Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group What to do about healthcare? Can it be fixed?

Yes, it could be a federal sales tax imposed in addition to what the states impose, or it could be imposed instead of the federal income tax (either in part or altogether). A few states have no state income tax. I know Texas, Tennessee, and Washington don't. I'm pretty sure there are a few others. How they fare under this way of collecting revenue, I don't know. I recall some favor the idea of abolishing income tax in favor of a national sales tax.

Please help me understand that a national sales tax wouldn't fly very well. Is this because everybody would be required to help fund the services from which they benefit instead of getting something for nothing and shifting the entire burden on to someone else? It's only fair that everybody share the financial burden for services they use. This would be more fair than an income tax since everybody doesn't work, right. Much of what the legislators propose or do doesn't fly with a given subset of the population. Whether that is a national sales tax to fund health care, a tax to fund wars, the wars themselves, etc., not everyone will be accepting of it.

Regarding the burden to the poor, it is true that this wouldn't be adjusted for income. The wealthy, though, would still continue to pay the majority of taxes from an absolute dollar perspective. The thing I don't understand though is that this is no different from what the states (states that have sales tax) currently do. These state sales taxes are not adjusted for income. Perhaps drop the previously mentioned tax on the basics (food, clothing, a few others – electronics are not necessities), etc., or tax them at a lesser rate, or tax only certain items. I don't know. Some states do levy sales tax on food. I thought the state in which I reside did, but it is actually a local tax, not a state tax. However, everyone would be forced to rethink their priorities regarding spending, wealthy and poor alike. I never quite understood this practice of placing the majority of the tax burden on society's producers. It penalizes and basically discourages success.

I can appreciate Driz's comment about using tax dollars for what they are intended, as things cost money and we can't continue to borrow as we do. These wars (Iraq and Afghanistan) have consumed nearly 1 trillion dollars. The fact that they (mainly Iraq) have manifested into what they have is incomprehensible. The nagging thing is that if we stop SPENDING, whether it be unwanted wars, money losing government sponsored enterprises, inefficiently government run monopolies, etc. the country would be on better economic footing and some aspects of a national health insurance plan might be less contentious.

Regarding the economic impact of a national sales tax and it stifling spending. One, it sounds like something W advocated after the terrorist attacks for everybody to go out and shop and everything will be fine. Right. Sure. Two, actually, the price of the goods, sans what taxes add, might actually decline to offset the economic burden now added by the tax. The manufacturers/retailers are not going to continue to price goods (things like deodorant, televisions, etc.) at the same/current level putting it out of reach for consumers. The final cost (good + tax) will likely be similar or the same as it would have pre-national sales tax, but to not rethink the pricing in the wake of such a tax would have too big an impact on their revenues. The exception might be something similar to gasoline where there really aren't current viable alternatives for nearly all consumers. Three, the majority of spending would continue to be driven by the upper middle class and wealthy, therefore I wonder how significant the economic impact would actually be. Keep in mind had everyone lived within their means (all income levels), we wouldn't be in much of the economic trouble in which we currently find ourselves. The stimulus was poorly conceived and poorly executed. It, like the bailout before it, are doing little to help “main street” and the foundation of this country.

I agree that the proposed health care plan is not supposed cost more money in the long run. This may be accomplished, but I'm not hopeful. I also think that to try and accomplish this, the government will employ any means necessary. I think it is overly optimistic to think that this health care plan is a magic wand and everybody will be healthier and things will be all sunshine and roses. You are discounting the human factor (e.g. overeating, eating inadequate foods, substance abuse, laziness) and the evil entities that market the products tied to some of the aforementioned examples.

I'm a little more optimistic about the debate of this proposed health care bill. I would have thought that you would be similarly optimistic given how far this concept since there have been multiple bills) has advanced.

2008 Pharmaceutical Lobbying Top Recipients

2010 Pharmaceutical Lobbying Top Recipients

2008 Insurance Lobbying Top Recipients

2010 Insurance Lobbying Top Recipients

When I lived in Florida there was no State income tax... not sure if it changed. I think Hawaii may be another State without.

