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	<title>Comments on: Looking at the Budget and GOP ideas in HCR</title>
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		<title>By: J</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1579824</link>
		<dc:creator>J</dc:creator>
		<pubDate>Thu, 11 Feb 2010 03:42:09 +0000</pubDate>
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		<description>test...hoping comment lets me see site</description>
		<content:encoded><![CDATA[<p>test&#8230;hoping comment lets me see site</p>
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		<title>By: Ruckus</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575961</link>
		<dc:creator>Ruckus</dc:creator>
		<pubDate>Mon, 08 Feb 2010 22:37:45 +0000</pubDate>
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		<description>@&lt;a href=&quot;#comment-1575601&quot; rel=&quot;nofollow&quot;&gt;Tom Hilton&lt;/a&gt;: 
As evidenced by some of the comments in this thread
&lt;em&gt;painfully fucking obvious&lt;/em&gt; is a phrase that needs to be used much more often.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575601" rel="nofollow">Tom Hilton</a>:<br />
As evidenced by some of the comments in this thread<br />
<em>painfully fucking obvious</em> is a phrase that needs to be used much more often.</p>
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		<title>By: Ailuridae</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575757</link>
		<dc:creator>Ailuridae</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:22:47 +0000</pubDate>
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		<description>@&lt;a href=&quot;#comment-1575728&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

I don&#039;t know anything about Larry Mishel except that he&#039;s a great economist.  I find it amazing that someone like Gruber or any other economist would walk back something thats incredibly orthodox (a decrease in one source of compensation to workers would be made up in another or the other area) and never comment on it.  What I think is far more likely is that Gruber clarified that by increased wages he meant a slowing of the decrease in wage growth.  Economically the same thing but in laymen&#039;s terms his initial point (slowing health care cost will lead to increased wages) may seem too strong.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575728" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>I don&#8217;t know anything about Larry Mishel except that he&#8217;s a great economist.  I find it amazing that someone like Gruber or any other economist would walk back something thats incredibly orthodox (a decrease in one source of compensation to workers would be made up in another or the other area) and never comment on it.  What I think is far more likely is that Gruber clarified that by increased wages he meant a slowing of the decrease in wage growth.  Economically the same thing but in laymen&#8217;s terms his initial point (slowing health care cost will lead to increased wages) may seem too strong.</p>
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		<title>By: Ailuridae</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575744</link>
		<dc:creator>Ailuridae</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:18:26 +0000</pubDate>
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		<description>@&lt;a href=&quot;#comment-1575717&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

I&#039;m arguing that there isn&#039;t enough correlation to strongly argue for causation.  If I had to hazard a guess from everything I have ever read about cost versus quality of care I would say that it probably somewhere between 0.3 and -0.2 but thats just eyeballing it.  In short costs within a region are largely being driven outside of the quality of care provided.  Now, if you are asking whether within a single Kaiser network which of three programs has the best outcomes I would likely pick the most expensive one.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575717" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>I&#8217;m arguing that there isn&#8217;t enough correlation to strongly argue for causation.  If I had to hazard a guess from everything I have ever read about cost versus quality of care I would say that it probably somewhere between 0.3 and -0.2 but thats just eyeballing it.  In short costs within a region are largely being driven outside of the quality of care provided.  Now, if you are asking whether within a single Kaiser network which of three programs has the best outcomes I would likely pick the most expensive one.</p>
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		<title>By: Mnemosyne</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575731</link>
		<dc:creator>Mnemosyne</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:14:14 +0000</pubDate>
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		<description>@&lt;a href=&quot;#comment-1575714&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

&lt;blockquote&gt;But come now, are you REALLY arguing that the less spent on health care, the better the outcome per similarly situated patient? You’re not are you? Actually you are arguing that the MORE money spent the WORSE the outcome? And you claim there is a study that says that? Is it the link you provided?&lt;/blockquote&gt;

I&#039;m arguing that higher-cost healthcare is not automatically better healthcare and, yes, in the links I provided, there is some evidence that higher-cost healthcare actually leads to &lt;em&gt;worse&lt;/em&gt; outcomes, at least for Medicare patients.  Think of it this way:  what led to better outcomes, patients taking NSAID drugs that were available as generics like ibuprofen or patients taking the expensive new &lt;a href=&quot;http://en.wikipedia.org/wiki/Rofecoxib&quot; rel=&quot;nofollow&quot;&gt;Vioxx&lt;/a&gt;?  

