White House Still Pushing the Excise Tax Hocus Pocus
As Brian Beutler reports, Nancy Pelosi’s snippy comment about Obama’s campaign promises was a reference to the White House’s demand that the House accept the Senate excise tax.
[Pelosi] aides say she’s particularly steamed that the White House wants her to largely adopt the Senate bill in its entirety. And she’s particularly unhappy that the White House has thrown its weight behind the Senate bill’s chief funding mechanism: an excise tax on so-called “Cadillac” insurance policies, which she and many in her caucus have long believed violates President Obama’s pledge not to raise taxes on the middle class. According to one aide, that–not the public option–was likely the reason she ribbed Obama at her press conference yesterday, quipping, “there were a number of things he was for on the campaign trail.”
The House proposes paying for its bill by imposing a surtax on high-income Americans. And though there’s been speculation for months that the final reform package will include a combination of both sources of revenue, Pelosi, who’s already had to accept the demise of the public option, wants the excise tax gone.
Yet, the White House has not revisited any of the assumptions it has made about the excise tax that seem to be increasingly dubious–such as that it will end up giving workers a raise.
Interestingly, the EPI has just released a paper debunking the claim.
There is logic to [the argument that cutting health care costs leads to wage growth], but it is only skin-deep and deeper examination will show it to be simply not true. The logic can be seen looking at trends in health care premiums and wages—wage growth fared better in the late 1990s when health care premiums grew more slowly than in the early 1990s and wages performed poorly in the 2000s, a period when health premiums grew strongly again.
However, digging just a bit beneath the surface reveals the following:
- Health care costs are not large enough to substantially move wages as these proponents claim;
- Examination of actual wage and benefit trends confirms that changes in the trajectory of health care costs did not materially affect wage trends over the last 20 years; and
- The wage behavior described—accelerating in the late 1990s and more slowly thereafter—actually best characterizes wage growth for low-wage workers who have minimal access to employer-based health care. Conversely, this pattern of wage-growth over time is least pronounced for higher paid workers with the most health coverage.
Clearly, this “health care theory of wage determination” is wrong, and other factors explain these overall wage trends. The simple explanation is that productivity accelerated in the mid-1990s, and the low unemployment (and hikes in the minimum wage) facilitated faster wage growth. That this wage growth disappeared entirely in the 2002-07 recovery is not due to faster health care cost increases but to weak employment growth and employers’ ability to achieve increased profitability rather than pass on productivity gains to workers. This reveals a fundamental flaw in our economy: productivity gains are not passed on to higher living standards for workers.
Now, it should surprise no one that EPI is taking this on. After all, if I can debunk this myth, than surely real economists can, too.
But I find it interesting in that the paper itself cites an earlier paper co-authored by Jared Bernstein.
About half of all workers don’t even receive employer-provided coverage. According to the U.S. Bureau of Labor Statistics (BLS), 47% of workers did not participate in employer-provided health care benefit plans in 2005. Thus, there is no health care squeeze that would explain the wage losses of nearly half the workforce. In addition, the BLS data show that among workers whose average wage was less than $15 per hour last year, only 39% participated in employer-provided health plans….. low-wage workers also lost the most ground in terms of real wages. Thus, those least likely to get health care experienced the greatest loss in real wages, the opposite of what the trade-off explanation would predict.
Bernstein, of course, has gone on to a new job: working in the White House (albeit advising Biden, not Obama directly).
In other words, they’ve got to know that their earlier claims are–at the least–potentially flawed. Yet still they push it.
Of course, there’s a reason for that. It’s that the White House has promised some kind of cost controls. There were a number of cost controls discussed which used the power of the market to bring costs down: things like drug reimportation and a public option. But the White House chose, instead, to pursue this stinker. And now it has to invent some myths–the wage increase myth debunked here–to try to get around the fact that this does amount to a middle class tax hike.
Did you mean to have a link in the last graph on the wage increase myth debunked?
