Huzza, Huzza, Harry Reid!
Reid to McConnell: Do I make myself perfectly clear?
Excerpts of Reid’s letter to Senator McConnell:
“While Republicans were distorting the facts in the health care debate and inflicting delay after needless delay, millions of Americans have continued to suffer as they struggle to afford to stay healthy, stay out of bankruptcy and stay in their homes. Thousands of Americans lose their health care every day, and tens of thousands of the uninsured have lost their lives since this debate began.”
“Many Republicans now are demanding that we simply ignore the progress we’ve made, the extensive debate and negotiations we’ve held, the amendments we’ve added (including more than 100 from Republicans) and the votes of a supermajority in favor of a bill whose contents the American people unambiguously support. We will not. We will finish the job.”
“As you know, the vast majority of bills developed through reconciliation were passed by Republican Congresses and signed into law by Republican Presidents – including President Bush’s massive, budget-busting tax breaks for multi-millionaires. Given this history, one might conclude that Republicans believe a majority vote is sufficient to increase the deficit and benefit the super-rich, but not to reduce the deficit and benefit the middle class. Alternatively, perhaps Republicans believe a majority vote is appropriate only when Republicans are in the majority. Either way, we disagree.”
“At the end of the process, the bill can pass only if it wins a democratic, up-or-down majority vote. If Republicans want to vote against a bill that reduces health care costs, fills the prescription drug ‘donut hole’ for seniors and reduces the deficit, you will have every right to do so.”
Read the complete letter here.
67 Responses to “Huzza, Huzza, Harry Reid!”
“must be forced to pay for those who are not – something they would STILL do in a flat tax arrangement”
The flat (single-rate) tax in fact still results in higher-income people being net payers and lower-income people being net subsidized. The higher-income people pay out of proportion with respect to benefits received from government, while the reverse is true with lower-income people. The flat tax is more than enough.
Add to it an exemption because most of us agree that necessities or a minimum living standard ought to be exempt from tax as a practical consideration, and you're set. Change the (single) rate or the amount of the exemption to reach agreement. Easy.
Sadly, that's not the way it is. Other (ugly) motives come into play with tax policy, often dishonestly in the name of “fairness” (as with progressivity).
I doubt we'll go to a clean, moral income tax any time soon. Moreover, even more money will be sought ten years from now, anyway.
And if you read my post from earlier today, you will know that it is not clear or certain that that is what the Parliamentarian said. Even if it is, though, hcr will become law. I have no doubt of that.
“hcr will become law. I have no doubt of that.”
Those Demmies will find a way. Hell, Obama might even sign an executive order to do it if need be.
“The flat (single-rate) tax in fact still results in higher-income people being net payers and lower-income people being net subsidized”
That's exactly what I said, DLS. We are in agreement. The rich always pay the most. But in a “fair” arrangement, the pay the same percentage – which is fair. Most Americans support the “fair tax”, but the political machines are against it – both Democrat and Republican.
Hey, stop that! You never know who is reading this blog. It just might give them another idea to try.
means testing
I don't oppose that, but you do know, don't you, that Medicare recipients pay a premium that IS based on their means. It ranges from $98 a month to over $500 a month.
Christine, at current rates, a physician who had ONLY Medicare patients and an average patient load would receive around $300,000 a year. Assuming 50% staff, overhead and rent, that's $150,000 a year. Few docs, other than gerontologists, have only elderly patients, so let's say half. The other half, they get 19% more from private insurance to treat (plus the insurer skims off a third). So for Medicare half $75,000 a year, + for private insured $75,000 + 19% around $190,000 a year. Now that may seem paltry for doctors, but not for most Americans.
I don't have a problem with changing that 19% discount to 15% if we don't mind raising health care costs, but I really don't see docs suffering too badly at current rates. http://truecostblog.com/tag/medicare/
Cost per patient.
It actually varies by state, from around 5300 to 9500. Here's a nifty map of the rates in each state:
http://www.tulsaworld.com/news/article.aspx?sub…
Let me note about rural health care that it's not just a Medicare problem. It' affects the privately insured too. Docs can make more in urban areas, and many prefer to live there. In general, any concerns about doctor shortages can be tied directly to the outrageous exclusivity and expense of med school. Tens of thousands of qualified students with good grades are turned away because it's SO difficult to join the rich doctors' club. We can change that and we should.
I don't have a problem with an equitable flat tax, with ZERO DEDUCTIONS. And applied to capital gains and inheritance too. EVERY CENT made from ANY SOURCE taxed at the same rate. But you know that's not gonna happen, so you're just fantasizing.