Hey, here&#039;s a thought -- maybe you could actually, you know, look at the links and studies before you decide I&#039;m lying to you because what I&#039;m saying doesn&#039;t conform to your expectations?</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575714" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>
<blockquote>But come now, are you <span class="caps">REALLY</span> arguing that the less spent on health care, the better the outcome per similarly situated patient? You&#8217;re not are you? Actually you are arguing that the <span class="caps">MORE</span> money spent the <span class="caps">WORSE</span> the outcome? And you claim there is a study that says that? Is it the link you provided?</p></blockquote>
<p>I&#8217;m arguing that higher-cost healthcare is not automatically better healthcare and, yes, in the links I provided, there is some evidence that higher-cost healthcare actually leads to <em>worse</em> outcomes, at least for Medicare patients.  Think of it this way:  what led to better outcomes, patients taking <span class="caps">NSAID</span> drugs that were available as generics like ibuprofen or patients taking the expensive new <a href="http://en.wikipedia.org/wiki/Rofecoxib" rel="nofollow">Vioxx</a>?</p>
<p>Hey, here&#8217;s a thought&#8212;maybe you could actually, you know, look at the links and studies before you decide I&#8217;m lying to you because what I&#8217;m saying doesn&#8217;t conform to your expectations?</p>
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		<title>By: BTD</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575728</link>
		<dc:creator>BTD</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:10:08 +0000</pubDate>
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		<description>@&lt;a href=&quot;#comment-1575702&quot; rel=&quot;nofollow&quot;&gt;Ailuridae&lt;/a&gt;: 

Ok. You must know Mishel reported that Gruber admitted that to him.

But I suppose Mishel is a liar.

Anyway, John Murtha, RIP.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575702" rel="nofollow">Ailuridae</a>:</p>
<p>Ok. You must know Mishel reported that Gruber admitted that to him.</p>
<p>But I suppose Mishel is a liar.</p>
<p>Anyway, John Murtha, <span class="caps">RIP</span>.</p>
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		<title>By: BTD</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575722</link>
		<dc:creator>BTD</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:08:36 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575722</guid>
		<description>@&lt;a href=&quot;#comment-1575703&quot; rel=&quot;nofollow&quot;&gt;Sly&lt;/a&gt;: 

I think his point was pretty clear - that there are people who &quot;lose&quot;  when policies are changed.

for example, when Bush&#039;s tax cuts lapse, rich folks are going to lose.

In any event, upon hearing of Murtha&#039;s passing, I&#039;ll retire from this thread now. a sad day.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575703" rel="nofollow">Sly</a>:</p>
<p>I think his point was pretty clear &#8211; that there are people who &#8220;lose&#8221;  when policies are changed.</p>
<p>for example, when Bush&#8217;s tax cuts lapse, rich folks are going to lose.</p>
<p>In any event, upon hearing of Murtha&#8217;s passing, I&#8217;ll retire from this thread now. a sad day.</p>
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		<title>By: Sly</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575720</link>
		<dc:creator>Sly</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:07:51 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575720</guid>
		<description>@&lt;a href=&quot;#comment-1575716&quot; rel=&quot;nofollow&quot;&gt;Ash Can&lt;/a&gt;: 
&lt;blockquote&gt;We interrupt this &lt;del&gt;dunk tank&lt;/del&gt; discussion to bring you word that John Murtha has passed.&lt;/blockquote&gt;

Damn. My view has been &lt;a href=&quot;#comment-1575703&quot; rel=&quot;nofollow&quot;&gt;further dimmed&lt;/a&gt;.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575716" rel="nofollow">Ash Can</a>:</p>
<blockquote><p>We interrupt this <del>dunk tank</del> discussion to bring you word that John Murtha has passed.</p></blockquote>
<p>Damn. My view has been <a href="#comment-1575703" rel="nofollow">further dimmed</a>.</p>
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		<title>By: BTD</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575717</link>
		<dc:creator>BTD</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:06:39 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575717</guid>
		<description>@&lt;a href=&quot;#comment-1575707&quot; rel=&quot;nofollow&quot;&gt;Ailuridae&lt;/a&gt;: 

