Health Insurance Discussion

[TooMuchCredit]

If the federal government taxes you to pay for my sex change operations how is that providing for the GENERAL welfare of the United States? Does the answer change if the procedure is my broken arm? How about my flu shot?

None of those activities provides for the general welfare. Each is for my SPECIFIC welfare.

I do agree however, that it will never be shot down on Constitutional grounds if it becomes law but not because of the "general welfare" clause.

Because you have to look at it as a whole not what each individual is receiving. I shouldn't have to pay* for all the Interstates that I don't drive on by that logic.

*(Even if they're already built they have to maintained).

[OhioFiler]

Because you have to look at it as a whole not what each individual is receiving. I shouldn't have to pay* for all the Interstates that I don't drive on by that logic.

*(Even if they're already built they have to maintained).

I agree. They should be toll roads and not supported by gasoline taxes.

[justbroke]

I shouldn't have to pay* for all the Interstates that I don't drive on by that logic.

This is why Private Roads are becoming the new trend in Florida! We have several highways that are scheduled to be built, owned, and operated by private companies. They'll charge tolls in a "per-use" model. The highways will revert back to the public after 7-10 years for the investors to recover their investments.

Personally, I always liked the concept of the toll road, if applied correctly. Now, NY/NJ has just gone mad with them!

Okay, how does this relate to healthcare... I don't know. But I see the point where paying for more than you use... is just counterintuitive to me. I've always liked the concept of consumption-based taxation. However, in the end, you wouldn't be able to use that model and provide healthcare for those who have no money.

I think Chris Rock said it best. Insurance is just in case stuff happens. If stuff doesn't happen, shouldn't you get your money back? Love it.

(Okay, he didn't use the word stuff.)

[JRScott]

I don't see that challenge holding water in court.

Section 8. The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfarehealth, happiness, prosperity, etc., of a person, group, or organization; well-being: to look after a child's welfare; the physical or moral welfare of society.

Definition of Welfare in 1776:

Welfare
welfare n. 1. health, happiness, or prosperity; well-being. [<ME wel faren, to fare well] Source: AHD

Welfare in today's context also means organized efforts on the part of public or private organizations to benefit the poor, or simply public assistance. This is not the meaning of the word as used in the Constitution. (you can find that at usconstitution.net or cornell's website).

Thus yes what I said is true, it is Unconstitutional the power that Congress currently seeks and the President seeks.

In the context of Thomas Jefferson and the Founding Fathers who wrote the Constitution the context was prosperity where they used it. Prosperity not of the individual but of the nation as a whole was their meaning. Now when you look at that and then compare it to todays Congress and the President you find they are very far from the meaning the Founders intended.

He's already spent more money than Bush did in Bush's first 4 years in office. Congress continues to run us deeper into debt and the President continues to rubber stamp it. In essence they run contrary at this time to the precepts of the part of Article I Section 8 you quote.

If you want to see what Government Health Care is like I suggest you visit an Indian Reservation in the Dakotas. Talk to the Indians and see what they think about it. By treaty the government is suppose to provide their health care. In reality they fund about half the money necessary to provide the health care and the care is rationed to only the most serious injuries or illness often coming so late that there is usually side effects for the life of the individual.

Go visit a Veteran's Hospital and talk to the Veteran's about what they think of their care.

Don't believe the rhetoric, President Obama and the Democrats are lying to you about a great many things. There simply is no way they can cover everyone with the amount of doctors and facilities we have and not increase costs. It is simple supply and demand. The more folks that want to visit our limited facilities and doctors the greater the demand. When demand outstrips supply prices rise.

The two major things that would help reduce costs the most the Democrats have not entertained because to many of them have made their fortunes as trial lawyers. We need tort reform to lower malpractice insurance premiums for doctors and hospitals. Without it there is no real health care reform. The minimal payout in premiums for malpractice insurance is between 55k-60k a year for your average doctor with much more required in many states and cities.

The second thing is to open up trade restrictions between the states that currently prevent insurance providers from offering deals from one state to another. For instance there are approximately 1300 insurance providers in the United States. The State of California has only licensed 6 of them to operate within the state. This is what drives up insurance costs, when 6 of them have a near monopoly they manipulate the market and drive up prices. So when the most populous state is being held hostage by such measures the Federal government has the duty to step in but like with trial lawyers the Democrats have gotten to much money from the insurance companies and are not willing to take on true reform.

The third thing that is well within the power of congress but is also not part of the bills is to introduce a windfall tax on pharmaceutical and medical equipment providers. These companies enjoy profit marjins on average three times higher than Big Oil. (Average Big Oil profit was 6.5% in 2007, average pharmaceutical company was 26%). Once again due to the power of lobbyist they are looking out for their war chests and not you.

So if they aren't willing to do the three things that are constitutional and also would have the most effect on cost, what makes you really think they want Health Care or Health Insurance reform?

