Congratulations to the Democrats for passing a smaller, less corrupt version of Obama’s health care plan to cover the 30 million+ Americans who are uninsured. I’ve read numerous articles about the pros and cons of this plan, and I still can’t figure it all out. An Associated Press article writes, “Obama practically needs a spreadsheet to tell people what’s going on and when.” That said, progress has been made. I’d like to go over some of the basics, and end with a discussion.
LOOKING OUT FOR EACH OTHER
Unlike making money, we can only do so much with our health until genetics take over. We can eat fruits and vegetables until the cows come home. We can work out 5 hours a week and play another 5 hours of tennis on the weekends to improve our fitness. But who’s to say we don’t get cancer one day and die because we can no longer afford to treat the disease? As far as scientists can tell, if we’re destined to get some disease, we will. Wealth helps keep us alive.
Earning a living, on the other hand, is pretty straight forward. Don’t slack off in grade school, go to a good university, get a reasonable job, don’t slack off at work, add value, spend less than you earn, and voila! You will be rich when you retire. Along the way, you’ll find impasses such as economic Armageddon we just experienced. You might lose your job, or 30% of your net worth like I did. But that’s OK. We just go back to school, find another profession, extend our retirement age by a couple years and keep marching forward.
You can’t march forward if you are sick. You can’t even stand sometimes. This is where we MUST step in and provide a safety net for those who cannot help themselves.
HEALTH AND POVERTY
Watching a documentary about personal bankruptcies the other day, it was amazing to learn that 3 out of the 4 families profiled were living in poverty due to health related issues.
A beauty queen broke her neck, and couldn’t continue working. She now lives in a shelter because she couldn’t afford to pay her medical bills. A family of four live in their broken down car because the father severed a nerve in his arm at work, and could no longer operate the machinery. The insurance for rehab ran out, and he was left stuck, unable to do return to his old job.
If we had a better health care system, perhaps we’d have less health related bankruptcies. Is that so bad? Should we not try and help others out who bet on red but get black? We should.
THE OBJECTING CROWD
Everything comes down to money and service. Those who oppose ask how we can afford free coverage for 30 million more people? The opposition also asks with 30 million people in the system, does that mean my doctor’s visit wait jumps from 15 minutes to an 1 hour? Do the citizens who can afford to pay get crowded out as a result? Good questions, and I don’t have the answer.
However, if you were to ask me whether it’s OK to raise my taxes by a couple percent a year to insure that everybody in America can get proper health care, I say yes. Let’s say I earn $100,000 a year, and the tax increase of 2% is earmarked for health care reform. I’m willing to pay an extra $2,000 a year to ensure we all have the right to health care.
Whether my premiums go up $2,000 a year or my taxes go up by $2,000, it’s the same thing, so I’m not arguing where the money will come from. Ask me to pay $2,000 more in taxes a year for some pork spending I have no idea about, I would vehemently vote no.
Let’s say I do have to wait 45 more minutes for the doctor because of a crowding out effect. Fine, let me surf the web on my PDA, read some magazines, do some stretching, and perhaps take a nap. Maybe I have to wait a week longer than normal to see a doctor. That is a problem which will be solved by capitalists who will open more independent practices to meet demand. Just knowing that I will get assistance tempers my worries. And if you never had a shot at seeing a doctor in the first place, you won’t be complaining about a wait.
If I have an emergency, then off to the emergency room I go. I will be treated according to the degree of my trauma. Hopefully there won’t be millions of new hypochondriacs who abuse the emergency room system, but that is a chance I’m willing to take.
CONCLUSION
I feel it in my gut, opposing health care reform is bad. It’s as if the karma police is watching me. We can only do so much to control the outcome of our lives. We don’t know how long we will live, and whether we will die peacefully or painfully. Sickness affects a billionaire as easily as it affects a beggar. Why should someone lose everything just because they are poor? They shouldn’t, and that’s why I congratulate the passage of this bill again. Let’s just make sure everybody helps pitch in, and not just those who aren’t lucky enough to be Nebraskans or particular union workers.
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FS, I’ll completely disagree with you on this. I care just as much about others. I could also say the karma police are watching us but for different reasons. There are some positives in this bill but it’s mostly garbage. I’m also completely for HC reform, this is not it.
Counterpoints:
– When people don’t understand the costs for something leads to thinking it’s “free”. There should be direct understanding of what you are getting and what it costs (If people had skin in the game, their actions would be much different)
– will not be deficit neutral in 10 years regardless of what the CBO says. Anyone willing to bet me on this? GIGO (Garbage In Garbage Out) numbers.
– Does not control costs. If anything since all must have insurance, the insurance providers can raise rates
– Since no one can be denied, people in theory can get insurance on the way to the hospital. Depending upon the difference of what you are taxed for not having insurance to having a HC plan, some will opt out until they need it.
– taxes are much more than you state. 6 years of service for 10 years of payment. A 3.8% tax on passive income for high income earners This will overall slow the economy, which will lead to consistent higher unemployment for years to come. It’s no accident we’ve had lower employment on average than other countries.
– The proposed taxes on the “rich” will be no where near what they propose. More middle class will have to pay.
.-= Investor Junkie´s last blog ..Life Isn’t Fair. Now Get Over It. =-.
IJ, I understand your opinion, and I’ll certainly agree we can’t know for sure exactly how it will all pan out. But I just wanted to respond to a couple places where I think your facts are mistaken.
On the first one, sure there will be subsidies, but people on the exchanges will still see the cost of their insurance, and only for very few people will the subsidies bear the full cost. Most people will pay a percentage if not most of their costs. I think this entire plan will make people *more* aware of what health insurance really costs. Unlike now when you’re pretty well hidden from the full cost to your employer.
On the third one, its not entirely true to say that ‘all people must have insurance’. If you don’t, you’re not thrown in jail or anything, you just have to pay a tax surcharge, I believe it’s around $700 per person with a sliding scale. Nonetheless, from a pure dollars perspective, it will definitely be cheaper not to carry insurance than to buy it (although then of course you get no coverage). So the health insurance absolutely still have to compete on price… on both an absolute basis (vs. no coverage) and a relative one (vs. each other).
On the fourth one. This isn’t a disagreement, but merely an acknowledgment that you bring up an interesting question. Yes, that’s what the surcharge is intended to minimize. If you have no insurance, you pay taxes in order to cover the care that you may end up seeking anyway. Although you do make me wonder the specifics of this. Is there allowed to be a short deductible period to prevent this from literally occurring? Say 7 or 14 days before your coverage takes effect if you were previously uncovered. Or must it literally take effect to the minute?
Do keep in mind though, that in the current state of things, the hospitals end up treating these patients often for free, and have to absorb those costs and cover them elsewhere. So we’re all currently paying for that care now.
Hi Fredct,
“On the third one, its not entirely true”
I never said anything about jail time and not discussing some of the fear tactics
mentioned out there.
I don’t understand when you say they will compete on price? If it’s a choice of
a govt fine or your employer’s insurance provider, then that’s not a choice. Yes in
some cases people do have choice within their company, but most don’t. This
also assumes most employers don’t just drop their coverage and just pay the fine.
At the current rates of HC employers pay per employee, it will be cheaper for
most to pay the $2k fine.
“the hospitals end up treating these patients often for free, and have to absorb those costs and cover them elsewhere.”
Most hospitals don’t do it for free. Yes that’s what medicaid is for.
Medicaid is how the hospitals get paid.
That’s not working out to well for the states either.
A specific case in point is Romneycare is very similar to Obamacare.
The results in MA from all I’ve read have been awful.
Not sure how this will be any different on a bigger scale.
.-= Investor Junkie´s last blog ..Life Isn’t Fair. Now Get Over It. =-.
Investor Junkie,
My bf works in a hospital and has explained to me that when patients do not pay their hospital bills, the hospital essentially “writes it off” and tax payers pick up the tab. So, they are really doing it for free… We’re already paying for the care the poor and uninsured are being provided in emergency rooms when they can’t afford their bill.
.-= Red´s last blog ..His Story =-.
Red – Your BF is right. And with this bill, at least Hospitals will be able to recoop some of their write offs. This is why hospital stocks RALLIED after the proposed bill. Everything is rational.
Hey Red,
Hmm this is a case of Paul paying, it’s now Peter. Yes you are correct that they
will no longer be under Medicaid. Now they will be under some govt paid insurance plan.
So the net savings for ER would be zero. Since if before they couldn’t afford
insurance they certainly won’t be able to after Obamacare.
The savings is in preventive visits to a GP.
FS, also if you haven’t noticed they the hospital stocks are now below the their
rally from monday. Everything is rational, cept when it’s with karma. ;-)
.-= Investor Junkie´s last blog ..Will The Wealthy Donate Less Because Of Health Care? =-.
Of course insurance companies will compete on price in each state, the price comparisons and standardized care levels are available —for the FIRST TIME EVER— all in one place (“price transparency”), and most states have DOZENS of plan choices, more than existed for most people before. (The states with fewer competing plan choices, like Wyoming, have more expensive plans, which prove that price competition is ALREADY working for the better-served states. And, some insurance companies are saying they will see how things go and expand into more states slowly, so you might see DRAMATIC improvement (price drops) in the priciest states, in a couple of years, IF the Republicans don’t succeed in preventing that (many of these states are anti-ACA red states.)
Another way to lower costs even more is to have a “public option”, which would be a low-profit or non-profit, large-risk-pool option that would tend to undercut private insurance plans and lower their prices by competing. But the Republicans wouldn’t touch that, because for them, it’s profit first, consumers last, government-run never.
But what happens when you don’t pay your tax surcharge? I think this is a scary precedent of being forced to buy a consumer product by the Federal Gov’t for no other reason than breathing. I think that makes it different then lets say Auto Insurance in NY because I can choose not drive, I can’t choose not to breath.
It also worries me, and 12 other states since they have plans to sue – that this is WAY beyond the federal gov’ts allowed powers. I think people forget (or don’t really understand the Constitution) that the Federal Gov’t needs to justify the laws that it passes. I heard arguments that it falls under the interstate commerce clause but that seems REALLY weak.
Who doesn’t want to have everyone insured? But this backhanded force makes me nervous as hell
.-= Evan´s last blog ..I use ING For my Savings and You May Want to Also! =-.
“But what happens when you don’t pay your tax surcharge?”
