• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

It looks like Trump want to explode the deficit

Agree. Only question is; how is it paid for? I say it's paid for by raising taxes on the top 1%...perhaps adding a tax bracket at $1M that is 70% (and that assumes all forms of income are taxed the same...income, capital gains, etc.).

Raising taxes won't get what you desire as you need many of those top 1% small business owners to create jobs. You issue 30y Government bonds and in 30 years those bond are paid for 2x over (or more).
 
Financial penalties for poor performance are already part of what's been happening over the past six years. But that's not what ACOs are for, per se. We need ACOs because we want (1) better, more coordinated care delivery, and (2) to encourage efficiency and savings to the health care system. But ACOs as structures for re-organizing care delivery on the provider side aren't financially viable unless the financial incentives inherent in the industry change. You can't cajole providers into making investments in the relationships and tools needed to improve care if its ultimately going to reduce their revenue; you need to reshape the financial incentives so there's a business case for doing it. Hence the move to change those incentives.

The most succinct explanation of the problem I've seen is from a firsthand account several years ago from Intermountain, an integrated delivery system out west:

You shouldn't be paying any industry be it healthcare or any industry for doing what is morally right. Especially an industry in which is built upon the Hippocratic Oath. If you paying them to do what is most basic within the Hippocratic Oath, then blow the system up because it's not a system about caring for the sick and being selfless but rather one of profit.

The answer isn't UHC but rather Government drawing a tough line on the idea is that private health care in the US.. is for profit. Before Medicaid and Medicare.. it was non-profit. Since those programs it was for profit.
 
I isolated this part of the comments in your OP.

Isn't costing much right now?

This Is How Much Obamacare Will Cost Taxpayers in 2016

New projections from the Congressional Budget Office, however, anticipate that the federal government will need to spend more on Obamacare than previously thought.

The non-partisan office estimates that the program will cost the federal government $1.34 trillion over the next decade, an increase of $136 billion from the CBO’s predictions in 2015. In 2016 alone, Obamacare will cost a total of $110 billion.​

I don't know what your measure is for "costing much right now", but $110 billion and growing fit's in my category of costing much right now.
I didn't realize it was that high.
 
Raising taxes won't get what you desire as you need many of those top 1% small business owners to create jobs.

LOL! Business only creates jobs when there is demand. They don't create jobs because they feel like it.
 
How can it work when that part of the law was removed?

The work requirement wasn't removed, it was just transferred to the states. That's what Conservatives wanted. Now you're saying it was wrong? Yeesh. You people...
 
You shouldn't be paying any industry be it healthcare or any industry for doing what is morally right. Especially an industry in which is built upon the Hippocratic Oath. If you paying them to do what is most basic within the Hippocratic Oath, then blow the system up because it's not a system about caring for the sick and being selfless but rather one of profit.

Health care is a business (even for non-profit providers). Demanding that care providers put themselves out of business by being "selfless" doesn't make any sense. A more productive approach would to re-shape the financial incentives that determine what is financially feasible for providers to do and achieve. Which is what's in progress now.

I didn't realize it was that high.

That's $22 billion below what was predicted when it passed.
 
You shouldn't be paying any industry be it healthcare or any industry for doing what is morally right. Especially an industry in which is built upon the Hippocratic Oath. If you paying them to do what is most basic within the Hippocratic Oath, then blow the system up because it's not a system about caring for the sick and being selfless but rather one of profit.

The answer isn't UHC but rather Government drawing a tough line on the idea is that private health care in the US.. is for profit. Before Medicaid and Medicare.. it was non-profit. Since those programs it was for profit.

That sounds like an extremely naïve view as it pertains to healthcare.

Your solution is actually new government regulation. Conceptually, it is not that far from single payer, it just has a more convenient categorical description for partisans to accept.
 
Health care is a business (even for non-profit providers). Demanding that care providers put themselves out of business by being "selfless" doesn't make any sense. A more productive approach would to re-shape the financial incentives that determine what is financially feasible for providers to do and achieve. Which is what's in progress now.

