Rich_by_the_Bay
Moderator Emeritus
To make your point, you are implying that the private sector is covering a population which at comparable risk to the Medicaid/Medicare population.
Wow.
Your argument is specious.
Obama offers universal health care plan
- Thread starter Trek
- Start date
To make your point, you are implying that the private sector is covering a population which at comparable risk to the Medicaid/Medicare population.
Wow.
Your argument is specious.
cute fuzzy bunny
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
In many other posts I've made mention of the problems we'd have with getting insured outside of a group plan...its the primary reason my wife still works a few days a week.
And I never said anything about cost savings. Merely that much of this scary huge cost to run a universal program is already levied and spent...not some huge incremental cost.
I'm paying extra for insurance to cover all the overhead and bureaucracy. And to pay for people without insurance who are treated in emergency rooms. And to pay for people who are self destructive in their lifestyle choices. You focus that money onto the real problem and strip away all of the crapola, I think you've got 80-90% of the cost right there. You throw in some preventative care and maybe you get a little cost savings in the long run.
By the way, on that point about self destructiveness, I dont think people should receive insurance for situations they create themselves. Some level of self responsibility needs to be engaged. If you smoke and get lung cancer...tough. If you drive without a seatbelt or ride without a helmet and crash and screw yourself up...tough. If you're fat and drink too much and dont exercise and get diabetes and need a liver transplant...get out your wallet.
But people living a reasonable life and taking reasonable precautions that get sick or injured? Everyone should be equally covered and getting and paying for care should be easy and highly accessible.
Rich - I made the same point above. It seems this case will be made on the merits of worst possible scenarios wherever possible.
So anyhow, i'm thinking of something along the lines of suze orman eating a kayak with a whole group of lobsters attacking the kayak...maybe with some small flaming chickens shooting out of the lobsters butts.
Is that just too excessive? I'm quite willing to substitute Dr. Phil for Suze Orman. And i'm not married to having the chickens shooting out of the lobsters butts...
And I never said anything about cost savings. Merely that much of this scary huge cost to run a universal program is already levied and spent...not some huge incremental cost.
I'm paying extra for insurance to cover all the overhead and bureaucracy. And to pay for people without insurance who are treated in emergency rooms. And to pay for people who are self destructive in their lifestyle choices. You focus that money onto the real problem and strip away all of the crapola, I think you've got 80-90% of the cost right there. You throw in some preventative care and maybe you get a little cost savings in the long run.
By the way, on that point about self destructiveness, I dont think people should receive insurance for situations they create themselves. Some level of self responsibility needs to be engaged. If you smoke and get lung cancer...tough. If you drive without a seatbelt or ride without a helmet and crash and screw yourself up...tough. If you're fat and drink too much and dont exercise and get diabetes and need a liver transplant...get out your wallet.
But people living a reasonable life and taking reasonable precautions that get sick or injured? Everyone should be equally covered and getting and paying for care should be easy and highly accessible.
Rich - I made the same point above. It seems this case will be made on the merits of worst possible scenarios wherever possible.
So anyhow, i'm thinking of something along the lines of suze orman eating a kayak with a whole group of lobsters attacking the kayak...maybe with some small flaming chickens shooting out of the lobsters butts.
Is that just too excessive? I'm quite willing to substitute Dr. Phil for Suze Orman. And i'm not married to having the chickens shooting out of the lobsters butts...
Rich_by_the_Bay
Moderator Emeritus
Not to digress from the main points about which we agree wholeheartedly, but the problem with the above scenario is what is meant by "tough." If the victims of self-abuse have to pay themselves, they will quickly go bankrupt and guess who ends up paying. If a patient with lung cancer comes to me and has smoked for 40 years, I can't just say sorry, can't help you out. If a motorcyclist comes to me with half a head, I take care of them first and don't even think about reimbursement, but you know who pays. Unlike most free-market service industries, we don't have the ability to withhold or cancel the services for nonpayment.
So while it would be nice to make the abusers more accountable, implementing that at the sharp end just doesn't work. Better to raise the taxes on booze, tobacco, motorcycle licenses and other nonessential, known-to-be-a-health-risk services and products. Of course, even that has its problems (try taxing cocaine or meth).