Tim

See, here's the thing, income taxes are geared to income. The more you make, the more you pay (in an ideal, loophole-free world, anyway). A sales tax hits the poorest harder than the richest. You might argue that since the poor don't by big-ticket items, it doesn't hit them as badly; except that it's worse for them. Every article of clothing, shoes, bed linens or towels, cleaning supplies, baby diapers, soap and shampoo, all those basic necessities (not including food, which should never be taxed when purchased as groceries), including hydro, rent, gas heating, phone, etc., becomes, say, 8% more expensive. The middle and upper classes can afford this, the poor cannot. Full stop.

To put this in some perspective. We're renovating my house, so I'm shopping for a lot of stuff right now. One of the bath supply shoppes we went into had a gorgeous vanity. Oh, I would love to have this in my bathroom. Mahogany half moon table base, with white onyx counter and sink, and polished nickel faucet. It was stunning. It was $12,000!!!!

If you can afford to buy that for your bathroom, you can afford to pay more on your income tax, as well as paying a new sales tax.

If the idea of paying for a new toggle for your toilet so it refills properly leaves you weeping as you try to figure out how that's going to impact your ability to buy food for your baby, you sure as hell cannot afford to pay a new sales tax.

Earlier in this discussion, someone raised the spectre of "Do you want the government deciding what healthcare you can get," or something to that effect. I put it out there, if you are one of the lucky ones who actually has insurance, someone already is dictating what healthcare you are entitled to. Your HMO/insurance company. Why is it better for a profit-generating corporation to make these decisions than it is for a non-for-profit entity such as the government?

Just a couple of thoughts.

Warm hugs,

Good points, everyone thinking about different ways to collect revenue, each has its own pros and cons

But let me throw into it, how whenever the tax code changes, it has all kinds of repercussions

if you change the laws that affect the rich, you get the loudest screams, because they are paying the most attention, and they use their money to protect their money, hire the lobbyists, influence Washington, media coverage, etc

Conversely, when a state gives tax breaks, the state gets rewarded by getting people to move to that state, to reap the benefits. Same with corporations, that's why South Dakota and other states have credit card companies with their corporate centers there, the laws are different from state to state, they get to charge higher interest rates on their credit cards for all customers no matter where they live, depending on where their corporate center is

Also reminded that the Governator (Arnold) got elected largely because he promised to reduce the tax on automobiles in California

I read in a funny Al Franken book, a totally fictitious account of a presidential candidate who ran on a single platform, had no opinions on military, civil rights, family values, etc

All his speeches, all his rhetoric, all his campaigns, consisted of one pledge:

"No ATM fees"

and he gets elected! Silly, I know, but it made me laugh, cause I could imagine that happening in real life!



I maintain that if HC reform is going to work, it will be because it will end up costing LESS, rather than the same or more, for the average American, and the key to that will be the competition that having a giant co-op, consisting of the currently uninsured citizens, a leverage tool that is not a factor today

With you there with the human factor, obesity, etc

Hope would be, that health promotes health, when people start getting better, they feel better, and that gives them enthusiasm for continuing in that direction

from the government's role in promoting that, Obama's increase in tobacco tax seems right to me (even though he is still a smoker )

and last I heard, he wanted to similarly increase the tax for soda pop, I've seen some commercials that are against that, showing a mother complaining that times are tough, that it's unfair to increase a family's cost of groceries, completely ignoring the reason for the tax increase, which is less about revenue, than it is to discourage the consumption of unhealthy food



I am getting some optimism! Although tempered by expectations that the bills will get battered quite a bit by the process, probably a give and take affair, HC companies will definitely be using their influence to get some new loopholes put into it, and then if it reaches the point where it is likely that one of the bills will get passed, others will throw in the pork so that they can get their various agendas passed as part of the package

Here's the kind of news that gives me the most optimism, one that barely seems to register with current headlines:

Lobbyists pushed off advisory panels

Your links to HC's top lobbyist recipients are great! Important for people to take a look at those, a real eye-opener and a shock to those wondering how it all currently works!

Yes, I realize that income taxes are geared toward income. The higher the income, the more you pay, whether it be a progressive/graduated, flat, or (likely) regressive tax scheme.

