Continuing a Health Care Discussion

The rights discussion down the page has been remarkably free of typical blog posturing. As the discussion has turned to the issue of health care in America it has seemed expedient to open it up to more people.

The run of the mill blog is begun with an article on some partisan position drawn from the canon of acceptable partisan positions. It continues with partisans shouting past each other from the opposing canons of acceptable positions. Such "discussions" seldom change minds. This reveals, more than anything else, how culture blinds us to possibilities beyond those we see discussed around us. In our discussion of rights the general consensus developed that health care could not be properly described as a "right", but it has clearly become a feature of the public commons not unlike highway systems, sewage systems, and police forces.

To catch the reader up on the run of the discussion to this point, we began in earnest with consecutive posts by Kruser and j2t2. These were tied pretty much to the labelling ("capitalist" / "socialist") that besets political value exchanges. Moreover, though, these posts and a few that followed engaged in a pattern of "either/or" thinking that is typical of the present-day debate on medical care, as though we will either have a capitalist system or a socialist one.

This seemed to me to miss the point and I responded, in post # 249207 that we can't avoid the cost of paying for those who have no medical coverage because we have chosen to provide essential medical care. If we want to see the benefits of capitalism in the medical marketplace, then, we can't get it from a system that operates on two playing fields.

Toward the end of one thoughtful post, Mr. Haney shows us one of the great challenges the American economy must come to grips with, stating- "But if in the future, the American people decide it is appropriate to tax my family into an oblivion, I will take my engineering PhD and move to some country that won’t. I won’t suffer the tyranny of such a majority." Whatever our health care solutions may be they will fail if they chase productive people out of our economy. This sentiment is echoed in the following post by Jim M's comments on the cost of current medical programming.

In other posts Kruser posits that healthcare is not a right, but more like a public work and I agree, stating that- "Perhaps we simply need to be honest with ourselves about how we sell the public this collective 'service infrastructure', and how much of that we percieve to be in the urgent public interest."

In comment #249311 we start a series of posts in which there is a remarkable openness among posters to possibilities outside of the immediate rails of our personal political doctines. Jim M reveals an open mind to a plan like that in Massachusetts, for example. Shortly after that I explain why I think the current, supposedly capitalist system, is actually sabotaging medical care in America.

In comment # 249362 j2t2 gives us a link to a Boston Globe editorial describing the French system for medical finance. He follows this with a later link to an article by an American living in France about his very positive experience with their system.

Some key points in the discussion so far are that our system is not working cost-effectively, that it drives potentially contributing citizens into dependence on a public assumption of our medical risk, that there is at least one system that operates very much to the satisfaction of its citizens, and, finally, that depending on the format provided to us by the partisans will only extend both the argument and the problem.

If you have not been a party to the discussion so far I hope you'll at least look in on some of the ground we've covered and add your two cents worth.

Posted by Lee Emmerich Jamison at March 28, 2008 11:56 AM
Comments
Comment #249414

Lee -
Thanks for the summary. The discussion sounds really productive, and there’s no way I was going to read 145 comments to find that out.

Good idea… and keep up the intelligent positing!

Posted by: Chops at March 28, 2008 1:34 PM
Comment #249421

Thanks, though it really has not been my doing.

It is difficult to transplant a discussion from one place to another, especially one that was born in the bowels of another issue. In this case, because, as Remer points out in the center column, ignorance is used against us by politicians, appeals to our “rights” to medical care have been one party’s wedge to gain power and another’s wedge to condemn the power-grabs of the first. For us to have a really constructive approach to medical care we must tune out the rhetoric and look for things that work.

This is an issue where the people must lead and force the politicians to shut up and follow.

Posted by: Lee Jamison at March 28, 2008 2:28 PM
Comment #249423

I think we DO have to address how we are going to allocate resources and ration healthcare. We ARE doing it now, but poorly. I think the French and even British or Canadian systems are good plans.

As to flight for excess taxation, nice scare tactic, but the Cayman’s are going to get awful crowded.

Posted by: googlumpus at March 28, 2008 2:55 PM
Comment #249424

Any discussion about health care immediately spills over into issues of rights, the role of government and other ideologically divided and divisive frameworks.

I can’t work up a lot of enthusiasm for the ultra individualistic and ultra libertarian positions.
When they talk about the ‘tyranny’ of needing to contribute to the welfare of our society at large and then follow it up with threats to move elsewhere should things not work out their way, I’m reminded of spoiled children threatening to run away from home the minute they are required to practice responsibility to others in the family.

That said the tension between the individual and his society is natural and eternal. We need to discuss how to calibrate it without going to either exteme.

Pragmatically speaking. the failure of health care provisions affects everyone, even how the rugged individualists conduct their own lives. Money spent for emergency room care in place of a GP visit is not available for infrastucture, etc.

No modern society can survive UTube videos of people dying in the streets, so at some point, taxpayers do have to fund dealing with the consequences. The only question, and this is not an easy one, is whether we should deal with this proactively or depend on mop-up operations.
Which is more cost-effective over the long run?


There is often a cycle of neglecting significant sectors of society (whether they have a ‘right’ to attention or not) leading to ill considered bakclash measures. The antipathy to trade agreements is an example of such a backlash, something that should have been foreseen but was not addressed.

I see no alternative, then, to admitting the need to personally contribute to the health care available to all Americans. Improving the health of our work force brings more people into the ranks of contributors and reduces the ranks of those who deplete funds without contibuting.

What are called government programs need not be executed by government employyes.
A true public/private partnership, however, does imply more than just contracting services out. Opportunites for the private sector to profit need to be balanced with assuming its share of responsibility for the consequences.


Posted by: sisuntas at March 28, 2008 2:56 PM
Comment #249425

Mr. Jamison et al

We say that we are talking about health care but we always end up talking about sick care. Here is something form AARP on better health:
http://www.aarpmagazine.org/health/9_Secrets_Better_Health.html

and one definition of right, a word that has over 60 meanings, form dictionary com:

a moral, ethical, or legal principle considered as an underlying cause of truth, justice, morality, or ethics.
akin to L réctus ruled, Gk orektós upright

For most of the population, it is more important to get the medication that they are prescribing for themselves for conditions that they are well aware of. The FDA should make more medications available without prescription, and more presriptions should be made refillable without another doctor visit. To throw something new into the mix this time around, marijuana should be legalized and made available in small quantities by prescription.

Posted by: ohrealy at March 28, 2008 3:11 PM
Comment #249426

sisuntas,
OK, so take a look at the French system. Could that be a starting place?

ohrealy,
I’d like to see something that quantifies what diseases and other health problems cost us the most in medical resources.

If we start talking about marijuana we’ll lose the thread. That’s for another day.

Posted by: Lee Jamison at March 28, 2008 3:24 PM
Comment #249429

Lee, all these statistics start from this page:
http://www.cdc.gov/nccdphp/programs/index.htm Cancer Control
According to the National Institutes of Health (NIH), in 2007, cancers will cost the United States an estimated $219 billion, including $130 billion for lost productivity and $89 billion in direct medical costs.
///
Diabetes
According to the American Diabetes Association, the cost of diabetes in the United States in 2007 was as follows:
Total costs (direct and indirect): $174 billion.
Direct medical costs: $116 billion.
Indirect costs (related to disability, work loss, premature death): $58 billion.
Cost of caring for someone with diagnosed diabetes: $1 out of every $5 in total health care costs.
///
Heart Disease and Stroke
There is a whole series of graphs on heart disease and stroke here:
http://www.cdc.gov/nccdphp/publications/AAG/dhdsp.htm
The figures include direct and indirect costs. The cost of heart disease and stroke in the United States is projected to be more than $448 billion in 2008, including health care expenditures and lost productivity from death and disability. As the population ages, the economic impact of cardiovascular diseases on our nation’s health care system will become even greater.

///
On Obesity:
In the past 30 years, the prevalence of overweight and obesity has increased sharply for both adults and children. Between 1976–1980 and 2003–2004, the prevalence of obesity among adults aged 20–74 years increased from 15.0% to 32.9%. Among young people, the prevalence of overweight increased from 5.0% to 13.9% for those aged 2–5 years, 6.5% to 18.8% for those aged 6–11 years, and 5.0% to 17.4% for those aged 12–19 years.

People who are obese are at increased risk for heart disease, high blood pressure, diabetes, arthritis-related disabilities, and some cancers. The estimated total cost of obesity in the United States in 2000 was about $117 billion.

Promoting regular physical activity and healthy eating and creating an environment that supports these behaviors are essential to addressing the problem.

Despite the proven benefits of physical activity, more than 50% of U.S. adults do not get enough physical activity to provide health benefits; 24% are not active at all in their leisure time. Activity decreases with age, and sufficient activity is less common among women than men and among those with lower incomes and less education. Insufficient physical activity is not limited to adults. About two-thirds of young people in grades 9–12 are not engaged in recommended levels of physical activity. Daily participation in high school physical education classes dropped from 42% in 1991 to 33% in 2005.

Heart disease: 287 billion
(includes indirect costs)
Diabetes: 166 billion
Cancer: 89 billion
(direct medical costs only for these two)

Posted by: ohrealy at March 28, 2008 4:07 PM
Comment #249431

Lee-

The last two paragraphs of the Boston Globe story are especially true. We must move away from our employer based health system and how we move away from it should be the debate.

Most of the anecdotal “horror stories” you hear about health care have to do with our employer based system. My personal experiences are no exception. As soon as my father in law was diagnosed with liver disease his employer of 18 years “eliminated his position.” Another in-law has cancer. There is no way she will ever be able to leave her employer until she reaches Medicare age.

You don’t need the government to take over health care in order to address the employer based system. Just making insurance premiums tax deductible would bring market forces back to the insurance industry and foster the development of better individual products.

Posted by: George in SC at March 28, 2008 4:37 PM
Comment #249433

Lutheran General Hospital in Park Ridge had a little thrift store in DesPlaines, IL for many years. They had one full time and one part time employee, and all the others were volunteers. As their full time employee aged, she began to have numerous health problems, including a hip replacement. When Lutheran General became part of Advocate, they closed this store, eliminating their health care costs for this person. If you add up enough anecdotes, they become our real national health care policy.

Posted by: ohrealy at March 28, 2008 4:54 PM
Comment #249434

Jamison,

I think the French system is a very good place to start discussions. I would not support importing it wholesale, however. For one thing, anyone (tourists included) can arrive in a French hospital and, claiming vague symptoms, demand an array of specific, sophisticated and expensive tests.

The French, I think, are begininning to discuss limitations on health care largesse, and we would do well to follow those and learn from them.
An unquatifiable by-product of their sysem is that people don’t need to fear illness as a financial catastrophy. They read about he American experience as a lesson in what not to do.

I find it odd that on both sies of the Atlantic one topic is taboo: the consequences of technologies that extend life in both directions.
Premature babies at earlier and earller stages of gestation can now be saved and very ill people can live longer and longer.
Where are we going with this and what does this mean in terms of sustaining as well as preserving life?

Posted by: sisuntas at March 28, 2008 5:00 PM
Comment #249436

George from SC brought up two important points.

One of them I agree with.
We should move away from employer provided insurance to portable insurence. That would free individuals from the need to choose between keeping coverage by staying in an unwanted job and risking financial ruin. It would also free business from the burden in order to compete internationally with rivals who have no such encumbrances.

Jumping to a pure reliance on the market is going too far, IMO. The market does not work the same way in all areas.
Health insurance is not like buying a new car. People can affect mrket forces by refusing to buy any car at all, if they are all too expensive.
They can’t opt out of needing health care in the same way.

Additionally, market forces involve investors as well as prodiders and consumers. That breaks the traditional link betwee the provider and customer satisfation. Now it’s often investor satisfaction that determines provided services.


Posted by: sisuntas at March 28, 2008 5:33 PM
Comment #249437

H. R. 3344

To amend the Internal Revenue Code of 1986 to allow medical care providers a credit against income tax for uncompensated emergency medical care and to allow hospitals a deduction for such care.

H. R. 1898

To amend the Internal Revenue Code of 1986 to allow individuals a credit against income tax for medical expenses for dependents.

Food for thought.

Posted by: Weary Willie at March 28, 2008 5:36 PM
Comment #249440

The “rights” discussion on the blog that lead to this post contained numerous references to the “unfair” practice by insurance companies of assessing the applicant for insurance according to his/her medical history with some being denied coverage.

There are some on this site that apparently confuse insurance with something completely different. Any kind of insurance you can think of, including life, health, long-term care, auto, home, boat, etc. is based upon an assessment of risk to the insurer. When you or I complete an application for insurance we are making the insurance company an offer. The insurance company can accept the offer and issue the policy at the agreed upon premium, make a counter-offer with a higher premium or decline our offer.

With little risk the insured receives favorable premium treatment. As risk increases, premiums increase until a point is reached when the insurance company considers the risk unacceptable and refuses to accept the applicant under any circumstances.

Few would argue that this concept of insurability is unfair as it describes the very nature and essence of the business. It is not insurance if the insurer is not at risk for loss, and in consideration of the exposure to loss, the insurer is required to access the degree of loss to which it is exposed and charge premium accordingly.

A simple comparison would be the interest charged on a loan or credit card. Those with the best demonstrated credit receive the most favorable rates. Those with demonstrated poor credit receive higher rates or are denied credit. Were this not the case, banks would be hard-pressed to protect their depositors and rates charged to persons with proven good credit would pay much more in interest to subsidize the poor credit and higher risk applicant.

We should all stop referring to any form of universal health care as insurance…it’s not. If everyone understood this simple concept it would make for a much better discussion and we could eliminate the need for some to refer to insurance companies as greedy, uncaring, overbearing, etc. Instead, we would all understand that insurance is a legal contract with rights and duties afforded both the insured and insurer.

And, we would all understand why an insurance company has the legal and sensible right to charge premium according to risk or deny applications.

Posted by: Jim M at March 28, 2008 6:13 PM
Comment #249441

Regardless of whether which type of health care system we devise, that system would probably be much more efficient and affordable by eliminating the unnecessary middlemen, implementing some government and civil oversight, and stopping other abuses that are undermining and destroying many of our systems.

However, if a new government-run health care system is run like the current Medicare and Social Security systems, it may be the final straw, since the following are at record levels or have never been worse before:

  • the federal government already has a $9.4 Trillion National Debt, and $12.8 Trillion was borrowed and spent from Social Security (leaving it pay-as-you-go, with a 77 million baby-boomer bubble approaching); the total federal debt of $22.2 Trillion has never been larger in size or as a percentage of the $13.86 Trillion GDP;

  • nation-wide debt is $53 Trillion (excluding the $12.8 Trillion borrowed from Social Security; $65.8 Trillion including it); $53 Trillion is 3.81 times the nation’s $13.86 Trillion GDP and has never been larger in size and as a percentage of the nation’s $13.86 Trillion GDP;

  • 80% of Americans own only 17% of all wealth in the U.S. (the largest wealth disparity gap since year 1930);

  • real median incomes have fallen since year 1999, and they have also fallen since year 1978 when also factoring in more workers per household (real median household income in 2004 dollars was $40K in year 1978, and it only rose $3K to $43K in by year 2006);

  • home equities have fallen below 50%, the lowest level in 62 years (since year 1945)

  • inflation is eroding incomes and savings, and the U.S. Dollar has fallen signifcantly against all major international currencies since year 1999;

  • foreclosures (220,000 per month in Jan-2008) are at the highest levels in over 50 years (www.washingtonpost.com/wp-dyn/content/article/2007/06/14/AR2007061400513_pf.html);

  • as of 06-Mar-2008, the mortgage delinquency rate of 5.82% was the highest rate in 23 years (since year 1985).

  • as of Dec-2007, home ownership (money.cnn.com/2008/01/29/news/economy/home_ownership_vacancies/index.htm?postversion=2008012913) has taken a record plunge, and the 4th quarter of 2007 saw the biggest one-year drop in new home owners (1.1%) since tracking began in year 1965;

  • health care costs are not just high, but ridiculous; and health care is increasingly dangerous too, with an average of 195,000 people in the U.S. dying due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002. Since 1999, that is over 1.5 million people killed by preventable medical mistakes. That is more than all the U.S. troops killed in the American Revolution (4,435), the War of 1812 (2,260), the Indian Wars (1,000), the Mexican War (1,733), the Civil War (462,000), the Spanish American War (385), WWI (53,402), WWII (291,557), Vietnam War (58,209), Korean War (36,574), the Iraq Gulf War (529), the war in Afghanistan, and the current Iraq war Mar-2003-present (4,005), combined!

  • energy, electricity, and fuel costs are higher than ever before (even worse than the spike in year 1981, when adjusting for inflation);

  • the net losses due to illegal immigration has never been worse (costing Americans net losses of an estimated $70 Billion to $339 Billion per year);

  • average savings rates have been negative since year 2005, and have reached the worst levels since year 1933;
Perhaps we should fix some of this other stuff before asking the already severely bloated, wasteful, pork-happy, irresponsible and corrupt federal government to manage the heatlh care system?

Posted by: d.a.n at March 28, 2008 6:15 PM
Comment #249442

I apologize, up front, for not including links in my posting; I don’t know how to incorporate links into what I write. I apologize because I am going to make a couple of assertions that would be more defensible if readers could link to the data on which I based the assertions. Alas, readers will simply have to google the subject to find the data that I found.
The United States spends more (per capita or as a percentage of GDP or by any other measure)than any country in the world. We spend roughly 40% more than Switzerland, which is in second place, and more than double the average spent by developed nations. Many, if not most, of these other nations provide insured health care to a much higher percentage of their populations than we do, so it is reasonable to conclude that if we covered as many people as other countries cover, our total costs would be even higher than they now are. In short, health care in our country is dramatically more expensive than it is anywhere else in the world.
We might find this high cost acceptable if it were accompanied by equivalently better outcomes. Sadly, it is not. Our health outcomes (measured by life expectancy, infant mortality, prevelence of various diseases, and other measures)are not as good as most of the highly developed nations. We are paying more and getting less.
One would think that inquiring minds would wonder why we have such high costs and such mediocre outcomes. And, there have been studies…a few hundred studies, at least. Most of the studies I have found reached very limited conclusions. For example, a Johns Hopkins study in 2005 concluded that the cost differences between us and other nations were not driven by malpractice litigation or by waiting lists in those other nations. Another study concluded that the difference in outcomes was not the result of our “bad habits,” such as smoking or drinking to excess or driving too fast. Apparantly the citizens of other developed nations are careless about their health, just as we are.
But, there seems to be an abysmal lack of national curiosity about why we pay so much and get so little out of our health care system. Instead, we and our elected and aspiring leaders talk about more government health care or more private health care or mandates or incentives, etc. I would like to hear at least one of our candidates for president say something like this:
“Frankly, I don’t know why we spend so much on health care, get middling outcomes, and leave a big chuck of people uninsured. But, if you elect me president, I will pull out all the stops to learn why. Then, based on what we learn, I will propose changes to our current system.”

Posted by: Steve at March 28, 2008 6:39 PM
Comment #249443

The blosated, corrupt and wasteful government argument sounds hollow to me, even though it is, to a large extent, tue. It’s counteracted by the greedy and irresponsible corporations argument on the other side, which is equally hollow.

People are greedy and susceptible to corruption whether their pay check is signed by Uncle Sam or Bussinees, Inc.

That, in fact, is why I suuport a marriage between business and government - so they can counterbalance each other’s worst instincts. With a little luck, a co-operative effort could even give birth to adopting best practices by both.

In the meantime, it would help to remember that this is still an impwefect world, managed by lawed people. No plan will satisfy all people or solve all problems.


Taking up exteme positions will only guarantee extended debates instead of decisive action.

Posted by: sisuntas at March 28, 2008 7:01 PM
Comment #249446

Lee another concept we should take a serious look at is one proposed in an early article by Ray Guest, the singlepayer system as proposed by the Doctors themselves. Here is a link to their site.

http://www.pnhp.org/facts/singlepayer_faq.php#socialized

I favored the french system as a start because it seemed to “violate less rights” and although French less “socialized” than some other plans. If we could get ideology out of the way and see what actually works the PNHP plan sounds good and as you know we should always listen to the doctor.

