Monday, July 13, 2009

Death, Taxes and Such

Well it's been too long since I've updated, and it may be months again since I do another update, but I have a few minutes, so here goes..

The Baseball Update

David Pinto is doing a quick series over on Baseball Musings, reviewing each major league team at the all star break. So far, he's tackled just the AL West, but eventually he'll get to the Sox. He presents how a team ranks in several stats, OBP, SLG, etc. I remember as a kid noticing the Sox always seemed to be at the top of the league in AVG and 2Bs, but at the bottom of the pack in SBs. This is not news.

The interesting thing (to me) is how much the team has changed since those days (and even since '04 or so). Now, Sox are middle of the pack in AVG, but toward the top in SBs (the perennial success in 2Bs must be a function of the park).

Again, this is not news. Everyone knows that Theo Epstein has made a point of emphasizing OBP and, apparently, has embraced the speed game more than his predecessors (of course, it helps that he has Ellsbury who has by himself more than 1/2 of the team's stolen bases). This is to his credit, but I don't think he gets enough credit. It's one thing to espouse a philosophy, it's another to successfully implement it. And Epstein's been able to do that in spades.

The Taxes Update

For me, it's all health care, all the time. Taxgirl, the Tax Vox Blog, Kausfiles and Robert Ross at HuffPo all had interesting posts in the past few days regarding the various tax initiatives being put forth to fund health care reform

David Brooks had a great op-ed last week noting that the combination of the various tax increases leave Obama with precious little dry powder for future domestic spending initiatives.

I agree with this. To review the bidding, Obama has already proposed/assumed that the Bush tax cuts on individuals earning over $250K will expire in 2011. Added to that since he ran are: (i) a cap on the deductibility of itemized deductions for high earners, (ii) a "surtax" from 1% to 3% on income over $350,000 (ramping up based on income) which Rangel introduced last week (iii) a potential cap on the tax exclusion of employer-provided health insurance (for plans that cost > $25K/year in premiums) and (iv) rumblings about imposing payroll taxes on capital gains and dividends (i.e., nonwage income).

Neither Obama nor Congress has seriously considered any tax increases on the middle class (such as the total repeal of the tax exclusion for employer-provided health insurance).

The price tag for the increased coverage Congress is discussing (which would *not* be universal) is ~$1 trillion (CBO estimate from July 3 reported $600M, but the $1T number is still the one that is most widely reported). Apparently gone is the argument that reform will actually save money (probably for good reasons politically, there was already too much discussion of which end of life interventions would not be covered by government provided health insurance due to lack of "efficiencies" - see below).

I am not morally against a tax hike to fund comprehensive health care coverage, but so far, the plans put forth would not accomplish that goal. It seems to me that if you are willing to wager the rest of your domestic policy agenda (because that is what Obama would be doing if all of the above tax hikes are necessary for a credible plan to be passed, which would leave room for no further hikes, probably including the expiration of the Bush tax cuts), then the payoff had better be more impressive than even the most recent CBO estimates of the increase in the number of people covered in this country. It had better be damned close to universal coverage (Medicare for all, as Mickey Kaus calls it).

I don't think that's what we will see.

The Death Update

Michael. Farrah. Ed. Oxy-Clean. Karl. Robert. Steve. And Waldo.

That would be Waldo McBurney, America's oldest worker. He was 106. He worked from age 13 to age 104. He took up distance running when he was 65.

I was listening to an Adam Carolla podcast on the way home from work tonight and in it he said he had asked his friend Dr. Drew, what was with the health care reform debate - what all the controversy was about, why costs were rising so much. Dr. Drew's answer was simple(istic). Everyone is living longer than expected. This *can* partially explain shortfalls in corporate and public pensions and of course the coming disasters in Medicare and Social Security. The cost issue though is extremely loaded when you start to bring patient age into the equation - issues of rationing and treatment decisions made by reference to the efficiency (or necessity) of a given treatment. Who knows how much "extra" costs we all bore to help Mr. McBurney live to 106. Surely he wasn't getting there solely on "juices and berries".

It's a difficult question. When dad finally accepted his likely fate (late stage small cell lung cancer), he decided he didn't want to pursue more chemo or crap that would just make him feel sicker than he was. That was his decision though. I can't imagine (and we're a LONG way in the discussion from this) someone else making that decision for him. Obama alluded to this in a discussion of his grandmother - even when it was clear she would not make it, she had a hip replacement. He admitted that he would pay for the procedure himself, but what if someone can't pay. As a lawyer, I hate slippery slope arguments and believe that we as rational humans don't need bright lines because we should be able reason between different cases based on their own facts, but that's much easier to do in the dry world of tax where it's just money, ultimately, and not someone's cancer-infected dad.


This conversation on is a good primer on where the Obama Administration (and Stephen Colbert, er, Peter Orszag in particular) thinks the cost savings will come from.

In addition, this blog post by Orszag lays out the ground rules for health reform being "deficit neutral". This is the corner they've painted themselves into.

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