AMERICAN CONSERVATISM IN 2008 AND BEYOND

REDs (i.e., RE-Distributers) seek to equalize wealth, because they believe it will minimize human resentment and the agression it produces.

MACs (i.e., Modern American Conservatives) seek to equalize liberty, because they believe it will maximize human accomplishment and the self esteem it produces.

However, equalizing wealth has not minimized human resentment and the agression it produces, while equalizing liberty has maximized human accomplishment and the self esteem it produces.

The original objective of the Constitutional Republic of the United States of America was equalizing liberty. Let's re-establish that original objective, and again let wealth be accumulated in proportion to accomplishment.

http://www.mysanantonio.com/opinion/Federal_health_care_reform_would_cost_Texas_dearly.html
Web Posted: 09/11/2009 12:00 CDT
Federal health care reform would cost Texas dearly
As Congress continues its health care debate, the American public is focused squarely on the implications that current federal proposals will have on our nation's economy, health-care system and fiscal future.

“The Prognosis for National Health Insurance: A Texas Perspective,” the recent report by internationally renowned economist Arthur Laffer for the Texas Public Policy Foundation, concluded that a reform based on President Barack Obama's principles " including an estimated $1 trillion increase in federal government health subsidies over 10 years " will accelerate health-care inflation; slow our economy, cost every Texas resident an additional $4,265, and still leave about 30 million Americans uninsured.

But Laffer's report also addresses a critical angle that has been largely missing from the debate so far: what effect these proposals would have on the various states. As his research found, a larger government role in health care would impose a huge budget burden on Texas.

Texas would experience lower overall economic activity as well as increased pressures on our state budget.

Even more troublesome is the proposed expansion of Medicaid eligibility, estimated to cost as much as $600 billion over the next decade. If the federal government requires states to pay for this expansion of lower-income individuals' health insurance, the hit to Texas' budget will be staggering.

The House Tri-Committee Reform Proposal would force states to expand Medicaid eligibility to 133 percent of the poverty level and lock in current benefit levels. Although the federal government would initially cover new Medicaid enrollees under the plan, the lack of flexibility could damage Texas' ability to manage its growing Medicaid costs.

The Senate plans being discussed would force states to expand Medicaid eligibility to 150 percent of the poverty level, with the increased costs shifting to states after five years.

Even if the federal government were to absorb the full cost of Medicaid expansion, the cost to the state budget of health care reform, based on President Obama's priorities, is $8.89 billion, or $365 per Texan. Requiring Texas to foot the bill would sap as much as $28.2 billion from our state treasury.

Because Texas does not have the option to run trillion-dollar deficits, the proportion of health care expenditures as a percentage of total tax revenues would increase as well. Texas' tax collections would have to increase $2.1 billion just to cover the increase in health care expenditures in 2019 " even if the federal government bears the full cost for Medicaid expansion.

And the threat to our state budget doesn't end there. Expansion of Medicaid eligibility may create additional Medicaid costs in Texas. The Frew v. Hawkins lawsuit was based on inadequate access for Medicaid enrollees because the state's physician reimbursement was so low that not enough doctors would take Medicaid patients. Even after the reimbursement rate was increased 25 percent in 2007, the situation still exists.

Going from healthy budget surpluses to California-style financial distress in a few years " that's not the outcome Texans deserve from Congress.


Arlene Wohlgemuth is a senior fellow at the Texas Public Policy Foundation, an Austin-based nonprofit, free-market research institute.

“The Prognosis for National Health Insurance: A Texas Perspective,” the recent report by internationally renowned economist Arthur Laffer for the Texas Public Policy Foundation,

I advocate:
(1) equal limits on medical tort awards for non-expenditures such as pain and suffering;

(2) equal access to the purchase of any health care insurance sold anyehere in the US;

(3) equal percentage deduction from income taxes owed for purchase of health care insurance;

(4) equal percentage deduction from income taxes owed for private contribution to private charities that purchase health care insurance for those who cannot otherwise afford it;

(5) equal rate over time of phaseout of medicare and medicaid health insurance.

