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John Boehner’s Side of the Fiscal Cliff Story

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In “The Education of John Boehner,” WSJ‘s Stephen Moore sits down with the chain-smoking Speaker to talk about the 13th hour deal to address the fiscal cliff.

What stunned House Speaker John Boehner more than anything else during his prolonged closed-door budget negotiations with Barack Obama was this revelation: “At one point several weeks ago,” Mr. Boehner says, “the president said to me, ‘We don’t have a spending problem.’ ”

[...]

The president’s insistence that Washington doesn’t have a spending problem, Mr. Boehner says, is predicated on the belief that massive federal deficits stem from what Mr. Obama called “a health-care problem.” Mr. Boehner says that after he recovered from his astonishment—“They blame all of the fiscal woes on our health-care system”—he replied: “Clearly we have a health-care problem, which is about to get worse with ObamaCare. But, Mr. President, we have a very serious spending problem.” He repeated this message so often, he says, that toward the end of the negotiations, the president became irritated and said: “I’m getting tired of hearing you say that.”

While neither is completely right here, Obama is much closer. If we did nothing else, the deficit would largely disappear if we could get our healthcare costs down to the levels of our Western European counterparts. In addition to the obvious—Medicare, Medicaid, and VA hospitals—health care is everywhere in the federal budget. It’s a significant added cost for all of our civil service and military employees. It’s a massive added cost in maintaining our burgeoning military and civil service retiree populations. Plus, we’d take is radically more tax revenue without changing anything in our tax code if business weren’t writing off huge health insurance expenses.

Where Obama’s wrong is that there’s real money to be had in cutting or reforming Defense/Intelligence/Homeland Security and Social Security. The problem for Boehner is that he really doesn’t want to do anything about these. He’s ideologically opposed to cutting the former and politically afraid—and rightly so—of doing much with the latter.

On his FU to Harry Reid:

With the two sides so far from agreeing even on the nature of the country’s fiscal challenge, making progress on how to address it was difficult. Mr. Boehner became so agitated with the lack of progress that he cursed at Senate Majority Leader Harry Reid. “Those days after Christmas,” he explains, “I was in Ohio, and Harry’s on the Senate floor calling me a dictator and all kinds of nasty things. You know, I don’t lose my temper. I never do. But I was shocked at what Harry was saying about me. I came back to town. Saw Harry at the White House. And that was when that was said,” he says, referring to a pointed “go [blank] yourself” addressed to Mr. Reid.

I’ve read somewhere that politics ain’t beanbag.

Also interesting:

Mr. Boehner confirms that at one critical juncture he asked Mr. Obama, after conceding on $800 billion in new taxes, “What am I getting?” and the president replied: “You don’t get anything for it. I’m taking that anyway.”

This strikes me as a far more opportune junction for a “go F yourself.” It’s true that Obama held the leverage here; after all, taxes were automatically going up at the stroke of midnight New Year’s Eve. Indeed, they did. But there was the matter of the debt limit, unemployment benefits, and other things that the president needed cooperation to achieve.

Why has the president been such an immovable force when it comes to cutting spending? “Two reasons,” Mr. Boehner says. “He’s so ideological himself, and he’s unwilling to take on the left wing of his own party.” That reluctance explains why Mr. Obama originally agreed with the Boehner proposal to raise the retirement age for Medicare, the speaker says, but then “pulled back. He admitted in meetings that he couldn’t sell things to his own members. But he didn’t even want to try.”

That strikes me as plausible. Indeed, it’s been Obama’s MO throughout his presidency. Presumably, it’s an outgrowth of his time as a community organizer; he’s just extremely reluctant to spend political capital.

Mr. Boehner is frustrated that Republicans were portrayed by the press as dogmatic and unyielding in these talks. “I’m the guy who put revenues on the table the day after the election,” he says. “And I’m the guy who put the [income] threshold at a million dollars. Then we agreed to let the rates go up, on dividends, capital gains as a way of trying to move them into a deal. . . . But we could never get him to step up,” Mr. Boehner says with a shrug. Negotiations with the White House ended in stalemate when “it became painfully obvious that the president won’t cut spending.”