I struggle as to why the producers/earners, whether they be upper or middle class, should continually subsidize the able bodied of lesser economic means that choose not to productively enable their well-being. I can't grasp this concept of why an individual is entitled to the earned wages of another individual. I understand the exceptions for the elderly, those who are disabled and can't work, and children. I also can appreciate the extension of goodwill to help somebody get “back on their feet” and to enable them going forward for a period of time. However, there are too many out there that are too lazy to work or find it more economically advantageous to continue to live off the public dole. There is also those that fit into the category of not willing to get their GED if they didn't finish high school, not willing to try and achieve anything beyond high school, or have had the opportunity for post-secondary education, yet choose to obtain a degree that isn't widely marketable for a job. Those that exist in the previous sentence are fine; that's freewill; that's you reap what you sow. However, that is a choice that you made and you shouldn't reap what I sow.

I guess I have a little bit of a different perspective on your vanity example. While I agree the individual that can afford this price for a vanity can pay more in taxes (income or sales), it doesn't mean they should. The perspective I have is that you worked, expended your time, your effort, your strength, your knowledge, etc. to earn those wages. They are yours. You can spend them however you choose. No one outside of you is entitled to them. There's a whole different matter of should you spend that amount of money on such an object. Opinions vary I imagine. Personally, I am/was always frugal and would pass. However, instead of the government taking my money and re-allocating it, I'd rather spend the money on a reasonably priced object (after all, it is a thing) and donate a portion or the balance of it to the church or to charitable causes of my choosing. Bottom line though is that they are your earnings and you should be able to allocate them as you choose.

I concur with your toilet toggle/feed your child example also. It seems nearly everybody finds themselves in such a situation at some point in time. The situation may not be as dire as your example, but nearly everybody has a cash crisis of some magnitude at some juncture. I just hope folks in such instances can, at the very least, prioritize for spending of basic needs over discretionary items before such an occurrence occurs or that this is a rather infrequent occurrence. There are also public assistance programs for those in such dire straits (WIC in an instance of a woman and her infant/child). Ideally, this assistance is a temporary thing, but it's there if it is needed. I know it's not that simple or cut and dry; none of it ever is. I guess my point is that we, as a society, ultimately need to be reliant on self, not on subsidies.

Some of the problems I have with the government dictating healthcare versus a for-profit company lies mainly in the fact that services covered can vary from provider to provider and plan to plan, the appeals process, and the ability to initiate litigation against that for-profit company if need be. Currently, with for-profit insurance companies, doctors will perform a test, exam, etc. even if they know the insurance won't reimburse for it and explain to the patient (as least in my instances and insistence for action) that insurance is not likely to cover it. My fear is that doctors won't engage in such activity, even if the patient is willing to pay, due to fear of consequence from the government for coloring outside the lines. Also, I don't have any faith in an appeals process administrated by the government (at least our government). Just ask some of those appealing their decisions on SS disability. Want to bring a lawsuit against government run healthcare? Good luck. I'm sure there are others I'm not realizing at the moment, but this is my opinion of how things would take shape.

Understandably you get the loudest screams from the rich. They are paying the most attention because they are also paying the most tax. The top 1% of earners pay something like 42% of the taxes in the United States last I heard. Here is some information that supports that statement.

Tax Payers

That's a helluva curve for the 80/20 rule. Nearly half the wage earners paid nearly all the income tax! Apparently under the current administration that curve will get steeper.



I think this would be the case for a small portion of those that are not under the care of a physician. I also can't help but think that if they previously never subjected themselves for routine exams, many wouldn't be inclined to start. I might be completely wrong. Also, if they treated their bodies like crap before, that may well continue. Old habits die hard. Also, access to health care or a health care plan does not beget good health. There is free will. A doctor cannot control for an individual their diet, their exercise, their stress levels, etc. All a doctor can do is attempt to diagnose a malady and attempt to treat it using the tools within their toolbox. The patient and their body has to do the rest.

