News The US has the best health care in the world?

[WhoWee]

The right answer is quite probably "we don't". Evo already pointed out one of the ways that the distribution of taxes is complicated, and that was only the tip of the iceberg of the difficulties in making this kind of estimation.

There are surely people in this world who could do the calculation -- but you and I are not those people.

I agree taxes are complicated. I don't know how to make the specific calculation. But this discussion is about health care reform. Accordingly, I made the only comparison that is relevant to me. I'm an "average Joe taxpayer". I want to know how much my family will ultimately need to pay in future taxes as a result of HR3200. I don't consider this someone else's problem.

Let's put this into it's proper context - starting with the overall current deficit.

http://www.foxnews.com/politics/2009/08/21/official-obama-increase-year-deficit-trillion/

Obama Administration to Increase 10-Year Deficit Estimate to $9 Trillion
The 2010-2019 cumulative deficit projection replaces the administration's previous estimate of $7.108 trillion

This estimate doesn't yet include the cost of "health care reform" - which the CBO estimates at $1.042 trillion additional.

As far as I know, every US taxpayer ultimately owns a share of this debt - am I wrong? Aren't we all subject to taxes? Like it or not, this is our problem.

The responsible solution is to deal with the specific problems of health care costs now (starting with social security, medicare, and medicaid "reform") - not make the program larger, throw more money at it, and pass the problem on to future generations.

 

[bleedblue1234]

"Who Will Pay for It?"

Everyone asks.. no one has an answers.

"Tax the 'Rich'", Some Say...
"It Doesn't Matter", Some Say...
"Pay For It? We Have to Pay for Stuff?" Some Say...

One thing I can guarantee is that with fiscal deficits hitting $10+ Trillion MORE projected into the next decade, someone will pay for it. (and it will be US, the average American who will be paying drastically higher prices for everything we buy)

 

[WhoWee]

The right answer is quite probably "we don't". Evo already pointed out one of the ways that the distribution of taxes is complicated, and that was only the tip of the iceberg of the difficulties in making this kind of estimation.

There are surely people in this world who could do the calculation -- but you and I are not those people.

Can we agree on this - given the CBO estimate of $1.042 trillion in deficit spending for health care reform and approximately 112 million households in the US, the minimum cost of HR3200 for each household (that actually pays taxes) over time will be $1.042 trillion/112 million = $9,303 - then after subtracting the allocation from each household that doesn't pay taxes, the cost will be re-distributed accordingly to the households that do pay taxes?

Is this a correct assumption?

 

[Ivan Seeking]

"Who Will Pay for It?"

Everyone asks.. no one has an answers.

"Tax the 'Rich'", Some Say...
"It Doesn't Matter", Some Say...
"Pay For It? We Have to Pay for Stuff?" Some Say...

One thing I can guarantee is that with fiscal deficits hitting $10+ Trillion MORE projected into the next decade, someone will pay for it. (and it will be US, the average American who will be paying drastically higher prices for everything we buy)

We will certainly pay for it if we don't do something. The fallacy is the notion that we have a choice.

 

[Ivan Seeking]

As far as I know, every US taxpayer ultimately owns a share of this debt - am I wrong? Aren't we all subject to taxes? Like it or not, this is our problem.

You can't look at this in isolation. If we can return to a healty GDP, we can better afford the debt. If we don't return to a healthy GDP, we are hosed anyway. This is why issues like health care are directly connected to issues like a dwindling US manufacturing base.

Also consider that, for example, by eliminating oil imports, we easily could pay for universal health care; and even more so because oil imports deplete wealth by taking the money out of the domestic economy. Health care circulates wealth within the domestic economy. So while the costs associated with health care are real, so are the benefits of the big picture. We need to redirect the course of the nation. Health care reform is just a part of the equation.

