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The whole point of insurance is to mitigate future risk by spreading it out across a group of people. There's no risk involved with pre-existing conditions. I agree everyone should be able to get coverage, but that coverage shouldn't necessarily come in the form of insurance.
In addition Obama correctly states regularily that Medicare is our biggest long term problem due to balooning costs. However medicare regularily decreases what it will re-imburse and hospitals regularily lose money on medicare patients and make up the difference by charging the private sector insurers extra to cover the gap. I have a sister-in-law who works as a hospital financial auditor so she knows the books. If the government were to take over more of health care and attempt to create "cost savings" in the same way medicare does it just pushes private rates even higher and if private insurers eventually leave the system there will be no one to pass the bill on to. Obama has seniors upset now because of the proposed savings in medicare by simply reducing medicare payments for procedures by 500 billion over the next 10 years. It doesn't save any real costs if you simply "save money" by declaring that you will pay less. As far as I can tell thats what is being proposed with respect to medicare.
I don't know how to get the savings out of the system and I believe there are savings to be gotten there but I have yet to see any proposals that actually save money, just propose to spend less. Baring any real savings (Medicare has failed to find any in 40 years) the only solution is to simply pay more money to cover more people and people who are considered uninsurable. Taxes must rise significantly in order to pull this off. I am confused by the inclusion of 2 choices on this survey to raise taxes by 1% to pay for health care reform. Where did that number come from? Any kind of reform that insures everyone and guarantees coverage for all people with all pre-existing conditions, would not even be touched by a 1% increase in taxes. If someone in congress has suggested it would, they are simply horrendously wrong. You can look at the tax as a percent of GDP in most contries that provide government health care.
http://en.wikipedia.org/wiki/List_of_countries_...
Nearly all of them are over 40% of GDP. The US is 28% of GDP (and our numbers already include partial government health care with the medicare/medicaid program and military spending that vastly exceeds those nations). So to get to any kind of universal coverage, simply takes a lot of money. A lot more tax revenue than we currently spend compared to other nations anyway.
As a % of GDP our debt was higher after WW2 than it is now.
If you look at just the $ value of the debt then it will look larger and larger simply due to inflation. Same goes for many financial figures.
What are you talking about? LOTS of businesses choose which clients to have. Chain stores track which customers make lots of returns, and refuse to sell to them. Contractors reject gigs from problem clients. My wife had a photography business, and there are several people we would NEVER take pictures for again regardless of how much they were paying. My dad has a print shop, and he demands cash up front from clients who have a history of not paying, and won't serve them otherwise.
The difference is that the none of the businesses listed here are determining factors in the question of if someone lives or dies.
We're already paying for healthcare for the uninsured when they go to the emergency room. Reforming healthcare can reduce costs, especially if attention is focused on prevention and use of technology, (as in no paper files in doctors' offices!). There are skeptics who think it's not possible, but if we don't try, we are doomed as a nation. A healthier country is a more competitive country in the global market.
I've seen studies of "about 50" to up to 67% of bankruptcies are due to medical bills.
http://www.rwjf.org/reports/grr/042425.htm
1. Limited medical malpractice. They call it practicing medicine for a reason.
2. Don't allow drug companies to advertise. We're one of the only countries that allow this.
3. Provide more incentive for people who choose to live a healthy lifestyle.
4. Provide an equal tax deduction for individuals as we for a business.
Looking forward to reading everyone's comments.
Seriously though, I don't trust government to plan and/or implement anything well. Let's just go to recent history: Cash for Clunkers, Stimulus plan, FEMA during Hurricane Katrina. Of course, it's not all their fault, they can only work with what they're given...how many brilliant people do you know forsake a career in the private sector to go into government? That's not meant to be a slap to any government workers, it just that most people...and especially the smart ones...don't exactly have "government job" as something they aspire to attain coming out of college...the big money's not there.
Now Obama wants to sell everyone on his health care plan and is telling everyone youbetterdoitnowbeforeit'stoolatejustdoitDOITDOIT!! And instead of hammering people with details about what's being proposed, many Democrats are instead insulting those who question it. Meanwhile, with results of the 2008 stimulus plan not being exactly overwhelming to this point I think a huge leap of faith is being requested of the general public.
