Terry Schiavo and US Healthcare

Yes, the worst part. The part that set the stage for many other problems.


I believe the problem would begin to improve, yes.


Name one insurance company that can force a doctor to do business with it.


If I artificially inflate the price of rye bread, the price of all types of bread will rise in response. When the US had tarrifs of about $1,000 per unit on import cars in the past, it inflated the price of domestic cars by about $700 per unit, because the price with which those cars had to compete had been raised. (This effect is not absolute, but it is evident.)


If you thought I was saying they were the only problem, I was not. If you think they have not caused most of the problems, I think you are wrong.


Who subsidizes it? Who is "we"?


Maybe the fix is to make it a free market.

Sorry, Scrat. Got busy at work.



We is the taxpayers. Employers get breaks for providing health insurance, employees get to avoid paying tax on their share of the cost.



Again, depends on your goals. If we assume that there is a moral imperative to provide healthcare to those who need it, whether or not they can pay, then a completely free market isn't going to fulfill that. Who will provide healthcare to predominantly poor communities? It appears to me that, at some point, lawmakers saw this problem but new that there's no way Americans would go for socialized medicine. So they tied the benefit to employment and pushed the responsibility on to employers. This obviously isn't working.

If you haven't already, I wonder if you would scroll back a few pages and read some of the interesting commentary on this thread. Maybe others can make clear what I cannot.

I'm not so certain your bread example works, though I'm not an economist. If rye bread goes up, high enough that most people can't afford it, bakers begin to provide affordable alternatives to serve the market. People can do without bread and cars, but when it comes to healthcare, we don't often have a choice. There's no natural ceiling to costs -- at least not when we're talking about emergency care. In the end, if we can't afford to pay, we don't. If this happens often enough (and it does) prices go up to cover these non-payments.

Of course they do, but what price point do they have to beat to attract market share? The inflated price of rye bread.


It's more accurate to write that we have too few choices, which is again partly the result of government efforts to limit same.

And it is important to remember that a huge percentage of those without health insurance in this country have made a choice not to purchase same. These are families with cars and TVs and Xbox systems and other non-essentials that have decided these items were more important than health insurance. (A decision partially informed by the knowledge that the government will take care of that expense for them.)


Of course there is. It may be high, but it is there. Imagine what could be done to save a single life if the resources available to do same were limitless.


Which is why we need to have firm limits on what we are willing to do for those who cannot pay. Otherwise, the end result is a poorly working system for all.

We are talking about priorities aren't we? It's up to our government to protect its citizens, but more importantly, to stop wasting tax-payer's money. If this president didn't get our country involved in Iraq, there would have been enough money to provide universal health care for all of our citizens. All developed countries provide universal health care except the US. Are they all wrong and we are right? I don't think so. Not only was it wrong to get us involved in a war in Iraq, but this administration also failed in understanding the post war problems. If Bush's claim that "war is a last resort," why were they talking about "regime change" in 2002? Bush now wants to create personal accounts for social security that will reduce benefits for future retirees with no guarantee of "social security." He makes it sound "urgent," but most experts tell us social security will be funded until 2041. It's more urgent to provide universal health care for all Americans - when the uninsured increased by five million (12.5 percent increase) during Bush's tenure as president. That means more of our children go without health insurance. Our government has failed us big time.

Just think how great our healthcare system would be if we'd stayed out of WWII!

Quote, "Just think how great our healthcare system would be if we'd stayed out of WWII! "

I didn't know until today we started the war with Japan by our preemptive attack on their land. Please provide credible evidence of such an attack. I'm sure others on a2k are also interested in this new information.

CI - At issue isn't who started it but what was gained by it. If you honestly think nothing will be gained by our efforts in Iraq, then I suppose your statement makes sense. Personally, I think it's naive and overly simplistic to argue that if we hadn't done A we could do B. That's always the case. Imagine how much we could spend on healthcare if we spent nothing on education! (See my point?) This discussion is about healthcare, not Iraq. If you want to complain about Iraq, aren't there loads of discussions for that?

Wars are always stupid; for us to start one with a sovereign country that posed no threat to us is even more stupid. We have expended the lives of our soldiers and billions of dollars every month for a prospect nobody is sure of, and even this administration can't tell us what the "end game" is, and how much longer this war will last - at what cost to the US? Many congress members are now asking the right questions; when will we reduce our military in Iraq?

