PDA

View Full Version : Is the GOP health care plan a case of political suicide?



Norman Bernstein
05-24-2017, 11:40 AM
I find it impossible to believe that Republican lawmakers could see ANY silver lining in what they're trying to do.


While lawmakers on Capitol Hill wait for the CBO score for the revised GOP health care bill that recently passed the House, we know one thing: The new analysis will still find (https://politicalwire.com/2017/05/24/one-thing-wont-change-new-cbo-score/) that at least 14 million people will lose their Medicaid coverage.To compound matters, the Trump administration’s new budget proposes cutting an additional hundreds of billions from Medicaid.

What makes this especially interesting is that Republican voters — and especially those who support President Trump — aren’t clamoring for these cuts. In fact, Trump went to great lengths during the Republican primaries to promise to protect Medicaid from cuts.

The polling shows Trump’s instincts were correct.

A recent Quinnipiac poll (https://poll.qu.edu/national/release-detail?ReleaseID=2443) found that 54% of Republicans oppose cutting Medicaid.

A Kaiser Family Foundation tracking poll (http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-future-directions-for-the-aca-and-medicaid/) shows that 42% of Trump voters — and 51% of people who approve of Trump — say Medicaid “is somewhat or very important to them and their families.” Just 24% of Trump voters and 20% of people who approve of Trump want to decrease spending on Medicaid, while majorities of both want to keep it the same and many more want to increase it.

Greg Sargent (https://www.washingtonpost.com/blogs/plum-line/wp/2017/05/24/the-enormity-of-trumps-scam-is-coming-into-view/?utm_term=.c92599244cee) calls it a massive scam:



There are numerous Trump lies being forced out into the open right now. Trump claimed he would not touch Medicaid and simultaneously that he’d repeal Obamacare and replace it with something better for all. It was a lie for Trump to claim he wouldn’t touch Medicaid; it was a lie to suggest preserving Medicaid and repealing Obamacare were compatible; it was a lie to claim that his repeal-and-replace plan would result in better coverage for everybody. If anything, the White House’s justifications only throw the scale and audacity of these intertwined scams, lies and betrayals into even sharper relief.



It’s not entirely clear what motivated Trump’s change in position, but the polling suggests it’s a clear case of political suicide for Trump and the Republican party.

Chris Coose
05-24-2017, 11:50 AM
I have a conspiracy theory based on breaking news in Maine and the submission of the SCROTUS medicaid plans.

Mary Meyhew, the craziest governor's in united states history, DHHS commissioner has resigned today and her last day in Friday. I'll bet she is headed directly to DC to represent the hatchet work to be launched by the Baggers and the WH. She hates the poor.

John of Phoenix
05-24-2017, 11:50 AM
Suicide? Hardly.

They've screwed so many people for so long and gotten away with it that they now believe they can kill people outright with no consequences.

And it's true - they not only can, they WILL.

elf
05-24-2017, 11:55 AM
You don't understand. The policy is not coming from Trump and should not be attributed to him. He's a pawn in the game the Regressives are playing to get their dream programs voted in and signed off on and then impeach him so Pence can take over.

The silver lining for the people who are actually behind these proposals is support in the millions of dollars by the industries which will profit from privatization of everything, and reelection by the dopes who, for whatever rationalization, vote for them.

Chris Smith porter maine
05-24-2017, 03:54 PM
I have a conspiracy theory based on breaking news in Maine and the submission of the SCROTUS medicaid plans.

Mary Meyhew, the craziest governor's in united states history, DHHS commissioner has resigned today and her last day in Friday. I'll bet she is headed directly to DC to represent the hatchet work to be launched by the Baggers and the WH. She hates the poor.

I figured it was that or she is getting into the next race for governor.

TomF
05-24-2017, 04:02 PM
CBO scoring out for the "new" plan passed by the House (http://money.cnn.com/2017/05/24/news/economy/obamacare-repeal-cbo/index.html). It will only throw 23M Americans off health insurance by 2026, rather than the 24M of the original proposal.

Chris Smith porter maine
05-24-2017, 04:09 PM
It's worse than just that without the Medicaid reimbursement lots of small rural hospitals will have to close or cut way back it will affect even those rural people with insurance.

elf
05-24-2017, 04:43 PM
The amazing part is that the hospitals don't seem to have purchased enough influence, despite the billions they've spent, to bring a halt to this crap.

Nicholas Scheuer
05-24-2017, 04:58 PM
As long as voters are stupid enough to believe Republican lies, the Repugs can get away with murder. Trump isn't a LSOS for no reason.

Arizona Bay
05-24-2017, 07:15 PM
If we're lucky they are... This from the CBO


The CBO reported, “CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law. Under the legislation, a few million of those people would use tax credits to purchase policies that would not cover major medical risks.”

I'll likely be one of them.

Arizona Bay
05-24-2017, 07:27 PM
An ~800% increase for my group...



https://pbs.twimg.com/media/DAnqZkDXsAEWRX6.jpg

Keith Wilson
05-24-2017, 07:55 PM
And overall. In what conceivable ethical system could this possibly be OK??

https://assets.bwbx.io/images/users/iqjWHBFdfxIU/iwbOah_MQbdw/v3/800x-1.png

David G
05-24-2017, 07:56 PM
From your lips, bobele...

oznabrag
05-24-2017, 07:58 PM
Well, it would be nice . . .

The honorable thing to do . . .

Gerarddm
05-24-2017, 09:46 PM
We have a subcontractor at my office who voted for our current president after voting for Obama, mainly because he hated Hillary, but also because he swallowed the campaign swill as if it were manna. " Gotta shake things up", etc.

So it was interesting to overhear a conversation he was having with one of my colleagues about how surprised he was when one of his pals, evidently a staunch rabid conservative, savaged the president to him the other day. If cracks like these can occur, may they grow to be gaping chasms.

Too Little Time
05-24-2017, 10:07 PM
A quick search shows a couple pay $110K in Medicare premiums over their lives. They get over $300K in benefits. On average a poor deal for the government.

Those who are inclined to do the math will realize that considering the time value of the premiums waiting for the benefits Medicare has been on average a poor deal for the couple.

The math on premiums to cover health care prior to retirement shows that on average health insurance is a bad deal.

Arizona Bay
05-24-2017, 10:12 PM
And overall. In what conceivable ethical system could this possibly be OK??

https://assets.bwbx.io/images/users/iqjWHBFdfxIU/iwbOah_MQbdw/v3/800x-1.png

And with a universal system it should be flat lined at Zero!

skuthorp
05-24-2017, 10:25 PM
No, it's just a continuation of GOP/Trump policy.

Too Little Time
05-24-2017, 10:28 PM
An ~800% increase for my group...



https://pbs.twimg.com/media/DAnqZkDXsAEWRX6.jpg
No one has said that the model policies these charts are based on are the most suitable for anyone. Perhaps a fiduciary duty should be required. A high deductible policy with an HSA is almost always the best choice.

Old people were getting a really good deal with the ACA. Young people were picking up over 80% of the cost.

I am wondering how many 21 year old individuals - not old enough to have a college degree, are earing $68K. I don't think many.

64 year old individuals are about to enter the richest economic age group. It is hard to have empathy for a group of rich people. People who were 55 just prior to the ACA and are now 64 should have expected insurance costs to increase up to the $13K just prior to ageing into Medicare.

While the Republican plans are worse than the ACA they don't appear to be any worse than what one would have expected and planned for in 2007. (I aged into Medicare just prior to the ACA - 2 or 3 years ago. My health insurance premiums were reasonable. But $10K deductible plans with an HSA were cheap.)

mdh
05-24-2017, 10:41 PM
Health care and health insurance are two different things. Obama said you just might need to take a pill.

leikec
05-24-2017, 11:16 PM
Health care and health insurance are two different things.

Ok. So what?

In today's world people need health care and health insurance, and people will have to be able to afford both of those things. Eventually people will have to get past the insults and decide how to come to a solution.

That's where the rubber meets the road, and I think that's when we will begin to have a serious discussion about some form of national health care. Otherwise we are tacitly admitting that certain lives have less value than others.

Jeff C

elf
05-24-2017, 11:41 PM
People need health care throughout their lives. The problem is that privately provided health insurance is the worst way to provide for paying for it.

Tax benefits are useless to those who pay no or little tax.

leikec
05-24-2017, 11:53 PM
People need health care throughout their lives. The problem is that privately provided health insurance is the worst way to provide for paying for it.

Tax benefits are useless to those who pay no or little tax.

And this problem won't be fixed by kicking people off health insurance, or by denying coverage. We are either going to cover and care for our citizens or we aren't. Beyond all of the rhetoric it is really a simple decision, and there's no free lunch.

Jeff C

mdh
05-25-2017, 12:15 AM
People need health care throughout their lives. The problem is that privately provided health insurance is the worst way to provide for paying for it.

Tax benefits are useless to those who pay no or little tax.

And right now, it's easier to sell phone insurance than health insurance. Many have decided that healthcare is a right they don't want to pay for. But they'll pay to keep their phone.

skuthorp
05-25-2017, 03:55 AM
So, death panels after all eh? The GOP and private health insurance companies…. based on income or lack of it….
Who'd a thunk it?

Keith Wilson
05-25-2017, 07:31 AM
And right now, it's easier to sell phone insurance than health insurance. Many have decided that healthcare is a right they don't want to pay for. But they'll pay to keep their phone.And what does this have to do with cutting Medicaid by half? What does this do with 25 million people losing their health insurance?

Chris Coose
05-25-2017, 07:37 AM
And what does this have to do with cutting Medicaid by half? What does this do with 25 million peole losing their heath insurance?

Nothing, of course. But I can see when a thought like that gets in a Bagger's brain, I can see it ricocheting around and somehow causes happiness.

TomF
05-25-2017, 07:56 AM
Nothing, of course. But I can see when a thought like that gets in a Bagger's brain, I can see it ricocheting around and somehow causes happiness.or CTE.

Ross M
05-25-2017, 08:29 AM
Nothing, of course. But I can see when a thought like that gets in a Bagger's brain, I can see it ricocheting around and somehow causes happiness.

Brilliantly said, sir

Keith Wilson
05-25-2017, 08:31 AM
Had to look that one up:


Chronic traumatic encephalopathy (CTE) is a progressive degenerative disease found in people who have had repeated blows to the head.

Corvida
05-25-2017, 10:10 AM
They want to make this guy happen for real:
https://pbs.twimg.com/profile_images/1795351580/BreakingBadFinale225.jpg

John of Phoenix
05-25-2017, 10:28 AM
They are literally out to KILL us.
And overall. In what conceivable ethical system could this possibly be OK??

https://assets.bwbx.io/images/users/iqjWHBFdfxIU/iwbOah_MQbdw/v3/800x-1.png

mdh
05-25-2017, 10:32 AM
And what does this have to do with cutting Medicaid by half? What does this do with 25 million people losing their health insurance?

It means that the 'poor' folks that qualify for medicaid often have satellite television, high speed internet, a smartphone that they've paid for insurance on, but they need you to pay for their pre-natal care.

The Trump plan is attempting to lower the costs to those who are now paying exorbitant premiums, only to have deductibles so high they effectively don't have insurance.

amish rob
05-25-2017, 10:32 AM
Had to look that one up:
The best part is, they can only tell you had it after you go crazy and kill yourself. And hopefully not anybody else, first.

Really. No matter how many tests they give, or scans they do, you can only watch when you become symptomatic.

It's horrible and more terrifying than almost anything.

Peace,
Robert

Arizona Bay
05-25-2017, 10:39 AM
It means that the 'poor' folks that qualify for medicaid often have satellite television, high speed internet, a smartphone that they've paid for insurance on, but they need you to pay for their pre-natal care.

The Trump plan is attempting to lower the costs to those who are now paying exorbitant premiums, only to have deductibles so high they effectively don't have insurance.



https://www.youtube.com/watch?v=Hq98mY-j20w

Keith Wilson
05-25-2017, 10:45 AM
It means that the 'poor' folks that qualify for medicaid often have satellite television, high speed internet, a smartphone that they've paid for insurance on, but they need you to pay for their pre-natal care.

The Trump plan is attempting to lower the costs to those who are now paying exorbitant premiums, only to have deductibles so high they effectively don't have insurance.The 'welfare cadillac' lives! http://www.reduser.net/forum/images/smilies/rolleyes.gif

The Trump plan gives the wealthiest 2% a $250,000,000,000 tax cut, and cuts Medicaid by half. 25 million people will lose health insurance, in order to give the wealthy a huge tax cut. The net effect is an enormous transfer of resources from health care for the poor to the rich. In what conceivable ethical system could this possibly be OK, other than "I've got mine, bud; screw you"?

Republicans whine and Republicans b!tch
The rich are too poor and the poor are too rich.

Norman Bernstein
05-25-2017, 10:47 AM
The 'welfare cadillac' lives! http://www.reduser.net/forum/images/smilies/rolleyes.gif
Republicans whine and Republicans b!tch
The rich are too poor and the poor are too rich.