Great post.
The last blockquote? No, that’s quoted in the current EPI paper. I didn’t go back to the earlier Bernstein one.
(my bold)
What I bold faced – was that suppose to be a link?
No. “here” meaning “in this post.”
That economic practice worked just fine in the Deep South prior to Emancipation.
Works well as applied globally. Also.
This stinker of an excise tax, in lieu of a surtax on the top 1% of asset holders or income earners, is conveniently anti-union and anti-employee. The PTB love that like they do high returns, sweet desserts and aged, hard, um, liquor.
Longer term, it lowers expectations about what level of health care a quality insurance product should cover. That, in turn, will lower insuresters or the government’s costs or allow them to rise more slowly. If I could play chess, I’d say it’s all in being three or a dozen moves ahead of the opponent.
Is there nobody in the White House who learned that wages are “sticky”?
They may go down when there’s a collapse in demand for labor, but they don’t go up readily when demand for both goods and labor are stagnant or depressed.
A feature, not a bug, but one their rhetoric seems to ignore.
You’re assuming that they’d care, even if they did know.
Boxturtle (Objection! Assumes material not in evidence)
Well, Bernstein. But I’m guessing he’s not invited to a lot of the most important meetings.
The bottom line is that we gotta pay for whatever is passed. Or we trash the entire thing and hope the next congress will do better.
Given the current makeup of the senate and the disproportionate amount of power that President Holy Joe and V.P Snow have, it’s unlikely that anything will pass that doesn’t somehow put the majority of the burdon on the middle class.
We need to decide if the benefits are worth the cost, because it’ll be US paying for it. Not Rupurt Murdock or Sam Walton.
Based on what I see now, I think we’d be marginally worse off under the new plan. But that could change with but a single
bribesweetener.Boxturtle (Though I can’t see what else Pharma would want that they aren’t already given)
Everything you say is true, but it’s even worse. The theory (if you can call it that) behind the excise tax is that excessive health care benefits drive overutilitization of health care resources. This is just wrong. Think about it, if that were true, places with universal coverage and no co-pays for doctor visits would either have lots more doctor visits than the U.S. or much longer waits. We know that’s not true.
To the extent that the excise tax has an impact on health care costs, it will drive up costs because people will loses benefits, neglect basic care and end up with more serious and more expensive health issues. The more I look into it, the more I’m convinced that the excise tax is the worst piece of the whole legislation because, in the long run, it will affect more people than the unsubsidized part of the individual mandate.
Nicely said. It’s not as if Americans as a whole have too much health care, other than those who can drop down to the basement and ask the Navy medical staff for a quickie. Nor can Americans determine what specific treatments they need (which raises the issue of the hundreds of millions spent on advertising prescription-only medications, another topic). It is their doctors who do that. Basically, Americans are desperate for more and better health care and its already rationed beyond their reach. An excise tax will worsen that trend.
Right!
Like if I have a plan that allows 40 free doctor visits and 6 free surgeries a year I’m going to use them if I need them or not.
I don’t think so.
It is, of course, the docs that take advantage of the fee-for-service by prescribing more services (i.e., to their colleague who just opened an MRI clinic & needs to pay for his equipment) not the patients. Therefore, it’s the docs who should be penalized not the patients.
I’m all in favor of that.
In fact the only real way to bring down health care cost, is to bring down the costs.
But nobody want’s to deal with that, let’s instead talk about how to pay for sombody elses insurance.
It gives me tired-head.
That’s why I rarely participate in HCR threads.
That kinda limits your participation here, doesn’t it?
Why I usually show up in morning & evening. Only reason I’m here now is I got sucked into watching the Afghan panel on cspan2.
This guy who advised O is certifiable, imo.
smart.
those are about the only threads i’ve participated in during recent months and i swear it’s just making me more stupid and frustrated every day.
