It must be nice to live in such an uncomplicated, comic book-esque type world…
-XT
Well, first of all, I’d be wary of claims that Medicare or SS is going bankrupt:
Second of all, it does not seem like a particularly large hurdle. The tax increase need not be great, and it need not apply at all to those earning <$200K.
Third of all, an increase in the income tax is not even necessary. A miniscule 0.5% tax on derivatives trades (which were estimated at over $500 trillion in 2008) would be more than sufficient to cover these deficits, as well as provide money to, say, expand Medicare. If conservatives want to protest this tiny tax on those who wrecked the economy…well, that would not be a very popular move.
And you counter this with the possibilty that having dems preemptively cave to some of the pubs more outlandish ideas would be a step in the right direction? Sorry XT, but if dems spare the rod now, they’ll spoil the child. Real conservatives don’t seem to be willing to reign in the radical takeover of the party. Heck McCain was scared to vote for Paygo, and now he’s being primaried from the right anyway.
Nope, as things stand, your plea for moderation smacks of “Peace for our timeism.” It’s counterproductive, and it won’t work with the current GOP.*
*Of course, when Boehner and Cantor show up at Obama’s health care summit week after next and stun us all with their cooperative and productive attitude, you can point at me and laugh. But only fools are holding their breath for that particular outcome.
Well, I never said you had to cave, but suit yourselves. We’ll see how it plays out. I DO find it fairly ironic that, now that you have the whip hand you are advocating the same kinds of politics that the Pubs did when they were on top. How’d that work out for them again?
-XT
That $500 trillion isn’t actually the underlying assets (money) so it’s not something you can tax. That number just measures activity and guarantees.
Suppose you buy a $2000 refrigerator. Then you buy an 5-year extended warranty to cover (repairs and replacement) that refrigerator. Is there now $4000 worth of wealth to tax? No. And what if another company buys out that extended warranty. Is there now $6000 of wealth to tax? No.
Or suppose you make $50,000 annual salary. You buy disability insurance that covers your full salary in case of an injury. Does that mean there’s now $100,000 ($50k salary + $50k insurance) to tax?
If we try to tax wealth that doesn’t actually exist, Medicare and SS will go bankrupt.
Well, my understanding was that that was the amount of money traded, not a set amount of money. I was referring to a tax on transactions.
Well, they got their war and their taxcuts and…
I understand the concept of working with the opposition, it even kind of appeals to me, but conservatives of conscience, such as yourself*, seem to have abandoned the GOP, leaving a stump that is neither capable of negotiating in good faith or engaging in compromise. I figure if the current party gets beat on hard enough they might get weak enough to allow some decent conservatives, again such as yourself, into the nooks and crannys, maybe even the corridors of power. That’d be cool. I’m pretty tired of all these literalist Reagan worshippers.
I should stop this minor hijack now. ITR champion just annoyed me when he ceded without thought the possibility of the feds actually taxing people to pay for services rendered. Sure the GOP doesn’t want to pay taxes, but that’s a route to sky high deficits unless also we decide to stop high school at 11th grade, or let those on medicare die of preventable diseases or something. The possibility of raising taxes to keep medicare afloat deserves some serious attention.
*except that I hear you’re an atheist now, so can’t possibly be a conservative…
That’s what they tell me…
(I’ll also stop the hijack…sorry to the OP)
-XT
It’s not the money that’s actually traded or changed hands.
That $500 trillion is a somewhat meaningless sum of everybody’s position. You can create and buy a derivatives contract on a silo of wheat or a bundle of homeowner mortgages and those assets often don’t change hands.
Here’s a short article that may help: How can the derivatives market be worth more than the world's total financial assets?
In summary, there just isn’t $500 trillion in transactions to tax. Therefore your mathematics (0.5%) to levy new taxes on that number don’t work. So, we’re still back to square one: Medicare is bankrupt.
Well actually that seems to strengthen my point. There are so few lawsuits **because **there are so many unnecessary tests.
