Health Care Plan/CBO Report

[Anonymous]

I rarely come to this forum, but I am curious what Jeff thinks about the article in today's Post on the CBO finding that the proposed Health Care plan would be a disaster for the economy.

I am a big Obama supporter, but think we can't afford this plan right now. I totally understand the concept that if we don't do it now, we may never, but I still don't think now is the time. What a shame.

[jsteele]

Anonymous wrote:I rarely come to this forum, but I am curious what Jeff thinks about the article in today's Post on the CBO finding that the proposed Health Care plan would be a disaster for the economy.

I am a big Obama supporter, but think we can't afford this plan right now. I totally understand the concept that if we don't do it now, we may never, but I still don't think now is the time. What a shame.

I think a fundamental goal of health care reform should be to reduce the overall cost. One irony of this debate is that Republicans and conservative Democrats object to both cost-saving measures (especially those aimed at lowering drug costs) and revenue-generating ideas (tax on those making over $350,000), but then complain that the program is too expensive.

A similar phenomenon occurred during the debate over the stimulus bill. Tax cuts -- which generate fewer jobs per dollar than infrastructure expenditures -- were added to gain conservative support. While that may have helped with some conservative Dems, it didn't gain a single Republican vote in the House and only three in the Senate. The result was a weaker bill which is now the basis of attacks on the Democrats. It would have been better to ignore the conservatives and get a better bill.

My feelings about the healthcare bill is the same. I wouldn't even bother to talk to the Republicans. Just expect them to oppose this bill which they will likely do no matter what. Concentrate on putting together the best bill possible because ultimately the Dems will be judged on its success or failure.

As for whether we can afford to do this now. I think that's the wrong way to look at the issue. Healthcare reform is not a luxury, it's not a nice to have like a new car purchase that you can put off while driving an older one. Healthcare reform is a fundamental need, that lack of which is weighing down our economy and harming our nation. The costs will only get higher. Not only must it be done now, it should have been done long ago.

[Anonymous]

Healthcare reform is not a luxury, it's not a nice to have like a new car purchase that you can put off while driving an older one. Healthcare reform is a fundamental need, that lack of which is weighing down our economy and harming our nation. The costs will only get higher. Not only must it be done now, it should have been done long ago.

But what is being proposed is fundamentally not healthcare reform. There is nothing concrete being proposed to actually cut healthcare costs. The plans simply add millions of people into the insurance pool (and insure some of them via a new government option). I am also an Obama supporter and believe strongly that we need true healthcare reform (which really should be a single payer plan).
The current proposals will bankrupt this county. Adding people to the pool without fundamentally restructuring healthcare and the insurance industry will do nothing but drive up costs. Look at Massachusetts! They've successfully insured 98% of their citizens (without any sort of underlying reform) and their costs have risen at alarming rates. Healthcare spending in Mass. is now 33% more than the US average.

I agree that healthcare is a right. But simply adding 40 million people into our system without restructuring the system in any sort of meaningful way will simply drive up costs at a record rate.

[Anonymous]

Healthcare from the government is not a fundamental right.it just isn't. Access to healthcare might and the only thing that I would be open to is reform that you cannot be turned away based on a prexisting condition or capped out. That I am open to. The idea that I have to pay for people who choose not to be covered and the numbers indicate a huge portiono of the uninsured are people who Choose Not to be covered and illegals.

[jsteele]

Anonymous wrote:
I agree that healthcare is a right. But simply adding 40 million people into our system without restructuring the system in any sort of meaningful way will simply drive up costs at a record rate.

I think you and I are on the same page. My complaint is that the sort of reforms necessary to cut costs are blocked by conservatives. Similarly, tax increases needed to offset spending are also blocked. A health plan that gives up those things in the interest of gaining conservative support ends up being a disaster. That's why I suggest forgetting about conservative support and creating a plan that contains needed reforms and revenue increases.

I also support single payer, but recognize that's probably politically untenable. Also, while I am as disgusted by the insurance industry as anyone else, I in no way favor destroying that entire industry over night. Any transition to single-payer will have to be long term that allows the insurance industry to adjust.

[jsteele]

Anonymous wrote:The idea that I have to pay for people who choose not to be covered and the numbers indicate a huge portiono of the uninsured are people who Choose Not to be covered and illegals.

I've got news for you. You do pay for the uninsured, even "the illegals". Their primary care physician is the emergency room and it's the most expensive treatment possible. So, save yourself some money and support reforms that will make cheaper alternatives available. Also, Obama just suggested that he will accept insurance mandates, meaning if you choose not to be insured, you will still be required to pay.

