My local paper reports that 27,909 South Dakotans signed up by December 24 for individual marketplace health insurance policies under the Affordable Care Act. That’s 27,909 South Dakotans who will lose insurance coverage if Kristi Noem, Mike Rounds, and John Thune keep voting to repeal the Affordable Care Act.
But don’t worry—Donald Trump just promised “insurance for everybody“:
“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.” People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better” [Robert Costa and Amy Goldstein, “Trump Vows ‘Insurance for Everybody’ in Obamacare Replacement Plan,” Washington Post, 2017.01.15].
Simpler, cheaper, better—I can’t wait to quantify those advances in whatever plan the Trump Congress enacts. But we won’t even have to work that hard to hold the President accountable for his health care plans. Next year, and in 2020, we simply ask our neighbors—not just the 27,909 whom Trump, Noem, Rounds, and Thune will kick out of the ACA marketplace, but everybody—“Got health insurance?” If any of them don’t, the President will have lied to us, and we will have all the justification we need to vote him and his Congress out.
Trump is saying there will be insurance for everybody at the same time Rep. King from Iowa said last week on NPR that people don’t have a right to healthcare. On the first day of the new Congress, King introduced a bill to repeal Obamacare without a plan to replace it. King seems fine with kicking 20 million folks off of Obamacare.
http://www.npr.org/2017/01/12/509542812/rep-steve-king-pushes-ahead-on-obamacare-repeal-before-replacement
King and the Tea Party wing of the GOP are going to make this debate very interesting. Trump is likely going to need Democratic votes for any new replacement plan if Trump can’t get Republicans to unite behind a replacement plan.
This is going to be very interesting. Trump can’t back down from his promises that everyone gets to keep their healthcare and many Republicans don’t support this promise.
The question is how do we pay for Healthcare for everyone. That’s the problem. Everyone that posts here would end up paying the taxes for “Healthcare for Everyone”. I think the Republican plan will be to have available healthcare for those who want it. Those who desire healthcare will be able to choose in their states the healthcare, they can afford. That is the outcome of all this. The mandate on Healthcare will die. IMO
I think that we need to focus on SS and Medicare and assure the elderly and affirmed are taken care of. There is only so much tax money out there. It is key to keep those to programs working. That should be a priority over “Healthcare for Everyone”. IMO I don’t think we can expect to get everything.
Further divisions in the ranks: Trump’s first big political battle is shaping up on one of the signature pieces of his campaign. How will Trump respond to the Tea Party when they say kick everybody off of Obamacare and to heck with the consequences?
http://www.cnn.com/2017/01/17/politics/congress-obamacare-trump/index.html
Mike Boswell says: “I think the Republican plan will be to have available healthcare for those who want it. Those who desire healthcare will be able to choose in their states the healthcare, they can afford.”
These two sentences are at odds with each other. The number of people who want healthcare obviously exceeds by a large margin the number of people who can afford healthcare. That was the whole point of the ACA: getting healthcare to more people who can’t otherwise afford it.
To say that we can’t afford healthcare for all in the richest country on earth is belied by the fact that most 1st world countries already have universal healthcare. Given American innovation and resources, there is no reason we can’t come up with a plan that reduces the cost of healthcare while at the same time improving access to healthcare for all Americans. We have a bloated healthcare system that has huge inefficiencies and no effective market constraints on cost. Single payer with market competition for healthcare services along with negotiated drug pricing would provide healthcare for all at less cost. We could incorporate elements of healthcare savings accounts and other incentives for healthcare consumers to make smart, informed decisions about their healthcare that would also save money.
In the 21st century, in the richest country on earth, the answer cannot be that you get the healthcare that you can afford.
No they aren’t Darin. Some people don’t want to buy Health care. The ACA never lived up to the promises it made and it wasn’t affordable.
While we are the richest country in the world, we also benefit from some of the lowest taxes of any industrialized nation. Many people enjoy that benefit (low taxes). So we need to make choices, so we can keep our taxes low.
Right now we (our nation) is struggling to afford to provide SS and Medicare benefits for the elderly and the affirmed. That is a greater need. Sometimes we need to make hard choices.
Especially when we already have close to $20 Trillion Dollars of Debt.
Mike: “The question is how do we pay for Healthcare for everyone.” I disagree: I think the first question to ask is if it is OK for some to not have health care because they cannot afford it? Is health care the same as getting the new iPhone – if you can afford it: enjoy, if not: so be it.
We begin paying for it by taking all the money currently being spent on insurance and health care and putting it toward achieving the outcome we as a nation ought to be working toward: universal access to health care (not just insurance) to all. it seems like we pretend that increasing taxes to pay for a better system is all new spending; that so many of us are not already spending tens of thousands of dollars on a system that is too expensive and too selective.
Isn’t guaranteeing health care “pro-life?”
How can we afford the 9 trillion cost for repealing the ACA as NOem wants to do? We have a program in place, right now that covers folks with pre-existing conditions with a long history. This program is called Medicare. To find out how it works, ask your parents, grandparents or just about anyone 65 and older.
Regarding Medical Savings Accounts, they are more of a joke than anything. They are great if you are in a high income bracket because you can use these as another form of an IRA. If you are just an ordinary pay check to pay check kind of person, they are expensive and useless.
Meanwhile, Medicare recipients use their health plans with ease. The doc fix is in place so the providers get their loot from taking care of us and we all smile to one another. It is possible that daddy Don could pull this rabbit out of his hat, but that does not seem likely. In the meantime, NOem and company march to destroy healthcare in this country. There march seems much more likely as it is fluid to daddy Don’s blather. Are we gonna let NOem take it from us without so much as a whimper in South Dakota? Maybe not, NOem does have a couple of offices and there are ways to protest that little goofball that she may not like.
