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There are many points of debate with healthcare. One is whether elderly or those with pre-existing conditions should pay higher premiums. The young and healthy argue that their premiums should not be higher to compensate for the condition of others. Understandably so, but how about someone that becomes ill out of no fault of their own? One's perspective likely depends on which category applies to them. Being old is not in our control - it just happens. In some cases illness is the same, but not always. Disease doesn't discriminate and plenty that live a healthy life still become sick. If we compare it to auto insurance, people that break the law pay more for car insurance and that is in their control. They should pay more. People that drive safely but are in accidents due to the actions of others also experience higher premiums. Healthcare providers already charge more for people that have unhealthy habit(s) such as smoking, and they should. What is the proper moral and economic solution for those that live healthy lifestyles with regard to healthcare premiums?
us-usa-healthcare-idUSKBN19Y10B
Posted from reuters.com
Health
Insurance
Government
Congress
Posted 7 y ago
Responses: 2
2
2
0
CWO3 William McIntosh - Thanks for the great post. This is a very interesting topic and one that we as Americans should really have a hear to heart talk about. I could go on for days about my personal opinion on how we should run health care, but there is not enough space here to do that. And no one would care anyways as it is a personal opinion.
There is a moral contract between the generations that I think we as Americans have forgotten. This is that we, the older generations will provide the younger generations with the education and environment for their success and in return they will take care of the older generations, not just health wise, but along many facets that allow the older generations to be secure and retire comfortably.
As to the question on what younger patients should pay more to support older patients and their health care needs is two fold. First those older generations have paid for so many other things the younger generations that it is a payback of sorts. The older generations have paid for the schools and education the younger generations received, they paid for all the infrastructure to travel and leisure, and they paid to essentially ensure the newest generations get the best start they can in life (Note to older generations, we are failing at this actually by not truly funding primary and secondary education to level that were funded when we went to school and we have not taken care of our infrastructure and we have not set the newest generations up for success, but that is a different topic). Secondly, as the younger generations become older, their children and grand children will pay the high premiums, allowing them to receive the care they need much like the older generations today with young people paying higher premiums.
So morally the youngest generations should pay more, have done much for them already. Economically, the older generations who have done a poor job of governance and fiscal management and have not set up the younger generations for success should have to pay more in taxes to subsidize the premiums. As
There is a moral contract between the generations that I think we as Americans have forgotten. This is that we, the older generations will provide the younger generations with the education and environment for their success and in return they will take care of the older generations, not just health wise, but along many facets that allow the older generations to be secure and retire comfortably.
As to the question on what younger patients should pay more to support older patients and their health care needs is two fold. First those older generations have paid for so many other things the younger generations that it is a payback of sorts. The older generations have paid for the schools and education the younger generations received, they paid for all the infrastructure to travel and leisure, and they paid to essentially ensure the newest generations get the best start they can in life (Note to older generations, we are failing at this actually by not truly funding primary and secondary education to level that were funded when we went to school and we have not taken care of our infrastructure and we have not set the newest generations up for success, but that is a different topic). Secondly, as the younger generations become older, their children and grand children will pay the high premiums, allowing them to receive the care they need much like the older generations today with young people paying higher premiums.
So morally the youngest generations should pay more, have done much for them already. Economically, the older generations who have done a poor job of governance and fiscal management and have not set up the younger generations for success should have to pay more in taxes to subsidize the premiums. As
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CDR (Join to see)
LTC Michael Martin - thanks for the response. I like that term moral equivalency. I did say spend more, but I think that can be done with some caveats. We can spend more in some places and cut the budget through better governance in other areas and we can fix the tax code to bring in more revenue without damaging our consumer based economy to much.
The debt issue is a difficult one to deal with as is social security and medicaid plus extra funding for education. While certainly not popular I think you have to raise taxes and also cut the budget in certain areas to increase spending in others. So for instance to increase revenue:
1. If you eliminate all deductions credits and exemption in taxes you would raise revenue pretty significantly.
2. If you also treat capital gains as regular income instead of taxing it at the 0% to 20% levels you again will gain revenue.