I’m inclined to side with Boehner here on the grounds that it’s essentially an admission against interest. He got rolled in the negotiations, getting essentially nothing from the president other than moving the threshold for the top marginal rate to $400,000 from $250,000—a concession that Obama almost surely was thrilled to make, given pressure from powerful big city Democrats—and looked pathetic doing it.

Interestingly, it’s a reversal of the way negotiations over ObamaCare went down, when the president was essentially negotiating against himself.

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About James Joyner
James Joyner is the publisher of Outside the Beltway, an associate professor of security studies at the Marine Corps Command and Staff College, and a nonresident senior fellow at the Atlantic Council. He's a former Army officer and Desert Storm vet. He has a PhD in political science from The University of Alabama. Views expressed here are his own. Follow James on Twitter.

Comments

  1. JohnMcC says:

    If the US spent the same percentage of GDP on ‘defense/military’ as most of the world (or most of our potential adversaries) – no federal deficit.

    If the US spent the same percentage of GDP on ‘healthcare’ as most of the OECD nations – no deficit.

    But what Mr Boehner and his caucus thinks is that we should curtail social welfare spending. We are already near the bottom of the world average in that category.

    So he is either stupid or thinks we are by claiming the problem is some sort of general “spending” without specifying WHAT spending.

    Until so-called-conservatives can explain who they want to impose austerity on there is no reason to talk with them. The reasonable alternative is to crush them politically. They have nothing to add to any discussion conducted by reasonable people.

    Highly-rated. Helpful or Unhelpful: Thumb up 75 Thumb down 2

  2. steve says:

    I find it very disturbing that after all this time Boehner still does not recognize how important it is that we control medical spending. Sure, we can save in other areas, but if you dont address Medicare and Medicaid, those other things dont matter. Health care eventually chews up the entire budget if not addressed. I am further concerned that Boehner represents conventional GOP thinking on this issue. The GOP has consistently failed to address health care costs when they have been in a position to do so. All we got was Medicare Part D.

    If one is truly concerned about future US debt, and understands its composition, how can one support the GOP?

    Steve

    Highly-rated. Helpful or Unhelpful: Thumb up 43 Thumb down 2

  3. john personna says:

    I think an “ideological” President would have gone for a harsher outcome. I mean, if he means that in “tax and spend” liberal fashion, I’d think the President would take the cliff. Or negotiate lower taxes on the rich in exchange for more spending.

    Obama is a fiscal conservative. Boehner is just lost and doesn’t know what that is anymore.

    Highly-rated. Helpful or Unhelpful: Thumb up 45 Thumb down 3

  4. john personna says:

    @steve:

    The Republicans think that medical spending, and government spending, are separable.

    Indeed their prayer book has been that if you just cap government spending, health care costs must fall. People on the short end of that stick just need to suck it up.

    Highly-rated. Helpful or Unhelpful: Thumb up 28 Thumb down 2

  5. OzarkHillbilly says:

    @JohnMcC:

    So he is either stupid or thinks we are by claiming the problem is some sort of general “spending” without specifying WHAT spending.

    FTFY. How do I know he thinks we are stupid? The whole debt ceiling shenanigans. He thinks we haven’t noticed. All that spending? It came out of a House that he controls and a Senate in which his partner in crime McConnell has a veto. So they voted for all that spending via continuing resolutions.

    If they were really serious about cutting that spending, they could. But they haven’t. And they won’t. Because they are gutless. Hence their repeated calls for “leadership” from the President.

    “Hey Boehner, McConnell, You are the leaders of your party. If you want to go somewhere, you have to lead.” Nancy Pelosi has more balls than the 2 of them combined.

    Highly-rated. Helpful or Unhelpful: Thumb up 22 Thumb down 1

  6. sam says:

    Mr. Boehner says. “He’s so ideological himself, and he’s unwilling to take on the left wing of his own party.”

    Q:How about that insurrection — doesn’t that prove that Boehner is a weak leader who can’t control his caucus?