Obamacare has regulations against insurance premium “price gouging”. When repealed, if rates double, will you blame Republicans, insurance companies or Obama?
The truth is that healthcare in general will be eliminated. Starting with the ACA, then Medicare and then Medicaid. http://www.politico.com/story/2016/11/tom-price-radically-conservative-healthcare-vision-231965
What will then happen? Ask NOem, Thune and Rounds to explain Tom Price’s plans for our future. Daddy Don is clueless, so he says this kind of stupid, so don’t bother trying to get an answer from him. These three need to have their offices visited to demand answers to questions only they understand. The fix is in and they know it.
Really Jerry HSA is available in many manufacturing companies. I highly doubt that it will cost $9 Trillion to dismantle a program, that’s leftist spin. No the ability to get health care doesn’t equate to pro-life. That’s using other’s empathy as a weapon to push your position. Should everyone be forced to buy healthcare and then increase the Premiums to the point they can’t use it. (That is what has happened under the ACA.) The thought was if we forced everyone into it, the cost would go down. That never happened. Again like many of the promises offered by the ACA they just didn’t work. That’s the reality. Now if we want to start spending 50% of our income for Universal Healthcare and SS and medicare, then maybe we could afford it all. I don’t see that being popular with many.
Leftist spin? Okay, there is that. Pro life? What are you talking about? The ability to have healthcare is pro life. The question is affordability. Medicare is not free, but it is affordable. Ask your family members 65 and over what will happen when Tom Price pry’s that from their grasp.
The problem with cost going down for those who make to much to qualify for a subsidy is that Congress had the mechanism in place to fund the expected over utilization of the plans by the sick. That was taken out by Marco Rubio. That is not leftist spin either, look it up.
The HSA is available to all individuals as well as all companies. It is designed in particular for management to squirrel away another retirement plan that is tax deferred. The HSA account can even be used for investments.
Mike, how is it that the 9 Trillion cost is leftist spin (which is the actual amount Congress voted to pre-approve as the “first vote t repeal the ACA), but your figure that we all would spend half out incomes for universal health care, Medicare, and SS? Your price tag seems far more “rightist spin” to me.
Why is heath care access not “pro-life?” How can you take the position that life is valuable only in-utero? Of course I am using empathy to push my position – the REASONABLE empathy for the health and well-being of others. Do you seriously take the position that all life and well-being issues are only a secondary matter of cost and preservation of wealth?
Our government has become a kleptocracy of the well-connected. President Obama took some steps to reverse that with Republicans fighting him all the way. Trump seems intent on accelerating that process. If the Republicans succeed with their plan to drastically cut taxes for the 1% and cut off healthcare, food and other subsistence assistance for the poor – the poor will eventually figure out that GOP gun and bible demagoguery doesn’t do a damned bit of good for anybody. “Let them eat cake” say the Republicans. History shows us how the peasants will react to that.
Let’s get to brass tacks here If you want to fork over 50 or more percent of your hard earned income to provide Universal Health Care, then we can afford it like the other industrialized nation. If we don’t then we have to pick and choose what are priorities. That’s the reality.
The rap Republicans always accuse Democrats of is “tax and spend.” Republicans on the other hand prefer to “borrow and spend.” Which is more financially responsible?
When it comes to spending, Republicans prefer to spend on the military and giveaways to people who don’t need giveaways – like wealthy estates, large corporations, hedge fund managers, and investors whose tax rates Republicans always insist should be far lower than those of wage earners. Democrats on the other hand prefer to spend on people who actually need help in the form of food stamps, healthcare, etc. Which is more responsible?
Where does health care cost 50% of peoples income? You are saying that 1/2 the earnings of the whole country would have to go to health care to provide universal coverage? I am not conceding that premise.
The highest tax rate in Europe is 45% in Denmark where the economy is thriving. That’s about 15% more then we pay. They are purchasing a quality of life much above USA. At the end of the month Danes have more money left after bills and taxes are paid than Americans have left. Their taxes reduce risks, uncertainties and anxieties among their citizens and prevent extreme unhappiness.
-Education is free and even at university level, there is no tuition fee. Meanwhile, every Danish student receives around $900 per month from the state.
-The Danish laws for parental leave are among the most generous in the world with a total of 52 weeks, out of which the parents can receive up to 32 weeks of monetary support from the state. Furthermore, most employees have five weeks of fully paid vacation allowing families and friends to spend quality time with each other.
-There is free quality health care for everyone and their health care model works as a risk-reducing mechanism. Danes simply have less to worry about in daily life than most other people.
-Denmark is by no means a perfect utopia, and the country faces challenges and issues like any other country. However, the things Americans pay 80% of their paychecks for cost only 45% in Europe. It’s because buying things we all use as a group is much cheaper.
@jerry: “The HSA is available to all individuals as well as all companies. It is designed in particular for management to squirrel away another retirement plan that is tax deferred. The HSA account can even be used for investments.”
No, the HSA is only available to those who purchase a high deductible health plan. It is designed to re-interject the consumer of the product into the marketplace instead of having a third party paying for most or all procedures. It also helps to prevent over purchasing health care which has been partly responsible for the increase in premiums.
And why wouldn’t you want to allow people with HSAs to invest their contributions into investments other than savings accounts paying under .5% interest just as the insurance companies do? This serves to increase the size of the pool of funds for later distributions/expenses. Unlike 401Ks/IRAs the funds can only be used for qualifying medical expenses (even dental expenses which the ACA does not cover).
Porter, you missed disability and unemployment inclusive as well. Yes, Europe pays those high tax rates for the goods and services required to be a valued member of society. August is basically known as the holiday month. You can also purchase private insurance there as well. Those plans are underwritten, so they are selective on who they insure.
