Health care....Fix? - Tilted Forum Project Discussion Community

Chimera · 01-21-2007, 02:24 PM

It would seem Mr. Bush has decided to finally address one of the biggest financial crisis facing most Americans, and is doing so in his usual way. Here we have what seems to be an Oxymoron (no pun intended), as his alleged plan will be detrimental to those of us currently paying up to a third of our earning into a medical plan....to support those who simply cannot afford one at all. What happens when these poeple of poverty, make it big, and become middle class? They get taxed.

Lets see here.....No effect whatsoever on the wealthy, we'll have none of that.
Taxation of the dwindling middle class.
Incentives (wellfare), for the poorest.

I smell a warped socialism.

"WASHINGTON -- President Bush will propose deep tax breaks for Americans who purchase their own medical insurance and would finance the plan with an unprecedented tax on a portion of the healthcare plans that workers receive from their employers, according to the White House."

http://www.dfw.com/mld/dfw/16513010.htm

Ahhhh....The Irony.

"In 1993, United States President Bill Clinton's administration proposed a significant health care reform package. Clinton had campaigned heavily on health care in the 1992 election, and he quickly set up the Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, to come up with a comprehensive plan to provide universal health care for all Americans, which was to be a cornerstone of the administration's first-term agenda.

The result, announced by President Clinton in an address to Congress on September 22, 1993, was a complex proposal running more than 1,000 pages, the core element of which was an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely-regulated health maintenance organizations (HMOs)."

http://en.wikipedia.org/wiki/Clinton_health_care_plan

Willravel · 01-21-2007, 02:35 PM

I am 23 years old. I pay $515 a month for my health insurance alone. The average 23 year old in the US makes something in the neighborhood of 12-24k a year (I'll find a source for that later). That means that from one quarter to one half of the income would go to health insurance alone. Add on to that food, rent, utilities, etc., you have people who are getting more and more broke. It's wrong, and it pisses me off to no end.

I'm seriously considering starting a full out campaign to start REAL health care reform in this country. I'm doing research into what it takes to start a non-profit program for people, I'm doing research into what it takes to get a free lobyist, etc. If anyone wants to help, PM me.

dksuddeth · 01-21-2007, 04:10 PM

anything to keep the insurance companies with a steady and growing income.

Lizra · 01-21-2007, 05:57 PM

I recently went to a luncheon to hear a guy tell our little Art Center how to try to get grants. Some rich dude, didn't look much older than me, but had already retired....he decided to start some sort of organization to dole out $$$ to "deserving" groups to pass his time now.

He made all his big $$$ in health care administration. After making sure none of us were reporters....he said "If you didn't make $$ in the health care administration field in the 90's....there was something wrong with you."

I just wanted to puke.
Our small family pays over $500 a month for insurance too.....$40 a pop for my husband's monthly prescriptions on top of that. There is no "extra" $$ anymore.

It's scary.....

flstf · 01-21-2007, 08:44 PM

It does not seem fair to allow people's employers to provide insurance tax free while at the same time not allowing those who purchase insurance on their own to not be able to deduct the cost. I'm not saying it is a great idea to tax the benefit (income) but it is a good idea to allow for the deduction.

Besides I imagine that the amount an employee spends on insurance would also be deductible and most times would be larger than the additional tax on the employer provided benefit.

Quote:

The basic concept of the plan is that employer-provided health insurance, now treated as a fringe benefit exempt from taxation, would no longer be entirely tax-free. Workers could be taxed if their coverage exceeded limits set by the government. But the government would also offer a new tax deduction for people buying health insurance on their own.
----snip---
The Bush administration estimates that 80 percent of people with employer-provided plans would see their tax liability fall because the deduction would be larger than the value of their insurance plans.

host · 01-21-2007, 10:26 PM

Quote:

Originally Posted by flstf

It does not seem fair to allow people's employers to provide insurance tax free while at the same time not allowing those who purchase insurance on their own to not be able to deduct the cost. I'm not saying it is a great idea to tax the benefit (income) but it is a good idea to allow for the deduction.

Besides I imagine that the amount an employee spends on insurance would also be deductible and most times would be larger than the additional tax on the employer provided benefit.

Let us compare the impact of a "benefit tax" on an employee who earns $40k vs. and employee earning $200k per year.

The $40k earner spends all of his disposable income to provide necessities and a few non-necessities for his household each year, and pays sales taxes on all that he has spent.

The $200k earner does not need to spend all of his income, just to live, and does not pay sales tax on the portion not spent on necessary retail purchases.

The $40k is taxed at a 7-3/4 percent rate on his entire income, for SSI and medicare insurance.

The 200K earner is taxed on only the first $90k of his income for SSI & medi, so the tax rate for him, on his entire income is just 3-1/2 percent.

Assume that the benefit amount in Bush's proposed tax is $6000 per year, and the tax is 10 percent. The added tax burden to the $40k per year earner is an additional yearly tax of 1-1/2 percent of his entire income, vs. a tax of just 3/10 of one percent for the $200k earner.

The $40k earner, statistically, is likely to own no common stock in health insurance or in any other stock company.

The $200k earner has contrbuted to the campaigns of his congressman and senator. He is more likely to persuade his representatives to vote yes for Bush's "reform" bill, than ten or fifty $40k earners who contact their reps to vote "no", but who never could afford to be campaign contributors, could hope influence the rep's vote.

The $200k earner is more likely to own or to buy stock in the health insurance vendors who stand to gain from Bush's tax plan. The $200k earner buys a hundred shares in Aetna tomorrow, and he sells the stock on the news that Bush's plan has passed in the senate, after it passed in the house.

The $200K earner nets $1k on his stock trade, pays 15 percent cap gains tax, $600 for Bush's new health benefits tax, and goes out for a nice dinner with a nice bottle of cabernet with the last $150 from his stock trade profits.

The $40k earner drops his weekly family vacation savings set aside from $20 per week, to $8, and uses the other $12 to compensate for the weekly payroll tax increase resulting from Bush's health benefit tax.

Sounds fair to me, too....great reform idea, president Bush !

flstf · 01-22-2007, 12:08 AM

Host

Let's compare two people each making the same amount per year. One is given a $10K insurance benefit per year by their employer tax free while the other has to spend $10K for the same insurance with no deduction.

It does not seem fair to allow one whose insurance is provided by their employer to take a tax credit (or not have to claim the income at all) for the total cost and the one who has to buy their own insurance to not even be able to deduct the amount from their taxable income.

Why shouldn't these two people be treated the same as far as taxes and deductions are concerned? Shouldn't a person without employer provided insurance be given the same deduction or at least shoudn't they both be taxed the same? Those without employer provided insurance should not have to pay additional taxes simply because they have to buy their own insurance. The tax code should treat the cost of insurance the same whether an employer is providing it or the person has to buy their own.

host · 01-22-2007, 02:30 AM

flstf, according to the 2006 tax prep. IRS guidelines:

http://www.irs.gov/publications/p502/ar02.html

If you pay $6k annually out of pocket with net income dollars, and you make $40k per year, you can deduct the excess of 7-1/2 percent of your adjusted gross income. If you have a file your tax return with a family of 3 standard deduction, for simplicity's sake, I'll use a round number of a $30k adjusted gross, defined as adjusted by subtraction of $10k standard deduction.

$30k X 7.5 percent= $2250. $6000 medical insurance expense, less $2250 equals $3750 eligible for deduction from taxable adjusted gross income.

This adjustment, coupled with, for example, with $6000 of deductible mortgage interest, $2000 deductible property tax, $300 deductible vehicle tax, $500 deductible charitable donation expense, and your total deduction could then exceed the original $10,000 standard deduction,
$6000 + $3750 + $2000 + +500 + $300, and now your total deductions are $12,500 instead of the original $10,000 standard deduction.

Deductions for medical treatment co-pay expenses, prescription expenses, transportation expenses, tax preparation fees, originally ineligible because the $40k annual earner could not "beat" the $10k standard deduction, become eligible when the $3750 medical insurance premium deduction allows the taxpayer to exceed the original $10k standard deduction.