I'm kind of split on these “sin” taxes. At one level I'd like to see junk food (including soda pop) taxed to discourage consumption since there is a detrimental effect on society, but on the other if the consumer wants to eat or drink those foodstuffs in question, it is their freewill. I mean, such a tax basically amounts to the government dictating what you should/should not consume. Should they tax such items, I'd like to see the amount in tax listed alongside the price on the grocery store shelf as opposed to burying/hiding it on a receipt after the item has been purchased.

It's nice to know that Obama wants to root out some of undesirable influence. However, it occurs to me as disingenuous.

Lobbyists As Cabinet Members

India Daily
UK Telegraph (See Number 3)

(Lack of) Transparency In Government

MSNBC

Visitors (Lobbyists) To White House

The Reporter (AP Service)

and that's why many rich people work so hard to defeat this administration, they've already looked at those charts, W gave tax breaks to the people who needed them the least, and at a time when we went to war, no less, and to pay for that, he had to borrow the money that we didn't have from China. So again, the money has to come from somewhere, some sort of sliding scale is needed, when the difference between the rich and the poor reaches an imbalance, as it has, we get just the kind of economic breakdown that we are trying to climb out from now



the best rebuttal to that is what we learned from the recent free health care clinics that have been taking place in several states:

Arkansans Line Up For Free Health Care Clinics

New Orleans free health care clinic

these and other events like them demonstrate that people DO want the health care, they will use the services if they are available, they just can't afford them




good idea. And you used the word "discourage" rather than outlaw, since the taxes would be meant to do exactly that, if someone still wants to smoke, eat Twinkies, and drink soda pop, let 'em, and we should demand that the tax revenues from such purchases be only used for health care purposes



Okay, time should reveal that



that story is from India, in Jan. 30, 2009 Tom Daschle was booted a few days later for the income tax scandal mentioned



(many of those are just promises that haven't been fulfilled yet, doesn't seem fair to cast a verdict this early)

but Number 3 on that list is:

3.PROMISE BROKEN. Mr Obama solemnly pledged that "no political appointees in an Obama-Biden administration will be permitted to work on regulations or contracts directly and substantially related to their prior employer for two years". In practice, Mr Obama has granted several waivers to this rule, allowing lobbyists to serve in the top reaches of his administration.

Okay, both of those links make the same fair point, he promised no lobbyists in the White House, but there are in fact some that have been granted waivers and concede that is kind of like dressing up a cow and calling it a pony

I've searched for the specific number of current waivers, it looks like the number is currently between 3 (as the White House claims) and 10, depending on how strictly a lobbyist is defined



that story you linked is from June, here is the update from September:

Obama yields on White House visits

Still not perfect, it shows that he resisted doing so, but they are now releasing the visitor's list. A far far cry from the previous administration, in which the policy was to not release any records at all



So now you see why he didn't want to release that visitor's list!

But I think that is good, now we can see exactly who is visiting, and we do see that he is in fact meeting with the lobbyists from the HC industry. If after those meetings, Obama suddenly changes his tune, announces something like "I was thinking about this over the weekend, and decided that maybe this whole health care reform thing is a bad idea after all, instead I'm just going to take the week off with my brand-new Maserati, (thanks!) and play some golf..."

Earlier you gave a link that showed Obama got significant contributions from the HC industry, which gave support to getting to elected. I know he would have preferred to have done it all without that money, but sadly, it just isn't possible in this day and age, he got very far with grass root support, ten and twenty dollar contributions, but in the end of the campaign he needed the big bucks to compete with the well-funded opposition

So of course, because he got that money, he has to at least meet and discuss this with them, next is to see the results of those meetings...

However, there are too many out there that are too lazy to work or find it more economically advantageous to continue to live off the public dole. There is also those that fit into the category of not willing to get their GED if they didn't finish high school, not willing to try and achieve anything beyond high school, or have had the opportunity for post-secondary education, yet choose to obtain a degree that isn't widely marketable for a job. Those that exist in the previous sentence are fine; that's freewill; that's you reap what you sow. However, that is a choice that you made and you shouldn't reap what I sow.

