Explaining Why Federal Deficits Are Needed[W:5330]

[Incisor]

Of course how an insurance company reimburses affects care. I guarantee you that. How that insurance company reimburses greatly depends on your level of care.

Level of care = coverage. Again, what we're talking about isn't coverage, it's the administration of payments to your provider. So you're conflating how your provider is reimbursed for what care you've been provided. So it's not like the insurance company is in the room with you when you get a prostate exam. They're just the party that moves money from the pool to the provider. That is all they do. The means by which the insurer reimburses the provider is the sole function we are talking about, specifically why that part of the transaction has to be done for-profit. I don't see a need to have that part of the health care billing cycle as for-profit, mostly because it does nothing when it comes to the care your provider gives you. Now, it may restrict your care, but why would an insurance company do such a thing? The answer is profits. No other reason.

One patient has blue cross blue shield. A private insurance. The patient comes in and a referral is made to PT and the patient gets better.
One patient has Medicaid.. a government insurance. The patient comes in and has to have x rays before a referral to PT can be made. When the referral is made.. it requires pre authorization that takes 30 days before being approved. The patient gets better but needs injection and possible surgery.

So all you're talking about is access and that access relates directly to the profit margin. Also, you're really speaking of vague situations that aren't fully realized. And Medicaid is administered by the states, so if your state Medicaid is bad, that's (probably) because the Conservatives in the state made it that way on purpose. Medicaid varies from state to state. Of course you already know this.

the first patient with private insurance gets cost effective efficient care. Because its much cheaper.

So this is the problem with arguing in hypotheticals, as you are here...you are using broad strokes to paint over what are fundamental flaws in a for-profit insurance system. The insurance isn't delivering cost effective care to you, your provider is. All the insurance company does is administer payment to that provider. For that, they take as much as 20% for themselves and there's no clear improvement of outcomes.

That's the reality..

No, it isn't.

And this gets back to my point. Until we HAVE such a situation and demonstrate that we CAN MAINTAIN IT.. then I suggest we not hand over important facets of our personal lives.. like our healthcare over to guys like trump.

We can maintain it already, we do that with Medicare. So I don't know what point you're trying to make. And now you get into the subjective and theoretical and philosophical argument you're keen on leaning. It seems to me that Conservative ideology is decidedly anti-government, and Conservatives employ that ideology by undermining government in order to undermine the public trust in government. So the solution, of course, is to stop voting for Conservatives.

OF course you are in the equation.. see above.

No! You certainly are not. You pay your premium to an insurance company. You go to your doctor. Your doctor provides you with care. Your doctor then sends the claim to the insurance company and the insurance company then reimburses. So that last step, how are you involved?

 

[jaeger19]

Level of care = coverage. Again, what we're talking about isn't coverage, it's the administration of payments to your provider. So you're conflating how your provider is reimbursed for what care you've been provided. So it's not like the insurance company is in the room with you when you get a prostate exam.
?

Wrong.. it is like the insurance company is in the room with you when you get a prostate exam. Depending on your insurance and what it will pay for.. if that prostate exam is positive for hypertrophy.. a PSA test might be ordered.. and if that's positive.. a biopsy.

OR if you have a different insurance you might have to have two positive exams before they pay for a PSA .. or you might have to have two positive PSAs over 6 months before you can have a biopsy etc.

Incisor.. you simply do not understand the interface between insurance and providers and the care that's provided.

So all you're talking about is access and that access relates directly to the profit margin.

Well in the example above its more timeliness of care and level of care and not just access. They all access therapy. The timing of that therapy, the scope of therapy and what procedures in therapy that are paid for all very per insurance.

Also, you're really speaking of vague situations that aren't fully realized

Not vague at all.. specific instances that happen every day.

And Medicaid is administered by the states, so if your state Medicaid is bad, that's (probably) because the Conservatives in the state made it that way on purpose. Medicaid varies from state to state. Of course you already know this.

Within guidelines yes its administered by states. The example I gave by the way is in a LIBERAL state that went for Hillary. Its dominated by liberals/democrats. So.. you are wrong yet again. And other liberal states that I do business in also have the same restrictions on their Medicaid.

Ironically.. one of the states I deal with that's red as red can be.. is actually more lenient with Medicaid when it comes to providers. Pays better... easier access etc.

So this is the problem with arguing in hypotheticals, as you are here...

Just as you are.

YOU are talking about a hypothetical "medicare for all".. without knowing how medicare currently works.. how its administered.. without understanding how it reimburses and how that effects care.. nor the fiscal issues with medicare.
Meanwhile.. I have real world understanding of how the system works currently comparing government programs and private insurance.

No, it isn't.

Oh yes sir.. it very much is. I deal with it every day. If you bothered to do even a bit of research you would find that I am completely and utterly correct in my statements.

We can maintain it already, we do that with Medicare

.

I see.. so the changes to medicare under Obamacare didn't actually happen?

Hmmm..

Wait.. so right now.. there is no thought of changing OBamacare and thus medicare?

Sir.. you don't know of what you speak.