I think what the republican will force upon us will be what are called “mini meds” or “skinny plans’. These are allowed now. I present to you daddy Don and NOem’s healthcare plan, repackaged as genuine. https://www.vice.com/en_uk/article/skinny-health-insurance-plans-might-be-the-worst-thing-about-2015
When you go in for your cancer treatments, show the doctor this plan. Boy, will they be impressed with how it works and how well they are gonna treat you.
Now factor into Porter’s numbers the roughly 13% of my income that goes to health insurance for my family. That is the cost if we do not use health care because every office visit and cost has to also be paid out of pocket until we meet the deductible; then we get to start splitting the bill with the insurance. A 15% increased tax burden doesn’t seem like such a boogie man when put in the context of me already paying at least that amount for health care now.
Right, Jerry & O, I didn’t want to make it sound to good to be true but t also provides a retirement plan that pays three times as much as our Socal Security. Even if you live in Goodwin or Kranzburg. 45% is a darned cheap group rate for that package. USA CAN DO BETTER.
But it is available to all individuals as well as companies. Yes it is high deductible with you paying the full deductible before the insurance picks up any of the costs. For those 65 who want to keep private insurance, their is no credible coverage for your drug plan. So you must buy a Medicare Part B as well as Medicare Part D, so it limits your freedoms.
You, the policy holder must contribute to the HSA. So lets say that you are an employee that makes $15.00 an hour as promised by the new jobs plan. (Where are these jobs coyote?) You make $31,200.00 per year. After you have paid for your portion of health insurance for the privildge of having this plan, you then have to fund it as well as covering all of your medical bills. Say you have a health issue and it costs you $5,000.00, you must pay that and not get any help whatsoever from the insurance. So you have paid out of your pocket $5,000.00 for healthcare costs plus your premium. Say that you are one of my children’s age 36 and you pay half of the insurance cost while your employer pays the other half. His premium is about $180.00 a month for a $6,550.00 deductible or a total out of pocket of $7,160.00. Deduct that from $31,200.00 and you have $24,040 left over. Now explain to me how you are going to fund something like an HSA without considering your house payment, your other insurance, your utilities, your vehicle, your clothes, your food, your 401k. All of these numbers consider a 52 week year with no time off. In short, it ain’t happening. These HSA’s are only taken out for catastrophic coverage, not for anything else. No one can afford to put any more money away other than that little amount they contribute to their 401k.
The HSA was never designed for the rank and file, it was designed purely for management and those that have the money they can fund another retirement account. You still have to pay for the dental expenses Coyote. If you are 19 and under, the ACA does pay for them as well as vision as that is inclusive in all ACA plans except HSA’s. BTW 401k/IRA’s can indeed be used for medical hardship expenses without penalty.
The CBO is reporting today that with the current repeal of Obamacare, 27 million will be left uninsured. That is 7 million more than the 20 million most often used.
Additionally, the number of uninsured could climb to 32 million by 2026.
Regardless of what Trump does, there will have to be an increase to health insurance premiums.
The $9 trillion is going to cost to fully repeal Obamacare is a real cost that congress already approved. At this point it is pure speculation how much more it will cost to fully implement a Trump plan since he hasn’t released any details.
You may not buy in that you will have to fork out 50% but if you look at every other nation that has Socialized Healthcare that’s what they are paying. I deal in realities.
Does anyone remember the costs of insurance prior to the ACA? I do. Insurance companies, by law, could raise premiums to the full max of 67% per year. Some individual plans could raise your premiums monthly according zip codes to those maximums. So if you lived in Quinn, South Dakota or Orient, South Dakota and you were the only policy holder in each of those great cities, your premium would pool to that zip code, monthly. As you now would have cancer or heart disease or some other life drainer, you would not qualify for any other insurance because of a pre existing condition. Tough luck dude. So the only thing you could do if you could afford it, was to hang on until Medicare. Now NOem is after that as well.
Good for you Mr. Boswell, then it will not be an issue for you to go back to the old ways of reality. Me, I think to look ahead rather than behind. I do not want to make America Great Again. I want to make America Great, Period. No past tense for me. The rear view mirror is for passing, not for moving forward and progressing.
The coffee companies are getting ready to bring back the large cans metal. We will need those for the pictures of those poor souls that are dying the slow death of unconcern and ignorance. The big ol’ cans will have a picture on them to indicate that there will be a chili supper with a silent auction while the sick will be on hand to witness the love given. In the meantime, put what you can in the can for help. Yes, the $2,400.00 will be appreciated and the sick will be grateful, but the credit collection company will not be impressed. Welcome to NOem’s South Dakota vision, with Mr. Boswell signing on as well.
I did an article on health care in the early 90s for the weekly paper in Rapid City. Heartbreaking story of a single, childless, working woman in her early 30s. Her employer didn’t offer health insurance and she couldn’t afford an individual health insurance policy. She had to have an emergency operation for a condition that could have been much less expensive had she had good preventive, regular care. She developed a post-operstive infection and had to undergo another operation. She had an extensive recovery period and lost her job. The medical bills piled up and she had no way to pay. She borrowed some money from her parents to pay rent for a couple months. The financial problems weighed heavily on her, and she became depressed on top of her other health problems. She was too proud to seek assistance, but due to my writing the article, I was able to get her hooked up with a county program that paid her medical charges. She couldn’t go back to work in time to pay her rent, so she was evicted. She ended up sleeping on friends’ couches for a few months, but then ended up homeless. I lost track of her, but saw her at the store a year later. The county was paying to have her lodged at one of the East North street motels.
Lack of proper health care cost county taxpayers nearly $50,000 in 1993. Her life was shattered. I never found out what happened to her after that. She doesn’t appear to be on social media. And I have found no obit.
We never tote up the costs Obamacare saves. How much are county taxpayers saving because there is far less need for county medical assistance? How many people no longer become homeless due to medical bills and no longer require housing? How many spirits aren’t shattered?