I agree with that. I think the first thing to do would be to go back to the clearly successful tax system we had under Bill Clinton.
But because Republican tax cuts turned a big surplus into a huge deficit, that isn't a good enough reason to avoid trying to fix the system.
Cash for Clunkers was a runaway success, even though some dealers fear they won't be reimbursed. I trust that they will.
The Stimulus Plan seems to be working. Here's the diary of a guy who's been charting all sorts of economic indicators, and though things aren't "good", we've definitely passed the bottom: http://www.dailykos.com/storyonly/2009/7/8/7513...
Hurricane Katrina was an obvious tragedy, and bad things would've happened no matter who was in charge. I can't explain what went wrong, there.
When I listen to him talk, I hear him frequently say, "Look, we've been talking about this for decades. Now we have a chance to actually get it done." I guess it depends how you get your news.
I've been convinced that a public insurance option is the only real way to keep the private insurance companies honest.
If I lose my job, will I be able to keep my unchanged coverage the same way I can keep it now through COBRA by paying the premiums?
If I change jobs, will I be able to sign up for my new employer's plan?
Can you give us some more information about the outlawing of individual plans, and what that means?
I'm going to say it, maybe we should stop spending so much money on people near the end of there lives. Very contoversial I realize. However, if we stopped doing $100,000 operation on people in there 70s, 80's and 90s we would be spending a lot less money on health care.
Americans eat a lot of unhealthy food.
Americans are obese.
Americans shoot each other at rates much higher than other countries (yes we are violent).
Americans have a lot higher percentages of people dying in car accidents.
None of these are a reflection of the health care system.
What is a reflection is cure level for disease.
American's are cured of major diseases at a level that exceeds every other nation on the planet and for some of the other major industrialized countries like Britain, American's cure rate literally blows their numbers out of the water.
Here is proof from the British Journal the Lancet: about Cancer survival rates.
http://www.telegraph.co.uk/news/uknews/1560849/...
Surely, as the writer of a personal finance blog, you should subscribe to supporting fiscal responsibility on the part of our government. If our government spends more than it makes, which is what it is currently doing, it doesn't take a genius to connect the dots.
And raising taxes on an arbitrary wage number is not going to solve the problem. While doing so in small amounts is something that even I could support, the amount of money needed makes this a red herring. You simply cannot raise enough money doing so to fund the currently proposed plan without severely effecting economic growth and small business in this country in what is one of the worst recessions in US history-- seriously, this is not the time to be putting through massive tax increases. On top of that, any plan that taxes current benefit providers will simply force businesses drop all benefits and push their employees to the 'public option,' if it is available. Do you think employers won't do this when their health insurance costs, which are on average *FAR* more than their employees' costs, rise at triple the rate of inflation every year? All of the 'revenue' that is supposed to come from these benefit taxes will essentially be zero.
The math doesn't add up, and I honestly don't believe the american people, as a whole, want to sacrifice their current healthcare benefits, as expensive as they are and as imperfect as they are, for an unknown government run system just to ensure a small minority of uninsured americans. That is the reason the plan is falling on criticism... I'm afraid that while the American people want healthcare reform, their main concern is their own costs, not insuring the remaining 1% of the population who is uninsured through no fault of their own. This is the big disconnect between the president and the vocal liberal minority and the rest of the country. People voted for reform and the president has decided that reform means insuring every american at any cost and regardless of how it affects most Americans. This is *not* what the majority of the country voted for or wanted. As long as the left side of the Democratic party still doesn't understand this, nothing will get passed to reform anything, I'm afraid.
Sorry to have ranted, but I felt it necessary..
What's being sacrificed? According to this handy flowchart, nobody's going to have less of anything.
That really isn't what the American people, on average, want. And that is my point. What does 'increased consumer protections' mean? What is to stop small businesses from dropping healthcare benefits altogether? What happens in cases where employers drop current benefit levels to an extremely expensive level to their employees, forcing them into the public option? Why wouldn't they? Does the government possibly comprehend that *anyone* that is below the income threshold will be on the public option, resulting in a massive increase in proposed cost? Small business will, literally and almost without exception, do this...they will drop benefits to anyone at 3x the poverty level and under, which is a *huge* number and will be unbelievably expensive to the US taxpayer.
