Health Insurance Discussion

[OhioFiler]

]I don't know that they deserve to be paid that low[/B]. (Or mechanics make alot more than I think!). European doctors make about 1/2 what US doctors do, but they also don't have that college loan burden as their medical school are paid for by the government. From what I have read that's still in excess of $100K a year. Maybe have some loan forgiveness in exchange for working a certain number of years in rural or less desireable areas would be one of the answers.

We live in a free market economy. The market sets the wages. Interference by the government always makes the situation worse. Always.

[justbroke]

We live in a free market economy. The market sets the wages. Interference by the government always makes the situation worse. Always.

My thoughts in all this, and how I dragged it out... You eitehr go all the way to socialized medicine, or you leave it as a market-based (cost-per procedure) model (while maybe doing some tort reform).

The problem is, you can't have a semi-public system. We are already seeing the waste, fraud and abuse of the Medicaid and Medicare systems, through overcharging, double billing, and outright fraud. The reason for the abuse of those programs are squarely because of the reimbursement rates as well as the ease of actually doing it.

[OhioFiler]

My thoughts in all this, and how I dragged it out... You eitehr go all the way to socialized medicine, or you leave it as a market-based (cost-per procedure) model (while maybe doing some tort reform).

The problem is, you can't have a semi-public system. We are already seeing the waste, fraud and abuse of the Medicaid and Medicare systems, through overcharging, double billing, and outright fraud. The reason for the abuse of those programs are squarely because of the reimbursement rates as well as the ease of actually doing it.

And it's easy because we have career bureaucrats minding the store. There is nothing more inefficient nor more wasteful than a government operation.

[JRScott]

I think voter apathy has more to do with having a First-Past-The-Post (FPTP)/Winner-Take-All system plus wild gerrymandering of districts. A candidate wins with 50.1% of the vote and the other 49.9% feel alienated, especially if there is strong polarization. In a district where say 70% affiliates with one party, the remaining 30% don't feel they ever have a shot winning so why vote at all.

Instant Runoff voting, Single Transferable vote, and MMP (Multi-member Proportional or something like that) moves that debate to the legislative body which actually makes the decisions.

The way it would work would be say Georgia had 9 districts. Ideally you'd use Instant Run-off for those elections but you could use FPTP. If using IR, you would rank the candidates you wanted to win. If you didn't care for any particular candidates, you'd leave them out of the ranking. So if you have 3 candidates running, During the 1st round, the candidate with the fewest votes is eliminated and those ballot's 2nd choice is entered. The winner would then be the one that had the most votes. You could technically get rid of primaries this way. You just have one election. Or the primaries could use this method to pick their 1 candidate then have 1 candidate per party in the general election today.

With MMP this is where it gets interesting. Say you double the seats available to each state. So GA would now have 18. 9 would be elected by district. The remaining 9 would be awarded by party (which you would vote for in addition to the candidate - it doesn't have to be the same as the candidates party though). Lets say the republican candidate won all in all 9 districts. The democrats and libertarians and greens feel pretty left out. If the total of all the votes showed 55% voted for republican and 35% democrat 8% libertarian and 2% Green. Those new 9 seats would come into play. The winners of the districts have guaranteed seats, but the system "tops up" to come closer to the actual party makeup of the vote. So we'd take 55% of 18 which is 10. The Republicans already had 9 seats, so they will get 1 additional. The Democrats get 35% of 18 - which is 6. The Libertarians get 1 (8% of 35). The Greens get none because a party would have to get more than 3% of the vote to be eligible for "topping up". (However, any party that actually won a district seat would be able to keep it). That leaves 1 open seat. It can either be left vacant or filled by the party with the greatest remainder.
Under the current system 100% of the Georgia delegation would be republican. Under MMP, the delegation from Georgia would be 55% republican, 33% democrat and 5% Libertarian. So pretty much everyone partywise is now represented.

Then it's up to those in the house to form coalitions to form majorities. And those coalitions might shift given different topics being discussed.

This would allow everyone to be represented in actually making policy.