No! You certainly are not. You pay your premium to an insurance company. You go to your doctor. Your doctor provides you with care. Your doctor then sends the claim to the insurance company and the insurance company then reimburses. So that last step, how are you involved?

the doctor decides the care you get based partially on what your insurance pays for.

 

[Incisor]

Wrong.. it is like the insurance company is in the room with you when you get a prostate exam. Depending on your insurance and what it will pay for.. if that prostate exam is positive for hypertrophy.. a PSA test might be ordered.. and if that's positive.. a biopsy.

You're still under the impression that an insurance company pays for anything. They don't. You pay your premiums into a pool and an insurance company reimburses the doctor with money from that pool. They don't pay anything. They just facilitate the transfer of payment. That's it. That's all they do.

Incisor.. you simply do not understand the interface between insurance and providers and the care that's provided.

The "interface"? No...what you're doing is trying to conflate access to care with quality of care and somehow the insurer is the facilitator of that. But that's not what they do. They administer payment to your provider. They do nothing else.

Well in the example above its more timeliness of care and level of care and not just access.

Well, I'm not sure what health insurance you are on, but I don't have to wait for my insurance company to reimburse my doctor because I'm not a part of that transaction, and that transaction is what an insurance company does. So all these things you are talking about are really vague, unsubstantiated examples that are being used as a substitute for defense of the private insurance industry. Timeliness of care isn't affected by how your insurer reimburses your care. You seem to be arguing that it is.

 

[Moderate Right]

You're still under the impression that an insurance company pays for anything. They don't. You pay your premiums into a pool and an insurance company reimburses the doctor with money from that pool. They don't pay anything. They just facilitate the transfer of payment. That's it. That's all they do.




The "interface"? No...what you're doing is trying to conflate access to care with quality of care and somehow the insurer is the facilitator of that. But that's not what they do. They administer payment to your provider. They do nothing else.




Well, I'm not sure what health insurance you are on, but I don't have to wait for my insurance company to reimburse my doctor because I'm not a part of that transaction, and that transaction is what an insurance company does. So all these things you are talking about are really vague, unsubstantiated examples that are being used as a substitute for defense of the private insurance industry. Timeliness of care isn't affected by how your insurer reimburses your care. You seem to be arguing that it is.

Then the solution is to get rid of the insurance companies and everyone can pay their own, not even government is needed.

 

[jaeger19]

You're still under the impression that an insurance company pays for anything. They don't. You pay your premiums into a pool and an insurance company reimburses the doctor with money from that pool. They don't pay anything. They just facilitate the transfer of payment. That's it. That's all they do.

.

Yeah.. you are under the impression that you are paying for your care.. you are not. The insurance companies is through the pool of money that they have collected AND perhaps the money that they have put into reserve and invested..

They also determine what, how much, how often etc that a provider will be reimbursed etc. Not to mention negotiating the reimbursement with the provider. Which AS YOU POINT OUT.. gives them more clout than say you negotiating yourself.

They don't just "facilitate payment".. sorry but you are wrong.

The "interface"? No...what you're doing is trying to conflate access to care with quality of care and somehow the insurer is the facilitator of that. But that's not what they do. They administer payment to your provider. They do nothing else.

Yeah.. you have been proven wrong over and over.

Well, I'm not sure what health insurance you are on, but I don't have to wait for my insurance company to reimburse my doctor because I'm not a part of that transaction, and that transaction is what an insurance company does. So all these things you are talking about are really vague, unsubstantiated examples that are being used as a substitute for defense of the private insurance industry. Timeliness of care isn't affected by how your insurer reimburses your care. You seem to be arguing that it is.

Yeah.. see what you think are vague unsubstantiated examples are ACTUALLY real world examples that are easily proven with some research. The problem is.. they are only vague and unsubstantiated because you have ABSOLUTELY NO IDEA how the system works. NONE.. and it appears that you have no desire to understand it..

Timiliness of care is DEFINITELY affected by how your insurer reimburses your care. IF an insurer.. government or private says that you may only have an MRI after you have had x rays.. it affects your timeliness of care. IF you have back pain and need surgery but your insurance states that you cannot be referred to a surgeon until you 1. Have therapy for 30 days. or 2. See a pain specialist for injection first or 3 have a psych evaluation. then yes.. it affects the timing of care.

That's what happens in the real world. You sir are just plain wrong.

 

[mmi]

You could actually argue that taxing you more might make things worse for your employees.

But that would be ignoring the need to fund public services that yer employees benefit from. Where's that money supposed to come from? If I didn't pay my mortgage, I'd have more money to spend on other things.

>>The left just automatically assumes your employees are so underpaid that they are collecting at least some government benefits so that by taxing you more, your employees will get an increase in their government benefits.

Nonsense. All Americans, including those who collect higher incomes, benefit from public expenditures.

>>Assuming that were actually true

… would be very foolish.

Wrong.. as has already been explained to you.. PRE TAX income inequality has grown.. the growth in income of the rich vs the poor is PRE TAX.

And post-tax.

