JimofPennsylvan
Platinum Member
- Jun 6, 2007
- 865
- 510
PART ONE
America has a Health Care crisis with the number of Americans uninsured, underinsured and the number of American employers who are on the verge of dropping their employee health insurance because of costs. The bottom line on Health Care is America needs the Congress to pass good legislation in this area soon and major compromise is needed from both the Republican and Democrat parties to do this. Members of Congress have a serious duty to solve this crisis and political considerations are no defense in not doing this duty. Members of Congress on both sides of the aisle here need to start being guided by the merits of the issue and not by partisan ideologies! The following describes what this means.
I)
Republicans have to compromise and agree to raise significant levels of money to pay for the legislation and Democrats have to compromise and dramatically cut the costs of the excessively expensive current bills and not soak the wealthy to pay for the legislation and not be foolish with fees on businesses in the health care industry which will just be passed on to ordinary Americans. Democrats on this subject have to drop their contempt and listen to those Americans saying this legislations price tag has to be what America can afford not what America needs because Americas deficits and debts and all that they mean demand this; the Democrats need to accept that this legislation can only be a large down payment on the promise America should give on Health Care. The current bills and public discussions have offered many ideas on raising revenue to pay for this legislation; the following is a list of the only good ideas.
1) Employers that don't offer employer sponsored health insurance where the employer pays a sizable and responsible portion of the premiums will need to be charged a fee and it should not be the token fee that the Senate has been contemplating. Principle requires not only that employers pay a just wage to their employees, but also, that employers pay a sizable and responsible portion of their health insurance costs, in a developed and wealthy nation like America one would expect employers to provide their employees with these two major expectations from a job. Employers use the health of their employees, that is, the labor of their employees so it is fair to expect them to help pay for maintaining that health, that is, help pay for health insurance. It also needs to be remembered that America would not be the only country in the world that mandates employers pay a fair fee for the health care costs of their workers, in Germany employers are required to pay seven percent of an employee's wages for the health care costs of that worker and it certainly doesn't stop Germany's industries from being competitive and profitable. Critics of this revenue raising course make one somewhat valid criticism in their claim that this fee mandate may cause the loss of jobs or the suppression of hiring because of the financial costs on employers from this mandate. Congress on this issue should do what any good government does when they have a mandate and it may have a negative economic effect they phase it in over time; specifically, the Congress should phase the fee in over twelve years. If fazed in this charge may have a slight long term effect on employment, but that is not the dispositive factor on this issue doing the right thing is the dispositive factor on this issue - Congress mandates a minimum wage and experts tell us this has a negative impact on employment but Congress does it because it is the right thing to do. The House bill has a mandate of eight percent of a workers wages on those employers that don't provide employer sponsored health insurance - The House is right on this issue!
2) The Senate idea to raise some of the revenue needed to pay for this legislation by increasing the Medicare tax on high wage earners is a responsible and good idea. The initiative adds a .5 % increase in the Medicare tax (to 1.95%) for individuals kicking in for wage income over $200,000 for an individual and $250,000 for couples. It is legitimate because it is a very modest Medicare tax increase. It is only applying to wage income as opposed to investment income and all things considered these Americans can absorb this modest additional expense it is not going to affect their quality of life.
3) The Senate/White House idea of taxing insurance companies for the Cadillac health insurance plans they sell is a good idea. This plan is a tax on plans with a yearly premium over $8900 for individuals and $24000 for families, it is a 40% tax on premiums exceeding these limits. The goal of this initiative is not only to raise revenue but to stem the unnecessary use of health care services - these "cadillac" (generous coverage) plans tend to foster over use of health care services. America has a growing problem of a shortage of physicians, initiatives like this that work to curb unnecessary use of health care services would obviously help this problem and this initiative will drive businesses to use lower cost non-cadillac plans which will free up money for such businesses which they can use to increase wages and for job creating capital investment all desirous effects. A lot of hay has been made about unions getting an eight year exclusion on this "cadillac health insurance" tax for plans connected with collective bargaining agreements and with State and Local government employees. This is a completely bogus and unjust criticism. The workers this exclusion applies to are largely middle class Americans and if there is no exclusion they are going to get walloped with insurance premium increases (which they can ill afford) because the tax will be passed through to them, insurance company executives have said as much. Furthermore, these workers have sacrificed for years taking less yearly wage increases to maintain high quality health care insurance and so it would be unfair for the government to suddenly blind side these Americans with this Cadillac tax which will cause them an onerous financial burden.