What happens when you cheat on your taxes? The same thing that happens if you cheat on your taxes now. Lets not making it out to be something its not… cheating on your taxes is cheating on your taxes. Its not okay just because you don’t like the law.
“It also worries me, and 12 other states since they have plans to sue – that this is WAY beyond the federal gov’ts allowed powers.”
I’ve yet to hear a coherent argument as to why it would be. Again, its just tax policy, if you choose not to buy it impacts your taxes. Which is something that’s well within the government powers.
I agree that people don’t really understand the constitution, but i think its all these people shouting about how any policy they don’t like in unconstitutional. It *is* interstate commerce, and it’s just tax policy, something that’s well within their realm.
Regarding the CBO numbers NYTimes had a great Opinion piece by a former
CBO director:
https://www.nytimes.com/2010/03/21/opinion/21holtz-eakin.html?ref=opinion
Anyone still want to make a bet with me?
.-= Investor Junkie´s last blog ..Life Isn’t Fair. Now Get Over It. =-.
Keep in mind that the 50% or so of folks with employer plans WON’T be required to buy insurance, subsidized or otherwise, on the exchanges. It took me a while to fully realize this and learn to keep it in mind when discussing this big-news current issue of the day. We’re talking about insurance from exchanges for maybe 20% of people, not almost all of us. The rest of us will go along quite similar to before. (The other 30% of people are already on a government plan–Medicare, Medicaid, VA or federal employee health care.)
Donno IJ, I think the karma police is going to get you! Sure, costs might be underestimated, but we’ve got to do something. If we didn’t pass this bill, no bill will ever be passed.
Now, we can count on the system to provide checks and balances to this bill, to make sure it doesn’t sink us all.
Best,
Sam
.-= Admin´s last blog ..Insuring The Uninsured Is Worth It =-.
FS, I never said do nothing. HC in it’s current form is broken. Think about
what you are saying. So the solution is more of the existing solution?
My suggestion is this bill isn’t the solution. This bill does nothing to control costs
and just adds people.
Regarding the karma police, how is that debt gonna work out for our children?
I don’t see how this current bill is sustainable.
This is why the GOP will start battling now….. this is where the real fun begins.
Checks and balances.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Thanks so much for posting on this topic. I’m watching the whole thing from France which is just . . . weird. I definitely feel detached from what people are thinking in the US. I look forward to the discussion.
I really have a “what just hit me?” feeling about all of this, so I won’t be providing any negatives (or positives) for a while. I just don’t feel like I’ve managed to grasp this topic fully yet.
.-= Simple in France´s last blog ..What kind of blogs do you read? =-.
No problem. Hopefully we can learn more by discussing the topic out in the open. France has a good system for health care yes?
.-= Samurai´s last blog ..The Art of The Interview =-.
I oppose the bill that passed. I hope it will be repealed, at least in large part.
I very much believe that we need health care reform. I think it was a mistake for Republicans not to push a reform bill during the time they were in power.
The middle-class worker is caught between the power of the big insurance companies and the power of big government. It’s not hard to understand why many would seek protection in the government in these circumstances. I think that’s a mistake. But the current system does not work and so I can understand why some would be drawn to the idea of giving more power to the Federal government here.
Rob
.-= Rob Bennett´s last blog ..“Many People Tell Me They Take Seriously What the ‘Experts’ Promoting Buy-and-Hold Say” =-.
Rob, can you clarify exactly what you *would* like to see as far as reform goes? If you’re not sure its okay, its definitely a complicated issue. One thing I’ll say though is that this bill doesn’t expand government power nearly as much as opponents want to imply it does. There’s definitely some new rules and regulations for the market place, but it remains an open supply & demand marketplace within the new rules. For the magnitude of the improvements, the federal power is as small as possible.
I’m a liberal – lets just come right out and say it. However, I think I am against what has been passed. It is not the expansion of health care that I am against. It is that little to nothing was done to keep costs down.
I believe we pay twice as much as a percentage of GDP than any other country in the world for health care. However, when you look at statistics, we are no where near the top in any health statistic! That makes me believe that rather than put more people into our bloated costing healthcare system – we should have written a law to decrease the cost of healthcare in America.
Then we could have taken the cost savings and insured more people.
However, I realize that controlling cost is big time political loser and thus I understand why they went for increasing the number of people that are insured. Why is controlling costs a big time political loser – virtually everbody in America, wants to decrease costs for things that do not effect them. However, for themselves they want every test/procedure and they want the best and most expensive equipement used for the test and procodures they receive.
I’m just going to come out and say it, I think we are spending much to much money on the last year(s) of people’s lives. I think the quality of someone’s life should be taken into consideration before they have operations like open heart surgery and liver transfers. These operations are very expensive and maybe just maybe our tax dollars would be bettter spent on other things?
David, looks like your longer comment did post after all. As a declared liberal (and that’s not a curse word for me :) ), I understand you’re not as prone to have unlimited faith in markets, but I think only a limited belief in the power of markets is needed to see where this bill can do some real good in the cost arena.
Right now, what kind’ve choices do you have for health insurance? Your employer probably offers what… 2 or 3 plans? Probably all from the same company. How much opportunity do you have to seek our lower cost options? More efficient companies that can keep costs down?
Sure, your employer probably has a few choices, but likely only a few. And their interests in minimizing *their* costs don’t necessarily line up with yours. Imagine being able to shop for health insurance plans like you shop on the web for books now. Company A and B offer similar things, then they must compete on price for your business. The concept has a very good potential to lower costs.
If it doesn’t, I agree with you, the bill won’t do much for costs. But if that works, it has substantial ability to be a big time improvement in costs as well.
Truth. I have the choice of many plans – I work for the US Government.
What type of plan do I have – a high deductable plan. For me this plan works great as I’m very healthy. This plan keeps my premiums very low. As an additional benefit, I’m able to sock away $6,000 tax free and the grow I get is also tax free. A high deducatable plans is great for me as I have the money to put away tax free. However, I realize that for most people these plans are horrible. 1) they are not healthy and thus these plans are very costly 2) they do not have the money to put into an HSA.
The real way to lower costs – INCREASE THE COST OF HEALTH CARE!
Do not bother with the last sentence – I was going to complete this thought but decided to not – however, I forgot to delete this sentence.
I wrote a long comment and it did not show up. Thus I’m going to write a shorter comment -hopefully it shows up.
I’m against this healthcare bill as it does little to control cost. In the US we spend much more on health care than any other country. However, we are no were near the top in any statistics.
Thus I belive they should have first tackled the costs associated with our bloated healthcare system.
Then taken the savings and used that to insure more people.
I think health care is going to bankrupt America.
I could be wrong, but I believe we are the only country that does not budget a certain number of dollars for health care and then tries to use the money in the most efficient and effective way.
Wow, Sam, I have much more respect for you right now. I was kind’ve concerned you were an ideologue who would just oppose everything coming from democrats, but clearly you are a more thoughtful, in depth person than I give you credit for. There are a lot of people like that on the web (and vice versa), but clearly you are not one – and I owe you an apology for ever thinking that you were. We do not agree on everything, but I look forward to thoughtful disagreement in the future.
There are legitimate objections to this bill, and its not perfect, but its a big step forward. The idea of your health insurance being tied to your job is an idea who’s age has long since passed, and this bill is a major step towards allowing people to purchase their own coverage however they so please. If you lose your job, change jobs, are out of work, or want to start your own business, you will not be prevented from doing so because you can’t get coverage.
It will open up financial freedoms and portability for millions, allow entrepreneurs to fear one less thing about starting their own business, and open up new free markets of insurance coverage that will drive down prices since people could actually shop around.
Let me share my own personal gain from this historic reform. I by no means am someone who you should feel pity for, but this bill gives me one big freedom I did not have before. You see, I’m a big saver, and its because I want to achieve financial freedom, and I’d love to retire early. It may not happen, but at my rates of savings it very well might. If it does, in my retirement I would volunteer, get involved, maybe work part time or part of the year. Not that I don’t like what I do, but I’d love to have the freedom to do what I want.
However, my fiance has a congenital health issue. Nothing that effects her day-to-day life – she’s been quite well in the last few years – but definitely enough that she would never be approved for any individual coverage ever, at any price. If she & I want to retire early, I would have to take the full risk of any health issues fully on my pocketbook. No matter how much I was willing to pay for insurance, I could not get it for her. So either I take a major personal risk to the tune of potentially millions, or at least one of us would have been forced to continue working until we qualify for Medicare… if we both make it that long.
Now, if I save up, if I’m responsible and live below my means, if we put ourselves in a position to be financial independent before age 65, I can retire without a huge financial risk.
I’m surprised you think I’m against the Democrats. What would make you think I’m an idealogue (donno what that means) or a Republican?
I’m glad this bill will help you and your fiance, to not worry so much about the future!
Glad you have more respect for me know…. guess that means you thought very lowly of me before then!
.-= Samurai´s last blog ..Insuring The Uninsured Is Worth It =-.
“I’m surprised you think I’m against the Democrats. What would make you think I’m an idealogue (dunno what that means) or a Republican?”
And ideologue is someone who advocate a strict set of principles, no matter the facts of the particular circumstances. Things like “we should never raise taxes no matter what”, or “we should never fight a war no matter what”. Something particular facts or causes or problems need to overcome a general principle. Even if that principle is generally worthy or honorable, sometimes there are situations for which it’s not the right approach.
I did not think lowly of you before, I just think more highly now :-)
Ha, thnx! Ok, thnx for explaining your definition of what ideologue means. It’s pretty obvious to me that nothing is black and white. What’s important is the direction one heads. No matter how far away the goal, so long as the direction is right, we will get there.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Making sure everyone has access to medical care is a good thing. However, I think the basic problem with the plan is our medical industry itself and trying to reform it to be able to offer coverage for our entire population of over 400,000,000 people.
For instance, my friend is from Canada, which offers medical coverage for all of its residents. Her mother needed a knee replacement. Because she didn’t want to wait an eternity for her surgery to be scheduled, she had it done here in the states (she had the money to cover the cost herself). Canada is a country with only about 40,000,000 people. We are ten times their size. I think this will end up being the hugest hurdle for us, trying to offer medical services on an immense scale. No other country that offers medical coverage for their entire county has such a large population.
I guess we will learn as we go, I just hope that we don’t get in our own way and never see this plan actually materialize.
.-= Little House´s last blog ..How credit card debt consolidation can eliminate your anxieties =-.