    [ Retired Rep. Steve LaTourette]: I think it’s ridiculous. They should kick them all out of the Republican conference. The picture in Politico of a sitting Republican member of Congress on the floor with an iPad showing a screen with a whip count to deny the Republicans the speakership of the House is asinine. This is what I’m talking about: These guys are OK when it comes to ideology and dogma, but they don’t have a clue how to participate in the legislative process.

    I don’t know what their objective is. If it was to deny the speakership to Boehner and hand it to Mrs. Pelosi, I don’t know how their cause would have been furthered. If it’s to force the vote to a second ballot to make some demands, well, who the hell do these people think they are? Twelve out of 233, and they’re making demands? That’s the dumbest thing I’ve ever heard.

    Q: Is there any way for Boehner to assert some leadership now that he’s been reelected and bring the insurgents into line?

    LaTourette: He resisted, the entire last Congress, until the very end, the temptation to punish anybody. I sat on the steering committee, and there were cries from all parts of the conference: ‘These guys are ruining everything!’ He wouldn’t chastise them or do anything until the recent mini-purge.

    I don’t think his inclination is to punish people.

    Molly Ball, The Atlantic, Are People Being Unfair to the House Republicans?

    Like or Dislike: Thumb up 9 Thumb down 1

  7. scott says:

    It’s always has been about the cost of healthcare. I’m old enough to remember back when Hilary Clinton was leading the healthcare taskforce. It was about the cost of healthcare back then (20 years ago). It was also about universal healthcare. And the tension between the two.

    When Republicans start reciting cant (like, “its a spending problem”) and don’t bring up facts and figures, they lose too many people. That doesn’t work anymore.

    Like or Dislike: Thumb up 10 Thumb down 1

  8. OzarkHillbilly says:

    @john personna:

    Obama is a fiscal conservative.

    John, according to the Republican Book of Fiscal Conservatism, Obama is not a “fiscal conservative”. According to them, a True Fiscal Conservative ™ is one who cuts taxes at every opportunity, starts wars with out funding them, passes huge expansions of entitlement programs with out funding them, and inflates the cost of health care by forbidding gov’t agencies the ability to negotiate price, AND….

    Calls for the leader of the Democrats to name cuts to entitlements.

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  9. scott says:

    @steve:

    All we got was Medicare Part D.

    You notice no one has proposed repealing Medicare Part D.

    Highly-rated. Helpful or Unhelpful: Thumb up 20 Thumb down 0

  10. OzarkHillbilly says:

    @john personna:

    The Republicans think that medical spending, and government spending, are separable.

    Indeed their prayer book has been that if you just cap government spending, health care costs must fall. People on the short end of that stick just need to suck it up.

    This.

    The Republicans Idea for the control of health care costs amounts to making American’s pay more, the idea being that if we have to pay for more of it, we will seek less of it. And this is true. The only down side is that we will get less health care even as we need more and more of it.

    But this is actually an upside, because we will die sooner which will reduce Social Security payouts over the long term. See? It all works out.

    Highly-rated. Helpful or Unhelpful: Thumb up 21 Thumb down 1

  11. OzarkHillbilly says:

    @scott:

    You notice no one has proposed repealing Medicare Part D.

    I don’t want it repealed, I want it fixed. But then, I consistently come down on the side of old people. Guess that’s why I am a Dem.

    Highly-rated. Helpful or Unhelpful: Thumb up 17 Thumb down 1

  12. scott says:

    @OzarkHillbilly: I don’t want it repealed either. I want it funded. I want all the government goods and services we want and consume funded.

    And that’s the fight we are having.

    Like or Dislike: Thumb up 13 Thumb down 1

  13. Rob in CT says:

    Obviously both “we have a spending problem” and “we don’t have a spending problem, we have a healthcare problem” are simplifications, but yeah, the latter is a lot closer to the truth than the former.

    Healthcare spending is the back-breaker. It’s not the *only* place to look for savings, but it’s numero uno.

    Like or Dislike: Thumb up 5 Thumb down 0

  14. Rob in CT says:

    Regarding controlling healthcare costs:

    http://www.motherjones.com/kevin-drum/2013/01/republicans-vote-increase-cost-medicare

    Ahhh, death panels!