The Trump plan gives the wealthiest 2% a $250,000,000,000 tax cut, and cuts Medicaid by half. 25 million people will lose health insurance, in order to give the wealthy a huge tax cut. In what conceivable ethical system could this possibly be OK, other than 'I've got mine, bud; screw you'?

I have come to the conclusion that middle class Republicans are simply people who haven't YET had a medical catastrophe which threatens to either kill them, or bankrupt them. When it does, it's a 'Come to Jesus' moment, like that hard core right winger who was a huge Trump supporter... until Obamacare essentially saved his life when he developed cancer.

amish rob
05-25-2017, 10:51 AM
I have come to the conclusion that middle class Republicans are simply people who haven't YET had a medical catastrophe which threatens to either kill them, or bankrupt them. When it does, it's a 'Come to Jesus' moment, like that hard core right winger who was a huge Trump supporter... until Obamacare essentially saved his life when he developed cancer.
I think there's a goodly portion that fool themselves into thinking they are "rich", too, and will be seeing some tax cuts.
I really do.
I don't think most people realize how paltry a hundred grand is, in the grand scheme of things, these days.

Peace,
Robert

oznabrag
05-25-2017, 10:58 AM
I think there's a goodly portion that fool themselves into thinking they are "rich", too, and will be seeing some tax cuts.
I really do.
I don't think most people realize how paltry a hundred grand is, in the grand scheme of things, these days.

Peace,
Robert

A hundred grand, today, was only $60K a mere 20 years ago.

John Smith
05-25-2017, 11:05 AM
I have come to the conclusion that middle class Republicans are simply people who haven't YET had a medical catastrophe which threatens to either kill them, or bankrupt them. When it does, it's a 'Come to Jesus' moment, like that hard core right winger who was a huge Trump supporter... until Obamacare essentially saved his life when he developed cancer.

The problem here is, if nothing passes and nothing changes, those who vote republican will continue to do so. ONLY if this bill is passed into law and it slaps them solidly in the face is it likely to impact their vote next election.

Not all the people are paying attention. Those who are not will not until it hits them personally. Many of those who do pay attention get their news from FOX and/or other right wing outlets, where they are told this is a good bill.

There's a part of me that, although many innocents will get hurt, hopes this does pass into law. The short term pain may lead to long term progress. If nothing gets through congress, the status quo, including voting patterns, stays as is.

mdh
05-25-2017, 11:06 AM
The 'welfare cadillac' lives! http://www.reduser.net/forum/images/smilies/rolleyes.gif

The Trump plan gives the wealthiest 2% a $250,000,000,000 tax cut, and cuts Medicaid by half. 25 million people will lose health insurance, in order to give the wealthy a huge tax cut. The net effect is an enormous transfer of resources from health care for the poor to the rich. In what conceivable ethical system could this possibly be OK, other than "I've got mine, bud; screw you"?

Republicans whine and Republicans b!tch
The rich are too poor and the poor are too rich.


From each according to his ability, to each according to his needs, eh?

David G
05-25-2017, 11:07 AM
http://www.huffingtonpost.com/entry/gop-health-care-plan_us_59265e95e4b061d8f81f37e2?ncid=edlinkushpmg 00000313

Wednesday’s report from the Congressional Budget Office (http://www.huffingtonpost.com/entry/gop-health-care-bill-congressional-budget-office_us_5924e896e4b00c8df29feb68?ncid=inblnkushp mg00000009) ought to erase any lingering doubt about how Republicans are trying to change American health care.


If they get their way, they will protect the strong at the expense of the weak ― rewarding the rich and the healthy in ways that punish the poor and the sick.

Republicans have tried mightily to deny this, and accused their critics of dishonesty. President Donald Trump (http://www.huffingtonpost.com/topic/donald-trump), Vice President Mike Pence (http://www.huffingtonpost.com/topic/mike-pence), House Speaker Paul Ryan (http://www.huffingtonpost.com/topic/paul-ryan) (R-Wis.) ― they and their allies have insisted over and over again that their proposals would improve access to health care and protect people with pre-existing medical conditions.


But it’s the Republicans who are lying about what their plan to repeal Obamacare would do.

They were lying back in March, when they introduced the initial version of the legislation ― a bill GOP leaders had to pull at the last minute because it didn’t have enough votes to pass. And they have been lying since early May, after they revised that proposal and rushed to vote on it before the CBO, Washington’s official scorekeeper, had time to evaluate it formally.

Now the budget office analysts have done their work (https://www.cbo.gov/publication/52752). And if they are right, then the revised legislation would punish economically and medically vulnerable Americans more than the earlier version would have ― leaving many millions without insurance and unraveling the market for insurance for people with pre-existing medical conditions.


To be clear, CBO’s overall assessment didn’t change much, since the basic framework of the bill hasn’t changed much either.

Older people would still face higher premiums, as insurers would gain more leeway to vary prices based on age. Lower-income people buying private insurance on their own would still lose financial assistance, as a new formula for tax credits would steer money away from them. And the very poor would still lose access to Medicaid, as states would lose funding they otherwise would have gotten from the federal government.


Some people would feel better off as a result of these changes ― young people in relatively good health would get access to cheaper coverage, for example, while more affluent people who get little or no financial assistance from the government today would start to get more. Wealthy people would get extra money in their pockets, since the GOP legislation would undo the taxes that finance the Affordable Care Act’s coverage expansion.


But the net effect would be 23 million fewer people with health insurance ― many of whom, as a result, would face financial or physical hardship because they could no longer afford medical care. That’s nearly identical to the 24 million that the CBO estimated would lose coverage from the bill’s previous version.


The one big change Congress made to that bill is a set of amendments that would allow states to waive some of the Affordable Care Act’s most important regulations, including rules that prohibit insurance companies from charging higher premiums to people with pre-existing medical conditions.

Republican leaders have insisted that these amendments, so essential to winning over holdout lawmakers in the House, wouldn’t actually make much difference to consumers.

Even in states that sought the waivers, GOP leaders promised, insurers could engage in “medical underwriting” ― that is, varying premiums based on health status ― only for people who allowed their coverage to lapse for more than two months. And that was bound to be a small number of people, Republicans said.


On Wednesday, the Congressional Budget Office indicated just how wrong that argument is.


For one thing, coverage lapses (http://kff.org/health-reform/issue-brief/gaps-in-coverage-among-people-with-pre-existing-conditions/) of more than two months would be pretty common under the GOP bill, because lower-income consumers who struggle to pay premiums would be getting less financial assistance than they do today. More important, the CBO pointed out, allowing insurance companies to vary premiums based on medical conditions even in some cases would inevitably create a bifurcated insurance market.


Insurers would end up setting up two sets of plans ― one with medical underwriting and one without. Healthy people would flock to the underwriting plans, since they’d be eligible for cheaper coverage there. The older plans would be left with a relatively sicker population, forcing them to raise premiums for everybody still enrolled in them and thereby encouraging more healthy people to leave ― until, eventually, those plans had shrunk to small groups of people with big medical problems.


Premiums in these plans would be much more expensive, and in many cases downright unaffordable, making access to them for people who had maintained continuous coverage essentially meaningless. As a result, the CBO concluded, “People who are less healthy ... would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all.”


The finding echoes an analysis that Matthew Fiedler (https://www.brookings.edu/blog/up-front/2017/04/27/new-amendment-to-gop-health-bill-effectively-allows-full-elimination-of-community-rating-exposing-sick-to-higher-premiums/), a former Obama administration economist who now works at The Brookings Institution, published shortly before the House bill passed. And on Wednesday, in an email to HuffPost, Fiedler noted that the people the GOP bill would marginalize are those that, in theory, an insurance system should prioritize. “Those markets would no longer fulfill one of their fundamental purposes, which is ensuring that people can get health care when they need it,” he said.


Of course, insurance markets under the Republican scheme would serve other purposes ― like limiting the size and scope of government, offering cheap coverage to younger and healthier people, and allowing wealthier Americans to keep some money they now pay to the federal government in the form of taxes.

Republicans may think that pursuing those goals ultimately does society more good than guaranteeing health insurance for the people who need it most. Such thinking would be consistent with the way they have tried to govern more generally, with their constant efforts to strip down programs for the poor and middle class while showering the wealthy with tax cuts.


But when talking about health care over the past few years and especially in the past few months, Republicans have pretended they have different priorities ― a deception the CBO exposed quite clearly on Wednesday.

TomF
05-25-2017, 11:08 AM
From each according to his ability, to each according to his needs, eh?more "love your neighbour."

amish rob
05-25-2017, 11:09 AM
A hundred grand, today, was only $60K a mere 20 years ago.
Werd.

A million bucks used to raise eyebrows. Now it's papitas.

Peace,
Robert

oznabrag
05-25-2017, 11:14 AM
From each according to his ability, to each according to his needs, eh?

There ARE those who believe that Capitalism is a Political System.

The US is a Liberal Democracy, the first of its kind, and the mother to dozens of such political systems around the world.

There is an organization bent on destroying the United States' form of government, and it is not the Communist Party.

The Soviet version of Communism stated bluntly that Communism was indeed a political system, and poor, misguided Morons in the US were thus convinced that Capitalism is the political system of the United States.

It is not.

Capitalist Oligarchical Totalitarianism is the political system that the Sleazy Jesus wants to put in place.

A vote for Trump is a vote for burning the Constitution.

oznabrag
05-25-2017, 11:16 AM
From each according to his ability, to each according to his needs, eh?

From the 99.9%, take EVERYTHING, to the .01% give it ALL.

amish rob
05-25-2017, 11:17 AM
more "love your neighbour."
My neighbor? Eww. He's not rich OR famous.

Why would I care about some schlub nobody no one ever heard of, anyway? ;)

Peace,
Schlub

TomF
05-25-2017, 11:18 AM
Hell, you've heard of him. ;)

oznabrag
05-25-2017, 11:20 AM
Hell, you've heard of him. ;)

Dear God! Now I'VE heard of him, too!

Where will it all end!?!

TomF
05-25-2017, 11:21 AM
Dear God! Now I'VE heard of him, too!

Where will it all end!?!I could lend you a book ... :D

Keith Wilson
05-25-2017, 12:11 PM
From each according to his ability, to each according to his needs, eh?


Strawman Fallacy

Substituting a distorted, exaggerated, or misrepresented version of one's opponent's argument.Shall I point out that every other developed country has tax-financed health care? Their systems vary, but they cover 100% of the people 100% of the time, pay on average half of what we do in the US, and get equally good results.

Try again.

Osborne Russell
05-25-2017, 12:14 PM
The rich are too poor and the poor are too rich.

Seems un-Protestant.

Osborne Russell
05-25-2017, 12:18 PM
From each according to his ability, to each according to his needs, eh?

No.

1. Right of property
2. To secure rights, government is instituted
3. Government secures right of property by reducing desperation

Government has secured your property so well for so long, you've forgotten, if you ever learned, that you need force to have property. One big reason you're not a conservative at all.

Corvida
05-25-2017, 12:25 PM
From each according to his ability, to each according to his needs, eh?

Don't worry, work will set you free.

oznabrag
05-25-2017, 03:12 PM
No.

1. Right of property
2. To secure rights, government is instituted
3. Government secures right of property by reducing desperation

Government has secured your property so well for so long, you've forgotten, if you ever learned, that you need force to have property.

I think this is actually the root of the problem.

The typical Trump voter has no frame of reference to identify tyranny, so they can be taught to smear civil rights as 'tyranny'. Freedom of speech is 'tyranny, too, if the 'wrong' people are speaking.


It is as I said before.

THIS NATION IS A LIBERAL DEMOCRACY. IF YOU HATE LIBERALS, AND YOU HATE DEMOCRACY, YOU ARE NO AMERICAN.




One big reason you're not a conservative at all.

Nope. They are not 'conservatives', they are wreckers. Sort of the antithesis of conservative.

Thanks, Osborne. You're a gem!

Osborne Russell
05-25-2017, 04:17 PM
I think this is actually the root of the problem.

The typical Trump voter has no frame of reference to identify tyranny . . .

Such FOR as they may have is a grossly distorted carefully designed product of the propaganda industry that serves right-wing politicians, whom they claim to mistrust, even as they adopt the tortured FOR uncritically.


THIS NATION IS A LIBERAL DEMOCRACY. IF YOU HATE LIBERALS, AND YOU HATE DEMOCRACY, YOU ARE NO AMERICAN.

Yep. Whereas in MDH's understanding, liberalism is the same as socialism. His mistake would be instantly clarified for him by thirty seconds with a socialist, if he could find one; or, in the alternative, in ten minutes on Wikipedia.


Nope. They are not 'conservatives', they are wreckers. Sort of the antithesis of conservative.

Thanks, Osborne. You're a gem!

