Obamacare - Even higher rate hikes approved

[ampaphb]

When you designate the Federal government to "take care of" the young, old and infirm, you sideline family, neighbors, churches, charities and altruists. Everything depends on benevolent politicians and bureaucrats.

This neither a zero sum game, nor an either or proposition. There is room for both the public and private sectors to be involved.

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[ampaphb]

because "we" shouldn't have to provide anything for anyone. Every adult is responsible for their own needs...

So you plan on turning down Social Security, Medicare, Disability SSI, your Unemployment benefits, federally funded college loans, FEMA help in case of a disaster, etc? Cause, I mean, to take those would mean you weren't "responsible for your own needs"

 

[ampaphb]

no one else owns my stuff, my income, or my labor...I don't owe any of it to anyone and they don't have a moral right to take just because they outnumber me

No, but you couldn't do what you do without the presence of law enforcement, the defense of the military, infrastructure like roads, the electrical grid, water and sewage, clean air and clean water, as well as other governmentally provided services (firefighters, sanitation workers, the court system, the diplomatic corps, etc).

Your narcissistic view point to the contrary, no one functions in a vacuum. The market doesn't, and is in capable of providing such services. Government, and by extension the greater community, are an important factor that allows us to achieve what we have accomplished.

So unless you plan on moving off the grid, and not availing yourself of any of the aforementioned services, you do rely on others,and thus you have a moral and legal obligation to pay for them.

 

[Ligament]

 

[deleted480308]

So you plan on turning down Social Security, Medicare, Disability SSI, your Unemployment benefits, federally funded college loans, FEMA help in case of a disaster, etc? Cause, I mean, to take those would mean you weren't "responsible for your own needs"

I do actually advocate against those things existing as a govt function.

No, but you couldn't do what you do without the presence of law enforcement, the defense of the military, infrastructure like roads, the electrical grid, water and sewage, clean air and clean water, as well as other governmentally provided services (firefighters, sanitation workers, the court system, the diplomatic corps, etc).

Your narcissistic view point to the contrary, no one functions in a vacuum. The market doesn't, and is in capable of providing such services. Government, and by extension the greater community, are an important factor that allows us to achieve what we have accomplished.

So unless you plan on moving off the grid, and not availing yourself of any of the aforementioned services, you do rely on others,and thus you have a moral and legal obligation to pay for them.

all of that can be funded by per user fees as most actually are via local municipalities or private entities.....you seem to be conflating some issues with things funded by disproportionately having the "wealthy" pay everyone else's bills via federal income tax which is how these health insurance subsidies come about

 

[Stim4me]

Again, I agree with your points, which is why I never supported Bernie in the first place. So why don't we emulate a 2 tier system like in Australia? I personally think Australia has the best healthcare system in the world. The doctors work 50% private, 50% public. Everyone gets healthcare, if they don't like the public stuff (Medicaid equivalent), they can opt for private insurance and get their stim in 3 days instead of waiting for 3-4 weeks in Canada. The UK has same 2 tier system. Canada is actually crappy in this regard, since it is in their constitution to make it illegal to provide any form of private health care.

So why can't we provide a turbo boosted medicaid for all, and then allow for private insurance to those who want to opt for

Blitz, do physicians in Canada have the ability to have private practices and set up corporations? As you know our fed rate is 39% plus state plus Obamacare. I pay 49% currently and Hillary will add another 4% as well. We get nothing for this (i.e. Healthcare, education etc). But what we do get is business write offs , and untaxed munisiple income. If these two every changed I'd move to Canada....

Blitz, do physicians in Canada have the ability to have private practices and set up corporations? As you know our fed rate is 39% plus state plus Obamacare. I pay 49% currently and Hillary will add another 4% as well. We get nothing for this (i.e. Healthcare, education etc). But what we do get is business write offs , and untaxed municiple income. If these two ever changed I'd move to Canada....[/QUOTE]

 

[powermd]

You are correct. But like I said in my previous statement, things like healthcare, education and malpractice is much lower, so keep that in mind.

There is set malpractice fees for each specialty, for each province. For example, I know for a fact OBGYN is 75k/year in Ontario (and this is the highest). Similarly here in NYC, it runs around 140-150k. I'm not 100% sure for pain docs, but I think it is around 20k/year.

I got quotes in NYC back in 2010. PRI was 25K, MLMC was 30K. They rate you based on your primary specialty, so an anesthesiologist will probably pay more than PMR or neurology.

 

[ampaphb]

I do actually advocate against those things existing as a govt function.
all of that can be funded by per user fees as most actually are via local municipalities or private entities.....you seem to be conflating some issues with things funded by disproportionately having the "wealthy" pay everyone else's bills via federal income tax which is how these health insurance subsidies come about

So infrastructure, police and fire services, sanitation, water and sewage, etc, are not things we are all entitled to? Or should they only be provided with sufficient financial wherewithal? Per use fees are the most regressive forms of taxation.