    The whole fight, ultimately, is over how to ration. Not “shall we ration” but “how shall we ration.”

    Sigh.

    Like or Dislike: Thumb up 10 Thumb down 0

  15. MarkedMan says:

    James, I don’t see where you are coming from when you say that Boehner was even semi-justified in his frustration with Obama as a negotiator. You negotiate according to what your partner is capable of delivering. Boehner has never been capable of delivering anything. His willingness to put revenue on the table? He couldn’t even deliver the votes to get a ridiculous CYA proposal passed by his own party, much less a real negotiating position.

    Serious question: Why did Obama bother negotiating with him at all? In the end he didn’t deliver d*ck

    Highly-rated. Helpful or Unhelpful: Thumb up 26 Thumb down 1

  16. Andre Kenji says:

    The Republicans killed any discussion about controlling health care costs in 2010, with all the talk about rationing and death panels(There are also stupid things like *patient-doctor centered solutions*.. For profit hospitals and millionaire doctors are part of the problem, but controlling health care costs means that you also have to deal with things like waiting time for procedures and so on. For instance, Medicare was projected to easily pay for medical procedures – seniors like that, because they don´t have to face waiting time for any procedures, but that makes Medicare prone to fraud and increases medical costs.

    Republicans killed this discussion in 2010 with the “Death Panels” and whatever, there is no bigger fiscal crime.

    Like or Dislike: Thumb up 13 Thumb down 1

  17. OzarkHillbilly says:

    @scott: Agreed Scott.

    Like or Dislike: Thumb up 2 Thumb down 0

  18. Rob in CT says:

    Republicans killed this discussion in 2010 with the “Death Panels” and whatever, there is no bigger fiscal crime.

    It still makes me angry, thinking back to it.

    Like or Dislike: Thumb up 11 Thumb down 1

  19. OzarkHillbilly says:

    @Rob in CT:

    The whole fight, ultimately, is over how to ration. Not “shall we ration” but “how shall we ration.”

    Exactly Rob. And that is what has conservatives so outraged. We threw out the old rationing system (“Those who can pay for it, get it”) and no one knows just exactly how the new one will work. What they do know is that the janitor in their office building will have just as much a right to health care as they do.

    And they can’t stand that.

    Highly-rated. Helpful or Unhelpful: Thumb up 24 Thumb down 1

  20. Rob in CT says:

    I just think there is a lot of magical thinking involved. Unless & until we reach some sort of fantasy post-scarcity world (ala Star Trek), there will be a point at which the answer to more treatment is “no.” The question is the process through which we get to no.

    Lots of people simply don’t think that through.

    Sure, some are selfish enough to fully understand it all and simply resent the janitor. But most folks, I think, have been sold scary stories of terrible socialized medicine abroad and have no idea they’ve been sold a bunch of bunk.

    Like or Dislike: Thumb up 7 Thumb down 1

  21. C. Clavin says:

    So you have one side of the story…dishing to Stephen Moore…one of the more clueless political hacks in the stenography business?
    Where is the acknowledgment that Obama just spent the entire campaign getting bashed for cutting $716B from Medicare. The there is the the sequester. Maybe James is angling to join Moore in the ranks of the clueless.
    I have a hard time taking any of this seriously.
    Except the part about the US having a Health Care problem. That is true.
    My understanding is that the WH is going to be putting out some additional Health Care reforms as a way of controlling Medicare growth. As is well known outside of the Republican echo chamber the PPACA has already extended the ife of Medicare nearly a decade.
    So what we see here is Republicans busy trying cover their asses…and the Obama Administration busy trying to find solutions.

    Like or Dislike: Thumb up 13 Thumb down 1

  22. scott says:

    @Rob in CT: Yes, how come there is never any discussion on the ethics or morality of rationing based on ability to pay?

    Like or Dislike: Thumb up 9 Thumb down 0

  23. OzarkHillbilly says:

    @Rob in CT:

    It still makes me angry, thinking back to it.

