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On Takers and Payers
Remember the big flap about the Supreme Court ruling on the Affordable Healthcare Act (AKA – Obamacare – ACA)? The issue that made the headlines was that the Supremes ruled that ACA was legal, provided that the penalty for not having health insurance was collected as a tax.
This is a big deal as the penalty ($700 a year per person) was supposed to be the discipline that forced people to go out and buy their own insurance. One either acquires health insurance, or they pay a price.
The CBO took a look at this last week (link). The results surprised me. The reality is that few people will end up paying the penalties. So the basic premises of ACA is actually a fraud.
CBO estimated that there will be 30Mn uninsured in 2016 when ACA goes into effect. Of that 30Mn, the following groups will be excluded from paying the penalty:
1) Undocumented workers.
Really? But that is 10Mn people; a third of the problem!
2) Religious Beliefs
Huh! What religion is that? If it gets you out of paying taxes, I want to join!
3) Native Americans
Okay, after all, it is their land.
4) Individuals and families with low incomes.
I can live with this. But isn’t this where we are today? Poor people don’t have health insurance today, and they don’t have to pay any fines. In 2016 they will still have no insurance, and they won’t have to pay any fines. What has been accomplished?
5) Anyone who does not file federal income taxes.
This is directed to those with income of less than $10k per year (same as #4), but there are an awful lot of people who don’t file taxes who are making much more than the minimum amounts. Most waiters and bartenders would fall into this group.
6) Individuals who can’t afford the cost of health insurance.
The annual cost of health insurance must be less than 8% of an individual’s income for the penalties to apply. What is this new insurance policy going to cost? If the answer is $250 per month (too low in my opinion) it means that anyone with an income less than $37,500 is excluded. If the cost of that Ins. policy is $500 a month (a more reasonable estimate), then anyone who has annual income of less than $75,000 would be excluded.
With these carve outs the number of individuals who would be subject to the penalty falls to 6Mn (80% drop). But it gets worse:
Among the uninsured individuals subject to the penalty tax, many are expected to voluntarily report on their tax returns that they are uninsured and pay the amount owed. However, other individuals will try to avoid payments.
Oh boy! How many of the remaining 6Mn will “voluntarily” pay the penalty, and how many will seek to “avoid” it? At least half will avoid it. There is not much risk of getting hit by the IRS if one’s income is < $75,000. The IRS does not have the manpower to chase after those who “avoided” the penalty. The CBO recognizes that the actual amount of fees collected is subject to:
the ability of the Internal Revenue Service (IRS) to administer and collect the penalty.
The only people who are going to end up paying are those who have something to fear from an audit.
Households with income that exceeds $60k are estimated to constitute about one-third of people paying penalties and to account for about two-thirds of the receipts from those penalties.
The CBO reckons that Uncle Sam will collect about $8Bn a year in fees. This money will be used to offset some of the costs of the uninsured. The Penalty is also the “stick” of ACA that forces people to get insurance by one means or another. I see it differently:
- Post the introduction of ACA there will still be 30Mn people without insurance. These people will still get sick or injured; they will continue to be a drag on everyone else.
- The fees/taxes that are supposed to provide discipline and revenue for ACA will accomplish very little. I will be amazed if the penalties total more than $2Bn a year (peanuts). There will still be 30Mn people without insurance, and they will get sick (not peanuts).
- The Administration and Congress have cooked up a deal that got amended by the Supremes that will result in a great new opportunity for people to cheat on their taxes. Millions will take advantage.
- ACA is a wealth redistribution program. ACA will create more TAKERS; the PAYERS will foot the bill.
++
Mitt probably lost any chance he had with the election with is words about the “other” 47%. But the fact is the country is divided between Takers and Payers. The CBO head, Doug Elmendorf had this to say about the dilemma the country faces:
Formidable? I would say impossible.
Four years from today the Taker - Payer ratio will exceed 50%. The argument then will be the same as it is today. In order to pay for the cost of government, taxes will have to be much higher than the historical norm. But the necessary higher taxes will drag on the economy, and growth will be far less than potential. Sub-par growth means high unemployment and low tax receipts. The vicious debt spiral will continue.
