Paying for Health Care: Did Obama Have the Answer?

Fear of taxation strikes me as being the number one disease facing our political landscape. For years Republicans have sold tax cuts as a panacea and Democrats have sold all the wonderful things that the Federal government can accomplish that Private enterprise cannot.
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But no one seems willing to admit that it all has to be paid for. Under our current electoral system, the only rational choices we have are precluded by political infeasability.

And don’t me started about our inability to even think about the defense budget!

Sorry for asking (I don’t know), but re: those Bush tax cuts set to expire soon, have they been “baked into” the numbers already? Or must everyone budget without them?

If not, I’d support small, fair tax hikes across the board – all pay – but maybe the social conservatives would insist on taxing behaviors more, such as monty python ‘tax on thingy’. If THAT gets adopted, I’m moving to Argentina.

they are baked in.

Wouldn’t we need less charity, at least in health and human services, if we had better programs like universal heath care? It seems that bypassing the possibility of real health care reform in lieu of nonprofits garnering greater donations (or donors garnering greater tax breaks) is just another way of putting the well being of the less fortunate in the hands of the top 1%.

Charities, for one, worry that this would dampen giving at a time when they need it most.

I hereby declare bollocks. At least until such time as it is illustrated to me exactly how crucial philanthropy is, that we dare not endager it.

And if it is that crucial, why are we depending on free money from rich people in the first place?

I agree, fear of taxes has spiraled out of control. California is a stellar example of this. I’ve been under the impression that taxes are even lower now than they were under Regan. And even Regan raised taxes when he needed to! What always gets me the most is when middle class Republicans get all up in arms over raising taxes on the rich end of the spectrum, like it’s even more un-American than taxes in general.

Everybody agrees that taxes suck. I just wish people would agree that you gotta do what you gotta do, and sometimes you gotta pay for stuff you need. Like health care.

And don’t get me started on the defense budget either!

FYI:

“WASHINGTON (AP) — The drive to remake the nation’s health care system suffered yet another setback in Congress on Thursday when a pivotal group of House Democrats demanded numerous changes in legislation the leadership was drafting on a fast track.

The emerging bill “lacks a number of elements essential to preserving what works and fixing what is broken,” 40 members of the Blue Dog Coalition of moderate to conservative Democrats wrote in a letter to party leaders. To win their support, they said, any legislation would need to be much more aggressive in reining in the growth of health care.”

http://www.google.com/hostednews/ap/article/ALeqM5jlMpJGn28kqCcgU-aGcYE_ZHW-ywD99B8EVO0

August recess? No looking so good.

That’s supposed to be Not looking so good…
I guess No works too.

“Fear of taxation strikes me as being the number one disease facing our political landscape.”

It’s the real third-rail of American politics (“conservatives” have been bashing and lying about Social Security like, forever).

It’s why I’m hoping to see California (at least) make draconian cuts in services – closing parks, recreation, social services, emergency services, etc. etc. It’s appears to be the only way to shake people out of their “conservative” indoctrinated delusion that they can have good government without paying for it.

Yes, it would be a shame if rich people couldn’t selflessly give away their money without receiving a cash reward for their charity.

Karen…
You mention the Blue Dogs — how many of them voted for funding the war in Iraq? Why don’t you mention this kind of gross hypocrisy from elected officials who have no problem busting the budget by spending trillions on overseas wars, but suddenly become fiscal conservatives when health care for American citizens is the issue?

What everyone else has said re: the kabuki act that is congress. Dems have the better ideas but dare not speak of the means necessary to achieve those ends. CA is the ultimate cautionary tale for the US writ large. Though prop 13 makes their “leaders” impotent to do much of anything to escape the tailspin, since when has congress (under either party’s stewardship betrayed leadership or honesty?) Not to mention the 3$ trillion (Link!) elephant in the budget.

I agree w/Shep, perhaps we need to witness things getting much worse before we can have an honest debate about the future. Though I don’t live there, when I visited in April, I was convinced of one thing, it ain’t the Great Depression… yet. Sadly, the costs to millions of Californians will be extreme. How a land of such plenty can fail so epically should make people go hmmm (sane people mind you).

Expect the wingnut liars and their pet media hacks to distill this down to “Obama’s going to raise your taxes.”

Actually, by their lights it’s true because they only talk to the small elite that would be minimally affected. It’s just that they make no effort to correct the false impression left when, you know, “others” overhear.