Little House, I understand your concerns and I do agree that it will likely be a challenge. However, I think your ‘population’ argument is mistaken. While there are more people, that also means there’s a larger pool of population for doctors & other health care workers. Canada may have only 40M people, but that means they have 1/10th the population to send to college to become health care professions.
To use a little analogy, yes, we have more people, but that doesn’t mean people go hungry due to lack of food – we also have more farms, more restaurants, and more supermarkets accordingly.
The transition will be one of the challenges, but the absolute population doesn’t appear to be relevant to me.
One last point, if the numbers of 30-something million uninsured are correct, then 85% or so of the US population is already insured. So the increase in usage will be something along the lines of 15/85 = ~18%. A challenge, no doubt, but its not like we’re looking at doubling or tripling the number of uninsured. A change of 18% should be a challenge that a free market can handle.
This is a good counter point to LH’s good point. More with more.
Good you highlighted the marginal increase.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Whoops, a couple typos in there, but none more important than saying “doubling or tripling the number of uninsured” when I meant to say “doubling or tripling the number of *insured*”.
I guess my main concern is implementation of the health care plan. I do want all people to have access to health care. And I see your point on how most of our population is already insured. If only 18% of the country is uninsured, then maybe it won’t be too much of a challenge. But if this is the case, only 18% uninsured, why is it going to cost us nearly a trillion dollars to insure them?
.-= Little House´s last blog ..How credit card debt consolidation can eliminate your anxieties =-.
A trillion dollars over 10 year, is, of course, $100 billion per year. Divided by 32 million uninsured who will now be covered is ~$3200 per person per year. If my math is righ that sounds like about the cost of health insurance to me in a group plan (especially for family plans, etc)
To be fair, some provisions kick in right now, but not all do. Its completely in force for only 6 years. Using only 6 years you get $5200 per person per year. The number will fall somewhere in between those since, as I said, some of the costs begin immediately.
But somewhere in the range still sounds about right.
@Little House – we aren’t on a single payer system like Canada is. Rest assured money will still buy you more quality/service (as it should), and you won’t have to go to a country that’s like the US used to be to get your knee replacement.
That said, health care is a right. It all comes down to “do people deserve to get sick and die because they don’t have money?” And remember, sometimes they don’t have money because of circumstances beyond their control. There is no easy way to separate slackers (do people deserve to get sick and die because they are lazy?) from non-slackers with bad luck.
I totally agree that all people have a right to health care. But that is not my concern, my concern is implementing this health care plan. I hope that in 5 years from now, those who are uninsured have access to health care that they don’t have now. But what happens if we spend all this money and find out the plan was a total flop because it was too broad?
Look at the No Child Left Behind Act. Some teachers feel this act was and is a total failure, and that it did more harm than good. (Thankfully, this act will likely be changed in the next few years.) Taxpayers invested almost $800 M into this act (much of the money was spent on standardized test materials) and now we are finding the results aren’t what was expected. Hopefully this won’t be the outcome of the health care plan.
.-= Little House´s last blog ..How credit card debt consolidation can eliminate your anxieties =-.
I’m from Canada and I think that health care should be a right. Hearing about people going bankrupt (even though they’ve saved money) because their insurance company denied coverage breaks my heart. That being said, our Canadian health care system is buckling with the pressures of the aging population.
I do agree that the focus on aggressive curative treatment for people who are 85+ with chornic disease or aggressive cancers should change. There are 90 year old people in our intensive care units costing us >$10,000 a day…because our society is so focused on a cure instead of quality of life.
.-= youngandthrifty´s last blog ..Cohabitation Agreements and Living Together Common Law- What you Need to Know =-.
I just forgot to add: Great post Sam! You cease to amaze me with your thoughtful posts!
.-= youngandthrifty´s last blog ..Cohabitation Agreements and Living Together Common Law- What you Need to Know =-.
Thanks for your thoughts Y&T! It’s interesting how good Canada is doing relative to the US. From healthcare, to property, to the financial system.
Perhaps you guys have a competitive advantage due to a smaller population to take care of and better gov’t oversight.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
it is very important for the people that can take care of themselves to find ways of helping those who cannot. it is a God given duty because we can very easily be sleeping on the sidewalk tomorrow and i am sure that in that situation you would want someone to help you
I agree, though will this cause less people to donate to charities? After all if you follow the logic, many charities help those in need, if the government taxes are used to help ones in need, will less people donate? I’ve heard quite a few times we donate in the US much more per capital than France. Could it be because of the differences in our economic systems? Meaning people are looking at their tax increases as a form of donations? This is something I’m mulling over for my next blog post.
.-= Investor Junkie´s last blog ..Life Isn’t Fair. Now Get Over It. =-.
Rob, can you clarify exactly what you *would* like to see as far as reform goes?
I favor free-market solutions as a general rule and government solutions in circumstances where there is a job that needs to be done that can only be done by the government. The market doesn’t function in the health care area because many people get health care through their employment and never really shop to get the best plan for someone in their circumstances. The root problem (in my view!) is that health insurance is not purchased in the way that other things are purchased.
For example, I would like a plan that had a low premium and that protected me only in cases where procedures were needed that came at a very high cost. But there are big problems with going with such a plan today. The big insurance companies are able to negotiate lower prices, so those in employer plans usually do not pay the sticker price for most care. Little guys purchasing their own coverage get stuck paying far larger fees for the same procedures; they have little bargaining power in today’s marketplace. So the appeal in that kind of plan is obviously limited.
I believe that we need to provide coverage for those who are unemployed or who cannot afford coverage or who have pre-existing coverage. That’s the big driver here and it is the failure of those who favor free-market solutions to insure that everyone has access to at least a minimal level of care that garners support for the government-intrusive approach that is now being enacted into law.
My view is that our political system is to a large extent (but not entirely) broken. Both “sides” are always trying to score points rather than to solve problems. I think there is a role for government in health care. But I think that we are letting government take on too big a role with this law. I believe that the result is that there is going to be even more disdain for government in years to come, which is a frightening prospect.
We need to have a government than wins people’s respect AND a free market that wins people’s respect if our system is to function well and today my personal take is that we don’t really have either. Roughly half of us distrust everything the private sector does and the roughly the other half distrusts everything the government does. My personal belief is that both have their place and the trick is figuring out what each does best and assigning duties accordingly.
I know it’s easier said than done. Still, that’s the job. My personal view is that those who wrote the new law did not even make much of an effort to draw the line effectively. The people who wrote this law have trust in government solutions and they don’t make enough of an effort to understand points being made by the other side (and those on the other side often make the same mistake in reverse, to be sure).
Rob
.-= Rob Bennett´s last blog ..“Many People Tell Me They Take Seriously What the ‘Experts’ Promoting Buy-and-Hold Say” =-.
I agree with all the general principles you stated, Rob, but I guess we disagree on where this bill falls on that line.
In my view this bill is about as free-market as you can get and still address the big issues. The main benefit of this bill is setting up ‘market exchanges’ for health care, where anyone can purchase and where prices matter and people can shop around freely.
You can argue around the edges about the level of regulation and control over what plans are available, etc (and when you do, I would tend to side more, though not entirely, with the Republican view of it).
But from everything I understand on any big level, its hard to make a system that meets your goals that could possibly give the market much more of a role than this one does.
Honestly, this bill depends highly on an effective mostly-free market exchanges driving down prices in order to meet it costs goals. The rationale being that insurance companies now average I believe 24% of premiums in overhead. Meaning that if you (and your employer) pay $10K for your coverage, $2400 never gets to doctors or hospitals. The company who figures out how to do that for 20%, or 15%, or 10%, will be the one that can offer lower prices and earn more customers. It’ll finally give them major incentives to go electronic and streamline their operations.
Anyway, its amazing how much I agree with all the principals you laid out in your first 4 paragraphs, and yet how much I differ where where this bill falls in your final 2 paragraphs. I guess we’ll have to see.
i wish these bills were more transparent if they were i wouldn’t be so against them.
for better or worse- i feel they are all about trying to spend money and Obama is just trying to get his name on something so people will get off his back and stop saying that his first year has been a complete waste of time.
that being said i don’t know if it will turn out good or not but i am not a fan of health care companies that feel they can pick and choose there clients based on the history of there health.
James, I wish the bill wasn’t so murky too… 2,600 pages? Wow. Obama is trying to get his name on something, which every person in his position will do. He can’t be a lame duck president. Spending other people’s money is easy. Saving/raising money is hard.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Insurers will be required to spend between 80 cents and 85 cents of every premium dollar on health care. They have been paying about 74 cents on average. So I think there is definitely a cost-containment factor there, because they can’t raise premiums unless they also raise services…and even most of the companies now will have to either lower their premiums or provide better services. Also, since it will be so much easier for people to switch providers, the marketplace is going to have to get more competitive.
I think this is a huge victory both economically and morally.
.-= Honey´s last blog ..How to Deal When Things Get Rough =-.
Good post Sam – I keep waiting to hear some good non-partisan explanations of what really is in this thing.
I think most of us, if not all, would agree that their needs to be some reform in healthcare, I’m just not sure what it would be!
The whole system seems so jacked up that I’m just not really sure where to start.
I’m really glad you brought up the point about those who are poor because of health-related issues. Too often we (myself included) think that it’s because of bad decisions that they’re in poverty, but there are a lot of outside forces that make a bad situation worse.
Anyways, I wish there were more civil conversations on both sides of the aisle to promote the betterment of humanity and not just their party’s ideals!
Excellent post, Jason. As far as a non-partisan explanation, I found this today, and I thought it was a good, albeit quick, overview:
https://www.cnn.com/2010/POLITICS/03/16/health.care.immediate/index.html?hpt=C2
But amen about civil conversations on this issue… and all issues for that matter. We could all use more of it!
Thnx Jason. At the heart of the issue, the debate remains should a nation has wealthy as ours allow millions of people to go without health insurance and suffer b/c they are too poor. I’m specifically talking about folks who WANT to have health insurance. My answer is all people should absolutely have a right.
With health, accidents, so forth, we never know when we catch the unlucky bug. We’re all in this together.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Hi Folks, thanks for all your input so far. There are some comments which are captured by my filter which are waiting to be released, and I have no access since I’m not near a computer. In a couple hrs they should be released. Best, Sam
I thought you finally just came to your senses and decided to shut me down LOL
.-= Evan´s last blog ..I use ING For my Savings and You May Want to Also! =-.