    My mother had a Living Will and a DNR, but she still had a long, slow, and painful decline. For 4 months after open heart surgery she was in and out of ICU with long periods in Rehab only able to come home briefly for about 3 weeks.

    I was fortunate in that when I asked my boss if I could have a few days off over the next 2 weeks he promptly layed me off. As I was leaving the job site, my foreman said, “Don’t worry, you’ll be back in a week or so.” I replied, “No I won’t.” Most miserable SOB I have ever worked for. As it was, I was able to take care of my Alzheimered father while she was in and out and see to it that she was visited on a regular basis by my sibs, me, and my father.

    At the end, when she was in ICU for the 4th time, on a respirator again, legs swollen to the point of bursting, again….

    I finally looked at her and said, “Ma, you wanna go home?”
    And she said, “Oh sure, when I get better.”
    I said, “Ma? What if you don’t get any better?”

    She got this thoughtful look on her face and we did not talk about it any more. The next day my mother told the Doctor she was ready to go home and the Doc said “Well, we can still do this, or that, or this and that, or whatever…” And Ma said, “No, I am ready to go home.” And the Doc turned and walked out of the room without another word like her business was done. And as far as she was concerned, it was. We never saw her again even tho Ma was in the ICU for another 36 hrs as we waited for my sis to get home from MN. Then we took her home.

    Hardest thing I have ever done was speaking those words. I knew what the end result would be. And harder still has been living with the fact that I did. But I could see where she was going and I knew she did not want to go there.

    We in this country deny the existence of death until it is staring us in the face and slapping us upside the head. We really don’t know how to deal with it.

    Hence the GOP “Death Panel” Freakout.

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  24. stonetools says:

    This sums up the difference between the parties. Boehner came at this from the starting point of ideology and slogans ( ” The government has only a spending problem”) and the President came from the starting point of reality ( Health care costs are the biggest driver of the deficit).
    In the end, can you really negotiate with people whose starting point is fantasy?
    Also too, Boehner cannot deliver the votes he promises . If I was Obama, my position is that I wouldn’t negotiate with Boehner because he can’t deliver on what he negotiates for.

    Like or Dislike: Thumb up 11 Thumb down 1

  25. Rob in CT says:

    @OzarkHillbilly:

    My grandfather is 89. He’s a bit of a mess at this point… diabetes mostly. But he had an accident and he’s in rehab. The injury is very slow to heal b/c of the diabetes. Medicaid is paying, btw, for teh care of my angry right-wing lunatic relative (I use lunatic deliberately. Unhinged, let’s have a revolution stuff).

    Anyway, he’s not happy. He’s never been a good patient. He hates healthcare facilities. He barely tolerates doctors. And his great fear is that he cannot go home. The reality is that he was past the point of living unassisted years ago, and now things have come to a head.

    And part of him clearly wants be done. But he waffles. Some days he’s ok, others he’s really down (the best was the day he told one of my aunts that he had done a “test” by not eating for 3 days to see if he’d die). It’s hard to nail down how much of it is just being frustrated because of a temporary thing (the injury & recovery) and how much of it is a clear-eyed view of reality going forward and a rejection of living like that.

    These things are never easy. Regardless of how you get to “no more.”

    Like or Dislike: Thumb up 9 Thumb down 0

  26. Rob in CT says:

    @scott:

    To be fair, we do have that discussion. That’s the whole point of the “X number of Americans don’t have health insurance.” People know what that means – they know it means very limited access to care (ER only, basically).

    Like or Dislike: Thumb up 6 Thumb down 0

  27. rudderpedals says:

    Brutal interview, some real hard hitting questions. Boehner was under siege from the moment he sat down with the beast Moore. And that response to the Plan B failure!

    Like or Dislike: Thumb up 3 Thumb down 0

  28. cd6 says:

    It is a crying shame the way you lefists are attacking our brave and patriotic speaker. This man is a national hero, working his heart out, and libs just howl and wail about how we can’t cut spending. It makes me misty eyed, when I think about all the arrows and attacks and stabs in the back Mr. Boehner had to put up with from Obama; I am weepy just writing about it. And Obama’s refusal to admit we have a spending problem? What a baby. Shed some tears for America, because we are well and truly finished.