Posted by: j2t2 at March 28, 2008 8:00 PM
Comment #249449

Doctors want single payer to help them get paid. It will not directly affect the care that their patients get, just accounting expenses.

Posted by: ohrealy at March 28, 2008 8:18 PM
Comment #249452

Whenever you have a third person paying for a service there is inflated cost. This was appearant in a discussion I was having with a tow-truck operator.
He was angry because nepetism in the local police force was dominating the calls for tow service in our county. He felt he should be allowed his turn along with the relatives of the police officers on duty because “..it’s insurance, and you can charge more!”

Third party payer relieves the receiver of service the obligation to control the cost. If each person had to pay, the outrage would reduce the cost immediately.

I’ve seen a 3 dollar charge for a 1 inch piece of rubber tubing used to drain an abcess. That is ridiculous and outrageous. But it’s being charged and the insurance is paying and the receipient is outside the loop with no motivation to stand up and complain.

Posted by: Weary Willie at March 28, 2008 8:41 PM
Comment #249454

We debate this occasionally so commenting on the French system is easy.

Disadvantages,

Taxes spread out over numerous areas, employers, employees and co pays (out of pocket 30%). Also included in auto licensing fees.
High unemployment nationally due to the great expense to employers.
Tension between doctors unions and the government for pay rate increases and caps are undesirable
It is fairly new in the present form and costs are rising, including co pays.
Started in 2000; before then a plan existed that didn’t cover everyone. It really hasn’t been proven.

Advantages.

Hindrances from lawyers and lawsuits are eliminated and therefore waivers and high liability are nonexistent .
http://www.huffingtonpost.com/martin-varsavsky/us-vs-french-medical-care_b_44164.html
Doctors and patient relationship is protected. Patients can go to whoever they want.
Patients can go directly to specialists without referral.
Billing is streamlined.
Supplemental private policies are allowed ; 85% have them.
The bottom ten percent in income have their co-pays waived.

I agree that the states should be encouraged to start their own. I just left a mismanaged state. That is the advantage of having united states. We can examine each other’s disadvantages and advantages and make changes accordingly.
A federal system will require too many people to manage it and a large portion goes to administrative costs for such a dinosaur. Also lobbying is limited with a smaller program. (As was stated previously) France has a 64 million population vs. US 300 million. California alone has 37 million.
We should eliminate all federal taxes from income. It is too invasive and is closer to unlawful search and seizure than most of the privacy complaints I hear today. Employers should be able to focus on business instead of entitlement. Employees won’t feel trapped by benefits.
If we start a new entitlement, or rather replace the ones we have now, it should be a broad sales tax. If gas tax pays for roads, maybe a food tax would pay for human maintenance.
The entity to disperse should be private with a board of experts to provide oversight for minimum requirements. Everything stays the same except the risk factor “insurance” principal would be eliminated in the minimum policy.
We can start by applying the changes in the first four advantages to our present system.

Posted by: Kruser at March 28, 2008 8:59 PM
Comment #249461

“Patients can go directly to specialists without referral.”
Sounds like the best idea in the French system, but I don’t think we will ever get over our desire to sue incompetent doctors. Maybe we have more people chasing ambulances here than they have, or we just like revenge more.

Posted by: ohrealy at March 28, 2008 9:26 PM
Comment #249463

A bifurcated system:

Universal coverage for:
Basic (annual exams and preventive) care, Emergency care (accident, high fever, etc.), and long term catastrophic care (50% coverage).

Private insurance and private practice care for all other Medical conditions and situations.

Lastly, any medical patents generated on the back of taxpayer paid research and development requires the patent holder to remit 1/2 of 1% of all revenues derived from that patent back to the federal government in annual payments, as a precondition to participation or purchase rights of patents developed with tax payer funding.

Posted by: David R. Remer at March 28, 2008 10:36 PM
Comment #249464

I am repeating myself here but I have to say again, we already have a universal, single-payer system in this country. It presently covers most of the sick, almost all of the elderly, and most of the disabled. It’s called “Medicare”.
It is in terrible financial shape because it does not have the healthy people in this country paying into it … that money is going to the health insurance industry.
I realize that I’m over simplifiying the solution but I would at least think that it would be looked at before considering the “french system”. (I hate those guys!).
I think most health care providers (those people that actually provide health care!) would accept a universal Medicare system. Maybe reimbursment would not be as good but it is a single billing system, with a single set of rules and dependable payment returns. They may lose a little on reimbursement but save a ton on A/R recovery costs.
Can Medicare be improved? Yes. I have really no idea how but I know with the cost savings of single payer they could improve payment to providers, dedicate money to research (credits to those companies doing research), and fund training to address the chronic shortage endured in many disiplines (nursing, pharmacists, rural medical care to name a few); and, at the end of it all, there would still be tremendous savings.
Government single payer would certainly influence the health care system but it does not have to run it. It need not force consumers toward any service or provider.
I know that familiarity breeds contempt and Medicare is a system with which most Americans have had direct or indirect experience with but, jeez, the French??? Liberal or not, I have to say, I HATE the French!

Posted by: charles Ross at March 28, 2008 10:38 PM
Comment #249472

Steve said “Frankly, I don’t know why we spend so much on health care, get middling outcomes, and leave a big chuck of people uninsured. But, if you elect me president, I will pull out all the stops to learn why. Then, based on what we learn, I will propose changes to our current system.”

Perhaps its because the focus is on profits and competition instead of healthcare. As an example, with dueling hospital chains competing for a greater share of the market they each have to purchase expensive equipment that if distriubted correctly (shared) could serve the community at less cost. How many MRI’s does one city need?

“High unemployment nationally due to the great expense to employers.”

Kruser do you think the expenses to employers in France for healthcare are greater than the expenses to employers that offer insurance to employees in this Country?

“Tension between doctors unions and the government for pay rate increases and caps are undesirable”

I would think we need more tension here. Seems that a reason for cutting costs/improving efficiency would help here. Perhaps a method for paying for the education of the doctors so they arent buried in debt before they start practicing medicine would help.

“It is fairly new in the present form and costs are rising, including co pays.
Started in 2000; before then a plan existed that didn’t cover everyone. It really hasn’t been proven.”

The French have been working on their system since 1947. Just because they tweak it now and then doesnt mean it hasnt been proven. If we wait till a system is proven we could be waitng quite a while. Even in this country costs are rising and coverages are declining. That problem is universal.

“I agree that the states should be encouraged to start their own.”

I would think that may help to streamline costs and avoid unnecessary layers of nonmedical personnel. The smaller population states could partner with a neighbor for cost effective care.

“I know that familiarity breeds contempt and Medicare is a system with which most Americans have had direct or indirect experience with but, jeez, the French??? Liberal or not, I have to say, I HATE the French!”

Well its not like we are asking them to administer it we are just using what gthey have learned to improve our system.

Posted by: j2t2 at March 29, 2008 12:42 AM
Comment #249478

Given that our present Medicare system alone will one day demand every single dollar the government has, maybe we better deal with that before we expand health care to others.

Of course, that would require something of democrats and republicans we haven’t seen for a long time in either party. Responsible government, and ultimately CUTS because we have promised too much to too many and can’t possibly tax enough to deliver it all without destroying our economy.

Posted by: Stephen at March 29, 2008 4:32 AM
Comment #249483
ohrealy wrote March 28, 2008 08:18 PM Comment #249452: Doctors want single payer to help them get paid. It will not directly affect the care that their patients get, just accounting expenses.
Good point.

There was a time when health care providers dealt directly with their customers (patients).
What happened?
What caused health care costs to not only skyrocket, but EXPLODE ! ? !

Weary Willie wrote March 28, 2008 08:41 PM Comment #249452: Whenever you have a third person paying for a service there is inflated cost… . Third party payer relieves the receiver of service the obligation to control the cost. If each person had to pay, the outrage would reduce the cost immediately.
True. We have to reduce or eliminate the unnecessary middlemen.

Then, we have to reduce or eliminate the motives for greed (i.e. profit).

Currently, the Medicare HI (Hospital Insurance) trust fund, financed by federal payroll taxes (2.9% of gross; 1.45% from employee, 1.45% from employer), is currently running a deficit and is projected to be exhausted by 2018/2019.
The rapid growth in Medicare expenditures is fiscally unsustainable.
That also does not account for any decreases in federal payroll taxes in the event of economic downturns(s).
Especially with the affect of the current mortgage bubble that will easily continue in 2010 (or longer).
The 2008 Medicare Trustees Report states that expenditures in 2007 were $432 billion (32% of the $13.86 Trillion GDP), and in the next 75 years, the expenditures are scheduled to rise rapidly to 110% of GDP due in part to the 77 million baby-boomer bubble (13,175 new recipients per day). The trustees also estimate that Medicare’s long-term unfunded obligations will be $36 trillion (260% of GDP).

110% of GDP, much less 260% of GDP for Medicare is not possible.
Medicare’s current costs (and borrowing) can not be sustained.
The federal debt can not grow much larger.
The federal government is already taking about one fifth of GDP in federal taxes.
Even if the tax system is fixed to remove regressive taxation, it still would not be enough to support unfunded liabilities.

Then there’s Social Security.
$12.8 Trillion was already borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching.

sisuntas wrote March 28, 2008 07:01 PM Comment #249443: Taking up exteme positions will only guarantee extended debates instead of decisive action.
True.

But is it extreme to question whether government should take on another vast health care system, in view of the current massive federal debt, 77 million baby boomer bubble, unfunded liabilities, and $53 Trillion nation-wide debt (3.81 times the $13.86 Trillion GDP), and current government bloat and dysfunction?

Despite the Federal Reserves ability to create money out of thin air, that can not last forever.
Eventually, that pyramid scheme will collapse when the nation can not carry any more debt.
The $53 Trillion nation-wide debt is already 3.81 times the $13.86 Trillion GDP.
The $9.4 Trillion National Debt is 3.5 times the federal government’s 2.7 Trillion in tax revenues.
And that does not even include the $12.8 Trillion borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching.

Seriously. Where is the money going to come from?
What ever system is decided on, it should save money for most (if not all) people, except for the CEOs and shareholders making millions and billions by capitalizing on others’, and capitalizing on these abuses.

After all, no one can say where the money come will come from to pay the interest alone on the $53 Trillion of nation-wide debt, much less the money to reduce the principal $53 Trillion of nation-wide debt, when that money does not yet exist, and 80% of the U.S. population owns only 17% of all wealth?

Posted by: d.a.n at March 29, 2008 11:08 AM
Comment #249484

Kruser Seems the state insurance idea is not favored by the insurance industry. Under Bushes just revealed plan to regulate fiscal concerns the insurance industry has managed to get in on the act with a national regulator instead of state regulation.
According to yahoo news-
“The plan would create a national regulator for the insurance industry, which is now largely governed by the states, and would create a Mortgage Origination Commission to try to address the abuses exposed in the current tidal wave of mortgage defaults.”

Posted by: j2t2 at March 29, 2008 11:50 AM
Comment #249487

Steve,

I would be interested in your links. Look just above this posting box and you will see “HTML formatting tips”. The second from the bottom is the one you use.
What you do is copy your link address by highlighting it and using the copy command (left click in the address bar and then use the ‘ctrl + c’ command), then follow the form you see in the tips. Paste the address you copied with the ‘ctrl + v’ command. You can see how we do it directly by clicking on the “view” button at the top of your browser window and then clicking on “source”. That will show you the actual text characters we typed in to produce an article and its links.

d.a.n.,
It is irrelevant whether we will “take on” another health care system. We, whether through taxes or through expenses tranferred from public payers and charity work to insured payers, are already paying for it. All we are really talking about is whether we will or will not organize the provision of those services efficiently.

What I see in the French system I like is that the medical system is not burdened with the support of people like clerks, insurance administrators, and lawyers who provide no medical care. Compare the two medical systems to flying creatures and the French system is a seagull, while the American system is a griffin that is being required to fly while pulling a plow.

In the previous discussion I referred to economics happening in “real time”. Here is a good example. American medicine is a burden on the economy not because it can’t fill our medical needs, but because we have appended so many unneeded people to the process of delivering medical care. They not only don’t improve care, their pointless participation in medical practice prevents them from doing genuinely useful, productive work. They are a drain on the whole American economy because they consume, but do not create.

The other “real time” issue going on from here will be that politicians have made a promise that people would have services provided for them that are simply impossible to provide in real time. Had the 12+ trillion dollars from Social Security been placed in investments in improving the capital foundations of our economy we might have been able to produce far more goods with far fewer people as boomers retired. Instead, we used that money primarily to provide consumer goods and services that didn’t increase our productivity. That means we can’t have people leave the workforce while continuing to consume goods and services. The money, which as I have said many times is an imaginary metric (just look at the value of it over the last decade) no longer exists. If the economy wants to eat, and have medical care, it will have to work.

Period.

charles ross,
In the intro above I meant to mention your contributions to the prior discussion as well. Hope you didn’t feel slighted.

Posted by: Lee Jamison at March 29, 2008 12:42 PM
Comment #249488

“Few would argue that this concept of insurability is unfair as it describes the very nature and essence of the business. It is not insurance if the insurer is not at risk for loss, and in consideration of the exposure to loss, the insurer is required to access the degree of loss to which it is exposed and charge premium accordingly.”

Jim M , Yes you are correct on this matter. However this is akin to ” I was just doing my job”. Its just that insurance is not what is needed to solve the problem, because it is the problem. The purpose of health insurance companies is to make money on the backs of the sick and at the expense of doctors and hospitals. It seems the insurance companies drain money from the health care system. They actually work against those in need. How does this help contain costs?
I dont know of a way the private for-profit sector can solve the problem. What is needed is a pool of money that people contribute to and then draw from when needed to cover health related costs. On the other end cost effective processes and treatment are needed. The current approach no longer serves us well IMHO. What are your ideas on this?

Posted by: j2t2 at March 29, 2008 1:18 PM
Comment #249489

j2t2,
The for-profit part of insurance is just a means of incentivizing the availability of capital with which to distribute risk. Unlike the ‘pool of money’ notion you have, in which the government would presumably sit on a pool of money so that it could be doled out as the need arose (look at the governments relative success at resisting the temptation to spend that pool…) the profit motive demands that the insurance industry keep that money doing useful things even as it is pooled for the proverbial rainy day. Government maintains a “lockbox” full of IOUs to the Social Security Trust Fund pricipally so they don’t have to admit the principal is gone.

Otherwise the ‘pool of money’ idea sounds wonderful.

Posted by: Lee Jamison at March 29, 2008 1:37 PM
Comment #249491

charles ross,
Get over how you feel about the French for a moment and just look at the system. Systems are non-personal, don’t smell odd, and don’t get mad at you if you complain about Paris or expect them to speak English.

Oh, my word. I just thought of several ways the French act like Texans.

Posted by: Lee Jamison at March 29, 2008 3:05 PM
Comment #249492

Lee I would not want to argue in favor of the government on this issue. But there is coming a day when we will be forced to address the SS and Medicare issue. Those funds should go to a lock box and out of the reach of politicians. In fact that should be an election year issue instead of this foolishness we are seeing now. But to continue to rely upon the same methods that got us to where we are doesnt seem all that smart to me.

Posted by: j2t2 at March 29, 2008 3:10 PM
Comment #249493

j2t2,
That is another “real time” issue. The economy will not expand by 500% overnight (and, actually, those are time-distributed obligations) but will be made of as many people as there are. A certain percentage of them will work and all of them consume at least something. What we will work out is how the WORK will be distributed.

For the time being the money, debt, etc. is a distraction from the really important things like the capacity of the medical industry to serve a given population to some level we think we can sustain. That is a function of how we distribute PEOPLE in the economy and how useful we make their labor.

Posted by: Lee Jamison at March 29, 2008 3:35 PM
Comment #249495

” I dont know of a way the private for-profit sector can solve the problem. What is needed is a pool of money that people contribute to and then draw from when needed to cover health related costs. On the other end cost effective processes and treatment are needed. The current approach no longer serves us well IMHO. What are your ideas on this?”
Posted by: j2t2 at March 29, 2008 01:18 PM

j2t2, I disagree with your assessment of insurance companies in your paragraph just above the one I quoted. Replace insurance company with any other type of company and they are also making money on the “backs” of someone, right?

The problem with your pool of money outlined above is twofold. Who pays into this pool, and how much does each person pay? Without assessing risk, as is done by an insurance company, how can anyone calculate how large the pool of money must be to afford everyone the ability to withdraw benefits from the pool to pay costs?

Are we back to the “soak the rich” attitude so prevalent in liberal thinking? If so, any plan based upon the “rich” paying for the program will fail. And, how does government decide which doctor visits and hospital procedures are necessary and which are not? There is massive fraud already in Medicare and even worse fraud in Medicaid that isn’t being corrected contributing to massive red ink in those programs.

I am on Medicare and my physician regularly wants me to have expensive tests performed which I believe are unnecessary and I don’t have them done. The same is true with my urologist. Even thought my prostate is small and smooth as evidenced by an inexpensive DRE, he wants to be safe and has already done two prostate biopsies costing Medicare thousands of dollars in what I believe is CYA medicine. I refuse to have any more biopsies done unless there is a change in the size and contour of my prostate and will save Medicare many more thousands of dollars.

The problem j2t2, is that there are many folks, given the opportunity, who would elect to have every procedure their physician recommends done if it didn’t directly come from their own pocket. With private insurance the insurance company acts to restrain unnecessary spending. While there may be abuses, restraint is still necessary for any system of health care to remain solvent. And as witnessed by the failures in Medicare and Medicaid to exercise oversight and restraint, I can’t see how any new health care program would be any different.

I read the article in the website someone recommended on the “French System” and find that it too is deeply in red ink already with much more to follow unless premiums are increased.

Frankly, I don’t believe it is possible to provide all the health care people want at government expense. Social Security doesn’t provide all the retirement income everyone would like to have and consequently those who can, save money from their own incomes to provide income in excess of SS in their retirement years. Government encourages this type of planning by offering tax incentives such as IRA’s, Pension Plans, etc. Who would argue that those who have saved for their retirement should share that savings with those who didn’t?

Those who can’t afford to save for their own retirement are left with SS. Now, even that minimal safeguard is being threatened because of mismanagement by politicians. Who will bail out SS? Who will bail out Medicare and Medicaid? Who will bail out national health care if such a system is ever installed?

Government has attempted to help people with health savings accounts. Without going into detail I believe HSA’s are a great idea and are being used by millions of people. It encourages people to become directly involved in their care and the cost of that care. It involves people in some responsibility for their care and rewards those who shop carefully and use their common sense.

Perhaps some very smart people can figure out a way to provide HSA’s to every American combined with some form of minimal preventive medicine but there must be a cost to everyone, including the poor. Humans value that which costs them something, and as a rule, do not value that which is free.

Posted by: Jim M at March 29, 2008 4:13 PM
Comment #249497

Reading over the comments has been dishearteninng in one sense: The word ‘universal’ seems to evoke such emotional reactions when it appears in the context of health insurance. Considering that the problem is universal, that seems distinctly odd. After all the problem is universal, just like crime is universal. You may not have been personally robbed, but the existence of crime necessitates financing a police force, building jails and prisons, and etc.

Everyone is affected when a society has so many without access to basic health care because affordable health insurance is not available.
We all pay the hospital bills of those without insurance who can’t pay their bills. The business owner is affected if his employees aren’t healthy enough to show up for work because of ill health. Like it or not, we’re all in it together, and thinking that an individual can escape the universal effects of our current situation is an illusion.

The underlying argument for universal coverage is not to be found in a business model that is suitable for credit cards or selling merchandise. It relies on the notion of pooling risks and resources. The more people are participants, the more the risks are diffused and the more resources are made available via premiums.