To sum it up, under the current taxation structure, the "little guy", with a modest income and deductions formerly too small to exceed the standard deduction, receives income tax reduction on a significant portion of his out of pocket medical premium expense.

The purpose of the "standard" deduction allowance is to simplify tax filing and the "standard" includes consideration of "average" deductions for a single or a couple with "X" number of child dependents and an average size mortgage interest and property tax deduction, or a renter with a similar income.

So, there is already an allowance for payment of some medical and medical insurance expenses factored into the standard deduction tax tables.

The status quo is that the tax system is progressive, but skewed in favor of those who earn income above $90k because SSI & Medi tax withholding stops there.

Recently I posted a table from the census.gov site that illustrated how few singles exceed an annual household income of $80K per year, and how few multi-person households exceed income of $150k.

If your income exceeds "average" or mean, the system is designed for you to pay a progressively higher tax than the lower 2/5 ths of tax filers earn.

Bush's "reform" would reverse that and shift some of the tax burden for financing universal insurance premiums, to those who already spend everything that they earn on necessities.

No one expects that employees who work for firms that offer above average pension, vacation, or holiday benefits, to suddenly pay a tax to subsidize those who work for less generous or prosperous employers. Many law enforcement personal are permitted to retire, with immediately redeemable taxpayer paid retirement benefits, after just 20 years of employment.

Should those favored employees pay a tax to subsidize those of us who must work until age 66 to qualify for pension benefits?

The wealthiest are experiencing the initial stages of a period when their percentage of total income taxes paid by all tax payers will shift to the tiers under their tier. Would it not be fairer to levy an excess profits tax or a markup "cap" on insurance company medical coverage premiums, or a higher capital gains tax on stockholder dividends and gains from stock sales in that industry? Should the "little guy" with most of his medical premiums provided as a company benefit, pay more, along with the modest income earner who shoulders is entire health insurance premium cost, because Bush's government failed to secure the borders or to enforce laws that prohibit illegal residency?

Should the average or below average income employee with a health insurance employment benefit, be taxed to pay the added cost built into health insurance premiums because the federal government refuses to fully reimburse county and municipal hospitals for providing care to elderly or welfare patients, or to the uninsured? The government and private policy holders are paying for all of the medical care, for everyone in the country, and they always have.

The Bush administration and congress have refused to put policies in place to manage how this care is dispensed, resulting in huge and avoidable expenses shifted to public hospitals who end up operating emergency rooms that are used as outpatient clinics of last resort by the indigent and the uninsured, and by expensive treatment actual emergencies that could have been diagnosed and treated much more cheaply if medical clinics were available to routinely diagnose and treat less severe ailments at a much earlier stage in the progression of an illness or disorder.

This official, intentional neglect is further aggravated by the abandonment of the inner cities by government. Increasingly unequal wealth distribution, ignorant and ineffective illegal drug distribution and abuse enforcement, economics driven segregation, and illegal immigration, and the elimination of living wage employment opportunities formerly available to inner city residents before the disappearance of the American industrial manufacturing base, along with the withdrawal of the will of the federal government to encourage or provide affordable housing and equal public education, results in higher incidence of homelessness and violence that ends up at the doorstep of already overburdened and under supported urban public hospitals.

Bush is proposing another wealth shift from the wealthiest to the rest of us, and it's bullshit.

loquitur · 01-22-2007, 06:30 AM

My plan is to make third-party payment of medical expenses illegal (other than for catastrophic). Costs are out of control. Push down the costs and you, well, push down the costs. Get rid of the insane paperwork. What's now spent on med insurance would ultimately make its way into salaries. A dr visit would cost $40 instead of $100 (one doctor friend of mine said that 30-40% of his revenue is spent on insurance-related paperwork). The price of pills would come down. All you need is to have people being in charge of their own care. The biggest losers would be insurance companies and to a somewhat lesser extent pharma companies.

Yes, there would have to be some tinkering (the basic concept is sound but there are kinks that need to be worked out), but it's pretty clear to me you'd see benefits right away, and increasing over 5 years before levelling out.

flstf · 01-22-2007, 09:14 AM

Quote:

Originally Posted by host

flstf, according to the 2006 tax prep. IRS guidelines:

http://www.irs.gov/publications/p502/ar02.html

If you pay $6k annually out of pocket with net income dollars, and you make $40k per year, you can deduct the excess of 7-1/2 percent of your adjusted gross income. If you have a file your tax return with a family of 3 standard deduction, for simplicity's sake, I'll use a round number of a $30k adjusted gross, defined as adjusted by subtraction of $10k standard deduction.

$30k X 7.5 percent= $2250. $6000 medical insurance expense, less $2250 equals $3750 eligible for deduction from taxable adjusted gross income.

This adjustment, coupled with, for example, with $6000 of deductible mortgage interest, $2000 deductible property tax, $300 deductible vehicle tax, $500 deductible charitable donation expense, and your total deduction could then exceed the original $10,000 standard deduction,
$6000 + $3750 + $2000 + +500 + $300, and now your total deductions are $12,500 instead of the original $10,000 standard deduction.

Deductions for medical treatment co-pay expenses, prescription expenses, transportation expenses, tax preparation fees, originally ineligible because the $40k annual earner could not "beat" the $10k standard deduction, become eligible when the $3750 medical insurance premium deduction allows the taxpayer to exceed the original $10k standard deduction.

To sum it up, under the current taxation structure, the "little guy", with a modest income and deductions formerly too small to exceed the standard deduction, receives income tax reduction on a significant portion of his out of pocket medical premium expense.

The purpose of the "standard" deduction allowance is to simplify tax filing and the "standard" includes consideration of "average" deductions for a single or a couple with "X" number of child dependents and an average size mortgage interest and property tax deduction, or a renter with a similar income.

So, there is already an allowance for payment of some medical and medical insurance expenses factored into the standard deduction tax tables.
---snip---

That's my point I think. Shouldn't a person who buys their own insurance be able to deduct from their income the total amount like those with employer furnished insurance instead of just a portion?

I can tell you from experience, my wife and I with modest income have never been able to satisfy the 7 1/2 percent requirement for the partial deduction. I have family members who make much more and pay no taxes on their employer provided insurance benefit simply because it is not considered income for tax purposes.

I agree that the tax system and medical insurance (healthcare) are pretty messed up but it seems only fair to treat employer furnished and personally purchased insurance the same for tax purposes. I think Bush's proposal at least attempts to do this.

As a side note: Those who purchase their own insurance usually already have to pay more for the same coverage because they are not part of a negotiated group like most employers have.

kutulu · 01-22-2007, 09:54 AM

This 'plan' is bullshit. If the govt is not going to set up its own health care plan, then ALL money spent on it (down to copays and meds) should be tax free.

Furthermore, this won't make much of an impact on the amount of uninsured. If you can't afford it, being able to write it off at the end of the year won't change that.

flstf · 01-22-2007, 10:17 AM

Quote:

Originally Posted by kutulu

If the govt is not going to set up its own health care plan, then ALL money spent on it (down to copays and meds) should be tax free.

Furthermore, this won't make much of an impact on the amount of uninsured. If you can't afford it, being able to write it off at the end of the year won't change that.

I agree, but those of us who have to buy our own coverage should at least be treated the same as those whose employers provide it, at least for tax purposes. This certainly does little to solve the healthcare problem but it does make the tax system a little more fair.

aceventura3 · 01-22-2007, 02:04 PM

It is not the Federal government's responsibility to make sure every American has health insurance.

It is not an employer's responsibility to make sure every employee has health insurance.

It is not the responsibility of the "rich" to make sure every "poor" person has health insurance.

As long as American's have the opposite attitudes about health insurance the system will never get fixed.

The federal government will be inefficient, employers will focus on cutting costs, and the "rich" will always get better healthcare and have more healthcare options than the "poor". These truths may be sad, but they can not be ignored and will never change. Bush's plan doesn't address these issues nor has anyother proposed plan.

Willravel · 01-22-2007, 02:07 PM

It's no one's responsibility, so nothing gets done.

aceventura3 · 01-22-2007, 02:11 PM

Quote:

Originally Posted by willravel

It's no one's responsibility, so nothing gets done.