The “system” is to put new doctors deeply in debt – my daughter entered her 4 year residency getting paid $35,000 a year 4 years ago with a $200,000 loan to pay back. She did not eat well or have a decent apt.
So our doctors – unlike those in other countries that provide free or nearly free post high school education – must charge a lot – God forbid they might want to make up income lost from 10 years delayed income.
The insurance company overhead – 30% – compared to Medicare’s 3% – is an easy target – made easier when William McGuire of UnitedHealth Group, now retired, made $125 million for a single year (2005) and a total of 1.7 BILLION while CEO – others have numbers like $700 million for their CEO career – and 8 digit annual comp is common (in the recession years of 2008/2009). A claims payment ratio law forces a given percentage of your premium dollar to not be given the CEO and to instead be paid to the insureds for their claims. Which makes the Rockefeller 90% (Nelson’d to 80% – and they are still trying to reduce to 65%) important.
Doctor fee control is better if the insurance is truly non-profit – but our system allows non-profit to be owned by for profit with accounting moving expenses around between companies so the rich still get richer, screwing your health. Without Ins profit control, any doctor fee control just gets added to the ins co CEO bonus.
excellent points. and add to that the control for reimbursement rates (for medicare thanks to the ama scam) heavily weighs against pcps and for specialities pushing debt laden medical school grads away from primary care, etc. something else that does nothing to bring down costs.
but, as you write, the insurance industry is the big target. one that must, imo, be taken on directly.
You also point out the scam that a qualified doctor who works ungodly hours for four years in order to learn a new qualification is worth only $35k a year. That’s indentured servitude, a partial remnant of the medieval guild system, with the caveat that his or her employers are billing them out at orders of magnitude more than they are being paid.
Compare that to newbie lawyers at big firms, who have comparably little experience and know equally little about the depths of their new profession. At big firms, the salaries range from $150-200k, quality small to mid-size firms pay $75-100k.
Teaching hospitals claim they would rather close down than pay market scale or work their residents only 40-50 hours a week. Why, they’d have to hire two people to do the same work, a comment more revealing than I think is intended.
As many have said, medical services were to be the next target of reform. With the disaster Congress and the White House are making of insurance reform, I’d say medical services reforms will arrive just after Godot does at the bus stop. I presume the PTB consider that a feature, not a bug.
And don’t forget those joy rides in ambulances. That’s a gas.
OT- more trial balloons.
Dawn Johnson nomination redux: Hit me baby one more time?
Video here:
http://www.youtube.com/watch?v=-ohYJUu0ujc
Actual trial balloon report here:
Reported by Sam Stein at Huffington Post.LINK:
http://www.huffingtonpost.com/2010/01/06/obama-frustrated-by-slow_n_413475.html
A few excerpts for your entertainment:
Dawn Johnson to be renominated..
” As Gibbs briefed reporters, sources said that the White House will push to re-nominate seven of those judicial and political appointees who have been held up in the Senate, including Dawn Johnsen, the controversial nominee to head the Office of Legal Counsel.”
Or not: (From Sam Stein again):
“But administration officials emphasized that no decisions have been made as of yet. Senate Democratic aides, meanwhile, said they were in the dark about where those nominations stood.”
Your assessment may vary: (From Sam Stein again):
“The president, along with Democratic leadership in Congress, has been criticized by progressive activists for an apparent unwillingness to press for Johnsen’s confirmation. As of several weeks ago, it was largely assumed that her nomination was dead.”
The Song Remains The Same (live at the LA Forum June 21,1977 bootleg) LINK:
http://www.youtube.com/watch?v=rmrPd7hWN0k&feature=related
If he is going to renominate her, he should have recess appointed her in the interim too. He did not.
Beat me to it. This is nothing more than an attempt to keep the office in limbo a few more months.
Boxturtle (Who does he think he’s fooling?)
“Boxturtle (Who does he think he’s fooling?)”
There’s a lot of real estate that will need to be sold in the near future, maybe some buyer prequalification efforts under way?
