National Healthcare

[vf-xx]

You run into ethical issues there. You are moving healthcare back a few hundred years to where you had to pay for all your own services.

It would raise mortality rates amongst the poor, and the US would be crucified for it. When you start looking at the statistics and you notice the poor have a life expectancy of 60 years and the rich are living to 90, you'd have some explaining to do.

EDIT: There would be some balancing. The less doctors had to fight with insurance companies, the more likely they would be to be able to charge reasonable rates for their services.

You still run into issues where the poor are going to the doctor less because they can't afford it. They may still get treatment, but preventative care would go down the toilet across the board.

So, encourage private organizations / charities to help out with the poor. That's what they're there for. Makes that funding optional. So if I don't want to support a group that does stuff I don't believe in, then I don't have to.

Stop forcing me to subsidize people with morals / beliefs I don't agree with. I can respect their right to exist and do their things, but I don't have to support them.

[Lohman446]

The poor who cannot afford it... AND I MEAN TRULY NOT AFFORD IT, NOT THE ONES LIVING IN HUD HOUSING DRIVING MERCEDES.

Let's say we keep a form of medicare but run it on a far more localized level. For instance, around here Michigan Works pays for car repairs of those who cannot afford it. They pay the going local rates, but pay for services as rendered. This allows those who cannot afford it to operate to some degree as "cash" customers and gives them choices in repairs.

Those who chose not to afford it (for instance I go to the doctor on a very minimal basis - once every few years) are a different ball game and are making there own choices

Its not a moral dilemna for me (except for children) - I did not make the "life choices" that people insist they are entitled to that lead to the problems they have.

[teufelhunden]

Has anybody thought about doing away with health insurance all together?

Maybe expand how HSA's are used to allow for companies to provide that benifit to employees, but get rid of the overhead all together?

Why not make people responsible for themselves? *shock gasp*

HSA's, I think, are a wonderful tool. I have one myself, coupled with the required high-deductible health plan. I'm on the hook for the first $1500/yr in health care, and insurance pays the rest. Accordingly, my premium is lower - it costs me $41 twice a month, as opposed to $54 twice a month. This saves me $338/year. However, my employer is covering 3/4 of my health insurance - so, overall, the savings are $1,352. My company, in turn, contributes $600/yr to my HSA.

This is a great option for me - I'm generally healthy, if I'm at the doctor once a year, it's a lot. I've been once since my HI switched to this in November - puncture wound that I wanted to have looked at, went to an urgent care place. Cost me about $70. Other benefits include: above the line deduction for HSA contributions (both by me and by my employer) - meaning that any funds I put into the HSA or my employer puts into my HSA are not taxable income items. In effect, it makes your healthcare cheaper by your marginal tax rate - a la, my $70 trip would have otherwise cost me (in real terms, not the bill from them) $87.50 because I'm in the 25% bracket. HSA funds can also be used for things that health insurance doesn't often cover - dental care, for instance. Another benefit is that any earnings are tax free (the HSA is just another account- earns interest, can also choose to invest it) if spent on healthcare (or tax deferred, one moment on that one...). Otherwise, a HSA can be rolled over to, or rolled into an IRA when/if I choose to go to a more typical cafeteria plan (hence tax deferred).

All in all, a good system with good benefits. I think that offerings of HSAs are picking up, too. Plus, it makes one think about how one uses healthcare - it's not someone else's money for the first part, so likely not running to the ER for the flu.

[Lohman446]

HSA's, I think, are a wonderful tool. I have one myself, coupled with the required high-deductible health plan. I'm on the hook for the first $1500/yr in health care, and insurance pays the rest. Accordingly, my premium is lower - it costs me $41 twice a month, as opposed to $54 twice a month. This saves me $338/year. However, my employer is covering 3/4 of my health insurance - so, overall, the savings are $1,352. My company, in turn, contributes $600/yr to my HSA.

This is a great option for me - I'm generally healthy, if I'm at the doctor once a year, it's a lot. I've been once since my HI switched to this in November - puncture wound that I wanted to have looked at, went to an urgent care place. Cost me about $70. Other benefits include: above the line deduction for HSA contributions (both by me and by my employer) - meaning that any funds I put into the HSA or my employer puts into my HSA are not taxable income items. In effect, it makes your healthcare cheaper by your marginal tax rate - a la, my $70 trip would have otherwise cost me (in real terms, not the bill from them) $87.50 because I'm in the 25% bracket. HSA funds can also be used for things that health insurance doesn't often cover - dental care, for instance. Another benefit is that any earnings are tax free (the HSA is just another account- earns interest, can also choose to invest it) if spent on healthcare (or tax deferred, one moment on that one...). Otherwise, a HSA can be rolled over to, or rolled into an IRA when/if I choose to go to a more typical cafeteria plan (hence tax deferred).

All in all, a good system with good benefits. I think that offerings of HSAs are picking up, too. Plus, it makes one think about how one uses healthcare - it's not someone else's money for the first part, so likely not running to the ER for the flu.