Personal responsibility.

First employers should pay me for the job I do.
Government should tax based on consumption to pay for government services as outlined in the Constitution.
Then I should make the best choice for me and my family based on the free market for healthcare.

flstf · 01-22-2007, 03:23 PM

Quote:

Originally Posted by aceventura3

Personal responsibility.

First employers should pay me for the job I do.
Government should tax based on consumption to pay for government services as outlined in the Constitution.
Then I should make the best choice for me and my family based on the free market for healthcare.

I believe that the government should be able to step in and take control when the nature of an important service like healthcare does not result in a free market. There seems to be little "free market pricing" of hospital charges and what little there is seems to be dictated by the insurance companies.

aceventura3 · 01-22-2007, 03:46 PM

Quote:

Originally Posted by flstf

I believe that the government should be able to step in and take control when the nature of an important service like healthcare does not result in a free market.

Government regulations and control are part of the problem. Our healthcare system currently spends too much of its resources to comply with what some in the industry have called excessive regulation. Our judicial system is another part of the problem. Government has a role, but in this case less would be more.

Quote:

There seems to be little "free market pricing" of hospital charges and what little there is seems to be dictated by the insurance companies.

Hospitals and insurance companies are regulated at the state level.

There are trade-offs, if you want highly restricted and regulated markets, like the hospital market, you in essence give monopolistic pricing power to those who meet the standards required.

I don't know the statistics but it would be interesting to see the successful birthrates of babies delivered by mid-wives 100 years ago, to that of hospitals today. If a person wanted to deliver a baby today using a mid-wive could she? If that option no longer exists, or is prohibative due to excessive regulation and the threat of lawsuits the cost goes up doesn't it?

I bet we could have a system that includes mid-wives that would provide high quality deliveries at a lower cost than our current system if we want to. These are the kinds of changes that will fix our healthcare system.

Willravel · 01-22-2007, 06:43 PM

Quote:

Originally Posted by aceventura3

Personal responsibility.

First employers should pay me for the job I do.
Government should tax based on consumption to pay for government services as outlined in the Constitution.
Then I should make the best choice for me and my family based on the free market for healthcare.

The free market has given birth to these outragous costs. The free market, left unchecked, will eventually spiral down to a system based on profit alone. As medicine is something everyone needs, they can afford to hike up prices to unreasonable heights and "personal responsibility" has no control over that. It is your and my responsibility to stop those free marketeers from taking advantage of or hurting people. How would I go about doing that? Threatening to take away their market. How would you do that? Put universal healthcare on the table. Either private healthcare shapes up, or federal healthcare takes over.

host · 01-22-2007, 08:42 PM

aceventura3, picture a funnel of money flow that begins with a wide mouth that sucks in all of the medical insurance premiums deducted from every worker's paycheck for the medicare portion of the FICA deduction, matched by an equal employer "contribution". It's comprised of 1.45 percent of earnings from each, or 2.90 percent total, of all W-2 earnings, wuth unlike the SSI joint deduction, <a href="http://en.wikipedia.org/wiki/Federal_Insurance_Contributions_Act_tax">no limit</a>.

Here is a report on what the private sector has been doing to medicare:

Quote:

http://www.sfgate.com/cgi-bin/articl...12/MN63168.DTL
Medicare bilked for billions in bogus claims
Private watchdogs rife with conflicts make system an easy target for fraud
- Reynolds Holding, Chronicle Staff Writer
Sunday, January 12, 2003

The system of private contractors policing the $250 billion-a-year Medicare program is riddled with conflicts of interest, financial disincentives and regulatory breakdowns so severe that fraud and abuse bleed tens of billions of dollars from the program every year.

Several of the most egregious frauds have involved the watchdogs themselves -- private insurance companies the government hires to examine and pay Medicare claims -- court records show.

But even reputable companies lack incentive to search for fraud. They serve at the behest of medical trade groups and, in some cases, are business partners with doctors and hospitals. They skimp on oversight, checking for the proper completion of claims forms but rarely for deceit.

The result is a variety of billing scams involving nonexistent patients, unnecessary treatments, phony tests, excessive charges, services never rendered or procedures billed more than once.

"It is utterly ridiculous," says Malcolm Sparrow, a health care fraud expert at Harvard University's Kennedy School of Government. "We are trusting insurance companies to do oversight of the medical profession, and they are riddled with corruption themselves."

Sparrow estimates Medicare fraud at $50 billion to $75 billion a year -- about twice the amount of Congress' most expensive proposal for helping senior citizens buy prescription drugs.

Fraud is so costly that it has helped force Medicare into drastic spending limits since 1997. Last year, the program cut doctors' reimbursement rates 5.4 percent, with an additional 12 percent reduction scheduled for the next three years. Lower rates have led many medical providers to drop Medicare patients, leaving millions of Americans without sufficient health care coverage.

The system's failures emerged with disturbing clarity Oct. 30, when FBI agents seized records involving two heart specialists suspected of billing Medicare for unnecessary procedures at Redding Medical Center.

Several days later, the medical center's owner, Tenet Healthcare Corp., announced that a private watchdog -- Mutual of Omaha -- had persuaded the federal Department of Health and Human Services to investigate the company for extracting billions of dollars in possible overcharges through a Medicare loophole.

No charges have been filed in either case.

But other Medicare scams are so brazen that critics say even cursory oversight would reveal wrongdoing.

From 1991 through 1997, Healthcare One, a medical equipment seller in Encinitas (San Diego County), persuaded more than 110 elderly cancer patients to order special pumps for draining excess lymph fluid. Though the pumps didn't meet federal standards, the company forged doctors' letters to certify that the patients could not survive without them.

Failing to check the paperwork, the Medicare watchdog reimbursed the company $5,400 for each pump, a total of more than $500,000 in public funds for bogus medical equipment.

"They jeopardized patients' lives in the name of the almighty buck," says Ray Pettersen, Healthcare One's former national sales manager. "And they weren't ripping off the government, but you and me and every other taxpayer."

CONFLICTS OF INTEREST

Medicare's persistent breakdowns derive in part from its size. The program, created in 1965 to guarantee health care coverage for Americans over 65 or with certain disabilities, covered more than 40 million Americans last year and paid about a billion claims.

But critics say the system's fraud problems stem from a compromise Congress struck with the health care establishment 38 years ago. Fearing socialized medicine, doctors and hospital owners agreed to participate in the program only after being allowed to select the insurance companies that process the claims and serve as the program's watchdogs.

Today, 49 private insurance companies work for the Centers for Medicare and Medicaid Services, the federal agency that runs Medicare.

The insurance companies receive bills from doctors and hospitals that treat Medicare patients, examine the bills for mistakes and then pay them with checks drawn on two federal trust funds. The trust funds are financed through payroll taxes, patient premiums and general tax revenues.

The government reimburses the companies for their costs of processing claims, and grants them a fixed budget for administrative tasks such as controlling fraud and abuse.

Typically, the U.S. government awards contracts through competitive bidding.

But the compromise with Congress allowed the American Hospital Association, an advocacy group for hospitals, to decide which insurance companies should handle hospitals' Medicare bills.

Virtually all the companies turned out to be members of the National Association of Blue Shield Plans, now the Blue Cross Blue Shield Association, a frequent political ally of the American Hospital Association and the American Medical Association.

"'No sooner had the ink dried on that compromise than we began . . . to have horror stories," says Richard Kusserow, inspector general in the Department of Health and Human Services from 1982-1991. For every abuse the government tried to stop, says Kusserow, three would appear in its place.

Bilking Medicare became so lucrative that professional criminals got involved. In 1993, Gabriel Hernandez, a former "logistics coordinator" for the Medellin, Colombia, cocaine cartel, opened a chain of Florida health clinics that billed Medicare and state Medicaid programs for fictitious patients with phony ailments. Over two years, he received checks for more than $1.7 million.

"Everything was easy compared with being in the trafficking business," he says. "All I was doing was picking up checks every week. And I got caught, but I didn't get killed."

Hernandez was convicted in April 1997 of racketeering and spent five years in prison.