The argument about overhead costs is also seriously misrepresented. Actually, overhead for governemtn programs is lover than in the private ssector. The relative savings by contracted services comes from the temporaty nature of the cnatract (no pensions, etc), not the cost of prividing a service perse. That applies to Blackwater but not to health insurance, where the contract is not duration specific.

What is missing in programs like Medicare is an effective means of detecting waste and fraud. In the age of such sopisticated software programs tracking every move you make on the Internet, it just seems stupid (for lack of a better word) that there is no implanted mechanism for doing so.
That’s a political problem, and it requires citizen vigilance to demand accountability - in both government and participating businesses.

Posted by: sisuntas at March 29, 2008 4:30 PM
Comment #249507

CORRECTION:

    The 2008 Medicare Trustees Report states that expenditures in 2007 were $432 billion ( 32% 3.2% of the $13.86 Trillion GDP), and in the next 75 years, the expenditures are scheduled to rise rapidly to 110% 11.0% of GDP due in part to the 77 million baby-boomer bubble (13,175 new recipients per day). The trustees also estimate that Medicare’s long-term unfunded obligations will be $36 trillion (260% of GDP). 110% 11% of GDP for Medicare alone, much less 260% of GDP for Medicare over 75 years is not possible.

Lee Jamison wrote at March 29, 2008 12:42 PM Comment #249487: d.a.n., It is irrelevant whether we will “take on” another health care system. We, whether through taxes or through expenses tranferred from public payers and charity work to insured payers, are already paying for it. All we are really talking about is whether we will or will not organize the provision of those services efficiently.
If it saves most Americans money, that’s great. If it doesn’t, it may be the last straw, with $22 Trillion of total Federal debt and $53 Trillion total nation-wide debt.
Lee Jamison wrote: What I see in the French system I like is that the medical system is not burdened with the support of people like clerks, insurance administrators, and lawyers who provide no medical care. Compare the two medical systems to flying creatures and the French system is a seagull, while the American system is a griffin that is being required to fly while pulling a plow.
Maybe.

BTW, many of the French also have supplemental insurance too.
What works in France may not work so well in the U.S.

I still think we should address the obvious abuses either (a) first OR (b) simultanteously (e.g. regressive taxation, illegal immigration, killing 195,000 people per year due to potentially preventable medical mistakes; 101,000 of those being from adverse drug reactions). Otherwise, I think a new government-run health care system will be a complete flop. Especially with so much nation-wide ($53 Trillion)and federal government debt.

Posted by: d.a.n at March 29, 2008 8:55 PM
Comment #249511

The whole issue of preventable medical mistakes is an extremely important one, but it’s just not that obvious why who is paying for medical care—whether the government, individuals, or insurance companies—is key to resolving this.

That is a front-line medical issue. People also debate education as a national issue, but I don’t think that anybody believes that vouchers, increased public funding, or any other measures will suddenly make the profession of teaching infallible and that we’ll suddenly have zero illiteracy and across-the-board perfection no matter what we do. Human error and the inability to be perfect always will be there no matter what. In medicine like anything else.

Posted by: Loyal Opposition at March 29, 2008 11:29 PM
Comment #249514

Something that hasn’t been discussed much is the high cost of educating a doctor as a factor in health care cost. Tuition rates increase much faster than inflation. I have a son and daughter in law who just finished pharmacy school. Ask them or new doctors to cap rates for service and you will have a student loan crisis on your hands.
We have those who want universal care and criticize doctor pay, yet colleges are untouchable for the abusive charges to our students.
The same goes for lawyer lobbies and liability rates.
These abuses will continue with a new or revised plan. Just pass it on to the taxpayer.

Limit tuition and lawsuits and then discuss limiting charges with doctors.

To be honest I see a shortage of doctors (even with the high pay) on the horizon.
My son is one who easily has the capability to become a doctor yet he doesn’t want to accumulate huge expenses until he is thirty and pay off loans into his forties. The requirements for education to get his degree and the charges are simply too high and are increasing.
What do we pay per doctor for education as compared to the French? This information should be included in any comparisons but in all the articles I have read it isn’t. They just say it is free. What do they pay the professors, administrators and colleges to educate per student compared to us?

Posted by: Kruser at March 30, 2008 12:53 AM
Comment #249515

When you talk about fraud in the medicare/medicaid system does the costs include the fraud perpetrated on the American public by all parties involved in the “no negoiating on the cost of drugs” bill from the 108th Congress? Maybe one of the answers to medicare fraud is an incentive to the patient for keeping costs low. It just seems that if the French can do it why cant we. Not just the French the whole of the industrialized world except us can do it. With 300 million people you would think certain effeicienies would be available that would allow us to lower our high cost of health care while providing coverage to most people.

“Replace insurance company with any other type of company and they are also making money on the “backs” of someone, right?”

Not if it is a not for profit entity.

“Government has attempted to help people with health savings accounts. Without going into detail I believe HSA’s are a great idea and are being used by millions of people. It encourages people to become directly involved in their care and the cost of that care. It involves people in some responsibility for their care and rewards those who shop carefully and use their common sense.”

HSA’s would be ok as part of the answer such as deductables, copays and in lieu of or to pay for supplemental insurance. But for most people without anvanced degrees in this country its tougher to save anything significent on $10 /hr wages in this day and age.

“Are we back to the “soak the rich” attitude so prevalent in liberal thinking? If so, any plan based upon the “rich” paying for the program will fail.”

Oh heaven forbid the rich should have to pay their fair share Jim M.. Thats what the middle class is for,afterall someone has to pay taxes.
After the way they have stacked the deck in the past 30 years why should they have to pay anything for anybody but themselves. Isnt that exactly what our forefathers wanted an aristocracy above the law in this country. I know that not the kind of respect you would expect but after watching the $30 bil note from the taxpayers to bailout bear stearns while the Ceo walked away with $60 mil Im not real respectful of what the rich want right now.

” And, how does government decide which doctor visits and hospital procedures are necessary and which are not?”

The doctors decide not the insurance companies nor the government. The patient and the doctor decide.

“With private insurance the insurance company acts to restrain unnecessary spending. While there may be abuses, restraint is still necessary for any system of health care to remain solvent.”

How do you know its in the best interest of the patient Jim M.? Why would you think the insurance company is looking out for anyone but themselves? If the insurance company suspects the doctor ordering the “extra care” is not exercising good sound medical judgement then take the doctor off the list of those your insured can use. One persons restraint is another’s careless. Now if as a patient you choose to exercise restraint then dont blame your doctor down the road, but more power to you.

“And as witnessed by the failures in Medicare and Medicaid to exercise oversight and restraint, I can’t see how any new health care program would be any different.There is massive fraud already in Medicare and even worse fraud in Medicaid that isn’t being corrected contributing to massive red ink in those programs.”

Without a doubt, when we have such a hell bent desire to maximize profit at any cost their will be fraud. Enough swindling of the system for your own personal gain and you can become rich so you are protected from having to pay your fair share. Its the prevelant attitude of the day, cut taxes lax or no enforcement, no serious time if your caught, whats to lose. Maybe if a few of those caught lose their corporate charter things might change. Of course the Ceo’s should be exempted afterall they are just trying to get rich so they dont have to pay their fair share. :)

The problem is attitude and ideology. We are to divided as a country to take on anything of any importance. Maybe the time has come to call in Chinese and Indian help to solve the problem. Surely Doctors from those countries will work cheaper here in return for citizenship. Then we can deregulate the industry by getting rid of the AMA and bring in prescription drugs from Mexico. With deregualtion anybody would be able to make the drugs cheaper than the drug companies especially without any FDA interference. Hell we could get rid of insurance regulations and licenses for agents and other professionals and let others try their hand at it. We could off shore hospitals and/or bring in nurses from 3rd world countries, degrees wont be required after deregulation. While smuggling people and illegal drugs into the country the Columbians could transport sick Americans to off shored hospitals on the return trips. Maybe then we could bring costs down. Quality might be an issue but hey what are ya gonna do, its worked for all the other industries in this Country. Afterall Jim M wasnt this deregulation thing the idea of those rich guys you seem to want to protect so much and who gained so much from it at the expense of all of us? :)

Posted by: j2t2 at March 30, 2008 1:12 AM
Comment #249527

Loyal Opp said: “The whole issue of preventable medical mistakes is an extremely important one, but it’s just not that obvious why who is paying for medical care—whether the government, individuals, or insurance companies—is key to resolving this.”

To some extent it is obvious. When a for profit corporate medical care delivery institution’s investors and managment’s profits are dependent upon processing the maximum number of patient’s per hour through their facilities, efficiency will inevitably compete with quality, and people will die from malpractice caused by speed of action and decision making which facilitate profitability.

That is why I believe that the government sponsored Medicare system should contract first and foremost with NON-Profit health care delivery institutions which have no shareholder profit concerns bearing down on the Board of Directors, and whose Board of Directors and management is not bearing down on medical practitioners to make speed compete with quality. Non-profits can reverse the managerial accounting priorities, quality first, efficiency goals secondary to quality treatment and decision making.

I worked for Ford where cranks were molded, cleaned, heat treated, inspected, and shipped. There was a 6% rejection quota we inspectors were expected to not exceed. Meaning we would not hear from the Foreman for 3% or less rejects being sent back to the melting pot for remanufacture. That 3% figure was derived at by the managerial accounting
department which determined that this rate of rejection would maximize quality and customer satisfaction, (not guarantee it) while minimizing the overhead costs of recycling rejects. Which is fine for automobile cranks.

Not for human beings. A 3% malpractice rate, failure to deliver responsible medical care and treatment to 3 out of 100 people, would be intolerable. Our malpractice rate is substantially less than 3%, but, when it comes to human life and suffering, there is no acceptable rate of malpractice at the hands of medical care deliverers. Not if you are the patient suffering the malpractice or family member of the deceased due to malpractice.

Posted by: David R. Remer at March 30, 2008 6:27 AM
Comment #249528

Kruser said: “Limit tuition and lawsuits and then discuss limiting charges with doctors.”

If you do that, you will vastly increase doctors engaging in medical malpractice and malfeasance. Law suits encourage quality medical care.

I agree with you entirely that our nation has a nursing shortage of major proportions and is facing a severe doctor shortage with boomer retirements, but the answer is not to simply lower the bar and increase graduates who have nothing to fear by hurrying and making mistakes to maximize annual earnings.

We do need to lower the costs of medical education but at the same time such lowering of costs must be commensurate with lowering of Doctor compensation to keep the cost of medical care from rising.

I think we desperately need vastly superior peer review and medical review courts, who can and WILL bar repeat malpracticers from practicing medicine. That alone would dramatically reduce litigation for malpractice, and hence, insurance rates or costs to the taxpayer for Medicare underwriting.

Another practice I think needs to be implemented is a patient review system, in which patients may provide feedback on doctors and nurses and such a database could be reviewed statistically for anomalies to spark investigatory reviews of health care deliverers. This too would increase customer satisfaction and promote an enhanced trust relationship between patients and health care deliverers overall, which in turn would drive down frivolous malpractice litigation.

Lastly, I think we should invest in lowering the cost of attorney educations and like the medical system, install review and oversight systems that could detect and remove abusers of the system, clients, and insurance underwriters. The peer review system now in place is an utter joke.

Finally, I believe Congress could/should pass a stronger set of ethical and legal standards for the legal profession, in addition to facilitating a vast increase in lower courts, in order to regain the right to a speedy trial, a right abrogated and denied to citizens for decades now.

Posted by: David R. Remer at March 30, 2008 6:44 AM
Comment #249530

“The problem is attitude and ideology.”

Posted by: j2t2 at March 30, 2008 01:12 AM

The truest statement I’ve seen so far.

One attitude is that the government owns all resourses including your labor. The other attitude is that of private property.

Who owns the fruits of our labor? A person buries his nose in books from the time he starts school untill he’s almost 30 years old, amassing hundreds of thousands of dollars of debt. I believe they, as anyone else, deserve to charge what the market will bear for their service or product.

Posted by: BOHICA at March 30, 2008 9:03 AM
Comment #249534

I agree with you Dave on ways to limit lawsuits and malpractice you showed.
Peer review and courts sounds like a private system and would be an improvement.
The requirements and charges, however, have little governing force and are contributing to runaway costs.
My son will have excess of 100k and six plus years to simply dispense medicine (can’t perscribe) with a computerized system. It seems there are a large amount of usless required classes that charge too much. They need better regulation also.
Malpractice (neglect) in America is not an educational issue but a moral one. Education cannot make people care. I have experience in taking care of the elderly and this is definatly a big problem.
Does anyone know the Licensing requirments for the French and the cost of their degrees to the government?

Posted by: Kruser at March 30, 2008 10:01 AM
Comment #249535

Governing officials in a non profit system will also need high wages to keep them there, otherwise we will have incompetent low wage people managing things. That would be a form of neglect toward the recipients.
This is an advantage of a private for profit system. You won’t remove high managerial costs by socializing it.

Posted by: Kruser at March 30, 2008 10:24 AM
Comment #249539

“One attitude is that the government owns all resourses including your labor. The other attitude is that of private property.”

Actually thats not attitude Bohica, that just another misrepresentation of the facts based upon your own personel ideology.

Posted by: j2t2 at March 30, 2008 12:35 PM
Comment #249540


Kruser seems education costs for french students are high to.

http://chronicle.com/news/article/3780/french-students-increasingly-become-prostitutes-to-pay-tuition-2-books-suggest

Posted by: j2t2 at March 30, 2008 12:42 PM
Comment #249542


French health care from the British point of view. Also some continueing education for French doctors information.


http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1079565

Posted by: j2t2 at March 30, 2008 12:53 PM
Comment #249546

j2t2, I have decided not to respond to your rebuttal as you apparently read, but didn’t comprehend what I wrote.

The link to the French health care system article someone provided said that nearly 85% of the French population purchase private supplemental insurance to pay deductibles and co-pays. This is similar to the number of Americans on Medicare who purchase private Medicare supplement insurance. My question, if the French health care program is cost efficient compared to private health insurance why did they not go all the way and provide 100% of coverage and eliminate the need for private supplemental insurance? Was this need left uncovered to throw a bone to the private insurance companies? The article said that the private insurance companies providing these supplement policies were making a nice profit and the competition was fierce for the business. Couldn’t the profit on these private supplemental policies have been used to provide 100% coverage with no copays or deductibles? If 80% socialized health care is better, why would 100% not be great? What am I missing here?

The U.S. government in its unfailing wisdom has determined a national level of poverty. Those living below the arbitrarily established poverty threshold are entitled to certain government benefits to bring them up to this floor.

Question; why hasn’t government established a similar floor for health care? What is the minimum accepted level of health care in the U.S. We have been told what it is for poverty, why not for health care?

Next, was the official poverty level established as a percentage of the income of the wealthiest people in America. Or, was it established by measuring the cost of the most basic needs of food, clothing and shelter? If the answer is the latter, couldn’t the government in its great compassionate wisdom establish a poverty level for health care based upon the most basic needs?

Why, in establishing a base level for poverty are we willing to recognize and accept a disparity in living standards and in health care we are not willing to accept any disparity at all. Many demand that everyone receive health care equal to what government employees have by virtue of their employment, but these same people don’t demand the same equality in living standard.

The reality is that people capable of, and willing to work, are earning the money to enable them to have choices. Those incapable of or unwilling to work will have their choices diminished. And we, those paying the bills, get to choose the level of poverty benefits we are willing to pay for.

Posted by: Jim M at March 30, 2008 1:55 PM
Comment #249549

(1) We need more doctors and health care providers, but there are some that want to limit the number of new students, pharmacists, etc.
We need to create more schools and create incentives to increase the numbers seeking a career in the medical profession.
Currently, the U.S. medical schools graduate only about 16,000 doctors each year.
That number has been almost constant for over two decades.
There are 20,000 first year residencies available each year.
Where do the additional 4,000 doctors come from?
They are coming from overseas (e.g. Pakistan, India, the Middle East, etc.).
Also, the number of students in American medical schools preparing to become primary care physicians is going down (not up).
The basic laws of supply and demand help explain another of many reasons for exploding health care costs.

(2) Another huge cost that many Americans choose to ignore is illegal immigration.
Hundreds of hospitals are closing their doors. Between years 1993 and 2003, 60 hospitals in California closed, and 24 others were near closure.

In year 2005, in only one city in Texas (Laredo), there are 2,000 anchor babies born annually to illegal aliens in the Laredo Medical Center maternity ward, only one of hundreds of U.S. maternity wards, paving the way for blue PassPorts for the parents. Despite the estimated $70 Billion to $338 Billion in annual net losses due to illegal immigration, hundreds of hospitals closing in border states, and the untold cost of crime, job displacement, 20,000 public-school teacher lay-offs in California (www.fairus.org/site/PageServer?pagename=research_research2fdc), many Americans still choose to ignore it. And part of the looking-the-other-way seems to be due to partisan loyalties; i.e. over-looking it, since their candidate and party don’t have a good voting record or any real plan to deal with it. As a result, many of our services will simply continue to decline in quality or disappear completely (such as the 60-to-84 hospitals and 20,000 teachers jobs in California). Also, border states are not alone. Pennsylvania and New Jersey hospitals gave almost $2 billion in free emergency and short-term care to uninsured patients, of which a large percentage are illegal aliens. Chicago’s Alivio Medical Center provides $1 million a year in uncompensated care and estimates that more than half of its 20,000 annual patients are illegal aliens (more … www.wvwnews.net/story.php?id=3978). And securing the borders alone will not resolve the problem. And another amnesty could quadruple the problem, as did the amnesty of 1986. Compassion is great, but now when it leaves you, your family without, and fellow American citizens without.

(3) Any plan is also likely to fail if the U.S. continues to do nothing about the abuses that are hurting many of its social service systems (e.g. education, health care, lawlessness, regressive taxation, wars, inflation, nassive nation-wide debt, election problems, and government bloat, corruption, and waste).

Also, many of those abuses that ail the health care system are quite likely the same things ailing the public education system, tax system, law enforcement, economy, mortgage meltdown, massive nation-wide debt, government bloat, corruption, and waste. Some will simply try to rationalize it away, and claim mediocrity is normal, but it isn’t normal, and it isn’t getting better. The $53 Trillion of nation-wide debt alone has the real potential for causing an economic downturn that could last for years. If the major abuses were addressed first, we may find out a lot of solutions will naturally follow. If not, few (if any) new government-run systems are likely to succeed.

(4) Lastly, repeatedly rewarding Congress with 93%-to-99% re-election rates is not likely to lead to anything different, except more abuses and painful consequences (one-simple-idea.com/Factors1.htm).

At any rate, the voters will have the government that the voters elect.

Posted by: d.a.n at March 30, 2008 2:11 PM
Comment #249562

Kruser said: “Governing officials in a non profit system will also need high wages to keep them there, otherwise we will have incompetent low wage people managing things”

True. But, their high wages would be competitively priced, and not supported by the profit margin on number of patients processed per minute. Non-profit providers can and will insure quality care supersedes efficiency. Efficiency in processing (maximizing patients per minute) is for-profit’s primary incentive, likely resulting in significantly higher malpractice events.

Posted by: David R. Remer at March 30, 2008 5:21 PM
Comment #249570
True. But, their high wages would be competitively priced, and not supported by the profit margin on number of patients processed per minute. Non-profit providers can and will insure quality care supersedes efficiency.
It could work.

However, it isn’t likely if they do not eliminate the middlemen (insurance companies), and if too many voters continue to reward irresponsible incumbent politicians with 93%-to-99% re-election rates.

A government health care system must SAVE money.
It can’t be another huge, bloated, mismanaged mess like Medicare and Social Security.
It can’t be another huge Ponzi scheme like Social Security, where $12.8 Trillion has been borrowed and spent from it, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching.
It can’t be another huge debt generator like Medicare, with tens of trillions of unfunded liabilites.