 

[turbo]

It is certainly true that we don't have a choice if we want to revive our economy. Health-care costs are rising too fast, and that money is enriching middlemen that obstruct the system instead of contributing to it. It is very easy for someone young and healthy to say "I've got my health insurance, and everybody else should have to get their own." This attitude ignores the fact that too many people can't afford health insurance and many more couldn't get coverage at any cost due to pre-existing conditions. It also blithely ignores the sad fact that if the currently-healthy young person develops a serious condition (kidney failure, one of the many hard-to-treat cancers, etc), and the insurance company doesn't drop them outright, the soaring cost of treatment will cause them to hit their lifetime cap very quickly, and continued treatment will eat up their savings and other assets, including perhaps their home. I certainly don't want to leave my wife facing her retirement penniless just because I couldn't get adequate insurance coverage. There is no reason that citizens of the US should have to turn over all their assets to the health-care providers just because they get sick. They should be able to provide for their loved ones without driving them into poverty. The current system is heartless and terribly regressive.

 

[Ivan Seeking]

National Health Care Spending

National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6 percent of the gross domestic product (GDP). By 2018, national health care expenditures are expected to reach $4.4 trillion—more than double 2007 spending.1

National health expenditures are expected to increase faster than the growth in GDP: between 2008 and 2018, the average increase in national health expenditures is expected to be 6.2 percent per year, while the GDP is expected to increase only 4.1 percent per year. 1

In just three years, the Medicare and Medicaid programs will account for 50 percent of all national health spending. 1

Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures this year than it receives in taxes and other dedicated revenues. In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the prescription drug benefit will continue to require general revenue financing and charges on beneficiaries that will grow substantially faster than the economy and beneficiary incomes over time. 2

According to one study, of the $2.1 trillion the U.S. spent on health care in 2006, nearly $650 billion was above what we would expect to spend based on the level of U.S. wealth versus other nations. These additional costs are attributable to $436 billion outpatient care and another $186 billion of spending related to high administrative costs. 3...

http://www.nchc.org/facts/cost.shtml

 

[jreelawg]

Certainly something should be done about health care in the US. I don't understand why iut must cost us over a trillion.

One thing that seams like a no brainer is providing medicine at realistic prices. In cuba an inhaler cost about 5 US cents, and in the states up to 120 US dollars. That 2400% more. I can find no other explanation why this should be the case except that someone knows they can make a 2400% profit. Solving this issue won't happen because their is too much pressure from drug dealers who are making a killing.

Another thing that doesn't make sense is this issue of pre-existing conditions and the system in which turning you down for care is the first attempted action when you need care. It wouldn't be hard for congress to regulate this, yet it goes on and on.

Why can't we fix these things one at a time and spend next to nothing?

Lastly, I want to clear something up that confuses me about Obama's health care plan.

They say it is a government option to compete. Do you have to pay into it to get the option, or is it a "free" option with the cost reflected only in the deficit?

 

[Wax]

Obama said you have to buy into the government option.

 

[BoomBoom]

Hmmm, I wonder if you had insurance through your employer and decided you wanted the gov't plan instead, if your employer would be required to increase your salary by a % of the amount they were contributing to your health insurance costs?

 

[Wax]

Hmmm, I wonder if you had insurance through your employer and decided you wanted the gov't plan instead, if your employer would be required to increase your salary by a % of the amount they were contributing to your health insurance costs?

lol

You probably would get a raise. That was one of Obama's main points. He was saying the reason you haven't noticed an increase in salary is because your health care cost is eating it up. You'd receive a down grade in your health care service if you opted for the public option though.

 

[BoomBoom]

You probably would get a raise. That was one of Obama's main points. He was saying the reason you haven't noticed an increase in salary is because your health care cost is eating it up. You'd receive a down grade in your health care service if you opted for the public option though.

The plan I have through my employer is really splendid and I pay no premiums at all, but I hardly ever use it. The amount of $$ they put up for my healthcare is probably nearly as much as my salary. If there were a public plan available, I'd rather all that $$ go to support the general healthcare costs of all, than have it go to lining the pockets of rich insurance bigwigs.

...so even if the plan wasn't as good (which it wouldn't be), it would still be better IMO.

 

[WhoWee]

You can't look at this in isolation. If we can return to a healty GDP, we can better afford the debt. If we don't return to a healthy GDP, we are hosed anyway. This is why issues like health care are directly connected to issues like a dwindling US manufacturing base.