Just for the record, although i know it's futile, Fox claimed that tort reform would lead to reduced health care insurance premiums. She has not provided a scintilla of evidence that this is true. The article she has linked does not provide any evidence that tort reform will reduce health care insurance premiums.

ican711nm wrote:
I advocate:
(1) equal limits on medical tort awards for non-expenditures such as pain and suffering;

How would you equalize this? For instance, should there be no differentiation from negligence that creates pain and suffering that is temporary and causes no permanent disability such as administering the wrong medicine or doing an unnecessary procedure as opposed to that which cripples or incapacitates or blinds or produces intractable pain for the rest of the person's life? I've seen both happen as a result of incompetence, unjustifiable carelessness, or impairment due to use of some controlled substance.

I recommend a limit such that the total for non-expense tort payments be a specified constant multiple of actual expenses. I think that which causes a permanent disability does generate actual expenses like loss of x-years of income.

Like the CATO Institute, I do not wish to give medical providers license to be negligent. But there should and must be protection for doctors and other healthcare providers who have no reasonable way to avert an unhappy consequence when performing medically accepted procedures. For instance I know of ObGyn's who have stopped practicing because they were being sued too often for delivering less than 'perfect' babies or there were unforseen complications from a pregnancy.

Many doctors are sued for things that didn't actually happen--frivilous lawsuits. In such cases I think doctors or their insurers should be reimbursed for the doctor's legal expenses.

I think there must be some distinction between the unexpected or unforeseen unhappy result and that which is done through malicious or intentional or careless negligence.

I don't know how it can be proven that something done was malicious, intentional, or careless. But if that can be proven it should be proven in a criminal trial not in a civil trial.

Quote:
(2) equal access to the purchase of any health care insurance sold anywhere in the US;

This one I think could be doable through some interpretation of anti-trust laws which would be within the federal scope of responsibility.

I agree! This can be done by prohibiting states from continuing quasi-monopolies for insurers in their states.

Quote:
(3) equal percentage deduction from income taxes owed for purchase of health care insurance;

Percentage or a flat amount up to a specified maximum? Would a deduction or a straight tax credit be preferable?

For example, assume one's taxable income equals a gross income of $100,000 minus total deductions of $30,000, or $70,000. Then according to my 2009 tax schedule for "Married filing jointly,"one's income tax would be 9,350 + 0.25 x (70,000-67,900) = 9,350 + 0.25 x 2,100 = 9,350 + 525 = $9,875.

So, I recommend one be allowed to deduct up to a fixed percentage, say 30%, of that $9,875 or $2,962.50 to help pay for one's medical insurance.

Quote:
(4) equal percentage deduction from income taxes owed for private contribution to private charities that purchase health care insurance for those who cannot otherwise afford it;

This one is already in effect and, in my opinion, it certainly should be retained.

Currently, I believe one can only deduct from one's gross income to compute taxable income. One cannot yet deduct from one's tax payment.

Quote:
(5) equal rate over time of phaseout of medicare and medicaid health insurance.

At least that medicare and medicaid that is administered at the Federal level.

I agree!

Currently, I believe one can only deduct from one's gross income to compute taxable income. One cannot yet deduct from one's tax payment.

As one who IS familiar with 'formal debate rules'
<snip>
blatant ad hominem or direct personal insults would almost certainly cause the guilty party enough points to lose if it didn't disqualify him outright.

A good debater will effectively dismantle his opponent's argument with fact, not emotion or prejudice or weak unsupportable assertions, and will present his own argument competently to make it difficult to dismantle.

Health insurance premiums rose 91.6 percent in Texas

By Mary Ann Roser | Tuesday, September 15, 2009, 12:48 PM

A national report that was released today says family health insurance premiums in Texas increased 91.6 percent since 2000 " 4.6 times faster than earnings.