Otherwise, it will most certainly fail.
The odds of it faling are VERY high.
We have not yet got our ducks in a row.
The economy is already in a very precarious state, and the politicians appear to be pandering to grow the debt ever larger by bailing out banks and mortgages holders.
The politicians are promising this and that, but none of them can tell us where the money to pay the interest alone on the the $53 Trillion of nation-wide debt will come from, much less the money to reduce the principal so that it stops growing larger.
It’s lunacy.
Instead of focusing on fixing a number of serious problems, we appear to be adding to the list.

The candidates for president and Congress don’t seem to get it. The spending and borrowing has to stop soon, or the problem will solve itself the hard and painful way. The debt has been growing worse and worse every year for decades, and is now at a record $53 Trillion, which is not only the largest debt ever in size, but also the largest debt as a percentage of $13.86 Trillion GDP.

I don’t think a government-run health care system has much of a chance at the moment, until the many abuses that are already destroying the health care system are addressed.

(1) Education: train more doctors and healthcare providers.
(2) Stop tens of millions of illegal aliens from overruning the healt care system and numerous other systems.
(3) Stop the other abuses destroying the health care system, and burdening many other systems.

In case no one has noticed, the list of economic factors have been growing worse for many years.

While it isn’t impossible, and while the current system is pretty bad (i.e. 195,000 deaths due per year to potentially preventable medical mistakes), who really thinks the government is going to create a government-run health care system that is better?

At any rate, the voters will have the government that the voters elect.

Posted by: d.a.n at March 30, 2008 7:47 PM
Comment #249579

“Oh heaven forbid the rich should have to pay their fair share Jim M..”

The premise that you can “soak the rich” has proven to be false. The richest 1% simply move their money into investments which are low tax or tax exempt. Thus, most policies which intend to make the rich pay “their fair share” simply don’t do so. Instead, the results are often counter to the stated intent because these policies increase the tax burden paid by the middle class. So isn’t it logical to assume based on past results that an attempt to defray the costs of the poor (health care or otherwise) onto the rich is very likely to fail just as Jim M stated?

That’s why IMO, class warfare, “soak the rich” arguments only take away from a legitimate debate on what policies enable the pursuit of economic prosperity for the other ~99% of Americans.

Posted by: Mr. Haney at March 30, 2008 10:43 PM
Comment #249581

d.a.n., If you simply expand medicare to the population as a whole you would not be creating a government run health care system. Medicare, right now, pays most of the medical bills in this country because it accepts the elderly and the disabled into its system. Why does it have to do this? Because no one else wants them!! Everyone is so concerned about government running our health care system (a system that many conservatives proclaim is the best in the world), and yet do not seem to acknowledge that medicare is already, now, deeply involved in a single payer system for all the sick, injured and disabled. All that’s being suggested is that healthy people be brought into that same system.
Medicare is going bankrupt because most of its members are in need of healthcare. (a guess, but a reasonable one.) A single payer system is far more efficient than what we have now. Filing and refiling claims, trying to figure out what Blue Cross, Pacific Care, Aetna, Kaiser, Life Care and all the thousand others require in claim verification in order to process it and generate a check to the health provider is costly, time consuming and wasteful. It is not unusual for an office to dedicate 25 to 30 percent of their resources to A/R the Get The Money department.
Where would tax money come from? I don’t know. Probably we should end the present employer based health care system, and raise taxes across the board. (a move espoused by the big 3 automakers for obvious reasons) You don’t need to go back the the 70 percent corporate taxes of the 60’s; maybe 39%, where it was in the 90’s (remember those years when we actually came close to a balanced budget). establish a higher tax rate on dividends and cap gains ( presently a tax benefit just about useless to the middle class in this country), establish a fair tax on estates that is indexed, take good care of the illegals who come to the emergency room AND THEN SEND THEM HOME!!, and establish a modest fee-for-each-service that will support the system and yet not keep people away from seeking medical help.
Finally, we need to be heavily taxing those things in our society that are bad for our health. Do I need to list them? ok. i will: ciggies, gas guzzling autos (don’t laugh, people who live along our freeway system here in Portland have extremely high levels of benzene in their blood) Cars that are less efficient are, I would think, more polluting. Food that is determined to be unhealthy. Why in the world would the government subsidize the production of corn syrup and give nothing to, say, the carrot growers? At least John Mccain is the honest one here with what he said to the Iowa caucus goers. Anyhow, my thoughts

Posted by: charles ross at March 30, 2008 11:13 PM
Comment #249582

Mr. Haney, I would like to point out that the rich pay most of the taxes in this country, not the middle class. They pay most of the taxes because THEY HAVE MOST OF THE MONEY!!!!!!
I’m not sure what “soaking the rich” means. After the’re soaked would they still be rich? Then I say soak ‘em!

Posted by: Charles ross at March 30, 2008 11:18 PM
Comment #249584

Charles,

Yes, exactly. The top 1% pay over 35% of the taxes. And so on… The point I am making is that a 5% increase in the top marginal tax rates creates no net increase on the average tax rate paid for the top 1%(see Note). Since most middle class Americans can’t access the tax shelters, they can’t avoid paying when the top marginal rates are increased.

I don’t know what soaking the rich means either. Though, I have to agree that soakin ‘em does sound like a good time.

Finally, I just saw the Congressional Budget Office report on the Geographic Variation in Health Care Spending, and I thought it might be of interest to those participating in this discussion.

Note: The tax rates in the IRS tables linked above are calculated using adjusted gross income. The graph in the article I linked before uses unadjusted gross or “comprehensive household” income for its calculation. The difference in calculation methods should account for the difference in the “average tax rate” trends.

Posted by: Mr. Haney at March 31, 2008 1:25 AM
Comment #249591

David,
“Efficiency in processing (maximizing patients per minute) is for-profit’s primary incentive, likely resulting in significantly higher malpractice events.”

That is not exactly true. For-profits’ incentive is maximizing profit. That means maximizing the amount of money paid by each customer and minimizing the loss per customer. The issue in malpractice events is that this often includes a scenario such as you describe in which there is a minimization of the number of practitioner-minutes per patient. When the HMO craze first hit in the ’80s I experienced this with the family practice clinic we went to as their patient burden suddenly grew exponentially. Doctors were so harried that they simply could not deal with the patient loads and they made mistakes. Such a strategy breaks down as a business model, though, because, as with our clinic, doctors refuse to continue the program. The HMO they had contracted with failed.

The strategy of the day is to cherry-pick only patients who will not use services and kick the rest down to the government. This is the industry blatantly throwing in the towel and making hay while the sun shines. This market place is going away and they know it. In ten years we will have some sort of centralized payment structure that provides the funds to deal with private medical contractors of some sort, and there will be a huge restructuring of the industry along the way.

As some mentioned before this discussion became principally about medicine I think the model that will eventually prevail in the reorganization will be like that of public infrastructure. By that model highways, for example, are designed and organized by government entities which contract with private firms to carry out their (our) desires. It is not the most efficient conceivable system, but it is the most practical one.

As for “soak-the-rich” tax systems, they are all variations on cutting the golden goose open. The rich are rich because they are productive and create jobs, goods, and opportunities. They are productive because they maximize the productivity of capital. Taxation reduces the amount of capital they have to maximize and, therefore, their ability to be productive and create jobs, goods, and opportunities. You may be able to maximize the tax output of the goose by keeping a laparoscope in it, scraping off bits of golden eggs, but you might also miscalculate and damage your source of gold.

What else happens when you “soak-the-rich”? Exxon-Mobil makes 12 billion dollars in a reporting period and people scream! Well, surprise, surprise! That is a pre-tax report. Those 12 billion are currently taxed at 42% in aggregate taxes which reduces MY RETIREMENT because the mutual funds in which I am invested own stock in Exxon-Mobil. Politicians want to REDUCE MY RETIREMENT EVEN MORE by slapping ME with “windfall profits taxes”.

That strikes me as typical scumball sleight-of-hand. As someone who has never grossed $80,000 in a year, and only got close to that once, I can say with confidence “soaking the rich” is a bad deal.

Posted by: Lee Jamison at March 31, 2008 9:41 AM
Comment #249592

I want to address tort theory for a moment because it is an important part of this discussion. In an entrepreneurial society torts are a means of keeping common sense in the process of dealing legally with a rapidly changing environment.

It is not hard, for example, to establish a fine stucture for traffic violations that helps us to provide order to automotive traffic. That’s because the parameters of street traffic have remained essentially the same for years.

Things are different in, say, the online computer environment. There the ways in which harm may be done can change almost by the day and one can’t anticipate how to create administrative controls for specific potential threats. Torts provide for us a means of asking, and answering, the question of whether harm has been done and whether the practitioners at a given state of an industry’s art could have anticipated that harm.

Unfortunately, because it is possible to make a lot of money in tort law, there is a disincentive to make the logical transition from the entrepreneurial phase of regulation to the administrative phase a more mature market demands.

Most of what passes for medical malpractice is utterly predictable. Procedures become well established as do the sorts of errors people can make in them. The logical approach is to establish administrative remedies in fines, reimbursements, and procedural oversights as formerly novel procedures work their way to maturity.

Torts are necessary. Preserved too long, however, they become an impediment to proper integration of technical advances in common practice.

Posted by: Lee Jamison at March 31, 2008 10:39 AM
Comment #249593

“No plan will satisfy all people or solve all problems”

Which is why our founders were smart enough to limit govt and leave such things up to the individual.

And respecting the rights of others and expecting your own rights to be respected as well, is now nothing more than “ideology?” If your going to take our “rights” out of the equation, then you might as well do it right and set everybodys pay as the same, make everybody drive the same vehicle, wear the same clothes, pay the same 80% in taxes, live in the same size house, make every business govt owned and let govt run every aspect of our lives.

As with most issues, rights are the main roadblock here, and the fact that you all are so eager to ignore that roadblock just because something else “may be easier” in your eyes, just shows how far our country has fallen.

The only thing special about the USA, is what we once had and what we foolishly gave up.

Posted by: kctim at March 31, 2008 10:48 AM
Comment #249594

“Those 12 billion are currently taxed at 42% in aggregate taxes which reduces MY RETIREMENT because the mutual funds in which I am invested own stock in Exxon-Mobil. Politicians want to REDUCE MY RETIREMENT EVEN MORE by slapping ME with “windfall profits taxes”.”

Lee the day Exxon pays 42% in taxes is the day I’ll kiss …. well lets just say that if you want me to believe that please show some proof. My bet is their actual tax rate is lower than mine.

Posted by: j2t2 at March 31, 2008 10:58 AM
Comment #249596

j2t2,
From Investor’s Business Daily I find these statements-

“This year, according to Mark Perry, the economist who made this striking observation on the Seeking Alpha Web site, Exxon will pay $30 billion in taxes, at a 42% rate, leaving $40.6 billion in profit.”

and
“And it’s not just Exxon Mobil that’s paying the freight. From 1977 to 2004, according to Tax Foundation data, U.S. oil companies cleared $630 billion after taxes while paying $518 billion in federal and state corporate taxes at an average rate of 45%.”

There has been online criticism of the editorial in question but the numbers are not all coming from a single source.

Posted by: Lee Jamison at March 31, 2008 11:14 AM
Comment #249597
charles ross wrote: Mr. Haney, I would like to point out that the rich pay most of the taxes in this country, not the middle class.
The tax system is regressive, as evidenced by Warren Buffet, who paid 17.7% in federal taxes on $46 Million in year 2006, while his secretary paid 30% in federal taxes on $60K. People point to the progressive income tax rates, but often omit a few key factors. Not all income is taxed the same. Capital gains are taxed at 15%, and are not subject to Social Security and Medicare taxes. Also, the Social Security cap of 94,200 (in year 2006; $97,500 in year 2007) is clearly regressive.
charles ross wrote: d.a.n., If you simply expand medicare to the population as a whole you would not be creating a government run health care system.
Where will the money come from?

Medicare is not even really pay-as-you-go, because the federal government is borrowing and creating money out of thin air to fund it.
The nation-wide debt is already $53 Trillion (3.81 times the naiton’s $13.86 Trillion GDP).
Interest on the $9.4 Trillion National Debt is costing $1.3 Billion per day in interest alone and the debt grows larger every day.
Americans need to look closer at the math, and they might seriously reconsider these vast programs to grow government ever larger.
Part of the problem is the myth perpetrated by pandering politicians that we can all live at the expense of someone else.

The nation is already swimming in massive debt, and suffering from multiple abuses, and reforms and abuses need to be addressed FIRST, before creating more vast and costly overnment-run systems that will most likely be mismanaged as badly (or worse) than the current Medicare, Social Security, and other various systems.
That may seem too ambitious, but it is in fact a necessity.

charles ross wrote: Medicare, right now, pays most of the medical bills in this country because it accepts the elderly and the disabled into its system.
Not really. That money is being borrowed and created out of thin air.

Also, many doctors already do not accept Medicare patients, and other limit their number of Medicare patients. Why is that?

Everyone is so concerned about government running our health care system (a system that many conservatives proclaim is the best in the world), and yet do not seem to acknowledge that medicare is already, now, deeply involved in a single payer system for all the sick, injured and disabled. All that’s being suggested is that healthy people be brought into that same system.

And based on the federal government’s track record, why should we believe an expanded health care system will be better (e.g. massive Medicare fraud; $12.8 Trillion borrowed from Social Security, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching; illegal immigration continues to cost Americans $70 Billion to $338 Billion in annual net losses; etc.)?

Regarding Medicare fraud, consider how many people could be treated with the $30 Billion in annual Medicare fraud (7% of the 432 Billion in Medicare expenditures in year 2007). Consider Bill Frist’s HCA hospitals, which bilked Medicare out of $1 billion (resulting in a final fine of $631 Million, which ended the investigation (www.sourcewatch.org/index.php?title=Bill_Frist#HCA-Medicare_investigation).

Corruption within government is a large part of the problem, since it is the duty of government to enforce laws, and prosecute violators. Instead, Bill Frist’s HCA paid a massive $631 Million fine, and the investigation was discontinued. The point is, the corruption is not only within for-profit corporations, but government too. And that is why the abuses should be addressed FIRST, before creating more vast and costly overnment-run systems that will most likely be mismanaged as badly (or worse) than the current Medicare, Social Security, and other various systems.

charles ross wrote: Medicare is going bankrupt because most of its members are in need of healthcare (a guess, but a reasonable one).
Medicare is already bankrupt, and the unfunded liabilities are growing, and the money is being borrowed and created out of thin air.

The math simply does not work.
The rapid growth in Medicare expenditures is fiscally unsustainable
The 2008 Medicare Trustees Report states that expenditures in 2007 were $432 billion, which is 16% of the federal government’s total $3.7 Trillion in tax revenues.
Medicare’s current costs (and borrowing) can not be sustained.
The federal debt can not grow much larger.
The federal government is already consuming about one fifth of the $13.98 Trillion GDP in federal taxes.
Even if the tax system is fixed to remove regressive taxation, it still would not be enough to support the unfunded liabilities.

Something has to give somewhere. Major changes in spending, taxation, illegal immigration, end the war in Iraq, and law enforcement would have to occur first, and that ain’t likely when too many voters continue to reward incumbent politicians with 93%-to-99% re-election rates.

Since those major reforms are very unlikely to come about voluntarily, they will more likely come about the more painful way, and the first casualty will be wide-spread economic consequences? Especially since the current candidates and Congress are so eager to pander to voters that want something from the government, instead of focusing on the abuses that are destroying our numerous social services.

charles ross wrote: A single payer system is far more efficient than what we have now. Filing and refiling claims, trying to figure out what Blue Cross, Pacific Care, Aetna, Kaiser, Life Care and all the thousand others require in claim verification in order to process it and generate a check to the health provider is costly, time consuming and wasteful. It is not unusual for an office to dedicate 25 to 30 percent of their resources to A/R the Get The Money department.
True. It’s ridiculous. However, even a single payer system (which I also advocate; non-profit too), that eliminates the middle-men (for-profit insurance companies) is part of the solution.

But that will fail also if the abuses are not addressed FIRST ( one-simple-idea.com/DisparityTrend.htm ).

charles ross wrote: Where would tax money come from? I don’t know. Probably we should end the present employer based health care system, and raise taxes across the board. (a move espoused by the big 3 automakers for obvious reasons) You don’t need to go back the the 70 percent corporate taxes of the 60’s; maybe 39%, where it was in the 90’s (remember those years when we actually came close to a balanced budget).
Corporate taxes should be eliminated, and corporations simply pass through health care and insurance costs ( one-simple-idea.com/TaxSystemReform.htm ). Corporate taxes are essentially regressive hidden sales taxes passed onto consumers. All sales taxes are regressive.

The first step to reforming the tax system is to simplify it to make it fairer (instead of the current system, which is regressive).
Addressing the many abuses to the tax system and health care system would save tax payers hundreds of billions per year:

  • (1) reduce fraud; enforce existing laws; reduce lawlessness;

  • (2) reduce the $70 Billion to $338 Billion in net losses due to illegal immigration (not to mention the untold cost of hundreds of hospitals closing, job displacement, and crime: VictimsOfIllegalAliens.com ). If Americans want all these numerous government-run services, Americans need to learn that they can not afford to provide them to tens of millions of illegal aliens too.

  • (3) fix the regressive tax system; the complexity alone costs billions per year;

  • (4) start bringing home the U.S. troops from Iraq (monetary costs ranging from $517 Billion to $2 Trillion; zfacts.com/p/447.html , www.nytimes.com/2008/03/19/washington/19cost.html)

  • (5) fix the inflationary, dishonest, usurious monetary system that creates bubble after bubble, breeds corruption, fuels ponzi schemes (e.g. the sub-prine mortgage melt-down), and destabilizes the economy; also, rework the regulations to increase transparency and accountability to reduce these bubbles which are driven by greed and rampant with fraud;

  • (6) reduce the 101,000 people killed per year due to adverse drug reactions; reduce the 195,000 people killed per year by preventable medical mistakes;

  • (7) deal with the massive $53 Trillion nation-wide debt

charles ross wrote: … establish a higher tax rate on dividends and cap gains ( presently a tax benefit just about useless to the middle class in this country), establish a fair tax on estates that is indexed, take good care of the illegals who come to the emergency room AND THEN SEND THEM HOME!!, and establish a modest fee-for-each-service that will support the system and yet not keep people away from seeking medical help.
Unfortunately, many Americans choose to ignore the cost of illegal immigration. Their compassion is misplaced when they, their children, and their fellow Americans that go without? And that is what is happening, as hundreds of overrun hospitals are closing (60-to-84 in California alone).
charles ross wrote: Finally, we need to be heavily taxing those things in our society that are bad for our health. Do I need to list them? ok. i will: ciggies, gas guzzling autos (don’t laugh, people who live along our freeway system here in Portland have extremely high levels of benzene in their blood).
You are right. It isn’t a laughing matter. Urban sprawl kills. The lack of urban planning is actually deadly (indirectly). A one hour commute (1 way) is 65 eight-hour days per year sitting in traffic. The fuel cost is only part of it. That isn’t healthy either. Air pollution in many cities are unhealthy. Dallas (where I live) don’t only have RED OZONE alert days, but PURPLE OZONE alert days.
charles ross wrote: Cars that are less efficient are, I would think, more polluting. Food that is determined to be unhealthy. Why in the world would the government subsidize the production of corn syrup and give nothing to, say, the carrot growers?
There are some common-sense things that cities and employers could do to greatly reduce traffic and congestion.

For one thing, all going to work at the same time (e.g. 8 AM) is not too smart.
If employers adjusted their shifts (e.g. 8 to 5, 9 to 6, 10 to 7, etc.), everyone would spend much less time in traffic (saving fuel and time).
Also, more mass transit would save fuel, money, and reduce air pollution.
Also, cities could increase the number of HOV lanes, and reduce the number of single occupancy vehicles.
And many people could take advantage of telecommuting (e.g. one or more days per week).