You can’t make it cost less Jerry that’s reality. You don’t have to like it.
So Mike doesn’t think that anyone should be forced to by medical insurance. Fine! Then, when an uninsured person breaks anm or has a heart attack and had decided to save money by not purchasing insurance, they should be denied care unless they pay cash. Fair is fair. I don’t want my insurance rates to go up because that person decided not to jump into the pool. We share risk, we all benefit!
Actually Loren you usually end up paying for it in your County Property Taxes at a much lower rate than quoted. It depends on where you live.
Mr. Boswell,
Q – You’re an Army guy. Do you know why the Army doesn’t just pay soldiers a little more and make them buy their own meals?
A – Because it’s cheaper to pay for and cook meals for a group.
Same with all the things the 50% tax would pay for. Things that we now pay 80% of our paychecks for. Healthcare, retirement, unemployment, sick leave, maternity leave, vacation, college and more.
Mike, can you explain to me how Donald’s story of the woman who needed surgery she could not afford is NOT an example of how health care is a pro-life issue?
County taxpayers will pay most of the cost. The rest of the cost is shifted to others.
Ever try to ask about how much you will be charged for a doctor visit or lab test or a procedure? They can’t tell you without weeks of research. Even then they will not guarantee your charge. There could be thousands of different prices for the same thing at the same medical facility, depending on insurance coverage. It’s a bit easier with Medicare.
Mike, if you are claiming that we would need to pay roughly 50% of our incomes in taxes just to help pay for healthcare, then do you happen to have a source to support that number?
I did some checking myself to see what other nations pay vs. what we pay in the US. According to the Tax Foundation, American workers pay approximately 31.5% of their incomes towards taxes. This is a combination of all taxes taken from the paycheck.
Now obviously we would expect to pay more if the government suddenly offered national healthcare. So perhaps we could look to some other nations and see what their tax rates are in comparison to ours.
Canada? 31.5%.
UK? 31.1%
Ireland? 28.2%
But wait? Those numbers are lower and yet they all offer universal health coverage. How very odd.
Granted some nations are taxed at higher rates. Japan is at 31.9%, Norway is 37.0%, Denmark is 38.1%, Spain is 40.7%, and Sweden is 42.5%. All of these nations offer universal healthcare for their citizens. The average is 36%, so when you look at the US being at 31.5% I think most people would say getting universal healthcare and being taxed at 36% or even 40% would be well worth it.
Check out Chart 2 at this link if you would like to review the numbers yourself: http://taxfoundation.org/article/comparison-tax-burden-labor-oecd-0
The fact is, many Americans are already spending a lot of their pre-tax as well as after-tax dollars on healthcare. If you factor in what percentage of paychecks are going towards health insurance, doctor co-pays, and all out of pocket costs, you will find that the average person who actually has health insurance would likely be better off with universal coverage even if it resulted in their taxes going up.
Those who would not benefit from universal healthcare generally fall into one of two camps. The first group are those with low incomes. These people don’t have health insurance thus they don’t pay for it. They also make so little money that when they do get sick, they are unable to pay the bill. This means those costs are shifted over to us… the taxpayers and users of medical services that can pay our bills. The second group are the wealthy. They would likely end up paying a percentage of their income in taxes used for healthcare, but that percentage would exceed their personal benefit. So someone who makes $10MM a year might end up pay a 5% tax on that income ($500k) and logically they would never use anywhere near that amount of healthcare throughout the year thus universal healthcare isn’t the best idea for them.
Are we starting to understand why a certain political party in Washington is so against universal healthcare yet?
The truth is, once we take away the massive profits from hospitals and clinics and laboratories and testing centers and insurance companies and use that money for ACTUAL HEALTHCARE (like many other nations already do with their healthcare systems) we would find the amount our taxes would need to go up would likely not be a significant amount. The average American might see their income taxes go up by 2 or 3% a year, but much of that (all of it in most cases) would be offset by savings on health insurance and medical costs. So universal coverage would be a benefit to the average American.
Let me be clear however – even if I ended up paying a bit more in taxes, and even if I found when everything was calculated that I was paying more for universal healthcare than I am under the current system, I would still support universal coverage. The reason is that I am totally ok with my taxes being used to help so many others that other wise wouldn’t have the ability of receiving medical care or would have to suffer because they can’t afford their medications or preventative treatments. I guess I feel that is a worthy tradeoff but I know some don’t agree… or at least they claim not to agree until they find themselves sick with mounting medical bills with no way to pay for them.
So would we pay 50% of our paychecks for the “luxury” of universal healthcare? Nope. Not even close.
When we get those jobs, those good paying jobs as promised, we will not have to worry about anything as we should be able to pay our own way for insurance and everything else. A couple making $30.00 bucks an hour starting, will do just fine. Those jobs are going to start like next week, shovel ready stuff. Let’s do this.
Craig, in their tax, they also include disability insurance, unemployment insurance. Those things are yuuuuge. When you get hurt here, off the job, you are in bad shape financially so you go to work sooner than you should to cause yourself even more problems.
More brainiacs that will be manning the picket lines when they finally realize that daddy Don just took away their healthcare. It is gonna get ugly. http://www.usatoday.com/story/opinion/2017/01/17/planned-parenthood-trump-gop-abortion-column/96618992/
You all forget we still have $20 Trillion Debt to pay down as well. You can’t have everything.
There are 8 men in the world that have as much wealth as the bottom 3.5 billion people. Even with that wealth gap the repubs fight the estate tax, progressive taxation and any other plan or program that might level the playing field. Anything supported by the repubs seems to lead to more income equality.
I read, can’t remember where, that healthcare would be used to further increase income equality. Before the ACA 50% of the people taking bankruptcy were those that had health insuance. Once the ACA is repealed and the junk policies that are pushed by the repubs take over, bankruptcy rates will increase. Foreclosure is music to the rich man’s ear.