After taxes, top 1 percent incomes are increasing even faster than before taxes. Before-tax income growth for the top 1 percent has averaged 174.5 percent since 1979. The after-tax increase: 200.2 percent. A progressive tax system should function to narrow income gaps between the affluent and everyone else. Over recent decades, America's tax system has done no narrowing. (source)​

Who is it that has already had this explained to him? Who is it that continues to be "wrongah"?

according to you.. the tax system becoming more progressive.. is causing more wealthy to the top 1%.

No, the tax system has not become more progressive. That's yer false claim.

>>Taxes are more progressive.. because the poor pay dramatically less than they did.

The system is less progressive because the incomes collected at the top have increased dramatically.

Globalization has been ongoing since before the civil war.

The effects we're concerned about started in the 1980s. Can you offer a relevant analysis that predates the upheaval associated with the Second World War?

>>Our economy has evolved over the last couple of decades to a service based economy because we have chosen to allow our manufacturing supremacy to decline.

Chosen? How would you say that trend could have been avoided?

>>Illegal immigration creates decreased wage pressure.

You never offer any evidence to back that up.

>>our educational supremacy … allowed us to produce goods more efficiently … we have switched to a service economy as we have lost our competitive edge in manufacturing

How much education does a very-low-wage, third-world factory worker require? And don't the high-wage professional services that Americans compete very effectively at (financial, legal, educational, scientific, medical, etc) require a high level of education?

>>We have failed to continue with our infrastructure

Yes, and which end of the political spectrum has opposed public investment in infrastructure?

>>We have failed to continue to be as dominant in development of technology. … government financed [research] that paid huge dividends in the private sector

Same thing.

>>THOSE are the reasons for wage stagnation.. not taxes

You simply insist on leaving the changes in the tax system that have shovelled trillions of dollars at wealthy households out of the equation. I figure yer blind to this because yer determined to protect yer own high income from added taxation.

the country as a whole as not kept up with the rest of the world … your liberal insistence that the issue is taxation … simply furthers the problem.

The tax system is part of the problem.

>>Raising taxes on the wealthy in NO WAY.. directly helps the middle and lower classes.

The effect is indirect, through public investments in education, infrastructure, and R&D.

>>we have already largely shifted the burden from the poor and middle class to the rich.

Not as much as the incomes of wealthy households have increased.

>>the poor and middle class … paid a much greater burden of federal income taxes than they do NOW. Those are the facts

The incomes collected by wealthy households have increased much more dramatically. That is the fact, one you refuse to accept.

There is no mechanism that insures that taxing me more WOULD mean more revenues spent on the poor and middle class.

You mean "ensures," and there needn't be any such mechanism. There's no guarantee that you won't be run over by a truck if you leave yer house, but you keep on doing it anyway.

>>the burden of taxation has fallen more heavily on the wealthy.. and yet inequity continues and expands.

Because incomes at the top have increased dramatically.

 

[mmi]

the percentage of americans making minimum wage is about 5%.

Ten percent work for hourly wages under $10, and 42% collect less than $15/hr. Raising the MW to ten dollars would lead to higher wages for many of those workers.

>>don't be trying your bull that we have put a greater burden on the poor and middle class because we reduced the taxes of the wealthy.

The burden is found in the twenty trillion dollar national debt and the inadequate funding of education, infrastructure, and R&D.

what could it be that stopped the growth of wages you wonder? Lets see.. decreases in infrastructure, illegal immigration, decrease in unions, increase in foreign competition.. etc. NOT TAXES.

You'll never stop insisting that the failure of the gubmint to compensate for the dramatic increase in incomes collected at the top by proportionately increasing the tax burden on wealthy households has expanded inequality and led to economic hardship for those in the lower quintiles. This is nothing more than a broken record you won't stop playing.

Your ideological hatred of the rich is clouding your judgement.

We don't hate the rich — you just don't wanna pay up.

he's like a punch drunk fighter … after receiving a terrible beating he raises his hand in "victory".

You'd never be granted a boxing license.

 

[austrianecon]

You're still under the impression that an insurance company pays for anything. They don't. You pay your premiums into a pool and an insurance company reimburses the doctor with money from that pool. They don't pay anything. They just facilitate the transfer of payment. That's it. That's all they do.

You know very little of what Insurance companies do. They don't just facilitate transfer of payment. They also limit liability. Set the price they will pay for everything used at a hospital that is billed to you. So instead of X-Ray costing you $300. It'll cost might just cost $100, of that you pay $20 (your co pay).

 

[Incisor]

They don't just facilitate transfer of payment. They also limit liability. Set the price they will pay for everything used at a hospital that is billed to you. So instead of X-Ray costing you $300. It'll cost might just cost $100, of that you pay $20 (your co pay).

So by "limit liability", you're really just saying "mitigate risk" which is another way to say "for-profit administration". Also, the insurance company doesn't set the price, providers and drug companies do. They do that by playing insurers off one another. All that playing does nothing to improve or enhance your care, and only increases cost.

Like I asked before, who has the bargaining power when there are more buyers than sellers?

