Universal Health Care

<div class='quotetop'>QUOTE(etyler88 @ Jul 30 2007, 03:20 PM) [snapback]487557[/snapback]</div>

And here is an excellent solution to the current problem... From the NY Times:

http://www.nytimes.com/2007/08/01/us/polit...amp;oref=slogin

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 1 2007, 07:45 AM) [snapback]488567[/snapback]</div>

From reading the article it looks like his plan is to provide up to a $15,000 tax exception per family for those that purchase health insurance. He also advocates eliminating employee provided health insurance. So now everyone has to purchase their own health insurance but they get a tax exemption. The problem with this is that he is proposing a tax exemption not a tax credit. So if you do not pay $15,000 in taxes you do not get the full amount. Considering that the poor and middle class in this country pay very little in federal income taxes and no where close to $15,000 per year, what he is proposing is that the government will in effect pay for the health insurance of the wealthy and not the poor. Sounds like a winning plan to me and I will lose my company provided health care too. Yes, that sounds like a Republican plan to me.

This sounds like the mortgage interest deduction all over again. It is a huge windfall for those with large expensive houses and big mortgage payments. However, if your are a lower or middle class person that purchases a modest house for say $100k to $150K, you will never come close to paying enough interest to beat the standard deduction. Again a big windfall for the wealthy and nothing for the lower classes.

 

Who could possibly take Giuliani seriously? The guy won't even lobby for the 9/11 volunteer workers to get the treatment they need for the health related problems they incurred while rescuing Rudy's rescue workers. His 'family values' include cheating on his wife and his kids are so alienated from him he'd send them to Guantanamo to get them out of the picture if he could. He's on the healthcare bandwagon only because it polls well.

A single person would have to earn about $70,000 and not have any itemized deductions to 'reap' the rewards of Rudy's "plan". But if one DID earn $70000 one could afford to pay for one's own health insurance out-of-pocket WITHOUT government subsidies. Rudy's plan is in the same vein as the give-away of farm subsidies to mega-corporate farm operations.

Rudy's plan is just yet one more example of republican double speak where the promise is help for the less fortunate, disguised as a slap in the face to those who need it most, and a gimme to the rich. Dishonesty disguised as grace. Beware.

 

Want universal Health Care? Look at Britan's helth-care system... And the pros & cons.....

 

<div class='quotetop'>QUOTE(jhinton @ Aug 1 2007, 08:42 AM) [snapback]488580[/snapback]</div>

Bingo!!

 

<div class='quotetop'>QUOTE(Godiva @ Aug 1 2007, 11:54 AM) [snapback]488651[/snapback]</div>

I think people are being to closed minded about using tax codes changes and market forces to our advantage - to allow capitalism to have at the problem rather than government - with its dismal track record of success and its amazing history of inefficiency, increasing taxes associated with decreasing return - not to mention the use of RATIONING resources rather than INCREASING availability to all via marketplace forces and competition.

Here is an interesting editorial from a New Hampshire paper:
http://www.unionleader.com/article.aspx?he...ce-903298cd8201

Obviously if your ideology is centered around socialism it wont rock your boat.

 

I agree with universal health care in principle, but I don't think that now is the time. How would it get paid for? Our country is in massive debt already. We need to (1) stop this endless stupid war that's sucking up so much of our taxes; (2) repeal the tax cuts on the rich, and (3) go back to the fiscal responsibility of the Clinton years when we did not spend more money than we had. When we can get back to a federal surplus, let's talk about health care.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 1 2007, 09:51 AM) [snapback]488677[/snapback]</div>

As a doctor, you should have a pretty good idea of how market forces are doing currently at making our healthcare system work. So, what's your report card? How are those market driven forces doing? I know that I have less quality of care now than I did ten years ago - my doctor is always extremely busy and limited in time during office visits.

I pay more for perscriptions. Think those pharma company direct marketing adds might have something to do with that?

My employer is dictating that we change (reduce) medical coverage and increase how much share is payed by the employees or face layoffs. I thought market competition between HMOs was supposed to solve that? How about your practice? Do the HMOs pay you on time, and the billed amount? Do you really think that the government could possibly do worse than the HMOs?

