Hoosier Access posted a statement by Rep. Todd Young on voting to repeal the recent Health Care reform law. Rep. Young apparently recognizes that repealing the reform necessarily means continuing on with the status quo of the current health care and insurance system, which is generally about as popular as a rabid dog. He attempts to soften the reality what repealing the reform bill means by saying:
That’s why I also plan to vote today for a resolution instructing Congress to begin exploring new options; options to ensure high-quality and lost-cost health care for all Americans.
Such a resolution sounds about as useful as writing blog post. If they have concrete alternatives, they should put those in the repeal legislation to take effect at the same time as the repeal. Otherwise, it’s just so much sound and fury and, ultimately, a vote for the status quo ante.
Why is reform better than the status quo?
As a matter of logic, it’s not, necessarily. (I happen to think this reform is better than the status quo, but nobody elected me.) But, it seems to me what Young is trying to do here is soften the reality of his vote by alluding vaguely to some amorphous possible future reforms.
I hated the reform that was passed. It seemed that for everything I liked (pre-existing coverage protections), there were 9 things that I hated.
That said, the Republicans should do exactly what they said Democrats should do: read the bill (now law). After reading, they should repeal the truly awful parts first. The public will back them on it and if the Senate or President doesn’t pass it, they will be voted out. Then, go for repealing some more moderate parts, until we find a true compromise.
That would actually accomplish something. We all know this current action is accomplishing less than a pissing contest.
Seriously, I’d actually be more interested in knowing what elected official can urinate farther than I would to hear about useless measures like this.
A pay-per-view pissing contest might actually raise some money that could be used for deficit reduction.
It seems to me that the problem with the status quo is health care inflation, which Obamacare does nothing to address and may even accelerate.
The real cost with the status quo is the very nature of “health insurance” in America: tax advantaged, third party payment of all medical expenses. But it doesn’t seem like Democrats or Republicans are going to do anything about that.
I agree that, from what I understand of the bill, both sides got very weak when it came to cost containment. Obama’s decision to lay off the pharmaceutical companies is a prime example.
Employer-based health care has a certain fish & bicycle quality to it. One really isn’t intrinsically linked to the other and, while I understand the historical background that gave rise to the system, I think we should end it.
But, given the ridiculous amount of political capital needed to pass the weak tea that we got, I can’t imagine what would have been necessary to attack profit-centers and remove employer-based health care in favor of something more rational. As it was, we still got a bunch of noise about death panels.
Doug… I am sure you know this… but it is much easier to get everyone to agree that the Obama system sucks than it is to get everyone to agree on a new system. The repeal was a show of Republican solidarity, the best way to ruin that would have been to outline ideas for the future.
This occurs all the time. The best recent example may be the estate tax. Not a single congressperson wanted the exemption to switch to $1M in 2011, but getting the exemption amount changed was extremely difficult because everyone had a different exemption amount that they preferred.
Sure, I realize it’s harder to get folks to agree to what should replace the recently passed health care reform; but to quote the great philosophers of Rush: “If you choose not to decide, you still have made a choice.” In this case, the choice Rep. Young is making is to return to what we had before. Don’t try to sugar coat it by pretending there might be some unspecified improvements later.
I think that our insane $1.3 trillion deficit and $14 trillion debt gives us the opportunity to make employer provided insurance a taxable benefit. That would put a nice dent in the deficit, without increasing tax rates (which would increase the disincentive to work).
I would also make Medicare payments taxable income, which would means test it without being heavy handed.
I would be honest with people that catastrophic health insurance is the only thing that is going to be affordable in the future. All health insurance spending below some level needs to be paid for out of people’s own pockets, and that level that insurance kicks in needs to be very high. Anything else is not insurance, it is tax avoidance.
And maybe that insurance in government provided single payer. Who knows. What is most important is to make as much of the health care system taxable and paid for directly by the person receiving the care. That will put a brake on health care inflation without resorting to death panels or other ways of rationing.
My primary concern with this – and I don’t necessarily know how you address it without inviting other kinds of waste – is that if you make preventative care an out of pocket expense while paying for catastrophic care, you’re probably going to have a lot of people skipping the cheaper preventative care and waiting until a problem is much tougher to treat before going to get help.