Aw, shucks ! BY:D

Garret
05-25-2017, 04:46 PM
The math on premiums to cover health care prior to retirement shows that on average health insurance is a bad deal.

Of course it is! Jimminy Cricket... Do you buy auto insurance? On average it's a bad deal - unless you hit a kid. Health insurance is a bad deal too, unless you get a catastrophic illness.

Do you not understand just what insurance is? It's gambling, plain & simple & the house has to win or they go out of business.

Keith Wilson
05-25-2017, 04:57 PM
Paul Ryan gets up on his hind legs and lies, and lies, and lies some more. (Source (http://nymag.com/daily/intelligencer/2017/05/heres-paul-ryans-biggest-health-care-lie.html))


Here’s Paul Ryan’s Biggest Health-Care Lie
By Jonathan Chait

The American Health Care Act is basically a straightforward welfare-state rollback. That’s why the conservative movement supports it. Conservatives think the government spends too much money on income-transfer payments. AHCA would eliminate just over $1.1 trillion ($834 billion in Medicaid, plus another $276 billion in tax credits) in subsidies for health care for the poor and middle class. The trade-off for those cuts is the opportunity to finance a large, regressive tax cut. Spending way less to help people afford health insurance means those people wouldn’t be able to afford health insurance. That’s why the uninsured rate declined by 20 million since Obamacare started, and why it would go back up by about the same if AHCA gets passed.

At his press conference today, Paul Ryan insisted that access to affordable health coverage for one and all is truly his goal:

"What do we want? What do we all want? We want everybody who doesn’t get health care from either Medicare or Medicaid or from their job, about 11% of Americans, we want them, too, to get access to affordable health care."

There is all kinds of sophistry and distortion in Ryan’s remarks. He argued that, by freeing up states to “innovate,” his bill would somehow lead them to fund high-risk pools to cover the costs of people with expensive conditions. He did not explain why the states would somehow pony up this money when they were free from Obamacare regulatory burdens for decades leading up to 2014 and did no such thing. There is zero reason to believe that letting states go back to the deregulated insurance markets that prevailed before Obamacare would have any different result.

If Ryan were honest, he would admit he thinks that’s fine. He doesn’t like taxes, spending, or regulation, and he thinks going back to the pre-Obamacare system would be better for that reason. Instead he smarmily insists his plan would do that while also making health care affordable to everybody. Whatever design he decides to use for the health-care system, cutting a trillion dollars from health-care subsidies in order to reduce taxes is going to deprive a lot of people of their coverage. This is the core effect of his plan, and he won’t fess up to it at all. Ryan is a Social Darwinist without the courage of his convictions.

oznabrag
05-25-2017, 06:28 PM
Such FOR as they may have is a grossly distorted carefully designed product of the propaganda industry that serves right-wing politicians, whom they claim to mistrust, even as they adopt the tortured FOR uncritically.



Yep. Whereas in MDH's understanding, liberalism is the same as socialism. His mistake would be instantly clarified for him by thirty seconds with a socialist, if he could find one; or, in the alternative, in ten minutes on Wikipedia.



. . .

10 minutes?

Slow reader?

Lew Barrett
05-26-2017, 01:03 AM
And right now, it's easier to sell phone insurance than health insurance. Many have decided that healthcare is a right they don't want to pay for. But they'll pay to keep their phone.

Ever hear of Maslow and the hierarchy of needs? To start you off in this discussion about what needs fit where in a person's life, I'll ask another question. Have you imagined trying to live, work or hold a job down without a phone in today's world?

Discuss.

mdh
05-26-2017, 01:44 AM
No.

1. Right of property
2. To secure rights, government is instituted
3. Government secures right of property by reducing desperation

Government has secured your property so well for so long, you've forgotten, if you ever learned, that you need force to have property. One big reason you're not a conservative at all.

I view the right to own personal property as our greatest right of all. The Marxists would have the gov't take my property, at the point of a gun, and give it to someone else. That goes against my conservative principles.

mdh
05-26-2017, 01:48 AM
Ever hear of Maslow and the hierarchy of needs? To start you off in this discussion about what needs fit where in a person's life, I'll ask another question. Have you imagined trying to live, work or hold a job down without a phone in today's world?

Discuss.

No

Where i work, cell phones are not allowed to be used. A home phone is all i need.

Garret
05-26-2017, 05:47 AM
I view the right to own personal property as our greatest right of all. The Marxists would have the gov't take my property, at the point of a gun, and give it to someone else. That goes against my conservative principles.

And just who is "taking your property"? Where are the Marxists in this country? please expand on/explain this - as it makes no sense to me.

re: Phones: I get that you do not need a cell phone, but my work requires that I have one. Different lifestyles have different requirements. My plan is also just about exactly the same cost as a landline - which I no longer have - so it's not really an extra cost.

Keith Wilson
05-26-2017, 07:19 AM
I view the right to own personal property as our greatest right of all. The Marxists would have the gov't take my property, at the point of a gun, and give it to someone else. That goes against my conservative principles.I hate to tell you, but Marxists, if not entirely extinct, are a highly endangered species, and I'm pretty sure there has never been one on the WBF. You'll just have to get along somehow without your preferred boogeyman; sorry.

A couple of obvious points: Every law is enforced at the point of a gun. Laws against murder, fraud, arson, robbery, pollution, forgery, what have you - if you do not obey the law, armed representatives of the State will come and lock you up. Tax laws are no different, and every state requires revenue to operate. You may not like it, but it sure does beat the poor, solitary, nasty, brutish, and short-lived alternatives. Every state on earth, and every government since the beginning of our species, has taken some of its citizens' property at the point of a gun, (or a sword, in the old days). Get used to it. This is why government by the consent of the governed is important.

At bottom this has nothing to do with Marxism; it's merely another dispute about which things should be paid for privately and which through taxes. Some things pretty much everybody agrees should be paid for with taxes - police, armies, roads, bridges, schools (at one time that was controversial), courts, etc. Some things everyone agrees shouldn't - car repair, facelifts, wooden boats, vacations in Aruba . . . The dispute here is how we should pay for health care. The evidence of every other developed country on earth shows beyond the shadow of any doubt that it is both far more efficient and far more equitable to pay for heath care like roads and police, through taxes. Now we haven't yet been able to get there because of people like you, and are still paying way too much. We have a half-assed hybrid system that, although far better than what we had before, is sill pretty crappy. But you want to make it far, far worse.

TomF
05-26-2017, 07:34 AM
No

Where i work, cell phones are not allowed to be used. A home phone is all i need.
And where I work, management is eliminating landlines to offices, and retaining only cells.

oznabrag
05-26-2017, 08:22 AM
There ARE those who believe that Capitalism is a Political System.

The US is a Liberal Democracy, the first of its kind, and the mother to dozens of such political systems around the world.

There is an organization bent on destroying the United States' form of government, and it is not the Communist Party.

The Soviet version of Communism stated bluntly that Communism was indeed a political system, and poor, misguided Morons in the US were thus convinced that Capitalism is the political system of the United States.

It is not.

Capitalist Oligarchical Totalitarianism is the political system that the Sleazy Jesus wants to put in place.

A vote for Trump is a vote for burning the Constitution.

Well?

Osborne Russell
05-26-2017, 08:55 AM
Paul Ryan gets up on his hind legs and lies, and lies, and lies some more.


He argued that, by freeing up states to “innovate" . . .

You know, when you think about it, a lot of this stuff could be state instead of federal. Defense, commerce, civil rights, the environment. Just get out of the way and watch them innovate.

Lew Barrett
05-26-2017, 09:28 AM
No

Where i work, cell phones are not allowed to be used. A home phone is all i need.

Does yours have push buttons, or the romance of a traditional dial?

Too Little Time
05-26-2017, 09:47 AM
Of course it is! Jimminy Cricket... Do you buy auto insurance? On average it's a bad deal - unless you hit a kid. Health insurance is a bad deal too, unless you get a catastrophic illness.

Do you not understand just what insurance is? It's gambling, plain & simple & the house has to win or they go out of business.
I view neither investing nor insurance as gambling. I have said what I think is a reasonable solution to the health care issue. Give free healthcare to those in the bottom 50%.

I have auto insurance to pay for damage I cause to others. I have the maximum that my insurer will write.

My comments on Medicare were intended to show that everyone gets a poor deal from Medicare. The government loses money by not investing. The people lose money by not have the premiums to invest. Much more efficient to give the old poor free health care.

Too Little Time
05-26-2017, 09:54 AM
The 'welfare cadillac' lives! http://www.reduser.net/forum/images/smilies/rolleyes.gif

The Trump plan gives the wealthiest 2% a $250,000,000,000 tax cut, and cuts Medicaid by half. 25 million people will lose health insurance, in order to give the wealthy a huge tax cut. The net effect is an enormous transfer of resources from health care for the poor to the rich. In what conceivable ethical system could this possibly be OK, other than "I've got mine, bud; screw you"?

Republicans whine and Republicans b!tch
The rich are too poor and the poor are too rich.
I am sure all of your comments are true.

But you ask about ethical systems. That brings up other questions you might find embarrassing. Those about providing food or education to the poor. I do understand you want more insurance (maybe even health care) for yourself, but you have enough food and education. Democrats use different weapons against the poor. Ethics are terrible issues to argue.

Look on the bright side: The ACA will remain. If it does not, the Democrats will start the revival in 2 years.

Keith Wilson
05-26-2017, 10:01 AM
Ethics are terrible issues to argue.But we hardly have a choice. When discussing politics, any really difficult question always comes back to ethics. The rest is just engineering; what works and what doesn't.

While I entirely agree that neither party is pure and blameless, there are different degrees of imperfection. At present, we really do have one party that has made cruelty toward anyone who may need some help its central principle. "I've got mine, bud; screw you" is all too common, but never in human history has it ever been accepted as good and right.

Norman Bernstein
05-26-2017, 10:02 AM
A home phone is all i need.

Yes, it's ALL about YOU.

oznabrag
05-26-2017, 10:15 AM
But we hardly have a choice. When discussing politics, any really difficult question always comes back to ethics. The rest is just engineering; what works and what doesn't.

While I entirely agree that neither party is pure and blameless, there are different degrees of imperfection. At present, we really do have one party that has made cruelty toward anyone who may need some help its central principle. "I've got mine, bud; screw you" is all too common, but never in human history has it ever been accepted as good and right.

Indeed.

It's the same party that has made racism a 'legitimate' campaign issue, found treason to be the only tool in its box capable of placing a candidate in the Oval Office, and believes in its heart of hearts that poor people are inferior PEOPLE, and they owe the rich their very lives, fortunes and sacred honor.


If every, single Republican Elected Official were to vanish in a puff of brimstone, the world would INSTANTLY become a better place.

Keith Wilson
05-26-2017, 10:35 AM
I’m coming to believe that too much economic inequality is a significant threat to democracy. Increasing inequality is particularly dangerous; the direction of the trend may be more impatient than the actual level. I'll have to think about this some more, but I'd bet a fair amount that this is the underlying cause of a whole lot of unpleasant stuff in current US politics.

https://francescosyloslabini.files.wordpress.com/2016/03/gini-index-usa.jpg?w=604&h=425

TomF
05-26-2017, 10:37 AM
Not only in American politics, but global.

Osborne Russell
05-26-2017, 10:56 AM
I have auto insurance to pay for damage I cause to others.

Because government requires you to have it, in the interest of society. Like with health insurance, there is a huge question beyond interests of the parties, even in the aggregate. A policy question. No one pays for the damage, there is an injury to the whole society, which society is not obliged to just suffer helplessly.

Osborne Russell
05-26-2017, 11:00 AM
I am sure all of your comments are true.

But you ask about ethical systems. That brings up other questions you might find embarrassing. Those about providing food or education to the poor.

No it doesn't. Is it ethical for a city councilman to vote on giving a paving contract to his brother's paving firm? Tough question. It brings up other questions you might find embarrassing. Those about providing food or education to the poor. GTFOOH

elf
05-26-2017, 11:00 AM
No

Where i work, cell phones are not allowed to be used. A home phone is all i need.
And if you had no home?

TomF
05-26-2017, 11:16 AM
And if you had no home?It would be because those damned Marxists took his sacred private property away at gunpoint, of course. To truly have a land line, one requires land.

Keith Wilson
05-26-2017, 11:43 AM
And, of course, the way sacred private property is distributed right now is just, equitable, the way it ought to be, ordained by natural law, or divine edict, or something, and messing with it in any way is wrong. It's not in the slightest an artifact of how we've decided to set up human institutions, or history, or luck. The reason that white folks in the US are on average a lot richer than black folks, for example, is due entirely to their personal qualities and work ethic, no doubt, and has nothing at all to do with any of that stuff that happened a long time ago and mostly nobody remembers anyway. And those who are careful, foresighted, hard-working, and intelligent in their choice of parents have earned their inheritances entirely by their own virtue, and taxing them would be horribly unjust. (This is heavy irony, in case anybody missed it.)