 

[Incisor]

Yeah.. you are under the impression that you are paying for your care.. you are not. The insurance companies is through the pool of money that they have collected AND perhaps the money that they have put into reserve and invested..They also determine what, how much, how often etc that a provider will be reimbursed etc. Not to mention negotiating the reimbursement with the provider. Which AS YOU POINT OUT.. gives them more clout than say you negotiating yourself.

The insurance company is paying the provider on your behalf, with premium dollars you and everyone else contributed to the pool. For this, they take as much as 20% of your premium for themselves. And they do determine what, how much, and how often a provider is reimbursed (aka rationing) that still maintains a profit margin for the insurance company. So it's all coming back to profits for the insurer. That's why they may or may not reimburse a claim, not because doctors have improved outcomes. My point is that profit motive does nothing to improve or enhance your care, and ends up restricting it to doctors that are in your network.

And when it comes to negotiating, this gets to my point. The insurance company does negotiate with the provider, however that insurance company isn't the only company negotiating with the provider. So a provider, using its leverage, plays multiple insurance companies (buyers/payers) off one another...and that drives up the cost. Whereas if the reverse were the case, that the single payer has the bargaining power, the single payer can dictate the costs since it's the entity that the providers have to negotiate with. You see the difference?

Yeah.. see what you think are vague unsubstantiated examples are ACTUALLY real world examples that are easily proven with some research. The problem is.. they are only vague and unsubstantiated because you have ABSOLUTELY NO IDEA how the system works. NONE.. and it appears that you have no desire to understand it..

All you've done over and over is just re-label "for profit administration" to different phrases. But even you are admitting that the profit motive is tied to the administration of those benefits. So again, it seems like you think an insurance company does more than it actually does.

Timiliness of care is DEFINITELY affected by how your insurer reimburses your care. IF an insurer.. government or private says that you may only have an MRI after you have had x rays..

OK, but that's access, which isn't what we are talking about. What we are talking about is once the procedure has been performed, how that procedure is paid. Requiring an X-Ray prior to an MRI isn't what we are discussing. We are discussing who and how pays the doctor for performing either the MRI or X-Ray...or any other procedure. So you keep conflating access to care with the means by which insurers reimburse providers for that care. The reason is obvious; private insurance companies do nothing different from Medicare, except that they ration care because of profit margins.

 

[Incisor]

Then the solution is to get rid of the insurance companies and everyone can pay their own, not even government is needed.

No, the solution is to have a single payer that reimburses all providers...which encourages doctors to produce better outcomes in order to compete for patients. Right now, you may think you have the best doctor, but you don't know that for sure. For all you know, your current doctor might not be that great compared to your neighbor's, who may have different insurance than you. Because there is no level playing field for providers, they have no incentive to produce better outcomes because they're not directly competing for your care. We hear over and over from Conservatives how competition leads to innovation. Single payer forces providers to compete for your care, which leads to innovation. Right now, providers aren't directly competing for your care. Instead, they are in the position where they can force insurers to compete for reimbursements. But that doesn't improve or enhance your care, or even guarantee better outcomes.

 

[jaeger19]

And post-tax.

.

Of course.. if you have more money pre tax.. it stands to reason you would have more money post tax. Unless your tax rate was more than 100 percent after a certain level.

Who is it that has already had this explained to him? Who is it that continues to be "wrongah"?

Lets see... MMI, Gimmee, Incisor, off the top of my head.

No, the tax system has not become more progressive. That's yer false claim.

Of course it has between the poor and middle class and rich. Among the rich.. not so much. but definitely between the poor and middle class and the rich.

The system is less progressive because the incomes collected at the top have increased dramatically.

The income collected have increased dramatically PRE TAX.

Which proves its not the taxes that's causing the inequality.

The effects we're concerned about started in the 1980s. Can you offer a relevant analysis that predates the upheaval associated with the Second World War?

Not sure what you are asking... but we were a global economy well before the 1980's. Well before the second world War. Heck.. one of the reasons for the Civil War was the trade between the South and Europe vs the industrialization of the North.

Chosen? How would you say that trend could have been avoided?

Improved infrastructure, education and technological development in order to compete with other countries. We have lost our competitive edge in these areas.

You never offer any evidence to back that up.

not true. You just choose to ignore the massive amount of evidence that show it does.

You have 2 people for a job..

You have 100 people for the same job. Which situation has more wage pressure? I would like you to present evidence that having more people competing for a particular job INCREASES wage pressure.

Whatever MMI.. you simply don't want to believe the truth.

You simply insist on leaving the changes in the tax system that have shovelled trillions of dollars at wealthy households out of the equation. .

1. first.. it hasn't shoveled trillions at wealthy households. Those households had the income pre tax. They earned it for the most part. Your post is why we know that your argument has nothing to do with real economics but anger at the wealthy. the tax code didn't shovel millions to wealthy households FROM poor and middle class. They made it from their own work. The tax code simply lets them keep what they earned.
2. Well it certainly makes no sense to tax me more when it will do nothing to help the poor and middle class. And it will likely simply hurt the economy further making it harder on the poor and middle class. the issue isn't post tax income.. its pre tax income and as long as you liberals insist on simply hating on the rich.. nothing will improve for the poor and middle class and you are far more likely to hurt the economy. And as far as "we need more revenue".. we are currently collecting enough revenue (and mostly from the rich) since we are at about historic revenue levels as a percentage of GDP.