Greed or Empathy, guess which road healthcare will take?
Craig you are forgetting VAT taxes on things people buy in the EU and elsewhere. Vance you are the one and every other hard working American will be paying as we have the numbers. Right now if you make under 50K you are getting a bargain in taxes. If we push Universal Healthcare that goes away. You may not like the reality of it but it is the reality. There is no free lunch.
Craig is telling it the way it is. The current healthcare system is unsustainable and socialized healthcare via Medicare for all will eventually become reality. Our taxes will go up but losing your savings and the mortgage won’t be nearly as common as it is today.
After a few years people will start appreciating their Medicare and will wonder how on earth people were ever able to afford health insurance back in those days.
Mr. Boswell … You’ve thrown out that $20 trillion like it has a reach that should cause drastic action. If you’re going to talk about our debt, first tell us how much we’re worth. (e.g. If I have a farm worth $282 trillion and a farm debt of $20 trillion, is that a “hair on fire” financial situation that would warrant not taking my kids to the doctor?)
Mike Boswell: “Craig you are forgetting VAT taxes on things people buy in the EU and elsewhere.”
Yes I am. I am also “forgetting” to add in sales taxes, gasoline taxes, property taxes, the fact that many other nations also offer free or extremely inexpensive post-secondary education (read: free college), as well as PAID family leave. For example, the UK offers 39 weeks of paid maternity leave and even 2 weeks of paid paternity leave. Some nations offer less, some much more. Heck even Iran offers 12 weeks of paid family leave – yet the US offers 0.
So yes I didn’t mention VAT, because it wasn’t core to the discussion. If we wish to discuss all possible taxes paid by those in any particular nation this discussion is more complex, but with that we need to consider all possible benefits citizens of those nations receive. I think you’ll find many people would gladly pay more taxes to have universal healthcare, paid family leave, and free or extremely inexpensive post-secondary education. Even better, as Jenny references, people would gain stability without the fear of losing their homes or having to file bankruptcy due to a sudden health issue or birth of a child.
Safety and security serves us (the taxpayers) in other ways as well. Imaging when people have the power to take jobs with other companies without the fear of losing their health insurance. Imagine a family knowing that when they have a child and can’t work for a few weeks they will be ok. Imagine the relief of knowing if your child needs an emergency appendectomy that it won’t result in filing bankruptcy or potentially losing your home.
You go on ahead and worry about VAT or having to pay a few bucks more in taxes. I’ll worry about what is better for my fellow citizens.
Mr. Colbert has something to say to you Mr. Boswell. https://www.youtube.com/watch?v=Di9R9oA5Qzk
Food has a 4% VAT in the EU. South Dakota has a 4% VAT. So there is that.
If your numbers are accurate that is a powerful and informative post Craig. Thanks! You have shown that, for once, Trump was right. The countries you identified provide actual evidence that universal health care can be made available for everyone at a cheaper price than we pay today without increasing taxes.
Boswell, your comment about our national debt got me wondering how bad is it to have debt. For example, my family is not in debt but we are not rich, yet Trump is heavily in debt, but he is fabulously wealthy.
If you are in debt with a mortgage you have a house to live in. Homeless folks have no ability to get credit and are not in debt.
Typical families can only rely on whatever income that they can earn and if they get over their heads and cannot meet their creditors demands, they often go into bankruptcy, like Trump. In contrast to families, the USA government has the US Mint and the Mint has the legal authority to print money as needed to pay whatever interest is due on the USA debts.
The interest paid on US debt provides income to the top holder of that debt –
http://money.cnn.com/2016/05/10/news/economy/us-debt-ownership/
It seems that pretty compelling evidence clarifies that adding to the debt as necessary is not a negative factor after all.
Here in the United States, if you want to hire a builder to get some work done, the builder charges you tax on his work. He figures in workmen’s comp, unemployment, use tax. Unless you are someone who works in Aberdeen, you have to declare that and pay it to the state, and city. In some respects, that is a VAT.
Also, different food types have a different VAT in the EU. 4% to 10% depending on what it is you are purchasing. If memory serves me, milk, bread, beans and foods in that group are 4%. Specialty foods like sweets and so on are taxed at 10%. I guess it is because they have such low rates of obesity and know that the more sweets you buy, the more it costs the taxpayers to treat you for being a fat arse.
Thanks Secretary Burwell for a job well done! All Americans will miss you!
“The current Open Enrollment period ends on January 31. 11.5 million Americans are already signed up for 2017 coverage, but if you don’t yet have health coverage, visit HealthCare.gov or your state Marketplace and explore your options today. Financial assistance may be available to help you get covered. In fact, most Americans shopping on HealthCare.gov will be able to find health coverage for less than $75 per month, after tax credits. Shopping for a plan has never been easier thanks to tools that help you find plans based on whether they cover your doctor or prescription drugs. And you can get help 24 hours a day, seven days a week, comparing plans and enrolling in coverage by calling 1-800-318-2596. Or find in-person assistance in your community at LocalHelp.HealthCare.gov.”
NOem needs the McMorris treatment. The Resistance is strong https://www.youtube.com/watch?v=W4yQs5pIgS4 Save our healthcare is real. McMorris is like NOem, from a red district and they booed her arse off the stage.
So right, Jenny. On a timeline, in order to get to Medicare For All, Obamacare must be repealed. The Republicans are doing our work for us and THEY’RE going to suffer the blowback from the inconvenience and rate hikes, not us. We’ve got ’em right where we want ’em. Medicare For All will happen only when the people (Republicans, Democrats and Unaffiliateds) demand it. When the chaos from repealing Obamacare without a replacement happens, the people will eventually demand it. They’ve knotted their own noose and are smiling indignantly on the way to their own gallows.