    Like or Dislike: Thumb up 4 Thumb down 4

  29. scott says:

    @Rob in CT: I don’t believe we clearly and explicity have that discussion. Just as we don’t have a real discussion on whether healthcare is a basic human right.

    Like or Dislike: Thumb up 1 Thumb down 0

  30. Rob in CT says:

    Ok, fair enough, we tend to discuss it in an abstract sort of way.

    Like or Dislike: Thumb up 3 Thumb down 0

  31. Andre Kenji says:

    @cd6:

    It makes me misty eyed, when I think about all the arrows and attacks and stabs in the back Mr. Boehner had to put up with from Obama; I am weepy just writing about it

    That´s a parody, right?

    Like or Dislike: Thumb up 2 Thumb down 0

  32. Rob in CT says:

    Yes. Actually not one of his best.

    Like or Dislike: Thumb up 1 Thumb down 0

  33. Nikki says:

    @OzarkHillbilly: One of the most beautiful comments I have ever read. I am humbled.

    Like or Dislike: Thumb up 1 Thumb down 0

  34. OzarkHillbilly says:

    @Rob in CT:

    Anyway, he’s not happy. He’s never been a good patient. He hates healthcare facilities. He barely tolerates doctors. And his great fear is that he cannot go home. The reality is that he was past the point of living unassisted years ago, and now things have come to a head.

    That is my eventual reality I fear. I am also not a good patient. I had some minor surgery a week ago and got into an argument with the anesthetist. I’m sorry but when you ask me a stupid question, I am going to call you an idiot.

    To start with, I hate anesthesia but the surgery was on my face and the Doc refused to proceed w/o it. So I was in a foul mood anyway. Then this idiot comes up to me and asks me, “If you were running up some stairs, how many flights would it take me to catch you?”

    For starters, I have no idea how many flights of stairs I can run up (much less how fast) as I have never had a lion chase me up any. 2nd of all, how in the hell do I know how fast he can run them? So really, the question was not to get any usable information but to assert his superiority over me as one who never smoked compared to one who quit smoking 2 and a half years ago (as he knew from my file).

    So I looked this d!ckhead in the eye and said, “None. I’d kick your ass on the first floor.”

    The OR nurse laughed. He did not.

    Like or Dislike: Thumb up 9 Thumb down 0

  35. OzarkHillbilly says:

    @Nikki: I appreciate the sentiment, thank you.

    Like or Dislike: Thumb up 0 Thumb down 0

  36. Nikki says:

    @OzarkHillbilly: Seriously, must you make me laugh and cry on the same day?

    Like or Dislike: Thumb up 2 Thumb down 0

  37. anjin-san says:

    That is my eventual reality I fear.

    I hear you on that one. My grandmother lived to 98. The last 6 years of her life she was nearly blind, nearly deaf, and suffered from severe demential. In a lucid moment, she told my mother “when I go to bed at night, I pray that I won’t wake up.” My grandfather’s DRN was ignored by the convelescent hospital he was at when he had his second stroke and he lived for 9 more miserable months, unable to take use the bathroom by himself and in constant pain.

    The system did work to an extent however, every nickel they had painstakingly saved over the years was gone by the time my grandmother passed.

    We need to have a serious dialog in this country about end of life planning and care. But what do we get from the GOP? Death panels.

    Like or Dislike: Thumb up 14 Thumb down 2

  38. Rafer Janders says:

    @steve:

    If one is truly concerned about future US debt, and understands its composition, how can one support the GOP?

    Good question. James?

    Like or Dislike: Thumb up 8 Thumb down 1

  39. OzarkHillbilly says:

    @Nikki: Just think of it as honey roasted peanuts. Both sweet and salty.

    Like or Dislike: Thumb up 0 Thumb down 0

  40. OzarkHillbilly says:

    @Rob in CT:

    And his great fear is that he cannot go home. The reality is that he was past the point of living unassisted years ago, and now things have come to a head.