The tax system is part of the problem

No its not. Now.. when we were taxing at 15% of GDP? You might have an argument.. but we aren't and haven't been for some time now.. we are at or above historic revenue levels.

The effect is indirect, through public investments in education, infrastructure, and R&D.

Again.. no its not. There is no mechanism that even makes this a sure bet. That money could just as well be spent in foreign wars or giving Russia "aid".. or Donald Trump a big fat tax credit.

Not as much as the incomes of wealthy households.

Well.. that could only occur if the tax code was over 100%.

The incomes collected by wealthy households have increased much more dramatically. That is the fact, one you refuse to accept.

That's what I think its funny. I am the one that points out the inequality is due to PRE TAX income.. PRE TAX income which has increased. And you keep claiming "NO ITS TAXES ITS TAXES".. and then you claim I refuse to accept that there is an increase in pre tax income. Its why you have no credibility here MMI.

You mean "ensures," and there needn't be any such mechanism. There's no guarantee that you won't be run over by a truck if you leave yer house, but you keep on doing it anyway.

Of course their needs to be said mechanism.. Particularly since increasing taxes can make things worse for the poor and middle class. And there are many things that are in place that prevent me being run over by a truck when I leave my house.

Because incomes at the top have increased dramatically.

Yeah Duh... which means that its not a tax issue..

and 2. its not going to be solved with taxes. :doh

 

[jaeger19]

Ten percent work for hourly wages under $10, and 42% collect less than $15/hr. Raising the MW to ten dollars would lead to higher wages for many of those workers.

.

Or it could cause those workers to lose their jobs entirely. Either to automation or outsourcing, or simply make a business non viable.

The burden is found in the twenty trillion dollar national debt and the inadequate funding of education, infrastructure, and R&D.

Except for the FACT that we have been for the most part collecting revenue at or higher than what we have collected in the past.. when marginal rates were higher. We don't have a revenue issue.. we have a spending issue. Those are the facts.

You'll never stop insisting that the failure of the gubmint to compensate for the dramatic increase in incomes collected at the top by proportionately increasing the tax burden on wealthy households has expanded inequality and led to economic hardship for those in the lower quintiles. This is nothing more than a broken record you won't stop playing.

Of course.. because the FACTS are that the dramatic increase in income was PRE TAXED.. and has nothing to do with taxes... BUT you are the broken record that keeps claiming that increasing taxes will reduce inequity when the cause of the inequity is not the tax system.

The one that's the broken record here is you. "Tax the rich" " tax the rich" "tax the rich" despite the facts that the income growth is PRE TAX.. despite the fact that there is no direct.. nor assured indirect effect that increasing taxes will make ANYTHING better for the poor and middle class.

You'd never be granted a boxing license.

I have already fought in the ring and the octagon.

 

[Critter7r]

...


1. first.. it hasn't shoveled trillions at wealthy households. Those households had the income pre tax. They earned it for the most part. Your post is why we know that your argument has nothing to do with real economics but anger at the wealthy. the tax code didn't shovel millions to wealthy households FROM poor and middle class. They made it from their own work. The tax code simply lets them keep what they earned.

... while creating deficits which are then blamed on 'entitlements'.

 

[jaeger19]

The insurance company is paying the provider on your behalf, with premium dollars you and everyone else contributed to the pool. .

And at times with money that they have made through investment.

For this, they take as much as 20% of your premium for themselves. And they do determine what, how much, and how often a provider is reimbursed (aka rationing) that still maintains a profit margin for the insurance company.

Yes.. that's right.. and to maintain that profit.. they have to reimburse in a way that 1. keeps the customers that buy their insurance happy.. 2. They have to reimburse in a way that keeps providers happy and willing to keep accept their insurance.

SO.. in a competitive market.. the only way to do that is to reimburse for better, cost efficient care. Which keeps their costs down.. (more efficient), but keeps their customers and providers happy.. better care and access.

My point is that profit motive does nothing to improve or enhance your care, and ends up restricting it to doctors that are in your network.

See above. See.. in a competitive private insurance market.. if an insurance company simply decides to not reimburse for things it should.. or deny access.. then patients get pissed and go to another insurance.

If you are pissed with your government insurance.. well too frigging bad... its what you have.

And when it comes to negotiating, this gets to my point. The insurance company does negotiate with the provider, however that insurance company isn't the only company negotiating with the provider. So a provider, using its leverage, plays multiple insurance companies (buyers/payers) off one another...and that drives up the cost

True.. but it ALSO means that an insurance company simply cannot gouge the providers and provide crappy coverage for things because providers can say "take a hike" and so can patients... It keeps the system more responsive to the needs of the patients.