This year, however, the growth rate in Texas is below the national rate in which premiums grew 4.9 times faster than income between 2000 and 2009.

Set, how could it NOT reduce health care premiums (or at least keep them from rising faster (I'm using Obama's preferred accounting method here)).

Less expense for the business means that they can charge less money. Even if they save only 0.01% of their budget by reducing TORT payouts, that's still a cost savings for the business, which means they don't need to raise their prices to maintain their profit margin.


I'm not saying that it's going to FIX the problems we have, or even that whatever reduction occurs would be enough to mean anything to the average consumer, but there would be A reduction.

I'm still FOR TORT reform. I don't think it works right.

Agreeing or taking under advisement your responses. I like the fixed percentage of deduction for insurance premiums but would prefer that they be tax credits rather than deductions from gross income so long as we have an income tax.

Whoops! Obviously I didn't explain that very well, because I did mean to recommend that the fixed percentage for deduction for insurance premiums was a tax credit rather than a deduction from gross income. However, I didn't use the words tax credit. Instead, I used the verbal equivalent of algebra to try and say the same thing.

Here again is what I previously wrote:
<assume one's taxable income equals a gross income of $100,000 minus total deductions of $30,000, or $70,000. Then according to my 2009 tax schedule for "Married filing jointly,"one's income tax would be 9,350 + 0.25 x (70,000-67,900) = 9,350 + 0.25 x 2,100 = 9,350 + 525 = $9,875.>
30% of that equals the $2,962.5 tax credit I computed.

But for this one related to receiving tax relief for contributing to charitable groups who provide healthcare to indigent or needy persons you said:

Quote:
Currently, I believe one can only deduct from one's gross income to compute taxable income. One cannot yet deduct from one's tax payment.

Without thinking it all the way through, at first blush I would object to allowing a tax credit for this kind of charitable donation and not for other kinds of charitable donations as I think that would make it non-uniform and non-equal and would unnecessarily disadvantage many worthy charities. Also, you would have everybody from the YMCA (who already provides a form of healthcare for their programs such as Silver Sneakers and aquacize for rehab patients) to Planned Parenthood to ACORN claiming they are providing healthcare to needy persons and wanting in on that deal. I think it would become a bureaucratic nightmare deciding who qualified and who didn't. Better to treat all charities alike.

I'll have to rethink this. I think you're saying that to be equal liberty, all charitable deductions would have to be tax credits. Hmmm! I like that idea. I'll think about it some more.

And why would providing healthcare be of more social value to merit extra tax relief than would giving a meal to a hungry person at a soup kitchen or a warm winter coat to the child who doesn't have one:?

Good points!

I work for a government (State) agency, a Law school. I spent several years during a hiatus of my college career working for a Fortune 50 company. I can not see any differences in the level of efficiency or waste. While I understand your theory, the reality of my experience has been that waste occurs just as frequently, personalities and idiots riddle private enterprise to the same level as public, and the end results come out on schedule about as often.

Not all Gov't agencies work this way, btw. My Law school has trimmed many employees lately and my office now does the work with 4 people that we used to do with 7 - and we do it better and faster, thanks to process improvements we've made. We didn't need some 'profit motive' to make those improvements happen, either; simply caring about your job and the mission of your company is enough.

I believe this is a rather childish view of the budgeting process, or perhaps just an exaggeration on your part. Either way, it is not accurate.

This is a good thing, not a bad thing. If 'bosses' don't want to take the time to correct an employee's problems, and work with them, that's their failure. A company should be willing to put the same level of commitment into working with it's employees, that they expect the employees to display towards the company.

You're quite incorrect about this. The overall management cost, as a percentage of total outlays, of Medicare is lower than that of private insurance.

Set, how could it NOT reduce health care premiums (or at least keep them from rising faster (I'm using Obama's preferred accounting method here)).