Too Little Time
05-26-2017, 12:06 PM
But we hardly have a choice. When discussing politics, any really difficult question always comes back to ethics. The rest is just engineering; what works and what doesn't.

While I entirely agree that neither party is pure and blameless, there are different degrees of imperfection. At present, we really do have one party that has made cruelty toward anyone who may need some help its central principle. "I've got mine, bud; screw you" is all too common, but never in human history has it ever been accepted as good and right.
There are good arguments that both parties have a long history of "I've got mine; screw you." The Democrats seem to hide it better. They seem to cater to a less affluent sector - 90-99th percentile.

As I said the poor were "given" health insurance because the rich wanted it. But the poor were not given food or good schools, because the rich already have all they want. The Democrats had a lot of opportunity to act.

The Democrats might be willing to help with college costs. There are reasonable arguments saying that will benefit the rich much more than the poor. (Ignoring the fact that the poor who attend poor schools have less opportunity to go to college.)

Who is screwing whom depend son where one sits in the economy.

oznabrag
05-26-2017, 12:10 PM
There are good arguments that both parties have a long history of "I've got mine; screw you." The Democrats seem to hide it better. They seem to cater to a less affluent sector - 90-99th percentile.

As I said the poor were "given" health insurance because the rich wanted it. But the poor were not given food or good schools, because the rich already have all they want. The Democrats had a lot of opportunity to act.

The Democrats might be willing to help with college costs. There are reasonable arguments saying that will benefit the rich much more than the poor. (Ignoring the fact that the poor who attend poor schools have less opportunity to go to college.)

Who is screwing whom depend son where one sits in the economy.

I'm sure you believe this.

mdh
05-26-2017, 01:13 PM
Yes, it's ALL about YOU.

Deflection

I was answering this question: Have you imagined trying to live, work or hold a job down without a phone in today's world?

My question: Have you imagined trying to live, work or hold down a job without satellite television, high speed internet, and being on your smartphone while you are at work?

Garret
05-26-2017, 01:53 PM
Deflection

I was answering this question: Have you imagined trying to live, work or hold a job down without a phone in today's world?

My question: Have you imagined trying to live, work or hold down a job without satellite television, high speed internet, and being on your smartphone while you are at work?

I'll agree that Sat TV is not necessary. Internet often is for many jobs (& absolutely required for mine) as is the smartphone.

However $60 for internet & another $60 for phone is $120. This covers 23% of my health insurance premium - so saying that having them prevents one paying for health insurance is more hyperbole (I'm being polite) from those who just want poor people to go away.

Hugh Conway
05-26-2017, 02:02 PM
Deflection

I was answering this question: Have you imagined trying to live, work or hold a job down without a phone in today's world?

My question: Have you imagined trying to live, work or hold down a job without satellite television, high speed internet, and being on your smartphone while you are at work? Many poor use a pay as they go smartphone with free wifi to access the internet. It's cheaper than your strawman, and your solution of 20 years ago.

I'm glad you encourage the poor to overpay for telephony services though.

Keith Wilson
05-26-2017, 02:15 PM
I don't have any kind of pay TV. Internet's about $35/month, mobile phone a little more. If I didn't get health insurance through my wife's job, that would cover a couple of days of premiums. So what's the point?

So how do you justify legislation that will cause over 25 million people to lose their health insurance in order to give a $250,000,000,000 tax cut to the wealthiest 2%?

oznabrag
05-26-2017, 02:24 PM
I don't have any kind of pay TV. Internet's about $35/month, mobile phone a little more. If I didn't get health insurance through my wife's job, that would cover a couple of days of premiums. So what's the point?

So how do you justify legislation that will cause over 25 million people to lose their health insurance in order to give a $250,000,000,000 tax cut to the wealthiest 2%?

That's only a thousand bucks a person, Keith. In their view we should be grateful they aren't demanding more!

oznabrag
05-26-2017, 02:28 PM
Wait, it looks like $10,000 !

Still, with ten years to pay, who are we to complain?

TomF
05-26-2017, 02:30 PM
I have auto insurance to pay for damage I cause to others.Because government requires you to have it, in the interest of society. Like with health insurance, there is a huge question beyond interests of the parties, even in the aggregate. A policy question. No one pays for the damage, there is an injury to the whole society, which society is not obliged to just suffer helplessly.That's an important point.

Governments don't require 3rd Party Injury insurance to protect TLT from steep costs; he could perhaps cover damages assessed were he at fault in a car accident. Government wasn't protecting less wealthy drivers either. Government was protecting the innocent victims of accidents ... who not infrequently got little or no compensation when a driver with ordinary resources hit them, and went bankrupt after paying a bit. Victims who thus got victimized twice. The mandatory auto premiums you and I pay for the privilege of owning/driving a car support the "public good" of protecting innocent victims; that "public good" is financed by an "individual mandate" user-fee, paid (usually) to a for-profit company.

Lest we devolve into "but nobody has to have a car" debates ... quite a lot of the work of Nation States amounts to insurance. How many non-boaters (or even boaters) ever get rescued by the Coast Guard? The Cuban Missile Crisis is a stark example of American Military action actively repelling a threat to the lower 48 ... but your only formal land-based war on American soil was ... 1860 or so? The last against a legit foreign power threat was what, 1812? A nation state's Defence spending is its most "legitimate" viewed as premiums paid towards an "insurance policy" to deter foreign aggression against the homeland. And (one hopes) is never fully used.

Here's a topical one - I've heard some argue that America should re-vamp how it tries to dissuade foreign rapists/murderers/drug dealers from attempting to illegally cross America's borders. Shucks, if the policy was effective enough those bad hombres wouldn't even try.

Those are all "insurance programs," which will only directly benefit a very few of the citizens whose money is stolen from them at gunpoint to pay for them. You steal it anyway, because it's a "public good."

Health insurance for medically necessary conditions, in every other developed nation on earth, is seen the same way. The difference being, about 100% of the population actually uses health care services regularly over their lifetimes. Unlike auto insurance, or the Coast Guard, or the Infantry.

Lew Barrett
05-26-2017, 02:37 PM
Deflection

I was answering this question: Have you imagined trying to live, work or hold a job down without a phone in today's world?

My question: Have you imagined trying to live, work or hold down a job without satellite television, high speed internet, and being on your smartphone while you are at work?

I see you have not checked into what Maslow's comments regarding needs are. You can't imagine a job that requires continuous communication in today's world because you don't have such a job. That's why it's all about you. It's very useful to have a cell phone just to get a job these days.

A bit of imagination will further an understanding of why.

But this is all an aside. I don't know if the GOP's health care "package" is political suicide or not. GOP supporters and Trump lovers are an incredibly docile herd and seem pretty immune to facts on the ground. Humans who operate based on belief systems rather than objective analysis are not easily swayed by reality.

mdh
05-26-2017, 04:33 PM
If healthcare is a right, and you're trying to even things out between the haves and the have nots, why aren't you trying to get the doctors to treat poor people for free; rather than taking money from me ( not a 1%er) and giving it to a doctor (who is a 1%er)?

Bobcat
05-26-2017, 04:36 PM
If healthcare is a right, and you're trying to even things out between the haves and the have nots, why aren't you trying to get the doctors to treat poor people for free; rather than taking money from me ( not a 1%er) and giving it to a doctor (who is a 1%er)?

Boy, that's a question with no thought behind it

Garret
05-26-2017, 04:37 PM
If healthcare is a right, and you're trying to even things out between the haves and the have nots, why aren't you trying to get the doctors to treat poor people for free; rather than taking money from me ( not a 1%er) and giving it to a doctor (who is a 1%er)?


So - make sure no one has insurance, so they use the ER as their doctor & it costs us all 10 times as much? That'll take far more money from you.

And me.

Keith Wilson
05-26-2017, 04:47 PM
Right. Uncompensated medical care; that's a great idea. Everybody who works in medical care is a 1%er. The nurses, the ultrasound tech, the receptionist, the nursing assistant, the lab tech, the people who run the x-ray machines, and the folks who clean the hospital . . . http://www.reduser.net/forum/images/smilies/rolleyes.gif

Look, the US pays twice as much as the rest of the civilized world for health care, for no better result; this is a serious problem. But silly one-liners don't help. Think about this a little, please.

http://www.interfaces.com/blog/wp-content/uploads/2013/09/Graph-of-healthcare-spending-as-percent-of-GDP.jpg

Hugh Conway
05-26-2017, 05:01 PM
Plenty of Physician's aren't in the top 1%. Top 1% of household income = AGI of $465k (2014 tax year). Average Primary Care physician salary = $195k, specialist physician $284k. And that's before the cost of schooling, etc.

I think though this is the depth of the Trump/Conservative distorted meshing of the past/present. Land lines are cheaper (they aren't). Physicians are 1% rich (they aren't, plenty have left for wall street/investing or management to make more money)

Too Little Time
05-26-2017, 06:54 PM
Health insurance for medically necessary conditions, in every other developed nation on earth, is seen the same way. The difference being, about 100% of the population actually uses health care services regularly over their lifetimes.
It is not clear who pays for health care in other countries. If you want to tax the top 25% and pay for health care for the bottom 50%, you will be on my side of the debate.

You almost made use of a false fact. Yes, everyone does use health care regularly over their lifetime. But your implication is that most people cannot afford the health care they use. Then you draw the conclusion that there is a need for a government program with some sort of cost sharing. We could look at bankruptcy records to base an estimate of how many people can afford their health care. I don't like the accuracy, but it does indicate fewer than 50% of families file for bankruptcy. So more than 50% of families can afford their lifetime health care costs.

If you think people in the top half of the economy cannot afford health care, why do you think those in the bottom half can afford the premiums they are asked to pay under the ACA? (A person earning $50K is expected to pay about $5K in premiums. A person earning $100K would have to pay about $55K in premiums to put him in the same economic condition. (50-5 = 100-55))

TomF
05-26-2017, 08:24 PM
Tlt, I may have a better idea than you how much an individual's health care costs are. Bits of that are part of my day job, after all.

The great majority of most people's health costs come in the last 6 months of life; the other lesser blip is in the first year or two. In between, the great majority of us are healthy enough to be not desperately expensive. But damned few can actually afford that last 6 months, nor can their survivors. And a large proportion of us actually start to be fairly expensive by the time we are in late middle age, for all that much of that is self inflicted.

Keith Wilson
05-26-2017, 08:38 PM
The great majority of most people's health costs come in the last 6 months of life; Which in the US are mostly covered by Medicare, and paid for by somewhat regressive taxes on wages.

PeterSibley
05-26-2017, 08:48 PM
Australia http://www.aihw.gov.au/australias-health/2014/health-system/

http://www.aihw.gov.au/assets/0/6442451003/6442451004/6442453834/6442454453/60129542499/60129542509/60129542508/28271153-37f5-4282-b48b-1c3b5cf55387.jpg?n=5091

Too Little Time
05-27-2017, 10:38 AM
Tlt, I may have a better idea than you how much an individual's health care costs are. Bits of that are part of my day job, after all.

The great majority of most people's health costs come in the last 6 months of life; the other lesser blip is in the first year or two. In between, the great majority of us are healthy enough to be not desperately expensive. But damned few can actually afford that last 6 months, nor can their survivors. And a large proportion of us actually start to be fairly expensive by the time we are in late middle age, for all that much of that is self inflicted.


Which in the US are mostly covered by Medicare ...
TomF: As Keith Wilson indicated the last 6 months tend to be covered by Medicare which is outside of what we are talking about.

You indicate that few can afford the last 6 months. But that is the wrong way to look at this. As I said earlier a person at the median who is required to pay 10% of his income for insurance has a different view of what is affordable than a person making $100K. A person at the median does not need to need health care to be in economic trouble. He is in trouble just from paying the premiums. The ACA cost structure seems to ignore this economic reality. As does single payer.

I keep indicating that the poor should not pay for health care. Everyone ignores that. Because those who are not poor would have to pay for it. And few want that.

Osborne Russell
05-27-2017, 03:56 PM
I keep indicating that the poor should not pay for health care. Everyone ignores that. Because those who are not poor would have to pay for it. And few want that.

Wouldn't that raise the tax bracket problem? You get a raise but it's a loss because you lose your health care and the raise doesn't cover it? OK, make it progressive. Oboy, more complexity to the tax code and to health care admin. Are those costs worth the benefits?

Why not just quit dicking around and socialize medicine?

TomF
05-27-2017, 05:13 PM
I keep indicating that if your tax system is actually progressive, the poor wouldn't pay anyway.

Too Little Time
05-27-2017, 05:36 PM
Why not just quit dicking around and socialize medicine?
I used to be against socialized medicine. I am now interested in who is going to pay the bills.


I keep indicating that if your tax system is actually progressive, the poor wouldn't pay anyway.
Medicare, a socialized program, seems to not be progressive. We all pay the same percentage of earned income under $250K. My investment income seems to be exempt making the tax regressive. But as I said earlier Medicare pays out $3 of benefits after retirement for every $1 paid in. So no one is actually paying for Medicare.