All you've done over and over is just re-label "for profit administration" to different phrases. But even you are admitting that the profit motive is tied to the administration of those benefits. So again, it seems like you think an insurance company does more than it actually does.

Well.. I point out how insurance actually works. In fact..many of those same insurance companies also provide for profit administration for Medicaid and medicare as well. Something you don't understand.

But I understand what that profit motive means. In a competitive marketplace.. to be profitable they have to provide a service that makes their clients happy. If they aren't responsive to the needs of their clients.. then they lose business.

A government system does not have that motivation.

OK, but that's access, which isn't what we are talking about

Of course it is.. you simply don't want to listen to facts. YOU keep thinking access to care doesn't have an effect on care.. which it does.

FIrst.. private insurance companies DO THE ADMINISTRATION for medicare... so when you say they don't do anything different than medicare.. well you are right. They do the administration of payments for medicare.

Something you don't seem to understand.

 

[jaeger19]

... while creating deficits which are then blamed on 'entitlements'.

Wrong.... except for a few years,, the tax code as brought in what is historically our normal revenue.. about 18% of GDP. Our deficits have not been created by our tax code.. they have been created by our spending habits. Its just the facts Critter.

 

[mmi]

Of course.. if you have more money pre tax.. it stands to reason you would have more money post tax. Unless your tax rate was more than 100 percent after a certain level.

Again:

After taxes, top 1 percent incomes are increasing even faster than before taxes. Before-tax income growth for the top 1 percent has averaged 174.5 percent since 1979. The after-tax increase: 200.2 percent.​

>>The income collected have increased dramatically PRE TAX. Which proves its not the taxes that's causing the inequality.

No. The evidence shows that yer … wrongah. Changes in the tax system — shovelling trillions of dollars at wealthy households — have exacerbated inequality.

>>we were a global economy well before the 1980's.

This is just more of yer sophistry. Like yer BS about how the economic environment in 1945 can be used as a guide to understanding what's going on today. That year was one of turmoil characterised by conditions that are in no way present today.

>>Improved infrastructure, education and technological development in order to compete with other countries.

All of those have been implemented. Manufacturing in the US is much more automated today than it was thirty-five years ago. But foreign competitors have developed along the same lines. In many cases, American workers simply can't compete with very-low-wage, third-world counterparts. We don't want them to.

>>I would like you to present evidence that having more people competing for a particular job INCREASES wage pressure.

Many undocumented workers have jobs for which there is little competition from documented workers. Moreover, those same workers in some cases support a labor market that allows documented workers to be employed in positions that pay higher wages. You have no evidence to back up yer claim, and rely instead on "common sense."

>>Whatever MMI.. you simply don't want to believe the truth.

Yer simply determined to maintain yer view. You say it's "true" for no reason other than having decided that it is. I'm more careful in my judgements.

>>it hasn't shoveled trillions at wealthy households. Those households had the income pre tax.

The shift is both pre- and post-tax.

[R]esearch suggests that changes in tax policy over recent decades—particularly reductions in top marginal tax rates—have exacerbated market-based income inequality growth. This is critical because the shift in market-based incomes, particularly capital income’s rise as a share of total income, is driving income inequality growth.

Market-based income inequality, as measured by the "Gini" index, rose 23.1 percent between 1979 and 2007, while dampened post-tax, post-transfer income inequality rose 33.2 percent. That's because the federal tax and transfer system reduced the Gini index of income inequality by only 17.1 percent in 2007, down from a 23.4 percent reduction in in 1979. Roughly three-tenths of the percentage rise in post-tax, post-transfer inequality is attributable to changes in the redistributive nature of tax and budget policy since 1979. (source)​

As that analysis points out, and as I've been saying, the effect of changes in tax policy is substantially less than that brought about by other factors, but it is present and should be addressed.

Tax policy changes have exacerbated post-tax, post-transfer income inequality by less than one might reasonably suspect, and there are practical limits to how much increased redistribution can push back against strong market trends (though we should be pushing harder).​

>>Your post is why we know that your argument has nothing to do with real economics but anger at the wealthy.

This "envy" crap exists only in the imagination of RWers like you and MR. Why would I be angry at rich folks? I simply oppose policies that create unjust and destabilizing levels of inequality. Some wealthy people do as well, see, e.g., Warren Buffett.

>>the tax code didn't shovel millions to wealthy households FROM poor and middle class. They made it from their own work. The tax code simply lets them keep what they earned.

Earned? I'd say "collected" is a more neutral term. The shovelling takes place when taxes are paid — wealthy households pay less than they would otherwise, and that money is not available to fund programs (education, infrastructure, R&D) that would allow those in the lower quintiles to collect relatively larger incomes. Either that or the spending does take place and the national debt increases. Yer response is that the money would be wasted.