Bottom line is that we're in this together, fairly or not, and we need a solution that covers everyone.
As I stated in an earlier post one health care insurance company had gross income of 75 billion dollars. As I recall that is the about the projected costs of Obama's plan. Remember that is just one insurance company. So there is money already in the system to provide health care for everyone at affordable prices. That insurance company had net income of 7 billion dollars. With that kind of money floating around there must be away to solve our broken health care system.
ziggy29
Moderator Emeritus
This could work, provided that the "sin taxes" raised were actually used to pay the additional cost of health care for those who use these products, and not used to pad the general fund.
Look at what some of the states have done with all the tobacco settlement money. They sued ostensibly to recover the costs of caring for sick smokers; many of them are using the money for other things.
Also, to assess the true cost to American society, one has to offset the added cost of treating smokers/drinkers/junk food eaters with the reduced cost to Social Security. They die sooner on average, and therefore collect less in benefits, right?
cute fuzzy bunny
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
Its easy to see how complicated such a scenario can be, but in these cases the guy still has to go bankrupt paying the bills.
I think people are willing to play fast and loose with their lifestyle if they think someone else will foot the bill when something goes wrong. If they know the first dollars are all out of their pocket until its empty, maybe theres a motivation to make some lifestyle changes.
My wife works with a fair number of per diem workers, most with families, most without any health insurance. Their take is that they live as healthy as they can and try to avoid medical expenses, rather than do what they want and expect to be fully covered out of someone elses pocket.
Financial and social influence doesnt always work very well to change behavior...but it just irks me to pay extra for all of my insurances to finance someone elses reckless behavior. Then we lay 50' of nanny laws on top to try to legislate good behavior.
I think people are willing to play fast and loose with their lifestyle if they think someone else will foot the bill when something goes wrong. If they know the first dollars are all out of their pocket until its empty, maybe theres a motivation to make some lifestyle changes.
My wife works with a fair number of per diem workers, most with families, most without any health insurance. Their take is that they live as healthy as they can and try to avoid medical expenses, rather than do what they want and expect to be fully covered out of someone elses pocket.
Financial and social influence doesnt always work very well to change behavior...but it just irks me to pay extra for all of my insurances to finance someone elses reckless behavior. Then we lay 50' of nanny laws on top to try to legislate good behavior.
ziggy29
Moderator Emeritus
But what if we could determine the medical costs of smoking, for example?
What if it were determined that smoking causes an extra $20 billion in medical costs per year? And what if we know we sold 10 billion packs of cigarettes in the U.S. each year? Tax each one at $2 per pack, and the system is no longer subsidizing smokers.
Smoking is just one example but the example could be tailored to other things. As far as the nanny state goes, tax it for the extra cost of treating them and be done with it. You wouldn't even need to charge separate tobacco rates in this case, because they've paid the "surcharge" through tobacco taxes.
Rich_by_the_Bay
Moderator Emeritus
Or, more likely, stop paying his bills long before legal bankruptcy occurs. Ouch.
hmmmm, mmmmmm. It's a delicious breakfast burrito.
And if you think that is the sum total of what you pay for healthcare, you are very, very naive and misinformed.
Not only do you have no idea the total cost of our healthcare system today, but an army of motivated accountants couldn't figure it out. What we all can figure out very easily with a ton of data to back us up, is that the current healthcare system is not providing adequate healthcare for millions of people.
I hope you brought your Curmudgeon Certificate along and showed it to those kids giving them something to work for in the future.
At least your efforts on this board earned you something that's suitable for framing. All I got was a breakfast burrito and there's nothing left of it to show.
HFWR
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
What we're discussing is a way to insure the uninsured, insurance portability between jobs or into retirement, etc. Does Obama's plan include "free" access to unlimited care, or is that a strawman?
ziggy29
Moderator Emeritus
Hyperbole aside, it *is* an important aspect of cost containment to not shield health care consumers too much from the consequences of overuse.
At least some of the reasons health care inflation has been so rampant historically is because consumers were almost completely shielded from its true cost. This would be like an auto insurer offering zero-deductible comprehensive insurance. Every time a pebble dinged your car even a little, you could go get it hammered out at "no cost" to you.