4) Another legitimate and good means to raise revenue for this legislation is a manifestation of a Republican idea that hasn't been publicly embraced by them since President Obama took office. Republicans used to acknowledge that comprehensive health care reform legislation would require significant revenue raising and their idea for doing it was to do away with the taxable income exclusion for health insurance premiums on employer sponsored health insurance making the entire premium taxable income to the employee. And because obviously these American taxpayers bill would be going up for their taxable income would be increasing the Republican plan was to give the taxpayer a tax credit to offset the increased tax charge and the tax credit would be in the amount that if the American taxpayer had a high-deductable health insurance plan (which have lower premiums) it would be a wash, a complete offset, the taxpayer would have no increased tax bill. Any person of conscience knows that applying this plan today on working and middle class America would cause too much pain on those who didn't have high-deductable health insurance plans who would have an increased tax bill; however, wealthy Americans (individuals making over $200,000/yr and couples making over $250,000/yr) could afford this plan. Congress should implement this Republican plan for wealthy Americans and thereby raise a significant amount of revenue for the legislation.
5) Congress in the current reform bills has some good Medicare savings and could do significantly more. Congress should designate that only twenty percent (not all) of the balance of Medicare savings can be used for non-Medicaid spending in the bill. By balance of Medicare savings it is meant the bill has or should have increased Medicare expenditures which should "all" be used in offsetting the Medicare savings to be fair and responsible. Medicare expenditures, in part, include closing the "doughnut hole" in the Medicare prescription drug program and the permanent cancellation of the automatic Medicare cuts to doctors that Congress has to continually defer. Congress should only be designating this twenty percent, basically a minor amount, because to do otherwise is unseemly and inconsiderate to America's seniors; Medicare is far from a perfect health insurance plan, for instance, there is no out-of-pocket limit on hospital costs and it is just not right to be paying for new non-senior health spending government program off the backs of seniors and their less than ideal insurance program which would be the case without this limitation. Moreover, Medicare projected budgets should not be viewed as exactly reliable for many reasons so Congress should leave this 80% balance to address unforeseen contingencies; for one, many hospitals across America operate in the red if this problem gets worse a fix would have to include increasing Medicare rates for hospitals, plus, the Medicare rolls are projected to increase with the aging of the baby boom generation and with advances in science average life expectancy will likely significantly increase all affecting future Medicare budgets.
SEE PART TWO
America has a Health Care crisis with the number of Americans uninsured, underinsured and the number of American employers who are on the verge of dropping their employee health insurance because of costs. The bottom line on Health Care is America needs the Congress to pass good legislation in this area soon and major compromise is needed from both the Republican and Democrat parties to do this. Members of Congress have a serious duty to solve this crisis and political considerations are no defense in not doing this duty. Members of Congress on both sides of the aisle here need to start being guided by the merits of the issue and not by partisan ideologies! The following describes what this means.
I)
Republicans have to compromise and agree to raise significant levels of money to pay for the legislation and Democrats have to compromise and dramatically cut the costs of the excessively expensive current bills and not soak the wealthy to pay for the legislation and not be foolish with fees on businesses in the health care industry which will just be passed on to ordinary Americans. Democrats on this subject have to drop their contempt and listen to those Americans saying this legislations price tag has to be what America can afford not what America needs because Americas deficits and debts and all that they mean demand this; the Democrats need to accept that this legislation can only be a large down payment on the promise America should give on Health Care. The current bills and public discussions have offered many ideas on raising revenue to pay for this legislation; the following is a list of the only good ideas.
1) Employers that don't offer employer sponsored health insurance where the employer pays a sizable and responsible portion of the premiums will need to be charged a fee and it should not be the token fee that the Senate has been contemplating. Principle requires not only that employers pay a just wage to their employees, but also, that employers pay a sizable and responsible portion of their health insurance costs, in a developed and wealthy nation like America one would expect employers to provide their employees with these two major expectations from a job. Employers use the health of their employees, that is, the labor of their employees so it is fair to expect them to help pay for maintaining that health, that is, help pay for health insurance. It also needs to be remembered that America would not be the only country in the world that mandates employers pay a fair fee for the health care costs of their workers, in Germany employers are required to pay seven percent of an employee's wages for the health care costs of that worker and it certainly doesn't stop Germany's industries from being competitive and profitable. Critics of this revenue raising course make one somewhat valid criticism in their claim that this fee mandate may cause the loss of jobs or the suppression of hiring because of the financial costs on employers from this mandate. Congress on this issue should do what any good government does when they have a mandate and it may have a negative economic effect they phase it in over time; specifically, the Congress should phase the fee in over twelve years. If fazed in this charge may have a slight long term effect on employment, but that is not the dispositive factor on this issue doing the right thing is the dispositive factor on this issue - Congress mandates a minimum wage and experts tell us this has a negative impact on employment but Congress does it because it is the right thing to do. The House bill has a mandate of eight percent of a workers wages on those employers that don't provide employer sponsored health insurance - The House is right on this issue!
