Assuming Affordable Care Act Is Shot Down, Should There Be a Healthcare Hospital Tax?

[CAC1001]

On privatizing fire services, it would be stupid to privatize a fire house in the sense of having individual people pay for the fire service, and if they refuse, then if a fire starts, their house burns down (I don't know why any town would have tried it that way). The way to do that would be for private fire companies to compete for contracts to cover the fires in a certain area, being paid by the local government with taxpayer money. If a fire company doesn't do its job properly, then it loses the contract, and another company would take over. Maybe the fire houses could be publicly-provided for the fire companies (otherwise each company would need to build its own fire houses), but the firefighters and the trucks are provided by the company in this theoretical example.

Thats not true- private military contractors (mercenaries) exist, and it is certainly possible for the federal government to hire a private sector military contracting company.

Private military cotnractors aren't the same thing as mercenaries. Mercenaries are paid soldiers who will work for anybody, who have no loyalties. That is different than a soldier who goes to work for a private military company that is licensed by the U.S. government.

The same argument you are making for roads could be made for risk pools/insurance. Private companies would only take the least risky people, leaving people with genetic illness (or bad family histories of such illness) to suffer, the elderly would suffer, etc. There is no profit in insuring risky people, just like there isn't much profit in rural roads or electricity.

A government-run system might function the same though. The people who are the most likely to die may be given secondary consideration, as the system will have to ration care.

 

[mege]

Control/power?

This is my greater point - the ACA just entrenches the current system and subscribes millions more to it. Costs of health care are high in the United States because (some could argue) too many people have access to health care. The ACA will naturally disincentivize health care and force the government to subsidize the resources necessary for healthcare to be successful at even a basic level (and the setup costs dealing with building more facilities, training more staff etc).

What needs to be done is encouragements in efficiency in the health care world. Adding another elephant to the equation (ie: government hand-holding, the first elephant being medicare/aid) doesn't favor that approach. Limit the litigation, stop the micro-transactions, and stop the government involvement. I am of the mind that the health care system wouldn't be broke if we didn't have medicare/medicaid manipulating the administration practices and associative costs of most hospitals and doctor's offices. If medicare and medicaid functioned more like traditional insurance we wouldn't be in this problem. Instead medicare/aid's menu of services forces hospital's hands in the name of accountability.

 

[mege]

They tried to get those fundamental changes in, but didn't have the support (no I'm not talking about JUST the government option, which, honestly, I don't see as all that bad since France has only government options and they rate pretty high in healthcare, but that's a different debate), so they went with the "let's get everyone on to insurance and see what we're able to come up with down the road" plan.

My grandparents were dual citizens US-Canada. My grandfather worked for OHIP post-retirement as a consultant. They paid for US health insurance, and only used the government plan in Canada when they had a single emergency while they happened to be in London, ON. For emergency services - the costs were slightly higher because of the deductable in the US, but for anything else - cancer screenings, routine care, preventitive care, 'sick visits' their insurance from an American provider was superior. My grandmother could walk in for a mammogram in the US, but the wait was months in Ontario. My pessimism of a government run system comes from family experience. It sounds shiny when you're 25-40 and healthy because you're probably not getting your money's worth out of insurance currently (out of the 1500/yr I pay in premiums I have visited the doctor twice in 5 years (And 1500 more I am sure my employer provides)). But when you're in waning health and need to visit the doctor for more than a sinus infection, days and weeks waiting can matter.

Aside from the 'coverage' aspect of a government option, I fear for what it will do to medical developments. Can the US continue to operate teaching and research hospitals with a single payer option? Will places like the Mayo Clinic still exist? If it does, it will be requiring massive private donations to stay afloat like St. Judes or other charity-funded research hospitals.

In addition - when we have a government option for health care, and your body becomes an investment of the government, what else will start to be controlled? A second prohibition? A pop ban? A 'fat tax'? These all seem very big-brother-ish and remove any sense of responsibility from the individual to actually do something right (they are all ideas that have been seriously considered by congress in the last 5 years by the way...). Many of us have had a 'sugar sickness' as a kid that probably taught us to eat healthier and remind us that too many sweets are bad, if the government bans this type of behavior - we never learn and are doing things 'just because'. Seems very anti-intellectual to not allow for simple, innocent learning mechanisms in a youth's life. I often wonder if the nanny-state is part of why we are seeing a relative decline in the interest of science - too many youth are given truisms rather than allowed to discover basic, harmless things on their own.

 

[WhoWee]

My grandparents were dual citizens US-Canada. My grandfather worked for OHIP post-retirement as a consultant. They paid for US health insurance, and only used the government plan in Canada when they had a single emergency while they happened to be in London, ON. For emergency services - the costs were slightly higher because of the deductable in the US, but for anything else - cancer screenings, routine care, preventitive care, 'sick visits' their insurance from an American provider was superior. My grandmother could walk in for a mammogram in the US, but the wait was months in Ontario. My pessimism of a government run system comes from family experience. It sounds shiny when you're 25-40 and healthy because you're probably not getting your money's worth out of insurance currently (out of the 1500/yr I pay in premiums I have visited the doctor twice in 5 years (And 1500 more I am sure my employer provides)). But when you're in waning health and need to visit the doctor for more than a sinus infection, days and weeks waiting can matter.

Aside from the 'coverage' aspect of a government option, I fear for what it will do to medical developments. Can the US continue to operate teaching and research hospitals with a single payer option? Will places like the Mayo Clinic still exist? If it does, it will be requiring massive private donations to stay afloat like St. Judes or other charity-funded research hospitals.

In addition - when we have a government option for health care, and your body becomes an investment of the government, what else will start to be controlled? A second prohibition? A pop ban? A 'fat tax'? These all seem very big-brother-ish and remove any sense of responsibility from the individual to actually do something right (they are all ideas that have been seriously considered by congress in the last 5 years by the way...). Many of us have had a 'sugar sickness' as a kid that probably taught us to eat healthier and remind us that too many sweets are bad, if the government bans this type of behavior - we never learn and are doing things 'just because'. Seems very anti-intellectual to not allow for simple, innocent learning mechanisms in a youth's life. I often wonder if the nanny-state is part of why we are seeing a relative decline in the interest of science - too many youth are given truisms rather than allowed to discover basic, harmless things on their own.

I'd like to address the "Big Brother" factor. While I don't have direct information to support, I'll assume a number of people receiving food stamps are also on Medicaid - is that a fair assumption?

Perhaps the Government SHOULD control the types of food allowed for purchase with food stamps? Perhaps processed snacks and sugary sweets should be excluded - in favor of more raw fruit and fresh/canned vegetables, meat, poultry and fish, pasta and bread?

I see a lot of "fruit roll-ups" and gourmet ice cream in the carts of people paying with food cards.

 

[CAC1001]

I can't find a specific breakdown of credits vs. FICA (the best I can find includes state taxes and sales tax). If we include payroll and credits, roughly how many people pay no federal tax?

I know that a few of the ways lots of people can reduce or eliminate their federal income tax bill is through the Child Income Tax Credit (which doubled under President Bush from $500 to $1000), the Earned Income Tax Credit, there's the mortgage interest deduction, and probably a few others I am not thinking of.

 

[Vanadium 50]

Only a credit can make your income tax negative. If you deduct more than you made, the tax is pegged at zero.