Porter I think you have too much hope for Medicare for All. I think you will get something between what was here before the ACA and bit more. That’s it.
Mike Boswell … I think you have an overinflated opinion of your validity to predict anything. I have lots of friends from Goodwin and believe me folks, it’s not a progressive thinking, cutting edge Mecca of modern thought.
Whatever daddy Don is selling, we cannot afford to buy. Daddy Don is the meth dealer down the block, you make a deal with him, and soon you are destroying yourself. Just say NO. Hell ya, worked for NOem for all these years. Just say NO!
There are a lot of improvements that could have been made by Congress and the Pres since the ACA took effect. All of these politicians, regardless of party, are paid by Big Health Care and none of them have done a thing about health care costs. They do nothing about the Medicaid drug prices that are artificially high. Not a peep about their hedge fund friends and contributors buying patents and increasing prices tens of thousands of percents. Healthcare in America is still a blood sport for the working poor, on Wall Street and at your local hospital.
No one has ever explained why an after regular hours x-ray, taken in South Dakota and read in India costs $200, while the procedure is $4 in India. Since an Indian doctor reads the x-ray, shouldn’t there be a discount for that part of the bill? Why is an MRI is $20 in India and $1,000 here?
Why do insurance companies pay $700 for a 70 cent epipen? Answer: they don’t. Only people with cash but no insurance pay $700, failing that, county taxpayers write the check. Where is Congress? Where are the County Commissioners? Where is Obama and his huge Executive Order Pen to defend us?
Priorities.
If Trump and Troupe repeal, they better start with the Mandate and the 15% Federal Income Tax increase we saw with the ACA. What are the odds that those will the only two things left intact?
@Jerry: “Here in the United States, if you want to hire a builder to get some work done, the builder charges you tax on his work. He figures in workmen’s comp, unemployment, use tax. Unless you are someone who works in Aberdeen, you have to declare that and pay it to the state, and city. In some respects, that is a VAT.”
No it’s not. Not in anyway shape or form. A VAT (value added tax) is collected at all levels of production, every time there is a transaction. For example a steel mill will pay a VAT on the ore and coal it buys to make steel. The auto manufacture will pay a VAT on the steel, paint, glass and tires it buys to make a car. The car dealer pays a VAT on the cars it buys and finally the customer pays the VAT on the car when it is bought.
To avoid a cascading effect of the VAT, each level is allowed to deduct the total value of the VAT paid (input) from the total value of the VAT charged (output). This however introduces steep administrative and compliance costs on the tax system which creates a deadweight loss on the economy. This is one reason that you see the European Union economies so slow at recovery from recessions or economic stagnation. It’s also a very regressive tax, much more so than the simpler sales tax which also is more efficient in it’s collection reducing the deadweight loss on the economy.
@Porter Lansing: “If you’re going to talk about our debt, first tell us how much we’re worth. (e.g. If I have a farm worth $282 trillion and a farm debt of $20 trillion, is that a “hair on fire” financial situation that would warrant not taking my kids to the doctor?)”
Ahhh the old debt to GDP ratio argument. The problem with that argument is that the national debt is much higher than the “official” $20T probably in excess of the entire economy. Much of the debt is off the books or even calculated as an asset instead of a liability. All those Social Security bonds, Medicare bonds, Highway Trust Fund bonds, etc,etc,etc will need to be paid off at some time in the future or issue new debt. The interest on all that debt can currently be serviced due to the low, low interest rates the Fed is setting. However as the economy heats up the Fed is going to have to raise rates to avoid hyper-inflation because of the trillions of dollars they have monetized in all their quantitative easing purchases. At some point debt servicing could consume all Federal tax revenues.
@Coyote … pure speculation ~ Pay off the bonds or Issue new bonds. Machts Nichts. Debt servicing won’t consume all tax revenues because wait for it … at that point the economy has heated up. Your imaginary scenario will never come true. You’ve been spreading that manure for 50 years and it hasn’t and it won’t. It’s just a scare tactic to get voters to allow the rich to pay less taxes. As a teen I was told (by Republican sycophants) that Social Security wouldn’t be there when you get old. In fact, I hear it often from young people, today. I get a check. Everyone gets a check and speculation like you’rs would only come true if our dynamic economy comes to a complete halt for a couple decades. At that point … machts nichts. The debt is the debt and our net worth dwarfs it.
Ya’ know, Coyote. We’ve had this discussion three times, which makes if officially a “dead discussion”. Words will never convince someone. Another may act as if you’ve changed their mind but within a week or two they will revert to what they previously thought, usually just from habit. That’s why arguments and back and forth repartee are essentially worthless. The only qualitative example of changing someones mind, is action. If a person sees happen, what someone else is asserting, they will actually change their mind, forever. You’ve been telling your story about quantitative easing disasters and The Fed ruining our country for too long for it to be believed, without some visual demonstrative proof. LWIY (last word is yours) on this subject until you’ve got more than speculation.
Here’s the Problem with Universal Health Care (UHC) for all. This will touch a lot of subjects, but explains why we can ill afford UHC. First of all, the inconvenient truth is we as a nation spend more money than we take in, that has been happening for Decades.
Congress can no longer borrow from SS and Medicare as those funds wouldn’t be able to pay out the current need.
They have had to borrow now to pay for the overspending now which has increased our National Debt to almost $20 Trillion Dollars. That Debt requires us to pay interest on that debt.
So current situation is that we are getting a smaller amount of the budget that is discretionary and more of the budget that is needed to pay for SS, Medicare, Fed Employees, Retirement, Military Personnel, Vets, Military infrastructure, Interest on the National Debt, and others. These items must be paid.
The ACA was also part of the in-discretionary budget. It added to the have to pay items.