3. I would also say adjusting the upper income tax brackets a bit would help. For instance go with the current sytem until you income exceeds a million a year form there you pay 50% tax on the income over 1 million dollars. Above that you could pay 60% for on any income over 5 million and 70% on any income over 10 million. This affects very few people and it is the people who can afford to help others the most. Fair, no but we have a lot of debt and they have benefited the most from the current tax laws.
4. Reduce corporate tax to 0% to bring corporations back in to the US. You will lose some revenue but it is compensated for with the other tax increases. There would be caveats to this though. SO the corporate marginal tax rate would be 60% but corporations could reduce that to zero if they meet certain criteria such as annual pay increases that slightly be inflation, they pay for basic health care, they do not lay people off unless they are in debt and other basic worker rights just to ensure workers do well instead of corporate leadership and investors being the only ones who reap the rewards. The benefit of a corporate tax rat of effectively 0% if that many corporations will look to move back to the US or move more of their operations back to the US, which will increase the number of well paying jobs as competition for employees increases and unemployment decreases.
For Social Security and Medicaid I think it time to remove the cap contributions based on income level. So social security tax starts to phase out gradually at $118,000 a year roughly. If you pay the 6.2% and the 1.45% taxes on social security and medicaid tax respectively on all pay regardless of limits then you should be able to keep social security and medicaid solvent. Anotehr option would be to open medicaid up to allow people to contribute more to medicaid and have it become a cheap version of the ACA. It would be a no frills system but if you as an individual contributed more then you could use the services more if you really needed to. I don't know on that one but i though of it today and on first glance it sounded good. Need to think more on it.
Budget cuts are next. The DOD budget could be severely cut and we could still maintain readiness and acquire good weapons system if we fixed our business practices, eliminated redundancy in a lot of offices, have realistic contractor contracts and eliminated some of the more costly weapons systems current in procurement (F-35). There was a defense business board ??? review a few years ago the got squashed after they saw that the DOD could save $125 billion over 5 years by doing the above.
Also I would get rid of ACA as it stands, but really don't have a better system to put in it's place. Going back to the old system is not realistic as it is overly expensive as well. I'd be happy to hear ideas on how to fix that.
As for education, the major issue is that schools are not funded enough and not funded equally because we have a system that uses local, state, and federal funds. In reality it should be one funding source kind of like the national highway trust fund or something along those lines that can't be stolen from by congress but is use equally for all schools. I though about a national education tax, much like we have gasoline tax and social security tax and medicaid tax, but not sure on that as well. The real point is that primary education spending have overall decreased leaving many with worse education than we had 20 to 40 years ago. Secondary education has also lost funding hence why so many people are in debt up to their eyeballs because regardless of what college you go to it costs a fortune. And whether we like it or not education is important to securing those well paying future jobs, which benefits all of us. The more money our children and grand children make, the more they can contribute to investments and other programs that will ensure or generation is taken care of and will set the stage for future generations to be taken care of.
One other program I would cut is most of the welfare programs as they currently operate. Instead of say SNAP or other food entitlements, I would use that money and a bit more to subsidize supermarkets and farmers markets to reduce the costs of healthy foods by 75-80% or more if possible. This allows all Americans to benefit by spending less on food and also by driving them to eat healthier. I would also spend a bit more to ensure all students in primary education have free lunches as that reduces family costs and ensures students do not go hungry. I would ensure that there are fully stocked hunger relief organizations just encase someone falls thought the cracks but they should be the norm.
I would also radically change jobless benefits. I would make more of either a very low cost loan that would be paid back once you had stable employment or you could with drawl against your future social security benefits or a mixture of both. Maybe those could still be slightly supplemented with money that does not need to be paid back as the system is now but that would be on a case by case basis.
Sorry to ramble on, but if we can get our tax system straightened out, get our system of spending under control and tightened up so we get the most bang for or buck and we do little things have and there to improve the chance the future generations will have an opportunity to find and keep high paying jobs everything will sort itself out. It just might take a little sacrifice on everyone parts, kind of like everyone did in WW2 to support the war effort, we we are fight the debt war and we all have sacrifice a little to win the war.