 

[Incisor]

FIrst.. private insurance companies DO THE ADMINISTRATION for medicare... so when you say they don't do anything different than medicare.. well you are right

Right, so that shows that there can be a government-run insurance plan that is managed by private companies. In this, I have no problem...what I have a problem with is when private insurance companies fracture the market in such a way that they don't have the leverage when it comes to negotiating with providers and drug companies. So in a situation where you have more buyers (insurance companies, also could be called "payors") than sellers (providers, drug companies) to whom do you think the bargaining power lies? So setting aside the redundancy of paying a fee for administration, you're also hurting patients because you've eliminated their ability to collectively bargain for lower rates by pooling all their premiums into one pool, administered by the State & not-for-profit, for the current model of multiple payors that outnumber the providers, from a market perspective. So what I don't understand about your position is, if you are looking for the most cost-effective way to provide access to care, there is no other solution than a single payer that can force providers and drug companies to negotiate with it, rather than the other way around.

 

[mmi]

Well it certainly makes no sense to tax me more when it will do nothing to help the poor and middle class. And it will likely simply hurt the economy further making it harder on the poor and middle class. the issue isn't post tax income.. its pre tax income and as long as you liberals insist on simply hating on the rich.. nothing will improve for the poor and middle class and you are far more likely to hurt the economy. And as far as "we need more revenue".. we are currently collecting enough revenue (and mostly from the rich) since we are at about historic revenue levels as a percentage of GDP.

You just keep repeating the same drivel. I stand by my argument.

>>when we were taxing at 15% of GDP? You might have an argument.. but we aren't and haven't been for some time now.. we are at or above historic revenue levels.

Conditions change. The demand on programs like Social Security and Medicare has expanded substantially in recent decades. With powerful market forces (globalisation, automation, higher return on education, etc) creating higher levels of inequality, that aging-baby-boomer effect can be diminished through tax and transfer policies.

>>There is no mechanism that even makes this a sure bet.

We need to act purposefully, and hopefully wisely, despite there being no such assurance. You keep leaving the house not knowing if you'll be run over by a truck.

>>that could only occur if the tax code was over 100%.

Nonsense. It has occurred, and the rates are nowhere near that high.

>>I am the one that points out the inequality is due to PRE TAX income.. PRE TAX income which has increased. And you keep claiming "NO ITS TAXES ITS TAXES"

You continue to misrepresent my position. I say it's both.

>>you claim I refuse to accept that there is an increase in pre tax income.

BS. When did I ever say anything like that?

>>Its why you have no credibility here MMI.

Gee, now I feel just awful. As I've said before, yer an intelligent man, and you don't insult us with flat-out lies like some others on the Right here do. But you suffer from a malady common to the intelligent — you make up yer mind and then close it.

>>Of course their needs to be said mechanism

Why? Because you say so?

>>there are many things that are in place that prevent me being run over by a truck when I leave my house.

And we have the mechanism of democracy. If revenues gained by increasing taxes on wealthy households are wasted, there will be a loud cry to lower them back down. See, e.g., the screaming associated with the ACA and the ARRA.

>>which means that its not a tax issue … its not going to be solved with taxes.

It can be addressed with changes in tax policy. I don't say it can be "solved."

Or it could cause those workers to lose their jobs entirely. Either to automation or outsourcing, or simply make a business non viable.

Capitalism is characterised by creative destruction. You seem to be content to simply allow low-wage workers to suffer economic hardship. Liberals/progressives seek to adapt to change while looking out for the interests of those with little leverage.

>>We don't have a revenue issue.. we have a spending issue.

It's both.

>>the dramatic increase in income was PRE TAXED.. and has nothing to do with taxes

The evidence shows that it's both pre- and post-tax.

>>you are the broken record that keeps claiming that increasing taxes will reduce inequity when the cause of the inequity is not the tax system.

The evidence indicates otherwise. You refuse to accept it because you don't wanna pay up.

>>"Tax the rich" " tax the rich" "tax the rich" despite the facts that the income growth is PRE TAX.. despite the fact that there is no direct.. nor assured indirect effect that increasing taxes will make ANYTHING better for the poor and middle class.

It's pre- and post-tax. We must act, even in the absence of assurances.

>>I have already fought in the ring and the octagon.

That comment was not directed at you. You'd lose in a unanimous decision.

the tax code as brought in what is historically our normal revenue.. about 18% of GDP. Our deficits have not been created by our tax code.. they have been created by our spending habits.

Spending on Social Security and Medicare.

>>Its just the facts Critter.

"Selected" facts. Not as bad as "alternative facts," aka "lies," but misleading nonetheless.

 

[YorkshirePete]

I encourage everyone to look at this with an open mind.
Explaining Why Federal Deficits Are Needed - New Economic PerspectivesNew Economic Perspectives

I'd like to add on this doesn't include the recent clinton surplus.
How Bill Clinton's Balanced Budget Destroyed The Economy - Business Insider



I look forward to some interesting discussion.

Did you see Marc levinson on WJ? His book theorizes growth much over 3 % will never happen again. After WWII we had 50 % of the world production and there was a huge labor influx from the land. No longer. Everything has been tried, trickle down , Thatcherism,
You name it. So it will be interesting to see if mr trump can produce $30/hr jobs for high school boys and girls

 

[Incisor]

Yes.. that's right.. and to maintain that profit

Exactly...it's all about profits. Now what I'm not getting from you is why does that part of health care have to be for profit, and how does making it for profit improve outcomes when we have all the health metrics that show our outcomes consistently rank below other First World Nations. In fact, Texas has one of, if not the highest maternal mortality rate in the developed world. So that's not indicative of a system that works for outcomes.

