SB 2016-047 - Universal Healthcare and Affordability Act (Debating)

[Potus]

Like I pointed out in the House thread, this needs a full score of fiscal, healthcare, and economic impacts before an honest, real debate can occur.

[Southern Senator North Carolina Yankee]

This needs a full cost estimate and coverage projection. Why would we vote on a comprehensive, behemoth of a healthcare bill without a score?

Practical reality of the game. If such can be obtained then yes, but in its absence, the game has to move forward. This was what kept the old Senate moving despite the absence of a working GM for the vast bulk of the time. And then the GM quit doing scoring all together for a few years before the reset.

POTUS has the right idea. This bill needs a CBO score before we vote on it.

We don't have a CBO, any scoring would have to be done by the GM and would be dependent on whether or not AZ as a policy does scoring on legislation. Some GMs have not because it is a tedious process and takes away time and effort from story creation. If he does not, then any cost estimates would have be made by us.

[Southern Senator North Carolina Yankee]

Like I pointed out in the House thread, this needs a full score of fiscal, healthcare, and economic impacts before an honest, real debate can occur.

This is more far reaching then what you called for in the House bill.

Also keep in mind that it is difficult to score the full range of impacts because this is not a centralized healthcare structure. Since this attempts to decentralize regulation authority, it would be difficult to pin down the full range of impacts because each of the three regions can take any number of different approaches to implement this.

We can get the budgetary effects, but it is difficult to get the healthcare impact.

Once this passes and then knowing this is in place, a regional gov't could get a study of the healthcare impacts based on what legislation they are proposing.

X+Y=Z   X being this federal law, Y being the subsequent regional law and z being the final impact for that region.

Aside from that, you can assume a default variable, but it is going to change the minute the regions pick up the ball and run with it.

I don't think responsible legislating and regionalization/game enrichment are necessarily at cross purposes and both are important, but when the former gets in the way of the latter, I think the game should come first.

[Donerail]

I agree with the representatives and object to the motion for cloture

[Fmr. Representative Encke]

I'll have to say that I completely agree with Yankee here.

The basic issue with asking for calculations of the economic impact of a piece of legislation is that there is no real economy that can respond to it, and thus it is difficult to quantitatively determine effects accurately. As such, any economic impacts would be left to the discretion of the GM department, allowing it to effectively control what legislation gets passed and what legislation doesn't.

The problem of accuracy gets worse as time progresses. Realistically, each piece of legislation should have its own economic effects, and thus the statistics and figures from RL that are used to develop budget analyses gradually become obsolete as other economic figures (e.g. unemployment) gradually diverge from reality. Consistency becomes a problem, and then everything ultimately becomes arbitrary.

If realistic economic simulation is to become a part of the game, then it needs to be built from the ground up (as well as contained entirely within the game), rather than the top-down approach that is currently being taken.

[The world will shine with light in our nightmare]

Encke and Yankee raise good points here.  Any assessments of how this bill would affect the economy or healthcare market would be totally arbitrary, especially as regions begin to model their own systems around the new program.  As far as the budget is concerned, the subsidies would cost, according to PiT's estimates, about $465 billion.  (I posit that Atlasia would spend notably less on healthcare as a percentage of GDP than the United States does, although I can't prove this definitively.  However, I'll note that countries which do guarantee universal access to healthcare for their citizens spend considerably less than the United States does.)

[The world will shine with light in our nightmare]

Any other questions or comments?

[Southern Senator North Carolina Yankee]

Encke and Yankee raise good points here.  Any assessments of how this bill would affect the economy or healthcare market would be totally arbitrary, especially as regions begin to model their own systems around the new program.  As far as the budget is concerned, the subsidies would cost, according to PiT's estimates, about $465 billion.  (I posit that Atlasia would spend notably less on healthcare as a percentage of GDP than the United States does, although I can't prove this definitively.  However, I'll note that countries which do guarantee universal access to healthcare for their citizens spend considerably less than the United States does.)

Healthcare expenditures would gradually decline as a percentage of a GDP. Not just because of this bill, but because of bills we have also passed previous (Drugs and stuff) and will pass subsequently as well on interrelated matters. Once again why it is hard to quantify this bill alone over a longer term period.

The subsidy cost is the most important one to look it. If one were to look at total cost and total revenues, you would probably get 1.6 Trillion and 1.4 Trillion, but 1.4 Trillion of each is already existing expenses and revenues being shifted to a different umbrella (Medicare, Medicaid, CHIP etc) and hopefully those costs will also be brought under control (both because of this, laws on drug costs etc). Since that encompasses so much existing expenses (80%), it obscures the picture gives the impression that this bill is larger than it actually is.

[The world will shine with light in our nightmare]

As I told Yankee via PM, I think the Congress should get this done before the lame-duck session begins, so I'd like to put this to a vote today.

I'll post the final amended bill later.

[The world will shine with light in our nightmare]

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[The world will shine with light in our nightmare]

A final vote is now open.  Senators, please vote Aye, Nay, or Abstain.


Enthusiastic AYE

[Wikipedia delenda est]

Aye

[The world will shine with light in our nightmare]

This is not a good bill to miss votes on, people.

[ZuWo]

Abstain

[Grumpier Than Thou]

AYE

[The world will shine with light in our nightmare]

This has enough votes to pass.  Senators have 24 hours to change their vote.

[Barnes]

Aye.

[Associate Justice PiT]

     Abstain

[The world will shine with light in our nightmare]

With four votes in favor and two abstentions, this bill passes the Atlasian Senate and is sent to the Vice President for his signature.

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[The world will shine with light in our nightmare]

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People's House of Representatives
Passed 7-0 in the Atlasian House Assembled,


People's Regional Senate
Passed 4-0 in the Atlasian Senate assembled
Be it resolved, X President pro tempore
[/quote]

[Goldwater]

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People's House of Representatives
Passed 7-0 in the Atlasian House Assembled,


People's Regional Senate
Passed 4-0 in the Atlasian Senate assembled
Be it resolved, X President pro tempore

President of Congress

[/quote]

[Southern Senator North Carolina Yankee]

Not that I can blame him since it requires two posts, but that is only the last part he signed.


That said we need a full Congressional Level text for the Wiki. I guess I can assembled that.

[Southern Senator North Carolina Yankee]

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[/quote]