The problem is not so much that we lack good ideas and solutions.
The problem is that Congress and government is where good ideas and solutions go to die, and too many voters help cause it by repeatedly rewarding irresponsible incumbent politicians with 93%-to-99% re-election rates ( one-simple-idea.com/CongressMakeUp_1855_2008.htm ).

kctim wrote: Which is why our founders were smart enough to limit govt and leave such things up to the individual.
Which is why I still prefer a voluntary, non-profit health care system with only civil and government over-sight ( one-simple-idea.com/HealthCareSolutions.htm ).

I can accept paying taxes for national defense and welfare for the truly needy.
But it bugs me when government starts trying to take care of people from cradle to grave, and does such a pathetic job of it (as evidenced by massive Medicare fraud (7% of annual expenditures); the $12.8 Trillion borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby-boomer bubble approaching, regressive taxation, massive $9.4 Trillion national debt, massive unfunded liabilities, etc.).

Also, I think it may not only be a total flop, but could possibly contriubute to worsening economic conditions so severely as to bring about a severe economic down-turn, unless the many abuses hammering the economy are not addressed FIRST. That is, health care is important, but can any government-run health care system succeed without addressing the many abuses and problems that are already threatening the Social Security system, Medicare system, and the U.S. economy?

Posted by: d.a.n at March 31, 2008 11:24 AM
Comment #249598

From ExxonMobil’s Annual Income Statement on Yahoo Finance:

- - - - Income Before Tax - - Income Tax Expense
2007 - - 70,474,000,000 - - - 29,864,000,000
2006 - - 67,402,000,000 - - - 27,902,000,000
2005 - - 59,432,000,000 - - - 23,302,000,000

The tax rate they are paying is over 39% for each year including 42.38% for 2007. Is that proof enough?

Posted by: Mr. Haney at March 31, 2008 11:28 AM
Comment #249599

Mr. Haney No thats not but I will need to get back with you later with the “rest of the story”.
This issue was brought up within the past fews months on this blog and there is much more to it as I recall. Anyway duty calls.

Posted by: j2t2 at March 31, 2008 11:51 AM
Comment #249602

Recognizing that this is partly my fault, let’s try, for the time being, to keep this from becoming a tussle over taxes on the oil industry. There clearly is a value to this discussion in the exchange over the distribution of expenses over the breadth of the economy for medical expenses.

When we get into a tit-for-tat partisan argument what we are really doing is displaying a sense of powerlessness. If “We the People” really want to solve problems like that of medical care we must discipline ourselves to deal with issues as though we do have power to affect the outcome- and there is real significance to the manner in which we take up the issue. Politicans do not benefit from solutions. They are empowered by PROBLEMS.
Solutions, therefore, are up to us.

Posted by: Lee Jamison at March 31, 2008 12:31 PM
Comment #249604

d.a.n.,
You talk about ‘addressing the abuses’. How would you change the rules to do that?

For example, in this month’s Scientific American Magazine Michael Shirmer has an article about using rules based on game theory to reduce doping in sports. Game theory also applies in the inefficiencies in medical care. How do we use that to our advantage?

Posted by: Lee Jamison at March 31, 2008 12:41 PM
Comment #249605

I find it amusing to read some of the comments about raising corporate taxes. Apparently there are some who still buy into the magical thinking that corporations actually pay taxes. They don’t pay taxes but rather, merely collect taxes from you and me and pass them on to Washington. When I purchase a gallon of gasoline I have paid all the taxes levied all along the production line from drilling to filling at the pump. Included in the pump price are the corporate taxes.

How bright does one have to be to understand that only individuals pay taxes. If corporate taxes were increased by $1 on a gallon of gas which of the following would be true:

A. The oil company would loose $1 of profit.
B. The oil company stockholders would loose $1 of dividends.
C. The end-user would pay the $1 at the pump.

The next time you hear a liberal say something stupid like “let’s increase corporate taxes” just realize that they are advocating another tax increase on themselves.

Posted by: Jim M at March 31, 2008 12:50 PM
Comment #249613
Lee Jamison wrote: d.a.n., You talk about ‘addressing the abuses’. How would you change the rules to do that?
STOP these 10 abuses, because they are not only hurting the health care system, but dozens of other systems too (especially illegal immigration; fraud; regressive taxation; the usurious, dishonest, inflationary monetary system; growing the massive $53 Trillion nation-wide debt ever larger; the occupation of Iraq; and other lawlessness and Constitutional violations):
  • (01) STOP Lawlessness and corruption; enforce the laws and uphold the U.S. Constitution; stop pardons that put politicians above the law;
  • (02) STOP starting unnecessary wars; 7 wars in the last 90 years (about 1 war every 13 years); and stop the fear mongering and lies as an excuse to start wars; especially with wide open borders and thousands of Americans being killed (VictimsOfIllegalAliens.com) annually by illegal aliens;
  • (03) STOP all pork-barrel, graft, bloat, peddling influence, waste, and other abuses of power (e.g. such as Congress giving itself 9 raises between 1997 and 2007);
  • (04) STOP illegal immigration which is costing tax payers an estimated $70 Billion to $338 Billion annually in net losses;
  • (05) STOP election problems; election fraud, stop blocking access to ballots; implement common-sense election reforms, and give voters a printed verifiable receipt of their vote;
  • (06) STOP the borrowing, spending, and growing the massive $9.4 Trillion National Debt; stop plundering Social Security surpluses ($12.8 Trillion borrowed and spent, leaving it pay-as-you-go, with a 77 million baby-boomer bubble approaching; that’s 13,175 new entitlement recipients per day!).
  • (07) STOP abuse of the monetary system; inflation and force the Federal Reserve and government to target ZERO inflation and stop excessive money-printing;
  • (08) STOP regressive and unfair taxation;
  • (09) STOP the misinformation and ignorance. An educated electorate is paramount. Ignorance is not an excuse or defense, and will simply result in abuses and exploitation.
  • (10) STOP the unnecessary middle men (i.e. government and insurance companies) and fraud in the healthcare system; stop killing 195,000 per year by medical mistakes and adverse drug reactions; also, if the 9 problems above were adequately addressed, it would reduce the pressures on the healthcare systems and make health care more affordable and attainable;
Where will the money come from for all of the new (or expanded) systems (e.g. health care, Medicare, Social Security, etc.), when no one can even tell us where the money will come from to pay the interest on $53 Trillion of nation-wide debt, much less the money to reduce the principal $53 Trillion of debt, when that money does not yet exist?

The U.S. could be in for a rude awakening, because it can not control spending, debt, borrowing, and creating money out of thin air. And political dysfunction results in voters that complain, but repeatedly reward irresponsible incumbent politicians with 93%-to-99% re-election rates.

As a result, the following have never been (ever), and/or are at record levels:

  • (01) Total government debt is larger now (in size and as a percentage of GDP, when including the $12.8 Trillion borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching).

  • (02) Personal nation-wide debt has never been larger (ever), both in size and as a percentage of the $13.9 Trillion GDP.

  • (03) Total nation-wide debt ($53 Trillion) has never been larger (both in size and as a percentage of the $13.9 Trillion GDP).

  • (04) Real median household incomes have fallen since year 1999, and have actually been falling since year 1978 when also including the fact that there are more workers per household, more regressive taxation, and the disappearing 40-hour work week.

  • (05) Illegal immigration has never been worse and more costly, costing American citizens an estimated $70 Billion to $338 Billion annually in net losses. The problem has quadrupled since the amnesty of year 1986. Hundreds of overrun hospitals have closed (60-to-84 in California alone), California is now laying off 20,000 teachers in the public school system. 29% of all people incarcerated in Federal prisons are illegal aliens. The politicians capitalize on it 3 ways: (a) by dividing the voters, (b) by pitting American citizens and illegal aliens against each other to depress wages, and (c) by pandering for votes;

  • (06) The wealth disparity gap has never been larger since year 1930. It changed direction and has been growing larger since year 1976.

  • (07) Taxation has been regressive since year 2000 (or before).

  • (08) Home equities have never been lower (below 50%) since year 1945.

  • (09) Since year 2006 (money.cnn.com/2006/03/22/real_estate/homeownership_study/index.htm), home ownership has fallen for low-income and middle-income groups. A study shows that only 59.6% of working class families owned their homes in 2003, lower than the 62.5% in year 1978. That is, home ownership is rising among the wealthy, while falling for most Americans that are losing wealth, losing equity, losing income, and losing their homes at record levels.

  • (10) Foreclosures at at record levels.

  • (12) Average savings rates are negative (since year 2005), and at the lowest rate (-0.5%) since 1933.

  • (13) Energy vulnerability: oil and energy prices have never been higher ever (both in nominal price and adjusted for inflation; now higher than the spike in year 1981 (one-simple-idea.com/OilPrices20080320.gif).

  • (14) Some reports show home ownership increased, but it actually decreased for lower and income groups.

  • (15) The severely bloated federal government has never been larger, and continues to grow to nightmare proportions. There are now more jobs in government than all manufacturing nation-wide.

  • (16) Jobs are leaving the nation; a trend that started in the early 1970s, and helps to explain why real median household incomes have actually been falling since year 1978.

  • (17) Medicare and Social Security have never been in such dire straits and it will get worse before it gets better, because $12.8 Trillion was borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby boomer bubble approaching (that’s 13,175 new recipients per day!; www.socialsecurity.org/reformandyou/faqs.html#2).

  • (18) Global competition has never been stronger. Trade deficits have never been larger (see China: www.census.gov/foreign-trade/balance/c5700.html#2008). Transnational corporations want cheap labor. At this rate, when Americans are poor enough and cheap enough, the transnational corporations may return? WageStagnation + CheapLabor = BigProfits

  • (19) While inflation was higher in the mid-to-late 1970s and early 1980s, we have had positive inflation since year 1956. 3% to 5% inflation doesn’t sound bad, but when it is every year, it becomes exponential (i.e. 3% this year is really more than 3% of last year, which is more than 3% the year before, etc., etc., etc.). Thus, a 1950 U.S. Dollar is now worth less than 11 cents (one-simple-idea.com/USD_Falling.htm).

  • (20) Other exacerbating problems are 2 wars in Iraq (cost estimated between $517 Billion to $2.0 Trillion) and Afghanistan, skyrocketing health care costs, declining quality and rising costs of education, election system problems, lawlessness, and crime rates are on the rise again, after falling for many years.
Who thinks that above is all normal.

Where will the money come from to pay the interest on so much debt, when that money does not yet exist?

One obvious solution is to stop the abuses that are costing Americans hundreds of billions per year.
How much heatlhcare can be paid for with the $70 Billion to $338 Billion in annual net losses due to illegal immigration alone (and that does not even include the untold cost of job displacement and crime).

And what should be especially disturbing, despite all of the above, is that the majority of voters complain and give Congress dismally low approval ratings, but continue to repeatedly reward irresponsible incumbent politicians with 93%-to-99% re-election rates. Thus, voters have the government that the voters deserve.

Posted by: d.a.n at March 31, 2008 2:46 PM
Comment #249615
Lee Jamison wrote: d.a.n., You talk about ‘addressing the abuses’. How would you change the rules to do that?
It’s not so much that “rules” that need to be changed, as it is the “rules” that need to be enforced (i.e. law enforcement).

While there are some much needed reforms and some amendments needed, it is futile to hope Congress will ever pass any reforms when they are repeatedly rewarded for ignoring numerous common-sense reforms with re-election. In fact, Congress is already in violation of Article V, since 38 states (more than the 34 required) have already submitted applications for a BALANCED BUDGET amendment.

That is, it’s not so much new things (or “rules”) we need to do, as it is old things (abuses) we need to stop (with lawlessness at the top of the list).

And the voters are culpable too.
Things are likely to continue to get worse as long as too many voters repeatedly reward irresponsible incumbent politicians with 93%-to-99% re-election rates.

Posted by: d.a.n at March 31, 2008 3:24 PM
Comment #249622

I can agree with the principle that costs incurred by a business, a successful business, are generally passed on to the consumer, and that taxes are a cost; but costs also serve to restrain a business, to perhaps make them more efficient. By suggesting that raising taxes to corporations would also raise prices to consumers opens up many questions, the answers to which may be contraditory.
1. All corporations have one strong disincentive to raising their prices: it reduces unit volume. An increase in cost does not always result in a commiserate increase to the consumer because it drives the customer away. How have businesses responded to the drastic rise in fuel costs? Is it all passed on to the consumer or are efficiencies imposed. (big trucks not idling, reducing speed, etc.)

2. Sometimes raising costs allow businesses to increase profit as they are able to raise their profit margins under the cover of increased costs of materials, labor, new plant, (taxes?) I’m in the bread business. Ingredient prices and fuel prices are soaring and yet my parent company is doing better and better because they have folded increased margins into price increases that are occurring for other nominal reasons.

3. Just as raw materials, energy, new plant, etc provide a benefit to a business it should be asked by a business: What benefit do I receive for my taxes? Is it simply money down the rat-hole with limited benefit to me? Are my (the business) taxes too high? Are they too low? (don’t laugh, it is a legitimate question). Is it a benefit to my business that we defend not only territory but “national interests”? Would my business benefit or be harmed if we, for instance, eliminated Medicare and set up “an every man for himself” system of health care; a system where if you’ve got it you get it and if you don’t, you won’t. What does the general health of a society have to do with the prosperity of a business? Anything? How do long-term structural federal deficits affect a business? A lot? Not at all?

I’m not sure exactly where I’m going with this; probably something along the lines that taxes should be “right-sized”, that the issue of higher taxes equals higher consumer costs is simplfiying a complex issue, that there may be a level of taxes to corporations that are both harmful if they are too high and harmful if they are too low (what a concept!)
I would point out also that the very nature of a corporation is that it is a “person”, a fictional person but a person nevertheless. It was created, among other reasons, to allow the individuals who own, manage and work for them to avoid liablity; not completely, but it gives the real person a ‘vail’ under which he can run his business with risking his personal assets.
That’s it.

Posted by: Charles ross at March 31, 2008 5:00 PM
Comment #249625

Charles Ross, I read and reread your post trying to find some instance when corporate taxes are not passed along to the consumer.

In every instance you describe the consumer does pay the entire corporate tax when they buy the product. And, it’s not complicated, as you say, tabut actually simple to understand.

When companies choose to not pass along tax increases or reduce prices in response to competition it doesn’t affect the tax already embedded in the price you pay. The fact remains, they have added the tax they pay into the price of the product you purchase.

Price = cost of production + profit + taxes. If production costs and profit are reduced it will affect the price. But, taxes remain a part of the price.

And, when someone says, we need to increase the tax on corporations, they are endorsing an increase in the tax they pay on the product they purchase. I challenge anyone to present a convincing case that disputes my statement that only individuals pay taxes.

If corporations paid all taxes and individuals paid none on income or investments; to be revenue equal the federal government would have to increase corporate taxes by the amount not collected directly from individuals. The method use to collect this difference would be reflected in the price of the product. Where else would it come from?

Convincing people that they don’t pay the embedded tax in the goods they purchase is a great magic act by politicians. You pay all those high taxes and vent your anger on the nasty evil corporations. The politicians get what they want, higher taxes, and you get fooled again.

Posted by: Jim M at March 31, 2008 5:47 PM
Comment #249626

Charles ross,
I think where you were going with that was- if the benefit associated with a cost improves the structural position of your company (say, new roads ease your transportation of bread so your market can expand without you having to hire new people) then it actually improves your company’s situation.

In the medical care situation were we to provide a more orderly marketplace taxes on your business might actually offset a cost imposed by the current chaotic situation. Your employees might become less expensive to employ. If they, or their families, are healthier they might miss fewer days of work. If your customers are healthier they may be more prosperous and might feel comfortable buying more premium products, etc.

Close?

Posted by: Lee Jamison at March 31, 2008 5:49 PM
Comment #249629

Lee, that’s it. It’s difficult for a business owner to justify the payment of taxes as being a good, particularly to the feds. One reason that small business owners tend to buy the conservative argument that low taxes are good and lower taxes are better is that they must take the initiative to prepare and pay their taxes, in much larger increments, say quarterly rather than out of a weekly pay check. An employee sees the net after taxes are taken out, the small business owner pays his taxes out of what he perceives as being his net.
Jim, I think much of what I said suggests that increased costs incurred by a business are not passed on 1:1 to the customer. As costs increase, businesses seek to recoup not only through price increases to the customer but also through increased efficiency. Look at the converse as an example: If the federal tax on diesel were eliminated would the cost benefit to business be passed on to the customer on a 1:1 basis or would some of the benefit be folded into increased profits, and perhaps increased INefficiencies?
I own a S corporation. I am president, sole shareholder, my own board of directors and its only employee. If I were to incur an increase in costs (taxes, energy, insurance, maintenance, whatever) I would look first at efficiencies, then to raising the price to the customer (hypothetical in my case as I have no control over the price my customer pays for my product, but I think you get the idea). the reason why I would look at efficiencies first is that if I just raise prices 1:1 I will lose a certain unit volume that would counter the benefit to me of the increase. Does that make sense?
It does not really matter what the increase in cost is. If my tax rate was increased it would be just as much of an incentive to me to be more efficient in the use of fuel as it would be in the case of fuel prices being the increased cost.

Posted by: charles ross at March 31, 2008 6:20 PM
Comment #249631

Thanks Charles. My proposition pertains to income taxes but fuel taxes also are paid by the end-user as well. I understand that a compassionate and well managed business will attempt to control costs and remain competitive. However, no matter how well managed or despite the best intentions of the business it remains a fact that;

Price = Cost of production + profit + taxes.

Reduce cost of production to zero and profit by 50% and the price of the product will still reflect the tax the business pays. And, that tax can only be collected from the end-user of the product or service. Only if the company reduces it profit to zero will it not have a tax to include in the price of its product.

If my business earns no profit on which to pay taxes I will not be a business, but rather a philanthropic entity. I am sure you and others understand that I am not referencing intentional non-profit companies.

Posted by: Jim M at March 31, 2008 6:58 PM
Comment #249632

Let’s be clear about something. Government is only helpful if it creates a better environment in which to be human. We can interpret that in a wide variety of ways but, by and large, the governments that thrive best are the ones that create the best environment for entities that create and distribute those products that we need or that can acquire those things for us. Governments are a form of business. We are self-consciously taught otherwise, but that’s just a lie. Their “product” is structure. Taxes, therefore, are only worth something to us if a service of societal structure commensurate with our LOSS is provided and we are made better able to provide for ourselves as a result.

In this debate on medical systems we need to keep that in mind. Taxes are horrible, even tyrranical, if insufficient structure to make medical practice in America efficacious is provided as a result. If, on the other hand, the economy is freed from the burden of an ineffective, time consuming, medical rat-race even high taxes could make America more competitive in the world.

Posted by: Lee Jamison at March 31, 2008 7:45 PM
Comment #249634

Sorry Lee but I just gotta challange this.

“The tax rate they are paying is over 39% for each year including 42.38% for 2007. Is that proof enough?”

Mr. Haney what you are telling me is that Exxon’s income for 2007 is

- - - - Income Before Tax - - Income Tax Expense
2007 - - 70,474,000,000 - - - 29,864,000,000

However I beleive that the $70 bil figure is their profit(EBT) not their income. I would say their income would be $400 Bil. if their NIAT is 40 bil using a 10% profit figure. So the 40% figure you mention is what their book taxes are as a % of their profit not their income. So it would seem their actual tax rate is in the 7% range. What am I missing here?

Posted by: j2t2 at March 31, 2008 10:16 PM
Comment #249637

j2t2,

$404 Billion represents their revenue, not their income. Income is the gains after expenses. After you remove the cost of the raw materials, the $404 billion in revenue falls to roughly $172 billion. However, this number doesn’t really capture the gains because it doesn’t account for paying XOM’s employees and wear and tear on the XOM’s equipment. Once you subtract these expenses, you land up with roughly $71 billion…the earnings/income before taxes stated previously.