The plan doesn't make sense, and the American people just want cheaper healthcare. Universal healthcare is something that is an aside in most people's minds, not the *point* of reform.
Does that make any sense? The average American is a little bit liberal and a little bit conservative. Any plan that is to have public support needs to balance these two and be more in the middle. Provide for better insurance for uninsured, but possibly not universally or fully covering everything, and show a real, calculated cost for the plan, not something made up with horrible assumptions, that doesn't result in massive taxpayer consequences, regardless of what income level it is, and then you'll have a plan that will have public support.
Does that kind of plan exist? I think it could, but the currently proferred plans are not even close.
We can't improve the healthcare situation unless we try. We may have to increase the debt now to reduce future debt from our health care system. If we don't fix our medical system, it will be an economic burden on our whole economy, our people will continue to be collectively unhealthy, and again, we will be less competitive as a nation. Sick people aren't productive. People who are bankrupt from medical bills, (even the insured), are not good for our economy. They probably tend to foreclose on their homes. And we know how that's bad.
As for being financially responsible, the tax cuts for the wealthy were a bad idea fiscally because they lead to higher debt. At some point, a cut-off income level has to be decided on, one above which people's taxes will go up. A reasonable number can be figured out based on income distribution, cost of living. The lower tax rate on capital gains is another tax cut that should be eliminated since it tends to help the wealthier among us only.
Employers will be required to either provide a basic level of coverage OR pay 8% of payroll into a fund. So they either have to provide a decent level of coverage as mandated by the government or pay 8% of wages. Small businesses will get a credit to help them pay for it.
I think you should have a little more faith in the American people. And even if it's hard for you to believe that most americans can be compassionate people that truly want our country to be a healthy one, at least look at it from a logical standpoint. Think of all of the people that have become incapacitated because their insurance won't cover treatment for injuries or diseases, or they simply can't afford insurance in the 1st place. Are those people in the workplace? In many cases No, and if they are they are certainly not performing at optimum levels to make production and services function as well as they should. That makes the American economy suffer.
Think of what could happen if everyone had some form of affordable healthcare that wasn't trying to find any loophole to screw people out of getting help. Healthier people make for happier, more productive people, and more productive people make for a better economy, thus raising up funds and helping the healthcare change pay for itself.
I think that's something the American people want to see too.
One of the main gripes against this plan is the money it's going to cost 'it's not practical when looking at the debt that we're already in.' Well here's the thing. The fact that we are one of the most developed countries in the world and yet we have so many problems with such a basic thing as caring for our citizens is not something we can deal with later. We have to deal with it now. It's going to be difficult and it's going to cost, but it's necessary and i believe the ultimate results are worth it.
And didn't Britain implement universal healthcare after WW2? I'm sure their national debt wasn't looking to peachy.
Until I get an answer to my questions, I'll keep asking them:
If I lose my job, will I be able to keep my unchanged coverage the same way I can keep it now through COBRA by paying the premiums?
If I change jobs, will I be able to sign up for my new employer’s plan?
Yes COBRA would work the same way as it does now.
Yes if you change jobs you would be able to get insurance from your new employer.
Somebody is either lying or unclear on the subject.
A lot seems open to interpretation and depends on who writes the implementing regs, and on who is appointed to decide what's covered and what isn't.
I keep hearing Obama say that the bill does not mandate coverage for abortion. True enough, but highly misleading:
If Obama gets to appoint the decider, does anyone doubt that coverage for abortion WILL be mandated for all plans? Which sets us up for turning every presidential election into a referendum on abortion.
5 freedoms you'd lose in health care reform
http://money.cnn.com/2009/07/24/news/economy/he...
4. Freedom to keep your existing plan
This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.[/B]
[Continue reading and you'll see that your large-employer plan is grandfathered for five years, at which point you'll be dumped into the "exchange" to change to a different plan...and small-employer plans are grandfathered for only 12 months.)
http://factcheck.org/2009/08/keep-your-insuranc...
I think it's fair to say that the bulk of Clinton's success resulted more from the internet boom and dot-com bubble that occurred during his tenure than anything else. That was an incredibly fortuitous opportunity for any administration to happen upon. You might argue Gore's introduction of the High Performance Computing and Communication Act as being what greased the skids of the internet boom, but that happened in 1991 and was even signed and endorsed by George Bush Sr.