Where does this lead us? Elmendorf's thoughts:
The conclusion is that we are headed into a crisis, and when it happens we will not have the resources available to fight that crisis off. What kind of plan is that?
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Dear Gringos,
Here's a thought or two:
1. Reduce the size of your military by 50%
2. Reduce nbr and size of your letter soup security agencies by 75%
3. Tell your local cops they have really big swinging dicks, they don't need no stinking tanks.
4. Limit the liability for doctors and tell the lawyers to take a hike, settle malpractise cases by expert panels.
Maybe that helps a little bit so you can afford basic healt care to the most vunerable and over taxed middle class.
Kalevi
Good advice. And I live in the gestapo-run, fascist shithole known as Amurika.
Only exception is the expert panels...the experts are going to be the very doctors and medical professionals that are being sued. I don't know what it is, but something else needs to be instituted.
$250 per month, $500 per month, when are you people going to get your act together?
Here, in France, universal health care, which is paid by the tax base, covers 70% of health care costs. Supplemental insurance to cover the remaining 30%, for wife and I( age 68) costs €1000 per year. This includes all medical, pharmaceutical, surgical, hospital, dental, opthalmic, optical, audio, osteopath, chiropracter, massage, pedicure and visits to health spas, plus visiting nurses and transportation.
Quality of health care is way above anything available in the fascist states and I write from experience of 30 years of practicing medicine in the fascist states.
I am now a patient of a French doctor, who shares the same specialties, as me. Whereas I had to charge a patient $400 for an office visit, the French doctor, with similar credentials charges €40. At the end of the year, his net income equald what mine was.
What stimulates growth in technology in the French system? If doctors don't earn much, how do they pay for their education? How is malpractice handled and what recourse do you have in your medical treatment? And what is your definition of a fascist state and is France one or are you more of a committed socialist? Would Europe have a more advanced and quality healthcare if the US had not stopped Germany's agression in WWII, given all the successfull state directed medical experiments that were carried out in the concentration camps of the day? France should have some significant feeling on this given their large Nazi commitments of the time. Just wondering.
Fair enough.....
University education, including medical school is essentially free in Europe. When I graduated from med school, in USA, I was $700,000 in debt.
Malpractice insurance in USA was $500,000 per year, when I retired. In France. malpractice insurance is included in the basic health care system, at no cost to medical professionals. If a patient suffers from a proven iatrogenic condition, a fixed predetermined payment is awarded to the patient. There is no need to bring the matter to court.
A fascist state is one which provides benefits to the corporations over the citizens.
I can not guess what woulf have happened if Germany won WW2 but I am more familiar withh illegal medical experiments conducted by US agencies than most people are.
Be grateful we pay to look after Europes security:all this would change in a New York minute should the US close its bases. Mother Wolf Russia would be
breathing down your necks inside 30 days. Then so much for your cheap health care. See America has had the decades old problem of Guns and Butter. Not OR. AND.
How many illegals do you have in your country? Can patients sue doctors for any reason at any time? Our Health care system has to carry that burden and more, including crooked Doctors, Hospitals, Insurance companies, and ESPECIALLY Big Pharma. If there ever was an evil that needed to be crushed its Big Pharma.
BP has a monopoly on all drugs in the US. No competition. Its beyond belief. Obama has kept this going.
US style "security" is largely unwanted in Europe and the rest of the world. Refresh your basic geography lessons, Russia is actually part of Europe, geographically, and, if the EU survives, Russia will someday be part of the EU.
I reside in France but am a Swiss citizen. Before I applied for legal residency in France, I was an illegal for many years. France and Europe have large illegal populations from the ex-soviet states to the East and from Africa, to the South.
European societies are not as litigous as USA. It may be because the USA has the highest percentage of attorneys in any population. There is no need to bring a malpractice claim into the court system. Compensation for iatrogenic conditions has been provided in the medical insurance scheme.
There are many big pharma corporations in Europe. Why is it that pharmaceutical medications, produced either in USA or Europe, cost 10% of what they cost in USA?
What utter fucking drivel.
What utter fucking drivel.
Like most Europeans, I am so afraid of the Russians! /sarc
The US military is just the enforcement arm of the criminal Zionist Elites. Its only purpose is rounding up the sheep so their wool and mutton can be stolen. The Kosher Nostra has always had an enforcement gang.