Now, if only Obama would get his hands dirty and start pushing on this, I’ll forgive him for letting DADT fall by the wayside.

Actually, pluk, i did not mention the Blue Dogs, but go right ahead and segue into how I’m shilling for the insurance companies.

[...] Daily life, Democrats, Government, Healthcare, Obama administration at 3:03 pm by LeisureGuy Karen Tumulty writes at TIME’s Swampland blog: Whenever I talk to anyone at the White House about the difficulties they are having on Capitol [...]

Two words that explain the American fiscal train wreck more than any others: Ronald Reagan

The Economic Recovery Tax Act of 1981 saw the rates top earners pay drop from 70% to 50%

The Tax Reform Act of 1986 dropped them further, from 50% to 28%. The lowest tier saw their rates rise from 11% to 15%. Wiki: “This would be the only time in the history of the U.S. income tax (which dates back to the passage of the Revenue Act of 1862) that the top rate was reduced and the bottom rate increased concomitantly”

See here for the Federal Individual Income Tax Rates History:

http://www.taxfoundation.org/files/federalindividualratehistory-200901021.pdf

See here for a comparison of tax rates around the world (i.e. the irrelevant world). Coinkydink that most of the nations with higher personal rates have affordable health care. Or that these nations don’t drop trillion $ stones into the abyss of war?

http://en.wikipedia.org/wiki/File:Income_Taxes_By_Country.svg

Owie. Looks like a good day not to cross KT.

“Two words that explain the American fiscal train wreck more than any others: Ronald Reagan”

He had practice. He wrecked California – capping individual income tax, etc., before going on to destroy the nation. And of course, he began the very movement that deluded the country into thinking: 1) “government is the problem”, 2) lowering taxes on the ultra-rich would benefit others and cost nothing and 3) regulating industry is a bad thing, thereby destroying small-government conservatism (and, eventually the Republican Party) and replacing it with military-industrial, war-mongering, big-government, corporate-whore “neconservatism”. Morning in America my @ss.

http://digbysblog.blogspot.com/2009/06/man-who-destroyed-california-by-digby.html

Is it just me, or does the modern GOP have more in common with Gordon Gekko than anyone else?

Fortunately for all of us, “military-industrial, war-mongering, big-government, corporate-whore ‘neconservatism’” will be invalidated as a rational approach to governance b/c our media is so adept at conveying truth (not false equivalence) to its consumers. And, of course, our beloved dems have the cojones to show the contempt such a bankrupt philosophy merits, unafraid of attack ads (“tax & spend”) or questions about their patriotism where war is concerned.

Uh huh.

I’d add Krug (the guy who’s always right):

http://www.nytimes.com/2009/07/10/opinion/10krugman.html?_r=1&ref=opinion

And Reich:

http://www.commondreams.org/view/2009/07/10-5

Gekko was just a cheap opportunist. The Republican Party is much, much worse. It creates and legitimizes Gordon Gekkos, and much, much worse.

Did Obama have an answer on health care? Well, I suppose the real question may be, “Has Obama had the answer on anything?!” I mean, you tell me. America has spent dump truck loads of money…has anything really “changed”? Lots o’ promises from the left… extremely little return. Well, except ill-conceived investments in the Demo lifestyle. But hey, it appears that’s coming to an end. I bet Barry hopes to ram as much garbage as he can down our throats while his disciples are still on board. Hey, check the numbers. The monkeys are jumping out of the tree faster than we can count ‘em!! Eh…nothing personal towards Michelle.

jeepmanjr:

Get the back to 1954…

If it gets pushed back, fine. Do it once and do it right.

Also, let’s invest in creating a time machine, specifically for individuals like jeepmanjr, spob et all who just aren’t comfortable outside of “real” America!

The only thing is that instead of sending them to 1954, let’s just sort of, well, “miss” by about 65,000,000 years.

Hope we can build one that has “live”* video…

*how “live” would a 65,000,000 year old video be?

So, are we poking the trolls or not?Just curious? I prefer to ignore them, but if freeper comes back, I’m all for poking.