Why HSAs though? Why not just make all medical spending tax deductible (rather than having to exceed $3000? a year IIRC) and allow you to administer your own plan. This gives you total control over your choices, as well as the savings of administration.

I'm normally for private companies handling problems, however the insurance companies, the health care companies, employee contributions and the tax code have all come together to royally screw up this industry.

[bornl33t]

So, encourage private organizations / charities to help out with the poor. That's what they're there for. Makes that funding optional. So if I don't want to support a group that does stuff I don't believe in, then I don't have to.

Stop forcing me to subsidize people with morals / beliefs I don't agree with. I can respect their right to exist and do their things, but I don't have to support them.

Not to chase a rabbit trail here but that's what churches and religion entities used to help with. When people decided they wanted their own moral law the outside these entities the churches and so on of course had to go. Once the places that provide help and welfare go of course some one/thing else needs to replace the lack of handouts, so that's what the government became. We transfered the good heartedness of the individual to the government who forces us to donate. Something else the government did worse then the private sector.

In the end it really makes no difference. Until some one can show me ONE budget that achieved more under government supervision then it did in the private sector I can not support a move to socialism.

btw did you know that the feds want to take away tax exempt status for non-profit organizations? If that doesn't kill it I don't know what will!

/rabbit trail...continue with NH debate

[teufelhunden]

Why HSAs though? Why not just make all medical spending tax deductible (rather than having to exceed $3000? a year IIRC) and allow you to administer your own plan. This gives you total control over your choices, as well as the savings of administration.

It's in excess of 7.5% of AGI (so ~3k if you make around 40,000) as long as it benefits you to itemize versus taking the standard deduction.

The HSA makes all of your medical spending tax deductible, provided you run it through the HSA. Same with an FSA.

Having it in said fashion I would bet eases enforcement burden on the IRS and burden of proof on the individual. HSA administrators (I believe) verify your spending - accordingly, the IRS doesn't have to hunt down everybody who is trying to deduct $14k on $40k income for medical and get them to prove the expenditures.

[teufelhunden]

btw did you know that the feds want to take away tax exempt status for non-profit organizations? If that doesn't kill it I don't know what will!

Do you have a cite? I know there was some talk about additional scrutiny on private foundations, but revoking tax exempt privilege is news to me.

[bornl33t]

Do you have a cite? I know there was some talk about additional scrutiny on private foundations, but revoking tax exempt privilege is news to me.

I do not, came accrost on a news feed about febuary. I pick up on it but wanted to hear more before I got all bent out of shape. But it's obviously on some ones mind

[Lohman446]

IMO it should be

Either health care is tax deductible or it isn't. Using an HSA administered by a private company should not make it any more or less. If a $100 DR bill is deductible how it is paid for should be inconsequential.

Employer contributions (HSA or insurance) just serve to hide the cost of healthcare from many people - it also "loopholes" some people into federal programs they do not belong on (IE I only make XX a year (not including health insurance, vision insurance, food stamps,rent assistance, etc)). Its one of the reasons we have spiraled to where we are now.

[chafnerjr]

IMO it should be

Either health care is tax deductible or it isn't. Using an HSA administered by a private company should not make it any more or less. If a $100 DR bill is deductible how it is paid for should be inconsequential.

Employer contributions (HSA or insurance) just serve to hide the cost of healthcare from many people - it also "loopholes" some people into federal programs they do not belong on (IE I only make XX a year (not including health insurance, vision insurance, food stamps,rent assistance, etc)). Its one of the reasons we have spiraled to where we are now.

It's not about just being tax deductible. HSA's in my case are tied to my companies high deductible health care plan. Without going into huge detail the cost savings to the business were huge. Their money for health care goes, partly, to ME instead of just to my health insurance company to cover ME. I've got a $1500 deductible and $500/yr that's dumped into my account (plus contributions). Meaning that I'm on the hook for $1k/yr max and then it's 100%. Now... I've got $500 cash for any medical expense I want. It's in MY HSA bank account. This means I can use it for my wife, children, neighbor of whoever I want as long as it's a legitimate medical expense as defined by congress. (BTW this is the type of plan congress uses for themselves!). Things that might not otherwise be covered by my insurance program (like hearing aid's) I can pay for cash. Things like wisdom teeth removal w/anesthesia which is not covered by medical insurance I can pay for cash. What did my company get for all this? An annual premium increase of 1%. That's right 1%. That is what the true savings of HSA's with high deductible plans are.

It is, however very true that our tax code is totally otu of wack here... btu HSA's promote personal responsibility and competition because you're spending YOUR money and not the insurance companies. It brings down much of the "red tape" and cost to the insurance company as well as your own. It allows YOU to decide on what's fair for coverage and shop around. Believe me there are huge price differences from one place to another!

All in all I've got to agree. HSA plans are at least a step in the right direction.

P.S. I've been able to replace my dental insurance completely by using a HSA and I've got much better coverage! If anyone is interested to hear the number crunching let me know.

[drg]

Prove it, big guy.