The difference is you were paid exorbinantly enough to retire in his country. I guarantee that he could never have the opportunity to do the same.
Admit that US doctors (especially specialist) are overcompensated and we can start to have a real conversation about fixing it.
I am an equal opportunity basher...insurance companies, lawyers, even the government are leeching off of the system and need to have their tentacles removed.
A non-medical pro would be astonished to know how low the average doctor's income is in the states.
You know, I wouldn't mind having to live on these "low" wages....
http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey
Maybe your sense of entitlement is getting the best of you.
Rommney would call those salaries upper middle class.
What are the comparable starting and six year salaries for Wall Streeters?
Which requires more intensive training?
Which provides a positive social service and which skim off a share for themselves, without providing much of anything?
Just to put that in a little more of a concrete perspective for you, you are saying that making more than 90% of the population just isn't enough.
As for the wall streeters, it looks like doctors are still making about 3x as much for a starting wage:
http://www.ehow.com/about_4673536_starting-salary-wall-street-stockbroke...
to summarize:
https://www.youtube.com/watch?v=0Wn8-OMlPhY&feature=related
At least doctors do something productive for people.
CEOs and other corporate fucks that earn Millions per year are the real leaches.
When doctors are compensated at the same rate as CEOs and other corproate fucks (ie. CFOs, COOs, etc.), then people can start complaning about their compensation.
AND when your country defaults on its obligations where does that leave your health care, mon frère?????
France = lower debt/GDP ratio than the US. Equal productivity per capita. Europe as a whole: net trade surplus, versus 30 years US trade deficits. So picking on France is not really a great argument here.
France actually has higher marginal productivity than the US.
Exactimon !
They are all going to default one way or another. The political question is who will survive the people or the banks.
Q: What does the US have in common with Mexico and Turkey?
A: They are the only developed (OECD Member nations) that do not offer Universal Health Care.
Yet somehow...Americans are proud of this distinction. It's baffling.
Which developed nations do have universal health care?
Australia
Austria
Belgium
Canada
Czech Republic
Denmark
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Japan
Korea, South
Luxembourg
Netherlands
New Zealand
Norway
Poland
Portugal
Slovakia
Spain
Sweden
Switzerland
United Kingdom
Quick question alien IQ...how long does one have to wait in your long list of "developed nations" for a simple CAT scan or an MRI?...last I heard it was over two months in the UK.
Sounds like someone could get a bleeding ulcer from taking aspirin to deaden the pain while waiting to find out whats actually causing the pain ;-)
If you're a Canadian 16 year old and a hockey player...you go to the front of the MRI line. Jumping in front of the mother with breast cancer....
Well, at least we now have some gauge of a citizens worth to society in the Canadian health care system.
Do you get a hip replacement for 200 bucks without insurance?
You didn't pay for that hip....some one else did that for you.
Not sure I understand the question, was the society in question heavilly taxed beforehand in order for that hip replacement company making the parts and insurance company to be subsidized so it only cost 200 bucks with insurance?
The costs never change...nothing is "free" it only appears to be "free".
I have followed your posts for a while, you are smart guy and it was a simple question.
Si o No?
Well, I don't know about the smart part but I have found often times the simplest questions are the hardest to answer...its not that the answers are unknown...but because to answer would be extremely uncomfortable for the one trying to promote something.
Regarding hip replacements, you should be happy you don't live in England ;-)
"Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.
Two-thirds of health trusts in England are rationing treatments for "non-urgent" conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.
Examples of the rationing now being used include:
* Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation. (nmewn cutting in here...no word on if Bloomberg was consulted, fatasss need not apply...Seig Heil)
* Cataract operations being withheld from patients until their sight problems "substantially" affect their ability to work.(nmewn again...Arbeit macht frei!!!)
* Patients with varicose veins only being operated on if they are suffering "chronic continuous pain", ulceration or bleeding. (nmewn again, exploding veins required)
* Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.(nmewn, six is not enough)
* Grommets to improve hearing in children only being inserted in "exceptional circumstances" and after monitoring for six months.(nmewn, lol...wut?)