Of course that doubles the size of the House of Representatives :-)

Other changes I would also add:

The Reps should not make more than twice the median of their homestate with additional compensation for the difference in housing prices in DC vs their home state and travel expenses.

I'd also want a "Single Subject" rule implemented so that pork barrel stuff can't be tacked on to bills that originally had nothing to o with the original purpose. Possibly, add to that a line item veto for the president.

If there is a public healthcare option, congress and all gov't employees would have to participate.

Any pension benefits would be tied to the number of years served in Congress.

Any travel, especially foreign, would need to be approved by their home state's legislature and/or governor.

While what you cite is part of the problem the majority of the problem is really hand outs from the government such that almost a third of the nation does not pay any income tax and indeed gets what amounts to free money. In order for democracy to work everyone has to feel the pain of taxes, because when we feel pain is the only time we pay attention. That 1/3rd which also has a very poor voting record over the last 3 decades is more than enough to swing any election.

What you suggest actually isn't new.

"Article the first... After the first enumeration required by the first article of the Constitution, there shall be one Representative for every thirty thousand, until the number shall amount to one hundred, after which the proportion shall be so regulated by Congress, that there shall be not less than one hundred Representatives, nor less than one Representative for every forty thousand persons, until the number of Representatives shall amount to two hundred; after which the proportion shall be so regulated by Congress, that there shall not be less than two hundred Representatives, nor more than one Representative for every fifty thousand persons."

That's actually the 1st proposed Amendment to the Constitution, see the bill of rights started out as 12 Amendments not 10, only 10 were ratified at that time. Techinically this Amendment is still pending before the states. 11 States have ratified it (Including the one I live in). If you could get 17 more states to ratify it then it would become law. Unlike modern amendment proposals it never had an expiration date (and this was established by the Supreme Court in 1939)

(The original 2nd Amendment of the Bill of Rights was later ratified and is currently the 27th Amendment).

If passed today you could see a House of Representatives as large as 6000 if you accepted the 1 per 50000 as a minimum. That was the original intent of it, and yes that would make a far better system than we have today.

Another thing that hurts voters is large states. Ideally they should be broken up into smaller states, Texas could do it at anytime they decided to as it was part of the agreement of them joining the Union that they could subdivide into 5 states at any time their Legislature agreed to do so. Other states would be harder to break up, it would require their legislatures as well as the US Congress to approve. But in essence beyond 10-15 electoral votes per state is hurting the voters as you point out because the minority is drowned out by the majority thus skewering things like today where we have uber liberal congress when most americans are just right of center.

How districts are drawn is a matter of problem to. Originally Jefferson envisioned 7 sq mile districts, this was later dropped while the framers were drafting the Constitution in light of the population method. We have districts now that run like snakes over the ground. They were never intended either and are made to solely keep certain members of congress in power.

[SweetGeorgia]

From way back - DownNotOut, I'm not criticizing you for voluntarily self-insuring. Might be the smartest thing to do; we pay for the insurance but still don't have peace of mind. I guess I don't feel very oppressed by the government. It's the corporations that have their boot on MY neck.

As for taxes, I rather like the Fair Tax even though I loathe Neal Boortz. It would be about as progressive as the current system (way better for the people at the very tiptop, but whatever) and MUCH less expensive to administer. I like single-payer for the exact same reason.

Next time you go to the doctor, pay attention to how many women behind the desk have phones to their ears, sitting on hold. There's one to verify coverage, one to get referrals, one to appeal denials, and so on....

[JRScott]

Oh on my post above you need 27 more states not 17 that was a typo .

A Fair tax incidentally would be a tax whose burdened is felt equally by all participants. For example a tithe is a type of fair tax as it request the same portion of a persons income regardless of their economic status. Unless all people have pain and thus incentive to participate in our Democratic Republic, we will lose it.

[hereforinfo]

We often hear there are 47 Million uninsured Americans. I would love someone to break this list down by who these people are. How many are voluntarily uninsured? How many are temporarily uninsured? How many are illegals? How many are eligible for existing programs? I believe the actual number of uninsured Americans is around 10-15 million. Why can't we look to assist these people without overhauling the entire system?