Congress now has an ever decreasing pool of budget items they can spend on the tons of other programs. So they borrow more money. Thus the fed is now in a cycle of debt. Anyone that has been here knows how hard this can be to get out of.
The problem is that how do we get this under control and this is where the political parties run into and uncomfortable situation. They know the only way to get this under control is to 1. Increase Taxes on all, or 2. Decrease the part of the budget that is in the in-discretionary part.
Increasing taxes on all is a loser position for both parties and they won’t even go there. Republicans want to either grow the economy (increase tax base) or chip away at the in-discretionary part of the budget.
Democrats want to increase taxes on the wealthiest and business. Well the wealthiest are already chipping in most in income tax. Taxes on Businesses are always passed down to the consumer (yes even taxes on profits). The other part is increase taxes on Businesses decrease economy growth (decrease the tax base).
Both parties know the problem, but politically don’t want to do what is really needed. Decrease Discretionary Spending and Increase Taxes on all.
Now you want to add in UHC that automatically goes to the in-discretionary part of the budget. You now get into a deeper cycle of debt.
Another inconvenient fact is that the American People will not stand for the kind of taxes they have in Europe to pay for all of this. To purpose this kind of increase in taxes is a guaranteed loser for any politician.
So here we are, we are killing the ACA and replace it with what. I think the best we can do is take the best parts of the ACA and make it available for all (who want it). Make the plans adjustable so that the consumer can buy what they can afford. Does this mean some people will be without healthcare, yes. But it is probably the best you can hope for.
Porter will let your insult slide. Progressive thinking can also be what can “really” be done versus (desires and empathy) wish can be done. I am a realist.
OOps sorry I should have said to propose this type of tax increase.
Value added tax: a tax on the amount by which the value of an article has been increased at each stage of its production or distribution.
“With VAT, the consumer has paid, and the government received, the same dollar amount as with a sales tax. The businesses have not incurred any tax themselves. Their obligation is limited to assuming the necessary paperwork in order to pass on to the government the difference between what they collect in VAT (output tax, an 11th of their sales) and what they spend in VAT (input VAT, an 11th of their expenditure on goods and services subject to VAT).
However they are freed from any obligation to request certifications from purchasers who are not end users, and of providing such certifications to their suppliers.
On the other hand, they incur increased accounting costs for collecting the tax, which are not reimbursed by the taxing authority. For example, wholesale companies now have to hire staff and accountants to handle the VAT paperwork, which would not be required if they were collecting sales tax instead.
The advantage of the VAT system over the sales tax system is that under sales tax, the seller has no incentive to disbelieve a purchaser who says it is not a final user. That is to say the payer of the tax has no incentive to collect the tax. Under VAT, all sellers collect tax and pay it to the government. A purchaser has an incentive to deduct input VAT, but must prove it has the right to do so, which is usually achieved by holding an invoice quoting the VAT paid on the purchase, and indicating the VAT registration number of the supplier.”
The reason that some countries of the EU struggle is that they are under the same currency in that they cannot do like the United States can do as an example, just print more money. They gave up the printing press for a central bank that sets everything based on what Brussels says.
The American people are the most ill informed on the planet. They do not even know that Obamacare and the ACA are the same.
Here is what they would purchase with their tax: They would just like to know that they can go to the doctor when they are sick. That they can have the dignity to be treated for their broken bones and worn out parts. They want to be able to have the security that when they do get hurt and they do get sick, they have a disability that will cover them immediately. They would like to have sick days to stay home and not contaminate the rest of the workplace and be paid for those sick days. They would like to take care of an ailing parent or newborn child.
“Another inconvenient fact is that the American People will not stand for the kind of taxes they have in Europe to pay for all of this. To purpose this kind of increase in taxes is a guaranteed loser for any politician.” You are incorrect as the rest of the world proves you wrong.
Bernie wipes the daddy Don smirk off Prices smug mug. https://www.youtube.com/watch?v=81d6jbClgL4
Jerry I have been told by more than one person you go on a platform that you plan on increasing taxes you will never win an election.
We are a self centered lot who want to get the most without having to pay for it.
Mr. Boswell … You’re half correct. Red states won’t elect candidates who even hint at raising taxes, however we blue states do it all the time. We realize that taxes and buying as a group save all the state’s citizens money.
This is why red states will wither under Trump and blue states will bloom. (i.e. Here in CO, when federal taxes are cut, we’ll raise our own taxes and pay for what we want and not have to share it with you blue, moocher states any longer; by sending money to Washington, first.). You need to explain to yourselves why you voted for Trump and to cut off your nose just because your face was ugly. (nothing personal, South Dakota – just anology) lol
ooops … can you see my mistake?
There was a few Blue States that went Red in the last election. So you might want to rethink that. Saving money has very little to do with it. The point made is we are so far in debt, we can’t afford to spend.
BTW I didn’t vote for Trump. He and Hillary had too many character issues to even consider voting for. Again I am a realist.
Yes Mr. Boswell, South Dakota was one of those states. We are not in debt Mr. Boswell. Republicans have long said that deficits do not matter and that is one of the few things I can agree with them on.
What “real” blue state went red? What does “far in debt” mean? How much is USA worth? (Total U.S. assets amount to about $225 trillion.The Z.1 report does not disclose tangible holdings (such as real estate) owned by the financial sector, state and local governments, federal government and foreigners.) How much is our debt? ($18 trillion according to Forbes 4-24-2015) Our debt is insignificant and to prove it, Republicans have been predicting doom for 40 years and nothing has happened except growth. That’s why debt wasn’t even an issue in the Republican debates or the election. USA has “some” debt. USA has no debt crisis.
~ Complaining about the debt is done by Republican elitists and fools to steer timid people to buy gold … a notoriously poor investment.