Also consider that, for example, by eliminating oil imports, we easily could pay for universal health care; and even more so because oil imports deplete wealth by taking the money out of the domestic economy. Health care circulates wealth within the domestic economy. So while the costs associated with health care are real, so are the benefits of the big picture. We need to redirect the course of the nation. Health care reform is just a part of the equation.

I don't have as much confidence in a fast recovery as you Ivan.

As for oil imports. Domestic drilling is unpopular/discouraged. We're being told to reduce dependence on foreign oil, to build wind mills and invest in solar.

Then we hear reports President Obama may be assisting a prominent campaign supporter/investor in Petrobras, a Brazillian company, to drill offshore? I don't know if this is accurate or not - I haven't read the original WSJ article that all of the stories reference - most reports say $2 billion - this says up to $10 billion.

http://iplextra.indiatimes.com/article/0emQh1ye2nbuQ?q=Barack+Obama
Obama Helps Soros Drill Oil In Brazil

"The U.S. government is prepared to provide up to $10 billion in loans to finance the development of massive hydrocarbon reserves off Brazil’s coast, a Brazilian official said Wednesday. "

http://sweetness-light.com/archive/obama-helps-soros-drill-oil-in-brazil
I don't see a clear policy from the White House regarding oil.

No, I think we do need to isolate health care spending, put it under the microscope and fix it before it gets any worse.

 

[WhoWee]

Oil link follow up - this is from the WSJ site.
http://online.wsj.com/article/SB10001424052970203863204574346610120524166.html

 

[Ivan Seeking]

I don't have as much confidence in a fast recovery as you Ivan.

We have no choice. We have to pay in regards to health care whether we do something or not. And we have to turn this ALL around. If we don't, it won't matter what we do about health care.

As for oil imports. Domestic drilling is unpopular/discouraged. We're being told to reduce dependence on foreign oil, to build wind mills and invest in solar.

Biodiesel from algae is the ticket. And now Exxon, Shell, and DARPA agree. DARPA even thinks it can make diesel fuel for $3 a gallon in war zones and eliminate the need to ship in the fuel! [that even wows me, and I've been pushing this for three years now!] Obama is already focused on alternative fuels to help get us out of this mess.

http://www.nytimes.com/2009/07/14/business/energy-environment/14fuel.html
http://green.autoblog.com/2007/12/12/shell-oil-to-grow-biofuels-from-marine-algae/
http://www.independent.co.uk/news/b...powered-soldiers-in-the-pipeline-1766017.html
https://www.physicsforums.com/showthread.php?t=211274

As for the oil, the potential for large reserves in the coastal waters of Brazil probably motivates exploration for the sake of national security. But while the Fox Newspaper [WSJ is owned by Murdoch, much to the dismay of those who built the paper] takes cheap shots, in the grand tradition of infotainment, it makes no attempt to explain the decision or provide any context.

The only reason we haven't exploited US coastal reserves, along with many many acres already open to drilling here in the US, is that the price of the oil from those reserves is too high. As soon as the price of oil justified offshore drilling, we saw movement in that direction. Heck, we even saw people in Texas putting oil rigs in their back yards! As soon as the price fell, you heard nothing. With the prices rising, it becomes an issue again. If the oil companies could be competitive at the current price of crude, the demand for offshore drilling would be relentless. As for arctic reserves, it would barely amount to a trickle compared to the entire supply. The only thing tempting about the arctic oil reserves are the billions of profit to be made; that is unless you get excited about a minor bump on a curve.

 

[Ivan Seeking]

Sorry, that was a pretty severe diversion, but the point is that we can't solve any of these problems in isolation. We have to look at the entire picture; beginning with the cost of health care if we do nothing. It is a pretty dismal picture. Obama says he wants a plan that is revenue-neutral. Others say that isn't possible. Maybe it isn't possible, but its not like we don't have other ways of paying for it. With some good planning and a clear national vision, we can come out of this stronger than ever. That is why many people like me voted for Obama: He is looking at the big picture.