Exactly! I know off the top of my head two families who have no health insurance because they don't want to pay for it and claim they can't afford it. One of those families has a new boat, for which the monthly payment is about the same as an insurance premium. Their daughter is on medicaid, so our taxes pay for her healthcare so they can pay for their boat.

The other family takes several lavish vacations each year and the wife doesn't work even though their daughter is in preschool full time. The husband only works periodically BY CHOICE. He quit his most recent job after a few months has turned down 2 other job offers because he didn't think he would enjoy working at those companies.

I think a LOT of those people could afford health care but their priorities are messed up.

[OhioFiler]

Exactly! I know off the top of my head two families who have no health insurance because they don't want to pay for it and claim they can't afford it. One of those families has a new boat, for which the monthly payment is about the same as an insurance premium. Their daughter is on medicaid, so our taxes pay for her healthcare so they can pay for their boat.

The other family takes several lavish vacations each year and the wife doesn't work even though their daughter is in preschool full time. The husband only works periodically BY CHOICE. He quit his most recent job after a few months has turned down 2 other job offers because he didn't think he would enjoy working at those companies.

I think a LOT of those people could afford health care but their priorities are messed up.

O'bama chopped 15 million off the list last night by avowing not to cover illegal aliens (which led to Rep Wilson's outburst of "LIAR"). So now he has the list at 30,000,000.

I suspect folks like your acquaintances are in for a real shock if O'bama's pledge last night to FORCE them to buy insurance comes to fruition. They might have to either give up the boat, get a job or go on disability.

Liberals insist hard working Americans foot the bill for lazy fools under the guise of helping the less fortunate. I agree we should help those who are truly in need. For the others I say reap what you sow. If your boat is more important than health insurance no problem. Just don't come looking to me to pay for your gall bladder removal.

[TooMuchCredit]

While a "fair tax" seems to make sense on paper, I don't know that it works out in reality. Just because wealthier folks have more money, doesn't mean they spend it. They invest the excess. (which is good as that is how companies get started). Everybody up to a certain point of income is buying things just keep a roof over their head, food on the table etc. After you hit a certain point you have more than enough to meet your basic needs. I guessing the thinking is they'll use that extra money to buy jet skis, boats, jewelry etc.

Here is the scenario I that sort of makes me think it wouldn't work like it sounds. Now if I have a new product that people are interested in. If as was stated the current system, the bottom 50% of taxpayers that pay 2% tax now will pay the across the board 6% under the flat tax, they lost 4% of their income to taxes and now don't have the discresionary income to purchase said product. Weathlier folks only need 1 of this product so they just put their extra $ in the bank. That means you lost say 50% of your sales.

So it actually would cause fewer things to be bought and hurt the overall economy.

[justbroke]

Here is the scenario I that sort of makes me think it wouldn't work like it sounds. Now if I have a new product that people are interested in. If as was stated the current system, the bottom 50% of taxpayers that pay 2% tax now will pay the across the board 6% under the flat tax, they lost 4% of their income to taxes and now don't have the discresionary income to purchase said product. Weathlier folks only need 1 of this product so they just put their extra $ in the bank. That means you lost say 50% of your sales.

The 2% represents the federal tax burden. Trust me, there are more taxes like State and Local income taxes, and then sales and use taxes, that are not in that number.

Wealthy folks bury their money in long term treasuries (TIPS) so they don't actually pay tax on that money every year. A serious long term investor will "shelter" money in these things for a minimum of 10 years. Do you know what tax rate the wealthy pay on long term investments? It's 15%.

So, there really isn't a big gap in this and it's certainly not a 50% tax gap. But I do understand your point fully. The issue is that the wealthy and certainly the upper middle class, are the group that actually create jobs. Most jobs in this country are from small business. This will continue to be the case. It is absolutely proven, that the more money these middle class and wealthy investment type citizens have access to, the more they invest in "businesses". There was an explosion of chain restaurants, coffee shops, and fast food joints... and guess who owns them? When taxation hits those owners to hard, guess what happens?