Three years ago, the General Accounting Office (GAO) cited "fundamental" conflicts of interest as a factor in the watchdogs' poor performance.

Hospitals and doctors not only help select their overseers, they go into business with them. Many of these companies also run health maintenance organizations. The HMOs funnel business to hospitals and doctors that the insurers may regulate.

Some of the companies even own hospitals. For example, one subsidiary of Cigna Corp. reviews and pays Medicare claims for doctors. Another subsidiary owns Lovelace Health Systems, a hospital and physician group in Albuquerque, N. M. Last month,. Lovelace agreed to pay $24.5 million to settle a whistle- blower suit charging that the company had submitted tens of millions of dollars in false claims to Medicare over 10 years. Cigna did not review the Lovelace claims.

And when a private insurer and Medicare cover the same patient, the insurer is primarily responsible for paying the patient's claims, with Medicare picking up anything left over. But some insurers exploit their Medicare roles by making Medicare the primary payer, a violation that has cost the national Blue Cross Blue Shield Association, Transamerica, Travelers and other insurers more than $100 million in legal settlements.

"Government contractors policing themselves," says Kusserow, "is not a very healthy situation to have."

CORPORATE ABUSE OF SYSTEM.....(read on...if it doesn't make you queasy !)

ace....take a look at what happens to the rest of the money that enters the wide end of the funnel.....all of the medical insurance premiums paid to the "for profit" insurance "providers". How much of insureds' premium payments do you think is spent on IPO's, mergers and acquisitions lawyers, bankers, and advisors, secondary stock offerings, bond issuance, on investor relations, Sarbanes-Oxley compliance, tax accountants, determination and disbursement of dividends, and on issuance of stock options to executives that are dilutive to common stock holders?

How much of the premium payments is spent on advertising, marketing, sales, entertaining clients and prospective clients....the decision makers in the HR depts. at large employers who select the health plans offered to employees. How much is spent negotiating medical procedure payment rates with large hospital corporations like....HCA?

How much is spent paying interest on corporate borrowing, on dividends, on executive salaries, and how much ends up as net earnings available to common stock (total number of common shares divided by net earnings total= EPS)....???

Let's take a peek, shall we ???:

Quote:

Aetna Inc. (AET)
http://finance.yahoo.com/q/pr?s=AET
KEY EXECUTIVES
Pay Exercised
Mr. Ronald A. Williams , 57
Chairman, Chief Exec. Officer, Pres, Chairman of Exec. Committee and Member of Investment & Fin. Committee $ 2.70M $ 24.00M
Mr. Alan M. Bennett , 56
Chief Financial Officer and Sr. VP $ 1.09M $ 7.54M
Mr. Timothy A. Holt , 53
Chief Investment Officer, Chief Enterprise Risk Officer and Sr. VP $ 928.00K $ 13.92M
Mr. Craig R. Callen , 51
Sr. VP - Strategic Planning and Bus. Devel. $ 1.14M $ 0

http://finance.yahoo.com/q/ks?s=AET

Net Income Avl to Common (ttm): 1.73B

Aetna managed to dilute it's shareholder holdings by issuing stock options worth over $45 million to just three top executives in just one year, and earned $1.73 billion...which is the difference between premiums collected minus premiums paid, total expenses, and taxes paid, plus a contribution to a premium reserve.

Quote:

http://finance.yahoo.com/q/pr?s=HUM
Humana Inc. (HUM)

Income Statement
Net Income Avl to Common (ttm): 405.93M

http://finance.yahoo.com/q/ks?s=HUM
Balance Sheet
Total Cash (mrq): 4.42B

Quote:

Unitedhealth Group, Inc. (UNH)

http://finance.yahoo.com/q/ks?s=UNH
Income Statement
Net Income Avl to Common (ttm): 3.96B

Balance Sheet
Total Cash (mrq): 9.92B

http://finance.yahoo.com/q/pr?s=UNH
KEY EXECUTIVES
Pay Exercised
Mr. Stephen J. Hemsley , 54
Chief Exec. Officer, Pres, Chief Operating Officer and Exec. Director $ 3.45M $ 0
Dr. William W. McGuire M.D., 58
Former Chief Exec. Officer and Chairman of Exec. Committee $ 8.01M $ 0
Mr. Richard H. Anderson , 52
Pres of New Commercial Services Group $ 1.20M $ 0

Quote:

http://quicktake.morningstar.com/Sto...ocktab=finance
Cigna CI

Net Income 1,133.0

Here is the "story" of the experience of HCA, a company started by former senate majority leader, Bill Frist's (R-TN) father, and managed by his brother. After spending some time ago, whatever it cost for an IPO to take the company "public", now they've spent another slug of money on investment banking fees, financial advisors, and lawyers, to take the company private again, in a merger transaction.....The Frist family's holdings are reported here:

Quote:

http://uk.biz.yahoo.com/060810/323/gj6je.html
Thursday August 10, 05:13 PM
Shareholders to vote on HCA deal<
.... The next day, the offer was upped to $50.50 per share, which the special committee also rejected, but said it would consider a proposal at $52 per share, it said.
Later that day, Merrill Lynch representatives contacted the special committee and said the potential buyers would submit their 'best and final' offer of $50.75 per share. The special committee said it would only pursue a proposal at $51 per share, which buyers finally agreed to, it said.
The SEC filing also contained details of the expected buyout of shares.
It said that Thomas Frist Jr., who co-founded the hospital chain in 1968 with his physician-father, would put nearly 16 million shares of HCA stock back into the company.
Frist owns about 4 percent of HCA shares, but after the pending buyout he would own about 15 percent of the company.
Thomas Frist Jr. is the brother of Senate Majority Leader Bill Frist, who is under federal investigation for selling HCA shares last year around the time insiders were selling and when the stock price hit a 52-week high.
At least six members of HCA's senior management would invest a total of at least $46.5 million in cash or roll over a portion of their stock options into the deal, according to the SEC filing.
Of these executives, Chairman and Chief Executive Jack Bovender Jr., would put up the most -- about $20 million -- giving him 0.47 percent ownership of HCA after the buyout.
Richard M. Bracken, HCA's president and chief operating officer, would invest at least $10 million, for a 0.23 percent stake.....

Quote:

http://phx.corporate-ir.net/phoenix....l-fundsnapshot
HCA owns and operates approximately 179 hospitals and approximately 104 freestanding surgery centers in 21 states, England and Switzerland. We are dedicated to providing healthcare services that meet each community's local healthcare needs. We seek to integrate various services to deliver patient care with maximum quality and efficiency. Our approach includes focusing on quality; streamlining operations; sharing technology, equipment and personnel where appropriate; and using economies of scale when contracting for medical supplies and administrative services.

11/16/06
HCA Shareholders Approve Merger With Private Equity Consortium632

Income From Total Operations (mil) (FYE) 1,424.00

Quote:

http://www.tennessean.com/apps/pbcs....334/1003/RSS03
Monday, 01/08/07
Firms cash in on merger mania
Midstate bankers, lawyers, accountants collect hefty fees

By GETAHN WARD
Staff Writer

....The biggest was the purchase of hospital chain HCA by three private equity firms and the Frist family for $33 billion, the second largest leveraged buyout in history.

Beneficiaries included the law firm Bass, Berry & Sims of Nashville, which offered HCA legal advice and had a share in an estimated $62 million of legal and consulting fees.

"We did several billion dollar-plus deals (nationwide). That's very unusual," said Jim Cheek, a senior partner in Bass, Berry & Sims. "The amount of private equity money and the ability to leverage that money with significant debt-financing have been unparalleled."

In such transactions, lawyers and other professionals play various roles. Lawyers help with negotiating terms, reviewing contracts, advising directors and preparing regulatory filings.

Investment bankers help in structuring the transactions, including determining the appropriate price and arranging funding sources.

Accountants help to verify that financial information provided by a seller to a buyer is accurate, offer tax advice on structuring the transaction, and might help a party with negotiations.

In Nashville, fees lawyers can earn for work on such transactions range from $135-$140 an hour for younger attorneys up to $400-$500 an hour for senior partners. New lawyers in larger cities such as New York, Chicago and Atlanta can earn $200 an hour and senior partners $600 to $650 an hour, said George Bishop, a partner in corporate mergers and acquisitions with the law firm Waller Lansden Dortch & Davis.