Since the AMA is an advocacy organization with no governing power, they could only do this by lobbying against new med schools or new spots in med schools. They don’t do that.
I’d be happy to be proven wrong, but I’m not sure I believe this. In my experience, most people who have both the ability and the desire to get through medical training get in somewhere eventually. (It’s true that most schools get several applications for every spot they fill, but that’s because most students apply at a bunch of schools.)
Where the ranks are really swelling is in the mid-level practitioners (nurse practitioners and physician assistants). That helps alleviate some of the pressure, especially at the primary care level, but it comes with its own problems.
This happens, but it’s not common enough to be a huge problem. I certainly support tightening the rules to prevent such things.
But doctors order unnecessary labs and radiologic studies and antibiotics and everything else mostly for one simple reason: because that’s what patients want. People don’t want to come to the doctor only to be told to give it a few days and see what happens, even though it’s the most prudent thing to do most of the time. They want to feel like the doctor “did something for them”.
Satisfied patients keep coming back. But even for doctors on pure salaries (like I am), it’s just plain easier and takes less time to order tests than to explain to the patient’s satisfaction why you don’t need to order any tests.
How about, instead of raising taxes, give everyone under 65 the option to buy in to Medicare? That’ll get a lot of younger, healthier people into the system who will also save money. Money not being used on health care premiums that instead can be used to eventually buy things, further stimulating the economy.
Wasn’t that already being considered but got shot down?
“…addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services…”
Just stepping in to add some additional bad news: there is no Trust Fund. There is no account anywhere waiting to be be tapped. We spend every dime we take in and a lot more. The “Trust Fund” is chits, and will collapse along with everything else at some point given current projections.
It’s not Medicare that’s broke; it us. Our proposed single-year deficit for the current budget is 1.4 Trillion dollars out of a total of 3.8B. I find that remarkable; we are borrowing a third of what we spend.
Budget discussions should focus on only one thing: Should we borrow money from future revenues? It is all the same pot and at the level at which we are deficit-spending, which particular subset of the pot is going broke-er is very academic, like arguing over which part of the mountain underneath you is stable at that moment while the whole mountain is busy sliding into the ocean.
They were considering a buy-in from 55 on. Lieberman (I-Aetna) shot it down after it was proposed after hearing that people actually liked the idea.
This is the only realistic long-term solution. It won’t happen.
Look at the brouhaha a few years ago when insurance companies watned to release women from the hospital after 24 hours instead of 48. Statistically, there was no benefit from the extended stay - healthy women and healthy babies did just as well overall when they went home after 24 hours as otherwise. But there was actually legislation proposed forcing companies to reimburse for the full 48 hours.
It’s not like we don’t know how to fix Medicare. The Sustainable Growth proposal is thirteen years old. Congress has never made the cuts it called for.
But they will under Obamacare. Suuuuuure they will.
Regards,
Shodan
ALL us old farts don’t hold identical positions on UHC. Or anything else, for that matter.
This idea is laughable.
I agree there’s no shortage of people who want to be doctors and nurses, just as there’s no shortage of people who want to be NBA or NFL starters. There is a great shortage, however, of people that have the requisite talent and skills to serve in that capacity.
The problem is not “a shortage of programs.” I know we try to tell our kindergarten students, “You can be anything you want to be!” But that’s not really the truth. If you lack a certain base mental acuity, for example, you can’t be a doctor.
This makes no sense. What is a ‘doctor’? In theory anyone could call themselves a doctor, but in the U.S. the operational definition is any person who has satisfied the requirements for medical licensure. So, by definition, being a ‘doctor’ is not, as you argue, a function of the intrinsic qualities of the aspirant (e.g., mental acuity), but rather is determined by the system that evaluates whether people meet the qualifications. If they say you’re a doctor, you are, regardless of your individual qualities.
The number of physicians is determined by the number of spots in the training system. If the average ‘mental acuity’ of the medical applicants suddenly plummeted, we’d have dumber doctors, not fewer.