 

<div class='quotetop'>QUOTE(Dragonfly @ Aug 1 2007, 01:51 PM) [snapback]488701[/snapback]</div>

We might actually agree on some stuff here

If you repeal the tax cuts on the rich (and please define what rich is for me) how high a rate do want to go on them? And then when you add nationalized health care - how are you going to pay for that too? And what of the newly passed programs like the medicare drug plan that will cost hundreds of billions of dollars - how are you going to pay for that? And then if you grant amnesty to 10 or 12 million illegal immigrants and assume a 25-35 TRILLION unfunded liability how are you going to pay for that? And if you project future social security costs that are unfunded over the next 20-50 years - tens of TRILLIONS of dollars, how are you going to pay for that? You know the defense budget is not that big.

Seems to me you are correct, we cant afford nationalized health care - not now and not for the next 50 years plus. Then you have the added problem of either:

1. not having enough rich people to tax, and or,
2. defining rich as any american that works for a living

<div class='quotetop'>QUOTE(Mad Hatter @ Aug 1 2007, 02:11 PM) [snapback]488716[/snapback]</div>

EXCELLENT POINT - there are almost NO market forces in health care today - and that is the EXACT problem. Make doctors and insurance companies and hospitals COMPETE for your health care dollars/business. COMPETITION IS THE KEY FOR SUCCESS IN HEALTH CARE LIKE ANY OTHER MARKETPLACE.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 1 2007, 01:24 PM) [snapback]488726[/snapback]</div>

Is there that big a difference between the insurance companies telling the doctors what they can or can't do or the government telling the doctors what they can or can't do?

In an effort to cut costs and make things more efficient, would you want the insurance companies to tell the fire departments and police departments what they can or can't do?

 

I think "repeal the tax cuts" means a return to pre Bush tax levels. I don't remember wealthy people on wellfare as a result of the tax levels of the 90's. Nor do I remember "rich people" being an endangered species due to said levels.

Dr B. You're making a LOT of assumptions, bordering on hyperbole. TRILLIONS AND TRILLIONS!!! Who was even talking about immigration and social security anyways? No one's expecting "Free" healthcare. It's just a switch in how the coverage is provided. Instead of paying Medica $1000 every month, we'd likely pay $300 or so more in Medicare taxes and have basic coverage and have a supplemental Medica policy for $500.

Clearly, you prefer to submit your claims to the insurance companies, I get that. IT's what you're used to. But I really don't think you are at risk of a reduced salary due to nationalized healthcare. The insurance providers are at risk. Unless you're getting kickback from them, why do you care who you send your bill to if they both send you a check for the same amount?

 

<div class='quotetop'>QUOTE(Darwood @ Aug 1 2007, 02:05 PM) [snapback]488859[/snapback]</div>

I don't get it. Are you saying instead of paying $1,000/month to an insurance company, we will pay $300/month more in medicare taxes plus need to buy a supplemental policy for $500? If a family earns $60,000, there will already be $145/month paid to medicare, so $145 + $300 + $500 = $945. So I'll save $55/month or 660 a year?

Or if I earn $300,000/ year, we have $725 + $300 + $500 = $1525 plus I'm now in a higher tax bracket.

From each according to his ability to each according to his need?

 

All I was saying is we'll still pay for it. It's not free care for all.
I posted an example. I would assume that Nationalized health care would be a more basic coverage and people with enough money would buy supplemental insurance to keep coverage as complete as it is now.

The notion that it would cost trillions to care for the illegal immigrants is not accurate. We are ALREADY paying for their care indirectly.

Proposal:
We could expand medicare to all for basic coverage, maybe on an 80/20 basis (Which due to the shared cost, will encourage consumers to be smarter about the healthcare they receive and discourage runaway pricing that 100% coverage causes. Employer sponsered Medica plans would not go away, but rather turn into supplemental coverage (albeit much cheaper since Medicare would cover the basics). The supplemental insurance would cover the 20 % and services not covered by the basic plan. Just a thought, but I hope to invoke discussion, good and bad.

I do agree now is not the time, though. But it doesn't mean we shouldn't discuss it and try to find a better way than the the runaway cost model we have now. "Don't change anything" is NOT an answer made by anyone except those profiting off the current system.

