Healthcare proposals, problems, and alternatives

http://tinyurl.com/mfom5e
Obama leaves door open to tax on health benefits By DAVID ESPO, AP
WASHINGTON – President Barack Obama left the door open to a new tax on health care benefits Wednesday, and officials said top lawmakers and the White House were seeking $150 billion in concessions from the nation's hospitals as they sought support for legislation struggling to emerge in Congress.****Concessions from hospitals? Where is that going to come from? Community service via emergency rooms will be first to go; next public clinic hours and "free" services done for humanitarian purposes. Hospitals will "agree", because they have no choice when it comes to the Federal Government and Medicare but there isn't a chance that this will be without severe ramifications for patient care.
A tax on health-care benefits isn't a bad thing since any perk of employment should be fungible with cash payments and it might sever the stupid and pointless link between employment and health insurance (which arose during WWII when Congress decided to allow a swan to be called a duck for the purpose of raising remuneration in the face of wage controls.)All benefits should be taxed and everyone get a minimal tax deduction for payment of health benefits up to a limit. This would put private insureds and those insured under employee plans on the same footing and allow free job changing. There remains the issue of adverse selection and insurance demands that privately-insured people either belong to a sufficiently large and uncorrelated affinity group or submit to detailed medical examination. The former is preferable since there is a moral impetus not to exclude people with pre-existing conditions.Once everyone is in SOME plan, the issue of pre-existing conditions should disappear.****...Obama, who campaigned against the tax when he ran for president, drew a quick rebuff from one union president...****As will be seen below, unions still press for preferential treatment because...they support the Democratic Party.****For their part, key Republicans pressed the White House for assurances that any concessions made now would not merely lead to additional demands at a later date....negotiating with representatives of the nation's hospitals, hoping to conclude an agreement that would build on an $80 billion weekend deal with the pharmaceutical industry.****Of course, how THEY are going to fund research in the future is unclear. Anyone will succumb to pressure from the White House but they either won't deliver on "promises" (which can be vague enough so that "savings" come out of prices or increases that DON'T occur ) or that will hobble the research engine that has produced advances over the years.**** Hospitals were being asked to accept a reduction of roughly $155 billion over the next decade in fees they are promised under government programs such as Medicare and Medicaid, according to numerous officials.****Promises from the government are meaningless, anyway, so foregoing promises is less substantive that it might seem.****...Baucus is seeking similar concessions from nursing homes, insurance companies, medical device makers and possibly others, noting that any legislation would create a huge new pool of customers for industry providers. ****Aside from such market projections not being reliable, there is the circumstance that, if you lose on each sale, you really cannot make it up on volume.Politicians can pretend, however, and others have to go along with them.**** At its heart, any legislation is expected to require insurance companies to offer coverage to any applicant, without exclusions or higher premiums for pre-existing medical conditions.****Right, lower premiums in the face of actuarial disadvantages makes sense only for those arithmetically-challenged.****...hold the size of any legislation to $1 trillion...****A trillion here, a trillion there, pretty soon it amounts to real money...at least it used to.****
...appeared roughly $200 billion shy of achieving that goal. They added that a proposal to make it harder for taxpayers to itemize their medical expenses was drawing renewed interest among key senators as one way to raise revenue.****All one has to do is add another hundred thousand pages to IRS regulations and no-one will be able to deduct anything. Ergo...more revenue!! It will also serve the administration's apparent goal of further reducing productivity by spending more time on tax preparation and planning.****
Current law allows those expenses to be itemized when they exceed 7.5 percent of adjusted gross income... raise that to 10 percent...(On taxing benefits)
Organized labor weighed in quickly....said in an interview that union leaders believe Obama is "a person of his word." ...Obama's opposition to taxing those benefits during last year's campaign."They're not going to take it," McEntee said of workers' views of that proposal. "They're not going to tolerate that."
...he could sign legislation that does not contain an option for a government-run insurance plan....could accept a requirement for individuals to buy insurance, a position he opposed in the campaign....support taxing health care benefits, and officials have said discussions center on imposing the tax in cases in which premium costs exceed $17,000 combined in payments by the employer and worker. Democrats want to exempt union members covered by contracts, but Republicans are resisting.****They should understand that union members vote Democratic.****...higher-than-expected cost estimates from the Congressional Budget Office, internal disagreements and other difficulties....Democrats insist on having an option for government-run insurance...The U.S. Chamber of Commerce said Wednesday that the government-run option would "gut the private market."
ABC News was the lone network broadcasting Obama's town hall — drawing criticism from Republicans who wanted equal time.
In defense, ABC News President David Westin said the show would "include a variety of perspectives coming from private individuals asking the president questions and taking issue with him, as they see fit." ****Pretty lame, even for the Obama-owned media. ****

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