Great post. I gave up following the health care reform stuff b/c it was just confusing the heck out of me and with all the revisions and changes I couldn’t keep up with it all. These are interesting times we’re in and hopefully a lot of good will come out of health care reform. I read a headline that Pepsi Co is going to work on reducing things like sugar and sodium in their products which is great. Granted they’re doing it over a long period of time, but it’s still better than not doing anything at all.
And on a somewhat related topic, I’m all for putting a tax on sugary/toxic sodas and getting vending machines out of schools. I remember there was a vending machine in my college dorm and boy it makes me cringe thinking about how much I used to eat out of that machine just b/c it was there and convenient. I have much more discipline now about what I eat, but I sure didn’t as a kid. We have the ugly stats now that prove how big a problem child obesity (and adult obesity too actually) and type 2 diabetes are that really could be reduced with healthier options in schools.
Please encourage your family and friends to stop drinking soda and curb buying junk food. Your health will thank you. :)
Charlie, I agree, sugar is probably one of the biggest silent killers in America, if not the world.
This will definitely be a future topic to discuss.
.-= admin´s last blog ..The Art of The Interview =-.
I like the bill.
While I’d prefer a “free market” solution, it’s impossible. For example, I live in China now and costs are *super* cheap — even for those who make China salaries. A CT-Scan costs $40 because the hospital requires you to pay in cash before treatment. Here’s what I wrote a few months ago about health care costs in China:
Get rid of health insurance as is (leaving only catastrophic coverage to return to the true definition of insurance), you now have transparency in the system, you now have people with a stake in the system — prices drop dramatically. But seriously, who has the political will to do this? Can you honestly say even a single Republican would put forth such a bill to kill Medicare, Medicaid and health insurance?
The bill as is is a good compromise to move the costs back into the health care system. We *ALREADY* pay for the costs of the uninsured. As is, they check into a hospital and can’t be turned away. Instead, local taxpayer money partly covers them while the other part is covered by inflated medical bills for those who have insurance.
And the higher insurance costs will be a good thing — that will force more people into higher deductible plans where they have an incentive to stop being hypochondriacs — and most assuredly, Americans are far over-medicated, over-treated due to health insurance seeming “free”.
.-= MossySF´s last blog ..Moving to the repair phase =-.
We do pay for the cost of the uninsured with their last resort Emergency room visits. That is why this bill is GOOD and why hospital stocks are RALLYING, b/c with this bill, now hospitals can receive some income from the ER folks who can no longer pay.
Interesting insights on China healthcare! I will take a look. Thnx for sharing.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
I usually like to read everyone else’s comments first before I write something. But I am currently traveling and don’t have much time, so I will just say “I am glad it’s passed!”
I think the next step the Government need to do is to educate the people! We need to teach the general public how to eat right and, how to live the right livelihood! Afterall, it costs so much less to take the preventive measures. And life is much more enjoyable (or less painful) when we are healthy.
Dr. Campbell’s “China Study” in the 1980’s and his other reports (and many others’ reports) have proved we are what we eat!
We are what we eat indeed! Our diets are corrupt with so much sugar and processed food!
We do need to go through a period of education on the bill. We must. Through this post and all our various comments, I believe we are.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
I basically support the bill as I believe it will allow coverage to millions of uninsured and eliminate the prohibitions against lifetime caps and pre-existing conditions – which under the present system are the real “death panels” that the insurance industry uses to deny seriously ill people coverage. But the cost concerns are genuine, and I cannot share Obama’s confidence that the bill will be deficit-neutral. Since the primary entitlements – social security, Medicare, and perhaps now this – are what’s consuming so much of our federal budget, what’s badly needed are ways to contain these runaway costs. I believe we seriously need means testing to determine if one qualifies for these major entitlements. Someone with a $2 million dollar portfolio does not need to collect $2K a month for 25 years from social security, which was originally enacted when average life spans after retirement were far shorter than is typical today. And this person can easily afford a $75 office visit out ot their own pocket rather than billing it to Medicare. Tort reform is also badly needed.
Anything that has limited resources has to be rationed… Yes it’s rationed under health insurance companies. What make you think under the government it won’t be rationed? The government has magical powers to eliminate the economics?
Who said anything of the kind? I am saying we need to take a hard look at entitlements and to start applying means tests rather than just doling out money indiscriminately, regardless of the individual’s ability to pay.
Sam,
Gotta disagree that this is a Karma issue. It’s OK to oppose something that’s bad for your country but good for a subset of people who enjoy a transfer of wealth. The bill could have been more equitable and effective. This bill was done in a shameless pandering way where votes were flat-out bought. That is not the way we’re supposed to enact law in this country. Not a single Republican voted for it. If you’re interested in Karma, I’d like you to do a post after the mid-term election and see how Karma worked out for the Dems voted out of office over this.
Why? Well, certainly not because Americans aren’t compassionate and don’t want to help people. I challenge any of your international readers to identify a SINGLE country that gives more generously than Americans. Not just our government, but individuals. Katrina, 9/11…inflows of donations and help pale in comparison to what we give for Tsunamis, earthquakes and other natural disasters. America is compassionate. This Bill STUNK. That’s why people are pissed. So, let’s not mix issues. It’s not that Americans are stingy or want to see people without access to care. It’s the ridiculous way in which this was done what the lousy implications are going to be for the country down the road.
Don’t get me wrong, there are plenty of people who need better access to care. However, I love when they interview these hippies saying they can’t afford health care and they’re wearing designer clothes and have an iPhone in their hand. Millions CHOOSE not to buy health insurance because they don’t think it’s worth it. Just like millions don’t have life insurance and in many cases, drive without auto insurance.
Obviously, my post took a different tilt on this.
.-= Darwin’s Finance´s last blog ..What’s wrong With THIS Health Care Reform =-.
As I just posted on my blog. We donate more than any country:
I believe we’ll become more like Europe in donations amounts since isn’t that what our government wants? to be more like Europe?
Darwin, this isn’t a karma issue. I just shared in my post that I feel the “Karma Police is watching me” and in my gut, I feel that health care reform is necessary through the passage of this bill.
I’m also not saying that anybody opposed to this bill is bad, evil, or what not. I’m just sharing again that I feel bad opposing. I just want to learn as much about this landmark, murky bill as possible.
If we didn’t pass the bill, we’d never pass anything. At least we have something, and now we can fight to the death to make sure it’s a legit plan for a large majority of Americans!
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
This is an issue for the States. Not the Federal government.
This bill is a travesty and it further increases the ever-expanding reach and power of the Federal government at the expense of the States. Or Founding Fathers are turning over in their graves right now.
I’m still trying to figure out where in the US Constitution that it gives the Federal government the authority to ensure all of its citizens are provided with healthcare.
By the way, the pro-healthcare crowd used to throw out 47 million as the number of uninsured in the US – until it was conclusively shown that 18 million or so of that number consisted of illiegal aliens. So now the number being cited is 30+ million. However, I’ve seen figures that say 12 million people in this country purposely choose to NOT have healthcare (young people, the wealthy, and others who simply don’t want it). So now we’re down to less than 20 million uninsured.
That’s a very small fraction of this country. I ask you, why further expand our Federal government with such a radical overhaul and nationalize 17% of our GDP for such a small segment of society?
Why couldn’t we have started with something more modest, like tort reform and portability?
Is healthcare really a right? If so, why isn’t three square meals a day for every American a right as well? Our Declaration of Independence recognizes three inalienable rights: life, liberty and the pursuit of happiness. Nothing there about healthcare.
If the Federal government is going to ensure healthcare for everyone then they should also pay for all of our groceries too while they’re at it.
Then again, we are already on the hook for $107 billion in unfunded liabilities (Social Security, Medicare and Medicare D) – what’s a few more trillion for healthcare?
Has anybody stopped to think about how we are going to pay for that when our GDP is $14 trillion per year?
With that kind of debt burden, if you think our kids’ standard of living will ever be as good as ours, you’re sadly mistaken.
We’re ALL going to pay for this in the end. Not just the rich, or those earning over $250,000 per year. All of us.
It’s not hyperbole when I tell you that I am truly scared for my kids’ future.
All the best,
Len
We’re all going to pay for it in the end you’re right. Hence, we should ALL pay for it, and not just “the rich” or specific target groups. We all need to pitch in.
Tort reform would have been nice, but nothing would have happened. Now that the bill is passed, the debate begins until we can refine it so that even more people can agree upon it.
.-= admin´s last blog ..Sometimes Saving Money Is About Principle =-.
Good to hear others opinions on this.
My personal opinion, I’m having doubts that our Government can get the job done. We spend the most money out of any country in the world on health care, yet we thought the solution was to throw more money.
Unfortunately it seems to me we have many lawyers and lobbyist running our country. Insurance companies got stronger, we can still sue doctors for “practicing” medicine, drug companies can still spend billions of dollars each year promoting their drugs (we are one of two countries worldwide that let pharmaceutical companies advertise), and we choose to single out tanning beds when companies who are causing our country to be obese, like McDonalds and Coke don’t get a mention.
.-= RJ Weiss´s last blog ..How to Get a Guarnteed 34.95% Internal Rate of Return On Your Investment =-.
RJ, lawyers and lobbyists and people with money ARE running our country. There is no denying this. Coke, McDonald’s are huge boosters, and will always control us. This is why we got to educate ourselves, the masses, and practice a healthier lifestyle.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
Wow–a very thoughtful post and comments. I would just like to address the private ‘solution’ proposed by many — that it’s better if we shop around for health care like we do for other things.
To quote Rob Bennett “The market doesn’t function in the health care area because many people get health care through their employment and never really shop to get the best plan for someone in their circumstances. The root problem (in my view!) is that health insurance is not purchased in the way that other things are purchased.”
That viewpoint doesn’t take into consideration that when you’re sick, especially if you’re sick and old or dealing with a life-threatening illness like cancer, it’s horrible for an individual or their family to also have to deal with insurers and payment. When you’re sick, do you really have the energy to shop around? What if you don’t have a family to shop around for you? What if you’re not that educated or informed? Buying healthcare is not the same as buying a fridge.
.-= oilandgarlic´s last blog ..Overpriced Food And Priceless Views =-.
Hi O&G, shopping around is fine to get the incrementally better health care plan, however we’re talking about the basics of covering 30mil+ without health care. We just need health care coverage for all legal, law abiding citizens first.