I thought life, liberty and the pursuit of happiness were unalienable rights all Americans were entitled to, not just those who could afford the user fees.

 

[deleted480308]

So infrastructure, police and fire services, sanitation, water and sewage, etc, are not things we are all entitled to? Or should they only be provided with sufficient financial wherewithal? Per use fees are the most regressive forms of taxation.

I thought life, liberty and the pursuit of happiness were inalienable rights all Americans were entitled to, not just those who could afford the user fees.

The only thing you have a "right" to is someone not violating your rights, so of that list, a police force is the only thing that all people should be able to access regardless of ability to pay.

 

[Stim4me]

The only thing you have a "right" to is someone not violating your rights, so of that list, a police force is the only thing that all people should be able to access regardless of ability to pay.

Religion and bearing arms as well...

 

[deleted480308]

Religion and bearing arms as well...

any one trying to stop me from pursuing either would be violating my rights....I don't have a right to firearms and churches paid for by people I seize money from via the govt. The police serve specific function of finding/stopping those who violate the rights of others. I am proposing that is the govt service we all have a "right" to. We don't have a natural right to municipal sewer systems etc

 

[Blitz2006]

Blitz, we are comparing income levels. Malpractice has already been paid out of gross revenues in both country statistics in order to arrive at income levels, so malpractice insurance rates are not relevant. What is relevant though is the lack of incentive not to sue in the US. In Canada, if the patient sues and loses, they have to pay the legal fees of the doctor, therefore the malpractice claims are proportionally lower. Also, in socialized medicine systems, the population is trained to put up with mediocrity (e.g. delayed access, restriction on advanced procedures, longer distances that must be traveled in order to obtain specialized services, etc. ) for the good of the country. Not so in the US where everyone demands instant gratification.

I agree, but don't things like tax/overhead costs/malpractice indirectly (or even directly you argue) income level? Its fine to gross 1 million, but if you take home 100k whats the point?

 

[Blitz2006]

Socialized healthcare in Canada is not bad for specialists, for now. I am in agreement for this very small subset of physicians in this particular country, they are doing ok for now.

For PCPs, not great. For British physicians, TERRIBLE.

For patients, it is certainly terrible. 6 month wait for an epidural injeciton. 1 year wait to see a Pain Medicine specialist.

Again, I believe this is incorrect.

I think USA is slightly better for specialists. Here is a solid analytical article from Canada, (2012)

http://news.nationalpost.com/news/c...rn-fee-cuts-pay-inequalities-will-spur-exodus

http://wpmedia.news.nationalpost.com/2012/05/doctor-pay.jpg?quality=65&strip=all


"Ms. Matthews office cites statistics from the provincial Institute for Clinical Evaluative Sciences and the MGMA Physician Compensation Survey in the States that indicate Ontario family doctors make $143,000 more on average than U.S. counterparts, radiologists pull in $203,000 more and cardiologists $141,000 more."


So I honestly believe for PCP, Canada is the way to go. Specialists, USA is probably equal or perhaps slightly better. If you check out second link, bar graphs, you can see that PCPs in Canada throughout the country make on average between 220-250k, much higher than US. I know PCPs in Toronto making 200ish (9-5, no weekends, no call). Now here in NYC on average do not make more than 160k, and I believe the average is 145k (But don't quote me as I'm not a PCP Salary expert). To crunch 250k you're gonna have to head west to the tornado alley.

But as you can see, Opthalmologists are earning a cool 800k in certain parts of Canada, and easily clearing 650k in Ontario/BC. Even after overhead (40%), the average is 375k for ophtho. Not bad. I highly doubt most ophtho in the States are crossing 750k barrier gross.

 

[ampaphb]

The only thing you have a "right" to is someone not violating your rights, so of that list, a police force is the only thing that all people should be able to access regardless of ability to pay.

So now you disagree with the Declaration of Independence, the Constitution, and the Bill of Rights. Good to know.

 

[deleted480308]

So now you disagree with both the Declaration of Independence, the Constitution, and the Bill of Rights. Good to know.

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you might want to evaluate that "free access to mechanically cleaned water, municipal sewer, trained and expensive fire depts, retirement programs, and incredibly complex and labor intensive health care" isn't anywhere in those documents

 

[ampaphb]

"Life, liberty, and the pursuit of happiness". Ring a bell?

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[deleted480308]

"Life, liberty, and the pursuit of happiness". Ring a bell?