If I use your method of calculating tax rates, Charles Schwab (SCHW) pays a 33% tax rate. This is because your method makes the tax rate heavily dependent on the raw materials a company uses. For example, SCHW’s raw materials (blank financial forms) cost much less than the raw materials of XOM (petroleum). SCHW requires less revenue to recover the raw material cost compared to XOM. Thus, the low raw material cost of SCHW make it appear that they are paying a much higher rate than XOM. In fact, this is not the case because your calculation method is incorrect. Under the method that I used previously, XOM paid at a ~42% tax rate in 2007, and SCHW paid at a ~40% tax rate in 2007. These rates agree well with a calculation whereby the companies pay at the federal corporate tax rate (35%) plus at a range of state corporate tax rates between 4% and 10%.

Posted by: Mr. Haney at April 1, 2008 2:04 AM
Comment #249638

Oops, it should read…Charles Schwab (SCHW) pays a 13% tax rate. Sorry for the typo.

Posted by: Mr. Haney at April 1, 2008 2:07 AM
Comment #249642

Getting back on topic :)

Doctors support universal health care

WASHINGTON (Reuters) - More than half of U.S. doctors now favor switching to a national health care plan and fewer than a third oppose the idea, according to a survey published on Monday.

“As doctors, we find that our patients suffer because of increasing deductibles, co-payments, and restrictions on patient care,” said Dr. Ronald Ackermann, who worked on the study with Carroll. “More and more, physicians are turning to national health insurance as a solution to this problem.”

Posted by: womanmarine at April 1, 2008 8:55 AM
Comment #249643

womanmarine,
Thanks for that. Think what life must be like for doctors who are really focused on making their patients better. Does their plan let them reccommend that speicalist? Do they have to jump over some paperwork hoop for that procedure? How many times do they have to file a claim with “UnoCure” before one of them is not “lost”?
Will their malpractice insurance go up 40% this year like it did the last two years?

It’s not hard to understand the desire for some order.

Posted by: Lee Jamison at April 1, 2008 9:48 AM
Comment #249644

Lee:

I was a medical office manager. The paperwork and number of insurance companies was mind-boggling and labor intensive to file claims. It was a disaster, and I was considered one of the best at getting payment! I won’t do it any more. It’s a disgrace.

Posted by: womanmarine at April 1, 2008 10:11 AM
Comment #249645

My wife was not a manager but she was one of the people charged with dealing with the insurers (hence the reference to an non-existent brand name not necessarily intended to designate a real-life company…). Her experience was the same.

Posted by: Lee Jamison at April 1, 2008 11:15 AM
Comment #249647

Did you observe pharmaceuticals wining and dining the doctors, P.A.s, and other office staff?

Posted by: d.a.n at April 1, 2008 12:40 PM
Comment #249648

The parmaceuticals themselves? A vision of the drug version of Ready Kilowatt passed before my eyes…

Yes. In my personal experience this was not an extravagant affair, usually sandwiches, etc. It was, one time, a modest lunch at a local restaurant. The temptation may have been less in a pediatrics practice.

Posted by: Lee Jamison at April 1, 2008 1:16 PM
Comment #249649

Lee, the rich are increasingly investing in foreign countries, not ours, both directly and indirectly. What happens to the U.S. when 1% control 50% of the wealth and the US economy goes south? Obvious, wealth will chase better return on their money overseas, even move overseas if things get too bad here. Which amounts to a net export of about half of America’s wealth (minus significant losses trying to sell real assets in a market where there are no buyers).

This is the scenario America is building into our children’s future. If our young people understood this, they would take on the Revolutionary temperament of our Founders. A few are awaking to the impending reality, though.

Posted by: David R. Remer at April 1, 2008 4:20 PM
Comment #249650

David, that’s a scary scenario. What is your projected date for this to happen? And, what can be done to prevent it?

Posted by: Jim M at April 1, 2008 4:24 PM
Comment #249651

David,

I am engineering graduate student and am consistently around young people that do vote and do see the impending reality. However, I know the math/science skill set of my peers is why they see the impending financial crisis, and therefore I think it represents the minority of young Americans. I think the general lack of financial literacy among Americans makes your scenario difficult to avoid because they won’t demand the problem be addressed until the window of opportunity has passed.

Jim M,

The window to address the long term solvency of Social Security closes around 2020. For Medicare, this window occurs a little earlier. Clearly, Medicare is already creating problems in the health care system. After these windows close, it leaves only painful options such as the financial collapse of these programs…possibly via Great Depression II route David describes. To prevent it, the 65+ crowd must demand cuts in their benefits to ensure the future of their children, grandchildren, etc.

Posted by: Mr. Haney at April 1, 2008 11:19 PM
Comment #249667

Mr. Haney thanks for your advice to us 65+ crowd. You know what, I think I’ll first demand cuts in discretionary spending by congress. Second, demand cuts in the bloated salaries of our millionaire legislators. Third, demand cuts in Medicaid payments for the long-term care of the wealthy who artificially impoverish themselves to qualify for benefits. And fourth, demand a balanced federal government.

I believe your response Mr. Haney, was done tongue-in-cheek as I can’t believe anyone would seriously make this recommendation.

I read this morning that Senator Obama is considering the advice of his mentor Warren Buffet to call for an increase in the capital gains tax. Isn’t that just great, increase taxes at a time when our economy is just beginning to make some gains. Apparently Obama doesn’t realize that ordinary Americans have much of their retirement funds invested in the equity market? More money will flee the country and hasten the day David Remer talked about in post #249649.

Posted by: Jim M at April 2, 2008 11:29 AM
Comment #249674

Jim, I agree that those cuts should be made, but they will not address the Medicare/Social Security problem. Currently, these programs consume 7.5% of GDP which is roughly $1 Trillion or a third of the federal budget, and expenditures are growing at about 5% a year. Medicare and Social Security are projected to consume 9.75% of GDP by 2020 (~$1.9 Trillion) and 12.5% of of GDP by 2030 (~$3.2 Trillion). Over the same period, the payee to beneficiary ratio will shrink from 3:1 to 2:1. Funding shortfalls are a certainty if nothing changes.

Here are a few of the options to make up for the shortfalls:
(a) raise payroll tax percentage
(b) raise payroll tax ceiling
(c) raise other taxes
(d) restructure the programs to reduce benefits to some or all Americans
(e) reduce the cost of Medicare per beneficiary (w/o benefit changes)
(f) grow real GDP much faster than the historical average of 3%

The likely solution is some combination of these options and those I didn’t think of off the top of my head. The first three options simply push the problem out a few more years or hasten David’s scenario, and so by themselves, they don’t constitute a solution (unless you are a politician). A planned reduction in benefits, while painful, is superior to a unplanned reduction if our economy withers due to lack of investment. Thus, my statement was said somewhat tongue-in-cheek because I know Americans won’t demand it and a politician won’t dare propose it. I do however think it is part of the overall solution.

Posted by: Mr. Haney at April 2, 2008 2:20 PM
Comment #249675

While many will not agree with me, I believe the plan promoted by President Bush regarding fixing Social Security had some merit. Had he received more support from congress, instead of all the political posturing, together, they may have come up with a long-term solution.

I am a conservative and am usually against any kind of tax increase. However, under the right circumstances I and my conservative friends may be willing to support an increase in the payroll tax ceiling.

And, we should start now to ween American’s off the SS system now in effect. At some (to be determined) age young workers could be given the opportunity to invest a percentage of their payroll deduction for SS into a private plan. Then, allow the percentage to increase over the working years of that employee. This, combined with an increase in the payroll tax ceiling and some sort of means testing for future wealthy retirees could begin to fix the problem.

Congress can not, and should not, attempt any reduction in benefits to current retirees who played by the rules, made their contribution over their working lifetime, and rely upon those benefits to live.

Posted by: Jim M at April 2, 2008 2:49 PM
Comment #249679

Seeing we spend more on military than the rest of the world perhaps just cutting the military budget by 20% would help solve the problem.

As far as medicare/medicaid why not get rid of insurance companies for a single payer plan and make it more self sufficent?

Wasnt Bush’s solution to privatize it? Wall street and the deregulation of the past years should have taught us that the privateers are no better than the feds, when it comes to feeding at the trough of taxpayer money. Besides I already have a 401k why would I need another investment plan in lieu of insurance? Why not put SS back to a seperate fund and save for the future?

Posted by: j2t2 at April 2, 2008 3:08 PM
Comment #249683

I’m a conservative too and agree with you whole heartedly. I would love to be in control of some of my SS deduction. My primary concern is that the political posturing will not allow a solution to be implemented before more severe consequences are locked in. I don’t want to take anyone’s benefits away, but the longer we wait, the more likely it is that cuts would need to reach beyond the wealthiest retirees. Now how do you get such a plan proposed immediately? Then, how do you sell such a solution to the American public?

Posted by: Mr. Haney at April 2, 2008 3:27 PM
Comment #249687

Mr. Haney, you’d like to be in control of some of your SS deduction?
What would you invest in? Maybe some Bear Sterns, How about Citigroup? A little WaMu? Home builders may be a good buy. The Depot was up to 70, 7-8 years ago, what is it now, 27 or so?
Like it or not. If you invest your money, you are going to be doing it in such a way that involves risk. Risk means winners and losers. Winners and losers mean that some people will end up with little or nothing. What do you do with the losers? Screw ‘em?
It’s a little like the health care problem; the “winners” (healthy people) and the “losers” ( people who get sick or hurt).
Society (the government, you, me) has a vested interest in making sure people don’t get too poor, or too sick. I know that is socialist but I do feel the rest of it, the capitalist part, won’t work without that principle in place.
Take the example of Bear Sterns because it is a good one. This is an investment bank heavily involved in buying and packaging mortgage debt together and reselling it to their investors. When defaults rose (that’s the little guy sending the “jingle” mail (keys) to the agency servicing their loan) and interest in purchasing this sort of package collapsed, BSC got caught holding the bag. It’s as clear an example of the connection between the health and wealth of the little guy and the health of the system as a whole. Rich people should care that all those who are not rich have an interest, a stake in society. If there emerges a large enough percentage of people who have nothing it creates a problem for everybody.
All those (formerly) rich people at Bear Sterns (and there were a lot of them). Do you think they gave a rat’s ass about whether or not some poor schmo could make a mortgage payment?
They should have!
Social Security is not a type of investment. It is a type of insurance. It offers a level of certainty for old age and/or disability to the extent promised. That means there is a high level of probability that you will receive an income when and in the amount promised.

Posted by: charles ross at April 2, 2008 4:22 PM
Comment #249692
A planned reduction in benefits, while painful, is superior to a unplanned reduction if our economy withers due to lack of investment. Thus, my statement was said somewhat tongue-in-cheek because I know Americans won’t demand it and a politician won’t dare propose it. I do however think it is part of the overall solution.
“Planned”, or not, reductions in benefits will be necessary. Medicare (16%) and Medicaid (7%) were already 23% of the $2.7 Trillion federal budget in year 2007.
(f) grow real GDP much faster than the historical average of 3%
How, when these things have never been worse now, and/or since the 1930s and 1940s, and these abuses continue to make most Americans poorer each year?

The chances of any adequately-managed federal government-run health care system are not good, based on Congress’ current track record with Medicare, Social Security, and other irresponsible deeds of the past several decades. But there is one thing most (if not all) Congress persons can agree on in a heart beat: their own raises (such as their 9 raises in the past 10 years; while our troops risk life and limb, go without armor, medical care, and promised benefits).

Posted by: d.a.n at April 2, 2008 4:44 PM
Comment #249693

Charles, if SS is a type of insurance, why would liberals be so in favor of it as they mostly hate insurance companies. OH, WAIT, this is government insurance…that’s different.

If you know anything at all about the equity market you would understand that an investment (equal to the SS premium paid) in just the stocks making up the Dow Jones over a period of 40 years would yield more than ten times the current SS benefit for the same premium.

And, just as important, when you die, the remainder of your private investment would go to your heirs.

You could purchase a term life policy covering your working years that would provide a much larger death benefit to your spouse and children than SS would ever provide and for much less premium.

Have you ever heard of annuities? No one has ever lost a dollar invested in an annuity and I sure as hell would rather have my retirement in an annuity than in SS.

Posted by: Jim M at April 2, 2008 4:47 PM
Comment #249697

charles ross,

The proposal for SS never would have allowed people to choose individual stocks but would have allowed a menu of stock combinations and indices such as the S&P 500. Overall, though there may be periods as long as seven or eight years where such groupings stagnate, there has never been a 20 year period in which stocks overall did not grow by an average of 7% or more. I’ll take that over Social Securiy’s pretend (pretend because the principal is gone) growth rate of 1.5% any day. No one who has ever invested in a legitmate S.&P. 500 indexed fund has ever lost their principal over time, either.

Besides, if a business steals our principal as the Congress has we can put its officers in prison. I doubt we’ll get that satisfaction with 60 years worth of politicians.

Posted by: Lee Jamison at April 2, 2008 5:15 PM
Comment #249710

j2t2 said “Why not put SS back to a seperate fund and save for the future?”

How are you going to guarantee that politicians won’t revert back to the current system?

Lee and Jim, thanks for responding to Charles.

“How, when these things have never been worse now, and/or since the 1930s and 1940s, and these abuses continue to make most Americans poorer each year?”

d.a.n., this country is capable of consistently growing real GDP in excess of 3%, but I agree that a lot would have to change for it to do so. It’s not realistic, but it is possible.

Posted by: Mr. Haney at April 2, 2008 9:05 PM
Comment #249711

“How are you going to guarantee that politicians won’t revert back to the current system?”

The same way you would guarantee that Bear Stearns wouldnt belly up and leave the stockholders in a mess while the CEO walks away with $60 mil. There are no guarantees. It would be up to the people to learn from past mistakes and make sure their rep would vote against it. How many people are left holding the bag on private pension funds from public companies that defaulted?

“if SS is a type of insurance, why would liberals be so in favor of it as they mostly hate insurance companies. OH, WAIT, this is government insurance…that’s different.”

If it is? its called Old age survivors and disability Insurance Program (OASDI). It benefits not only the retired but young children that have lost a parent and those that are disabled. Im not sure annunities and such would do that if you die at 24 and leave a 5 year old behind.

Posted by: j2t2 at April 2, 2008 9:35 PM
Comment #249715

Lee, unfortunately investing in individual stocks is not the only way to lose your principle in the stock market. The scheme offered by w to divert money away from Social Security would have allowed investment in both mutual funds and index funds. It would have allowed the investor to switch in and out of various investments and it is the ability to move funds from one instrument to another that presents the risk.
What if you had invested into a S & P Aa rated bond fund in, say, 1992, saw your money increase at a modest %4-5 a year and then decided, say in 2000, to switch your principal and gained interest over to the QQQ fund (a fund that tracks the top 100 Nasdaq stocks) when it was at the top of its cycle, @ 5000 or so, then watched it decline by 80 percent (which is what it did). Then, at the moment of greatest pessimism, switched out of this Nasdaq 100 index and back into 10 year t-bills yielding around 3.5 percent, then, when the market moved back up to its peak, the funds are moved into a “solid” gold fund (hey, gold’s at 1000 an ounce, it has no where to go but up, right?). At that point the investor, without having purchased a single share of an individual stock, is looking at his prospective retirement and wondering what the hell happened.
And besides, you say that investors would not “be allowed” to invest their own money as they wish? Say, in Bear Sterns a month ago? Why not? I thought that was one of the big selling points of individual accounts, that people would have a choice. Isn’t “freedom of choice” one of the mantras on this board?
Jim, I admit it can be a confusing concept, insurance, that is. It should cover unknown events (diability, death) happening in the future. What I like about Social Security is that it takes my “premium” and passes it immediately on to a beneficiary
(At this point I must take a time out to thank D.A.N. in advance for the commentary that will soon be appearing pointing out that actually, there is no money, it’s all debt. Thank you!).
There is no profit, no advertising and only a modest overhead in Social Security and because of the insurance aspect of it and its relative security, it is a good deal in my opinion.
Back to investing. I have been investing for many years and I know for a fact that the average person out there is as dumb as a fence post when it comes to investing money. I’m sorry to say that but It is somehow a taboo subject to talk about, learn about or engage in. Hasn’t the recent subprime mortgage debacle demonstrated just that?

Posted by: charles ross at April 2, 2008 10:49 PM
Comment #249720

Charles, I am completely agree that someone would find a way lose their money. Wouldn’t this percentage of people be on par the number who already lose their money in 401(k) accounts? Since 55% of Americans hold these accounts, it’s reasonable to assume you could get an estimate of the “failure rate” by gathering a bit of data. I am willing to give a good, hard look at the numbers before I throw up my hands and say “It will never work! The American public is too ignorant to invest their own money.”

I would also like to point out that people would control only a third of the money paid into SS. The SSA would still operate as social insurance on the remaining two thirds.

Posted by: Mr. Haney at April 3, 2008 1:26 AM
Comment #249723

yes, Mr. Haney, people would still receive a benefit on the 4% that SS would pay. I know, I have had a lifetime of investing experience and I have made money. I follow the stock market every day, I read the 26 annual reports that are filed on each of the companys I own stock in. I consider myself to be pretty sophisticated in that narrow area of the stock market I am familiar with. And yet, over 34 years of trading, buying and selling, buying and holding, holding the stock, selling covered calls, selling cash-secured puts I have to say that I don’t have a vast fortune in front of me. I’ve done ok but when I turn 66 and start receiving a 1500 buck payment from SS, I will need it!! : )

Posted by: charles ross at April 3, 2008 1:46 AM
Comment #249738

charles ross,
“There is no profit, no advertising and only a modest overhead in Social Security and because of the insurance aspect of it and its relative security, it is a good deal in my opinion.”

!?!?! Charles, the MONEY’S gone! It has been spent. There is no there there. You can talk about theoretical promises and the “insurance” aspect from now till there are ski jumps in Hades , but the only way any of those promises will be kept is at the expense of a generation that has only now begun to work. They must re-make the principal. They must then begin to pay on the interest. All of the smoke and mirrors you think you see as some rock-solid future is really the ‘bankers’ (our Congress) laying a new form of slavery on the backs of our children and grandchildren and calling that “the full faith and credit” of the Federal government.

In your “worst case” example there is still principal left at the end of your exercise, which makes it infinitely better than the Social Security scam you would replace it with.

Posted by: Lee Jamison at April 3, 2008 9:08 AM
Comment #249752
Lee Jamison wrote: !?!?! Charles, the MONEY’S gone! It has been spent.
Essentially, that is correct.

There are some I.O.U.s and some surplus money in Social Security, but it is far exceeded by other federal debt, and Social Security is not a separate lock-box.
$12.8 Trillion has been borrowed and spent from Social Security, leaving it pay-as-you-go, which is not good with an approaching 77 million baby-boomer bubble (13,175 new recipients per day; 25% of the total U.S. population).

And in a far worse condition is Medicare (16%) and Medicaid (7%); a combined 23% of the $2.7 Trillion federal budget for year 2007.
Medicare alone was $432 Billion, and much of it had to be borrowed, helping to grow the National Debt to $9.4 Trillion (as of Mar-2008; 67% of GDP).
If the $12.8 Trillion is included, the total federal debt is $22.2 Trillion, and the nation-wide debt is $66 Trillion!

Mr. Haney wrote: d.a.n., this country is capable of consistently growing real GDP in excess of 3%, but I agree that a lot would have to change for it to do so. It’s not realistic, but it is possible.
Not consistently, and not without other negative costs.

Growing GDP by 3% would not be enough (from $13.86 Trillion to $14.3 Trillion).
Growing GDP by 3%, 5%, and 10% for 5 years straight would not be enough.

RATE = __ 3% ______ 5% _____ 10% __
2007 _ $13.86T _ $13.86T _ $13.86T
2008 _ $14.28T _ $14.55T _ $15.25T
2009 _ $14.70T _ $15.28T _ $16.77T
2010 _ $15.15T _ $16.04T _ $18.45T
2011 _ $15.60T _ $16.85T _ $20.29T
2012 _ $16.07T _ $17.69T _ $22.32T

It is very unlikely that the U.S. can grow GDP, and tax, and immigrate, and borrow, and create enough new money out of thin air to dig our way out of $53 Trillion of nation-wide debt.