What is the goal here? To find a way to pay for this so arcane and indirect that no important constituencies get mad about it? Can’t we just admit that health care reform is really, actually going to cost money?
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The polls that say 70-some percent of Americans want a public option have been widely publicized, and I believe it was in here that I saw an allusion a few days ago to a poll of the various proposals to pay for it, which all polled badly.
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Has anyone seen a poll that actually asks which matters more? Having a public option, or not having to pay for it? (Or how much of their income people would be willing to sacrifice for it?) Obviously people want nice things, and obviously they don’t want to pay for them. There is nothing inherently contradictory about those two answers when the questions are asked separately. But I don’t think I’ve even seen them asked together:
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Which matters more, improving healthcare, or having more money?
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(And I’m assuming here, based on the fact that Congress can’t or won’t do it, that “let’s do both” is not an option, at least not in the short term. “Make people richer than me pay for it” is also an acceptable option, although it falls under the header of “no, I don’t care enough to spend my own money”.)

Well, considering that a significant majority (that 70+ percent number you mentioned) actually want a public option, I would hope that most if not all of those people would be willing to pay for it. I think a better question might be, will those people pay ENOUGH for a decent public option? Of course, I’m hoping that people actually think before answering questions, which may be a vain hope.

Of course there has to be a public option, if for no other reason, we have to have it for people like me, whose income is such that it will never be subsidized but are victimized by private industry’s unfettered ability to charge me whatever they feel like.
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I personally don’t like the idea of asking people if the are willing to pay higher taxes for reform because immediately in the respondents mind the question becomes do I want to pay higher taxes to pay for those who are too poor, too unemployed, too irresponsible, too unworthy to have health insurance. For most participants this translates into supporting the poor, minorities, illegal immigrants etc. whomever the latest economic scapegoat happens to be. I am one of the 47 million Americans without healthcare and no one need pay for me, if only I could buy a fair product at a fair price and I am not alone.
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So how do we phrase the questions to really find out what Americans are willing to do, and not allow the debate to get sidetracked by the latest face of the welfare queen instead of remaining focused on how to provide access to an industry that has been market driven, profit centered long past the point of sustainability.

“Lots o’ promises from the left… extremely little return.”

Yeah, WTF, the black guy’s had six whole months already!? We had 30 years of promises from the right and we got a whole lot in return…a whole lotta disaster and rich, white aristocracy to avoid taking responsibility for it.

Yessa, Massa, we be gettin’ right on cleanin’ up yo big-ass mess. We liberals sure be sorry we be takin’ so long ta git to its an cleans yo slop off de flo.

Dare I mention that the current health care system that we have is unaffordable. Its sending families into bankruptcy which has a cost on the country overall when millions who could normally pay their loans and other bills no longer can because one serious illness drains them dry.

Its causing people even with insurance to delay care because they cannot afford the co-pays which are often always much more than just the cost for an office visit. But we kind of just gloss over that fact.

If a large companies offers insurance to their employees they are having to raise the employee’s share of that cost giving the employees an immediate cut in pay.

States can’t afford the current system because they no longer have the tax base and can’t pay their share of even medicaid costs. Illinois for example is nearly $1.5 billion behind on payments to doctors, pharmacies, hospitals and other medical providers.

The federal government already reimburses thousands of hospitals every year to pay for care they provide to people who do not have insurance.

Millions without jobs and small businesses cannot afford to pay for health insurance at the current going rates. What’s it now about $12,000 to cover a family?

Visit an emergency room where you live and see how many people are sitting in there at any given time. Most people in there have no primary care doctor so they are in the emergency room because the condition has reached a critical stage.

Most of us when we walk into our own doctor’s waiting area find the place packed. He or she is overbooking appointment times for a reason.

So we pretty much already have rationed care, long lines and delayed treatment at twice the costs of most other industrialized nation.

The only answer to this is of course lower taxes and making sure the insurance and drug companies make even more profit. Oh and pretend all the unnecessary hidden costs we as individuals and our economy over all are already paying really don’t exist. Because I like my health care.

If only these philanthropists gave their billions to soup kitchens, food banks, free community health centers, and the like, instead of their own personal foundations (which can employ their children and friends in sinecures) and alma maters (which are already rolling in cash from all the legacy admissions) or, at best, a new wing or dorm or something else vaguely worthy that their names can be attached to.

And now I’m remembering Ricky Santorum stopping at fast-food joints on his way home and charging his eats to his foundation.

At the end of the day, when the great game of “Musical Chairs” currently being played by the Healthcare Magicians gets played out, Obama’s choice will remain the only viable one that has a hope of successfully being implemented. Why? Because only the affluent have no excuse for not resorting to Noblesse Oblige. They are the only ones who have the excess resources that can be used to balance the healthcare scale. To quote the song, “All Else is Dust in The Wind”.

