On Wed, 13 May 2009 02:25:31 -0400, wrote:

On Tue, 12 May 2009 22:34:02 -0700, jps wrote:

I honestly don't know what the answer is, but I think I can say that
I'm highly suspicious of any national health care proposal given the
experiences of the average Canadian and British citizens with regard
to this aspect of living.

My biggest complaint is the 33% in average admin costs. The
government does it for medicare for about 2%.

Single payer system is the best answer. No gov't between you and your
doctors. Just eliminate the stinkweeds skimming the admin percentage.

That 2% is a questionable number, very narrowly defined and does not
include the doctor's side of the billing
We have doctors here who discourage medicare customers because the
government paperwork is onerous and they are "slow pay".
That is not saying the insurance companies are any better but I am not
sure the government will be an improvement.

BTW that "administrative cost" is "jobs". What will we do for them if
we put all of those insurance people out of work?

I'd like to know the tradeoff before answering.

In any case, the system needs to become more efficient. Such is the
case that jobs are lost when processes are automated.

wrote:
On Tue, 12 May 2009 23:53:07 -0700, jps wrote:

That 2% is a questionable number, very narrowly defined and does not
include the doctor's side of the billing
We have doctors here who discourage medicare customers because the
government paperwork is onerous and they are "slow pay".
That is not saying the insurance companies are any better but I am not
sure the government will be an improvement.

BTW that "administrative cost" is "jobs". What will we do for them if
we put all of those insurance people out of work?
I'd like to know the tradeoff before answering.

In any case, the system needs to become more efficient. Such is the
case that jobs are lost when processes are automated.

I just fear that we will simply roll all of that bureaucracy out of
the insurance industry and into government where bureaucracy was
invented and make a cumbersome process worse.
Nobody has ever given me a convincing argument that it will be more
affordable.
On the one hand they say there are lots of healthy, working, young
adults who don't have insurance and who would put money into the
system and then they say the people without insurance are mostly kids
and people who are already very ill. (the pre-existing condition
folks). Obama has finally started saying this won't be "free" medical
care. I am just not sure how many uninsured are prepared for a $500+ a
month medical insurance bill. (assuming the government actually wants
"pay as you go") Medicare is bankrupt and still going.
Until we get a better grip on the facts here we don't have a clue what
it will ultimately cost. I do not believe streamlining the billing
process will save enough to make this revenue neutral.
I suppose at this point, what is another trillion in deficit
spending?


I wonder what the impact would be if we removed the "caps" on salary for
Social Security and Medicare taxes, and added "all income" to the pool
of funds that should be taxable for purposes of Social Security,
Medicare, and a national health insurance program.

In other words, the rate you are paying for Social Security and Medicare
would not change, but you'd pay that rate on *all* income, instead of it
being capped as it is now.

My health insurance is via a PPO program, and I use a fairly large local
practice for just about everything except dental and opthamology. Every
time I go to one of the practice's offices, I see at least four young
ladies doing nothing but playing footsie on the phone with private
insurance companies, who apparently do everything they to make doctors'
offices jump through hoops to get coverage for their patients.

wrote:
On Wed, 13 May 2009 11:48:31 -0400, HK wrote:

I just fear that we will simply roll all of that bureaucracy out of
the insurance industry and into government where bureaucracy was
invented and make a cumbersome process worse.
Nobody has ever given me a convincing argument that it will be more
affordable.
On the one hand they say there are lots of healthy, working, young
adults who don't have insurance and who would put money into the
system and then they say the people without insurance are mostly kids
and people who are already very ill. (the pre-existing condition
folks). Obama has finally started saying this won't be "free" medical
care. I am just not sure how many uninsured are prepared for a $500+ a
month medical insurance bill. (assuming the government actually wants
"pay as you go") Medicare is bankrupt and still going.
Until we get a better grip on the facts here we don't have a clue what
it will ultimately cost. I do not believe streamlining the billing
process will save enough to make this revenue neutral.
I suppose at this point, what is another trillion in deficit
spending?

I wonder what the impact would be if we removed the "caps" on salary for
Social Security and Medicare taxes, and added "all income" to the pool
of funds that should be taxable for purposes of Social Security,
Medicare, and a national health insurance program.

The medicare tax is not capped. The SS tax cap goes up every year


I stand partially corrected. Remove the SS cap. Apply the taxes against
ALL income. Better?

wrote:
On Wed, 13 May 2009 12:36:10 -0400, HK wrote:

The medicare tax is not capped. The SS tax cap goes up every year

I stand partially corrected. Remove the SS cap. Apply the taxes against
ALL income. Better?

The reason I have heard that they want to make SS a capped tax on
wages is it is supposed to be some kind of pension type thing and not
just welfare but I guess that is ridiculous so I might be willing to
agree with your proposal. The problem is the SS tax would be bigger
than the income tax for guys like Gates and Buffett (either Buffett)

If you think you can pass it, go for it.