Considering that 50% of our income ($400K) is not currently taxed and after my wife retires none of our income ($300K) will be taxed. It seems the tax system is not progressive.

Peerie Maa
05-30-2017, 05:49 AM
Lifted from Facebook
https://scontent.flhr3-2.fna.fbcdn.net/v/t1.0-0/p480x480/18765795_1943029735972072_7413055263011322435_n.jp g?oh=c1922bc4767de94fd1d845f230d6838b&oe=59E833E1

TomF
05-30-2017, 06:02 AM
Medicare, a socialized program, seems to not be progressive. We all pay the same percentage of earned income under $250K. My investment income seems to be exempt making the tax regressive. But as I said earlier Medicare pays out $3 of benefits after retirement for every $1 paid in. So no one is actually paying for Medicare.

Considering that 50% of our income ($400K) is not currently taxed and after my wife retires none of our income ($300K) will be taxed. It seems the tax system is not progressive.Sure - from what you've just described, it certainly seems like your present tax system has big impediments to being called "progressive," and that there's no attempt to fund major social programs like Medicare via a progressive taxation model.

So change it - lots of models to choose from and adapt from among your "allies." While it would be groundbreaking legislation on the scale of the ACA, it doesn't take a Constitutional amendment, after all. Isn't "tax reform" already on the agenda, presuming that Congress can become functional? Why can't their proposal include making your tax system actually progressive?

Keith Wilson
05-30-2017, 07:05 AM
Medicare is paid for out of somewhat regressive taxes - regressive in that it's a flat percentage of income, zero after a maximum, and also that it's only on wage income; the wealthy get a larger percentage of income from other sources which aren't subject to Medicare tax. Yeah, it's a lousy way to structure the taxes.

But this 3:1 ratio is simply wrong; Medicare does pay out more than it takes in, and this is a real problem, but the ratio is closer to 1.3:1. It's basically heath care for old folks paid for by all workers. The central problem is that heath care costs in the US are ridiculously high compared to the rest of the civilized world. Also that people live longer, and population growth is slower.

Those who want to restrict immigration might think about the effects on Social Security and Medicare of a more-rapidly-aging population. Japan has very little immigration, and the ratio between young folks and old is a large problem.

Too Little Time
05-30-2017, 10:55 AM
Sure - from what you've just described, it certainly seems like your present tax system has big impediments to being called "progressive," and that there's no attempt to fund major social programs like Medicare via a progressive taxation model.
So change it - lots of models to choose from and adapt from among your "allies." While it would be groundbreaking legislation on the scale of the ACA, it doesn't take a Constitutional amendment, after all. Isn't "tax reform" already on the agenda, presuming that Congress can become functional? Why can't their proposal include making your tax system actually progressive?
There don't appear to be any progressive tax systems. In the US the problem comes in part from allowing some individuals to determine when to pay taxes.


But this 3:1 ratio is simply wrong; Medicare does pay out more than it takes in, and this is a real problem, but the ratio is closer to 1.3:1.
The ratio being 3:1 or 1.3:1 is not the issue. At 1.3:1 it is still a bad deal for the government. As well as a much worse deal for the retirees. This is due to the time value of money that neither individuals nor the government takes advantage of.


The central problem is that health care costs in the US are ridiculously high compared to the rest of the civilized world.
I don't find the costs to be rediculously high. But I do hear a lot of people with the ability to pay for their health care complaining.

Keith Wilson
05-30-2017, 10:59 AM
I don't find the costs to be rediculously high. But I do hear a lot of people with the ability to pay for their health care complaining.The important phrase there is 'compared to the rest of the civilized world'. Paying twice as much as everybody else for no better results does not seem like a good deal.

One more time:

http://madvilletimes.com/wp-content/uploads/2013/07/Health-Care-GDP-OECD-1980-2012.jpg

Too Little Time
05-30-2017, 11:52 AM
The important phrase there is 'compared to the rest of the civilized world'. Paying twice as much as everybody else for no better results does not seem like a good deal.
I understand your chart. I understand your argument. I just disagree that the costs are ridiculously high. I can pay the costs. Overall I find health care to be a good deal. Many of the poor cannot afford the cost of medical care, but many of those could not afford half the cost of medical care - bringing it in line with the rest of the civilized world. Even at half the price many of the poor would find health care costs to be a bad deal.

I don't know enough about your lifetime economic decisions or your current economic condition to know if health care is a good deal for you or not. If it is not a good enough deal for you, just turn it down.

I just was grazing the internet and found https://www.bloomberg.com/view/articles/2017-05-30/states-where-single-payer-health-care-could-work-if-it-could-work-anywhere I am not much in favor of cutting the wages of health care workers.


Unless they find some way to dramatically slash the incomes of health-care workers

Keith Wilson
05-30-2017, 12:18 PM
Whether the US health care system in general is a 'good deal' or not has nothing to do with whether any one individual can afford it. That's not what I'm talking about; you're changing the subject.

Single-payer in whatever form would not instantly cut US costs to the levels of the rest of the world. That would take a good long time, if it ever happens. This problem has been building for 40 years, and won't be solved quickly


If it is not a good enough deal for you, just turn it down."If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."

Too Little Time
05-30-2017, 01:16 PM
Whether the US health care system in general is a 'good deal' or not has nothing to do with whether any one individual can afford it. That's not what I'm talking about; you're changing the subject.
I did say that healthcare even at a deep discount was not a good deal for those in the bottom half of the economy. I have said that Medicare for those over 65 is not a good deal. The ACA is a bad deal for those in the "young" age group. The ACA is a bad deal for those who are healthy. Those comments have nothing to do with any one individual. Comments about me have nothing to do with any one individual. Somewhere between 10% and 25% of the US population have similar economic ability - a pretty big group.

Who is health insurance a good deal for? It is really hard to say.

There is a story about a fellow in Iowa (???). He has ACA marketplace insurance. It is a great deal for him and a rotten deal for everyone else in the pool. His covered health care costs are $1 million/month - $12 million/year. There is talk about all the insurers kicking in $300K each and buying him a real nice house across the state line. There is a reasonable argument that health care is about whether any one individual can afford health care. But I am not making it.

Too Little Time
05-30-2017, 01:21 PM
If it is not a good enough deal for you, just turn it down.
"If they would rather die," said Scrooge, "they had better do it, and decrease the surplus population."
There is a great deal of difference between not being able to afford health care and being reluctant to pay the cost. Some here want health care, are able pay for it, but unwilling to pay. As I said I don't know enough about your situation to know your position.

My position is that I don't want much health care for myself. I am willing to expend all of my assets for my kids and grandkids. (My wife does not want much care either.)

David G
05-30-2017, 01:25 PM
There's a reason I put some folks on Ignore. When the noise/signal ration is consistently too high, and shaky facts and bad logic regularly lead to very little to no sense being offered in their comments. And esp. when, despite repeated friendly attempts at correction/education... no learnitude seems to be taking place.

TomF
05-30-2017, 01:55 PM
There don't appear to be any progressive tax systems...Anywhere? In any country, of any time period?

My dear sir, every country has its own compromises and loopholes, but claiming that fundamentally progressive tax systems don't exist is ... mendacious. "The perfect is the enemy of the good," and "good" is better than what you claim to have. The reason that America hasn't got one is quite simply because American voters haven't forced their elected officials to make it so.

Norman Bernstein
05-30-2017, 02:02 PM
There's a reason I put some folks on Ignore.

Amen.

Norman Bernstein
05-30-2017, 02:11 PM
Some people simply don't get it... namely, conservatives who applaud the destruction of Obamacare. It seems that they inevitably are people who haven't YET had a phenomenally expensive chronic or serious medical problem that threatens to bankrupt them.

But, then again, we are talking about people who don't understand that health care is a life cycle phenomenon: most young people are healthy and need little in the way of health care.... and most people, as they approach retirement, are likely to develop chronic medical problems and need a LOT of health care.

The ONLY solution to the problem ought to be obvious to anyone with a brain: single payer universal health care, in which the costs are paid over a lifetime.

The conservative solution: eliminating any semblance of Obamacare or anything like it, especially a mandate.

WHY do they want this? It's pretty simple. With no mandate, and no minimum coverage requirements, health insurance for young people (read that: 'voters') will be dirt cheap. It's only much later, when those young people reach their 50's, where the devil demands his payment, and health care becomes un-affordable.

However, when you're trolling for votes for 2020, or 2024, that's OK.... in the short term, anything that elects a Republican President is worth it... and they don't give a damn about 30 years from now.

Too Little Time
05-30-2017, 03:03 PM
Anywhere? In any country, of any time period?

My dear sir, every country has its own compromises and loopholes, but claiming that fundamentally progressive tax systems don't exist is ... mendacious. "The perfect is the enemy of the good," and "good" is better than what you claim to have. The reason that America hasn't got one is quite simply because American voters haven't forced their elected officials to make it so.
You set the domain.


lots of models to choose from and adapt from among your "allies."
I don't see any in that domain. Since most countries don't tax income earned out of the country, that removes those models from those that are progressive.

Too Little Time
05-30-2017, 03:15 PM
Some people simply don't get it...

The ONLY solution to the problem ought to be obvious to anyone with a brain: single payer universal health care, in which the costs are paid over a lifetime.
As I pointed out - and there seem to be adequate references on the internet, retirement Medicare is a bad deal for both the insured and the insurer. It seems to be single payer. The costs seem to be paid as you suggest. And it is a bad deal for everyone. I have to conclude that you are happy with a bad deal for everyone as long as it meets your criteria.

I have offered a much better solution. These with income or assets (top 25%) are taxed to pay for those with neither (bottom 50%). I am not opposed to structuring it as single payer. It even seems to be a bit progressive.

People like me who have saved in their lifetime can pay out of pocket or find insurers for their own health care. Those who did not save enough are protected from falling much below the median.

It appears there are other solutions. Some I like much better than saddling young healthy poor people with insurance costs.

Norman Bernstein
05-30-2017, 03:40 PM
For those too obtuse to understand just what a major medical emergency costs, here are the top ten most expensive medical procedures, and their costs:

1. Intestine Transplant
Cost: $1,121,800

2. Heart Transplant
Cost: $787,700

3. Bone Marrow Transplant
Cost: $676,800 Allogeneic ($300,400 for Autologous)

4. Lung Transplant
Cost: $657,800 double ($450,400 for single)

5. Liver Transplant
Cost: $523,400

6. Open Heart Surgery
Cost: $324,000

7. Pancreas Transplant
Cost: $275,500

8. Kidney Transplant
Cost: $259,000

9. Tracheotomy
Cost: $205,000

10. Destruction of Lesion of Retina
Cost: $153,000

The bottom line:


Lack of insurance among more than 47 million Americans drives costs up, since the uninsured use emergency rooms, and often when they've waited so long that pricey emergency surgery is the only option. Add this to the high cost of medication and medical equipment, and you can see how these price tags balloon. The bottom line: health insurance (http://www.investopedia.com/terms/h/healthinsurance.asp) coverage is vital if you need one of these life-threatening and extremely expensive procedures.


The percentage of Americans who can afford to pay for procedures like this? Perhaps just a few percent. For the average middle class person, who is just rich enough to not qualify for any federal or state assistance, perhaps they can vaporize their retirement savings to afford it.... and then end up alive, but dirt poor. Maybe they can't... and since things like a heart transplant are considered 'elective' surgery, they simply suffer with progressive heart disease until they croak. If Trump's health care plan ever got passed, that's pretty much what will happen to people in their 50's, who cannot afford the whopping increase in health insurance premiums that Trumpcare would result in.

How do we have quality health care in America?

1) Insure everyone.
2) Have everyone pay, through their lifetimes, to cover any future adverse health circumstance
3) Control costs by eliminating the 'skimming' of money off the top by insurors, and regulating the charges
4) End the practice of resorting to emergency rooms instead of sensible preventative care

The 'free market' is NOT always the most efficient solution to economic problems!

Peerie Maa
05-30-2017, 04:04 PM
sensible preventative care




What? Have Congress promote the General Welfare. You UnAmerican Pnko Commie.

Too Little Time
05-30-2017, 05:24 PM
For those too obtuse to understand just what a major medical emergency costs, here are the top ten most expensive medical procedures, and their costs:
The most important observation is that the probability of needing any expensive medical care is small. Which is why health insurance is cheap in every developed country.

$100K over a 40 year working life is only $2,500/year. Just noticeable at the median. And less than 50% of families will have an expense that large. And many of them will have the assets to pay for it. And many of them will have insurance that will pay for it. And many of them will have Medicaid pay for it. And some will declare bankruptcy and be relieved of paying for it.

But many are obtuse. The argument is over who should pay for medical care not so much about how expensive the outliers are.

