It’s the assumptions stupid, and then the madness of individuals

Take just about any government program and costs are estimated over a ten year period using, by necessity, many assumptions. Costs and feasibility of any program vary greatly based on those assumptions … and the assumptions rarely prove valid.

Before developing your position for or against any proposal, look at the assumptions and then think for yourself.

This applies to just about anything, but as an example, look at a few current assumptions related to various healthcare proposals:

✔️ The gov­ern­ment will “ne­go­ti­ate” (or set) hos­pi­tal and provider re­im­burse­ment rates significantly be­low what pri­vate in­sur­ers pay.

✔️ The gov­ern­ment will charge “ac­tu­ar­i­ally fair pre­mi­ums,” which cover 100% of pro­vided ben­e­fits and ad­min­is­tra­tive costs.

✔️ Employers will pay no more than they current pay for worker health benefits.

✔️ Drug prices will be set at international levels.

✔️ There will be little or no changes in the use of services by patients

✔️ New taxes can be borne by a small segment of the population

✔️ Future costs (including fraud) can be managed without oversight, controls, limits, or scrutiny of health care provided.

✔️ Costs can be managed by turning patients into consumers through price transparency?

Considering all the variables, projections for changes in our health care system go from saving trillions to adding trillions to the federal deficit.

Assumptions often do not consider the impact of human behavior, so I apply a the reality check otherwise known as common sense.

For example, can you provide all health care at no cost at the point of service without changes in patient and provider behavior? [🤦🏻‍♂️] Can you manage health care spending while at the same time exercise no oversight over the type and frequency of services provided?

Did subprime lending and near zero down payment requirements in the quest to push home ownership work as assumed? 🤔

When promises sound too good to be true, they unusual are. When you are promised something for nothing, it may have a high cost. When nobody talks about the possible consequences, beware.

[🤦🏻‍♂️] Human behavior is the unknown factor in all of this. When assumptions include the actions of individuals, as most do directly or indirectly, all bets are off. For example, “in the 1700s, when Isaac Newton lost a fortune in the stock market, he observed that he could “calculate the motions of the heavenly bodies, but not the madness of the people.” In other words, the stock market doesn’t always behave rationally because it is, after all, just made up of individuals.” Read more on this concept HERE


  1. I do not have any idea what “fair” means so I do not know how any assumption can be made that are “fair”.

    You mention that human nature is often not taken into account. I would also like to point out that these assumptions can never factor in what politicians and lobbyist will do to the plan. Just when everybody understands a new law or rule they go and change it.

    Right now the only thing that you may be able to count on is political fighting that will result in inaction by Congress until the next election. Then which way the earth will move is anybody’s guess other than what happens when you assume, that is you make ass…..


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