KT is right, and indications that the wind is starting to blow in the right direction:
http://www.cnn.com/2009/POLITICS/07/10/house.health.care.tax/index.html

With this approach, we get not only the benefit of the 51 vote “reconciliation” clause, but none of the drawbacks.

No Swiss cheese.

Next:

Since we know we have a 51 vote instead of 60 vote hurdle, we don’t need the blue dogs or the Republicans.

With that in mind, get rid of the idiotic clause where health care providers can refuse the Federal plan, and get rid of the penalties that would be applied to the poor.

I look at it this way:

The Republicans positively scream about income redistribution, but really, the rural infrastructure i.e. telephones, power grid, roads, hospitals, schools, police and fire, doctors, water, farm, and technology subsidies come out of my pocket.

They should show their gratitude by realizing this, and that helping to support safety nets for our poor is something they can help us with in exchange!

Regardless of the status of who pays, income gets redistributed at every level. When it is Private Industry that gets to do the redistribution, it comes from our pockets in the form of Deductibles, Fees, Co-Pays, and Premiums. When Government gets involved, it comes in the form of Taxes. Either way, the American populace pays, it is just a matter of how the pay chain is formulated. When the Government does it, it comes out before the money gets in our hands, so we really don’t miss it because the per capita amount is small because everyone pays according to their ability to pay. That is, as you make more, you pay more. When the route is via Private Industry, not everyone is covered in the first place, so the pool is smaller. That forces everyone covered to pay more individually, and that exchange is focused more as the number covered gets smaller. Of course, the Government still is involved, paying for those that Private Industry won’t cover. In the end of this tightening of the pay chain, the individual again pays more because there are benefits that the Industry – Private or Government – just won’t cover.

If you haven’t seen last night’s Bill Moyer’s Journal interviewing a former Cigna exec. on how the insurance industry uses lies, smears, propaganda and lobbying to keep it’s monopoly (and our health care system screwed), you should.

Retiredsoldier:

One of the things people seem to forget is that income redistribution is why we aren’t just another country with a peasant class.

It might be worthy of those in “real” America that I pay for their infrastructure and that bill is a lot higher than the tab for social safety nets…

I tend to think of it as re-redistribution since the wealth of the top 1% is often really “earned” from the work of others.

Come on guys, you mean it’s not “trickling down”!? Here’s David Cay Johnston being interviewed by Amy Goodman (i.e. two journalists for those unaccustomed to such hereabouts):

Note, this is part II–the entire interview is excellent, but this segment is most relevant to re/redistribution.

I’d add that the same parasistic rel’ship applies globally–1st world wealth and privilege stands in direct correlation with poverty we can barely fathom in a nearly static developing world. IMO, we can’t have a just system in the US or here in J-town until that system applies the same sense of humanity to the poor, mostly brown and yellow people producing our goods.

The old adage “every society is judged by how it treats the least fortunate amongst them” must come to reflect about the global village too.

must come to reflect… our thinking … about

The GOPers and Dittoheads in particular have spent vast amounts of money and time ignoring adages that say a lot about our country and ourselves.

Among others:

You get judged by the company you keep.
Do unto others as you would have them do unto you.
Keep your friends close and your enemies closer.

Let’s not even get into the Ten Commandments, which, even though they were carved in stone, have been relentlessly shredded by these weasels…

If you recall, Obama said that he wanted Healthcare reform at a price that would not affect Middle Income Americans. It seems that the Congressional Democrats have finally heard his message, and are addressing his primary point.. I have some personal experience with this issue because when the workers where I worked before Retirement wanted an improved healthcare plan from our employer, our negotiations resulted in the original plan staying in place, but with an available overlay for an additional $13.00 per Pay Period from our check to double the benefits provided, which meant an additional $338.00 per Year for the increased coverage. In addition, current employees pay an additional 1.5% of their annual salary to pay for healthcare for Retirees – like myself – who are old enough to retire, but are not old enough to collect Medicare. And yet, there still are landmines out there for those who are covered by Insurance.

My Army career spanned from 1967 – 2008, and involved a period in the Regular Army, the New York Army National Guard, and the Retired Reserve. When I was in the Regular Army, I was covered under what was then the Army’s all-inclusive program of Healthcare for ALL members and their families. When I transferred to the National Guard, I lost all Military Healthcare except when I was actually on Active Duty. When I transferred to the Retired Reserve, I lost all Military healthcare, PERIOD, but had the promise that when I achieved Retired status I would regain my Healthcare In the mean time, I had access to the VA’s Healthcare, but – at the time – the VA’s program was a primary example of Healthcare Rationing. Before continuing with this part of the story, let me spend time with my Civilian Employer to round out this picture. When I left the Regular Army, and went to school on the GI Bill, I was employed by a series of Private employers who had crappy benefit packages before I ended up the Transit System in NYC, where I was covered by GHI.