I've never demanded that, nor did I suggest it. Just the opposite. What I am saying is Health Insurance companies shouldn't be list on the stock market, issuing earning reports and paying out dividends. Make a profit, but that profit needs to go back into reserve funds to A) cover more of the costs or B) expanding coverage or lowering premiums. Every major health insurance company went public between 2000 and 2001 when it cast off mutual organization status (non-profit). As they went public they started offering dividends on it's profits. Profits which a year earlier were reinvested back into the company.

So this idea that they would be putting themselves out of business by working on their old model is COMPLETE crap. It worked for hundred plus years for many of the these companies.
 
I've never demanded that, nor did I suggest it. Just the opposite. What I am saying is Health Insurance companies shouldn't be list on the stock market, issuing earning reports and paying out dividends. Make a profit, but that profit needs to go back into reserve funds to A) cover more of the costs or B) expanding coverage or lowering premiums. Every major health insurance company went public between 2000 and 2001 when it cast off mutual organization status (non-profit). As they went public they started offering dividends on it's profits. Profits which a year earlier were reinvested back into the company.

Health insurance companies shouldn't exist, period. They do nothing to enhance or improve your care, and their only function is to administer payments of premiums you've already paid to your provider. For this "service", we pay them as much as 20% of every premium dollar. Medicare does the exact same thing, but does it for less than 3% overhead. So what's the better deal? 20% or 3%?

We are paying an insurance company 20% to have them pay our doctor with the premiums we've already paid to them. And what do we get in return? Absolutely nothing.
 
That sounds like an extremely naïve view as it pertains to healthcare.

Your solution is actually new government regulation. Conceptually, it is not that far from single payer, it just has a more convenient categorical description for partisans to accept.

Not really. It's actually the view of health care prior to late 1970s and a bigger year in the changing of health care that took place between 2000 and 2001 when the major non-profit health insurance companies went from non-profit to profit based model and went public.

The solution isn't new government regulation nor does it require it. All it requires is Uncle Sam reapply 501(c)(4) status to the non-profits. Most of these companies went public because they lost their status and forced into 501(m) and there was no benefit in staying non-profit when half of their "profits" were taxed (their commercial side). Just FYI.. Commercial insurance is property, liability and workers' compensation insurance.
 
Health insurance companies shouldn't exist, period.
I see you advocate people save money for their doctor bills, surgery, etc.

Wow...

What about car insurance?

Home owners insurance?

Renters insurance?

etc... etc... etc...
 
Health insurance companies shouldn't exist, period. They do nothing to enhance or improve your care, and their only function is to administer payments of premiums you've already paid to your provider. For this "service", we pay them as much as 20% of every premium dollar. Medicare does the exact same thing, but does it for less than 3% overhead. So what's the better deal? 20% or 3%?

We are paying an insurance company 20% to have them pay our doctor with the premiums we've already paid to them. And what do we get in return? Absolutely nothing.

Maybe you should read this.
 
I see you advocate people save money for their doctor bills, surgery, etc..

No, I advocate for a single-payer plan that everyone pays into and does the administration of payments of your premiums to your provider. You building a straw man does not undermine the point that for-profit health insurance does nothing other than suck up as much as 20 cents of every dollar you pay in premiums for itself. Maybe it's just me, but I think a 20% administrative fee is a bad deal for patients. You seem to disagree. So here we are...
 

OMG dude, did you read the link? Here's the chart from your link:

insurance.jpg

Now please show me where on this chart the administrative costs for private insurance are lower than that of Medicare? Because in every single case, it's nearly double the cost.

You also want to know why Medicare's admin costs are that high? Because Medicare contracts with private insurers to administrate payments. So, again, all you're proving is that private health insurance is costlier than Medicare, and doesn't provide any benefit to the patient. Why? Because the patient isn't even in the equation. How your health care is paid is something you are not a part of. You pay your premium, then the insurance company pays your doctor from your premium. They are paying on your behalf, and taking a 20% cut for themselves. Bad deal.
 