For example, growing the U.S. population by 5 million per year (mostly due to illegal immigration) is costing most Americans annual net losses of $70 Billion to $338 Billion ($1.4 Billion to $6.7 Billion per state). The growth in GDP for the past decade has gone mostly to the wealthy, while real median household incomes have fallen since year 1999 (and since 1978 or earlier if you also factor in more workers per household). At this moment, the GDP growth rate is falling, and GDP for year 2008 could easily fall below that of year 2007, as the fiscal problems, massive $53 Trillion of nation-wide debt, $9.4 Trillion federal National Debt, massive illegal immigration, regressive taxation, 2 wars, declining quality of education, exploding health care costs, mortgage melt-down, and the usurious, inflationary, predatory, dishonest pyramid-scheme monetary system takes its toll on the economy.

Also, 3% this year is more than 3% of last year, which is more than 3% of the previous year, … etc.
That is exponential growth, which is not compatible with sustainability.

The $53 Trillion Nation-wide Debt:

  • If we had the discipline to stop borrowing $3 Billion per day, and start paying down the $53 Trillion nation-wide debt by $5.81 Billion per day (2.121 Trillion per year = 15.3% of the $13.86 Trillion GDP), it could take more than 272 years (at only 4.0% interest), and the total interest cost would be $525 Trillion.

  • Even if there was only a 2.0% interest rate on the $53 Trillion nation-wide debt, and we had the discipline to stop borrowing and spending irresponsibly, and started paying down the debt by $5.81 Billion per day (2.121 Trillion per year = 15.3% of the $13.86 Trillion GDP), it could take more than 34 years, and the total debt and interest would be $74 Trillion.

The $9.4 Trillion National Debt:
  • If pork-happy Congress had the discipline to stop borrowing and spending irresponsibly, and started paying down the $9.4 Trillion National debt by $1.161 Billion per day ($588 billion per year = 21% of the federal government’s total $2.7 Trillion tax revenues in year 2007), it could take more than 153 years (at only 4.5% interest; one-simple-idea.com/NationalDebtPayOff20060101.gif), and the total debt and interest would be $578 Trillion.

  • Even if there was only a 2.0% interest rate on the $9.4 Trillion National Debt, and if pork-happy Congress had the discipline to stop borrowing and spending irresponsibly, and started paying down the $9.4 Trillion National debt by $1.161 Billion per day ($588 billion per year = 21% of the federal government’s total $2.7 Trillion tax revenues in year 2007), it could take more than 30 years, and the total debt and interest would be $12.4 Trillion.

Therefore, whatever sort of new government-run health care system is created, it had better save money, or it will flop miserably, grow the $9.4 Trillion National Debt to dangerous levels, and that is not far-fetched based on the federal government’s track-record at mismanaging the Social Security, Medidcare, and Medicaid systems for many decades. All of those systems are in dire straits, pay-as-you-go, and the ratio of recipients to tax-payers is increasing with the beginning of the 77 million baby boomer bubble.

Therefore, it is very unlikely that the U.S. can afford to take on a vast new government-run health care system.
The government should first address these 10 abuses that are hurting the healthcare system (and many other systems).

3% growth in GDP will not be enough (not even close).
Especially with growing global competition, increasing energy costs, declining quality and rising cost of education, 30% of Americans not completing High School (news.yahoo.com/s/afp/20080401/lf_afp/useducationsociety), etc., etc., etc. (one-simple-idea.com/PressingProblems.htm)

It is very unlikely that the U.S. can grow GDP, and tax, and immigrate, and borrow, and create enough new money out of thin air to dig our way out of $53 Trillion of nation-wide debt.
The danger is that the Federal Reserve will continue to create new money out of thin air, and that will be equally disastrous, since the dollar has already fallen so far since year 1999.

Where will the money come from to pay the interest alone on the $53 Trillion of nation-wide debt, much less the money to reduce the principal of $53 Trillion of nation-wide debt (3.81 times the $13.9 Trillion GDP), when that money does not yet exist, 80% of the U.S. population owns only 17% of all wealth, and the U.S. Dollar has already been falling drastically since year 1999 against all major international currencies (one-simple-idea.com/USD_F alling.htm)?

No matter which way you run the numbers, they don’t look good.
Do you really think Congress is up to the challenge when most voters repeatedly reward incumbent politicians with 93%-to-99% re-election rates?
That one reason alone should be ample reason for serious concern.
Unfortunately, based on the track-record of Congress for the past 30+ years, it is quite likely inaction and the status-quo will continue, and numerous systems will simply fail, such as the hundreds of hospital closures (60-to-84 in California alone) due to being overrun by illegal aliens. Hope alone is not a strategy. Where will the money come from? We can’t all endeavor to live at the expense of everyone else. It does not work.

At any rate, the voters will have the government that the voters elect, and repeatedly rewarding irresponsible incumbent politicians with 93%-to-99% re-election rates has not, and will not resolve existing problems that plague existing systems, and will almost certainly doom new vast systems.

Posted by: d.a.n at April 3, 2008 11:03 AM
Comment #249755

CORRECTION:
The $9.4 Trillion National Debt:

  • If pork-happy Congress had the discipline to stop borrowing and spending irresponsibly, and started paying down the $9.4 Trillion National debt by $1.161 Billion per day ($588 billion per year = 21% of the federal government’s total $2.7 Trillion tax revenues in year 2007), it could take more than 153 years (at only 4.5% interest; one-simple-idea.com/NationalDebtPayOff20060101.gif), and the total debt and interest would be $578 $65 Trillion.

Posted by: d.a.n at April 3, 2008 11:16 AM
Comment #249770

“Social Security is not a type of investment. It is a type of insurance”

It used to be a type of insurance, but has since become an excuse to not save for ones own responsibilities.
The same will happen to socialist healthcare.

Posted by: kctim at April 3, 2008 3:23 PM
Comment #249772

kctim said “It used to be a type of insurance, but has since become an excuse to not save for ones own responsibilities.
The same will happen to socialist healthcare.”


Bull crap kctim I have paid into SS for years yet I still have a 401k, although the 401k is more of a gamble than a saving account. Seems according to Mr Haney 55% of people do the same.Those that dont have the SS plan to fall back on. At least they wont be sleeping in the streets and starving because they have no money coming in.

Posted by: j2t2 at April 3, 2008 3:41 PM
Comment #249795

Merely based on track-record and the worsening trend of 30 years, these systems (Social Security, Medicare, Medicaid, and a new government-run health care system, etc, etc., etc.) are likely to all fail unless several abuses causing the worst economic statistics ever, and/or since the 1930s and 1940s are addressed first. Especially since no one knows where the money will come from to pay only the interest on $53 Trillion of debt, much less the money to reduce the principal debt and keep it from growing larger (already 3.81 times the $13.86 Trillion GDP). The inflation that will be required to simply prevent the pyramid-scheme from finally collapsing will be so economically destabilizing, a new government-run health care system will only be one many systems that will most likely fail.

The Federal Reserve has made $610 Billion in new loans this year (14-Jan-2008, 28-Jan, 11-Feb, 25-Feb, 11-Mar, 17-Mar, 24-Mar; - www.federalreserve.gov/newsevents/press/monetary/2008monetary.htm), and the demise of the 5th largest investment bank (Bear Stearns; now JP Morgan), are signs of more fundamental problem that are being ignored and treated with short-term solutions; which will probably make future recessions worse. The Federal Reserve is essentially nationalizing the debt, and debasing the U.S. Dollar.

The money simply does not exist for all the spending Americans want.

Posted by: d.a.n at April 3, 2008 7:21 PM
Comment #249797

The money simply does not exist for all the spending Americans want.
Posted by: d.a.n at April 3, 2008 07:21 PM

d.a.n. it’s too bad that so many folks don’t understand your simple and true statement. We tend to blame our politicians for out-of-control spending but in reality, they are only following our wishes.

When the spending directly benefits us, we don’t complain, it’s always the spending done on behalf of someone else, or some other interest, that raises our ire.

All discretionary spending must be stopped immediately. All the fraud and waste must be wrung out of our existing social programs and military spending. When we get back to bare-bones government our economy and citizens will once again flourish.

Posted by: Jim M at April 3, 2008 7:43 PM
Comment #249802

j2t2,
Actually, yes, they will be sleeping in the street because they have no money coming in. All it will take is for the generation enslaved to taxes on their behalf to outnumber them and vote.

Since the Social Security generations failed to force their politicians to back up the promises with real money and keep it there there is no moral imperitive for future generations not to insist that they pull their own weight.

You can’t make a promise to yourself with another person’s money. That is precisely what a set of generations has done in social security.

Posted by: Lee Jamison at April 3, 2008 9:03 PM
Comment #249810

“Actually, yes, they will be sleeping in the street because they have no money coming in. All it will take is for the generation enslaved to taxes on their behalf to outnumber them and vote.”

Lee, I cant say I would blame them for voting their interest. I even have to agree that its our own damn fault.

“You can’t make a promise to yourself with another person’s money. That is precisely what a set of generations has done in social security.”

Lee when you pay into the system you feel like its your money to. At least that was the agreement. I dont feel like Im promising other peoples money at all. Although technically you may be right morally your not. The sad part is the Bush plan would only serve to destroy the system quicker. Which I guess is the plan.

Posted by: j2t2 at April 4, 2008 1:01 AM
Comment #249811

d.a.n, did you read my entire statement??? You act like I suggested GDP as a solution by itself. It’s not. I didn’t say it was. It can’t be. You would have stand DC politics on its head and write off trillions in government promises to accomplish that kind of growth (i.e. a complete overhaul of federal, state, and local governments). But as you said “Unfortunately, …it is quite likely inaction and the status-quo will continue…” So I repeat, it is possible, but it’s not realistic.

Posted by: Mr. Haney at April 4, 2008 2:13 AM
Comment #249817
Mr. Haney wrote: d.a.n, did you read my entire statement??? You act like I suggested GDP as a solution by itself. It’s not.
Not true. I was agreeing with you. Posted by: d.a.n at April 4, 2008 5:54 AM
Comment #249820

Bull crap J2?
Do you deny that we are a society which has been trained that we must have the latest and greatest gadgets?
Rather than buying a reasonable TV, auto, clothes etc…, people must have that 50+ inch plasma, $25,000+ auto and so on. They place their immediate want, over their future needs and they do so because they believe SS to be their retirement plan and that socialist healthcare will pay.

“At least they wont be sleeping in the streets and starving because they have no money coming in”

They wouldn’t be sleeping in the streets and starving if they would have worked and planned either. But why should they, when their unresponsible behavior is rewarded and encouraged.

Posted by: kctim at April 4, 2008 9:24 AM
Comment #249822
Jim M wrote: When we get back to bare-bones government our economy and citizens will once again flourish.
Yet, look at the severe bloat now. There are now more jobs in government than all manufacturing. Let’s try to put some of it in perspective. Which of the following things should we be (or not be) forced to do?
  • (01) pay taxes for law enforcement?
  • (02) pay taxes (i.e. local state, district, county, or parish) for public education ?
  • (03) pay taxes for $57.3 Billion (year 2005; with 4,487 federal employees) for the Dept. of Education (Executive Branch)?
  • (04) pay taxes for the $371 Billion (year 2005; with 2 million federal employess) for the (www.defenselink.mil/sites/) Dept. of Defense (Executive Branch)?
  • (05) pay taxes for the $40 Billion (year 2005; with 180,000 federal employess) for the Dept. of Homeland Security (Executive Branch)?
  • (06) pay taxes for the truly needy (e.g. welfare)?
  • (07) pay taxes for $66.8 Billion (year 2005; with 67,000 federal employees) for the Dept. of Health and Human Services (includes Medicare and Medicaid) (Executive Branch)?
  • (08) pay taxes for the streets, traffic signs, and traffic signals ?
  • (09) pay taxes for public (free) hospitals?
  • (10) pay taxes for subsidies for farms (some owned and operated by corporations) ?
  • (11) pay taxes for welfare for foreign nations ?
  • (12) pay taxes for the war on drugs?
  • (13) pay taxes for the border security?
  • (14) pay taxes for the $19.1 Billion (year 2005; with 109,832 federal employees) for the Dept. of Agriculture (Executive Branch)?
  • (15) pay taxes for the $5.8 Billion (year 2005; with 40,000 federal employees) for the Dept. of Commerce (Executive Branch)?
  • (16) pay taxes for the $31.3 Billion (year 2005; with 16,100 federal employees) for the Dept. of Energy (Executive Branch)?
  • (17) pay taxes for the $10.8 Billion (year 2005; with 71,436 federal employees) for the Dept. of the Interior (e.g. land management, Indian arts, park services, minerals, etc.) (Executive Branch)?
  • (18) pay taxes for the $22.0 Billion (year 2005; with 109,000 federal employees) for the Dept. of Justice (e.g. FBI, Attorney General, ATF, prisons, Tax Division, etc.) (Executive Branch)?
  • (19) pay taxes for the $11.9 Billion (year 2005; with 17,347 federal employees) for the Dept. of Labor (Executive Branch)?
  • (20) pay taxes for the $10.3 Billion (year 2005; with 30,266 federal employees) for the Dept. of State (Executive Branch)?
  • (21) pay taxes for the $61.6 Billion (year 2005; with 60,100 federal employees) for the Dept. of Transportation (Executive Branch)?
  • (22) pay taxes for the $10.8 Billion (year 2005; with 115,897 federal employees) for the Dept. of the Treasury (Executive Branch)?
  • (23) pay taxes for the $51.0 Billion (year 2005; with 219,000 federal employees) for the Dept. of Veteran Affairs (Executive Branch)?
  • (24) pay taxes for the Judicial Branch (e.g. Supreme Court, Courts, etc.)?
  • (25) pay taxes for the Legislative Branch (e.g. Senate, House of Representatives, President of the Senate, etc.) ?
  • (26) pay taxes for hundreds of Independent Agencies (e.g. National Science Foundation, NASA, Federal Reserve System, etc.)?
  • (27) pay taxes for dozens of quasi-official Agencies (e.g. Smithsonian, Technology Reinvestment Project, National Consortium for High Performance Computing, etc.) ?
  • (28) pay taxes for dozens of Federal Boards, Commissions, and Committees (e.g. Appalachian Regional Commission, Commission of Fine Arts, U.S. Institute of Peace, etc.) ?
  • (29) pay taxes for hundreds of Tangential Non-Government Agencies (e.g. Energetic Materials Research and Testing Center, The Food and Drug Law Institute, CSPAN, ) ?
  • (30) pay taxes for these (acuf.org/issues/issue35/050503gov.asp) top 10 ways the federal government wastes money?
  • (30) pay taxes for hundreds of redundant programs:
    • 342 economic development programs;
    • 130 programs serving the disabled;
    • 130 programs serving at-risk youth;
    • 72 federal programs dedicated to assuring safe water;
    • 50 homeless assistance programs;
    • 45 federal agencies conducting federal criminal investigations.
The Federal Government is so out-of-control, so bloated, and so wasteful, it may be approaching (if it has not already reached) the point in which is adds no net benefit to society?
Lee Jamison: You can’t make a promise to yourself with another person’s money. That is precisely what a set of generations has done in social security.
Excessive dependency on government is probably a sign of things to come?
  • ,-(1) Corruption, oppression, totalitarianism, pain and misery,
  • | (2) courage, Responsibility, rebellion,
  • | (3) liberty, growth, abundance,
  • | (4) selfishness, complacency, fiscal irresponsibility,
  • | (5) apathy, dependency, fiscal & moral bankruptcy,
  • ` - - return to step (1)
Pandering politicians, promise much, deliver little, and perpetuate the “great fiction through which everybody endeavors to live at the expense of everybody else”. — by Frederic Bastiat 1848

It’s not easy trying to live at the expense of everyone else … especially when your nation is swimming in massive see of debt ($53 Trillion), and no one can tell us where the money will come from to merely pay the interest on $53 Trillion, much less the money to pay on the principal to keep the debt from growing beyond the current nightmare proportions.

Overall Spending For Federal Lobbying (for 6 months: 7/1/05-12/31/05): $1,201,255,222 (politicalmoneyline.com/)
Average: $200,209,204 per month.
Leading Sector Spending For Federal Lobbying (7/1/05-12/31/05):

(01) Health Care Lobbying $183,324,757
(02) Communication, Technology Lobbying $158,841,159
(03) Finance, Insurance Lobbying $155,734,737
(04) Energy, Natural Resources Lobbying $92,525,968
(05) Transportation Lobbying $90,645,605
(06) Business - Retail, Services Lobbying $86,514,946
(07) Miscellaneous Lobbying $79,726,535
(08) Defense Lobbying $52,008,222
(09) Manufacturing Lobbying $51,695,791
(10) City/County Lobbying $47,032,198
(11) Agriculture Lobbying $40,364,028
(12) Single-Issue Groups Lobbying $39,881,570
(13) Real Estate/Construction Lobbying $32,017,367
(14) Foreign Countries Lobbying $18,423,869
(15) Law Lobbying $16,579,872
(16) Organized Labor Lobbying $13,643,353
(17) Undetermined Lobbying $12,555,967
(18) State/Territories Lobbying $8,118,766
(19) Public Employees Lobbying $2,671,000

Notice which lobbyists are at the top of the list (i.e. (01) Health Care).
Hmmmmm … and we wonder why healthcare is so expensive ? ! ?
How many jobs could be created with that money ($1.201 Billion in lobbying spending in only 6 months).

Just think if all those billions were spent on something constructive.
Is giving all that money to incumbent politicians making them more responsible? (one-simple-idea.com/Links1.htm)
90% of elections are won by the candidate that spends the most.
And 99.85% of all 200 Million eligible voters are vastly out-spent by a very tiny 0.15% of all 200 million eligible voters, who make 83% of all federal campaign donations of $200 or more (www.opensecrets.org/pressreleases/DonorDemographics02.asp).
The average American is being vastly out-spent.
Why can’t Congress get much of anything constructive done, but Congress is somehow able to give itself cu$hy perks and a raise faster than you can say pork-barrel (e.g. 9 raises in the last 10 years)?

There are two groups in America:

  • (1) one group that derives concentrated power and wealth from its concentrated wealth. Some rich people (not all), who are cheaters and extremists, abuse their wealth to control and influence government. Those certain rich persons don’t want to work in Congress, but chooose to control and influence incumbent politicians with money, power, etc. Too many Congress persons (in BOTH parties) are FOR-SALE.

  • (2) The other group is the majority of Americans, that could have power by their numbers, but their power is largely ineffective due to their inability to mobilize through education and education (such as merely not repeatedly rewading irresponsible, bought-and-paid-for incumbent politicians with 93%-to-99% re-election rates).

If most voters want a severely bloated and corrupt government, and pandering politicians to grow government to larger and larger proportions, the pandering politicians will be more than happy to oblige; to create another vast new government-run health care system full of money to plunder and mismanage (such as the $12.8 Trillion borrowed and spent from Social Security, leaving it pay-as-you-go, with a 77 million baby-boomer bubble approaching, such a Medicare and the $30 Billion of annual fraud, etc.). Just based on track-record, why should we expect anything different?

What ever health care system the already severely bloated federal government creates, it will also be pay-as-you-go, because the government can not save.

The federal government (and increasingly, state and local governments too) only know now to borrow and spend (as evidenced by the $9.4 Trillion national debt, and the $12.8 Trillion borrowed and spent from Social Security, leaving it pay-as-you-go).

Rather than probably making our problems bigger, we should first consider the reasons making health care unaffordable and dangerous.