[JRScott]

Because you have to look at it as a whole not what each individual is receiving. I shouldn't have to pay* for all the Interstates that I don't drive on by that logic.

*(Even if they're already built they have to maintained).

actually Interstates to promote trade between the various states are constitutional and a responsibility of the Federal Government.

What you shouldn't have to pay for are road projects like the Bridge to Nowhere which would have only benefited the residence of one state and then only a very small minority of even them.

[justbroke]

There was actually a really good and unbiased report on the Czech medical system. It's single-payer and everyone has it. They go to the doctor 10-15 times a year on AVERAGE. (In the U.S., we go less than 5 times a year.) The reason their healthcare system has been okay, is that they actually had reserves from when the economy was good. The system is 75% paid for through taxes and 25% through employers. This was one of the "model" systems that we keep using as a benchmark for how we should do it...

Now their system is about to collapse. They don't have the revenues to pay for it. The reserves have kept them running, but that's running out (sound familiar? medicare/medicaid?).

Seems like we are basing our new system on that model. The hospitals are all government owned, but there are private physicians (with offices). The hospitals are staffed with government salaried medical staff that are underpaid. The incentive was that the more staff a hospital had (and more beds), the more money the hospital itself got. So they grew and grew and grew and have too much staff now.

The other problem is that private insurance providers exits, and get to bill the government, but they are not for profit. They can only make 3-5% profit to cover overhead.

Did I mention that the system is collapsing?

I just don't have the answer. The reason I don't have the answer is because I think what's about to happen is exactly what happened with the Prescription Drug Benefit Program for Medicare. While it was the right thing, it wasn't thought through. In the end, that program is costing way too much because it was rushed through.

The change is necessary. I still don't see where the actual costs are being addressed at all by any bill in the Pelosi's, the Senate's, or the President's version. They are in for a serious uncontrolled costs problems. Only the collective they, won't be around when it comes crashing down.

[JRScott]

Well justbroke we don't have the money to pay current expenses more less a National Health Care. Also the CBO numbers being used are low. Total cost to cover everyone in the United States in a Medicare style system would top 3 trillion a year. They are hoping that companies don't dump their health care programs if this passes, but in truth many probably will especially if the 8% tax is cheaper than their current health care.

So worst case scenario about 3 trillion a year. Best case scenario about 1 trillion over 10 years (lol).

Tax Reform is what they really needed to have tackled first.

The current corporate and personal income taxes are a convuluted mess. They are that way because of lobbyist and congressman looking out for war chests more than the people. You see I could tell you how to really afford it for everyone even though I oppose it because I feel National Health Care is beyond the mandate of the Congress (I am not opposed to Congress attempting to amend the Constitution to give themselves the right if the states approve incidentally).

Remove the current taxes. Everything. Income (personal and corporate), estate, gasoline, all federal taxes.

Instead institute a 6% national sales tax that applies to all goods and services including stocks, dividends, etc. You'd in essence make about oh around 7-8 trillion a year. (Twice the current proposed budget).

However Congress isn't willing to do that even though it would provide tax relief to all Americans, would shift the burden to the rich who spend more money, force wall street to repay the loans we gave them, etc. They won't do it because you can't manipulate such a system, you can't have all those discriminatory exceptions the current code has that really should be against the anti-discrimination laws of the nation.

[justbroke]

Instead institute a 6% national sales tax that applies to all goods and services including stocks, dividends, etc. You'd in essence make about oh around 7-8 trillion a year. (Twice the current proposed budget).

I didn't go directly there, but I am absolutely for a consumption-based tax system. If you have no money, you don't spend, so you don't get taxed. You have lots of money, you spend alot, you pay lots of tax.

However Congress isn't willing to do that even though it would provide tax relief to all Americans, would shift the burden to the rich who spend more money, force wall street to repay the loans we gave them, etc.

Some of the costs saved just by reducing the size of Revenue departments in the Federal and State governments alone, would be enormous. The problem is, that the perception will be that the Rich only pay the 6% VAT. Unfortunately, most people who complain that they are overtaxed, have no idea how the tax system works (and yes, I said most, not all). Especially those in the lower tax brackets (and the negative tax brackets). The lower 50% have been taught that they are entitled to receive money they didn't earn. While it's commendable to spread wealth, in the end, this is all about getting re-elected and building that war chest.

The reason is because it's easy to create class-warfare by telling everyone that the Rich only pay 35% of their income in taxes, and have all these wonderful deductions available. What they don't say, is that the top 5% pays more than 60% of all taxes. The bottom 50% pays 2% of all taxes but make up 1/7th or about 14% of all income earned.

Yet, it's all the rich people's fault. (Okay, maybe I take this too much to heart, as I've been in the top 2% of earners for over 10 years... but I'm filing bankruptcy too! And it's not because I have jet skis, a powerboat, a Lexus, a Hummer, or even multiple SUVs in the driveway.)