PeterSibley
05-30-2017, 05:46 PM
As I pointed out - and there seem to be adequate references on the internet, retirement Medicare is a bad deal for both the insured and the insurer. It seems to be single payer. The costs seem to be paid as you suggest. And it is a bad deal for everyone. I have to conclude that you are happy with a bad deal for everyone as long as it meets your criteria.

I have offered a much better solution. These with income or assets (top 25%) are taxed to pay for those with neither (bottom 50%). I am not opposed to structuring it as single payer. It even seems to be a bit progressive.

People like me who have saved in their lifetime can pay out of pocket or find insurers for their own health care. Those who did not save enough are protected from falling much below the median.

It appears there are other solutions. Some I like much better than saddling young healthy poor people with insurance costs.

Now do those calculations for a low wage earner, even for a woman with children to support .

stromborg
05-30-2017, 05:54 PM
For those too obtuse to understand just what a major medical emergency costs, here are the top ten most expensive medical procedures, and their costs:

1. Intestine Transplant
Cost: $1,121,800

2. Heart Transplant
Cost: $787,700

3. Bone Marrow Transplant
Cost: $676,800 Allogeneic ($300,400 for Autologous)

4. Lung Transplant
Cost: $657,800 double ($450,400 for single)

5. Liver Transplant
Cost: $523,400

6. Open Heart Surgery
Cost: $324,000

7. Pancreas Transplant
Cost: $275,500

8. Kidney Transplant
Cost: $259,000

9. Tracheotomy
Cost: $205,000

10. Destruction of Lesion of Retina
Cost: $153,000

The bottom line:



The percentage of Americans who can afford to pay for procedures like this? Perhaps just a few percent. For the average middle class person, who is just rich enough to not qualify for any federal or state assistance, perhaps they can vaporize their retirement savings to afford it.... and then end up alive, but dirt poor. Maybe they can't... and since things like a heart transplant are considered 'elective' surgery, they simply suffer with progressive heart disease until they croak. If Trump's health care plan ever got passed, that's pretty much what will happen to people in their 50's, who cannot afford the whopping increase in health insurance premiums that Trumpcare would result in.

How do we have quality health care in America?

1) Insure everyone.
2) Have everyone pay, through their lifetimes, to cover any future adverse health circumstance
3) Control costs by eliminating the 'skimming' of money off the top by insurors, and regulating the charges
4) End the practice of resorting to emergency rooms instead of sensible preventative care

The 'free market' is NOT always the most efficient solution to economic problems!








Something not addressed in the list above is the cost on on-going care after recovery from something as drastic as a transplant operation. Acute medical problems are one thing, chronic conditions another. As an example I borrowed this from the American Diabetes Association:

"People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes."

Over a thousand dollars a month for a lifetime....and for a relatively "treatable" disease. They estimate that about 10% of the US population has diabetes.

Too Little Time
05-30-2017, 08:57 PM
Now do those calculations for a low wage earner, even for a woman with children to support .
I don't understand your issue? I said people in the bottom 50% should get free health care. I prevented your cases from falling below the median.

For those who want more realistic numbers of what typical health care problems and costs are (warning: you might need to do a bit of division):

https://www.hcup-us.ahrq.gov/reports/statbriefs/sb204-Most-Expensive-Hospital-Conditions.jsp

TomF
05-31-2017, 06:40 AM
Tlt, do you object to an actual progressive tax system? Only a couple of nations (America is one) have any provision to tax income earned in another country, but if you want to retain that unique provision, fine. Include such income within the progressive structure. Treat different kinds on income the same way, rather than looking at investment income differently from earned wages.

And use that framework to provide the series of "public good" things which your society considers to be important for citizens. Many of those things, as I mentioned earlier, are fairly analogous to insurance within their domains: military, policing, environmental protection, emergency preparedness for natural disasters, Coast Guard, etc. A minority of citizens actually ever use the full capacity of any of those services, yet they are each tax funded out of general revenue. Most of your allies among the developed nations fund and provide health care provision exactly the same way.

Norman Bernstein
05-31-2017, 08:12 AM
Here's a reference point:


The Kaiser Health Tracking Poll (http://kff.org/health-reform/report/kaiser-health-tracking-poll-may-2017-the-ahcas-proposed-changes-to-health-care/) finds that more Americans have an unfavorable view of the GOP health care plan than a favorable one, 55% to 31%.

For comparison, the Affordable Care Act has mostly favorable views, 49% to 29%.

Too Little Time
05-31-2017, 09:53 AM
Tlt, do you object to an actual progressive tax system? Only a couple of nations (America is one) have any provision to tax income earned in another country, but if you want to retain that unique provision, fine. Include such income within the progressive structure. Treat different kinds on income the same way, rather than looking at investment income differently from earned wages.

And use that framework to provide the series of "public good" things which your society considers to be important for citizens. Many of those things, as I mentioned earlier, are fairly analogous to insurance within their domains: military, policing, environmental protection, emergency preparedness for natural disasters, Coast Guard, etc. A minority of citizens actually ever use the full capacity of any of those services, yet they are each tax funded out of general revenue. Most of your allies among the developed nations fund and provide health care provision exactly the same way.
I don't object to actual progressivity. I simply said that among the nations presented there were none.

You seem to have some issue with my proposal of how to pay for health care. I don't understand your issue.

This stuff about the Coast Guard and military as insurance leaves me at a loss.

TomF
05-31-2017, 10:41 AM
I don't object to actual progressivity. I simply said that among the nations presented there were none.no progressive tax systems among any of the developed countries which are America's allies? Please. Not perfectly so with no loopholes, to be sure, but progressive taxation is a fundamental principle in most places. Under a certain income level, no tax; a series of tax brackets with increasing rates for income above a certain line. It's remarkable to suggest that "none" is present.
You seem to have some issue with my proposal of how to pay for health care. I don't understand your issue. Your funding proposal treats health care as a market-appropriate commodity. Those deemed wealthy enough are expected to be prudent (or lucky) and buy their own coverage; it penalizes those who don't, or have an unexpectedly cruel twist of fate. It distributes health care as charity to the poor, which frankly puts them at risk for receiving substandard care ... philanthropy usually does, in the long term. Visit a food bank or homeless shelter - even those which receive one or other kind of partial government funding.

In all the rest of the developed world, medically necessary health care is approached as a "public good," exactly to avoid these issues.


This stuff about the Coast Guard and military as insurance leaves me at a loss.Of course it does; you recognize those as "public goods" which are appropriate for citizens to fund out of Government general revenue. You probably don't support the notion, once common, that private firefighting agencies are the way to go. And that if a homeowner is unfortunate enough to have a blaze and hasn't a prioi signed a contract, the firefighters should just stand around protecting any neighbours who are subscribers. That was once reality; no longer. We now fund a service which was once solely available as private insurance, through taxation. And in principle provide access to all citizens on an equitable basis, regardless of their tax bill.

Part of the tax bill is the "premium" paid to "insure" the citizen against the ugly but unlikely chance that one day, they'd maybe need firefighter services. Or a Coast Guard rescue. Or the military to fight off waves of Nazi/Commie paratroopers landing in Nebraska. Most taxpayers never will, just like most citizens will never need some esoteric health care interventions.

Too Little Time
05-31-2017, 11:42 AM
no progressive tax systems among any of the developed countries which are America's allies? Please. Not perfectly so with no loopholes, to be sure, but progressive taxation is a fundamental principle in most places. Under a certain income level, no tax; a series of tax brackets with increasing rates for income above a certain line. It's remarkable to suggest that "none" is present.
As I said earlier: there are a number of definitions of progressivity in taxation. Yours is a very simple version. Easy to understand. And one that allows for a lot of misuse. The beggar should not complain. we have a progressive tax system and he pays no taxes.

A few months ago there was a radio talk show host complaining about taxes. He thought the 60% he paid was too high. The guy earns $20 million/years. Walks away with $8 million after taxes and complains. Which leads me to prefer a different definition of progressive.

After reviewing those that are available in light of my economic policy preferences, I like the ones that consider the change in assets over time: If the those above increase their net assets relative to those below, the system is not progressive. Not perfect, but I maybe better than yours.


Your funding proposal treats health care as a market-appropriate commodity. Those deemed wealthy enough are expected to be prudent (or lucky) and buy their own coverage; it penalizes those who don't, or have an unexpectedly cruel twist of fate. It distributes health care as charity to the poor, which frankly puts them at risk for receiving substandard care ... philanthropy usually does, in the long term. Visit a food bank or homeless shelter - even those which receive one or other kind of partial government funding.

In all the rest of the developed world, medically necessary health care is approached as a "public good," exactly to avoid these issues.
I never said anything about charity. Any poor person can go get as much free health care as they want. Everyone else gets as much health care as they want. But you want it opaque. I understand that. I don't find it necessary. I think that most countries that treat medical care as a "public good" offer better service at a price. I am not against that. That is why I let individuals who have the money make their insurance choices. I think putting 50% of the population on the same health care plan will keep services reasonable.

I give a substantial amount of money to food banks. Somehow few countries that treat healthcare as a "public good" treat food as a "public good." Based on that I am going to suggest the "public good" argument is a just a beard to hide the true motivations of those who use that argument.


Of course it does; you recognize those as "public goods" which are appropriate for citizens to fund out of Government general revenue. You probably don't support the notion, once common, that private firefighting agencies are the way to go. And that if a homeowner is unfortunate enough to have a blaze and hasn't a prioi signed a contract, the firefighters should just stand around protecting any neighbours who are subscribers. That was once reality; no longer. We now fund a service which was once solely available as private insurance, through taxation. And in principle provide access to all citizens on an equitable basis, regardless of their tax bill.

Part of the tax bill is the "premium" paid to "insure" the citizen against the ugly but unlikely chance that one day, they'd maybe need firefighter services. Or a Coast Guard rescue. Or the military to fight off waves of Nazi/Commie paratroopers landing in Nebraska. Most taxpayers never will, just like most citizens will never need some esoteric health care interventions.
I think you misunderstand the difference between insurance and government services.

Keith Wilson
05-31-2017, 11:51 AM
A 'progressive tax' by definition is one where the percentage rate increases as the taxable amount increases. There are a lot of different ways to structure it, of course. US income tax is progressive, pretty much. Sales tax is not, nor are Social Security or Medicare taxes.

TomF
05-31-2017, 01:17 PM
Actually, various public welfare programs are attempts to treat food/housing as "public goods." They do it imperfectly, because we still figure that the maximum a society owes to the least of its members is scraping by, but there's increasing pressure to experiment with Guaranteed Annual Income models. A couple of pilot projects in bits of Canada, a larger in Finland, etc.

I'm not especially confusing "government services" with "insurance."

Canada's health care system is still, in law, a "hospital insurance" program. Municipal Fire Departments are the direct descendants of for-profit fire-insurance agencies of prior centuries. Disaster relief programs provided by Governments in case of various kinds of catastrophe exist to cover risks which for-profit insurance companies have declined to cover or have been bankrupted by covering in the past. When I lived in British Columbia in the '80s, all auto insurance was operated through the Provincial government, and directly interfaced with auto registration and driver's license programs. Etc.

Each of these things which you call "government services" originated as private insurance; in each case, the programs still "insure" citizens against particular varieties of risk. The society has deemed that the benefits of providing insured benefits to any citizen who legitimately requires them are sufficient to make subscribership mandatory, and to fund the insurance premiums through taxation.

Peerie Maa
05-31-2017, 03:25 PM
I think you misunderstand the difference between insurance and government services.
The governments social services in the UK started out being funded by a tax named National Insurance, gathered by the sale of National Insurance Stamps.
Just saying.

Too Little Time
05-31-2017, 03:49 PM
A 'progressive tax' by definition is one where the percentage rate increases as the taxable amount increases. There are a lot of different ways to structure it, of course. US income tax is progressive, pretty much. Sales tax is not, nor are Social Security or Medicare taxes.
I have agreed that is a simple definition of progressivity.

So is the US tax system progressive? According to you it depends on what is taxed (income sources). It also depends on what you spend your money on. It also appears to depend on if you spend all of your money or not. Because of those issues and others, I don't find the US tax system to be progressive and I don't use that particular definition. Other economists also use different definitions of progressive. A quick search on the internet might broaden your view.

Keith Wilson
05-31-2017, 03:59 PM
Eh? What the money is spent on has nothing to do with whether taxes are progressive or not (in that specialized definition).

I've occasionally used 'progressive' to mean that the percentage rate increases with income, but I try to make that clear.

The US tax system as a whole is probably not very progressive, or perhaps not at all. Income tax is, if you only count wage income. Social Security and Medicare tax is not. State and local taxes are almost always regressive taken as a whole. There a pretty complete distributional analysis of state taxes here (https://itep.org/whopays/).

TomF
05-31-2017, 04:08 PM
I have agreed that is a simple definition of progressivity.