Hmm. I always thought I understood those concepts. Are you arguing there is no causation associated with the correlations we have been discussing?</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575707" rel="nofollow">Ailuridae</a>:</p>
<p>Hmm. I always thought I understood those concepts. Are you arguing there is no causation associated with the correlations we have been discussing?</p>
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		<title>By: Ash Can</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575716</link>
		<dc:creator>Ash Can</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:05:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575716</guid>
		<description>We interrupt this &lt;strike&gt;dunk tank&lt;/strike&gt; discussion to bring you word that &lt;a href=&quot;http://www.msnbc.msn.com/id/35299741/ns/politics-capitol_hill/&quot; rel=&quot;nofollow&quot;&gt;John Murtha has passed.&lt;/a&gt;

Carry on.</description>
		<content:encoded><![CDATA[<p>We interrupt this <strike>dunk tank</strike> discussion to bring you word that <a href="http://www.msnbc.msn.com/id/35299741/ns/politics-capitol_hill/" rel="nofollow">John Murtha has passed.</a></p>
<p>Carry on.</p>
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		<title>By: BTD</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575714</link>
		<dc:creator>BTD</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:05:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575714</guid>
		<description>@&lt;a href=&quot;#comment-1575695&quot; rel=&quot;nofollow&quot;&gt;Mnemosyne&lt;/a&gt;: 

Medicare is not at issue with regard to the excise tax. Moreover, there obviously is not a control for the differing COL in different regions.

But come now, are you REALLY arguing that the less spent on health care, the better the outcome per similarly situated patient? You&#039;re not are you? Actually you are arguing that the MORE money spent the WORSE the outcome? And you claim there is a study that says that? Is it the link you provided?

Do you have a quote for that?  I know that there are studies that show extra spending provides declining marginal value. But the inverse relationship is new to me. If true, I learned something.

But if true, it also argues for a cap on health care spending. Now I understood the economic argument for this, but never I have I heard it made as a health argument.

I am willing to learn. Please teach me.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575695" rel="nofollow">Mnemosyne</a>:</p>
<p>Medicare is not at issue with regard to the excise tax. Moreover, there obviously is not a control for the differing <span class="caps">COL</span> in different regions.</p>
<p>But come now, are you <span class="caps">REALLY</span> arguing that the less spent on health care, the better the outcome per similarly situated patient? You&#8217;re not are you? Actually you are arguing that the <span class="caps">MORE</span> money spent the <span class="caps">WORSE</span> the outcome? And you claim there is a study that says that? Is it the link you provided?</p>
<p>Do you have a quote for that?  I know that there are studies that show extra spending provides declining marginal value. But the inverse relationship is new to me. If true, I learned something.</p>
<p>But if true, it also argues for a cap on health care spending. Now I understood the economic argument for this, but never I have I heard it made as a health argument.</p>
<p>I am willing to learn. Please teach me.</p>
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		<title>By: Ailuridae</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575707</link>
		<dc:creator>Ailuridae</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:02:26 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575707</guid>
		<description>@&lt;a href=&quot;#comment-1575691&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

Wait, you can&#039;t &quot;accept&quot; something that is totally different from what you were arguing.

Read this:
http://en.wikipedia.org/wiki/Correlation_and_dependence

I&#039;m getting tired of constantly having arguments with other leftists and then realizing they are almost invariably innumerate.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575691" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>Wait, you can&#8217;t &#8220;accept&#8221; something that is totally different from what you were arguing.</p>
<p>Read this:<br />
<a href="http://en.wikipedia.org/wiki/Correlation_and_dependence" rel="nofollow">http://en.wikipedia.org/wiki/C.....dependence</a></p>
<p>I&#8217;m getting tired of constantly having arguments with other leftists and then realizing they are almost invariably innumerate.</p>
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		<title>By: Sly</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575703</link>
		<dc:creator>Sly</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:00:26 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575703</guid>
		<description>@&lt;a href=&quot;#comment-1575676&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 
&lt;blockquote&gt;As Ezra Klein says, there are “losers” in every policy choice.&lt;/blockquote&gt;

I think Ezra&#039;s whole point was that the purpose of good policy was to mitigate the extent to which losers actually lose. Further, the unions were holding out for a transition period in which contracts could be renegotiated. The dollar aspect of the negotiated settlement on the tax threshold amounted to around a 5% increase over what was already in the Senate bill. In other words, they were more concerned about how implementing the tax would affect them, not so much the tax itself.