It is certainly a balancing act. I had a small chain of 5 retail stores myself in the late 1990's and early 2000s. Taxes killed me and there went 10 people with no jobs. So there also went 10 taxpayers on unemployment, and then not providing any revenue into the system. What's a bigger loss? The 10 people not paying about 10-15%, or me still paying my 39%?

The key to "revenue" to fund the federal government, is an increase in jobs. A government -- that runs on revenue from taxation -- cannot support itself by making it harder for the people who actually create jobs by raising or otherwise stifling them with other burdensome requirements.

This is why tax cuts almost always are directed towards those who can increase revenue by creating jobs. It's a no brainer if you want a market driven economy.

[OhioFiler]

The 2% represents the federal tax burden. Trust me, there are more taxes like State and Local income taxes, and then sales and use taxes, that are not in that number.

Wealthy folks bury their money in long term treasuries (TIPS) so they don't actually pay tax on that money every year. A serious long term investor will "shelter" money in these things for a minimum of 10 years. Do you know what tax rate the wealthy pay on long term investments? It's 15%.

So, there really isn't a big gap in this and it's certainly not a 50% tax gap. But I do understand your point fully. The issue is that the wealthy and certainly the upper middle class, are the group that actually create jobs. Most jobs in this country are from small business. This will continue to be the case. It is absolutely proven, that the more money these middle class and wealthy investment type citizens have access to, the more they invest in "businesses". There was an explosion of chain restaurants, coffee shops, and fast food joints... and guess who owns them? When taxation hits those owners to hard, guess what happens?

It is certainly a balancing act. I had a small chain of 5 retail stores myself in the late 1990's and early 2000s. Taxes killed me and there went 10 people with no jobs. So there also went 10 taxpayers on unemployment, and then not providing any revenue into the system. What's a bigger loss? The 10 people not paying about 10-15%, or me still paying my 39%?

The key to "revenue" to fund the federal government, is an increase in jobs. A government -- that runs on revenue from taxation -- cannot support itself by making it harder for the people who actually create jobs by raising or otherwise stifling them with other burdensome requirements.

This is why tax cuts almost always are directed towards those who can increase revenue by creating jobs. It's a no brainer if you want a market driven economy.

The answer is different from a liberal or a conservative. The conservative says it's absolutely a bigger loss to lose 10 taxpayers.

The liberal expects you to share the wealth, that you have no right to evil profits, that it is your duty to care for these poor displaced people.

[TooMuchCredit]

What I was trying to say and didn't say it very clearly is that if the less wealthy pay less, they have more money to buy "stuff". Wealthier people tuck the money away. So increasing the tax on the poorer folks causes them to be unable to buy more "stuff". And if there are fewer people buying "stuff", any businesses that are opened with that tucked away money wouldn't have as many customers to buy "stuff" so they might not be successful.

So if you did a flat income tax of 25%, that means poorer people will pay significantly more of their income. Wealthier people who were paying 39% now pay 25%. So you have a group of people who can no longer afford to buy "stuff" and you have another group that has alot more money now that they tuck away or if they do invest it into a business there aren't as many customers to buy their "stuff".

So it seems you kind of have to make the structure progressive or you shoot yourself in the foot :-)

Now not all of those poorer folks are sitting on their porch while the wealthier are our working hard at their jobs. There are many poorer folks who work hard at jobs that just don't pay that much. They are content and live within their means. Their lower taxes allow them to live comfortably and be able to buy "Stuff". I think all we see though are the ones that have their hands out. I think those folks are the minority.

[OhioFiler]

What I was trying to say and didn't say it very clearly is that if the less wealthy pay less, they have more money to buy "stuff". Wealthier people tuck the money away. So increasing the tax on the poorer folks causes them to be unable to buy more "stuff". And if there are fewer people buying "stuff", any businesses that are opened with that tucked away money wouldn't have as many customers to buy "stuff" so they might not be successful.