Also as a note, if we look at taxes over the last 75 years or so, you can see that individual income taxes were much higher in the form the 40s to the early 80s until we started to really cut taxes both at the Federal and state levels. For most middle class Americans that did not really do much income tax wise except save a few hundred to a thousand dollars a year but it did allow corporations to generate a lot more wealth. Unfortunately this translated more into profits to help stocks than it did to help increase wages. So you started to see stagnate wages. Couple that with decreases in state taxes and therefore decreases in education spending you get a sharp rise in the costs of secondary education and a decrease in spending in primary education. Hence why schools today are not as good as they use to be and college is so expensive.
The debt issue is a difficult one to deal with as is social security and medicaid plus extra funding for education. While certainly not popular I think you have to raise taxes and also cut the budget in certain areas to increase spending in others. So for instance to increase revenue:
1. If you eliminate all deductions credits and exemption in taxes you would raise revenue pretty significantly.
2. If you also treat capital gains as regular income instead of taxing it at the 0% to 20% levels you again will gain revenue.
3. I would also say adjusting the upper income tax brackets a bit would help. For instance go with the current sytem until you income exceeds a million a year form there you pay 50% tax on the income over 1 million dollars. Above that you could pay 60% for on any income over 5 million and 70% on any income over 10 million. This affects very few people and it is the people who can afford to help others the most. Fair, no but we have a lot of debt and they have benefited the most from the current tax laws.
4. Reduce corporate tax to 0% to bring corporations back in to the US. You will lose some revenue but it is compensated for with the other tax increases. There would be caveats to this though. SO the corporate marginal tax rate would be 60% but corporations could reduce that to zero if they meet certain criteria such as annual pay increases that slightly be inflation, they pay for basic health care, they do not lay people off unless they are in debt and other basic worker rights just to ensure workers do well instead of corporate leadership and investors being the only ones who reap the rewards. The benefit of a corporate tax rat of effectively 0% if that many corporations will look to move back to the US or move more of their operations back to the US, which will increase the number of well paying jobs as competition for employees increases and unemployment decreases.
For Social Security and Medicaid I think it time to remove the cap contributions based on income level. So social security tax starts to phase out gradually at $118,000 a year roughly. If you pay the 6.2% and the 1.45% taxes on social security and medicaid tax respectively on all pay regardless of limits then you should be able to keep social security and medicaid solvent. Anotehr option would be to open medicaid up to allow people to contribute more to medicaid and have it become a cheap version of the ACA. It would be a no frills system but if you as an individual contributed more then you could use the services more if you really needed to. I don't know on that one but i though of it today and on first glance it sounded good. Need to think more on it.
Budget cuts are next. The DOD budget could be severely cut and we could still maintain readiness and acquire good weapons system if we fixed our business practices, eliminated redundancy in a lot of offices, have realistic contractor contracts and eliminated some of the more costly weapons systems current in procurement (F-35). There was a defense business board ??? review a few years ago the got squashed after they saw that the DOD could save $125 billion over 5 years by doing the above.
Also I would get rid of ACA as it stands, but really don't have a better system to put in it's place. Going back to the old system is not realistic as it is overly expensive as well. I'd be happy to hear ideas on how to fix that.
As for education, the major issue is that schools are not funded enough and not funded equally because we have a system that uses local, state, and federal funds. In reality it should be one funding source kind of like the national highway trust fund or something along those lines that can't be stolen from by congress but is use equally for all schools. I though about a national education tax, much like we have gasoline tax and social security tax and medicaid tax, but not sure on that as well. The real point is that primary education spending have overall decreased leaving many with worse education than we had 20 to 40 years ago. Secondary education has also lost funding hence why so many people are in debt up to their eyeballs because regardless of what college you go to it costs a fortune. And whether we like it or not education is important to securing those well paying future jobs, which benefits all of us. The more money our children and grand children make, the more they can contribute to investments and other programs that will ensure or generation is taken care of and will set the stage for future generations to be taken care of.
One other program I would cut is most of the welfare programs as they currently operate. Instead of say SNAP or other food entitlements, I would use that money and a bit more to subsidize supermarkets and farmers markets to reduce the costs of healthy foods by 75-80% or more if possible. This allows all Americans to benefit by spending less on food and also by driving them to eat healthier. I would also spend a bit more to ensure all students in primary education have free lunches as that reduces family costs and ensures students do not go hungry. I would ensure that there are fully stocked hunger relief organizations just encase someone falls thought the cracks but they should be the norm.