A big deal doesn't always mean more work, he said, adding that parties might not have the time to review every contract and that much information might already be available.

Nationwide, cash-flush private equity firms — with an ability to put down so little of their own money and borrow more than ever before — are a major force behind the mergers and acquisitions boom that kicked off in 2003.

But a Bloomberg analysis of last year's 246 Tennessee deals shows that only 29 involved such equity firms,with a total acquisition value of more than $36 billion. Most deals were acqui sitions of companies by another player in their industries, including foreign companies involved in 37 deals worth more than $3 billion.

Health-care and pharmaceutical companies accounted for 47 deals worth $83 billion, making Nashville's signature industry the most active sector in terms of total dollar volume.....

It seems to me that Mr. Bush represents only the few folks at the bottom "narrow end" end of the private health insurance and private health care provider industry....the end where the money all flows back out....and into the pockets of executives, major investors, M&A advisors and investment bankers, lawyers and accountants, ad agencies and a whole bunch of other "feeders" off this industry who add nothing to insureds' paid premium "value". In their spare time, these greedy, selfish, unethical parasites, along with some doctors and other healthcare providers, also rip off the medicare insurance trust, fix prices, and engage in phantom fraudulant billing, and they get to write checks from our medicare trust fund...to themselves.

But your convinced that the "private sector" does it better than government, even though 45 million are now uninsured, and Bush's "solution: is to tax the benefits received by employees, and take care of his politcal patrons at the narrow end of this upside down pyramid scheme.

Don't ever forget, the "liberals" are socialists, and the republicans are your friends !

flstf · 01-23-2007, 04:38 AM

Quote:

Originally Posted by host

---snip---
Bush's "solution: is to tax the benefits received by employees, and take care of his politcal patrons at the narrow end of this upside down pyramid scheme.
---snip---

host, we are mostly on the same page regarding healthcare but I think you are wrong to characterize Bush's proposal this way. This is not so much a healthcare proposal as a tax fairness issue. This would put those who have to buy their own insurance on the same playing field as those who get the benefit provided to them as far as taxes are concerned.

Sure he mucked it up by putting in a $15K cap for insurance before taxes kick in but at least both sides get the same deductions. From what I understand it is intended to be revenue neutral.

loquitur · 01-23-2007, 07:06 AM

Quote:

Originally Posted by willravel

The free market has given birth to these outragous costs.

Actually, no - health care costs ratcheted upward pretty much in tandem with the degree of governmental involvement in healthcare. Before Medicare was enacted in 1965 the rate of increase in the % of the economy dedicated to health care was much much lower than it is now. That doesn't mean Medicare was a bad thing, and it doesn't mean there necessarily shouldn't be some degree of governmental involvement in health care, but it's fallacious to say that the free market has caused the outrageous costs. It is the particular combination of government regulation and economic freedom that the US has had in the last 40 years that has yielded the current environment, which includes both extremely high costs and a truly amazing rate of innovation and creativity.

As with most things, there are always tradeoffs. Health care is no different.

aceventura3 · 01-23-2007, 09:06 AM

Quote:

Originally Posted by willravel

The free market has given birth to these outragous costs.

Laser eye surgery is not covered by most medical health plans or medicare. It is not normally done in hospitals. It is less regulated than other proceedures. The cost have gone down over the years not up.

Quote:

The free market, left unchecked, will eventually spiral down to a system based on profit alone.

Value. If you are in a free market and you sell goods or services with no value, you go out of business fast. In free markets profits come from added value.

Quote:

As medicine is something everyone needs, they can afford to hike up prices to unreasonable heights and "personal responsibility" has no control over that.

People taking cholesteral medicine have two choices or actually three. They can pay for the medicine. They can lower their cholesterol through diet and excercise. Or, they can live with high cholesterol.

Seems that you argue this point just for the sake of argument. Or, it seems that you think people are generally unable to make informed decisions. I think most people are pretty savy and can live o.k. without government looking out for them.

Quote:

It is your and my responsibility to stop those free marketeers from taking advantage of or hurting people.

Yes. Fraud, criminal activity, negligence are the things we need government involved in.

Quote:

How would I go about doing that? Threatening to take away their market. How would you do that? Put universal healthcare on the table. Either private healthcare shapes up, or federal healthcare takes over.

I would put people in jail for criminal behavior or fraud. Civil courts can handle negligence, although I would make some reforms to our present system.

Quote:

Originally Posted by host

aceventura3, picture a funnel of money flow that begins with a wide mouth that sucks in all of the medical insurance premiums deducted from every worker's paycheck for the medicare portion of the FICA deduction, matched by an equal employer "contribution". It's comprised of 1.45 percent of earnings from each, or 2.90 percent total, of all W-2 earnings, wuth unlike the SSI joint deduction

Some companies have about a 50% benifit load on base salaries, then you add federal, state and local deduction, then you end up with, for example an employer spending $100,000 on an employee. The employee is actually getting $50,000, then after deduction is getting about $35,000. I say pay the guy the $100k and let him spend the money or save it how he chooses. The government can collect taxes base on what the guy spends.

Quote:

Here is a report on what the private sector has been doing to medicare:

When you creat systems that only a few understand, those few will manipulate the system to their advantage. If you want to improve the system, simplify it.

EaseUp · 02-04-2007, 02:21 PM

Many here may not recall that Hillary blatantly violated laws by keeping the meetings secret, and by lavishly compensating the cronies she put on that committee. I hope her disregard for inconvenient disclosure laws doesn't take long to surface in light of her candidacy.

Additionally, what everyone is overlooking in this discussion is the enormous cost of providing health care in the emergency room to 12-15 milliion illegal aliens, who don't pay taxes. The elimination of that alone would make possible a HUGE reduction in costs which are now shouldered by those who pay for their care, or for medical insurance. Not that insurance companies would do so if they had a chance to avoid it.

Quote:

I believe that the government should be able to step in and take control when the nature of an important service like healthcare does not result in a free market. There seems to be little "free market pricing" of hospital charges and what little there is seems to be dictated by the insurance companies.

This is incorrect. There is extreme control over hospital charges.

Example: You have no insurance, and you need an operation. The first thing you should do is get an estimate of the charges from the hospitals and start negotiating. Let's say your estimate is $25 k.

The insurance companies will already have negotiated a price for their customers. It will probably (no exaggeration) be $15k or less. That should be the starting point of your negotiations. This IS a business. Therefore, you need to be an informed consumer. It isn't difficult, except in the case of emergencies.

Why the difference? The hospital has to recoup the costs of providing care to the people who show up in the ER and pay them nothing, i.e. the poor (or those who choose a big screen TV over health insurance) and illegal aliens. They can't collect it from people who have contracts via their insurance, or from people who have no money, so who is left? People who have SOME money, but no insurance.

Want proof? Check statistics from the labor and delivery wards of border towns. Those are places where it is illegal to ask if the patient is entitled to be here. It's also where a great many US "citizens" start their lives, if their mother was able to sneak across the border. You can thank the government that you would like to have "step in" for that situation.

I agree about self-employed getting the same tax break, and there have been a few steps toward that under the Bush administration. In any case the rich can't take the blame for this one.

flstf · 02-04-2007, 06:26 PM

Quote:

Originally Posted by EaseUp

This is incorrect. There is extreme control over hospital charges.

Example: You have no insurance, and you need an operation. The first thing you should do is get an estimate of the charges from the hospitals and start negotiating. Let's say your estimate is $25 k.

The insurance companies will already have negotiated a price for their customers. It will probably (no exaggeration) be $15k or less. That should be the starting point of your negotiations. This IS a business. Therefore, you need to be an informed consumer. It isn't difficult, except in the case of emergencies.

I agree with much of what you write, and I also think there is little competition and therefore little free market control of hospital charges.

I recently had to use the services of my local hospital's ER (about 30 miles away). The bill was reduced 50% because my insurance company is one of their preferred providers and it was still way too high for what they did. They would not negotiate the price with me and I suspect that if I had no insurance I would not be able to negotiate like an insurance company can.