"Cash for Clunkers was a runaway success, even though some dealers fear they won’t be reimbursed. I trust that they will."
From a public perspective, Cash for Clunkers was indeed a runaway success. It's hard NOT to be a success when the government essentially prints out coupons worth several thousand dollars towards the purchase of a new car.
However my beef is with the government's planning and implementation of just about anything. The problem was that the government anticipated it would last until November and then had to bring the program to a screeching halt when its one billion dollar funds ran out after only a few days, forcing them to scramble to come up with another two billion to continue it. In addition to all that, there were other missteps, such as a last minute update of EPA info that caused multiple vehicles to suddenly become ineligible and also an astounding IT decision where the public CARS website was placed on the same server that dealers used to process their info, causing them both to crash.
"When I listen to him talk, I hear him frequently say, “Look, we’ve been talking about this for decades. Now we have a chance to actually get it done.” I guess it depends how you get your news."
Then what's another few months to allow the public time to see what exactly is being proposed and to digest it?
Could you give me a few more details about how the success of a few entrepreneurs and stock traders bubbled up into a federal surplus? Sincerely, I don't get that.
I agree with that, too. Of course, there's no one single bill being considered by Congress, yet, which makes this a little tricky. What makes it even trickier is that massive dis-information campaign surrounding the bill that the House put out.
The trickiest part, the part that I could do without, is the notion that if it doesn't get done in 2009, too many politicians in 2010 will be extra concerned about running for re-election.
Does that include the National Weather Service, NASA, the USDA, the FDA, the National Highway Traffic Safety Administration, the EPA, the US Postal Service, GPS satellites and OSHA? I think plenty of federal programs work just fine. Is there waste and corruption to be found? Undoubtedly. But I'd never sign up to do without them.
On the other hand, if the Government asked me to sacrifice an extra $4 per paycheck to help pay for badly-needed medical care for other Americans, even people I've never met, I'd be the first to raise my hand.
In watching the "debate" as posed by the type of person to disrupt a town hall, I think that might be the core of the disagreement. I'm saying "all for one, one for all", and they're saying "every man for himself!" That's probably an insulting oversimplification, but I can't think of a better metaphor at the moment.
Thats actually quite easy.
1. The stock market achieved returns that were on the order of 20% per annum from 1995 - 2000. The capital gains revenue that generated alone were a huge boon to the treasury. This level of return had not been sustained for any such period in recent history. Certainly not since prior to the 60s.
2. This also resulted in tons of jobs being created that paid huge wages (programmers were in very short supply), so people were leaving good solid jobs at reputable companies to go work for a start up that was flush with venture capital paying them 50-100% higher wages vastly increasing tax revenues.
3. One company after another was reporting fraudulent earnings, earnings that they had to pay taxes on mind you and they did, but the earnings drove the stock price and they were happy to pay those taxes on fraudulent earnings as long as it kept the stock going up, the options vesting, the deals coming and the bonuses being hit, all resulting in increased tax revenues.
4. All this extra stock market gains resulted in huge broker business, M&A business, wall street bonuses, etc, also bringing in huge tax revenues off of some of those numbers.
5. Companies like Broadcomm & Cisco (and tons of other networker suppliers), SUN (and tons of other hardware suppliers), Oracle (and tons of other software suppliers), sold tons of product to put fiber in the ground, sell switches and network gear to drive the information super highway (remember that term), and sell the hardware and software to run the businesses on the super highway. They all made huge profits doing this and it was all over capacity and when the bubble burst in 2000, those companies all crashed (very hard because they had basically sold all kinds of equipment that far outstripped real demand). They had basically sold equipment over the final few years of the 90s for demand that would take them well into the mid 2000s. So they paid taxes on all those profits in 97,98,99 when it should have been spread over about 8 years instead of 3. Lots of companies were in the same situation and thats partially why things crashed so hard in 2000 and if it hadn't been for the artificial boost of the housing industry the 2001 recession would have been much worse. Thats why this recession has and will continue to be much worse. There are no more artificial industries to pump us up and drive us out of the recession, so it will be slow and painful.
6. All this artificial demand and fraudulent earnings drove demand for employees to the point that unemployment reached levels previously believed to be only theoretically possible without massive inflation. Thus just the sheer number of people who had taxable income had increased bringing in all those extra marginal tax dollars to the treasury.