Still, we have to keep in mind that Obama is nothing if not, ah, flexable. It may be he took enough heat to want to reverse course.
He must be shocked that the netroots won’t give him a pass because he’s not-bush. After all, He received a Nobel prize for being not-Bush.
He should have to give it back.
Boxturtle (well, give HALF of it back)
I labeled this a trial balloon,recent trial balloons all end the same way.
I failed to end with an appropriate sentence; the whole Johnson nomination
has been a fail for months and will remain so.
That would have been, um, confrontational. Too rude, and too bad about leaving a crippled DoJ without essential leadership. One might think Obahma and Rahma like it that way.
More than one might think that. There are at least two of us….
OT to fatster: see the li’l thermometer tonight? And that’s a newbie (number of contributors also went up, which doesn’t always happen).
Wonderful. Now look what you started!
This phrase does seem to be a bit mythological, kinda like the Unicorn. Has anyone actually ever seen this “power” in operation in any beneficial way?
I saw it mating with Governor Sanford on the Appalachian Trail.
O/T Overview of domestic spying, Part I. Brought to you by “progressive . . . functioning anarchy” (interesting concept).
Great analysis of the excise tax mess, EW. The WH, in trying to get from Point A (millions excluded or partially excluded from health care) to Point B (something not quite so bad) without hurting their benefactors, seems to have misstepped into a pool of tar and every time they try and extricate themselves or just move into a more comfortable position, they sink deeper into the tar pit.
May your article sprout wings.
Medicare for All. That would have been the ticket for an easier transition from Point A to Point C (almost none excluded).
Yes, and even if you could not go straight to Medicare for all (and granted that would be radical and hard), it was the PERFECT opportunity to start phasing it in through the Public Option or, alternatively, the lowering of the entry age as was duplicitously teased by the White House when they were publicly killing the Public Option. The simple fact is, there was never any intention to go anywhere near that, and conversely, the determination to stay away from it by the Administration and Congressional leadership.
Yep, and that simple fact is going to leave in its wake a wasteful, painful but expensive legacy for the American people.
no. No. NO!
the public option is NOT a perfect way to start phasing in single payer (as in hr 676). in fact, i don’t see how it could work at all — for one thing the financing is all wrong. there are lots of intermediate steps that could be taken, but the public option was and is NOT one of them. this was all explained over a year ago by actual policy experts (for example, at pnhp).
the PO as a path to single payer was one of the bullshit lies sold to progressives to get them on the public option bandwagon so that they would drop advocacy for single payer (expanded and improved medicare for all) for actual comprehensive (first dollar) universal healthcare.
OT, but the trash talk thread is closed. Why are they playing the Bankruptcy Bowl tonight between the Orange Bowl and the BCS Championship game? I mean, Troy and a directional school? Granted, the Gators only beat Troy (56-6) by a smidge more than they beat Cincy (51-24) in the Sugar Bowl, but still…
You speak ill of the Central Michigan Chippewas, the most consistently successful school in the Big Mitten lately and home of Dan Majerle??
I am aghast!! EW, this rogue commenter must be sacked!
You annoying peasant. Are you suggesting coconuts migrate?
Maybe it was scheduled by the same people who scheduled the Pro Bowl a week before the Super Bowl.
because there was an open slot. They have played that bowl like that for several years.
To return to the world of spooks, if you don’t mind. Among the many acronyms–CIA, DIA, USAID, BW, etc., that float endlessly in the fog of war and espionage–there’s DAI (Development Alternatives, Inc.). Interesting story about DAI and Cuba. Wonder where it will lead.
Bullshit, Mr.President. This is just bullshit.
And when this Congress gets to work on the Bush tax cuts, set to expire on 1/1/11, I suppose you’ll be going along with any old thing just for the sake of passing something so they can’t call it a tax increase.
Get some stones, Mr.President. Take a progressive stand on something or just quit. I lost hope last September. I can’t take much more of this change.