As for medicare, it shows the problem with government insurance. It
collects 3% of every dollar of wages earned in this country and is
going broke paying 80% of the medical bills for about 16% of the
population. If you expanded that to 100% of the population and 100% of
the bills, what would the tax rate have to be?
I know IBM says they spend $2000 a year on my insurance and I still
have to pay over $800 a month if I want reasonable coverage


My heart goes out to Buffet and Gates. :)

As far as I know, no one is seriously suggesting there be one "payer"
(the feds) for everyone's health insurance. I still favor the same sort
of coverage available through the FEHBA, with many plans from many
insurance companies available under a federal umbrella, lots of choice,
and oversight by the feds. I marketed one of those plans for many years,
and even though it was one of the least expensive plans, the coverage
was pretty decent. Those who were out of work or were paid so poorly
they could not buy even the least expensive coverage could then gain
entree into a federal plan.

And once again, I think these payroll taxes should be applied to *ALL*
income, not just to payroll income.

wrote:
On Wed, 13 May 2009 16:03:28 -0400, HK wrote:

As far as I know, no one is seriously suggesting there be one "payer"
(the feds) for everyone's health insurance. I still favor the same sort
of coverage available through the FEHBA, with many plans from many
insurance companies available under a federal umbrella

They are still calling this "single payer" and pointing at UK and
Canada where it is a government program.
Government programs always scare me because they become political.

As long as "politically correct" is referring to things you don't like
(like smoking), you have no problem with government sanctions against
the offenders "for the good of the program" but what happens if some
future government tries to make other lifestyle choices "politically
incorrect" and sanction them?
What happens when they decide gay people are more predisposed to AIDS.
Would a future government want to abort babies that were genetically
predisposed to being expensive to the program?
Would they try to sterilize people with DNA markers indicating genetic
diseases?
I just do not trust politicians with too much power and money is
power. This is going to be big money.

On the other hand, if they actually did a study they might find
smokers actually cost the program less since they die before they live
long enough to get cataracts, artificial hips and the other expensive
things that are common with old people.
I have had several family members die in the last several years. My
mother and father died from smoking related diseases (69 & 79) and did
not really use that much "medicine". My non-smoking grandfather died
of "old age" (complications of prostate cancer) at 99 and used a
****load of medicare over 44 years. He had both eyes done, hip, knee,
2 cancer surgeries and doctor visits at least once a month for a
couple decades. Just his drug bill for those 44 years was probably
more than my parent's total lifetime medical bills. Smokers tend to
avoid going to the doctor since he preaches at them.

A component may be single payer, but that doesn't mean many other
options will be eliminated.

BTW, the program for federal employees is single payer but not the way
you might think. While there are dozens and dozens (maybe hundreds) of
health plans federal employees may choose from, payment for these plans
is made by the federal government by withholding form the wages of
workers and, of course, by the government paying its share of the
premiums. The feds then forward payments to the administrators of the
health plans, typically to a lock box.

wrote:
On Wed, 13 May 2009 12:36:10 -0400, HK wrote:

The medicare tax is not capped. The SS tax cap goes up every year

I stand partially corrected. Remove the SS cap. Apply the taxes against
ALL income. Better?

The reason I have heard that they want to make SS a capped tax on
wages is it is supposed to be some kind of pension type thing and not
just welfare but I guess that is ridiculous so I might be willing to
agree with your proposal. The problem is the SS tax would be bigger
than the income tax for guys like Gates and Buffett (either Buffett)

If you think you can pass it, go for it.

As for medicare, it shows the problem with government insurance. It
collects 3% of every dollar of wages earned in this country and is
going broke paying 80% of the medical bills for about 16% of the
population. If you expanded that to 100% of the population and 100% of
the bills, what would the tax rate have to be?
I know IBM says they spend $2000 a year on my insurance and I still
have to pay over $800 a month if I want reasonable coverage

When created the social security system was an old age insurance system
that would provide a pension after the age of 65. In fact it was called
social security insurance. Check your facts.

http://www.socialsecurity.gov/history/fdrbill.html

Quote-- FDR had proposed a three-part program of old-age security
consisting of: old-age welfare pensions; compulsory contributory social
insurance (what we now think of as Social Security) --Quote

In the 60 or 70's The democrats dumped the social security money into
the general fund and spent it. Now they are must provide the funds back
to social security that was taken for other programs. They then
expanded the system to provide pensions to people who did not contribute
to the system.

What is spending another couple of trillion dollars to a democrats. The
are already spending nearly two dollars for every dollar they take in.
And with their proposed health care reform will increase that to four
dollars for every dollar they take in.

wrote:
On Wed, 13 May 2009 11:48:31 -0400, HK wrote:

Every
time I go to one of the practice's offices, I see at least four young
ladies doing nothing but playing footsie on the phone with private
insurance companies, who apparently do everything they to make doctors'
offices jump through hoops to get coverage for their patients.

Are you sure they aren't talking to Medicare or one of the "medigap"
companies. My doctors say that is as cumbersome as the other insurance
companies.
From my experience doctors do not really work that hard for you
either. They just bill you for whatever insurance doesn't pay on the
first go around and it is up to you to fight it. The real question is
whether it is easier to fight Aetna or the government.



Yeah, I am sure they are talking to insurance companies, because one of
the women at the office I visit is an old friend, and I always stop and
chat with her for a few minutes before I leave. Most of the chatting,
she has told me over and again, is with insurance companies. The
"Medigap" companies are insurance companies, too, as I am sure you know.