Here if roughly where most of medical expenditures go (in descending order):

  • (01) Hospitals and doctors (52% of medical expenditures in year 2006);

  • (02) Illegal Immigration (many billions in some states; 32% of illegal aliens receive welfare and/or Medicaid, and/or Medi-Cal; total net losses due to illegal immigration are $70-to-$338 Billion per year; hundreds of hospitals are closing (60-to-84 in California alone) shifting more burdens to other hospitals; 70% of women giving birth at Parkland Memorial hospital in Dallas,TX in only the first 3 months of year 2006 were illegal aliens (www.snopes.com/politics/immigration/parkland.asp); 29% of all incarcerated in federal prisons are illegal aliens, which also use medical services aside from the daily cost of incarceration; the costs of illegal immigration go far beyond medical expenditures alone; statistics from the Los Angeles Dept. of Public Social Services reveal that illegal aliens and their families in Los Angeles County received over $36 million in welfare and food stamp allocations in January 2008, 25%w percent of all welfare and food stamps benefits are going directly to the children of illegal aliens. Illegal aliens received over $19 million in welfare assistance for January 2008, and over $16 million in monthly food stamp allocations, for a projected annual cost of $420 million; with the additional cost of $220 million for public safety, $400 million for healthcare, and $420 million in welfare allocations, the total cost for illegal immigrants to Los Angeles County taxpayers far exceeds $1 Billion per year, which does not include the million$ (or billion$) for public education);

  • (03) Pharmaceutical corporations (10% of medical expenditures in year 2006);

  • (04) Insurance companies (12% of insurance premiums (not expenditures); health insurance, malpractice insurance for doctors, etc.);

  • (05) Politicians, government (Medicare fraud of about $30 Billion per year, bureaucracy, inefficiencies, waste, bloat, and see list of lobbying spending above; Congressman Bill Frist (R-TN), who owned a large portion of the HCA hospitals, bilked $1 Billion from Medicare, and $631 Million was returned, and the investigation was discontinued);

  • (06) Lawyers (2% of medical expenditures in year 2004; malpractice, 195,000 people die annually due to preventable medical mistakes; etc.);

  • (07) Patients (bad habits, smoking, addictions, obesity, lack of exercise, etc.);

There are many things that can be done to reduce health care costs, but too many refuse to look at the problems (such as fraud and illegal immigration) and think a new vast system will fix everything.

It won’t.
It will simply make it much worse.
Already, no one can tell us where the money will come from to pay for the things we already have that are already in trouble (i.e. the federal government is borrowing hundreds of billions per year).
No one can tell us where the money will come from to pay the interest alone on $53 Trillion of nation-wide debt, while many economic conditions are now worse than ever, and/or since the 1930s and 1940s (now causing rising unemployment). A big part of the problem is lawlessness and other abuses (e.g. laws ignored, war(s) based on false intelligence, usurious and inflationary lending abuses, regressive taxation, plutocracy, massive burdens on health care, law enforcement, education, welfare, Medicaid, Medi-Cal, border patrol, insurance, and prison systems and many other systems due to illegal immigration, etc.)

At any rate, the voters will have the government that the voters elect.

  • Posted by: d.a.n at April 4, 2008 9:59 AM
    Comment #249823

    “Do you deny that we are a society which has been trained that we must have the latest and greatest gadgets?” I know they try kctim but truthfully I know 1 family that owns a 50 ” TV and they traded for it. While Im sure that not the norm there are quite a few of us that dont take to the training as well.

    “They place their immediate want, over their future needs and they do so because they believe SS to be their retirement plan and that socialist healthcare will pay.”

    Do you have any evidence of this? I know its nice to think it but I have never heard anyone say Im buying this or that because SS will take care of me later.

    “They wouldn’t be sleeping in the streets and starving if they would have worked and planned either. But why should they, when their unresponsible behavior is rewarded and encouraged.”

    Do you mean like those whose pensions have disappeared planned? kctim investing is a lot like gaming. When you have someone that won big you also have many who dont.Saving your money in a saving account that pays 1% is well foolish yet how many places pay better for using your money.
    Do you realize that SS also pays out to survivors. I know a man that died at 24, his daughter who is 5 was able to receive monthly payments to help out with the costs of raising her. How do you plan for that when you are 5 or how much should a 24 year old have in the “when I die unexpectedly fund”?

    The problem with SS is that it went to the general fund years ago and that should change.


    Posted by: j2t2 at April 4, 2008 10:08 AM
    Comment #249827

    I know we drifted but from a Yahoo article
    “Part of the problem in the U.S., too, seems to be how we spend our health care dollars. We’re last among 19 industrialized nations in preventable deaths. We spend a fortune on health care, but it’s not working — an irony glossed over in the politicized health care debate. Our Bad Medicine Columnist Chris Wanjek notes:

    The United States has by far the highest level of health spending per capita in the world: nearly $6,100 or 15.4 percent of the GDP, according the World Health Organization. Scandinavian countries, with their universal healthcare coverage, pay less than half of this.

    Yet the United States has one of the lowest life expectancies among developed nations, at about 78 years, which is lower than Cuba’s and marginally beats Slovenia, according to United Nation’s figures.

    Posted by: j2t2 at April 4, 2008 10:46 AM
    Comment #249830

    J2
    And I truthfully know a family of 6, who makes under 30 a year, who just dug another hole for themselves, and got one. They “needed” it for the new XBox 360 and Blue Ray they got earlier in the year.
    Its on credit and they pay outrageous monthly payments instead of planning for their kids education, their healthcare or their future. And what about their retirement? They are “hoping” to be able to have everything payed off by the time they are retired so that they won’t owe anything and live off SS AND hoping that universal healthcare will be passed by then and take care of their medical expenses that come with age.
    Their story is not the exception, it is the norm.

    And yes, I do realize SS also pays survivors and I believe a totally voluntary plan to help survivors would be great.

    I agree that investing is alot like gaming J2, but you don’t put all your eggs in one basket when gaming and you don’t when investing.
    You plan and you don’t take risks which jeopardize that plan.

    Healthcare isn’t a mess because nobody cares, its a mess because nobody plans, and “continuing a health care discussion” without acknowledging this will accomplish nothing.

    Posted by: kctim at April 4, 2008 11:28 AM
    Comment #249832

    “Do you realize that SS also pays out to survivors. I know a man that died at 24, his daughter who is 5 was able to receive monthly payments to help out with the costs of raising her. How do you plan for that when you are 5 or how much should a 24 year old have in the “when I die unexpectedly fund”?

    Posted by: j2t2 at April 4, 2008 10:08 AM

    Answer, the 24 year old can have a 20 year term life policy of $1 million for about $12 per month. He can then convert the term life to whole life when the children are grown, and with additional premium retire at 65 with vastly more income from the policies cash value than he will ever receive from SS. And, all along the way to retirement the money in his life insurance grows free of income taxes and is accessible to him for emergencies, business opportunities or whatever.

    And, when he dies, there will be little bit more than the $250, provided by SS, in his policy to bury him.

    Posted by: Jim M at April 4, 2008 11:46 AM
    Comment #249836

    d.a.n.,
    I apologize. To me, your agreement was lost among all the words.

    j2t2,
    Americans must take some of the blame for their lower life expectancy. I live in the Colorado Front Range where proper diet and exercise are more widely practiced, and the average life expectancy tops 80. It’s by no means the only factor, but if people take responsibility for their health, they live longer.

    Posted by: Mr. Haney at April 4, 2008 12:55 PM
    Comment #249843

    Mr Haney I to have lived along the front range, on and off since 1978. I will be moving back there within a few shory months. I have also lived in other places mostly in western states and while I dont disagree that those in Colorado are better than average it seems its not that much better than most other western states I have lived and/or worked in.

    Of course Americans must take responsibility for their healthcare but then so must all those people in the other countries and the stats are the stats. Are you saying we are victims of the corporate advertising that promotes the junk food and soda’s to our young kids? Maybe those corporations that indoctrinate the young ones at such an early age should be held responsible for the costs of their actions? We could also hold those corporations that load our foods up with corn syrup and sugar responsible to. There seems to be a lot of responsibility to go around but the facts still remain that we spend more than others and get less results.

    Jim M “Answer, the 24 year old can have a 20 year term life policy of $1 million for about $12 per month.”
    I would say that your answer is sound but if it would have been left to this 24 year old the 5 year old would not have gotten anything. He just wasnt established enough to recognize the importance of life insurance when most of the time he couldnt afford car insurance. The inequities in the costs of things and the wages paid over the past 2 decades have forced a lot of people to live paycheck to paycheck and to do without non necessities. However I might be interested despite my low level of trust in the insurance companies. :)

    As far as insurance goes how many payments would he have been able to miss before all of the advantages of the policy you mention would have been down the drain?

    Posted by: j2t2 at April 4, 2008 3:33 PM
    Comment #249845
    j2t2 wrote: The problem with SS is that it went to the general fund years ago and that should change.
    True.

    In the beginning, it was supposed to be a separate account. But within only a few years, Congress found a way to spend the surpluses, and have been doing it ever since; essentially turning it into a giant ponzi scheme. Not it is pay-as-you-go, with a 77 million baby boomer bubble approaching.

    Mr. Haney, Me too. I can now see that my response was badly worded and it is easy to see why it appeared as though I was disagreeing, even though we both agree that GDP alone can’t fix it, and exponential growth can not be sustained indefinitely.

    I think some in government were hoping growth would stay strong in order to help the fiscal situation.
    However, it looks like a recession is now underway (80,000 lost in Mar-2008

    BTW, I am not opposed to Social Security or Medicare, provided they are not constantly over-budget, mismanaged, fraught with fraud, plundered (such as the $12.8 Trillion borrowed and spent from Social Security), and politicized by pandering politicians contantly promising more benefits.

    These systems must be managed much better, or phased out.

    Otherwise, all of those systems will die a horrible death all on their own.

    However, it does not seem likely that Congress will manage those systems better :

    • based on Congress’ dismal track-record of the past 30+ years; Congress will not stop borrowing and spending;

    • because the federal government is deep in debt, and it is growing fast; and the government has been borrowing for years to pay the hundreds of billions per year in interest alone (Fiscal Year OCT-to-SEP):
      • 2008: $198,517,767,159 (OCT-2007 to FEB-2008);

      • 2007: $429,977,998,108

      • 2006: $405,872,109,316

      • 2005: $352,350,252,506

      • 2004: $321,566,323,971

      • 2003: $318,148,529,152

      • 2002: $332,536,958,599

      • 2001: $359,507,635,242

      • 2000: $361,997,734,302

      • 1999: $353,511,471,723

      • 1998: $363,823,722,920

      • 1997: $355,795,834,215

      • TOTAL: $4 Trillion in interest alone since year 1997 !

    • because Congress pats itself on the back when they were merely able to nearly balance the annual budget in 1999.

    • because the usurious and inflationary monetary system and the fractional lending is too highly leveraged (9-to-1 in which 90% of new loans from the Federal Reserve are new money created out of thin air), and the $53 Trillion nation-wide debt is 3.81 times the nation’s $13.86 Trillion GDP. There’s a very good reason why the Federal Reserve is nervous. Their house of cards could collapse at any time, but the pyramid-scheme will most certainly collapse when the nation simply can no longer carry more debt, and $53 Trillion is already almost half of the nation’s net-worth (but 80% of Americans own only 17% of all wealth in the U.S.)

    • because enough voters (who are culpable too) will not stop repeatedly rewarding corrupt and irresponsible incumbent politicians with 93%-to-99% re-election rates (at least, until that becomes too painful);

    • … other reasons …

    Posted by: d.a.n at April 4, 2008 4:12 PM
    Comment #249849

    j2t2,
    I dont feel like Im promising other peoples money at all. Although technically you may be right morally your not. The sad part is the Bush plan would only serve to destroy the system quicker. Which I guess is the plan.

    OK, what I’m saying is that, while people did pay into the system, (1) the system they set up was more expensive than their payments could reasonably have been expected to support and, (2) they permitted the financial foundation of the system to be undermined by allowing it to be “borrowed” to finance unremarkable general obligation spending. This is exactly analogous to the consumer boom from allowing people to borrow on their home equity so that they could fritter that equity away on vacations and eating out. After a while one has to cut back on lifestyle.

    At least with the home equity situation judgement comes due on the original homeowner. With Social Security, though, the belt-tightening is passed down to a different generation.

    That’s what I think was wrong. The original Social Security bargain was real. People really did pay in and keep their money there. It was when Congress decided to borrow on the savings that the evil was done and a generation passed the burden of “full faith and credit” on to a series of generations who could not say “no” to the bargain they were being saddled with.

    I support the plan Bush outlined precisely because it would have put a potion of the Social Security funding in capital investments that would have grown the fund through the profitability of real production rather than through the added burden of greater taxes. Capital investments can at least make a given amount of labor produce more. Social Security taxes can’t and never will. Thoe SS taxes will, eventually make the work of the whole economy so inefficient that capital is chased from the country.

    Posted by: Lee Jamison at April 4, 2008 5:40 PM
    Comment #249853

    Lee:

    Capital investments are guaranteed and secure? Is that what you are saying?

    Posted by: womanmarine at April 4, 2008 7:26 PM
    Comment #249864

    Lee I concur. The Bush plan I was thinking of was the medicare/medicaid plan although I didnt make it clear. It seems to me the intent of the repubs in general and Bush in particular is to crash the medicare system and it is working. Its part of the starve the beast strategy. It is working.

    The Bush SS plan was intended to privatize the system and put the taxpayers money into the hands of the wall street crowd. That is akin to “putting the fox in charge of the chickens”.

    Posted by: j2t2 at April 5, 2008 1:28 AM
    Comment #249889

    “Jim M “Answer, the 24 year old can have a 20 year term life policy of $1 million for about $12 per month.”
    I would say that your answer is sound but if it would have been left to this 24 year old the 5 year old would not have gotten anything. He just wasnt established enough to recognize the importance of life insurance when most of the time he couldnt afford car insurance. The inequities in the costs of things and the wages paid over the past 2 decades have forced a lot of people to live paycheck to paycheck and to do without non necessities. However I might be interested despite my low level of trust in the insurance companies. :)

    As far as insurance goes how many payments would he have been able to miss before all of the advantages of the policy you mention would have been down the drain?
    Posted by: j2t2 at April 4, 2008 03:33 PM

    j2t2, How many payments could he miss in paying SS? Since term life has no cash value he would loose his coverage with non payment of premium. If he converted the term policy to permanent life insurance he could use the cash value in the policy to pay premiums if he needed to do so. Insurance companies, similar to banks, are required to reserve a percentage of premium to insure payment of claims.

    The purchase of life insurance from companies with high financial ratings presents nearly no risk of default or non-payment of benefit.

    At 24 years old I believe this person should be weened from the government teat and not require the government nanny any longer making his personal decisions.

    Posted by: Jim M at April 5, 2008 11:27 AM
    Comment #249890

    “Are you saying we are victims of the corporate advertising that promotes the junk food and soda’s to our young kids? Maybe those corporations that indoctrinate the young ones at such an early age should be held responsible for the costs of their actions?”

    No, I am saying you are responsible for what you put in your body. If you are a parent, you are responsible for educating your children on proper eating habits and enforcing them. Ignorance is not an excuse. The information on proper eating habits isn’t a secret. So if you body falls apart when you eat purely junk, it’s your own fault. You don’t simply get to pass the blame to corporations when you ignore the consequences of your own bad habits.

    Posted by: Mr. Haney at April 5, 2008 11:57 AM
    Comment #249899

    “How many payments could he miss in paying SS?”
    He would not miss any when he was working and receiving a paycheck. However SS would not be cancelled when he wasnt working and did miss a paycheck.

    “At 24 years old I believe this person should be weened from the government teat and not require the government nanny any longer making his personal decisions.”

    What government teat, what government nanny? Such ridiculous rhetoric. He pays into the system, its not your money, its not government money that was given to him, there are no hand outs. This system was put in place at our consent it wasnt forced upon us by anyone. You were represented and had your say. That rhetoric may help to stir up the AM talk radio crowd but its really such a overstatement and doesnt reflect the facts IMHO.


    “You don’t simply get to pass the blame to corporations when you ignore the consequences of your own bad habits.”
    But surely Mr Haney those that would manufacture and sell such food must also bear the full costs of their product shouldnt they? This is akin to saying that drug dealers should not be held responsible for selling you the drugs that cause your death. Certainly both parties are responsibility yet only 1 party is paying the price. Wish I was a corporation with that logic then I wouldnt be held responsible for my actions. I could even brag about a much higher tax rate than I actually pay. :)

    Posted by: j2t2 at April 5, 2008 6:13 PM
    Comment #249938

    j2t2 Would you voluntarily place your retirement savings into a plan that you know would be flat broke in 20 years?

    Try not paying the payroll taxes on your earnings and see just how voluntary SS and Medicare really is.

    Posted by: Jim M at April 6, 2008 5:18 PM
    Comment #249997

    “Would you voluntarily place your retirement savings into a plan that you know would be flat broke in 20 years?”

    Wow Jim M this appears to be one of those “do you still beat your wife” questions.

    “Try not paying the payroll taxes on your earnings and see just how voluntary SS and Medicare really is.”

    The difference between the public insurance plan and the private insurance plans is the fact that you pay into the public plan when you get paid. When you dont get paid you are not expected to pay into the plan. The private insurance plans require a constant feeding or you will be involuntarily removed from the plan. Of course this benefits the private plans as they can cut and run with years upon years of your money should you be out of work and unable to pay just 1 time. This predatory approach just wont work in the future as jobs are becoming more transitory, the competition from foreign workers coming to this country legally and illegally to drive wages down, and the outsourcing of jobs to communist and other slave wage nations continues. To continue with this stay the course approach to insurance in general will only serve to put more of a burden upon the backs of the next generation.


    Posted by: j2t2 at April 7, 2008 2:59 PM
    Comment #250042

    j2t2, using your logic of only paying when you’re working is a little lame. When one is not working do they no longer pay for housing and food? One should never be in debt for a car or anything else for fear of loosing their job? Not very realistic.

    The primary fallacy with your kind of thinking is that we, as individuals, simply can’t manage or plan our lives effectively and need government wisdom and government social programs to keep us from ruination.

    Posted by: Jim M at April 8, 2008 11:47 AM
    Comment #250079

    “using your logic of only paying when you’re working is a little lame.

    Its not my logic Jim M it is how SS/Medicare works as far as paying into the system. It is taken out of your paycheck, when you are working you pay in when you dont receive a paycheck you dont pay in. That actually sounds logical to me. What sounds illogical is paying into a plan for years then missing a payment and having your coverage terminated. Sounds rather predatory to me. Who would encourage someone to do that and call it logical?

    “When one is not working do they no longer pay for housing and food?”

    For some people without savings etc. Jim M. that is exactly what happens. Now throw insurance into the mix and what goes first?

    “One should never be in debt for a car or anything else for fear of loosing their job? Not very realistic.”

    I agree Jim M but then I find the fraudulent “globalization ” scheme that seems to be causing these problems not very realistic for a lot of middle class and lower middle class workers either. Yet here we are.

    However as far as trying to tie housing and food in with insurance wouldnt you agree that insurance would have to be the first to go. That was my point and why SS and Medicare is there for those that need it long after the private insurance companies have taken the money and run.

    “The primary fallacy with your kind of thinking is that we, as individuals, simply can’t manage or plan our lives effectively and need government wisdom and government social programs to keep us from ruination.”

    Not at all Jim M.. Most people manage quite well for most of their lives, however sometimes events outside of their control requires them to make use of the money they have paid into the government programs such as SS/Medicare/SUTA. I dont know anyone that plans to be out of work for any length of time Jim M. However they do pay into a system that minimally helps to cover expenses when they are. Most guys I know try to save for the downtime but after the years of stagnant wages and rising costs that is getting harder to do. It just happens, especially with our headlong rush into the winner take all economy. If they had to rely upon private insurance then to me that would be foolish because when you need them most is when they turn on you. Why do you think these government programs came into being? Wasnt because the insurance companies and stock market were doing the right thing.

    Posted by: j2t2 at April 8, 2008 8:20 PM
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