I really know very little of the details of the health
Insurance “reform” bill
But then I have had little detailed lnowledge of many other important I’m
The several decades I’ve been a close observer of u.s. Politics.
But I
Have acquired a special sense of folly-in-action with respect to this “health” legislation.
But the legislative convolutions involving who gets what coverage seem so deliberately untransparent and the legislative convolutions involving who
Pays seem so blatantly protective of the wealthy and powerful that my view of the senate legislation is that it needs to be crumpled up and thrown in the trash as with
A particularly muddled, endlessly rewritten chapter in a novel-to-be.
Madame speaker
Would do the nation a favor if she forced this overwritten legislative potboiler to be dumped in
Favor
Of a new start.
Did so.
I have now expressed my opinion to madame speaker. (Politely, but firmly.)
I found this commentary on the Obama administration in Scientific American this month.
By Jeffrey D Sachs the title: “Looking for Change in the Beltway: The Need for Open Process”.
The subtitle: ” The Obama administration must reform how policies are made, not just the policies themselves”.
The article is found here:
http://www.scientificamerican.com/article.cfm?id=the-need-for-open-process
The author takes to task the Obama administration like this:
“The Obama administration has not put forward one coherent plan as a detailed policy proposal. Every major piece of public policy has been turned over to the backrooms of Congress, emerging through the lobby-infested bargaining process among vested and regional interests.”
And this:
“By refusing to put forward clear plans, the administration is creating gaping and unnecessary weaknesses in public policy. First, and most important, the bad parts of legislation are not shot down.”
And this:
“Moreover, the administration has repeatedly lost the opportunity to convey important information to the American people. Only one third of the U.S. public believes that man-made climate change is even real.”
Excellent points all.
Is anyone actually doing any work at the White House except for helping BO write empty speeches and Rahm reprising Ahnold’s role as Terminator.
“Give me your clothes.”
You’ve done a great job, EW, explaining the economics of the so-called health care reform. I, for one, am very grateful, as I use your material to explain to relatives, friends, etc.
I thought you in particular would want to know that Chile’s torture files (Pinochet) are being re-opened.
For the car people. Apartheid legal case to go forward (GM, Ford–and IBM).
previous topic update: a 5th letter containing white powder has been found at UC Irvine, sent to the first male recipient, Ulysses Jenkins:
My personal expeience over the last decade has been that the dramatic increase in the cost of health insurance has impacted wages.
It has influenced me in setting wages for my employees and I have sat in many board meetings, both public and private, where it had a considerable influence on limiting wage increases.
I am dubious of the studies findings.
The problem with these kinds of studies, as you say, is that they assume they know where wages would have gone had insurance costs been reduced. So they pick a model and assume their answers are correct because they believe in the model. In the real world a normal business considers medical insurance costs as part of the package they offer and consider the complete thing as their employee compensation. Funny how that works.
There is no doubt from my examination of the data at a macroeconomic level that rising costs of medical benefits have held down wages.
However, that does not mean the relationship is symmetrical, i.e., if medical benefits costs are reduced, wages will do better. There is a ratchet effect, with corps learning every day that they can squeeze workers more & more. The power imbalance is such that workers can’t do anything about it.
I was in those wage setting meetings – and the Boards salary committee reflected the board – and health care costs had no effect on wages – wages were set based on the lowest we could get away with. The idea that a decrease in the next year’s premium would be reflected in more hiring or higher wages is LOL funny.
I dare say you have never set a wage in your life – or been near a board room.
In smaller businesses, which generally have no boards, wages are not set but negotiated for each employee. Not merely health insurance but potential bonus structures. Maybe you travel in more rarified circles but that doesn’t suggest that all experiences are equal.
If you dared to say it, you would be incorrect.
Do you often call individuals liars based on absolutely no information? It is less than honorable.
I’ve been to lots of meetings in bored rooms but can’t recall what anybody said.