Also when you are badly injured you are in no position to stop and negotiate prices. There is little you can do except pay whatever they charge and they have little reason to not charge very high prices since there is little competition.

kutulu · 02-07-2007, 09:38 AM

Quote:

Originally Posted by EaseUp

Additionally, what everyone is overlooking in this discussion is the enormous cost of providing health care in the emergency room to 12-15 milliion illegal aliens, who don't pay taxes. The elimination of that alone would make possible a HUGE reduction in costs which are now shouldered by those who pay for their care, or for medical insurance. Not that insurance companies would do so if they had a chance to avoid it.

Look, this is bullshit and there is no logic behind it. First of all, it is an outright lie that no illegals pay taxes. Many of them use fake or stolen SSNs. They give them to their employer and taxes get taken out of thier checks. Hell, they might even have health insurance and even if they don't, they might still pay the bill!

Second, we are talking about less than 5% of the population here. Unless they use the services at a grossly dispropportionate rate (like 3 or 4 times the norm) their contribution is far from HUGE.

I'm sick of illegal immigration being the boogyman that gets pulled into every topic. Yes, it is a contributing factor but it is dwarfed by the amount of actual CITIZENS that don't have insurance and skip out on the bill.

pan6467 · 02-07-2007, 10:16 AM

Quote:

Originally Posted by kutulu

Look, this is bullshit and there is no logic behind it. First of all, it is an outright lie that no illegals pay taxes. Many of them use fake or stolen SSNs. They give them to their employer and taxes get taken out of thier checks. Hell, they might even have health insurance and even if they don't, they might still pay the bill!

Second, we are talking about less than 5% of the population here. Unless they use the services at a grossly dispropportionate rate (like 3 or 4 times the norm) their contribution is far from HUGE.

I'm sick of illegal immigration being the boogyman that gets pulled into every topic. Yes, it is a contributing factor but it is dwarfed by the amount of actual CITIZENS that don't have insurance and skip out on the bill.

That's why Bush a few years back... (it's in a past post the link and news article, I'll have to find it)..... signed a bill to help border state hospitals that were going bankrupt by giving them $1 BILLION to treat illegal aliens.... (NOT US citizens.... ILLEGALS)

aceventura3 · 05-31-2007, 11:59 AM

I looked at Obama's heathcare plan. He says he is going to save the "typical consumer" $2,500 per year and make sure affordable healthcare insurance is available to everyone.

I don't see how he is going to do that based on what is in his plan and what he has said publically. I know it is fashionalbe to say rolling back the Bush tax rate cuts is is going to solve our problems, but it seems like rolling back those tax rate cuts is going to be paying for every new program Presidential candidates are promising. They make this promise inspite of the fact that taxes collected by the government has been going up even with those tax rate cuts.

Also he plans on a new tax to employers who are not offering "meaningfull" healthcare coverage for their employees. Increased employer cost will mean lower real wages, or higher costs to consumers (inflation) effectively transfering costs rather than generating cost savings.

In theory his plan sounds good, but my gut tells me his plan will increase costs and lower the overall quality of healthcare.

Here is a link to his plan.

http://www.barackobama.com/pdf/HealthPlanFull.pdf

Willravel · 05-31-2007, 12:12 PM

Quote:

Originally Posted by aceventura3

Laser eye surgery is not covered by most medical health plans or medicare. It is not normally done in hospitals. It is less regulated than other proceedures. The cost have gone down over the years not up.

That's probably due to technological improvements. It's much, much cheaper to do laser eye surgery now.

Quote:

Originally Posted by aceventura3

Value. If you are in a free market and you sell goods or services with no value, you go out of business fast. In free markets profits come from added value.

And things of great value, like medicine, can be hiked up to create higher profits to the detriment of the consumer.

Quote:

Originally Posted by aceventura3

People taking cholesteral medicine have two choices or actually three. They can pay for the medicine. They can lower their cholesterol through diet and excercise. Or, they can live with high cholesterol.

My dad has bad cholesterol and we have a family of severe heart disease. He exercises and diets. It's only lessened by medicine. He has two choices: take medicine or risk death. I'd hardly call that a choice.

Quote:

Originally Posted by aceventura3

Seems that you argue this point just for the sake of argument. Or, it seems that you think people are generally unable to make informed decisions. I think most people are pretty savy and can live o.k. without government looking out for them.

Nearly 47 million Americans, or 16 percent of the population, were without health insurance in 2005. The number of uninsured rose 1.3 million between 2004 and 2005 and has increased by almost 7 million people since 2000.

Rapidly rising health insurance premiums are the main reason cited by all small firms for not offering coverage. Health insurance premiums are rising at extraordinary rates. Over the past five years the average annual increase in inflation has been 2.5 percent while health insurance premiums for small firms have escalated an average of 12 percent annually
http://www.nchc.org/facts/coverage.shtml

Quote:

Originally Posted by aceventura3

Yes. Fraud, criminal activity, negligence are the things we need government involved in.

No one can do anything about it, so we might as well bend over and take it, right? That doens't sound like something a self-described wolf would do.

Quote:

Originally Posted by aceventura3

I would put people in jail for criminal behavior or fraud. Civil courts can handle negligence, although I would make some reforms to our present system.

So you'd change government to better regulate medicine? That's a bit of a 180 from what you've said above.

seretogis · 05-31-2007, 12:20 PM

The obvious solution is the abolition of the income tax. *eyelash flutter*

aceventura3 · 05-31-2007, 12:30 PM

Quote:

Originally Posted by willravel

That's probably due to technological improvements. It's much, much cheaper to do laser eye surgery now.

Whatever the reason, the free market is working.

Quote:

And things of great value, like medicine, can be hiked up to create higher profits to the detriment of the consumer.

Only when supply is artificially restricted. When profits are excessive in the free market, it is temporary because alternatives will become available.

Perhaps there is a role for government, similar to how we came up with the solution to polio

Quote:

My dad has bad cholesterol and we have a family of severe heart disease. He exercises and diets. It's only lessened by medicine. He has two choices: take medicine or risk death. I'd hardly call that a choice.

The medicine does not lower the risk of death to zero. High cholesterol is most common in the USA because of lifestyle. Most people can adjust their lifestyle and lower their cholesterol to normal ranges.

Quote:

Nearly 47 million Americans, or 16 percent of the population, were without health insurance in 2005. The number of uninsured rose 1.3 million between 2004 and 2005 and has increased by almost 7 million people since 2000.

Again, those numbers are interesting but what percentage of those people choose not to have health insurance and could purchase it?

Quote:

Rapidly rising health insurance premiums are the main reason cited by all small firms for not offering coverage. Health insurance premiums are rising at extraordinary rates. Over the past five years the average annual increase in inflation has been 2.5 percent while health insurance premiums for small firms have escalated an average of 12 percent annually
http://www.nchc.org/facts/coverage.shtml

I don't think health coverage is the responsibility of an employer. As the head of my family, I see providing healthcare coverage for my family as my responsibility. As long as people pass that responsibility on to others we will have a healthcare problem in my opinion.

Quote:

No one can do anything about it, so we might as well bend over and take it, right? That doens't sound like something a self-described wolf would do.

People generally spend more money and time on their automobiles than they do on healthcare. I some states every automobile is insured at a cost to the owner, but we choose not to insure every human.

Quote:

So you'd change government to better regulate medicine? That's a bit of a 180 from what you've said above.

I see a role for government, but a limited role.

Quote:

Originally Posted by seretogis

The obvious solution is the abolition of the income tax. *eyelash flutter*

Bingo.

Tax consumption. Don't tax the fruits of labor, savings and investment. Tax exhorbidant lifestyles. that is how to tax the rich. Rich people can avoid income taxes based on their ability to defer income or live off of capital. Just ask Edward Kennedy.

Willravel · 05-31-2007, 12:52 PM

Quote:

Originally Posted by aceventura3

Whatever the reason, the free market is working.

I would direct you to the percentage of Americans (or anywhere else) who don't have medical coverage and ask you to explain to them how the free market is working in medicine.