Buzz: your idea would significantly raise the taxes of many poor families. Insurance cost of $10k+ for a family is probably the norm. Even if a family is in the $34k of AGI and under tax bracket, they would pay additional taxes of $1500 on your suggestion. In comparison, the Illinois state income tax you and I were moaning about is peanuts.
However…… you got me thinking. why don’t we tax Medicare health insurance benefits?
Because old people vote.
Paul, no family of 4 making $44k (your $34k example plus that $10k insurance) pays any federal income taxes whatsoever.
Yes, it would subject them to Socialist Insecurity and Medicare taxes. But in my theoretical example, you are getting catastrophic insurance, not comprehensive insurance. Catastrophic insurance does not cost $10k per year.
Doug, couple things about preventative care:
1) There is absolutely no correlation whatsoever between preventative care and health outcomes (as in the famous double blind Rand study where people were randomly assigned to various health care plans with varying levels of care, no correlation was found).
Sometimes preventative care results in worse outcomes. For example, when using some of the high tech early detection scanning techniques, which can find “anomalies” that can kick off exploratory surgery, which is fraught with its own risks.
2) Is “preventative care” a problem in other areas of our lives? Is there an epidemic of automobiles, for example, where maintenance has been neglected, causing widespread societal chaos? I don’t think so, if anything, the exact opposite is true, people over-maintain their cars, going to Jiffy Lube far more frequently than they need to.
3) The things that really determine your health are genetics and lifestyle, things that our health care system don’t really address. I guess there isn’t much you can do about genetics, but lifestyle is totally under your control. Now, what gives you the most incentive to change your lifestyle? You personally being responsible for the health care costs resulting from that lifestyle, or a third party being responsible?
Is it just me? As soon as somebody says “Obamacare” I tune out, or quit reading anything else they say. Democrats have proposed “Nocare” as an appropriate tag for the right’s alternative “plan”, but either way, this propaganda label thing is just getting so tedious. Reform does not necessarily mean improvement, it means change, and it is certainly open to criticism. “HCR” is a nice, brief, non-partisan tag.
Great insight above,if true, that a family of 4 earning $44,000 pays no federal income tax. That’s why across-the-board tax cuts don’t mean much unless you have ‘significant’ money. A family of 4 earning 20,000 to 40,000 needs government subsidies to survive,but let’s not call it ‘welfare’. Whoever or whatever is ‘destibuting wealth’ in this country has been doing a poor job.
Is catastrophic health insurance the best case scenario for these families?
I was unclear, and was actually discussing Adjusted Gross Income, not total salary.
I don’t believe the $44k comment is true, but wasn’t going to push it until Lou commented. The standard deduction for a married couple is $11,400. Personal exemptions are $3,650, so even with 4 personal exemptions, we are only at $25k of total exempt income, and the other $19k of income (minus FICA, etc.) would be taxed. The rate for anything above $86 of AGI is 15%. Bottom line is the taxation of health care benefits would significantly change the number of people that pay income taxes, and increase taxation on the poor significantly.
Paul, you are missing the child tax CREDITS. The credits offset the taxes dollar for dollar.
I made far more than $44k in the past and paid no federal income taxes. The key is having kids and getting those child tax credits.
They’re GOLD I tells ya! ;) Almost makes having kids worth it. ;)
BTW, $44k is not poor. Neither is $34k.
I did forget the $1k child tax credit. You are correct that the family making $34k, with healthcare benefits costing $10k, with two kids would probably still have a $0 tax burden, but if they make $40k with $10k in non-deductible health care, they probably would pay something.
I can’t agree with the sentiment that a family of four living on $34k is not poor. This is ESPECIALLY true in high cost (and high population) areas such as Chicago, California, etc.
Really off topic here:
Just for the heck of it, I ran a theoretical family of 4 with wages of $34k and $44k through Turbotax. It was quite eye opening.
The $34k family of 4 not only has no federal tax liability, but because it recieves both the fully refundable child tax credit AND the fully refundable earned income tax credit, this family recieves over $3,500 from the feds.
That’s welfare, folks!
The $44k family of 4 also gets back more than it pays, to the tune of about $450. Still welfare, but not quite so blatant.
What is also crazy is that an additional $10k in income drops your welfare check by $3000. Quick, what’s the marginal tax rate on that? ;)
Man, our tax system is messed up.