So when you add all those things up it results in increases in tax revenue that were artificially inflated. And when you are dealing with a 2.5 trillion dollar budget, a 10-20% artificial increase in tax revenue is 250-500 billion dollars and presto, you have an artificial surplus.
You are right that Bush should not have lowered taxes in 2001. Not because he wasted the surplus, but because it was never real and it was going away all on its own anyway, lowering the taxes just made it go away faster and harder.
Well, I'm no economist here (and perhaps one can chime in) but I'm going to go off the simple supposition that greater wealth & more taxable transactions = more tax income. Besides, I think you're greatly underestimating the impact. Success for only "a few entrepreneurs and stock traders"? C'mon, the tech-heavy NASDAQ went from under 1000 points in 1995 to over 5000 points in 2000 before the bubble burst. There were more than a few who profited, and well at that.
You could assume that a large % of those capital gains are from stock sales. So a large % of that $84B in additional tax revenue is directly due to increases in the stock market.
From 1993 to 2000 we went from a deficit of $255B to a surplus of $236B. Thats a swing of $491B. The $84B from increased capital gains is about 20% of that.
What needs to happen is to stop the lawsuits so malpractice insurance isn;t so high. That would stop all the duplicate testing you get when you get referred from md to md. THe doctors right now are covering their asses with unnecessary retesting to stop a lawsuit
Next, make healthcare portable across state lines. If I want to buy a plan the is sold in North Dakota because it meets the parameters of the coverage I want, I should be able to. If I want a plan without maternity and mental health benefits I should be abole to buy a plan right now. Between the states and fed govt mandating what HAS to be covered we are getting insurance that some poele don't need/want.
The proposals being discussed aren't "government-run health care" as you describe it. The result would be all the same doctors at all the same hospitals, but doing their jobs smarter, and for reasonable amounts of money.
Healthcare reform explained on the back of a napkin.
I find myself in agreement with most of that. And I do agree that the current system is broken and doesn't work right. If we could all be convinced that we will get something better, more portable, and will work on reducing costs at the provider level, I think you could get a lot of people on board.
I think a lot of people have very little confidence that what is currently being done accomplishes any of that. And I am in that camp.
Let's work together, put all the ideas on the table, discuss them, do a little compromise if needed, and find something American's can get broad based support behind and it will sail through. We have a good system right now that has some serious problems. But since it is working pretty well still for most of the people (my wife just had 50K surgery and we will hit our max out of pocket of $1,200 and be done paying), we aren't going to be willing to trade that in for a bunch of unknowns based on promises that we will work out the kinks.
Sorry but no thanks. Work out the kinks on paper for everyone to see and understand and get us all on board, and then lets get it done.
http://energycommerce.house.gov/index.php?optio...
For example, in my Texas district, we could provide health insurance to 114,000 people, and only raise taxes for 1.8% of the people.
Regarding the surtax the resources says:
"The cost of health care reform under the legislation is fully paid for: half through making the Medicare and Medicaid program more efficient and half through a surtax on the income of the wealthiest individuals."
Here we have 50% of the savings coming from this magical reduction in medicare costs again which only comes about by simply lowering what they will pay.
As to the surtax, they say it only hits the wealthiest 1% or so. For how long? How are those numbers arrived at? Are they remotely reliable? This is the house energy and commerce committee. The committee has a large Democratic majority that wants to pass this bill. This is not the non-partisan CBO.
Meanwhile at least one liberal Democrat is so upset with the blue dogs, who are trying to use CBO numbers and demanding some fiscal discipline that he is calling them all kinds of nasty names:
http://news.yahoo.com/s/ap/20090827/ap_on_go_co...
I am sure calling people in your own party who you need to vote with you "brain dead", "wanting to cause trouble", "promoting a right wing agenda" and "looking to raise money from insurance companies" is a good way to win them over.
But we are assurred this is going to be a bi-partisan effort to pass the best bill possible that will be better for everyone. No attempt to ram through an agenda at all costs.
With all the disinformation (a polite word for lies) being distributed in the media, I don't really think I have enough facts to have an opinion on whatever Congress is blathering about.
But I am sure of one thing: The health care industry will win at the expense of the American taxpayer.