So if you did a flat income tax of 25%, that means poorer people will pay significantly more of their income. Wealthier people who were paying 39% now pay 25%. So you have a group of people who can no longer afford to buy "stuff" and you have another group that has alot more money now that they tuck away or if they do invest it into a business there aren't as many customers to buy their "stuff".

So it seems you kind of have to make the structure progressive or you shoot yourself in the foot :-)

Now not all of those poorer folks are sitting on their porch while the wealthier are our working hard at their jobs. There are many poorer folks who work hard at jobs that just don't pay that much. They are content and live within their means. Their lower taxes allow them to live comfortably and be able to buy "Stuff". I think all we see though are the ones that have their hands out. I think those folks are the minority.

Wealthier people "tuck" their money away in the capital markets. This capital in turn is used to finance new business ventures which in turn create jobs which in turn create tax revenue AND income for the lower wage earner. It's a win-win!

[justbroke]

What I was trying to say and didn't say it very clearly is that if the less wealthy pay less, they have more money to buy "stuff". Wealthier people tuck the money away.

Ah, but the money they "tuck" away goes into Treasuries and other market accounts. This allows capital to be available for borrowing! The Federal Reserve uses those Treasuries as well to loan money to banks and business.

Trust me... I'm in the top 2% and I spend spend spend. I have some money invested, but guess what happens to that money? Yep, it's loaned out to other people who in turn spend it.

So if you did a flat income tax of 25%, that means poorer people will pay significantly more of their income. Wealthier people who were paying 39% now pay 25%.

I never advocated a flat tax system. I advocated a value added tax like they have in the European Union.

Now not all of those poorer folks are sitting on their porch while the wealthier are our working hard at their jobs.

Not true. The reason there are jobs -- and more than 50% of all new jobs are small business jobs -- is because the so-called "wealthier" folks are looking to "invest" their money in business. Yes, it's a cooperative system and requires everyone to participate.

Headline, in July, small business added 50,000 while medium to large businesses lost 41,000 jobs. That is astounding. This will continue to be the trend. Small business owners are people not too dislike me. They are investors who want to open up that new Chipotle franchise, or staff up a new Holiday Inn Express franchise they just built. Oh, and their building that Holiday Inn Express kept many construction workers employed for a year alone.

A financial writer, after researching this small business phenomenon, wrote that these increases in small business jobs comes from three things... "sales increase, innovation and low taxes".

[JRScott]

The answer is different from a liberal or a conservative. The conservative says it's absolutely a bigger loss to lose 10 taxpayers.

The liberal expects you to share the wealth, that you have no right to evil profits, that it is your duty to care for these poor displaced people.

What's funny is that most of these liberal politicians have never given 10% to charity in their lifes, whereas many conservative ones have.

Take for example Barack Obama's and Joe Biden's tax returns for the last 10 years. They did not on any year manage to give even 10% to charity, not even 5%. I think Joe on a few years gave as little as 1%. So if it is their duty, why haven't they been doing it?

Don't get caught up in Rhetoric spin, that's really all you get from the Republicans and Democrats. They realize so long as 1/3rd of the country is basically paid not to vote because without having taxes and getting free money they have no incentive to vote they'll stay in power. It has been their philosophy for almost a century. They are not the party of Lincoln and Jackson and haven't been for well about a century.

Andrew Jackson would be appalled at the mess his party has made of this nation. In fact Old Hickory might be tempted to run em out of town. Abraham Lincoln wouldn't be all that happy with the Republicans either and would no doubt deride them for the mess they've made.

Keep in mind your Senators and Representatives after all perks are counted are making at least 5 times the national average. See when your company is facing hard times they slow down raises, cut coverage on your health care etc, but Congress doesn't do that. It plods along each year increasing its wage in cost of living adjustments (to get around the 27th amendment since the Supreme Court ruled that a COL adjustment was not a raise....odd that they did not include such a COL adjustment in the minimum wage...seems it would have been appropriate) and increases its perk budgets yearly as well.

Keep in mind almost no member of Congress nor the President have been willing to go onto this 'public option' they are peddling. If its so good for you, why isn't it good enough for them?

These men and women are suppose to be servants of the people not lords and ladies of the people.