[Anonymous]

You are forgetting something very important-people will still overuse the hospital and doctors esp. if they are not paying because unless you feel it's a substantial cost, those are the same people who will go to docs againa and again like social hour. Raising taxes in this ecomomic environment should just be a nonstarter. I actually think if we are pushed to go in this direction, I would like to see taxes on benefits for everyone because too often the answer is to target the rich and all people are equal and one group should not be asked to carry the burden of the other people they have managed to make money and possible people would think twice about the tax raising if it directly affected them and didn't just say..yes great idea but not for me. Possibly more people would think twice about stupid programs and say hmmm I would rather have lower taxes than a bridge to nowhere.

[Anonymous]

It's true that under current tax code a huge proportion of people in this country do not pay taxes ... at all. Is that a problem when it comes to the relationship between privileges and responsibility? Rather than raise the tax on the "wealthy" (or Obama's definition of such) should we at least impose a token tax as far down as possible, so there is some shared responsibility attached to these 'reforms'?

[jsteele]

Anonymous wrote:It's true that under current tax code a huge proportion of people in this country do not pay taxes ... at all.

This is absolutely not true. What is true is that many people do not pay income taxes. If those people are not employed, they likely have little to no income in any case. If they are employed, they pay payroll taxes. When they purchase things at stores, they pay sales taxes. If they have a phone, they pay a host of telecommunications-related taxes. If they own a car, they likely pay some sort of tax on that. Etc. etc. As a proportion of income, these people probably pay a higher rate of taxes then those of us lucky enough to have incomes high enough for income taxes.

Conservatives love to point out that many people do not pay income taxes, but fail to recognize the primary structural reason for that reality -- income disparity. Income taxes kick in at about $30,000. If 50% of wage earners are not paying income tax, it means that 50% of wage earners make less than $30,000 per year. People who complain that they make $350,000 (Obama's cut off for tax increases) and aren't rich should understand that they are basically in the top 1% of wage earners. And, please, please, please. Before anyone starts yelling about tax increases, take the time to understand "marginal tax rates".

[Anonymous]

But what is being proposed is fundamentally not healthcare reform. There is nothing concrete being proposed to actually cut healthcare costs. The plans simply add millions of people into the insurance pool (and insure some of them via a new government option). I am also an Obama supporter and believe strongly that we need true healthcare reform (which really should be a single payer plan). The current proposals will bankrupt this county. Adding people to the pool without fundamentally restructuring healthcare and the insurance industry will do nothing but drive up costs.

Totally agree with this. We need to actually cut costs, otherwise it's not worth it to add the tons of additional costs in terms of new coverage for people.

As to the "tax payers" point....sales taxes are not paying for federal programs. That's apples and oranges and so in a national debate, whether or not people pay sales tax means nothing - in some states there IS no sales tax. The payroll taxes are devoted to 2 specific programs and don't even pay for themselves (as evidenced from the fact that those programs are going broke). So it's still a very fair point to make that lots and lots of people don't put a cent towards the many national programs we have from defense to food safety to national park system to now potentially health care program expansion.

[Anonymous]

jsteele wrote:

Anonymous wrote:It's true that under current tax code a huge proportion of people in this country do not pay taxes ... at all.

This is absolutely not true. What is true is that many people do not pay income taxes. If those people are not employed, they likely have little to no income in any case. If they are employed, they pay payroll taxes. When they purchase things at stores, they pay sales taxes. If they have a phone, they pay a host of telecommunications-related taxes. If they own a car, they likely pay some sort of tax on that. Etc. etc. As a proportion of income, these people probably pay a higher rate of taxes then those of us lucky enough to have incomes high enough for income taxes.

Conservatives love to point out that many people do not pay income taxes, but fail to recognize the primary structural reason for that reality -- income disparity. Income taxes kick in at about $30,000. If 50% of wage earners are not paying income tax, it means that 50% of wage earners make less than $30,000 per year. People who complain that they make $350,000 (Obama's cut off for tax increases) and aren't rich should understand that they are basically in the top 1% of wage earners. And, please, please, please. Before anyone starts yelling about tax increases, take the time to understand "marginal tax rates".

You make a good point, but it is 'income tax' that will pay for all the initiatives that Obama has rolling down the pike--no? When so many people are not paying the tax that funds the initiative they support, a tiny bit of the responsibility is removed. Or am I wrong? I have heard--from my decidedly conservative mom--the words 'bread and circus'. Unfair? And I do support health care reform--especially vis making health care portable, health care for working families, and coverage for those with pre-existing conditions. However, what is being proposed seems massively beyond this....