2) The Senate idea to raise some of the revenue needed to pay for this legislation by increasing the Medicare tax on high wage earners is a responsible and good idea. The initiative adds a .5 % increase in the Medicare tax (to 1.95%) for individuals kicking in for wage income over $200,000 for an individual and $250,000 for couples. It is legitimate because it is a very modest Medicare tax increase. It is only applying to wage income as opposed to investment income and all things considered these Americans can absorb this modest additional expense it is not going to affect their quality of life.
3) The Senate/White House idea of taxing insurance companies for the Cadillac health insurance plans they sell is a good idea. This plan is a tax on plans with a yearly premium over $8900 for individuals and $24000 for families, it is a 40% tax on premiums exceeding these limits. The goal of this initiative is not only to raise revenue but to stem the unnecessary use of health care services - these "cadillac" (generous coverage) plans tend to foster over use of health care services. America has a growing problem of a shortage of physicians, initiatives like this that work to curb unnecessary use of health care services would obviously help this problem and this initiative will drive businesses to use lower cost non-cadillac plans which will free up money for such businesses which they can use to increase wages and for job creating capital investment all desirous effects. A lot of hay has been made about unions getting an eight year exclusion on this "cadillac health insurance" tax for plans connected with collective bargaining agreements and with State and Local government employees. This is a completely bogus and unjust criticism. The workers this exclusion applies to are largely middle class Americans and if there is no exclusion they are going to get walloped with insurance premium increases (which they can ill afford) because the tax will be passed through to them, insurance company executives have said as much. Furthermore, these workers have sacrificed for years taking less yearly wage increases to maintain high quality health care insurance and so it would be unfair for the government to suddenly blind side these Americans with this Cadillac tax which will cause them an onerous financial burden.
4) Another legitimate and good means to raise revenue for this legislation is a manifestation of a Republican idea that hasn't been publicly embraced by them since President Obama took office. Republicans used to acknowledge that comprehensive health care reform legislation would require significant revenue raising and their idea for doing it was to do away with the taxable income exclusion for health insurance premiums on employer sponsored health insurance making the entire premium taxable income to the employee. And because obviously these American taxpayers bill would be going up for their taxable income would be increasing the Republican plan was to give the taxpayer a tax credit to offset the increased tax charge and the tax credit would be in the amount that if the American taxpayer had a high-deductable health insurance plan (which have lower premiums) it would be a wash, a complete offset, the taxpayer would have no increased tax bill. Any person of conscience knows that applying this plan today on working and middle class America would cause too much pain on those who didn't have high-deductable health insurance plans who would have an increased tax bill; however, wealthy Americans (individuals making over $200,000/yr and couples making over $250,000/yr) could afford this plan. Congress should implement this Republican plan for wealthy Americans and thereby raise a significant amount of revenue for the legislation.
5) Congress in the current reform bills has some good Medicare savings and could do significantly more. Congress should designate that only twenty percent (not all) of the balance of Medicare savings can be used for non-Medicaid spending in the bill. By balance of Medicare savings it is meant the bill has or should have increased Medicare expenditures which should "all" be used in offsetting the Medicare savings to be fair and responsible. Medicare expenditures, in part, include closing the "doughnut hole" in the Medicare prescription drug program and the permanent cancellation of the automatic Medicare cuts to doctors that Congress has to continually defer. Congress should only be designating this twenty percent, basically a minor amount, because to do otherwise is unseemly and inconsiderate to America's seniors; Medicare is far from a perfect health insurance plan, for instance, there is no out-of-pocket limit on hospital costs and it is just not right to be paying for new non-senior health spending government program off the backs of seniors and their less than ideal insurance program which would be the case without this limitation. Moreover, Medicare projected budgets should not be viewed as exactly reliable for many reasons so Congress should leave this 80% balance to address unforeseen contingencies; for one, many hospitals across America operate in the red if this problem gets worse a fix would have to include increasing Medicare rates for hospitals, plus, the Medicare rolls are projected to increase with the aging of the baby boom generation and with advances in science average life expectancy will likely significantly increase all affecting future Medicare budgets.
SEE PART TWO