What are other ideas?

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 1 2007, 11:51 AM) [snapback]488677[/snapback]</div>

I read your article entitled "A healthy choice: Hillarycare vs. Rudycare" Though the title is quite misleading because the only mention of Hillarycare was the first sentence: "EVERY Democratic candidate for President has a plan for "universal" health-care coverage, which is a euphemism for socialized health insurance." The rest is a very brief description of of Giuliani's proposal that conveniently leaves out his support for the elimination of employer supplied healthcare plans.

What I don't get is the disconnect between the ideas and the proposals. Everyone claims that they want to make healthcare more affordable and available for everyone. Gulliani's plan does a little bit of the first part by making healthcare more affordable. However, this is on a sliding scale where the more money a person makes, the more the federal government will contribute towards their healthcare. Not a plan that very many would call fair or good use of the federal taxpayers dollar.

For example, take a hypothetical family of 4 that only takes the standard deduction therefore paying the maximum in federal taxes possible.

If they make $23,700 or less they get absolutely no benefit from this plan at all. Before you say no one makes that little, 2 people working minimum wage make a combined $21,424 per year.

If they make the median income for the US, $44,334, then they will get a benefit of $2,354. That's nice but nowhere near enough money to pay for health insurance especially now that they don't get it from their employers anymore.

If they make $111,250 than they will max out Gulliani's tax break and get the full $15,000. However, I doubt they were having a hard time paying for health insurance to begin with.

I don't see how this plan will do anything to increase the number of people with health insurance.

I DO NOT support using the tax code to attempt to influence behavior. We need to simplify the tax code and remove exemptions and credits not add them. For a "socialist" you may be surprised to find that I don't even support the income tax. I find it to be fundamentally flawed and serves only to punish those that are productive. I also don't support property taxes and inheritance taxes or any other tax that taxes the same assets repeatedly. I don't support taxing corporations and businesses because I'm smart enough to know that they just pass on this cost to the consumer so in the end it is the individual that pays. This "Socialist" is a big supporter of the Fair Tax, also known as a national sales tax that would replace all other forms of federal taxes.

 

<div class='quotetop'>QUOTE(burritos @ Aug 1 2007, 01:15 PM) [snapback]488804[/snapback]</div>

Yes - huge difference. I can choose my insurance provider or even pay out of pocket for a non-covered procedure. Under single payer (i.e. government) I can do neither. Just check out the post from the guy who lived in Canada.

<div class='quotetop'>QUOTE(Hard_working_student @ Jul 31 2007, 07:32 AM) [snapback]487985[/snapback]</div>

I think this about says it all. Sorry to hear about your first child - that is truly appalling and the kind of story I fear we will hear more of if our healthcare options are taken away from us.

 

Yes, We Can All Be Insured

 

Interesting poll results. Almost 80% tilted one way and about 20% the other. I wouldn't have guessed the result would be so lopsided.

 

<div class='quotetop'>QUOTE(dbermanmd @ Aug 1 2007, 02:24 PM) [snapback]488726[/snapback]</div>

Nice post! well said!!!

 

<div class='quotetop'>QUOTE(MarinJohn @ Aug 6 2007, 11:12 AM) [snapback]491278[/snapback]</div>

Maybe because no matter your political persuasion/philosophy everyone can recognize a system that isn't working well. I think a lot of people are to the point where they feel we should try anything because the current system keeps getting more expensive while services are being reduced. Nobody is really at fault for the current system, but everyone is playing the system for their own benefit - Patients, doctors, insurance companies, medical suppliers, drug companies, etc.

 

<div class='quotetop'>QUOTE(05_SilverPri @ Aug 6 2007, 02:23 PM) [snapback]491383[/snapback]</div>

Define for me "a lot of people". Here it is less than 100 - and you believe that that is sufficient to try a system of health care that:

1. rations health care
2. does not allow for medical malpractice suits
3. rations availability to medications
4. rations availability to diagnostic imaging
5. rations availability to organ transplantation
6. rations availability based on age
7. places the govt in total control of your health care
8. gives the govt access to your medical records
9. removes all market forces from health care (mind you we are near zero now, my idea would be to invigorate US health care by putting market forces to work instead of silencing them).