But I&#039;ll let the others handle all this stuff. Arguing HCR with Firebaggers and Teabaggers over the past few weeks has seriously dimmed my view on policy discourses and the extent to which people can actually have arguments in good faith.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575676" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<blockquote><p>As Ezra Klein says, there are &#8220;losers&#8221; in every policy choice.</p></blockquote>
<p>I think Ezra&#8217;s whole point was that the purpose of good policy was to mitigate the extent to which losers actually lose. Further, the unions were holding out for a transition period in which contracts could be renegotiated. The dollar aspect of the negotiated settlement on the tax threshold amounted to around a 5% increase over what was already in the Senate bill. In other words, they were more concerned about how implementing the tax would affect them, not so much the tax itself.</p>
<p>But I&#8217;ll let the others handle all this stuff. Arguing <span class="caps">HCR</span> with Firebaggers and Teabaggers over the past few weeks has seriously dimmed my view on policy discourses and the extent to which people can actually have arguments in good faith.</p>
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		<title>By: Ailuridae</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575702</link>
		<dc:creator>Ailuridae</dc:creator>
		<pubDate>Mon, 08 Feb 2010 20:00:00 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575702</guid>
		<description>@&lt;a href=&quot;#comment-1575687&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

No Jon Gruber never &quot;concluded he was wrong&quot;.  You could easily dispute this by showing where Gruber wrote this?  

And, every labor economist isn&#039;t Larry Mishel.  Larry Mishel is well, Larry Mishel and he&#039;s out on an island on this one.</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575687" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>No Jon Gruber never &#8220;concluded he was wrong&#8221;.  You could easily dispute this by showing where Gruber wrote this?</p>
<p>And, every labor economist isn&#8217;t Larry Mishel.  Larry Mishel is well, Larry Mishel and he&#8217;s out on an island on this one.</p>
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		<title>By: Mnemosyne</title>
		<link>http://www.balloon-juice.com/2010/02/08/looking-at-the-budget-and-gop-ideas-in-hcr/#comment-1575695</link>
		<dc:creator>Mnemosyne</dc:creator>
		<pubDate>Mon, 08 Feb 2010 19:55:24 +0000</pubDate>
		<guid isPermaLink="false">http://www.balloon-juice.com/?p=34268#comment-1575695</guid>
		<description>@&lt;a href=&quot;#comment-1575676&quot; rel=&quot;nofollow&quot;&gt;BTD&lt;/a&gt;: 

&lt;blockquote&gt;There is no study that says that there is NO correlation between health care spending and health care results.&lt;/blockquote&gt;

Actually, the studies say that the correlation is inverse:  higher-cost areas have worse outcomes than lower-cost areas, at least with Medicare.  This is not something that is in dispute.

&lt;blockquote&gt;the question you have to ask yourself is this – is the excise tax something you are willing to let the bill die over?&lt;/blockquote&gt;

I&#039;m angry that something that people have repeatedly lied about in order to get people to turn against it is going to be killed on the basis of those lies but, no, I&#039;m not willing to kill the entire bill over it.  Just don&#039;t expect me to swallow lies and pretend that OMG everyone is going to be taxed 40 percent!</description>
		<content:encoded><![CDATA[<p>@<a href="#comment-1575676" rel="nofollow"><span class="caps">BTD</span></a>:</p>
<p>
<blockquote>There is no study that says that there is NO correlation between health care spending and health care results.</p></blockquote>
<p>Actually, the studies say that the correlation is inverse:  higher-cost areas have worse outcomes than lower-cost areas, at least with Medicare.  This is not something that is in dispute.</p>
<p>
<blockquote>the question you have to ask yourself is this &#8211; is the excise tax something you are willing to let the bill die over?</p></blockquote>
<p>I&#8217;m angry that something that people have repeatedly lied about in order to get people to turn against it is going to be killed on the basis of those lies but, no, I&#8217;m not willing to kill the entire bill over it.  Just don&#8217;t expect me to swallow lies and pretend that <span class="caps">OMG</span> everyone is going to be taxed 40 percent!</p>
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