can't do that forever. https://fred.stlouisfed.org/series/GFDEGDQ188S

2/3. If the US pays more for health care and gets worse results why should we give them more money?

I don't think health insurance companies should be abolished by royal decree. I think the government should offer an alternative and when that alternative is 4x as dollar efficient the health insurance companies will die a natural death.

4. Your chart shows corporate tax rates have been flat for 50 years. Seems fine?

As an aside, I dislike the overemphasis on Federal spending and Federal income tax. The real question is federal+state+local spending and revenue.

I wish as a society we could work backwards. What services do we want to provide? How much will that cost? How do we pay for it? We've turned into a culture where some people thinking spending is good solely for the sake of spending. When politicians trumpet how much money they're going to spend rather than the benefits they're going to be provide I get very sad!

Re: DOGE's only public ledger is riddled with mistakes

#369

Post by KennyBlanken »

rayiner wrote: post #211
munchler wrote: post #186

Earlier quoted context omitted.

"We spend too much" is a political opinion, rather than a statement of fact. Only Congress can change the amount of money spent by the government, so the executive branch's actions are unconstitutional, no matter how large the crowd cheering it on. This is exactly the sort of mob rule that the Founders wanted to prevent.

It’s quite debatable what the founders intended here. Congress has the power to appropriate funds, it’s not clear as a constitutional matter it has the power to compel the executive to use all the appropriated funds. Even as a legal matter, the impoundment act only requires rescission notification once it’s clear that the executive won’t use all the money appropriated for a “program.” When Congress is appropriating s…

The Impoundment Act passed with overwhelming bipartisan support in the house and unanimous support in the senate. It was a direct rebuke to Nixon deciding he had the presidential authority to not fund programs he didn't like.

It unambiguously affirmed Congress's sole authority over federal spending.

The Constitution clearly gives Congress the authority over federal taxation and spending, and this power is a key check on executive power. If the executive branch could ignore congressional spending decisions, it would effectively render Congress’s "power of the purse" irrelevant.

It's called the Spending Clause, not the Appropriation Clause, for a reason.

As to the rest of your argument: not spending the full $100M congress specifies in 100M Mars Bars for the Air Force because Mars wasn't able to deliver the last 25 million Mars Bars, is not the same thing as "One person decided Mars Bars are Woke so we just stopped paying Mars Candy yesterday."

Re: DOGE's only public ledger is riddled with mistakes

#370

Post by danso »

balderdash wrote: post #347
sxyuan wrote: post #248

For those who want to have a substantive discussion on the federal budget and believe these cuts are justified, I have a few questions (putting aside questions of constitutionality for this thread): 1. There are claims that federal spending is out of control. How do you square that with the fact that spending as a percentage of GDP is only slightly elevated compared to the historical average going back to at least th…

The social security administration estimates ~$60b a year in fraud on ~$400b budget! [1] [2]. People can have a rational discussion as to where and how fraud and abuse are rooted out, but I have trouble understanding how people don’t think it’s an issue? [1] https://blog.ssa.gov/medicare-fraud-prevention-week/ [2] https://www.usaspending.gov/explorer/budget_function

The Medicare budget in 2023 was $830 billion [0]. Where are you getting $400B from?

[0] https://www.kff.org/medicare/issue-brief/what-to-know-about-...

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