1) The excise tax will go into effect on schedule, but it might be
indexed to inflation plus one (or even two) percentage points, rather
than just inflation.
2) The Medicare cuts will also go into effect with very few, if any,
changes.
3) There will be at least one policy in the bill that will be a very
effective cost control but that we're not thinking of. One contender for
this is the provision penalizing hospitals with high infection rates,
which could save quite a lot of money in terms of readmission and
recuperation costs if it's effective.
4) There's a very good chance that the difference between the bill's
spending and its cost controls/revenues/reforms will prove greater than
what the Congressional Budget Office is predicting. To make this a bit
clearer, I think there's at least a 60 percent chance that the bill
saves in excess of $1.5 trillion between 2020 and 2029.
5) This policy will be very popular in 10 or 15 years. The GOP will
not talk of repeal, and will instead argue that they will do a better
job administering the health-care system than Democrats.
6) Premiums will grow more slowly inside the exchanges than has been
the historical average for the individual and small-business markets.
7) There is a chance -- say, 30 percent -- that the Independent
Payment Advisory Board (the Medicare commission) becomes an extremely,
extremely important government body.
8) There will be significant supplementary reforms by 2018.
9) Most Americans will not find America to be a substantially more
tyrannical, totalitarian or socialist country come 2020. The frenzy over
this bill will be something people quote to discredit future frenzies,
not to give added weight to tomorrow's hysterical predictions.
10) There will be strong evidence that this bill led to important
quality improvements in medical care, particularly in terms of
hospital-acquired infections and cost-effectiveness of treatments.
11) Ezra. Are you there?
Try this on.
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