 

[WhoWee]

Sorry, that was a pretty severe diversion, but the point is that we can't solve any of these problems in isolation. We have to look at the entire picture; beginning with the cost of health care if we do nothing. It is a pretty dismal picture. Obama says he wants a plan that is revenue-neutral. Others say that isn't possible. Maybe it isn't possible, but its not like we don't have other ways of paying for it. With some good planning and a clear national vision, we can come out of this stronger than ever. That is why many people like me voted for Obama: He is looking at the big picture.

I too agree that we need to look at the big picture. My concern is that as a tax payer, I fully comprehend that my household share of the national debt exceeds my total personal debt. I'm not "netting" or subtracting assets from my liabilities - this is a debt to debt comparison.

 

[WhoWee]

But while the Fox Newspaper [WSJ is owned by Murdoch, much to the dismay of those who built the paper] takes cheap shots, in the grand tradition of infotainment, it makes no attempt to explain the decision or provide any context.

By the way, Bloomberg also reported. They just didn't point out Mr. Soros investment.
http://www.bloomberg.com/apps/news?pid=newsarchive&sid=aogq9sBiBhYo

 

[WhoWee]

Bloomberg has several interesting stories on health care today.
http://www.bloomberg.com/apps/news?pid=specialreport

Special Report

The Health Care Debate

Obama, Democrats Consider Bypassing Republicans on Health Care Legislation President Barack Obama and Democratic congressional leaders, unable to reach a deal with Republicans in health care, are considering alternatives to a bipartisan bill, Senator Charles Schumer said.

Biden Announces U.S. Grants to Increase Use of Electronic Medical Records Vice President Joe Biden announced almost $1.2 billion in grants to help health-care providers convert to electronic medical records, during a stop in Chicago.

Town Hall Turmoil Leads to Trauma for Obama's Health-Care Overhaul Effort There was Ed Hairston, again. In the front row of the convention hall and angry, he tried to tell Representative Vic Snyder what was wrong with President Barack Obama’s health-care plan.

McClellan Says Health Debate Should Focus on Care System, Not Insurance The Obama administration’s decision to focus on the insurance industry in its bid to revamp the U.S. health-care system misses the point, said Mark McClellan, former head of the Centers for Medicare and Medicaid Services.

Obama Campaign Ad Firms Now Reaping Cash to Pitch Health-Care Overhaul Two firms that received $343.3 million to handle advertising for Barack Obama’s White House run last year have profited from his top priority as president by taking on his push for health-care overhaul.

Town Hall Crowd Shoots Health Reform Message and Messenger: Caroline Baum Members of Congress have gone home for the August recess, and a relaxing vacation it isn’t.

Democrats Can't Repeat Health-Care Failure: Commentary by Albert R. Hunt Bill Kristol, a powerhouse policy guru for Republicans, often has a tin ear for politics. A week before last year’s presidential election he predicted John McCain would “win huge.” In May, he said President Barack Obama had decided to nominate Michigan Governor Jennifer Granholm to the Supreme Court, and he’s been a cheerleader for Sarah Palin.

Armey Leaves Law Firm Over Role in Rallying Health-Care Overhaul Opponents Former House Majority Leader Richard Armey is leaving his job as a consultant for the DLA Piper law firm amid questions about his role in rallying opposition to President Barack Obama’s drive to remake the U.S. health-care system.

House Committees Approve Health-Care Overhaul With Tax on the Wealthiest Two House committees approved a plan for the biggest overhaul of the U.S. health-care system in four decades today, including a surtax of as much as 5.4 percent on the nation’s wealthiest households to pay for it.

Mr. Market Chokes on Obama-Style Health Care: Commentary by Caroline Baum Health care is different. It’s ill- suited to market mechanisms because it deals with matters of life and death.

 

[Hurkyl]

There are surely people in this world who could do the calculation -- but you and I are not those people.

I take it back -- the calculation is impossible even in principle.

There are essentially two cases (that aren't exclusive)
(1) Funding for health care comes from juggling the budget. This means there is no added monetary cost to the taxpayers, but some other government services get reduced funding

(2) Funding comes from raising taxes. Who pays extra (and how much) is completely arbitrary -- taxes can be raised in whatever fashion the government wants.

 

[WhoWee]

I take it back -- the calculation is impossible even in principle.