Hopefully, we can raise health care quality so good that we really don’t NEED to shop around.
Best, Sam
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
I think getting more people into the insurance pool is absolutely critical – it’s the only way that insurance companies can afford to keep people with higher risks (and thus need more money paid out in claims) on insurance. I think it’s HUGE that insurance is not as tied to employer-based insurance anymore. So many people cannot afford coverage – even if they are healthy – because once they are laid off they are out of the larger employer pool. Also, this talk of socialism as a catch-all phrase for every government program or reform bugs me a little – a socialist society is a master-planned economy. The Soviet Union in the 1950s is Socialist. The United States right now with Social Security and now healthcare reform is not.
There’s varying degrees of Socialism I think we can all agree. We increased the degree just a little bit more with this bill, and I’m fine with it so long as we can have checks and balances to make sure more people will benefit.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
We currently pay around 17% of our GDP for health care and a high percentage of our population isn’t even covered. Plus, 62% of personal bankruptcies are caused directly or indirectly by medical costs.
I would support universal coverage, provided there were some major cost savings built into the new system. However, from what I have seen, these plans do virtually nothing to contain the runaway costs or reduce the overhead. It just adds Trillions of dollars in new overhead that will ultimately go to wealthy entites.
We can’t stay solvent as a nation if we allow our healthcare costs to consume 25% of our GDP. And, we can’t expect small business to generate a bunch of new jobs and spark the economy, as we load them with new overhead. Someone has to address the issue of cost and I don’t believe they have.
Good stats, and unfortunately, this bill is almost certain unable to save us money in the system. The only way we can save money in the long run is to reduce our poor health, and therefore, our dependency on health care.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
I’ve not heard anyone say that we don’t need healthcare reform. I believe all would also agree that HC costs are out of control.
When has the government ever managed anything in a more cost effective manner than the private sector? I saw and 20smoney.com today: “When Medicare was passed in 1965, it was estimated that 25 years later, in 1990, Medicare would cost $9 billion per year. When 1990 rolled around, the cost was $110 billion. That’s a miss of 1,122%.” – ouch!
Last year when this thing was ramping up I ran some numbers… (don’t quote these as nearly exact, I don’t have them with me at the moment) If you take all privately insured the cost per capita for insurance was around $7,000. If you take all those on medicare and medicaid the cost was closer to $11,000.
We need to do something but this is not it.
No doubt the impact of catastrophic health issues destroys lives and families. Isn’t it something like 50% of bankruptcies are due to medical and of those most had insurance? Rush Limbaugh last year promoted the idea of catastrophic care insurance. While it may not be ideal either it would be much less costly to the nation and would still encourage personal responsibility.
.-= LeanLifeCoach´s last blog ..Undercover Boss =-.
The government rarely manages anything in a cost effective way. It’s spend other people’s money first, and ask questions later.
65% of bankrupticies are due to medical reasons. That’s unacceptable in my book.
When Steve Jobs can fly to middle America and get a pancreatic transplant, b/c he has hundreds of thousands to spend, and a guy his same age making $50,000/yr is stuck to die b/c he can’t afford treatment, that’s not right.
The bill is a stinky one, which is undergoing a cleaning process now!
Best, Sam
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
To say this is a Karma issue is a complete disgrace to those of us who do care about others but oppose bigger Government, more debt, and a lousy health care plan, not to mention the corruption used to drive this thing through.
I oppose this bill because I do care about America and everyone in it, even those that support this joke of a President. I am so sick of people claiming that if you oppose this President or this HCR that you are not compassionate. If I wasn’t compassionate towards others I wouldn’t do what I do for almost nothing monetarily. I get paid nothing yet I carry on because I do care about my fellow Americans.
How about opening health care insurance across state lines, ending the pre-existing condition issues, and let private industry and free markets do what they do best—lower costs through competition. The health care in this country needs reformed, but it is not currently a failed system because capitalism and free market enterprise has not allowed it too, it’s because we were already practically socialized anyway. THE GOVERNMENT IS THE REASON IT NEEDED TO BE REFORMED PEOPLE!!!! Get the Government out of the damn way and we stand a fighting chance at fixing it.
So the Government over time takes a little here and a little there in the form of control over health care via regulations and other unconstitutional methods, yet you think it is BEST to give them freakin control? Unbelievable!! That’s like giving your broke alcoholic Uncle your estate and expecting him to keep it a float!
I’m sorry and I mean absolutely no disrespect to anyone but I love this country and I do not want it to be like Europe or anywhere else! I want it to be like America where we have control of our lives and the liberty to live out our dreams as we see fit. If you want socialized medicine then move, because most of America, and even people in other countries, do not want this crap. Why do you think they had to force it through the way they did? Jeez!
Bush screwed up a lot and people on the left cried foul. Obama is like Bush on multiple steroid injections 4 times a day, yet the flock still believes in him. (Should I have capitalized the H?)
Give me a break!
Sam I am surprised you believe what you just wrote man. Seriously? It looks like you gained some fans with this one. Good for you.
.-= Brad Chaffee´s last blog ..Manage Your Money Week 4 – GET OUT OF DEBT! =-.
Brad, I understand your frustration, but I take two major issues with what you said. First, you said eliminating pre-existing conditions ‘issues’? How exactly could you do that without doing something much like this? In order to allow people with pre-existing issues you be able to purchase insurance, you need to mandate coverage… because otherwise people would simply wait until after they got sick to purchase coverage, and then buy the coverage. There is simply no way to end pre-existing exclusions that is less than there.
It’s one thing to simply say ‘oh we should fix problem a, b, c, and d differently’, its another way to even begin to come up with a framework that would do it.
There are many ways that are much more intrusive than this – such as a public option, single payer, or socialized medicine, but I’ve never heard an idea to cover people that doesn’t include something like this or much more, and I don’t see how it could be done.
“If you want socialized medicine then move, because most of America, and even people in other countries, do not want this crap.”
Secondly… based on this statement I’m left to think that you don’t understand what socialized medicine is. Socialized medicine is when doctors, nurses, and all health care workers are direct government employees. They are paid – usually salaried – directly by the government and there are no private doctors practices, private hospitals, or health insurance companies. There is no exchange of money directly or indirectly between patients and providers – there are simply taxes and health care workers that work for the government.
This is nothing even close to that. The system will remain private – private practicing, private hospitals, and private insurance companies would all continue to exist. It’s not even close to socialized medicine.
I certainly do not claim to have the answers but I do know that the pre-existing conditions is a major issue. I admit I do not know how that would work but I do not believe this will work either.
Maybe this is complete socialization as you are suggesting I meant, but I do know that through regulations the Government has gained more and more control over health care which is a very big reason that health care costs are so high. Another issue is the impact that illegal immigrants have on the health care costs. No discussion of that here or in the bill that was signed. I also know that this bill just gave the Government a whole lot more power and control and will sure as hell make it easier for them to get to their ultimate goal of socialization. Private companies can never compete with the government, ESPECIALLY the way the Government spends money. Have you heard of social security or the current government run programs? My question is why do you think now will be any different? It won’t be.
The Government is not run like a business as you know, probably because they know all they have to do is scare us into believing a bunch of crap so they can come to the rescue no matter what it costs. Who cares our kids our kids will pay for it. I could in turn say that the Democrats don’t care about our children using the same logic this post uses.
Forget all of that though for one second. Do you think the way that this was forced through was the best way to do it? Most of America oppose this particular HCR but their leaders are either not listening or wait, they were, that’s why the first one didn’t pass. Let me ask you something else.
Why couldn’t they have just reformed medicare and medicaid to adjust for the minority of Americans that weren’t covered?
How about the fact that Americans are losing their jobs which is causing the health care crisis to get bigger and uglier looking. Gee I wonder if that was planned. Obama has destroyed jobs by killing incentive and by putting things in place that either destroys small businesses or at least makes them lay off more people and stop hiring. I guess if you destroy something, cause a crisis to get bigger, and then come to the rescue with a crappy bill you can still be a hero in some people’s eyes.
Whoever said doing something is better than doing nothing is sadly mistaken. Sometimes doing something stupid is worse than doing nothing.
.-= Brad Chaffee´s last blog ..When You’re Tired Of Being Broke, You’ll Start Saving =-.
Hi Brad, thanks for your thoughts. I’m really not here to gain fans, although that’s always something nice. I’m trying to educate myself, and readers more about this convoluted, confusing, murky bill.
I don’t believe people against this bill will be damned and receive bad karma b/c they are bad people. I just feel that in my gut, supporting the PROCESS of reform is the right thing. Now the fun begins where we have to peel away the layers and make sure there is MORE buy-in from Americans.
It sickens me the amount of political arm-twisting and shady deals that were done to get this bill passed. On the bright side, this bill is less of a beast than the original proposal.
We can talk and argue all day long, but if nothing is being pushed forward, we’re wasting our time. If this bill didn’t pass to provide universal HC, I don’t think a bill will EVER pass.
I can guarantee you that from an absolute dollar amount I will be paying more for this bill out of my pocket than most, but it is what it is for the good of more. I KNOW where my tax dollars are going whereas so much other crap from the government, I have no clue.
.-= admin´s last blog ..Sometimes Saving Money Is About Principle =-.
Sam, you’ve inspired a great discussion without spitting and name calling. I wish all Americans could discuss this issue civilly.
I do like this bill; not because it’s perfect (we all agree it is not) but because we’re finally starting to address the health care problem in our country. President Roosevelt (the first one) tried to do something about health care in 1912. Just think where we’d be if he had been successful.
President after president has tried to get something passed and failed. So despite what Brad thinks, President Obama has quite an achievement under his belt with this passage.
Oh, and on a personal level this bill lets my son in paramedic school get back on his parent’s health plan after aging out last year. So instead of being uninsured (and me praying that nothing happens to him) he will be covered as of September.
.-= Bucksome´s last blog ..Can Baby Boomer’s Afford to Retire? =-.
Hi Bucksome, very good to hear this bill will benefit you and your son! Always good to hear about positive anecdotes and how it affects real people. Thanks for sharing!
Here is a cool infographic that lays out the timeline for all of the new changes brought about by the health care reform bill year by year: https://www.healthinsuranceproviders.com/health-care-reform/
Jeremy – The bill certainly was shoved down the throats of many people. Now that it has, the real battle begins from all sides as to figure out more about the bill, and decide regarding the constitutionality of the bill. The fight has just begun, since now the GOP and others know what they are fighting against!