Imagine what would happen to auto insurance rates! So why should it have been a surprise that the more you subsidize something, the more of it you need to provide?
Health care is a tough nut to crack, because it seems as if for every legitimate desired outcome of a health care reform package, there is a side-effect that hurts our ability to manage another important aspect.
Universal and highly available. High-quality. Affordable. Pick any two. Any two will almost certainly come at the expense of the third. At best it will require reasonable trade-offs to not completely sacrifice one of the three.
So it may be hyperbole to say people are expecting "free health care," but to keep it (relatively) affordable -- and to prevent runaway inflation -- people also need incentive to be cost-conscious. Any reform package needs to keep that in mind. If people get the "free health care" mindset, the battle is already lost.
T
Tiger
Guest
According to an article in my local paper today Obama's way of getting the revenue to pay for his health care package includes raising taxes on dividends and capital gains.
maddythebeagle
Thinks s/he gets paid by the post
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I think that has been discussed several times before....the old "people go to the doctor for a hangnail theory"...I dont believe it for most people causing big cost increases....esp. with clinics getting smarter about using folks like nurses, physician assistants, etc. more....
I think the consumer directed health care has its place but more for consumers questioning unecessary and expensive tests and keeping doctors honest...My impression is that many tests are to cover people's butts and less diagnostic...Of course, I have no proof of that but impression
Cut-Throat
Thinks s/he gets paid by the post
Sounds great to me! - Take the health care insurance costs out of my budget and I've got plenty of money to pay taxes on my dividends and capital gains.
ziggy29
Moderator Emeritus
I hope he's not assuming people will take as many dividends or capital gains if this happens. People started moving back into dividend stocks in taxable accounts when the dividend tax rate was lowered; will they shift back to stocks that pay no dividends, which provide no tax revenue from dividends? (I won't even raise the 'double taxation' argument here.)
Also, someone who might be inclined to take a capital gain with a 15% tax rate might not be inclined to do so at their marginal rate of 25% or 28%, or even higher.
Many investors can easily shift focus so that they don't have to take dividends or capital gains. If many of them do, the funding that Obama thinks he has will dry up. They can easily choose to "hold forever" (if they don't need the cash) and choose non-dividend payers.
If this is something worth pursuing with tax increases -- and I take no position on that without seeing the details -- it's probably not wise to do it by raising easily avoidable taxes. Your revenue estimates will probably be way too rosy, and I'm pretty sure these are NOT the taxes to raise -- not for a specific purpose, anyway.
OKLibrarian
Recycles dryer sheets
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Ditto.
Easily.
FIRE'd@51
Thinks s/he gets paid by the post
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In addition to Ziggy's point, raising taxes on dividends and capital gains would likely have a negative effect on stock prices - it raises the cost of capital. I don't think it's simply coincidence that the last few years of stock price increases coincided with the 2003 tax cuts.
cute fuzzy bunny
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
I am sorely dissapointed. Where's my second burrito?
I can arrange to have that coming out of one of the flaming chickens coming out of the lobsters butts.
Anyone know for sure where the butt on a lobster is?
haha
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
cute fuzzy bunny
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
We'll never know. I asked my wife if I could go about commenting on the size of womens artichoke leaves and she said "uh...no!"
Cut-Throat
Thinks s/he gets paid by the post
Well, this is the standard kool-aid.
- The problem is that we borrowed money to fund those tax cuts for mostly people that were rich enough that they didn't need it.
This has become a mostly winner take all economy! With CEOs making a higher multiple of worker salaries than ever before. Companies eliminating and defaulting on pension plans, unions, health care just so that we can have the highest paid executives in the world.
It is not moral or in good defense of the country to abandon it's worker's health care needs to enrich executives. Most all of the poor helped these executives get rich and it is the rich's responsibility to ensure that the people that made them wealthy are taken care of in their illness or old age.
There are hardly any rich people that I know of that did not make their money on the backs and hard labor of the working class. Entertainers such as Madonna and Paul McCartney are probably exceptions, yet they don't seem to have the 'I made the money all by myself' delusion.
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