Jay, I think it's this that I really don't get. The assumption is that people in low wage jobs with no insurance aren't trying hard enough. Certainly, there are bonafide gold brickers out there. As long as humanity exists, there will be those who just don't bother to try. But the assumption appears to be that these types make up the majority of those on the dole in some form or other, or in low wage jobs. Are you truly saying that people who are stuck in the cycle of having to work 3 jobs just to put food on the table, let alone pay rent, aren't trying hard enough? If they don't have a high school diploma when are they supposed to go upgrade - on an all too rare lunch break? How about when their kids are home from school and baby sitters are too expensive? How about when they are trying to look after the disabled partner or parent, without the benefit of outside care workers because they cannot afford to pay for them? Are you really saying that people like this deserve to be without health care because they are in an impossible position?

Frankly, there are far too many rich kids out there who don't try to do anything but spend their parents' money, who never try to be useful members of society because they've never had to. They are more than a waste of space, because they have the opportunities but never avail themselves of them. Yet they get good healthcare because their rich parents can afford it, while the guy with no health insurance working those 3 lower than minimum wage jobs are less worthy because they aren't trying hard enough???

Or perhaps the guy on who can't work because of illness or injury, but is still fighting to get on disability, isn't worthy of good health care because he might be faking his symptoms.

Or let's go with the single mom with three kids who has a deadbeat husband who refuses to pay child support, let alone alimony, so she not only has to work multiple low wage jobs to make ends meet, but they don't give her health insurance and half her money is spent on baby sitters because one of them is a night job. Please don't tell me that this woman isn't deserving because she's not trying hard enough, or perhaps never completed her high school diploma.

I just hope folks in such instances can, at the very least, prioritize for spending of basic needs over discretionary items before such an occurrence occurs or that this is a rather infrequent occurrence.

Believe me, if you are the woman I described above, there are no discretionary items. What's more important, the food, or the appliance that allows the human waste from that food to be eliminated in a healthy and sanitary manner. Perhaps she should just forget the toilet and let it overflow all over her bathroom floor.

And are you really telling me that all university degrees that do not translate into an immediate high paying job are useless and people who go after those degrees are somehow not worth their salt? I prefer my version of the world, where people who go after arts and humanities degrees are as highly regarded as those who go after business or economics degrees (because those people with the economics degrees did such a great job with the world economy and the lack of regulation in the banking sector). Most people with those so-called 'useless' degrees do often end up in jobs completely unrelated to those degrees. Speaking specifically to people with arts degrees, from personal experience, they often end up doing the minimum wage or lower, back breaking, servitor type jobs while they try to pursue that which feeds the passion that sent them to university for that arts degree in the first place. I can't speak to the States, but I can say that in Canada, an out of work actor is not covered by EI and is not elligible for welfare; no starving artist is. Yet, the art they produce, whether through music, dance, painting or acting, is as integral to a fully rounded society as someone with a degree in commerce. And often, that art is produced while they are waiting tables for the upper 1% of society, or serving in an upscale boutique for spoiled women who wouldn't know how to put clothes on a hanger if their lives depended on it, let alone pick something up off the floor when they've dropped it there.

There's useless and there's useless. The truly useless are those who have every opportunity handed to them, but who don't even try to do anything with it. But that's a debate for another day.

Becareful of this type of broad-brushing, Jay, lest you spill paint on yourself. Because one day, you may find that you need help, and somebody is going to look down on you from a great height and tell you that you aren't worth it because you're just lazy and not really in need. And if this has already happened to you, I am truly sorry to hear it.

Warm hugs,

I'm not making an assumption that individuals in low wage jobs without insurance aren't trying hard enough. I am saying that there are many out there that don't take advantage of these opportunities to obtain new skills, better educate themselves, etc. I realize the situation in which some folks find themselves needing to work two or three jobs in support of themselves or of their families. Neither side of the coin is a one size fits all.

I concur with the statement that there are too many spoiled children out there that spend their parents money. Shame on the parents for that one. I find little blame ultimately rests with the children. This may be fodder for another day, but I see it as a result of the disappearance of the family, morals, and values and I don't see this problem reversing any time soon.