No, I advocate for a single-payer plan that everyone pays into and does the administration of payments of your premiums to your provider. You building a straw man does not undermine the point that for-profit health insurance does nothing other than suck up as much as 20 cents of every dollar you pay in premiums for itself. Maybe it's just me, but I think a 20% administrative fee is a bad deal for patients. You seem to disagree. So here we are...

As long as all tax payers pay an equal amount, I'm OK with that.
 
OMG dude, did you read the link? Here's the chart from your link:

View attachment 67211955

Now please show me where on this chart the administrative costs for private insurance are lower than that of Medicare? Because in every single case, it's nearly double the cost.

They are lower as a percentage only...
 
As long as all tax payers pay an equal amount, I'm OK with that.

The idea is a fixed payroll tax. Sanders' proposal was to scrap Medicaid, Obamacare, and private insurance and automatically enroll everyone in Medicare. To pay for this, it would be a simple 6.2% payroll tax on workers and businesses. Since the average worker spends about $5K/year for their employer-provided health care, and the employer pays about $12K/year per worker, most workers and businesses in this country would save money since the average wage is around $53K, and since most firms of 50 employees or fewer would rarely make $10M in profit a year.

6.2% x $53,000 = $3,286.

So which is more? $5,000 or $3,286?
 
Last edited:
They are lower as a percentage only...

Right, and what we're talking about specifically is the function of insurance companies, which is administration. So great, we are both in agreement that administrative costs for private insurance are higher than admin costs for Medicare. Now, my question to you is; knowing this, how can you defend private insurance from a cost perspective and a patient perspective since all private insurers do is administer payment? Why are we paying as much as 20% for them to do something so anodyne? It's that question that Conservatives cannot truthfully answer and is the silver bullet to private insurance.
 
Not really. It's actually the view of health care prior to late 1970s and a bigger year in the changing of health care that took place between 2000 and 2001 when the major non-profit health insurance companies went from non-profit to profit based model and went public.

No it isn't. You're just making **** up now.

And yes, for-profit insurance is part of the problem. Funny how single payer is guaranteed to fix that but you're still trying to peddle your snake oil substitute solution, anyway.

The solution isn't new government regulation nor does it require it. All it requires is Uncle Sam reapply 501(c)(4) status to the non-profits. Most of these companies went public because they lost their status and forced into 501(m) and there was no benefit in staying non-profit when half of their "profits" were taxed (their commercial side). Just FYI.. Commercial insurance is property, liability and workers' compensation insurance.

LOL that is the most ridiculously bizarre view of how to "fix" healthcare that i've ever seen.

A big part of the problem is that 60% of our hospitals are "non-profit" which essentially means that any profits must be reinvested in the hospital. Funny how so many of those "non-profit" hospitals have invested so much money into administrator salaries.

Funny how 1/4th of our healthcare costs are spent on administration, far more than any other developed nation, and your bizarre "fix" doesn't get anywhere near actually resolving that.
 
The idea is a fixed payroll tax. Sanders' proposal was to scrap Medicaid, Obamacare, and private insurance and automatically enroll everyone in Medicare. To pay for this, it would be a simple 6.2% payroll tax on workers and businesses. Since the average worker spends about $5K/year for their employer-provided health care, and the employer pays about $12K/year per worker, most workers and businesses in this country would save money since the average wage is around $53K, and since most firms of 50 employees or fewer would rarely make $10M in profit a year.

6.2% x $53,000 = $3,286.

So which is more? $5,000 or $3,286?

I'm good with a straight percentage for everyone on gross pay. Did you read my idea of changing FICA to a Social Tax?

I would prefer we didn't change our medical system, but I know those who think like me will be overruled one day.

I just hope that when we do become a single payer system, that multi million dollar lawsuits also go away in the medical industry.
 
I'm good with a straight percentage for everyone on gross pay. Did you read my idea of changing FICA to a Social Tax?
I would prefer we didn't change our medical system, but I know those who think like me will be overruled one day.
I just hope that when we do become a single payer system, that multi million dollar lawsuits also go away in the medical industry.