Quote:

Originally Posted by aceventura3

Only when supply is artificially restricted. When profits are excessive in the free market, it is temporary because alternatives will become available.

Explain that to me, who paid over $1m for a home that would cost maybe $125k if it were located only 100 miles east.

Quote:

Originally Posted by aceventura3

Perhaps there is a role for government, similar to how we came up with the solution to polio.

*looks up polio* It looks like the WHO and UNICEF did the most to eradicate Polio.
http://www.worldwatch.org/node/1644
I'm not sure where you're going with this. It's not something I'm familiar with.

Quote:

Originally Posted by aceventura3

The medicine does not lower the risk of death to zero. High cholesterol is most common in the USA because of lifestyle. Most people can adjust their lifestyle and lower their cholesterol to normal ranges.

And my father?

Quote:

Originally Posted by aceventura3

Again, those numbers are interesting but what percentage of those people choose not to have health insurance and could purchase it?

'Choose not to have health insurance'? I don't follow....

Quote:

Originally Posted by aceventura3

I don't think health coverage is the responsibility of an employer. As the head of my family, I see providing healthcare coverage for my family as my responsibility. As long as people pass that responsibility on to others we will have a healthcare problem in my opinion.

Look at income in this country and tell me that it's the comsumers fault for not making enough money. I dare you.

Quote:

Originally Posted by aceventura3

People generally spend more money and time on their automobiles than they do on healthcare. I some states every automobile is insured at a cost to the owner, but we choose not to insure every human.

Source?

Quote:

Originally Posted by aceventura3

I see a role for government, but a limited role.

....isn't that what I'm saying?

aceventura3 · 05-31-2007, 01:19 PM

Quote:

Originally Posted by willravel

I would direct you to the percentage of Americans (or anywhere else) who don't have medical coverage and ask you to explain to them how the free market is working in medicine.

Look at laser eye surgery, with minimal government involvment, active consumers and competition the price went down.

Outside of that, people in this country live longer and better than at anyother time in history, even those without health coverage.

Quote:

Explain that to me, who paid over $1m for a home that would cost maybe $125k if it were located only 100 miles east.

A. You paid for it. In areas where costs are high, incomes are usually high as well. When ther is an imbalance in a free market, adjustments would come natuarally. In most cities, zoning and other regulations often prevents the building of affordable housing.

Quote:

*looks up polio* It looks like the WHO and UNICEF did the most to eradicate Polio.
http://www.worldwatch.org/node/1644
I'm not sure where you're going with this. It's not something I'm familiar with.

When there was an available solution, that solution was made available to everyone.

Quote:

And my father?

You know I can not comment. There are exceptions, but generally cholesterol is a lifestyle issue.

Quote:

'Choose not to have health insurance'? I don't follow....

When I was in my 20's, single and healthy, I choose not to enroll in my employer's healthcare plan at first. I wanted to spend the money on other things. Many can afford health coverage but choose not to buy it. I know people who will spent over $1,000 per month on a car note, insurance, etc., but won't buy health insurance. I know people who will spend over $100 per month on a cell phone, but not buy health insurance. Do I need to go on?

Quote:

Look at income in this country and tell me that it's the comsumers fault for not making enough money. I dare you.

I say - pay me for the work I do, and let me spend my own money how I want. After taxes and factoring in benefit loads most people net less than half of what they earn. In some major corporations with top level benefit plans the benetif load alone can be 50%+ of an employees salary. In California between state and federal taxes, I bet you net perhaps 50% to 75% if you are salaried making between $75k to about $150K.

Quote:

Source?

My experience with people and what I have seen of the budgets ( most don't have budgets, but a history of what the spend money on). People without health coverage are spending zero on that coverage. A stand alone family healthcare plan can be purchased for between $400 - $600, depending on the deductable and other factors. Some people get subsidized health coverage form their employers, some get medicare or medicaid. People who own cars spend money on notes, maintenance, gas, insurance, car washes, etc. If you add it up, which do you think will be greater for most people?

....isn't that what I'm saying?[/QUOTE]

It is a question of how much government.

01-21-2007, 02:24 PM	#1 (permalink)
Chimera Banned	Health care....Fix? It would seem Mr. Bush has decided to finally address one of the biggest financial crisis facing most Americans, and is doing so in his usual way. Here we have what seems to be an Oxymoron (no pun intended), as his alleged plan will be detrimental to those of us currently paying up to a third of our earning into a medical plan....to support those who simply cannot afford one at all. What happens when these poeple of poverty, make it big, and become middle class? They get taxed. Lets see here.....No effect whatsoever on the wealthy, we'll have none of that. Taxation of the dwindling middle class. Incentives (wellfare), for the poorest. I smell a warped socialism. "WASHINGTON -- President Bush will propose deep tax breaks for Americans who purchase their own medical insurance and would finance the plan with an unprecedented tax on a portion of the healthcare plans that workers receive from their employers, according to the White House." http://www.dfw.com/mld/dfw/16513010.htm Ahhhh....The Irony. "In 1993, United States President Bill Clinton's administration proposed a significant health care reform package. Clinton had campaigned heavily on health care in the 1992 election, and he quickly set up the Task Force on National Health Care Reform, headed by First Lady Hillary Rodham Clinton, to come up with a comprehensive plan to provide universal health care for all Americans, which was to be a cornerstone of the administration's first-term agenda. The result, announced by President Clinton in an address to Congress on September 22, 1993, was a complex proposal running more than 1,000 pages, the core element of which was an enforced mandate for employers to provide health insurance coverage to all of their employees through competitive but closely-regulated health maintenance organizations (HMOs)." http://en.wikipedia.org/wiki/Clinton_health_care_plan

01-21-2007, 04:10 PM	#3 (permalink)
dksuddeth Junkie Location: bedford, tx	anything to keep the insurance companies with a steady and growing income. __________________ "no amount of force can control a free man, a man whose mind is free. No, not the rack, not fission bombs, not anything. You cannot conquer a free man; the most you can do is kill him."

01-21-2007, 05:57 PM	#4 (permalink)
Lizra Insane Location: rural Indiana	I recently went to a luncheon to hear a guy tell our little Art Center how to try to get grants. Some rich dude, didn't look much older than me, but had already retired....he decided to start some sort of organization to dole out $$$ to "deserving" groups to pass his time now. He made all his big $$$ in health care administration. After making sure none of us were reporters....he said "If you didn't make $$ in the health care administration field in the 90's....there was something wrong with you." I just wanted to puke. Our small family pays over $500 a month for insurance too.....$40 a pop for my husband's monthly prescriptions on top of that. There is no "extra" $$ anymore. It's scary..... __________________ Happy atheist

01-22-2007, 02:04 PM	#13 (permalink)
aceventura3 Junkie Location: Ventura County	It is not the Federal government's responsibility to make sure every American has health insurance. It is not an employer's responsibility to make sure every employee has health insurance. It is not the responsibility of the "rich" to make sure every "poor" person has health insurance. As long as American's have the opposite attitudes about health insurance the system will never get fixed. The federal government will be inefficient, employers will focus on cutting costs, and the "rich" will always get better healthcare and have more healthcare options than the "poor". These truths may be sad, but they can not be ignored and will never change. Bush's plan doesn't address these issues nor has anyother proposed plan. __________________ "Democracy is two wolves and a sheep voting on lunch." "It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion." "If you live among wolves you have to act like one." "A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

05-31-2007, 11:59 AM	#27 (permalink)
aceventura3 Junkie Location: Ventura County	I looked at Obama's heathcare plan. He says he is going to save the "typical consumer" $2,500 per year and make sure affordable healthcare insurance is available to everyone. I don't see how he is going to do that based on what is in his plan and what he has said publically. I know it is fashionalbe to say rolling back the Bush tax rate cuts is is going to solve our problems, but it seems like rolling back those tax rate cuts is going to be paying for every new program Presidential candidates are promising. They make this promise inspite of the fact that taxes collected by the government has been going up even with those tax rate cuts. Also he plans on a new tax to employers who are not offering "meaningfull" healthcare coverage for their employees. Increased employer cost will mean lower real wages, or higher costs to consumers (inflation) effectively transfering costs rather than generating cost savings. In theory his plan sounds good, but my gut tells me his plan will increase costs and lower the overall quality of healthcare. Here is a link to his plan. http://www.barackobama.com/pdf/HealthPlanFull.pdf __________________ "Democracy is two wolves and a sheep voting on lunch." "It is useless for the sheep to pass resolutions on vegetarianism while the wolf is of a different opinion." "If you live among wolves you have to act like one." "A lady screams at the mouse but smiles at the wolf. A gentleman is a wolf who sends flowers."