Yes, they have adequate health insurance because their parent(s) have employment with an employer that offers health insurance that covers the children. It's not free. They pay for that insurance. If it takes a government entity to cover those whose employer's who don't offer insurance, then apparently that's what needs to happen. However, the taxpaying public should not be required to pay for the entirety of that insurance, especially when they are paying for insurance for their own family. I'm not saying that anyone isn't worthy of health insurance (though, apparently I'm not, due to pre-existing illnesses), I'm just advocating that they help pay for the benefit. Heck, I'm not even advocating that individuals of lesser economic means pay for the entire amount of the premium. However, I find it wrong that they (those that are able to earn) don't pay one cent toward any health insurance from which they benefit.

Regarding your example of the woman with three children. She, in your example, is trying plenty hard. An example similar to this is an unfortunate situation indeed. However, I'd like to understand why the woman would continue, after having the first child, having children with a man who had no inclination to support his family. Personally, I find it atrocious to bring a child into this world if you are not going to take care of them. I'd argue that this woman erred by continuing to have children with this man. It's possible that a situation could have arisen after all three children were born, but I'm guess that the signs were there and the woman chose to ignore them.

I'm not the judge of real world applicability university degrees regarding employment, and I'm definitely not saying that people who pursue those degrees are not worth their salt. If I implied that about people that pursued arts, humanities, etc. degrees, I'd would have been without some good friends earlier in life. I don't measure an individual by material things (including university degrees). All I'm saying is that those who pursue degrees that don't substantiate sustainable employment at some reasonable time after exiting university and expect the taxpayer to support their existence...forget about it. We all make choices in life. There is nothing fair and just about one individual subsidizing/supporting another individual who decides to pursue a career/field of work that may not support their well being because that is their creative aspiration. That reeks of servitude. Decisions have consequences. Just because Joe got an accounting degree and is employed in a job with health benefits does not mean he should subsidize Jack's health insurance premiums since Jack chose to study creative water colors and now, after university, is working at a job offering only marginal wages with no health insurance since the degree he chose didn't enable him with the knowledge or skill set for a job offering benefits similar to Joe's.

Agreed on the useless statement and wasted opportunities.

Also, I am cognizant of throwing stones that find me on their way down. I've needed help and have been extremely thankful for help I received, regardless of the significance. I find myself in a bit of a pickle right now. I'm getting a lot of help from those where I thought I might get it. I'm not getting help from those whose job it is to help us. When the help runs out, if I can't help myself by then, it's sink or swim. There are choices that I've made along the way. I'll have to live, or perhaps perish, by them.

Understand, I'm not dark-hearted as you might think. I don't want to see anyone suffer. I don't want anyone to be without access to necessary healthcare. Government takeover of health insurance is another issue. However, I don't believe it is right for something earned by one individual to be taken away and given to another by means of a third party.

Jay, I don't see you as dark-hearted at all. I just don't agree with you.

I see healthcare as a human right, no matter what status in life you live, no matter whether or not your life (i.e. occupation) choices might be deemed wise in the eyes of another.

With regard to the single mom and deadbeat dad scenario, it's not so black and white as you would have it be. It's not always clear to a woman when the man she has married is an a$$. She might never know there were problems until the day he announces he's leaving her. Or, she might know there are problems, but be unable to change her situation (due to having been a stay-at-home mom for the last 10 years and having no, boss friendly, job experience, for example). Women get trapped like this all the time, and it isn't always (or even nearly always) due to her not having seen something she should have. Regardless, will you punish the children to spite the mother? I'm going to sound like your garden-variety femi-nazi here, but when you can bear children and the responsibility for their lives in the way that a mother does, then you can pass judgement on the choices a woman might make with regard to the father of those children and whether or not she truly has the option to get out of that marriage/relationship.

Jay, this, in particular, stuck in my craw:

I'm not saying that anyone isn't worthy of health insurance (though, apparently I'm not, due to pre-existing illnesses)...

You can say what you like about whether or not the Canadian system is ideal, but you will never hear of anyone being denied healthcare coverage due to pre-existing illness. Bar none. Now, extended healthcare packages (ie. job benefits) might be different, but the government funded healthcare is available to us regardless. I could move to any province in this country and be covered under that province's plan, simply by virtue of the fact that I am a Canadian citizen. That's one of the things that government run healthcare can potentially offer - an end to discrimination based on arthritis.

Warm hugs,