[JRScott]

I feel that the current system is the main reason we have such voter apathy, to many are being paid to maintain a status quo, everyone needs to feel the pain I feel, even the poor and the rich alike. Only then do we all pay sufficient attention to our government to avoid the slip into tyranny.

[TooMuchCredit]

I don't get these cost estimates that it will cost us more than what we are paying now. We already pay 50% more than the next highest country (Switzerland), yet every other country manages to cover everyone for less per capita.

We certainly are wasting something significant somewhere if we can't cover everyone at what we are paying per capita today. And before one goes and says it's all medicare waste, their overhead is 3% whereas insurance companies is 17-20%. So is all that extra money we pay per person going into the pockets of insurance companies, hospital companies, etc? Are they not taking into account the folks that do go to the public option would SHIFT their contributions from private insurance to public essentially negating that added cost?

If we expanded medicare to all, yes medicare's budget would grow significantly, but there would be nothing going to insurance companies so it would just shift money, not be an added cost.

[justbroke]

I don't get these cost estimates that it will cost us more than what we are paying now. We already pay 50% more than the next highest country (Switzerland), yet every other country manages to cover everyone for less per capita.

It's easy. Federalize the hospitals and have doctors on salary making what an average mechanic makes. That's how you solve that. But first, you'd have to reduce the costs of premium medical degrees from places like Harvard, Brown, Yale... because you can't get out of medical school and have $400K in debt (like TeacherMomma), working for $20-30 an hour. Just won't work.

The issue I have is, this new plan is not socialized medicine, doesn't address the root cause of costs (litigation, cost-per-procedure, insurance, overhead), and doesn't go far enough. It will be another Medicare Prescription Drug Benefit program.

They just want to slam something in, that would, in and of itself, need a major overhaul in 5-10 years.

[TooMuchCredit]

It's easy. Federalize the hospitals and have doctors on salary making what an average mechanic makes. That's how you solve that. But first, you'd have to reduce the costs of premium medical degrees from places like Harvard, Brown, Yale... because you can't get out of medical school and have $400K in debt (like TeacherMomma), working for $20-30 an hour. Just won't work.

The issue I have is, this new plan is not socialized medicine, doesn't address the root cause of costs (litigation, cost-per-procedure, insurance, overhead), and doesn't go far enough. It will be another Medicare Prescription Drug Benefit program.

They just want to slam something in, that would, in and of itself, need a major overhaul in 5-10 years.

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

[TooMuchCredit]

I feel that the current system is the main reason we have such voter apathy, to many are being paid to maintain a status quo, everyone needs to feel the pain I feel, even the poor and the rich alike. Only then do we all pay sufficient attention to our government to avoid the slip into tyranny.

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

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

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

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

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

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

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

Other changes I would also add:

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

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

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

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

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

[momisery]

The facts are from factcheck.org where they do tell both sides of the issue. We will not be giving healthcare to illegals, but we are right now. They go to the ER's and get their care on our backs. So, that arguments does not float at all. Medicare and works, and it would continue to work if they would not have taken the funds for a war, and give tax breaks to the wealthy. A public option is the only way to get around the profits. Does anyone realize that healthcare costs have risen 50% in a decade, has your income? And over the next year it will go up again 10%. The reasons are more than just costly test, CEO's for BCBS and companies like them keep competition out of their states and the CEO"S are making huge profits doing just that. They deny coverage and the employee who did it makes a bonus. CEO income now are 450 times more than ours, they use to be only 47 times more. We do have corruption in government but for gosh sakes big business is far worse. One look at wall street and the banks, is there any doubt? Medical debt causes more BK's than anything else, it certainly pushed us over the edge. How can an average earner pay in 250.00 per month for coverage and manage to pay at least 4000.00 out of pocket for ONE PERSON< or 9,000.00 for both??? That is 3000.00 plus my 4000.00 or 12000.00 if we are both sick. Of course if your both sick you will miss time and your income will come down even more. Then add on to that my BCBS wonderful MEDCO plan that covers rat tur+s basically. We are paying 120.00 for one medication right now.. crazy. We need watch dogs, and believe me the hospitals can't watch themselves let alone costs, and the insurance companies have no reason to watch a thing. The last time we tried for reform under Clinton healthcare and insurance told us they would be the watchdog, we don't need reform. They did not do that, and they never will. Public option is the best way to circumvent the huge profits needed to provide BCBS with the huge fancy buildings they so richly deserve on the backs of the dying public. 400 people die a day without coverage, and 14,000.00 Americans lose their coverage everyday. IT is coming your way, just a matter of time before you lose yours.

[FLBK7]

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

I agree completely. Another option would be to offer full or partial loan forgiveness for those who go into Family Practice, Pediatrics, or Internal Medicine. There's far too much specialization these days and because of the very "system" we have and the fear of litigation, primary care doctors end up referring us to specialists when they could have treated our ills themselves.