I did not read your idea of changing FICA to a Social Tax, but I think that doing so results in a flat-tax situation which harms the middle and lower classes. I think in the case of health insurance, it makes sense to have a single payer that can negotiate for better drug prices and other costs by using its leverage at the bargaining table. The fact that Medicare isn't allowed to use its collective weight to bargain for lower drug costs is just plain nuts!
 
I think in the case of health insurance, it makes sense to have a single payer that can negotiate for better drug prices and other costs by using its leverage at the bargaining table. The fact that Medicare isn't allowed to use its collective weight to bargain for lower drug costs is just plain nuts!
I haven't look at those arguments for some years, but if I recall, pert of the reason places like Canada can negotiate cheaper prices is an agreement they will not sure for drug related problems.

Just look at the payouts and lawsuits around prescription drugs. We can get a better price if the public chooses to lose the right of lawsuit.
 
We can do it tomorrow and not have to wait another 5 years. We can also cap payout to age 67, meaning you can't work another few years to boost your payout.
Sorry for the delays.

Legally, we could raise the age tomorrow. Politically, it's impossible. Any legislator or President who signs that law is done.


No, I am not confusing anything. You are bringing up two SEPARATE issues of ACA....
No, I'm pointing out that "rising premiums" is not the same thing as "ACA reducing Medicare costs." And now, we have to talk about how you don't understand premium rises.

Premiums outpaced inflation significantly for decades, and slowed down around 2009, in part because of the ACA. They jumped a bit more this year, because insurers were not getting as many younger people signing up as they hoped, so costs went up. The idea that the ACA is a disaster because in one single year, premiums went up as much as they did during the Bush 43 years is slightly ridiculous.

The thing is, despite Republicans now basically being in control, they won't be able to stop premiums from going up. Even if they get every single thing they want, premiums will still rise, and millions will likely lose insurance or get worse coverage. And they'll have to own it.

Anyway, the ACOs actually work, and reduce costs by adjusting incentives to produce better outcomes. It's not enough to tell a doctor "do your job" when the economic incentives reward doctors for running tests, rather than for producing good outcomes.


LOL really? The VA is a **** show and has been for years.
LOL ya really!!!!

Despite some high-profile mistakes and issues with antiquated records systems, the VA health care system is one of the best and most liked in the US. Vets don't want major changes at the VA, and they definitely don't want it privatized. What they want is shorter wait times (i.e. more doctors and facilities under the aegis of the VA), and some are aware of the issues with records. Many veterans groups are worried that Trump will burn the VA to the ground.

Even your own article (the CNN one) recognizes that the VA provides better care than the private sector.


The VA budget is around $180 billion/yr; an additional $5bn is a drop in the bucket.

And good luck slashing the VA budget to save money.


Treasury Department does sell bonds, but this is what you don't get.. those bonds in private hands and foreign governments are sold all the time. The Fed has been buying them. But the Treasury can easily issue 30y bonds and buy back 10y bonds (2008-2011) out there already with higher then 3% interest rates and the longer 30 years. You may not get all of them as you are right, you can't force a sale, but you can many to sell because of positions they want to move to. So what you ended up doing, without paying a "premium", you can lower the average interest rates by up to 1% (more likely .5%).
Let's try this again.

We've had exceptionally low interest rates for well over a decade, and most debt is short enough of a term that we aren't paying high interest rates. The average interest rate on federal debt has shrank since 2000. There is very little low-hanging fruit.

debt_interest1.png


Yet again: If interest rates are going down, and we do a buyback, that's done at an auction. The cost of the bonds targeted for purchase go up, and will be above face value, because they are worth more than the bonds that will replace them. Believe it or not, bondholders are not raving idiots who enjoy losing money.

Buybacks make the market more fluid. They don't decrease the total interest payments.


More to the point: Nothing you've proposed will make a serious dent in federal spending.
 
Back
Top Bottom