There are essentially two cases (that aren't exclusive)
(1) Funding for health care comes from juggling the budget. This means there is no added monetary cost to the taxpayers, but some other government services get reduced funding

(2) Funding comes from raising taxes. Who pays extra (and how much) is completely arbitrary -- taxes can be raised in whatever fashion the government wants.

That is my point - the Government will have to raise taxes to pay for HR3200 - nobody really knows how much. Middle class Americans are going bankrupt over $13,000 in medical expenses - how much will they be able to pay in extra taxes?

If the plan is to make the wealthy pay the entire amount - there's a childrens tale about eating a "golden goose" that might be applicable.

 

[Al68]

The tax rate is rather bogus, the rich don't pay 35% tax, unless they're crazy, they have deductions and tax shelters, so their adjusted tax is actually less than a much poorer person that can't claim deductions.

You know this statement is false. This is not the first time you've made this absurd and provably false claim. Here's real data from the CBO (2005):

Total Federal taxes paid as a percentage of total income. These are Effective tax rates of total income, not marginal tax rates after deductions, and includes SS taxes:

Top 20%...25.5%
Second 20%...17.4%
Middle 20%...14.2%
Fourth 20%...9.9%
Bottom 20%...4.3%

These numbers also include the employer paid portion of SS taxes as paid by the employee instead. The numbers are even more progressive for the income tax alone, even negative rates for the lowest two groups, reflecting refundable tax credits.

CBO has a lot more data, with more details at:

Source: http://www.cbo.gov/ftpdocs/88xx/doc8...TaxRates.shtml

 

[Al68]

I have lived in a Third World country and yes without the nanny government people just die and infectious disease runs wild. It is not fear mongering. It is my experience.

So you experienced people "wishing for the uninsured to just die", then. OK. I guess it's not hatespeech if that's your experience.

As far as third world countries, it's not the lack of a nanny state that keeps them down, just the opposite. Oppressive government is keeping them down, just because they're so against free enterprise they restrict it at the expense of the people.

 

[Al68]

I would like to remind people that taking government expenditures and averaging them evenly across all households is not a useful statistic (unless you are being intentionally deceptive), since the "average joe" is going to pay far less than that.

Only on the surface. In reality "average joes" and poor people pay the actual price of government spending in the form of inflation, reduced GDP growth, reduction in decent jobs, etc.

Sure the rich pay a lot, but who cares? The resulting price paid by the rest of us is far more costly.

 

[mheslep]

...
There are essentially two cases (that aren't exclusive)
(1) Funding for health care comes from juggling the budget. This means there is no added monetary cost to the taxpayers, but some other government services get reduced funding

(2) Funding comes from raising taxes. Who pays extra (and how much) is completely arbitrary -- taxes can be raised in whatever fashion the government wants.

or, for the short term, (3) Borrow or print the money

 

[turbo]

or, for the short term, (3) Borrow or print the money

Not a good idea to do too much of that. Much of the US debt is being held by foreigners, and if they see their holdings being diluted, they will pull back. That would bring calls on a lot of debt in a short time, making things even worse. I was disappointed in Bernanke's re-appointment today because he has followed Greenspan's policy of keeping money cheap for the financial gamblers on Wall Street, to the detriment of hard-working Americans who have saved all their lives and can get no interest on their savings. As a life-long fiscal conservative, I am disgusted by the Fed's pandering to gamblers while dumping people who have saved.

Health care must be reformed, but it is such a huge prize that every creep is trying to swing it their way so that they can make fortunes off whatever leverage they might be able to apply. We cannot afford to let the people who allowed this situation to develop be allowed to direct the "recovery" because their vested interests are demonstrably NOT for the public good.