A good roundup of how the private sector is the cause of the crisis:

http://www.mcclatchydc.com/251/story/53802.html

Then there's ...

http://www.federalreserve.gov/newsevents/speech/duke20090216a.htm

Although the current problems appear to be rooted in high-risk subprime lending, I would like to dispel the notion that these problems were caused in any way by Community Reinvestment Act (CRA) lending. The CRA is designed to promote lending in low- to moderate-income areas; it is not designed to encourage high-risk lending or poor underwriting. Our analysis of the data finds no evidence, in fact, that CRA lending is in any way responsible for the current crisis. In our analysis of loan originations, we found that approximately 60 percent of higher-priced loans went to middle- or higher-income borrowers or neighborhoods, which are populations not targeted by the CRA. Additionally, more than 20 percent of the higher-priced loans that were extended in low- to moderate-income areas, or to low- to moderate-income borrowers, were loans originated by lenders not covered by the CRA. In fact, the analysis found that only 6 percent of all higher-priced loans were made by CRA-covered lenders to borrowers and neighborhoods targeted by the CRA. This very small share makes it hard to imagine how CRA could have caused, or even contributed in a meaningful way, to the current crisis. Further support for this conclusion comes from our finding that serious delinquency rates for subprime loans are high in all neighborhood-income categories, not only those in lower-income areas, as might be thought if the CRA were a contributing force to the subprime crisis.2

And ...

http://www.occ.treas.gov/ftp/release/2008-136.htm

More if you want it ... if you can handle it.

http://www.housingwire.com/2008/12/05/fdics-bair-sets-to-shatter-cra-myth/

http://bigpicture.typepad.com/commen...erstandin.html

http://news.morningstar.com/newsnet/ViewNews.aspx?article=/DJ/200812021226DOWJONESDJONLINE000492_univ.xml

http://online.wsj.com/article/BT-CO-...04-706722.html
http://www.businessweek.com/investin...ity_reinv.html

http://www.reuters.com/article/pressRelease/idUS242041+06-Oct-2008+PRN20081006

http://www.slate.com/id/2201641/

http://www.responsiblelending.org/issues/mortgage/quick-references/cra-is-not-to-blame-for-blame-for-the-mortgage-meltdown.html

http://womeninbusiness.about.com/od/womenspolitics/a/cra-lie-truths.htm

http://www.ncrc.org/index.php?option=com_content&task=view&id=353&Itemid=80

You shan't be perpetuating right-wing myths and attempting to rewrite history while I can respond to it.

So, encourage private organizations / charities to help out with the poor. That's what they're there for. Makes that funding optional. So if I don't want to support a group that does stuff I don't believe in, then I don't have to.

Encouraging does nothing unless you put some teeth into it, in which case we get people *****ing about how government is interfering in private business. No, the correct way to handle this stuff is through government programs which the government obviously has the right to direct, and which indeed are one of the things government is for in the first place.

[Lohman446]

Encouraging does nothing unless you put some teeth into it, in which case we get people *****ing about how government is interfering in private business. No, the correct way to handle this stuff is through government programs which the government obviously has the right to direct, and which indeed are one of the things government is for in the first place.

Really? What portion of the Constitution allows / mandates the federal government to fend any health care program? That obvious right is pretty much non-existant in my mind

[chafnerjr]

@ Drg: Nice articles ... you are partially right though. The CRA itself didn't cause the sub-prime issue. It was the over de-regulation of the U.S. financial system by both congresses (1994/95) under Clinton that did. Those de-regulations were pushed through in order to enforce the CRA on the few GSE's (Fannie Mae and Freddie Mac in particular) that HAD to offer it. This opened up the flood gates for a few greedy companies to prey on people who didn't have enough financial sense (yep it's their fault too) to know what they could/couldn't afford. I won't get into explain the details about how AIG and many other real-estate investments played into this because you seem to understand that the massive over de-regulation is the main culprit here. You just have to understand that the de-regulations occurred in order to push CRA against the banks that HAD to support it. It was a "you need to do this and we'll look the other way." sort of move.

@Lohman446: It IS the gov.'s responsibility to create an environment in which private companies can facilitate the public's need. Now the preamble starts out "We the people of the United States in order to form a more perfect union, establish justice, insure domestic tranquility, promote the general welfare, and secure the blessings or liberty to ourselves and our posterity..." then section 8.1 of article 1 basically restates that congress shall have to power to collect tax's for the purpose of promoting the general welfare of the United States". That's the argument that I keep hearing from those in favor of gov. supported plans. Nothing in the constitution says anything about owning private companies or even running private companies. Actually, article 10 states quite clearly that "The powers NOT delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectivly, or to the people". This means that you are quite right. The gov. DOES NOT have the constitutional right to do so.

[Lohman446]

The right wing line... frankly is no longer even offered in national politics :).

That being said, while I may be fiscally conservative the "convservative" party does not represent me either fiscally or socially anymore.

[Army]

Woah! Let's keep it friendly guys. This is a rare political thread that hasn't devolved into stupid. Tossing left or right wing accusations will get it closed. Put up truth and fact, and leave it there.

Personal opinion is expected, attacks on ideology are not.