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
All I can say is that extending coverage to over 32 million uninsured people is an astounding figure and it’s been interesting to watch all the coverage on the news. The ‘Cadillac Tax’ is also an interesting feature of the bill.
.-= The Rat´s last blog ..Borrowing Against Your Home =-.
Argh! I’m having a very buggy internet day and can’t get my reply to go in the thread where I want it . . .but –yes, Sam, France has an excellent health care system that we benefit from directly as my husband has been in hospital/rehab after a car accident for nearing 4 months now. Had this happened in the States we’d be in a world of hurt–we always had insurance that was connected to our jobs . . . Since I watched a family member in the US lose his job during his battle with cancer, I know you can lose your job and your health insurance due to a medical condition your employer doesn’t want to deal with (yes, you can claim that it’s illegal and try to prove that. . .good luck doing that though, especially when you have a serious medical problem.)
I think that a few protections that we need back in the States would be–not having your insurance be dependent upon whether or not you are employed, not discriminating against folks with pre-existing conditions AND not dropping people for supposed pre-existing conditinos when health care gets to expensive (as was the problem in the State of California when we left).
That said, I’m very concerned about how this whole thing will work out in the States because of the wild costs of health care there. We have a system where doctors come out of university with ridiculous student loans and where doctor’s visits without insurance are just not affordable. In France, if you are a foreigner with no social security and no insurance, you will be able to see a doctor for 25 euros out of pocket, cash. That’s the cost before the government reimburses you–so, health care is just cheaper here. Also malpractice exists, but the lawsuits are way less popular and lucrative than they are in the States. Not that malpractice doesn’t happen here, just that people sue less (I don’t know how I feel about that actually).
Lately I don’t trust the markets or the government to do the right thing. I’d say that people need to be active in the whole debate–but then, have you ever worked on a project where a complex plan needed to be created by a group decision when no one trusts the leadership and wants to compromise. Ugh! What an awful process followed my a pretty flawed result.. .
So I’m worried, yet strangely hopeful.
.-= Simple in France´s last blog ..Fighting clutter: can it be painless? =-.
Wow, only 25 euros out of pocket for a foreigner with NOTHING gets treatment? That’s amazing!
It really is hard to trust the government… and if you peruse through the category “Big Government Love”, you’ll find a lot of topics that have a skeptical bent.
I guess the US can learn a lot from foreigners and their systems. Glad your husband is being taken care of!
Best, Sam
.-= admin´s last blog ..The Elegance Of Failure =-.
‘Please highlight some of the NEGATIVES of the health care reform bill so we can get more into detail and provide a balanced argument.’
Because you asked so nicely, FS, I’ll see what I can do. On the Right, there’s much highlighting of the lose of choice and the penalties attached if you fail to get health insurance. (A complete list of complaints, complete with references to the particular section of the bill, is on the Investors Business Daily site:
Of course, the Left isn’t too happy with the bill, either. The major complaint is the lack of a single-payer option (government controlled and run health care plan; sometimes called ‘Medicare for all’), although there’s also complaints about the lack of limits on what healthcare companies can charge and that the government will pay to help subsidize privately provided insurance policies. (There’s also some complaints about the abortion provisions in the bill, which are considered highly pro-life.)
My take? It’s not perfect, by any stretch of the imagination (although, as my previous comments have perhaps shown, what’s perfect by one group’s standard might be outrageous by another group’s), but it does seem like a step forward, and hopefully it will help those who currently lack in insurance.
.-= Roger´s last blog ..What Classic Sci Fi Can Teach Us About The Future =-.
Thnx for the info Rog. It’s not perfect at all…. it’s been rammed down millions of Americans throats. Now it’s time for those who object, to voice their reasons loudly and clearly so that by the time there is implementation, the bill will be MORE refined to satisfy more people.
.-= admin´s last blog ..The Elegance Of Failure =-.
HAven’t seen John Q, but I’ll check it out Forest. I agree with your point here: “If you don’t have a job you don’t pay any health tax and it’s unlikely you will ever live in poverty because of not being able to pay medical bills…. ”
I agree 10000%.
.-= admin´s last blog ..The Mental To Physical Connection For A Healthier Lifestyle =-.
@Len Penzo
Len writes: “Or Founding Fathers are turning over in their graves right now.”
Are you referring to the same Founding Fathers who wrote as follows, or to a different set?
“This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding.”
While I like the idea of improving health care, I don’t know if we are going to pay for this bill. The first (and most glaring example in my opinion) is the tax on tanning beds. Why tanning beds? Is skin cancer really such a drain on our health care system that we should tax tanning beds? What about other things that encourage activites that could result in skin cancer (can we say tax on beach equipment, pools)? I would be more satisfied with a tax on unhealthy food or fast food chains or clothing for large individuals.
Personally, it irritates me when taxes are levied against an industry in such a manner. The second is more from a personal situation. The reduction in benefits for the flexible spending account is something I strongly disagree with. While imposing a limit of $2,500 isn’t that big of a deal, the removal of allowing over the counter meds to count is very problematic. This does nothing but increases the cost of health care. I’ll be hard pressed to set aside enough to cover typical health care expenses in this account for fear of losing it if something changes during the year.
For example, what if my wife no longer needs her maintenance medication half way through the year (border-line thyroid problem) or instead only needs to have blood work once a year instead of the typical twice a year? We’ll be left looking for ways make up that difference instead of having the safety net of increasing our supply of cold medicine and advil. Those are just my two cents of what is wrong with the bill. Overall, I’m still deciding if I’m for or against it.
I’ve just returned from the UK where people to a man complained about their poor health care system. The two in our crowd from the Netherlands complained about their 52% tax rate. The people who can afford it get private insurance and the better doctors.
Socialism is a slippery slope. Europe is rotting from the inside out and it’s now spread to America.
It’s easy to say ‘I care’ and everyone should get healthcare, particularly when you’re taking money from one person to give it to another. But where does it end?
I’m pretty disappointed w/ your lack of financial reality, and therefore will be deleting your website from my favorites.
Best of Luck.
The money I’m taking from one person is my own. Thanks Jim for hanging around so far!
Talk about lack of reality. Sure, people like to complain, and I’ve heard that complaining about health care in Britain referred to a ‘national sport’, or something like that, but when push comes to shove, Brits are distinctly happier with their system then Americans are with ours. Or should I say, ever so gratefully, with our *former*, ending system.
Sure, 52% of Brits are ‘somewhat or very dissatisfied’ with the healthcare system according to one poll. But in the US, 72% are! Trying do eliminate the NHS in Britain is the third rail of politics, like Medicare or SS here. No one dares touch it. Trying to make it sounds like they all want to get rid of it… or like they would prefer the American system where your care depends on your income level and employment… *thats* lack of reality.
I was surprised to read Jim’s comment. During the heated debates last summer, I happened to be in Washington. In order to learn more about the cost to the reform, I managed to find time to watch every debate that President Obama was to give. No president up to now has cared enough about our country’s financial debt and many uninsured people’s hopeless situation, and said that he didn’t care if he was re-elected for a second term or not, or something to that effect.
I personally have spent many years doing research on finding out an easy way to stay healthy. (I had a Biology background and always like to find out the “why” and “how” to questions and problems.) I have come to a conclusion that I would rather stay healthy and give the insurance money that I paid for others to use.
During my research, I also found many medical professionals, including people in the pharmaceutical field, were not honest… It was part of the reasons why our Government has to waste so much money… I would be able to name a few if I could speak to you in person.
Lovingkind,
“No president up to now has cared enough about our country’s financial debt and many uninsured people’s hopeless situation, and said that he didn’t care if he was re-elected for a second term or not, or something to that effect. ”
Is this a serious comment? Obama has INCREASED the national debt more than any president EVER. People think Bush was bad with 500bill per year. So far Obama has done 1.5 Trillion, in 14 months. How has he cared about the debt? To think Obama cares about you personally or the general public (or any politician for that matter) is delusional. Obama obviously has not listened to the general public (based upon polls that were obviously against this) otherwise this bill will not have gone through.
“During my research, I also found many medical professionals, including people in the pharmaceutical field, were not honest… It was part of the reasons why our Government has to waste so much money…”
I think many medical professionals would take issue with this statement. So you trust the government and politicians more? Based upon the way this bill was shoved through congress? The government is the problem not the solution. Government wastes money because they are inefficient. They have no incentive to do better. Always have been, always will be..
.-= Investor Junkie´s last blog ..Will The Wealthy Donate Less Because Of Health Care? =-.
IJ, I can’t speak for Loving Kind, but does it make no difference to you that we were fighting off a huge recession and are still fighting substantial after-effects? Government policies are supposed to be counter-cyclical… if you took money out of the economy in a financial downturn, you’d just be making it worse.
I too believe that President Obama cares about reducing the deficit, but is also smart enough to understand that the middle of high unemployment and just after a major recessions, it is counterproductive to make it your first priority. The top priority has to be getting the economy back on solid footing.
And if he doesn’t, I’m not sure where to turn… to the Republicans that blocked a fiscal commission to study to reducing the deficit? To the Republicans that voted against installing pay-as-you-go rules in the house and senate, and never do so when they’re in the majority. To the Republicans who haven’t had a president run a balanced budget in 35+ years?
Hi Fredct,
Yes I understand we are in a huge recession. At least you didn’t state it’s Bushes
fault as most state. :-) Believe me I was no fan.
You are confusing fed policy with govt policy. At least with the govt policy a
counter augment (Austrian Econ) that govt spending does nothing to help
stimulate the econ and only prolongs the recession. It can be said the govt is
causing uncertainty with their policies and sucking money out of the econ that
can be used productively by business and individuals.
Ok let’s use the CBO estimates of debt, since everyone loves to use them for the
HC debate that health care will be neutral (I also have a bridge in NYC to sell)
The CBO now estimates in 2020 the debt will rise to 90% of GDP.
Honestly this isn’t a R or D issue and really don’t like either party. What we
need is a much smaller government, and less taxes to grow. Not more of each.
History has shown neither works well (not just here).
News for you in reality neither party has balanced the budget. Even for Clinton it was mainly smoke and mirrors.