So is the US tax system progressive? According to you it depends on what is taxed (income sources). It also depends on what you spend your money on. It also appears to depend on if you spend all of your money or not. Because of those issues and others, I don't find the US tax system to be progressive and I don't use that particular definition. Other economists also use different definitions of progressive. A quick search on the internet might broaden your view.
"When I use a word," Humpty Dumpty said, in rather a scornful tone, "it means just what I choose it to mean—neither more nor less." "The question is," said Alice, "whether you can make words mean so many different things." "The question is," said Humpty Dumpty, "which is to be master—that's all.":D Pardon me - let's define terms then.

I thought we were talking about taxes on income, rather than, say, taxes on goods and services. I understood you to be arguing that your preferred tax model treating income ought to include not simply earned income, but also investment income, and possibly income from other sources (e.g. inheritances, realized capital gains, etc. etc.). More than that, I'd understood you to prefer a tax model in which one's nation of residence levied such taxes on one's income, regardless of the country in which that income was derived.

Conventionally, a "progressive tax" system taxes at progressively higher rates at progressively higher income levels. This is distinct from a "flat tax" system, which will levy, say, a 15% tax regardless of whether one earns $10K or $10M in annual income. By the same token, a "regressive tax" levies a higher tax rate on those with lower income (say, 15%) while according a lower tax rate to those earning more. Some arguments proffered in favour of this are encouragement to investment, and a sense that 10% of a $10M annual income is still quite a lot more than 15% of a $10K income.

Are we square now? Or would you care to share how you'd rather define "progressive tax?"

I agree, TLT, that I can't think of any nation state which solely uses progressive taxes, though virtually all nation states in the developed world have progressive taxes on earned income, and most specifically, on income which was earned within that state's territorial boundaries. It would be an interesting thing to see the reactions to a move which would treat all income, of all types and from all locations, to the same progressive taxation structure.

I note, though, that the health services we've been discussing are, in every developed country except the United States, funded through the income tax system. And that in virtually all cases, the government's initiative was expressly described in its origins as a "health insurance" program, undertaken to relieve inequities it saw in the pre-existing private insurance marketplace.

Osborne Russell
05-31-2017, 04:26 PM
OK, TLT, your position is, free below a threshold, right? Free because, what's the point, below that threshold?

To remind that there's no such thing as a free lunch.

Too Little Time
05-31-2017, 04:36 PM
Are we square now? Or would you care to share how you'd rather define "progressive tax?"
I will give you a couple links that at least indicate how one person views the definition. It might make you rethink your use of a the definition you use. Incognito mode avoids the pay wall.

https://www.washingtonpost.com/news/wonk/wp/2013/04/04/u-s-tax-code-isnt-as-progressive-as-you-think/?utm_term=.3fe2281a8b05
https://www.washingtonpost.com/news/wonk/wp/2013/04/05/americas-taxes-are-the-most-progressive-in-the-world-its-government-is-among-the-least/?utm_term=.480ab46556fb

Economics is complex.

Peerie Maa
05-31-2017, 04:37 PM
OK, TLT, your position is, free below a threshold, right? Free because, what's the point, below that threshold?

To remind that there's no such thing as a free lunch.

That is not a problem.. Trouble is TlT sets the threshold unachievably high.
Ours is set at zero tax below £221 per week and zero NI below £113 per week on an national average weekly earning of £512

Norman Bernstein
05-31-2017, 04:45 PM
. This is distinct from a "flat tax" system, which will levy, say, a 15% tax regardless of whether one earns $10K or $10M in annual income.

There is no such thing as a flat tax. No one has EVER proposed a flat tax.

Every 'flat tax' that has been proposed has been anything but flat... every one presumes a threshold amount, below which, no tax is levied. The net result: the tax proposal is nonlinearly progressive at the very low end... and extremely regressive above that.

The virtue of a progressive tax is either apparent to someone, or not... depending on his own ethics and conscience. My own point of view: taxing someone's income used to buy a Rolls Royce, at the same rate as someone struggling to house, clothe, and feed his family, is utterly unconscionable.

Too Little Time
05-31-2017, 04:51 PM
OK, TLT, your position is, free below a threshold, right? Free because, what's the point, below that threshold?

To remind that there's no such thing as a free lunch.
Free below a threshold because: Some people want a minimum wage. Some want a guaranteed annual income. But mostly because when asked the poor are more concerned with having adequate money in their pocket for day to day needs than speculative medical expenses. (The middle class when asked are concerned about medical costs. The rich about retirement.)

Simply because someone once said there is no such thing as a free lunch, does not mean we cannot provide one. But the lunch is not really free. It buys good will.

Too Little Time
05-31-2017, 06:30 PM
That is not a problem.. Trouble is TlT sets the threshold unachievably high.
Ours is set at zero tax below £221 per week and zero NI below £113 per week on an national average weekly earning of £512

In the US the top 20% of the population has 50% of the income. There is little reason to believe they cannot pay for health care for everyone.

I am not up to date on UK healthcare taxes (and don't really need to be). And my reference is dated and may not be applicable. My short search http://www.ukstudentlife.com/Work/Employment.htm indicates that the tax is 12% on income between $7,500/year and $50,000/year. And then 2% on income above that.

I am sure that those earning over $50K/year are more able to pay the 12% rate than those earning less than $50K/year.

Peerie Maa
06-01-2017, 05:41 AM
In the US the top 20% of the population has 50% of the income. There is little reason to believe they cannot pay for health care for everyone.

I am not up to date on UK healthcare taxes (and don't really need to be). And my reference is dated and may not be applicable. My short search http://www.ukstudentlife.com/Work/Employment.htm indicates that the tax is 12% on income between $7,500/year and $50,000/year. And then 2% on income above that.

I am sure that those earning over $50K/year are more able to pay the 12% rate than those earning less than $50K/year.

National Insurance is no longer adequate to cover pensions and health care, so its revenue is put in the Treasury pot with income tax etc. So in addition to the 13.8% paid by our employers and the 12% (https://www.gov.uk/government/publications/rates-and-allowances-national-insurance-contributions/rates-and-allowances-national-insurance-contributions) we pay, you must include the progressive taxes.



Band
Taxable income
Tax rate


Personal Allowance
Up to £11,500
0%


Basic rate
£11,501 to £45,000
20%


Higher rate
£45,001 to £150,000
40%


Additional rate
over £150,000
45%


You can also see the rates and bands without the Personal Allowance (https://www.gov.uk/government/publications/rates-and-allowances-income-tax/income-tax-rates-and-allowances-current-and-past#tax-rates-and-bands). You don’t get a Personal Allowance on taxable income over £123,000.

from https://www.gov.uk/income-tax-rates/current-rates-and-allowances

Osborne Russell
06-01-2017, 11:15 AM
Some want a guaranteed annual income. But mostly because when asked the poor are more concerned with having adequate money in their pocket for day to day needs than speculative medical expenses. (The middle class when asked are concerned about medical costs. The rich about retirement.)

1. There are few things less speculative than the eventual need for medical care, seems to me. People go their whole life without a car crash; but in any case . . .

2. If the threshold is not having pocket money for day to day needs, that's quite a low threshold; low enough that what you have is essentially socialized medicine, right? I think there should be a line item for it in your tax bill.

Too Little Time
06-01-2017, 11:51 AM
1. There are few things less speculative than the eventual need for medical care, seems to me. People go their whole life without a car crash; but in any case . . .

2. If the threshold is not having pocket money for day to day needs, that's quite a low threshold; low enough that what you have is essentially socialized medicine, right? I think there should be a line item for it in your tax bill.
The closest I can come with an estimate is that at least 80% of individuals never have a large health care bill. That does not account for young people having lower healthcare costs. It does not account for individuals with chronic conditions. In the worse case one falls into Medicaid. For many of those in the bottom 50% that may be a better way to pay medical bills than insurance.

2) It does appear that the poor think they have more urgent needs than buying health insurance. We certainly have socialized medicine for the very poor thru Medicaid. I don't see the resistance to expanding that up to the median. But some people have their minds set on another plan.

Keith Wilson
06-01-2017, 11:55 AM
In the worst case one falls into Medicaid.Which the Republicans in Congress are proposing to cut drastically.

Too Little Time
06-01-2017, 11:55 AM
National Insurance is no longer adequate to cover pensions and health care, so its revenue is put in the Treasury pot with income tax etc. So in addition to the 13.8% paid by our employers and the 12% (https://www.gov.uk/government/publications/rates-and-allowances-national-insurance-contributions/rates-and-allowances-national-insurance-contributions) we pay, you must include the progressive taxes.
from https://www.gov.uk/income-tax-rates/current-rates-and-allowances
I think you more or less agree that there is a 12% tax on income to pay for health care plus other taxes. It is hard to compare taxes and benefits. So I am going to try to not comment about that. People in the UK seem to like what they have.

Too Little Time
06-01-2017, 11:58 AM
Which the Republicans in Congress are proposing to cut drastically.
We knew that prior to the election. It appears to be what a lot of people want. I don't want it. You don't want it.

Keith Wilson
06-01-2017, 11:59 AM
It appears to be what a lot of people want.It appears to be extremely unpopular. I expect a lot of the people who voted for them didn't understand the effects it would have.

Too Little Time
06-02-2017, 12:23 AM
It appears to be extremely unpopular. I expect a lot of the people who voted for them didn't understand the effects it would have.
And I keep saying that very few people have large health care expenses. Most people will not notice an economic difference between insurance and no insurance. While the change should be unpopular, I think after some time passes and people don't see a change they will consider the change as a nothing.

Peerie Maa
06-02-2017, 06:25 AM
I think you more or less agree that there is a 12% tax on income to pay for health care plus other taxes. It is hard to compare taxes and benefits. So I am going to try to not comment about that. People in the UK seem to like what they have.

We love what we have, creaky though it may be. A cheap flat rate for drugs unless not working, in which case free, everything else free at the point of use for everyone.

And as Keiths ubiquitous graph shows, much less expensive than your for profit system.

Keith Wilson
06-02-2017, 06:54 AM
THE UK spends 9.9% of GDP on health care, $4330 per capita. That's been roughly flat for 15 years. The US spends 17.1%, or about $9500 per capita. Before 2009, that was rising steeply, but has since flattened out.

The current Republican plans are a triumph of ideology over any possible measure of practical effectiveness.

TomF
06-02-2017, 07:06 AM
And I keep saying that very few people have large health care expenses. Most people will not notice an economic difference between insurance and no insurance...With respect, that is historically utterly untrue. The sole and overwhelming reason why universal health insurance was introduced in Canada was that an unacceptable proportion of citizens were being bankrupted by, or severely economically stressed by costs for necessary medical care. Or didn't have that care, and had poor health outcomes. People "noticed" so much that it was a population-led initiative which drove democratically elected leaders to develop the proposal, and frankly go to war with various organizations which wanted to keep the prior status quo.

The existence of universal health insurance is now a 3rd rail in Canadian politics, and the founder of our Canadian system was honoured some years ago in a poll about the greatest Canadian.

Canoez
06-02-2017, 07:09 AM
With respect, that is historically utterly untrue. The sole and overwhelming reason why universal health insurance was introduced in Canada was that an unacceptable proportion of citizens were being bankrupted by, or severely economically stressed by costs for necessary medical care. Or didn't have that care, and had poor health outcomes. People "noticed" so much that it was a population-led initiative which drove democratically elected leaders to develop the proposal, and frankly go to war with various organizations which wanted to keep the prior status quo.

The existence of universal health insurance is now a 3rd rail in Canadian politics, and the founder of our Canadian system was honoured some years ago in a poll about the greatest Canadian.

Tom,

TLT is using his own definition of "large health care expenses" because what would bankrupt anyone else seems to be a drop in the bucket from TLT's perspective. The blinders are so effective that TLT just can't see the world from anyone else's perspective.

Keith Wilson
06-02-2017, 07:16 AM
And I keep saying that very few people have large health care expenses. Most people will not notice an economic difference between insurance and no insurance...In any given year, most people won't have large health care expenses. In any given lifetime, most people will. There are some peole who are quite healthy until they drop dead; not that many.

Norman Bernstein
06-02-2017, 07:17 AM
In any given year, most people won't have large health care expenses. In any given lifetime, most people will. There are some peole who are quite healthy until they drop dead; not that many.

..and some people simply don't understand how insurance works.

Keith Wilson
06-02-2017, 07:28 AM
One posting here, at least.

Too Little Time
06-02-2017, 08:19 AM
TLT is using his own definition of "large health care expenses" because what would bankrupt anyone else seems to be a drop in the bucket from TLT's perspective. The blinders are so effective that TLT just can't see the world from anyone else's perspective.


In any given year, most people won't have large health care expenses. In any given lifetime, most people will. There are some people who are quite healthy until they drop dead; not that many.
Canoez is almost correct with his comment. Those in the bottom half have a much different view of "large health care expenses" than I do. Which is why I favor giving them free health care. Those in the top 25% have at least $50K/year more income than those in the bottom 50%. That $50K difference gives them the ability to pay for annual medical care that more than the 99% percentile of individuals will incur any year. And of course their chance of having expenses that high is less than 1% in any year.