    As most now know, my wife is from Spain. My mother-in-law, Monse, just died recently. She is also one who had long gone past living independently at home. But that is where she died. My wife is an only child so there were no children to help. There was a falling out between Monse and her sibs (over money what else?) when her husband died (they thought they should get some of the money from the sale of a commercial location he had) (my wife thought it should go for Monse… who’da thunk?)

    So how did she do it? The Doctor came once a month. A nurse came twice a week. She had a home health care worker come every other day. All of it paid for by Spain’s “Medicare.” Some will say that is why Spain is going broke, but then they don’t have clue about what they are talking about. Spain is going broke because they are bailing out their banks who were every bit as stupid as ours were. They just can’t afford it with the collapse of their tax base.

    Like or Dislike: Thumb up 14 Thumb down 1

  41. OzarkHillbilly says:

    Gotta go now. Gotta get the stitches removed. Thankfully, I won’t need any anesthesia for that.

    Ya’ll play nice now.

    Like or Dislike: Thumb up 1 Thumb down 0

  42. Tyrell says:

    Government agency and program administration costs usually are 35-45% of total budgets. Private sector average less than 20%. There’s some savings right there. Many agencies are still using outdated technology. Look how technology has actually helped in hospital information data bases. Health care problems: over tested, over medicated, and over doctor visited.

    Like or Dislike: Thumb up 1 Thumb down 12

  43. Colourfield says:

    @Tyrell:

    Evidence please.

    US pays way more

    http://www.oecd.org/unitedstates/49084355.pdf

    Like or Dislike: Thumb up 5 Thumb down 1

  44. anjin-san says:

    Government agency and program administration costs usually are 35-45% of total budgets. Private sector average less than 20%.

    Get back to us when you have documentation from a credible source.

    As someone who has worked for several Fortune 500 companies, I can assure you that bureaucratic blot, endless, pointless meetings, hiding in cubicles doing little or no work, and avoiding making decisions at all costs are an art form in the private sector.

    Like or Dislike: Thumb up 13 Thumb down 1

  45. C. Clavin says:

    @ Tyrell…
    I’d have to see links to this.
    The PPACA requires a limit of 20% in administrative costs…and the private insurance industry was forced to refund over $1B because of it. So absent the PPACA it’s clear they weren’t being more efficient.
    Comparing the two is nearly impossible because of their clients.
    On a percentage basis Medicare is going to look very efficient because it’s customers medical costs are astronomical so it’s not a fair comparison.
    On a per-beneficiary basis it’s also not a fair comparison. In 2005 Medicares administrative cost per patient was $509 compared to private insurers at $453. But the administrative costs for a 85 year old with multiple maladies and multiple visits/specialists/tests/prescriptions/etc. is by it”s very nature going to be higher than Aetna’s administrative cost to deal with me…middle age – no problems – no prescriptions – maybe a bi-yearly physical.
    It’s critical in all these conversations to remember why we have Medicare…in the 60’s no private insurer wanted to cover Seniors. Why? Because the real money is in insuring healthy people. Seniors all have a pre-existing condition…they are old.

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  46. Scott F. says:

    James –

    From an otherwise good post, I’ve got to ask how you can side with Boehner on these grounds:

    Mr. Boehner is frustrated that Republicans were portrayed by the press as dogmatic and unyielding in these talks. “I’m the guy who put revenues on the table the day after the election,” he says. “And I’m the guy who put the [income] threshold at a million dollars. Then we agreed to let the rates go up, on dividends, capital gains as a way of trying to move them into a deal. . . . But we could never get him to step up,” Mr. Boehner says with a shrug. Negotiations with the White House ended in stalemate when “it became painfully obvious that the president won’t cut spending.”

    Plain and simple, Boehner didn’t put revenues on the table or agree to let the rates go up. The Bush Tax Cuts were written into law (by Republicans BTW) to sunset – twice.

    To claim revenues were some kind of concession by Boehner and the GOP, is to accept a framing that is historically inaccurate. Current law should be the baseline for negotiations, so to see the post-election negotiations as anything but concessions by the Democrats on the rate for the $250,000 to $400,000 range of taxpayers is to pervert reality.