Time will tell, and I hope I’m wrong. My prediction Obama will make the
deficit worse than any other president and will make Bush look like he was
fiscally conservative (which he obviously wasn’t).
.-= Investor Junkie´s last blog ..Will The Wealthy Donate Less Because Of Health Care? =-.
Oh, one more thing…
“Obama obviously has not listened to the general public (based upon polls that were obviously against this) otherwise this bill will not have gone through.”
First, I find it funny that… if anyone remembers… President Bush was always very proud of the fact that he did not ‘govern by opinion polls’. He was proud of it, he made it a thing, and the people who supported him supported that. And now much of the same people are saying its an outrage and utterly undemocratic not to govern by opinion polls? Come on, that’s just too much.
Second, the polling on health care has been massively influenced by wording, which allows either side to pick-and-choose polls to prove their point. For instance, on the public opition, if the question was asked “do you support establishing a federal-run insurance plan, controlled by government bureaucrats”, the popularity was distinctly negative. But if the question was asked “do you support establishing a public insurance plan, like medicare, that people could elect to purchase insurance from if they wanted”, the popularity was pretty high.
It bugs the heck out of me, that something like 20-30% of people changed their opinion based on that kind of wording… when its really asking the same thing! But, they did.
The same went for the plan as a whole. If the question included words like ‘government run’ (or the very inflaming ‘government takeover’), the opinion was negative. But if the question focused on ‘deficit reducing’ or ‘expanding coverage’ the opinion was positive.
The most neutral questions – those that simply asked something like ‘do you support or oppose the plan currently before congress’, in recent days, generally found a slightly negative opinion, but not drastically, something like 40-45. But those that dug deeper did find that something like 10% of the opposition was from the left… people who opposed it because it didn’t include a public option, or single payer, or (boogabooga) socialized medicine.
Long story short, to imply that there’s overwhelming opposition to this bill – as many have done – is untrue, and its pretty likely that the people who oppose it from the left still support it as an improvement over the status quo.
IJ,
Are you saying there is something other than Keynesian Economics…BLASPHAMY
.-= Evan´s last blog ..Explanation of Health Care Bill in Time Line Form =-.
In the end we are all dead right? :-)
Keynes vs. Hayek rap video
https://cafehayek.com/2010/01/keynes-vs-hayek-rap-video.html
.-= Investor Junkie´s last blog ..Will The Wealthy Donate Less Because Of Health Care? =-.
Sam,
I see a few big problems with the HRC passage, although perhaps ramming it down this way will force some changes to surface:
1. I had read that this legislation eliminates the option for catastrophic insurance, meaning people are forced to buy a policy and pay a high premium even though the young and healthy should only need a catastrophic policy.
2. Already insurers are raising premiums and companies will need to lay off people if they are going to grow and get up to an employee count of over 50 people.
3. What about Americans living and working overseas? It makes no sense that they would need to purchase a US based insurance but currently there is no provision for these individuals, who total up to over 1 million.
4. Why should illegals not be subject to the IRS penalty and why do they need to be treated at general taxpayer expense?
5. How come this legislation maintains that drugs and medical devices cannot be re-imported back to the USA? Did you realize that US citizens pay several times more than non-US countries for drugs and medical devices?
Still a lot more work to do here and this ramrod passage makes me a hater of Obama and his policies. I expect him to try this approach with more bad bills like cap and trade. Obama is much smarter but Bush will have done less harm for the USA. Of course time will tell, but this is my strong prediction.
I agree that having insurance companies dropping people is not the right thing to do. But there are many other ways to solve this, such as creating a catastrophic insurance pool that is run by a non-profit agency. Sometimes keeping it simple does the best job.
-Mike
Hi Mike – All salient points and unfortunately, nothing is simple in politics because everyone has an agenda. What I’m counting on are for people like you and the GOP to now fight like mad to highlight these issues and come to more compromise.
This is only the beginning. I have to believe more compromises will be made.
Best, Sam
Good points and questions, Mike, let me reply.
1) Basically, yes. There’s a bit of a rock & a hard place problem there. You are right that catastrophic coverage can make sense for some, but I disagree that those are ‘the young and healthy’. Rather, it’s the ‘young, healthy, and wealthy’ (meaning, wealthy enough to be able to pay several grand (or several tens of grands) out of pocket in the case of that catastrophe).
Otherwise, what would happen is you’d have a lot of poor people purchasing only catastrophic coverage to save money, despite the fact that there’s no way they can cover the cost if they do get ill. Those people would have no preventive coverage, and would still continue to wait until major illnesses strike and go to the ER, rather than seeking the preventive check-ups that can hopefully keep them health in the first place.
Do remember that the ‘mandate’ is only a tax penalty. So if you decide its more worthwhile for you to pay the penalty and save more by carrying only catastrophic coverage, no one will stop you from doing so (but yes, it does change the equation).
So while it would be nice to open up the possibility for those that it makes sense for, you can’t really do so without opening up the option for exactly for whom it’s exactly the wrong thing, yet still very tempting.
As far as your ‘simplier way’ to fix the problem via catastrophic insurance, it really depends what you define ‘the problem’ to be, I guess. If you think the problem is people having no coverage at all, then catastrophic coverage is a solution. If you define the problem as people not seeking care until they get very sick, and then being unable to pay multiple-thousands of dollars of bills that go unpaid and hard hospitals, then catastrophic coverage wouldn’t fix the problem. Saying that giving catastrophic coverage is providing health care, is a little like saying that giving every kid an encyclopedia is providing them an education.
2) Insurers have been raising premiums drastically for years. Is there something to say it has to do with this just-passed bill, or is it just a continuation of what’s already been occurring?
The penalty for employers over 50 people is not *that* large. Its 50 minus a 30 person deductible times $2000 = $40,000. If you have a company that needs to grow, it seems rather foolhardy to refuse to do so to save the equivalent of one person’s salary or less. I don’t deny it it will have effects, but it won’t be the end of the economy like some people want to play it up as.
3) Good point about overseas. I would hope the IRS finds some rationale to make an exception in that case. Or they can conclude that the foreign coverage (or foreign government’s coverage) is sufficient. If not, it seems like a minor rule change would be due.
4) Are illegal’s officially exempt? Whether yes or no, you’d be trying to squeeze blood from a stone because illegals don’t file tax returns. They *may* pay taxes through withholdings, but there would be no way to collect a tax penalty with no return filed.
Besides, if you were to require them to purchase it (utterly enforceable), then you’d have to provide them subsidies to purchase it, and people would kick and scream and benefits to illegals (they already do kick and scream even though there’s no a dime paid out in this bill).
5) Alas this bill doesn’t fix every problem or issue. The counterargument though (usually the conservative argument) is that it would destroy the revenue of companies who develop these things in the first place, and there wouldn’t be the R&D money to develop the next big thing.
One more comment- right now Medicare billing costs are lower than other programs. Basically Medicare is subsidized by the uninsured and people with weak plans. Therefore for HRC to work everyone will have to pay much more. No such thing as a free lunch, as we will all soon find out.
-Mike
this is bad news for American, for Business. See link.
I’m not satisfied – and I won’t be until we take care of everybody – and I mean EVERYBODY! We are the wealthiest people in the world, and it’s a disgrace that over 5 billion people in the world go without adequate health care – not to mention clean drinking water and enough food to satisfy their daily hunger. None among us is superior over any of our fellow human beings – so we should not act it. We need to give up our investments, our savings, our 401(k), our Roth IRA, our huge house, our big cars and trucks, our vacations, condo on the beach, cottage on the lake, weekend get-a-way, and anything else that gives us any kind of pleasure – how dare we live like this while our own kind suffer?
The OP gave an example of having a $100,000 income and this bill costing him an additional $2,000. I would suggest that if he indeed DOES have a $100,000 income, more than 90% of it should go toward feeding, watering, and caring for the rest of the world. Why stop at our borders? What gives us the right to live this way?
ALL men (and women) should be equal!
Hi DB, just to clarify, you want me to get taxed 90% of my income so that I giveaway $90,000 and live off $10,000? Then, I will be the problem person in society and require everybody else out to bail me out.
Hey Sam,
The Beatles had a song about that, when they were getting taxed 95%. Next thing you know, John and Paul left England and moved to the U.S. There is only so much you can tax people before it kills the incentive to work and create new jobs. In my opinion, a tax rate above 35%, even for the wealthiest Americans, is way too much.
The Government needs to go on a diet and stop wasting all of our tax money. Then, we could have less debt and better services, for the same amount of taxes. In case anyone hasn’t figured this out, most of our tax money is going to wealthy entities like Haliburton, ADM and Goldman Sachs, instead of providing services to our citizens. The problem isn’t that our taxes are too low. The problem is that our Government is corrupt and inneficient.
Bret
Bret, I like it! Going on a spending diet and stop wasting our money is definitely a good idea. Thanks for sharing! You may be interested in an upcoming post on charity and taxes. Cheers, Sam
Rob Bennett “I oppose the bill that passed.”
Have you read it, Rob?
No?
I thought not. As usual, the important thing for you is that you speak a lot and get seen, not that you understand, learn, or communicate.
Have you read it, Rob?
Every last comma and footnote.
Truth be told, there were a few commas that I thought were extremely>/i> well placed.
Rob
.-= Rob Bennett´s last blog ..Google Knol #2 — The Bull Market Caused the Economic Crisis =-.
We do have a moral obligation to provide emergency-room-type healthcare services to folks with no way of paying for it. I’m not so sure we have the obligation to provide the same level of drug coverage, physical therapy, mental-health services, aromatherapy, etc services. Where does that thinking stop?
High-deductible plans with HSAs were a step in the right direction for a number of reasons (price-shopping and competition, better knowledge of the true costs of healthcare) but are being killed by this plan. I have to wonder if the fact that they were working (i.e. lowering healthcare consumption) is exactly why they were killed…
.-= gn´s last blog ..Time Machine: Health Care in USA circa 2025 =-.
I don’t know all the ins and outs of the insurance plan but I am glad that we have coverage for everyone. If it leads to everyone having access then it seems like a good thing.
.-= Jerry´s last blog ..How To Instantly Improve Your Selling Ability =-.
Universal coverage just makes more sense, both socially and economically. Those countries with the widest government health coverage actually have the LOWEST cost. Whereas in counties like the US it costs far more to provide the same services. No health system can ever be perfect, nor is it possible for government to treat every sick person as far as humanly possible. The cost would be too great. But government can and society should protect the weakest and poorest. What does it say about a country that can spend trillions fighting wars, but won’t give cancer drugs to its poorest?