 

[gravenewworld]

People are in a hissy fit over the projected deficits the US is going to run into over the next ten years, but let's not forget where a large chunk of it is coming from (the 2001-2003 tax cuts). Just how much are the tax cuts costing the US government?

http://www.brookings.edu/articles/2004/0919useconomics_gale.aspx

· Making the tax cuts permanent would generate large, backloaded revenue losses over the next 10 years. Combined with a minimal but necessary fix to the government's Alternative Minimum Tax, making the tax cuts permanent would reduce federal revenues by almost $1.8 trillion over 10 years — and that's in addition to the $1.7 trillion of revenue losses already locked into law. By 2014, the annual revenue loss would amount to $400 billion, or 2 percent of gross domestic product — almost the size of this year's federal budget deficit.

http://articles.latimes.com/2006/may/14/nation/na-outlook14

http://www.washingtonpost.com/wp-dyn/content/article/2006/02/17/AR2006021701848.htmlYou can take the sources with a grain of salt, but one thing is clear. The tax cuts are costing a hell of a lot of money. Maybe they should just let them expire.

 

[WhoWee]

Not a good idea to do too much of that. Much of the US debt is being held by foreigners, and if they see their holdings being diluted, they will pull back. That would bring calls on a lot of debt in a short time, making things even worse.

Last year the interest on our debt was $452 billion - that's $8,692,307,692.30 per week?

This is a Chinese perspective.

http://www.chinapost.com.tw/business/americas/2009/07/15/216272/U.S.-budget.htm

"... The Treasury Department said Monday that the deficit in June totaled US$94.3 billion, pushing the total since the budget year started in October to US$1.09 trillion. The administration forecasts that the deficit for the entire year will hit US$1.84 trillion in October.

Government spending is on the rise to address the worst financial crisis since the Great Depression and an unemployment rate that has climbed to 9.5 percent.

Congress already approved a US$700 billion financial bailout for banks, automakers and other sectors, and a US$787 billion economic stimulus package to try to jump-start a recovery. Outlays through the first nine months of this budget year total US$2.67 trillion, up 20.5 percent from the same period a year ago.

There is growing talk among some Obama administration officials that a second round of stimulus may eventually be necessary.

That has many Republicans and deficit hawks worried that the U.S. could be setting itself up for more financial pain down the road if interest rates and inflation surge. They also are raising alarms about additional spending the administration is proposing, including its plan to reform health care.

President Barack Obama and Treasury Secretary Timothy Geithner have said the U.S. is committed to bringing down the deficits once the economy and financial sector recover. The Obama administration has set a goal of cutting the deficit in half by the end of his first term in office.

In the meantime, the U.S. debt now stands at US$11.5 trillion. Interest payments on the debt cost US$452 billion last year — the largest federal spending category after Medicare-Medicaid, Social Security and defense.

The overall debt is now slightly more than 80 percent of the annual output of the entire U.S. economy, as measured by the gross domestic product. During World War II, it briefly rose to 120 percent of GDP.

The debt is largely financed by the sale of Treasury bonds and bills."

The cost of HR3200 is expected to add about 10% to this total.

 

[WhoWee]

People are in a hissy fit over the projected deficits the US is going to run into over the next ten years, but let's not forget where a large chunk of it is coming from (the 2001-2003 tax cuts). Just how much are the tax cuts costing the US government?

http://www.brookings.edu/articles/2004/0919useconomics_gale.aspx

http://articles.latimes.com/2006/may/14/nation/na-outlook14

http://www.washingtonpost.com/wp-dyn/content/article/2006/02/17/AR2006021701848.html


You can take the sources with a grain of salt, but one thing is clear. The tax cuts are costing a hell of a lot of money. Maybe they should just let them expire.

Has anyone adjusted for the loss of revenue/earnings as a result of the recession?

Many of the tax incentives will go unused (if profits are reduced). An example is wage credits - $9 billion went unclaimed last year.

 

[WhoWee]

People are in a hissy fit over the projected deficits the US is going to run into over the next ten years, but let's not forget where a large chunk of it is coming from (the 2001-2003 tax cuts). Just how much are the tax cuts costing the US government?

http://www.brookings.edu/articles/2004/0919useconomics_gale.aspx

http://articles.latimes.com/2006/may/14/nation/na-outlook14

http://www.washingtonpost.com/wp-dyn/content/article/2006/02/17/AR2006021701848.html


You can take the sources with a grain of salt, but one thing is clear. The tax cuts are costing a hell of a lot of money. Maybe they should just let them expire.

By the way, it appears you articles all pre-date the recent Congressional/Obama spending spree. What do these graphs look like with all of Obama's additional $Trillions?.