I would also radically change jobless benefits. I would make more of either a very low cost loan that would be paid back once you had stable employment or you could with drawl against your future social security benefits or a mixture of both. Maybe those could still be slightly supplemented with money that does not need to be paid back as the system is now but that would be on a case by case basis.
Sorry to ramble on, but if we can get our tax system straightened out, get our system of spending under control and tightened up so we get the most bang for or buck and we do little things have and there to improve the chance the future generations will have an opportunity to find and keep high paying jobs everything will sort itself out. It just might take a little sacrifice on everyone parts, kind of like everyone did in WW2 to support the war effort, we we are fight the debt war and we all have sacrifice a little to win the war.
Also as a note, if we look at taxes over the last 75 years or so, you can see that individual income taxes were much higher in the form the 40s to the early 80s until we started to really cut taxes both at the Federal and state levels. For most middle class Americans that did not really do much income tax wise except save a few hundred to a thousand dollars a year but it did allow corporations to generate a lot more wealth. Unfortunately this translated more into profits to help stocks than it did to help increase wages. So you started to see stagnate wages. Couple that with decreases in state taxes and therefore decreases in education spending you get a sharp rise in the costs of secondary education and a decrease in spending in primary education. Hence why schools today are not as good as they use to be and college is so expensive.
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SSG (Join to see)
CWO3 (Join to see) - Part of the problem is that we are looking for insurance to solve our problems. Years ago where I grew up there was a county home that the county ran and they took care of the elderly that could not take care of themselves that lived in the county. Now that place has been closed and they are in private nursing homes being paid for by Medicare and insurance. Years ago the major hospitals were ran an managed by the church as church missions. I find that was a much better way to take care of those in need and not the for profit insurance market that we have today.
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CWO3 (Join to see)
SSG (Join to see) - We find many foreign Nations that take care of the elderly by keeping them in the family. It's common practice in the Far East and other countries for more than 3 generations living in the same home. Most in the US either tuck their parents away in a retirement community or a nursing home. Social programs don't even start paying until the person is financially tapped out. Medicaid does a 5 year "lookback" to ensure money hasn't been "gifted" to get around this as well. Most elderly don't want to burden the children by living with them, and sadly some don't want their parents around. So, this is a situation of our own creation regarding care for the elderly. I wish my parents were still living and would do everything I could to provide for them if they were. It's not like they didn't care for me from birth, and besides being fair it's compassionate. Even the most basic nursing homes can cost $5000/month depending on the locale vs. the low cost to provide for them in the home. Few middle class elderly have saved enough to cover these amounts, so it definitely is a major slice of the big picture as you say.
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SSG (Join to see)
CWO3 (Join to see) - You are correct. There are many different ways that we can help the elderly and the needy. Some family's still do that on my wife's side her grandmother, mother and sister live together to take care of each other.
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The architect of ObamaCare has already developed a system that is in place today called The Complete Lives System. We are actually seeing it in play on the MSM with a sick child overseas. The European Nations, whom we are told are more sophisticated than us and forward thinking, have decided that the baby needs to die. The cost is just too much. They are even interfering with the child coming to America for treatment because their "experts" deem the necessity of life for this child is just too much. Where did this come from? Did the People of Europe cede their freedom to choose to a bunch of unelected officials? Well, this is actually codified in law for us now here in America. For all those that want free healthcare, this is your doing and could be your undoing if you are past the price cycle of life, say 47 years old. Read the attachment in order to understand that Sarah Palin was right, there are death panels here in America. They just have a nicer sounding name. Kinda like the Affordable Care Act. It was never affordable, and it offers little care and only to those that fit the Complete Life Cycle.
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LTC (Join to see)
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CWO3 (Join to see)
I don't know the solutions but the current ideology of "stall until I get out of office" is just kicking the can down the road. It is irresponsible to saddle future generations with debt when we can take measures to minimize it. We'll never be able to provide protection or benefits for every citizen, but we can find solutions that do the best they can without hobbling us economically. The problem now is that the two parties are so alienated that they don't even talk to each other. That is a failing system from the start. We have to find compromises that cater to needs and budget, both within reason. It will never be perfect, but anything would be an improvement from what we have now - stalemate.
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