Universal health care is one of those things which should be carefully considered before wishing for. The Canadian high court just reversed Quebec's law preventing private third party for profit entities from offering better health coverage at higher cost. This is a harbinger of, at least, a two tiered health care system, this coming in spite of Canada's health care system that is considered a model of socialistic medical care. Notable is not the high court's decision but business entities' judgment that there was a large enough demand for a different quality of private medical insurance services that would make the venture viable. The court's ruling has now paved the way for such business plans.

C.I. is correct in pointing out that Social Security reform is not a "Crisis" (crunch time varies according to source- some even predict 2079), but it does need solving. In my lifetime I have seen this portion of my paycheck get larger and larger. I cannot morally ignore that in the not too distant future 3 or less workers will have to devote a sizable amount of their hard earned money to support me in my dotage while this money could be used to, say educate their children, had they a choice. Additionally, given employer's mandated contributions, social security taxes work against the goal for full employment. One only has to closely examine the "Social Model" presently seen in France and Germany resulting in the decrease of both employment and productivity to see our future given a total commitment to these social "solutions".

Bush's plan is attractive at first blush but unacceptable in its details. Bush wants to fix it "forever", which means benefits must be pared back…period. Personal accounts only prolong the obvious path to Social Security's total demise. One only has to look to the "French Model" to view its future.

However, many people do not fully understand how Bush's personal account system will work: The money coming out of your check for SS will not change. The government considers that figure "THEIR MONEY". I CANNOT EMPHASIZE THIS CONCEPT TOO MUCH! If one chooses to set aside some of this government money into a private account he/she immediately agrees to a lower SS payment when the time comes and that's fair. The owner of the account now gets control on how he wishes to invest the money, stocks, bonds, hedge funds, mutual funds, futures (pork bellies), derivatives, CDs, REITs, tax free MUNIs, etc (if you are starting to get a little uneasy at this point you are not alone…and it gets worse) and that's not only fair but, seemingly, very American. When you finally reach your golden years and are ready to retire it is time to pay the devil his due. First all that money that the government took out of your paycheck week after week, year after year and deposited into "your personal account" must be paid back to the government (it's "THEIR MONEY" after all!). Second you must additionally pay the government 3% of the total amount of the total amount so deducted from your paycheck (for the use of "THEIR MONEY"?-you see it is considered a loan?-so that's fair). Thirdly you must pay for any inflationary decrease in the value of the money so borrowed?-this figure is not know until 30 or so years later, of course. All the money left over, if any, is yours to keep (minus any tax obligations?-and what might they be?). So, If you had invested wisely?-if, however, like myself you are not in possession of an MBA the operative adverb would be luckily not wisely?-in cryogenic futures you might have enough to pay back the government and retire on. But if you had invested in the magazine "Rosie" and Dotcom companies you would be in the red, so it's a wash right? Well, no. Just like Guido, your neighborhood barber/loan shark, you still owe the "nut'?-the government wants all its money back. Essentially those that opt for this plan are borrowing to invest. Financial advisors always refer to this as a No, No! They have a technical word for it: Speculation--tulip bulbs anyone? Certainly gives one pause.

Wars can be stupid and they can be just but not simultaneously. They are, however, always expensive. In the good ole days the sole purpose of war was to increase wealth, whether property or booty, and gain power over others. Bush?'s exclaimed goal of expanding democracy in, now, "The World" is certainly uplifting and we see positive changes in the ME because of Iraq. But this administration has obviously fumbled the ball in Iraq. Post war planning, taking Bush at his word, for the spread of democracy in Iraq seems at best non-existent. Given old values for war this is not a problem, but if this administration's stated goals of freedom for Iraqis is the measure they have much to explain. One cannot just remove the leader of a country, no matter how odious, and hope for the best. Colin Powell is correct?-we broke it we therefore have the moral responsibility to fix it.