Do recall lots of drones, though.
Stop already with snippy. Nancy Pelosi’s comment was sarcastic, and true. Deserved, even. Snippy trivializes, and Obama’s 180’s are not trivial.
If the goal of the excise tax is to “bend the curve”, as some Democrats have argued, then its current design is not a bug, it’s a feature. Doing the excise tax with an index would not bend the curve because it would only narrowly effect the well-to-do.
Drive down costs by not allowing insurance premiums to go up. Co-pays, bankruptcies, reduced medical care and all the other problems are moot against the goal. Once all insurance costs less then medical costs must follow it would seem. Except of course for state and federal insurance plans which surprisingly enough don’t appear to be covered. Perhaps they have some plans on the back burner to handle that oversight later on.
Why put price controls on iinsurance corps? Why not put them directly on medical services providers, like is done in other developed countries?
I’m not defending this in any way. If they wanted it to work they would control costs as is done in other countries like Canada. Then one would guess they would have to defend “death panels” which would require persuasion and leadership. Not much of that going around lately.
How about this one party government system? Maybe we don’t deserve better if we won’t fight for it. The president is fighting for what he wants (corporate sponsorship).
I’m becoming convinced that trying to work with our government in an effort to have them actually do their jobs (represent the American people) is an exercise in futility. I’m not giving any more time/money/phone calls to another ’cause’ until I see Americans finally pissed off enough to really want to change this POS system we call a democracy.
Currently it’s just groups (us progressives, the tea baggers, and various other Ron Pauls, Naders, etc.), we all have some things in common, if and when we find that common voice, I’ll be the first in line.
O is fighting with h-bombs. We’re fighting with tooth picks.
OT: Apologies if it’s already been covered. Worth a look.
I’m shocked! /s
even if the claim were correct, it’s counter productive and acutally uses the rediculous “trickle down economic” propaganda reagan/bush forced down our throats
but let’s make the leap from reality to fantasy and say this does give the workers a raise in the long run (it won’t)
it’s counter productive since we are trying to lower costs to business if we can
the way health care provided by the employer lowers their costs is this;
they can bulk buy health insurance at a far lower rate then the indidual can buy it, therefore they can pay less in wage to make up for health insurance and the laborer can consider what he’s pay indivually and add that to what he considers his compensation to be
so even if the trickle down fantasy were to work, (it wouldn’t), it’s counter productive anyway
now that was far too verbose so I hope you can follow what I had to say
HEALTH CARE REFORM
To help pay for health care reforms, the House voted for a surtax on very high incomes, such as those over $500,000. Sounds like a good idea, since affordable and a step toward fixing the huge inequality in US annual incomes. The Senate rejected this idea, opting instead to tax very expensive health care insurance plans.
As Bob Herbert of the NY Times, points out, the Senate plan hurts many in the middle class. This is supposed to produce savings of $150 billion over 10 years. Herbert notes “According to the Joint Committee on Taxation, less than 18 percent of the revenue will come from the tax itself. The rest of the $150 billion, more than 82 percent of it, will come from the income taxes paid by workers who have been given pay raises by employers who will have voluntarily handed over the money they saved by offering their employees less valuable health insurance plans.” Lots of luck counting on this.
The main effort to combat the rising cost of health care is through the insurance companies. Squeeze the insurers and they’ll squeeze costs out of medical providers. How has that worked so far? It’s beside the point but health insurance is an anomaly; sort of insuring to pay for food.
We don’t hear much about computerizing all health records, or other cost saving measures. Or sometimes the savings are supposed to come from patient decisions: declining tests, selecting lower cost providers. But patients don’t work this way. It’s difficult to shop for doctors or hospitals. And when your doctor recommends a test,you don’t disagree.
Making insurers compete (the public option, removing anti-trust exemption) would of course help the insurance purchaser. But more is needed, negotiated drug prices,
importation of drugs, pushing best medical practice, fostering hospital competition with less duplication, supporting clinics that and medical groups that compete with doctor services. In many ways, try to wring the high prices,excessive costs, and high profits. out of the system.