When I first started with Transit, my healthcare package, mentioned at the top of this posting, was paid 100% by Transit, and I had reasonably good coverage that met my needs. I stayed with Transit from 1980 through 2009, when I finally Retired for the last time. As I stated above, portions of the package were later transferred onto my shoulders to maintain the package as it was originally constructed, but the benefits actually either stayed the same or got better as the transition was made. Now, I am Retired, but not old enough for Medicare, so the investment I made while working is paying for my GHI, which has been reduced only by the lack of a Dental package.

Returning to the Military, this is where it gets hairy. When I turned 60, I was transferred to the Retired NCO List, and got my Pension. I also had my Healthcare restored, but – by this time – the Military had totally revamped its healthcare program all out of proportion. The healthcare I recall as a new Private is still available, but there is now an Insurance package called Tricare that is involved in controlling the costs.

For those on Active Duty, the package is called Tricare Prime, and it does everything that the old program did, but it polices the costs much better than the old system did. There are other packages for those in the Reserves and National Guard, and the coverage gets worse as you descend the ladder, but let me not digress. I have Tricare Standard as a Retiree, and it is structured as a Secondary Carrier, meaning that those things that GHI won’t cover Tricare Standard should – although they won’t.

I’ve worn glasses since I was Six, and have had coverage as part of my Healthcare since I first graduated High School and entered the Army. I’ve always had to pay Deductables, and I’ve never looked on that as a chore. Now, however, I am Retired, and I’ve found out that while GHI – through a sub-carrier – will pay the same 30% of the bill for Lenses, and $80.00 for Frames, Tricare doesn’t pay ANYTHING for Glasses after the Patient reaches the age of Six (I ended up eating the remaining $916.00), with some very interesting exceptions. They will pay for Glasses when they are part of a program that involves Eye Surgery, INCLUDING LASIK. That is significant because eye surgery is NOT inexpensive, and LASIK is VERY expensive. The reason why they will pay for eye surgery is actually very good for the American population as a whole. The US Military broke the Dam on paying for LASIK because they decided that they needed it for two things. First of all there are several jobs in the Military that require vision that isn’t worse than 20-40, and the NIH has achieved sufficient evidence that LASIK – when performed by a competent Surgeon – can always produce at least 20-40 Vision. So, persons who come into the Military today who want to be Pilots, or do other work that requires good vision without Glasses are offered – free of charge – LASIK treatment to allow them to pass their Medical Exam. Secondly, the Military always works hand-in-hand with NIH, and NIH needs a large database of successful LASIK procedures so that the costs can be regularized enough so that the Insurance Industry can start moving LASIK from the Cosmetic category to the Necessary category.

This brings me to my point. They are willing to cover me for eye surgery, AND throw in a pair of Glasses – if necessary – in the interim, but if I just want them to pick up at least a portion of the remainder of the bill that GHI nibbled at, they won’t contribute one penny. It seems to me that the glasses should qualify at least in the “Wellness” category, and as a means to control the cost of other procedures that might become necessary if I don’t have them.

retiredsoldier:
I don’t yet have to face the conundrums you face, but I know that it is coming. My wife is disabled and if I didn’t have my coverage on her, she would now be Medicare only.

Try getting a doctor to take a patient Medicare only these days, and you’ll see why I’m so harsh about that refusal clause.

Seems to me that if anything, you deserve at least the bennies that the congressweasels get. Hell, you’ve done more for our country than they ever did…

[...] proposed in the first place—limited itemized deductions for rich people and you get $318 billion over ten years. That’s about as progressive in its distributive impact as what the House is proposing, but [...]

[...] a transparently false statement, seeing as funding questions are routinely focused on by the press, but that fact isn’t mentioned by Time. And when she isn’t pushing the [...]

I think that LASIK should be looked at as a model to reduce health care costs. Competition and the free market model is always the most efficient way to deliver goods and services.

I have always viewed passive taxation to be the price I pay for Government Services that would have to be purchased from private industry if the Government didn’t provide them. In that event, I prefer to pay the Government because when I have a complaint I have a live body I can complain to, not a voice at the other end of the phone line who – more and more – actually lives and works in India.