JM

JM, Nice to see you back on a2k - at least in a forum that I'm involved in. I agree with most of your opinions, but your explanation of personal accounts leaves me confused. I can agree with the principal aspect of your thesis; it's THEIR MONEY." We are taxed on 80 percent of our social security benefits now; I imagine that can increase upwards before we see any possibility of a decrease. Another important information about social security beneficiaries is the fact that one-third of the people rely on it for 90 percent of their living expenses. Another third depends on at least 50 percent for their living expenses. That last third depends on social security for less than 50 percent. If this trend holds true for the future, it means 66 percent of Americans depend on social security to have any financial "security" in their retirement. If the American People are willing to gamble with personal accounts as a choice, they should also realize that there are no guarantees of any return of "investments" in the stock market. Most Americans today do not put aside any money for their retirement. That should be a clue as to how poorly Americans are prepared for retirement; the majority are not. Most expect to work beyond age 65-67, but finding those jobs is another question.

c.i., you have highlighted two important concerns: Social Security's promise to future retirees and the U.S.'s low rate of personal savings. The first obligation must be met and the second should be encouraged further.

There is no reason why both cannot be addressed via government action. Since the present administration, and republicans in general, strive for lower taxes, why not a public 401K program whereby mandatory taxed deferred contributions are directed into such a retirement account ? Currently, both IRA and 401K plans are mostly voluntary but a significant number people do not take full advantage. The WSJ just had an article whereby companies are automatically enrolling and allocating 2-3% of new employees' gross pay and if the employee so elects, he may opt out. But it seems that most have no problem with the program and stay in. The employer will also have a professional manager administer the employee's contributions but, again, the employee can manage his funds if so wished.

The problem of SS's obligation to present participants still remains; after all, they must be paid their due. Some sort of pro rated system comes to mind. Perhaps, the government can offer a cut off date for new employees after which they must forgo SS and must only contribute to a real personal account for their retirement.

JM

JM, Recent times have seen companies cutting back on 401k and health benefit plans for retirees. We've all heard of the United Airlines retirement plan that was taken over by the government, because it's underfunded. Any shortage will be made up by the taxpayers. Most airlines that have retirment plans are planning to give up their retirment plans to the government, because most cannot continue to fund them and survive. It seems that the only retirment plan that's not being cut are government retiree plans. Safety officers in San Jose, California, can retiree at 85 percent of the last/highest pay after working 30 years on the job at 50 years of age. Can you imagine how much taxpayers are going to be paying on these generous retirement plans for them? Some of them may live to be over 100 years old. They'll be collecting retirement benefits longer than they have worked on the job.

c.i. absolutely great points. Traditional pensions have relied upon company contributions which have been, essentially, unreliable. Traditional pensions rely on the companies to actually contribute to them, 401K's do not. The major part of 401k contributions are from employee contributions; employers may or may not contribute (even then there are timing and vesting issues involved regarding company contributions and individuals' claims towards such monies). But those funds contributed by payroll deductions are totally owned by the employee as are dividends or capital gains realized by their chosen investments (these may or may not be subject to taxes at time of redemption).

You reference such pension defaults by private companies such as Bethlehem Steel and, now, some airlines. Without going into details here, there is no doubt that the government is now burdened with the retirement obligations of many large corporations. In my opinion the airlines should have been given the opportunity to "go gentle into that good night" a long time ago rather than be federally subsidized (like farmers who have now morphed into large corporations subsidized by the federal government: think corporate welfare)

Your concerns of government retirees are noted. Seems unfair that somebody can retire with 80% of pay at age 50! But that was the deal, and it should be honored. It must be said that many of these employees accepted much lower wages than could have been garnered in the private sector with the proviso of guaranteed future retirement income (and perhaps medical benefits).

The old concept of pension funds is now passé. The onus is upon individuals (as is it has always been), the concept only accentuated by recent pension fund defaults and covered by the PBGC (Pension Benefit Guaranty Corporation) which you allude to. Although not news to yourself, others may be interested to know that government payment of private debt is welfare. Individuals so receiving of government largess are rightly subject to criticism and questions of personal nobility. But large corporations are given a pass?-why is this so, especially during almost 8 years of a Republican Administration?

JM

JM, That was the deal when corporate benefits were generous, and government had to compete for skilled labor. Government workers are no longer underpaid compared to the public sector. A lieutenant safety officer in San Jose retiring after thirty years will get over $114,000 in retirement pay plus health benefits. That's much more than the average wages in Silicon Valley of $75,000. Valley workers have seen their wages and benefits cut since the tech bust five years ago. Even stock options have been reduced at more companies. IMHO, I think that is obscene at a time when companies like Hewlett Packard will be reducing their work force by 14,500 workers.