” I don't have a problem with an equitable flat tax, with ZERO DEDUCTIONS. And applied to capital gains and inheritance too. EVERY CENT made from ANY SOURCE taxed at the same rate. But you know that's not gonna happen, so you're just fantasizing.”
Maybe so, Green. Socialized medicine was once “fantacizing” too once.
I do know there is an adjustable premium. It is completely inadequate. But that's only a start. Hard decisions will have to be made about Medicare to prevent it from going bankrupt.
I agree with you on this. But doctor lobby groups, and many doctors themselves, keep insisting they would have to close practices if the doc fix is put in. Nobody likes a pay cut, but everyone's going to have to chip in to make the system sustainable.
You cost data is 5 years old. It doesn't include cost growth (about a 20% increase since then and it doesn't include Medicare part D which went into effect in 2006. Today it's close to $12k average per enrollee. You can see the 2008 figures here on the table on page 5, which were $11k.
“[I]n a “fair” arrangement, they pay the same percentage – which is fair.”
Note that the percentage means higher-income people pay more than their truly “fair” share, and the opposite for lower-income people. Also, typically advocates of progressive taxation treat their goal of progressivity as synonymous with “fairness” (an appeal to emotion, which all too often is envy).
I actually don't have a problem with the flat rate tax, same percentage for all, based on the most bulletproof intellectual grounds (which is also true about progressive or regressive taxation). The tax is on income. Anything goes. I just view the flat rate as a sound tax and a reasonable compromise, with or without the exemption added, which I believe should either be the poverty level or minimum wage 2000-hour equivalent, or something more generous if we do up-to-date poverty research someday. (While it's just coincidental, my real-world assessment of incomes happens to coincide with the “ten times rule” leftist activists sometimes want for all wages, lowest to highest. I view around $20,000 annually or the price of a typical new automobile as the poverty threshold or low-middle break point, and $200,000, or the price of a typical new home as the middle-truly income division or break point.
(even though homes are still overpriced and ought to typically cost much less than that — same with cars!)
“Medicare recipients pay a premium that IS based on their means.”
It's subsidized — about 75% subsidized. About a quarter of beneficiaries will have their “premiums” increase substantially shortly, by the way. (Trustees' Summary)
Note that the Conyers bill addresses this by making Medicare (for All) 100% mandatory appropriations. (It fails to include the taxes that will be needed, just gives hints at what's preferred, namely progressive income and possibly wealth taxes and a Tobin-style tax, etc.)
* * *
“Nobody likes a pay cut, but everyone's going to have to chip in to make the system sustainable.”
Low pay already results in refusal to accept Medicare patients by doctors (worse still for the same reason is Medicaid). This is not the only cause of access problems, but is a problem in and of itself that often is superimposed on other problems. Where I currently am, nobody is taking new patients at all as a rule, but some may take a few some months(!) in the future. It depends on insurance, as frank discussions I have had with providers already have clearly involved. If I went to Medicare I'd risk even worse access (as well as possibly have inferior insurance coverage and benefits than I have now, at a higher cost counting Medigap or carve-out to try to approach what I have now with out-of-state individual insurance). If it is a poor deal, the portability that Medicare instantly and forever confers is irrelevent.
“Subsidized” sounds like they're giving me something for nothing, but in fact, I have paid into the fund for my elder care my entire working life. So yes, for over 40 years of working, I have paid into a fund to “subsidize” my health care when I no longer work.
Howdy, GD.
“'Subsidized' sounds like they're giving me something for nothing, but in fact, I have paid into the fund for my elder care my entire working life.”
Don't be in a rush (again), to defend SS and Medicare instinctively.
The fact is, Medicare Part B premiums are bogus; they are about 75 per cent(!) subsidized out of general revenues. (Okay, that's better than 90 per cent plus subsidity for growing alfalfa using water from the economically worst Western water projects.)
Conyers's Medicare for All would have all Medicare costs paid for by tax money — mandatory (so the payment is on autopilot and presumably worry-free if ability to raise enough taxes is certain). His preference for taxes is progressive income and possibly wealth taxes, and a Tobin tax on securities sales.
I was discussing Medicare, not Social Security. Social Security's faults include it is an extreme insult when it comes to being such a poor effective “rate of return” on cumulative taxes paid (analogous but not the same as an “investment” here). Going to means testing in the future makes it an even more bitter insult as well as insultingly low “return” (especially if that “return” were to become zero). Given so much reckless and improper debt (made worse by ObamaCo to where the “debt trap” as well as a possible future default, not to mention increased interest rates and debt levels later if Dems seek inflation someday) couldn't at least, with so much debt “assured” to be undertaken, Social Security become (if not a private equities investor) a giant institutional investor buying up Treasury securities, to improve the ”return” substantially for no difference in risk so long as enough debt existed and there was no debt trap or default?