How does having a for-profit tie to the administration of payments to providers improve outcomes? The answer is that it doesn't. So you can work in theory, which you're so fond of doing, but the reality is that what you're saying about how if the insurance company doesn't reimburse as it should, customers can just go to a different insurance company, is moot because ultimately how the insurance company reimburses your provider has nothing to do with the care you have received. Insurance companies are middle-men. They provide no service other than restricting access. If you have one insurance, and a doctor near you takes a different insurance, then you can't see that doctor, can you? In a single payer system, you can go see whatever doctor you wish because all doctors are reimbursed by the same entity. And that entity isn't taking 20% off the top for itself, wasting premium dollars that could otherwise be used on your care.

 

[YorkshirePete]

Right, so that shows that there can be a government-run insurance plan that is managed by private companies. In this, I have no problem...what I have a problem with is when private insurance companies fracture the market in such a way that they don't have the leverage when it comes to negotiating with providers and drug companies. So in a situation where you have more buyers (insurance companies, also could be called "payors") than sellers (providers, drug companies) to whom do you think the bargaining power lies? So setting aside the redundancy of paying a fee for administration, you're also hurting patients because you've eliminated their ability to collectively bargain for lower rates by pooling all their premiums into one pool, administered by the State & not-for-profit, for the current model of multiple payors that outnumber the providers, from a market perspective. So what I don't understand about your position is, if you are looking for the most cost-effective way to provide access to care, there is no other solution than a single payer that can force providers and drug companies to negotiate with it, rather than the other way around.

Keep the gov out of my Medicare as the trumpie said

 

[Critter7r]

Wrong.... except for a few years,, the tax code as brought in what is historically our normal revenue.. about 18% of GDP. Our deficits have not been created by our tax code.. they have been created by our spending habits. Its just the facts Critter.

Except that over the past 20 years we've gone through a double-dip in reductions from a high of ~20% down to our current ~15%.

 

[jaeger19]

[

Again:


After taxes, top 1 percent incomes are increasing even faster than before taxes. Before-tax income growth for the top 1 percent has averaged 174.5 percent since 1979. The after-tax increase: 200.2 percent

.

Which is because of the pretax income rates.

No. The evidence shows that yer … wrongah. Changes in the tax system — shovelling trillions of dollars at wealthy households — have exacerbated inequality.

no the evidence shows I am correct.

This is just more of yer sophistry. Like yer BS about how the economic environment in 1945 can be used as a guide to understanding what's going on today. That year was one of turmoil characterised by conditions that are in no way present today.

no.. its just more of you ignoring facts that you don't like. And yes.. understanding the economic environment after the war is a guide to understanding whats going on today. Those who ignore history and all that.

All of those have been implemented. Manufacturing in the US is much more automated today than it was thirty-five years ago. But foreign competitors have developed along the same lines. In many cases, American workers simply can't compete with very-low-wage, third-world counterparts. We don't want them to.

that's right.. foreign competitors have caught up. and americans workers can compete with very low third world counterparts. They did for decades before WW2.. they definitely did post WW2.. and they can now. And yes we do want them do compete with them.

Many undocumented workers have jobs for which there is little competition from documented workers.

Yeah that's a racist meme you liberals use to justify taking away American jobs. . there are plenty of americans working in those jobs as well. In fact well over half are americans working in those jobs. and there are more americans available to work in those jobs. Simply being brown doesn't make you "undocumented".

Yer simply determined to maintain yer view. You say it's "true" for no reason other than having decided that it is. I'm more careful in my judgements.

that's funny. Whatever makes you feel better about your ideology. I deal with facts.. you with ideology.

The shift is both pre- and post-tax.

Well duh.. of course because unless your tax rate is 100 % or more .. more pretaxed well is going to translate to more post tax wealth. the driving factor is pre tax income. The driving factor is pre tax income.. the driving factor is pre tax income.

but you focus on taxes... whatever.

This "envy" crap exists only in the imagination of RWers like you and MR. Why would I be angry at rich folks? I simply oppose policies that create unjust and destabilizing levels of inequality

.

Oh please.. that's a lie and you know it.. you already talked about "shoveling money to"... its not shoveling money to when you get to keep more that you earned.

Earned? I'd say "collected" is a more neutral term

.

Exactly my point.. see above. You can't even bring yourself to admit they EARN it. Its just collected.

And as far as money not being available.. the revenue collected is better or the same per GDP that is was post war when the middle class grew. This premise that somehow we don't have money available for education and infrastructure because of the tax codes is one of your many lies MMI...

 

[jaeger19]

Except that over the past 20 years we've gone through a double-dip in reductions from a high of ~20% down to our current ~15%.

Only for a very few years in those 20 years. So we are still at or above the average for revenue. And then add the deficit spending? On top of it. We have had way more than enough money available.