Good health care is a right for every citizen. It behooves our government to take the actions necessary to meet this goal.
homer http://www.altara.blogspot.com
Where to start?
Why not squeeze the providers directly?
Some have said when insurance companies don’t compete they can put the squeeze on providers and get better deals for the insured. More competation waters down their leverage.
I’m much more concerned about collusion.
That sounds good.
Not needed if you do the former.
OT
Panel on Afghanistan on cspan2. Current (first) speaker is guy who advised Obama during transition & shortly after.
Sez biggest recruiting ground for AQ & Taliban is NATO prisons in Afghanistan.
Sez U.S. has to not just nation building, but much bigger region building. This is the advice he fave to O.
Great! All we have to do is get rid of the prisons and we’ve solved the AQ problem.
Well, we could start by stopping torturing the prisoners.
you know, I made the point before and it really needs to get more progressive play;
this president is acting like there is such thing as “trickle down economics”
remember his “economic stimulous”?
what did he do?
he actually gave money to the criminals causing the problem and then expected more then that amount of money to make it’s way into small business loans!
his “health care reform” is the same thing, he’s giving more money to the industry with the “hopes” the extra profit will make it’s way down to lower costs
THIS MAN IS A TRICKLE DOWN ECONOMIST!
Personally I’m in favor of just referring to him as Reagan 7.0 but that’s probably because I’m not much of Windows fan.
Many people were convinced they were voting for a Mac; turns out he was a regular old PC.
We’re talkin’ Pentium 90 here.
With a 10 meg H/D and a trickle down memory card.
The real problem is in the larger view. The whole thing is being set up to be pulled down. Pols know that 1) ordinary people want health care, reform or otherwise 2) the monied interests do not want refrom, health care or otherwise 3) ordinary people hate “welfare.” Et, viola, make the health care bill look like a form of welfare so it can be pulled down in a few years, no real harm done. As the pols see it, they can work the welfare meme very effectively to get rid of the whole shebang in not too many years. Problem solved.
That’s what makes single payer for everyone so terrifying. Everyone’s invested, no definable group to isolate and aim at.
A plan that would increase the number of MDs, PAs and nurses by 30% over the next decade might be of considerable benefit.
That is an excellent suggestion, especially if the MDs part of it were to be directed at general practitioners, internal medicine types etc. Of course with the way we have choked off education funding, is going to be hard.
The other practical solution would be a real war on obesity. It is a huge factor in our health care costs.
Tsk, tsk. That would run into opposition from manufactured food campaign contributors.
I’d be in favor of an improved scheme to help people eat well and exercise. Better PR. Possibly additional ways for financially strapped folks to eat from the expensive sides of the stores.
Any sin tax approach to pre-existing or genetic problems would not serve to do anything but generate money from the already distressed.
I have more than one friend that exercises, is a vegetarian and has a weight problem. Few things are as easy to fix at they appear.
People know what causes obesity, but they play dumb and find any excuse to just make healthier choices. I see so many fat people in the town where I live. And, so many of them are young women. Also, lotsa fat mothers who are raising obese children. Very sad. And, yes, we all pay for the consequences.
Actually, there’s evidence that it is not. Obese people die younger and cost less over time than non-obese people who live longer. There are studies that have looked at this from a cost perspective, and that’s the conclusion. Live fast, die younger, cost the system less. I’m not advocating, you understand, just pointing out unsupported bias.
Like that guy who said the same thing about smoking a decade or two ago.
Once again, the “studies” do not line with my personal experiences and
discussions with people in the medical field.
“Thanks for Smoking”
Daddy, Daddy. When can we go hunting the fat people?
I agree my “war” metaphor was lame.
Understandable enough. You live in the U.S., where everything is a war.
We need to start a new war.