There are certainly people who have high medical costs every year, but they are rare. About 0.5% of individuals have medical expenses over $90K in any year - most are over 65. At least 80% of individuals will never have an annual expense that high even after they retire.

But you are free to worry about this all you want.

SMARTINSEN
06-02-2017, 08:44 AM
Richard Burr, Senator from NC:

"I don’t see a comprehensive health-care plan this year,” he told North Carolina television station WXII 12 News. Echoing comments previously made by the Majority Leader.

He s rabidly right, but not insane like most of the Republican fireeaters in the lower chamber. He also said that the House bill is DOA.

Canoez
06-02-2017, 08:48 AM
Canoez is almost correct with his comment. Those in the bottom half have a much different view of "large health care expenses" than I do. Which is why I favor giving them free health care. Those in the top 25% have at least $50K/year more income than those in the bottom 50%. That $50K difference gives them the ability to pay for annual medical care that more than the 99% percentile of individuals will incur any year. And of course their chance of having expenses that high is less than 1% in any year.

There are certainly people who have high medical costs every year, but they are rare. About 0.5% of individuals have medical expenses over $90K in any year - most are over 65. At least 80% of individuals will never have an annual expense that high even after they retire.

But you are free to worry about this all you want.

Cite please? Otherwise you're just pulling this data out of a dark, stinky place.

Realistically, a better measure is what portion of the population is having difficulty paying medical expenditures. The CDC studied these costs and showed that while you may think that people with "high medical costs were rare", a fairly significant portion of the population indicated that they were still having issues with health expenditures. (https://www.cdc.gov/nchs/data/nhis/earlyrelease/probs_paying_medical_bills_jan_2011_jun_2016.pdf (https://www.cdc.gov/nchs/data/nhis/earlyrelease/probs_paying_medical_bills_jan_2011_jun_2016.pdf)) Equally significant was the fact that we had been seeing a decline in those having difficulties with health expenditures during the period when the ACA was effective. Looks to me like the ACA was working. Could it have been better? Of course - without Republican efforts to ham-string the ACA, things could have been better. Is the proposed GOP plan better than what is in place? Not likely.

Too Little Time
06-02-2017, 10:52 AM
Cite please? Otherwise you're just pulling this data out of a dark, stinky place.

Realistically, a better measure is what portion of the population is having difficulty paying medical expenditures. The CDC studied these costs and showed that while you may think that people with "high medical costs were rare", a fairly significant portion of the population indicated that they were still having issues with health expenditures. (https://www.cdc.gov/nchs/data/nhis/earlyrelease/probs_paying_medical_bills_jan_2011_jun_2016.pdf (https://www.cdc.gov/nchs/data/nhis/earlyrelease/probs_paying_medical_bills_jan_2011_jun_2016.pdf)) Equally significant was the fact that we had been seeing a decline in those having difficulties with health expenditures during the period when the ACA was effective. Looks to me like the ACA was working. Could it have been better? Of course - without Republican efforts to ham-string the ACA, things could have been better. Is the proposed GOP plan better than what is in place? Not likely.
I have agreed that people in the bottom 50% have problems. That beats the less than 20% your link claims. Or maybe in combination they show that most people don't have "high medical costs." I have shown that most people in the top 25% should not have problems. I have even agreed to pay for health care of all those who are less than able to pay for health care.

The ACA is a lot like HSAs. Those who had enough money benefited. I am unwilling to pay insurance premiums to help out the poor guys who would rather have stuff - second homes, boats, new cars, than pay their medical bills. (I was one who benefited from HSAs. And I am willing to forego a second home, boats and new cars to pay for my family's health care.)

Lots of pictures for you. You might think it is from a stinky dark place - the internet.
https://www.excellusbcbs.com/wps/wcm/connect/7238a37f-e7b4-4a0a-b787-7af0b7b4c121/Concentration+and+Consumption+FS-EX+FINAL+FALL+2012.pdf?MOD=AJPERES&CACHEID=7238a37f-e7b4-4a0a-b787-7af0b7b4c121

To help you out the table on the second page shows the average for the top 1% of spenders is $90K. That almost means (the median would support this but they use the average) that 99.5% pay less than $90K. You might also note later text that says about 50% of the top 10% of spenders are over 65. Anyone with $100K of income (top 25%) can afford to be in the bottom 95% - It only reduced their income from $100K to $75K. Compare that lifestyle to that of those making $50K.

Want better numbers. CDC has them. Even a quick Google search has them. You should feel embarrassed that you could not find numbers that support my point. (I have found the numbers that "support" your point. I find them misleading.)

Canoez
06-02-2017, 11:06 AM
I have agreed that people in the bottom 50% have problems. That beats the less than 20% your link claims. Or maybe in combination they show that most people don't have "high medical costs." I have shown that most people in the top 25% should not have problems. I have even agreed to pay for health care of all those who are less than able to pay for health care.

The ACA is a lot like HSAs. Those who had enough money benefited. I am unwilling to pay insurance premiums to help out the poor guys who would rather have stuff - second homes, boats, new cars, than pay their medical bills. (I was one who benefited from HSAs. And I am willing to forego a second home, boats and new cars to pay for my family's health care.)

Lots of pictures for you. You might think it is from a stinky dark place - the internet.
https://www.excellusbcbs.com/wps/wcm/connect/7238a37f-e7b4-4a0a-b787-7af0b7b4c121/Concentration+and+Consumption+FS-EX+FINAL+FALL+2012.pdf?MOD=AJPERES&CACHEID=7238a37f-e7b4-4a0a-b787-7af0b7b4c121

To help you out the table on the second page shows the average for the top 1% of spenders is $90K. That almost means (the median would support this but they use the average) that 99.5% pay less than $90K. You might also note later text that says about 50% of the top 10% of spenders are over 65. Anyone with $100K of income (top 25%) can afford to be in the bottom 95% - It only reduced their income from $100K to $75K. Compare that lifestyle to that of those making $50K.

Want better numbers. CDC has them. Even a quick Google search has them. You should feel embarrassed that you could not find numbers that support my point. (I have found the numbers that "support" your point. I find them misleading.)

You undercut the people spending over $90K by half in your initial posting with data from 2009? You'll need to do better.

No the ACA is not like and HSA. At all. Go do your homework. The ACA is about providing more, better benefits for all and preventive care to avoid higher costs in the long run. An HSA is about insuring for catastrophic costs.

I did post data. From the CDC. Which supports my point.

Note that your data shows expenditures per person per year. Any one of us could be that 1% individual with a $90K annual expenditure due to accident or illness. Some of us could be that individual in successive years, and I can think of very few individuals with an average household income that could deal with those sorts of expenses two years running.

You make huge, unsubstantiated assumptions about lifestyle. Youuuuge.

Norman Bernstein
06-02-2017, 11:09 AM
An HSA is about insuring for catastrophic costs.

Actually, not... it was only intended to 'help' cover the deductibles and co-pays.

Canoez
06-02-2017, 11:22 AM
Actually, not... it was only intended to 'help' cover the deductibles and co-pays.

Yeah, actually it is - because it is attached to a high deductible plan.

I should point out that in my experience, the HSA's attached to the high deductible plan that my employer had at the time was a mechanism to funnel money elsewhere. In this case, into the pocket of bankers who were charging outrageous fees for the account, the checks, transaction fees, etc. Because of the limited number of places to put HSA dollars, the audience was a captive one. Neither I, nor my fellow employees, ever saw the benefits of either.

Norman Bernstein
06-02-2017, 11:26 AM
Yeah, actually it is - because it is attached to a high deductible plan.

I would still disagree. The deductibles in high deductible plans still don't approach the cost of many serious procedures, by a long shot. If you need a $500,000 operation, then the difference in a $1000 deductible and a $12,000 deductible will be significant to your personal financial situation.... but it will still not come close to covering the full expense. How many people accumulate $500,000 in their HSA accounts?

Canoez
06-02-2017, 11:33 AM
I would still disagree. The deductibles in high deductible plans still don't approach the cost of many serious procedures, by a long shot. If you need a $500,000 operation, then the difference in a $1000 deductible and a $12,000 deductible will be significant to your personal financial situation.... but it will still not come close to covering the full expense. How many people accumulate $500,000 in their HSA accounts?

The plans we had covered nothing - literally nothing - until you reached $5K in annual expenses after having paid several thousand in premiums. At that point it became an 80/20 plan in terms of what was covered for the next $2K or $2.5K. So, you've now spent about $8K and are starting to see coverage - for almost everything, but there were exceptions still that were un-covered expenses. For folks making less than $40-50K/year, that's a significant chunk of change. That's without contributions to the HSA which is another expense and paying fees for the HSA itself.

I can think of nobody that could or would accumulate $500K in their HSA.

If you can't tell, I'm not a fan of either high-deductible insurance or HSAs. :rolleyes:

Norman Bernstein
06-02-2017, 11:35 AM
I can think of nobody that could or would accumulate $500K in their HSA.

If you can't tell, I'm not a fan of either high-deductible insurance or HSAs. :rolleyes:

We're certainly in agreement on THOSE points.

Canoez
06-02-2017, 11:41 AM
We're certainly in agreement on THOSE points.

I think if you are an individual, you can contribute up to $3,300 or $3,400 per year and there is a "catch up" provision which allows for $1,000 more per year. Being that HSA's have been around since 2003, an individual who has withdrawn nothing would have about $45K plus some modest gains from earnings, less fees. Not that much.

Plus, that individual would still be paying other fees for the insurance.

Too Little Time
06-02-2017, 05:35 PM
You undercut the people spending over $90K by half in your initial posting with data from 2009? You'll need to do better.

No the ACA is not like and HSA. At all. Go do your homework. The ACA is about providing more, better benefits for all and preventive care to avoid higher costs in the long run. An HSA is about insuring for catastrophic costs.

I did post data. From the CDC. Which supports my point.

Note that your data shows expenditures per person per year. Any one of us could be that 1% individual with a $90K annual expenditure due to accident or illness. Some of us could be that individual in successive years, and I can think of very few individuals with an average household income that could deal with those sorts of expenses two years running.

You make huge, unsubstantiated assumptions about lifestyle. Youuuuge.
If you want more recent numbers, you have access to the internet.

The CDC numbers do not refute my position. Which should be your goal. As I said 50% of individuals cannot afford healthcare. It is impossible to argue that the bottom 50% need less help than those in the top 25%.

Actually only .25% of individuals under 65 have a $90K or greater expenditure in any given year. 99.75% have expenditures less than that. Over a 65 year period 99.75%^65 (85% of individuals) never have annual expenditures above $90K.

I could do the same math using the top 5% and show that those in the top 25% of income people can afford to pay the average expenditure for the top 10% of health care consumers. But it would be a waste of my time.

Too Little Time
06-02-2017, 05:52 PM
Yeah, actually it is - because it is attached to a high deductible plan.

I should point out that in my experience, the HSA's attached to the high deductible plan that my employer had at the time was a mechanism to funnel money elsewhere. In this case, into the pocket of bankers who were charging outrageous fees for the account, the checks, transaction fees, etc. Because of the limited number of places to put HSA dollars, the audience was a captive one. Neither I, nor my fellow employees, ever saw the benefits of either.
Our HSA bank has a $5/month fee for low balance accounts. They do free transfers to and from the brokerage account or our bank. Both my wife and I pay the $5/month. We have only $250 in the bank accounts - 50 months worth of fees. We have $135K in our HSA brokerage account. The brokerage accounts have the usual $10 (now $6) fee for stock purchases and sales.

The fees at our HSA bank and brokerage seem to standard for the industry. (They do charge for wire transfers, mailed statements and checks, but ACH transfers and internet statements are good enough. We pay providers out of pocket and then take money out of the account every 5 or 6 years. We just don't have much medical expense. (With the exception that medical expenses can be paid tax free the HSA acts like a traditional IRA.)

HSAs could be used for catastrophic expenses, but that is not how all people use them. Some people keep no money in them and just run medical bills through the account to get the tax break each year. That is why many have low balances. But a good number of individuals use them as IRAs and never intend to take money out. The rich have all sorts of options.


I can think of nobody that could or would accumulate $500K in their HSA.
If I had known I could invest in stocks, I would have a lot more in my HSA. Those thinking of using an HSA like an IRA could have $500K. But $500K is a ridiculous amount to use as an example of medical needs. The maximum out of pocket was $10K for the insurance portion. $100K in an HSA would provide that deductible forever - at least in my investment model.

Osborne Russell
06-02-2017, 06:13 PM
I thought the big thing was getting control of costs. The way I see it, with govt health care, you have your quotient of stupidity and thievery. Without it, the stupidity is about the same, the thievery isn't in the same league. They have to hire people to count the loot and launder it.