01-21-2007, 02:35 PM	#2 (permalink)
Willravel ... a sort of licensed troubleshooter.	I am 23 years old. I pay $515 a month for my health insurance alone. The average 23 year old in the US makes something in the neighborhood of 12-24k a year (I'll find a source for that later). That means that from one quarter to one half of the income would go to health insurance alone. Add on to that food, rent, utilities, etc., you have people who are getting more and more broke. It's wrong, and it pisses me off to no end. I'm seriously considering starting a full out campaign to start REAL health care reform in this country. I'm doing research into what it takes to start a non-profit program for people, I'm doing research into what it takes to get a free lobyist, etc. If anyone wants to help, PM me.

01-22-2007, 12:08 AM	#7 (permalink)
flstf Easy Rider Location: Moscow on the Ohio	Host Let's compare two people each making the same amount per year. One is given a $10K insurance benefit per year by their employer tax free while the other has to spend $10K for the same insurance with no deduction. It does not seem fair to allow one whose insurance is provided by their employer to take a tax credit (or not have to claim the income at all) for the total cost and the one who has to buy their own insurance to not even be able to deduct the amount from their taxable income. Why shouldn't these two people be treated the same as far as taxes and deductions are concerned? Shouldn't a person without employer provided insurance be given the same deduction or at least shoudn't they both be taxed the same? Those without employer provided insurance should not have to pay additional taxes simply because they have to buy their own insurance. The tax code should treat the cost of insurance the same whether an employer is providing it or the person has to buy their own.

01-22-2007, 02:30 AM	#8 (permalink)
host Banned	flstf, according to the 2006 tax prep. IRS guidelines: http://www.irs.gov/publications/p502/ar02.html If you pay $6k annually out of pocket with net income dollars, and you make $40k per year, you can deduct the excess of 7-1/2 percent of your adjusted gross income. If you have a file your tax return with a family of 3 standard deduction, for simplicity's sake, I'll use a round number of a $30k adjusted gross, defined as adjusted by subtraction of $10k standard deduction. $30k X 7.5 percent= $2250. $6000 medical insurance expense, less $2250 equals $3750 eligible for deduction from taxable adjusted gross income. This adjustment, coupled with, for example, with $6000 of deductible mortgage interest, $2000 deductible property tax, $300 deductible vehicle tax, $500 deductible charitable donation expense, and your total deduction could then exceed the original $10,000 standard deduction, $6000 + $3750 + $2000 + +500 + $300, and now your total deductions are $12,500 instead of the original $10,000 standard deduction. Deductions for medical treatment co-pay expenses, prescription expenses, transportation expenses, tax preparation fees, originally ineligible because the $40k annual earner could not "beat" the $10k standard deduction, become eligible when the $3750 medical insurance premium deduction allows the taxpayer to exceed the original $10k standard deduction. To sum it up, under the current taxation structure, the "little guy", with a modest income and deductions formerly too small to exceed the standard deduction, receives income tax reduction on a significant portion of his out of pocket medical premium expense. The purpose of the "standard" deduction allowance is to simplify tax filing and the "standard" includes consideration of "average" deductions for a single or a couple with "X" number of child dependents and an average size mortgage interest and property tax deduction, or a renter with a similar income. So, there is already an allowance for payment of some medical and medical insurance expenses factored into the standard deduction tax tables. The status quo is that the tax system is progressive, but skewed in favor of those who earn income above $90k because SSI & Medi tax withholding stops there. Recently I posted a table from the census.gov site that illustrated how few singles exceed an annual household income of $80K per year, and how few multi-person households exceed income of $150k. If your income exceeds "average" or mean, the system is designed for you to pay a progressively higher tax than the lower 2/5 ths of tax filers earn. Bush's "reform" would reverse that and shift some of the tax burden for financing universal insurance premiums, to those who already spend everything that they earn on necessities. No one expects that employees who work for firms that offer above average pension, vacation, or holiday benefits, to suddenly pay a tax to subsidize those who work for less generous or prosperous employers. Many law enforcement personal are permitted to retire, with immediately redeemable taxpayer paid retirement benefits, after just 20 years of employment. Should those favored employees pay a tax to subsidize those of us who must work until age 66 to qualify for pension benefits? The wealthiest are experiencing the initial stages of a period when their percentage of total income taxes paid by all tax payers will shift to the tiers under their tier. Would it not be fairer to levy an excess profits tax or a markup "cap" on insurance company medical coverage premiums, or a higher capital gains tax on stockholder dividends and gains from stock sales in that industry? Should the "little guy" with most of his medical premiums provided as a company benefit, pay more, along with the modest income earner who shoulders is entire health insurance premium cost, because Bush's government failed to secure the borders or to enforce laws that prohibit illegal residency? Should the average or below average income employee with a health insurance employment benefit, be taxed to pay the added cost built into health insurance premiums because the federal government refuses to fully reimburse county and municipal hospitals for providing care to elderly or welfare patients, or to the uninsured? The government and private policy holders are paying for all of the medical care, for everyone in the country, and they always have. The Bush administration and congress have refused to put policies in place to manage how this care is dispensed, resulting in huge and avoidable expenses shifted to public hospitals who end up operating emergency rooms that are used as outpatient clinics of last resort by the indigent and the uninsured, and by expensive treatment actual emergencies that could have been diagnosed and treated much more cheaply if medical clinics were available to routinely diagnose and treat less severe ailments at a much earlier stage in the progression of an illness or disorder. This official, intentional neglect is further aggravated by the abandonment of the inner cities by government. Increasingly unequal wealth distribution, ignorant and ineffective illegal drug distribution and abuse enforcement, economics driven segregation, and illegal immigration, and the elimination of living wage employment opportunities formerly available to inner city residents before the disappearance of the American industrial manufacturing base, along with the withdrawal of the will of the federal government to encourage or provide affordable housing and equal public education, results in higher incidence of homelessness and violence that ends up at the doorstep of already overburdened and under supported urban public hospitals. Bush is proposing another wealth shift from the wealthiest to the rest of us, and it's bullshit.

01-22-2007, 06:30 AM	#9 (permalink)
loquitur Junkie Location: NYC	My plan is to make third-party payment of medical expenses illegal (other than for catastrophic). Costs are out of control. Push down the costs and you, well, push down the costs. Get rid of the insane paperwork. What's now spent on med insurance would ultimately make its way into salaries. A dr visit would cost $40 instead of $100 (one doctor friend of mine said that 30-40% of his revenue is spent on insurance-related paperwork). The price of pills would come down. All you need is to have people being in charge of their own care. The biggest losers would be insurance companies and to a somewhat lesser extent pharma companies. Yes, there would have to be some tinkering (the basic concept is sound but there are kinks that need to be worked out), but it's pretty clear to me you'd see benefits right away, and increasing over 5 years before levelling out.

01-22-2007, 09:54 AM	#11 (permalink)
kutulu Junkie	This 'plan' is bullshit. If the govt is not going to set up its own health care plan, then ALL money spent on it (down to copays and meds) should be tax free. Furthermore, this won't make much of an impact on the amount of uninsured. If you can't afford it, being able to write it off at the end of the year won't change that.

01-22-2007, 02:07 PM	#14 (permalink)
Willravel ... a sort of licensed troubleshooter.	It's no one's responsibility, so nothing gets done.

05-31-2007, 12:20 PM	#29 (permalink)
seretogis Huggles, sir? Location: Seattle	The obvious solution is the abolition of the income tax. eyelash flutter __________________ seretogis - sieg heil perfect little dream the kind that hurts the most, forgot how it feels well almost no one to blame always the same, open my eyes wake up in flames