The War against War.
Not right now dear. It’s still bow season and you might poke your eye out with one of those things.
I do love the blame game – especially when it is wrong being based on incorrect logic and facts.
Fat people die early – death – early death – is a profit event for health insurers. Indeed it is a reduction for the nation in health care costs it would otherwise likely pay.
Perhaps we shoot all the thin runners instead?
Bingo. It should be obvious to all by now that “elections” — presenting a false choice of which flavor corporate drone we prefer — are not a path to change. They’re a sideshow distraction, to keep the people fighting amongst ourselves instead of taking on our feudal masters by means which actually work.
i don’t see how the excise tax controls costs — unless they are referring to cost to the fed budget. which is the least important element of our healthcare budget.
looks more like a way to shaft workers, especially union workers.
not just stupid. wrong.
marcy, i agree with almost everything you’ve written on this topic. but the following bit i have to take serious issue with:
the “power of the market” doesn’t, as a rule, bring down costs in healthcare or in healthcare insurance (the only case i can think of is if we were to get rid of all patent and ip law — then competition could bring down some pharma costs). sorry to give you a hard time, but most magic market claims rely faux neoliberal assumptions and i’ve kinda od’ed on neoliberal economic arguments. will provide references if you wish (will take me some time to find them though).
and drug reimportation depends, not on the “power of the market” but on the power of a gov (not ours) single payer insurance setting prices.
Yeah, I’m a naive, blue-collar trade unionist, but I never would have imagined that Obama and the Dems would treat us working folks like we are idiots and give us such a thorough George Bush beat-down.
From now on, my time and money’s going to the Green Party. I know some will scream that I’m helping to give the country back to the Republicans. I can only answer that there are enough people around to vote for Obama and his “stealth Republican” agenda to keep him in office and that my vote will not be missed. I still have to look at myself in the mirror each morning.
I didn’t mean my comment to be mean to people who are overweight. Really just wanted to point out that people have got to know why they are heavy. It’s not because you had a baby. It’s not because you’re large boned. Too much of the wrong food and not enough exercise. I don’t think we need a campaign to tell people what they already know. That’s all. So, apologies to anyone who got their feelings hurt, if any.
oh, and if speaker pelosi really does want the house bill to be considered in conference, why hasn’t she submitted her hr 3692 as an amendment to hr 3590?
The Dems. has screwed this up in every way. When Congress doesn’t want to do something this is what happens. In trying to make it look as if they’re doing something they’ve turned this whole tragedy into a “historic” foul up of monumental proportions.
This could be done easily through immigration reforms, but Dick Durbin won’t let that happen, as his wife (who works for an American nurses organization) would be pissed at him. The opening, even slightly, of the immigration spiggot for RNs and MDs would have a salary supressing effect on those professions somewhat (and my wife is an RN, so I’m advocating something that would seem to be against my own financial interests),but that is what HCR is trying to do. With the nursing shortages, hospitals use temp agencies (almost triple the cost of a staff nurse) or pay overtime (a nurse at Cook County Hospital was reported to have made over $150,000 in overtime alone a few years back, and that was in addition to her “straight time”). Looking at the French model, acheivements in health care delivery for about a third of what we pay in our country, are achieved, in part, by a compensation structure that allows a comfortable lifestyle, but is considerably less than the pay scales in the U.S.
great points throughout. Pelosi’s dig was priceless.
Can someone straighten me out here? A 20% excise tax/surcharge/whatever on plans above $26,000 is bad for what reason? I think it would be better to cap the tax exemption at $26,000 and let the marginal tax rate or the AMT kick in at that point, but that seems to me a relatively small matter.
How many of the working poor have such great plans that a 1/5th cut of the value over $26,000 is going to be some sort of hardship? Because there are some very, very well compensated executives who are right now hiding large amounts of salary in puffed up benefits, and it sure would be great to hit them up for it, even with a lame 20% flat tax like this.