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  47. gVOR08 says:

    Under Steven Taylor’s Sunday post “Understanding how Congress Works”, I commented

    This is always the problem with Republicans. Do they believe the nonsense they say, or are they just playing to a constituency they think believes it? This is complicated by their tendency to believe their own BS.

    Apparently I have an answer from Boehner. He sincerely believes his own BS. And he’s Speaker of the House. Lord help us all.

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  48. C. Clavin says:

    Every other year…is that bi-yearly??? Biennially?? Whatever.

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  49. Rob in CT says:

    @OzarkHillbilly:

    Unfortunately, between our system not supporting home visitation as much and my grandfather’s rural location, that approach isn’t feasible over a long stretch. If he lived in a retirement community, or even just a condo in a denser area, perhaps some in-home assistance would be good enough. If he’d accept it.

    There’s the dignity issue – that’s the core of it. And even with help… well, the needing of the help (for simple things like buttoning a shirt or going to the bathroom) is an issue.

    Also: very funny line! I’d like to think I’d laugh if I asked that (rather absurd) question and got that answer.

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  50. Herb says:

    “Stephen Moore sits down with the chain-smoking Speaker”

    John Boehner was smoking?

    Indoors?

    In America??? Mind blown.

    (I’ll never forget walking into a casino in Kansas City last year, smelling that old familiar tobacco smell, thinking “Now that’s a smell I haven’t smelled in a looooong time.”)

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  51. mantis says:

    @Tyrell:

    Government agency and program administration costs usually are 35-45% of total budgets. Private sector average less than 20%.

    Says who?

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  52. stonetools says:

    Tyrell is a typical conservative commenter . ” We don’t need no steenking facts! We argue by assertion, like God intended!”
    Hey, that’s all that’s needed , over on Hot Air, Althouse, and all the other conservative blogs.
    Also too, think of the way Jan posted. It’s the conservative way.

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  53. Jeremy R says:

    after conceding on $800 billion in new taxes

    My two cents on Boehner’s offer is that it was completely worthless. First, Boehner never had control of his own caucus when it came to his tax offers (see ‘Plan B’), so I’m doubtful he could have delivered, even if he was negotiating in good faith. Second, that was $800 billion, completely undefined except that it would absolutely not be through raising rates, but instead was through some mix of closing ‘loopholes & deductions’, dynamic scoring and broader tax reform. In other-words, there was never any concrete concession, just more pixie dust and wishful thinking.

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  54. al-Ameda says:

    John Boehner should have been relieved of his Speakership duties after pulling that dishonest “Plan B” stunt.

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  55. If we did nothing else, the deficit would largely disappear if we could get our healthcare costs down to the levels of our Western European counterparts. In addition to the obvious—Medicare, Medicaid, and VA hospitals—health care is everywhere in the federal budget.

    Dr. Joyner: Great post as usual, but one caveat. VA shouldn’t be lumped in with others, its cost per patient had been going up about 3% per year for a long time, that’s less than the UK NHS much less the rest of the US system.

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  56. MarkedMan says:

    @Keith Humphreys: Keith, this is a great point. The VA system is actually world class in virtually every category (and shouldn’t be confused with the active duty military medical system). And, because I work in the medical industry, I know that the technologists they have working for them are very focussed on improving in their target areas and willing to try lots of new things so as to really understand what works and what doesn’t. In fact, they are willing to get significantly farther out front than a company like mine can feel comfortable with.

    One of the ways you can judge a person is how accurate they are when they talk about something you actually know about. James is pretty darn good in this category, and perfectly willing to admit when he doesn’t know something. Other bloggers on this site (well, one other blogger) doesn’t fair nearly as well.

    On health care, I think there are two things that people very often get wrong, because they simply “know” what’s true:
    1) Fact: the cost of overhead in the government agencies that administer Medicare, Medicaid, etc is very low: something like 3%. “Wasteful government agencies” just is a non starter when we are talking about saving serious money.
    2) Whenever anyone says “Obamacare isn’t serious, because a serious plan would contain X”, it’s a fairly safe assumption that Obamacare does in fact contain X.

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