It’s says we are fooked up, for sure.
I never understood why everyone couldn’t pay a set amount and get into the federal government’s program. Health care costs are so high that even a millionaire can be bankrupted by having no coverage. I don’t get how other countries can make healthcare work and we have not been able to.
Well, what we learned from our Canadian friends is that they tax at a 40%+ rate with income over 100k equivalent!
If only America could get every worker to pay some taxes, not half the worker population, I think we can make unihealth a reality!
We definitely don’t need a 40% tax rate. Agreed…if every working American paid something in taxes that would go a long way to creating a uniform healthcare system.
I can’t say I know enough about all the details of health care reform.
However, I would love if everyone could be insured in an affordable manner. I have always had nothing but empathy for those who went bankrupt for medical reasons, that must be the absolute worst. There is a real problem in this country if you end homeless because of a neck injury.
I guess my problem is I am just turning into a cynic of sorts. People get out of paying taxes, which shortchanges everyone. People cheat to get out of paying their mortgage even though they can afford it. Apparently there is nothing illegal about what people are doing or jails would be filled up by now. But there are plenty of loopholes, and people are obviously finding them… So, I wouldn’t be surprised if it took a lot more than 2 percent in taxes to cover health insurance.
Robert Heinlein wrote about this 50 years ago in his science fiction novels. He proposed that no democracy could ever survive, because the poor people would always vote for “Bread and Circuses” if given the opportunity, which eventually bankrupts the state.
TANSTAAFL (look it up)
Is this the mid season recap? :) This is great for me because I only started following Financial Samurai in the last month or so.
I agree with you 100% on this. I would pay more tax if it goes toward health care.
My parents are retired in Thailand and they can go see a doctor and pay about $1.50 each visit. If they were rich, they can go to a private hospital and pay as much as they want to get excellent health care. Many foreigners go to Thailand to get excellent health care and pay a lot less than at home.
The negative I see is the upward spiral cost of health care in the US. Cost of health care seems uncontrollable and probably will bankrupt any single payer program. There need to be a cost-reward analysis and we should instate a “death panel.” Tax payer should get good return for their money. If you need $1 million to extend your life for one month – forget it. You can pay for it yourself if you have the money.
Parents in Thailand huh? Nice. I try and bring up posts that are relevant in the moment. With election season upon us, now is opportune.
Affording is pretty easy. Here’s a very simplistic argument. As far as I remember, insurance companies have a combined ratio (the money they swipe) of about 10% (maybe that number is different for health). There are 300+ million Americans. Eliminate the insurance companies and replace them with a single payer system. That should release treatment money for 30 million extra people.
A big reason for the mess is that they’re/we’re trying to change the current system into something it’s not. If you’re going to have roughly the same treatment options for everybody, does it make any sense to have a middle man?
Only for the middle man … so there’s a lot of lobbying.
From a stand point of the US paying twice as much as the next nation for a similar level of health, the entire system is broken beyond repair. There’s no fix. Scratch it and start over.
Health insurance lobby group is way too powerful to change. Govt needs to just charge all of us more and that’s that. It’s the right thing to do since health discriminates against no one unlike the govt!
I’ve been going through David Cutler’s slides on the bill. Re: wait time, wait times are considered too high under the current system and the government is hoping to reduce, not increase, that. I know I have to wait forever to see a doctor with my private insurance, and that’s costly and leads to increased emergency room usage, which is inefficient.
It is a complicated bill because it is a complicated problem. It would be much less complicated if we could scrap everything and go straight to a national single payer system, but that’s just not possible in today’s political climate. Clinton tried and failed. Nixon tried and failed…
Here’s the Kaiser Family Fund’s little fact-sheet. (Possibly less biased than the government’s version): https://www.kff.org/healthreform/upload/8061.pdf
Thx. Will have a look. I mentally prepare a min 30 min wait everytime. Any shorter and it’s an upside surprise !
The thing I think most people forget is that every insured individual is already paying for the uninsured. The uninsured receive medical care everyday at every hospital and clinic in the country. And usually they are getting help for something major since they never went to the doctor before. Furthermore, even the uninsured who self-insure end up bankrupting themselves trying to pay, and the hospital or doctor still doesn’t get paid.
The cost of this care is simply added to the bills of every paying customer. What many people don’t understand is that by requiring every person to be insured, you open up this huge new market to insurance companies, which they can make pay. This would lower the rates for most people (maybe not the ones who see the doctor for every minor issue) because now most people are in the system.
I think most people agree health care is already ridiculously expensive. Given the case, what’s another several hundred to a thousand bucks more a year to prevent catastrophies for others? Nothing, esp if we can convince the 47% of American workers who don’t pay any taxes to contribute.
Btw, can’t comment on ur blog bc I need to log in
I agree with some aspects of the bill, but let’s be clear here: This is not a health CARE reform bill, it is a health INSURANCE reform bill.
Very little in this bill addresses actual health care costs. It is assumed that if everyone has insurance, then costs will go down because there is coverage for services. They never drove down to the root of the problem. Why does a tablet of aspirin cost $20?
I think the root of this problem is insurance itself, it masks true cost and eliminates competition. As soon as cost oversight is removed from the equation, costs rise. The only time I’ve (and I’m guessing 99% of insured Americans) ever looked up the cost of a health care service is when I have to pay out of pocket or through a health savings account. One way to combat this and still have insurance is to open state boundaries. That creates nationwide insurance competition. That could have been a huge win for both sides, because competition drives down insurance costs, which will eventually drive back down service costs.
The drastic increase in medical tourism is a prime example of this. Now insurance companies are promoting it, because they pay less and make more money off of your premiums! Medical tourism is cheap not because of low cost of living locations like in India, it’s because you are paying the true cost of the services. Most of the doctors you see overseas are trained in American schools and use state of the art equipment. They don’t jack up their fees because it’s competitive!
Again, I agree with insuring everyone (although I don’t agree with mandating coverage, if you don’t want it and you get sick and die because of it, your problem), and I especially agree with insuring kids. Unfortunately, they stopped half way. The next bill needs to address costs and competition.
Tom, thanks for your insights and vey well said on ALL points!
I do not subscribe to the idea that healthCARE is a RIGHT. Especially the way I see so many folks “caring” for their health. As you pointed out in the original article, genetics eventually takes over. Why do we prolong the inevitable? Death is truly the only guarantee after birth. Actually caring for one’s personal health is the best we can do.
We already have Medicare and Medicaid that are abused beyond belief. Now we want to add more? Whether it’s insurance or MediCare/MedicAid, payments are usually only ~80% at absolute best. Health provider overhead is tremendous. I am so very against these enabling programs at the state and Federal levels. The greater population is only willing to do the minimum amount needed to get by. e.g. I knew a couple of folks who worked harder to work the system than to actually work. I have since met many more like them in my travels.
Our overall system is not meant to support parasites. Our system works with symbiosis, as well it should. Any relationship that moves unilaterally tends to break down over time. I think we are seeing the results of that break down in the enabling programs. Helping is NOT doing for.
I also have the same opinion that not everyone MUST get health insurance. I believe you should have the choice. This leads to more freedom and I think it just makes sense.
@Investor Junkie
Since you are provably factually wrong on almost every point you make, how do you expect to come to the right conclusion?
Sorry, most people who will have insurance, employer-covered or from the exchanges, will have “skin in the game”. Most people will NOT get a 100% subsidy, NO plans in ACA have zero deductible, most plans, ACA or otherwise, have co-pays, etc. Perhaps you want people to have NO insurance, which means that when someone gets a $50,000 bill they have no hope of paying, then the taxpayers and people WITH insurance end up having all THEIR “skin in the game.”
Sorry, Medical Loss Ratio is already saving premium payers money by limiting insurance company profits, and ACA’s wider risk pooling, price transparency, wider competition, standardized plan levels, requirement that “health-so-far” people get coverage and (hopefully) more use of preventative care and better healthcare outcomes should ALL reduce actuarial cost, as they are specifically designed to do.
Sorry, you can’t get insurance “on the way to the hospital”. Google “ACA open enrollment window”. It works the same way as employer-covered plans have for a long time. If you get bit by a snake on a hike in 2014, and spend a week in the hospital, that $50,000 bill comes to YOU and YOU alone, NOT to the insurance company you sign up for the NEXT YEAR, in 2015, during the next open enrollment. And having insurance sure is better than trying to negotiate a lower cost of care, by yourself, from your gurney, “on the way to the hospital”. And certainly better than trying to negotiate after the bill comes.
Sorry, the current economic recovery is slow because we had the worst crash since the great depression, and because the SINGLE sector that has NEGATIVE growth right now is the GOVERNMENT sector–the rest of the sectors are doing okay, and the economy would be doing better if we weren’t cutting government with the sequestor. The other reason for the slow recovery is the richest few percent are HOARDING cash rather than investing, because demand isn’t there. Demand isn’t there because the rich have been favored and coddled for a decade, so that the middle class is almost gone, and there is just NO WAY the richest 1% spends into the economy at a rate of 99 times the other 99% of people. This inequality is getting worse, and it’s already as bad as it was right before the Great Depression, which lasted more than ten years and ONLY ENDED DUE TO MASSIVE GOVERNMENT SPENDING ON A WAR.
America spends more money than any other country on health care and we have LOUSY health outcomes. Both public and private health care spending are bloated. Our health care system, whether you’re talking private or public, is so bloated that WE SHOULD NOT HAVE TO SPEND ANOTHER DIME IN TAXES to make it better.
Certainly genetics plays a role in health, but even scientists will tell you that 70% of our health care costs are driven by unhealthy lifestyle choices. 70%. That’s HUGE. Our publicly funded health care has done nothing to address these issues for the last 50 years….so I don’t see why Obamacare will be any different.
Just my opinion, I think Obamacare is more about centralizing power and control. You’ve said it in your other posts about Big Government….Government is greedy (for your tax dollars as well as power). It will try to gain more power over our lives by any means necessary. And yes, I get it, same thing goes for big business….the two have become so intertwined they’ve practically become a single entity (which was the goal all along, I think).
I think you will like my latest post entitled, “Subsidy Amounts By Income For Obamacare“. Even millionaires can get subsidies now b/c the subsidy amount is based on wealth and not income! Equality for all!