WE are now just $40 Billion shy of $20 Trillion. It is not insignificant as the payments on the interest of the debt is eating into the budget. We are not spending more than our annual GDP.
http://www.usdebtclock.org/
Do you know why, Mr. Boswell? Here’s two choices.
1. Because elderly, disabled and low income citizens are getting too much help with their living and medical hardships?
2. Because those making over $3 million a year aren’t paying the 90% tax rate they paid before Reagan slashed it?
It’s number two, sir.
Mike B: “Here’s the Problem with Universal Health Care (UHC) for all. […] First of all, the inconvenient truth is we as a nation spend more money than we take in, that has been happening for Decades.”
This is a red herring and has nothing to do with affording universal healthcare. Nobody suggested we can just open the floodgates for universal healthcare without increasing taxes to pay for it. Managed properly this system would be self sustaining much like Medicare and Social Security and thus would have no bearing upon national debt.
Mike B: “Congress can no longer borrow from SS and Medicare as those funds wouldn’t be able to pay out the current need.”
Nobody is suggested they borrow from those funds. However those funds can easily be made solvent with a few small changes. Namely removing the cap on Social Security taxes and allowing importation of drugs from outside the US. As the population ages and longevity increases we will always need to tweak the age of full retirement and full benefits for these programs. That isn’t unreasonable.
Mike B: “They have had to borrow now to pay for the overspending now which has increased our National Debt to almost $20 Trillion Dollars. That Debt requires us to pay interest on that debt.”
This is true, but again not central to why we can or cannot afford an independently funded program.
Mike B: “Thus the fed is now in a cycle of debt. Anyone that has been here knows how hard this can be to get out of.”
It wasn’t that long ago (under President Clinton) that the country had a budget surplus. We can’t expect that to be the case every year, but with a proper budget and an administration who isn’t focused upon starting multi-trillion dollar wars, it is feasible. Obama has greatly decreased the size of the budget deficit thus if future administrations can stay on target we could see surpluses again. Every cent of those surpluses could easily be directed towards the debt.
All that said, this has NOTHING to do with universal healthcare.
Mike B: “Another inconvenient fact is that the American People will not stand for the kind of taxes they have in Europe to pay for all of this. To purpose this kind of increase in taxes is a guaranteed loser for any politician.”
I’ve already shown the tax rates other nations have, and they aren’t drastically different from our own. I even cited a source for the figures – a novel concept I admit. The truth is, if you tell the average American that his or her taxes will need to go up 5% next year, but as a result they will no longer need to pay for healthcare insurance and their co-pays and out-of-pocket maximums will drop sharply… most would be on board immediately.
It is all about marketing. People don’t like taxes as a general rule, but if they understand the net benefit they will support it. Plus it isn’t like any of this would occur overnight – people will have time to understand the benefits just as those on Medicare already do. Ask the average 70 year old if they are willing to give up Medicare for a slight reduction in income tax rates and be prepared to have them laugh in your face.
Thanks Craig for laying out all the logical responses to Mike Boswell’s issues.
I would add one more thing here. Although the ACA has done a decent job at cutting the growth rate in insurance premiums, the ACA was a compromise whose primary focus was not on cutting the cost of healthcare. The votes in Congress were not there at the time the ACA passed to enact single payer universal coverage. Single payer universal coverage would have allowed significant cost saving mechanisms like competitive bidding by private healthcare systems, doctors and other healthcare providers. The ACA essentially pitted insurance providers against each other, but the insurance providers did not have the leverage or the legal mechanisms to get healthcare service providers to reduce costs. On the other hand, a single payer system in the vein of Medicare could put an emphasis on cost control, efficiency and quality. Mechanisms for keeping some “skin in the game” for healthcare consumers could also be added so that cost controls are aided by self-interested decisions. We could very well come up with a healthcare system that provides better service at less cost to essentially 100% of Americans. I don’t think we can afford not to go to a universal single payer healthcare system.
Well presented, Craig. If people, especially in red states, can come off the bullsh*t mindset they’ve had drilled into them by populist charletons, that taxes of any kind are bad they’ll understand how buying things we all need as a group is cheaper. But, of course … it’s 100% possible to get National Healthcare without one single person in South Dakota supporting it. FOLLOW THE BLUE BUS …..
ANOTHER CONSEQUENCE … CBO says 18 million will lose insurance upon repeal. Of those, probably 5 million will buy a policy (like before the ACA) where if you get cancer, diabetes, MS or a long term illness the insurance company can refuse to renew your policy at the end of the yearly term. No other company will sell a cancer infested, half-dead person a policy, so bankruptcy ensues … just like happened to my late wife when she got breast cancer. Every one of these five million people will be a nice commission to some insurance agent somewhere. Another windfall by making big coin from sick people. An evil system benefitting heartless business people.
Porter, here is the “some insurance agent” to be clear on, Senator Rounds will be rewarded handsomely for his vote in more was than one. Insurance agents work for insurance brokers and wholesalers like Fisher Rounds, Rounds is grinning like a cat slurping cream. That EB5 thingy is childsplay on what he will make with this shower of gold.
The dumb is contagious, we need something to cure it. http://www.huffingtonpost.com/entry/jimmy-kimmel-obamacare-affordable-care-act_us_587f95e4e4b0c147f0bc277e
Can’t argue reality with a Liberal. It can’t get past the empathy.
Someone needs a big hug so we can share the feelings.
If you wish to argue with someone Mike, you’ll do better with facts than opinions. If however you wish to just label people and continually change the subject, you won’t be on the winning side of many of those arguments.
The court settles stuff. Wellmark, Avera and Sanford should be dusting off their claims history and get some paperwork filed. An Oregon insurance company did just that and was just awarded $214,000,000.00. That is Two Hundred Fourteen Million bucks for Marco Rubio and the republicans bullpuckey killing of the risk corridor https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0
As Joe Bidden would say, “This is a big F’n Deal”.