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Old 05-11-2010, 11:09 AM   #81
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...because companies who are paying for employee health care have higher overhead, making them less competitive in the world market. (i.e. Caterpillar's recent earnings write-down to cover higher health care costs)This debate isn't defined to the US; it affects every company's operating costs. Whether you are local, national or global you need a level playing field to compete. Unfunded mandates do nothing to adresss this.

That's why it is a big deal.
I do agree with what you've said, in that companies should not have to pay for health insurance for employees. We should, and I believe will, move away from employer based health insurance. It's best for the public and the economy as a whole.

In general imo, the best way to control all this and fund all this is once again a "medicare for all" program. That would allow the govt to control costs as well.
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Old 05-11-2010, 11:12 AM   #82
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In general imo, the best way to control all this and fund all this is once again a "medicare for all" program. That would allow the govt to control costs as well.
Medicare would have to significantly increase provider reimbursement rates and force providers to accept Medicare patients. One of the only reasons some providers still *do* accept Medicare and its low reimbursement rates is because they can charge other patients (and insurance) more to make up for what they aren't getting from Medicare.

So tread carefully here. You could see a lot of doctors retiring if "Medicare for all" wasn't done properly.
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Old 05-11-2010, 12:33 PM   #83
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I do agree with what you've said, in that companies should not have to pay for health insurance for employees. We should, and I believe will, move away from employer based health insurance. It's best for the public and the economy as a whole.

In general imo, the best way to control all this and fund all this is once again a "medicare for all" program. That would allow the govt to control costs as well.
Again, people seem to want to get to the least common denominator when it comes to health care... I can hear the comment "everybody should have it at the same level..." that to me seems that I have no choice in what I want to do with my healthcare...

The reason we have employer provide healthcare is that it is pre-tax... even if you company does not pay a dime for it, you as an individual get a great tax break since you get to pay with pre-tax dollars...

Now, let me get my own insurance with pre-tax dollars and I would get me what I consider to be a better plan at lower costs... right now it costs me a lot more to go that way, so I live with what I am provided...


As for controlling costs... does anybody check the salary of doctors in other countries I had mentioned it before, but the salary for someone I knew in the UK whose wife was a doctor was very low... since there was a monopoly, you could pay what you wanted (in the same sense that we can pay teachers what we want since most are hired by school districts that basically pay the same in a given region)....
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Old 05-11-2010, 01:11 PM   #84
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Again, people seem to want to get to the least common denominator when it comes to health care... I can hear the comment "everybody should have it at the same level..." that to me seems that I have no choice in what I want to do with my healthcare...

The reason we have employer provide healthcare is that it is pre-tax... even if you company does not pay a dime for it, you as an individual get a great tax break since you get to pay with pre-tax dollars...

Now, let me get my own insurance with pre-tax dollars and I would get me what I consider to be a better plan at lower costs... right now it costs me a lot more to go that way, so I live with what I am provided...


As for controlling costs... does anybody check the salary of doctors in other countries I had mentioned it before, but the salary for someone I knew in the UK whose wife was a doctor was very low... since there was a monopoly, you could pay what you wanted (in the same sense that we can pay teachers what we want since most are hired by school districts that basically pay the same in a given region)....
I saw a specialist a few years ago who was from Egypt. he said the most he ever made there as a SURGEON was $40,000. Wonder how many surgeons we would have in the US if they could only make $40,000 a year. I think their student loan payments are about that, or the premiums o their malpractice, etc..........
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Old 05-11-2010, 01:36 PM   #85
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I saw a specialist a few years ago who was from Egypt. he said the most he ever made there as a SURGEON was $40,000. Wonder how many surgeons we would have in the US if they could only make $40,000 a year. I think their student loan payments are about that, or the premiums o their malpractice, etc..........
http://siteresources.worldbank.org/D...rces/GNIPC.pdf

The equivalent of US$40,000 in Egypt is a LOT of money given the gross national income per capita there (US$5,470 or less depending on methodology). If you look at it in terms of a multiple over the national "average" income per capita, it's more like $300,000 or so, give or take, in the U.S.
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Old 05-11-2010, 02:47 PM   #86
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http://siteresources.worldbank.org/D...rces/GNIPC.pdf

The equivalent of US$40,000 in Egypt is a LOT of money given the gross national income per capita there (US$5,470 or less depending on methodology). If you look at it in terms of a multiple over the national "average" income per capita, it's more like $300,000 or so, give or take, in the U.S.

To me not a good comparison... I have been to Egypt and there are a LOT of very very poor people... so the average tends to be low... but the cost of living was not a huge multiple like the $40K to $300K you mention..

And as my example of the UK... the lady made like 40K pounds (where is that pound symbol)... which is maybe $60,000... but I can tell you the cost of living in London is a LOT more than here... my usual comment when people came over was 'compare the cost of something like it was listed in $$$s... so a coke for $1 cost 1 pound... etc...
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Old 05-11-2010, 03:44 PM   #87
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One of the other problems is the cost of some of the medicine that is out there... why can we not have some negotiation with the companies... why does it cost us 25X here and only X in Canada or England....
It's cost shifting on a national level. We pay the higher price because we can. They pay the lower price because they won't pay the higher price.
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Old 05-11-2010, 04:02 PM   #88
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...because companies who are paying for employee health care have higher overhead, making them less competitive in the world market. (i.e. Caterpillar's recent earnings write-down to cover higher health care costs)This debate isn't defined to the US; it affects every company's operating costs. Whether you are local, national or global you need a level playing field to compete. Unfunded mandates do nothing to adresss this.

That's why it is a big deal.
The problem is, if the companies decide to not pay for health care it gives them an advantage in the world market place. At the same time they just cut the compensation packages for all of their employees. They could just as easily cut the pay and receive the same benefit. They don't because people would stop working for them. What would you (not you specifically, but you the forum) do if when you were working your boss told you instead of your typical 1-2-3% pay raise this year you were going to take a $2k-4k-5k-10k pay cut because now you had to provide your own health insurance? You will not receive an amount equal to the cost of your insurance for a raise because taxes will be paid on your pay raise, and the company penalty has to be paid, and if it a zero sum issue there wouldn't be any advantage gained by the employer so there would be no incentive to change.
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Old 05-11-2010, 04:23 PM   #89
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The problem is, if the companies decide to not pay for health care it gives them an advantage in the world market place.
Only because our laws have skewed what would normally be the case.

Fact: There's no law saying any private company has to provide any health coverage. So, why do they do it? Because it helps them attract the best employees. Why don't they just pay people more instead of buying them this one particular service? Because companies can get the insurance cheaper than the employees can buy it--because they can do it with "before tax" money and because they can get group rates from insurers.

These are the only reasons employers even bother supplying insurance. Those who cut this benefit will have to offer some amount of higher pay or other benefits to attract the present quality of employees, they won't just pocket all the money. (But, under the newly-passed law, the taxpayers will help subsidize this employer behavior by giving checks to workers to be used in the purchase of individual policies. As taxpayers, we will be in the position of helping employers provide compensation to their workers--hmm, there's a word for that . . .). At present, if the employers could offer lower compensation packages and achieve the desired result in attracting/keeping employees, they would (and should) be doing it already.

The present system actually benefits employers--at allows them to provide compensation (health insurance) to employees at a discount cost (compared to what the employee would have to pay--which is the value of the benefit to the employee, provided he would need/buy the insurance).

If we set up a system where people could buy individual policies at a standard (group) rate, and if we treated people and corporations the same in our tax code with regard to the purchase of health insurance, we'd quickly eliminate the dumb present link we have between employment and health coverage. But we'd have to address the adverse selection issue as well.
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