* Funding has also been cut in some areas for IVF treatment on the NHS.(nmewn, how much you wanna bet an NHS official won't have any issues getting treatment?)
http://www.independent.co.uk/life-style/health-and-families/health-news/cataracts-hips-knees-and-tonsils-nhs-begins-rationing-operations-2327268.html
Yet somehow most of these countries have better healthcare outcomes than the US. (longevity, infant survival rates etc)
The underlying issue that never, ever gets addressed is why the US pretty much always pays so much and gets so little: applies to education too.
The funny thing about infant survival rates (and statistics) is, how you define it and them. Switzerland doesn't count the death of "än infant" below a certain length...thats is, in the case of a premature baby. The baby was breathing, then died, was not long enough to be counted (statistically) so they say, apparently, it was never an infant.
There are statistics and then there are damned statistics...just compare apples to apples.
But my question remained unanswered...how long does the person in pain need to "take a pill" before they can get a common test done? In my case (here in America) for an MRI it was only three days in ordeer to find the source of the pain.
////////////////
;-)
Poor deluded junker. Lets take Italy, for another example, how do the different regions of Italy "describe" what is an infant, so as to descibe whether it was ever alive to be reported?
The argument to become more bankrupt does not work on me.
A perfect sign of what America has devolved into is that so many people are junking a post that is quite simply nothing more than a statement of easily verifiable fact.
Americans hate facts because facts are the antithesis of the American "dream".
Go back to sleep. Keep dreaming. That'll fix everything.
You have to stop listing all those socialist countries, it upsets people, specially if the socialist coutry has less debt and/or surveillance of it's citizens than USA.
If you openly advertise for the scum of the earth, how can you be surprised when it ends badly?
". "Give me your tired, your poor,
Your huddled masses yearning to breathe free,
The wretched refuse of your teeming shore."
LOL!
I have a lot of family in USA, I'll pass on your msg.
They need a dose of reality from pure Americans.
Actually, I'm a green card holder.....
80% of Americans believe "Angels" are real. With that kind of intellect populating the nation....a fact doesn't stand a chance of penetrating.
Not sure about angels, but I am pretty damn sure about the devil and i'm also pretty sure he is hidden in the details of every piece of legislation coming out of our government, including presidential signing orders.
That's why it's called the Moron Church. Their favourite angel is even call Moroni.
And the Republicans think one of these dudes should be their flag bearer and be President! Sheesh!
This doesn't mean I have anymore respect for the Democrats, BTW.
And what % of Europeans possess the laughable intellect to think that thier overloads will be able to continue the public largesse indefinitely (with or without the help of the ECB or IMF)? Because I sure don't see any rush to austerity going on in the countries around me.
I love the typo of turning "overlords" into "overloads". It works. It really does.
QWERTY (US, BR) QWERTZ (SwGr), AZERTY (FR) so many keyboard layouts on this laptop and I can't type in any of them...
I'll junk anything and everything that involves a government 'solution' to a government caused problem.
Bring back the free market in healthcare.
Everything government touches turns to crap. Ringo Starr
Oh, by the way, where is your list of all the socialist hell-holes that have or had universal healthcare?
I have lived in countries with socialist health care and now live in your dream type of society.
I would be happy to pay tax for the health care part, it is way less stressful then this private lawyer controlled crap where I have to spend huge amount of time avoiding been screwed by the insurance company.
And when I'm done working, no insurance.
But I hate to pay taxes for military, militarized cops, all frigging snooping assholes in big brother agencies and corrupt politicos.
So I don't pay no stinking taxes!
Are you also in favor of for profit, privatized fire departments? Police departments? Military?
If you want to go down that road...then go all the way.
Hell yes! Bring it on.
I would pay maybe 10-20% of what government steals.
Not only that, I'd get better service.
Hell yes! Bring it on.
It worked soo goood in Iraq and the other raghead country, afga something, much better than 2 previous imperial forces managed. Those Black Water, or WTF they are called, guys are really cool!
Cheney supports you, just don't go hunting with him.
Privat war, that's the ticket.
Rent a cop, if you can afford it.
Fill in the insurance form Sir and we go on with extinguishing your little fire here, oops Sir, you should try our gold member plan next time.
There are well managed enterprises and countries with socialist systems for basic needs, and there are stinkers.
Do you honestly think that what US is providing today, ghastly more expensively, is better then western Europe?