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you are falsely equating negative and positive rights...You have a natural right to not have those things taken from you, much like you have a right to your property. You don't have a right to force others to provide for you.

My right to religion is a right that I can't be forcibly stopped from worshiping, not a right to force my neighbors to build me a sanctuary and hire me a clergyman

 

[Ducttape]

I believe I read a scholarly article that stated that the distinction between humans and apes is the extent to which homo sapiens cared for and took care of other members.


reading what you wrote, from your standpoint, the Flint Michigan water crisis is something that is not something the government should have become involved in?

I find it self-serving to think that it is a right to protect what you own and society has to pay for police to protect that right, yet there is not a right for people to have viable drinking water so they can live 3 days longer.

 

[ampaphb]

I have still yet to hear how you managed to achieve your current lofty status without the benefit of infrastructure, police, fire, and sanitation services, clean air and water regulations, water and sewerage, military protection, etc. Again, unless you have been living off the grid, you, just like the rest of us, rely on community.

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[NOSfan]

You would prefer to have them return to those cost-effective emergency rooms for their care?

Sorry, but Obamacare insurance has not had any significant impact on ER visits.

http://www.usnews.com/news/blogs/data-mine/2016/02/18/obamacare-has-barely-made-a-dent-in-er-visits

 

[deleted480308]

I have still yet to hear how you managed to achieve your current lofty status without the benefit of infrastructure, police, fire, and sanitation services, clean air and water regulations, water and sewerage, military protection, etc. Again, unless you have been living off the grid, you, just like the rest of us, rely on community.

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please use the "reply" function if you wish to continue a direct dialogue, it's just easier to follow that way

I'll repeat, again, that you are conflating local services largely funded via user fees and federal services funded via the punitive income tax system. For those federal services that I'm referencing, they most definitely are not provided for by "the community". They are provided for by the roughly half the households that end up with a federal income tax liability free of charge to the roughly half of those that don't get forced to pay in to the general fund.

 

[hyperalgesia]

According to Obama, every society has "growing pains" as it emerges from the depths of free market capitalism to blossom into a flower of socialism. I think I want to be an academic in my next life...

 

[Ducttape]

please use the "reply" function if you wish to continue a direct dialogue, it's just easier to follow that way

I'll repeat, again, that you are conflating local services largely funded via user fees and federal services funded via the punitive income tax system. For those federal services that I'm referencing, they most definitely are not provided for by "the community". They are provided for by the roughly half the households that end up with a federal income tax liability free of charge to the roughly half of those that don't get forced to pay in to the general fund.

and actually, you are wrong. only about 14% of the population pay no federal tax - you forget about federal payroll taxes.

http://www.forbes.com/sites/beltway...ederal-taxes-including-the-poor/#6573a4eb7084

Nearly 63 percent of households in the lowest 20 percent of income (those making less than about $23,500) will pay some Medicare and Social Security taxes in 2013.

Many of those who don’t are the low-income elderly. Because they do not work, they pay no payroll taxes. And because their incomes are so low—often only Social Security benefits—they pay no income tax.

My TPC colleague Amanda Eng estimates that among the elderly in the bottom 20 percent of income just 5 percent will pay payroll taxes and less than 1 percent will pay income tax. By contrast, among households with no members 65 and older, more than 8 in 10 will owe payroll tax while just 6 percent pay income tax.

which btw might not include Donald Trump, because he has not denied the presumption that he has not paid federal taxes over the past 15 years.

 

[deleted480308]

and actually, you are wrong. only about 14% of the population pay no federal tax - you forget about federal payroll taxes.

http://www.forbes.com/sites/beltway...ederal-taxes-including-the-poor/#6573a4eb7084


which btw might not include Donald Trump, because he has not denied the presumption that he has not paid federal taxes over the past 15 years.

I'm not wrong. I have been specifically speaking about, and specifically clarifying more than once, about federal income taxes....as they are the source of general funds for the federal govt. And i've no particular love for donald trump so I'll let you work that one out on your own.

 

[Ducttape]

so go read that article. its not the only one to point out that a significant portion of poor people pay into federal income taxes.

 

[deleted480308]

so go read that article. its not the only one to point out that a significant portion of poor people pay into federal income taxes.

I'm trying to figure out if you literally don't understand what I'm saying or if you're feigning confusion for effect.

I've been repetitive in saying almost half of US households don't pay the federal income tax which feeds the general fund. Your article concedes that point and then attempts, much like you, to muddle up the discussion with the completely different issue of ss/medicare payroll tax

 

[Ducttape]

no, I will admit, you are correct about the general fund.

not trying to use a strawman statement, but doesn't infrastructure support and maintenance - for roads, etc - come from state funds, including local state tax, gas tax, etc.?

 

[ampaphb]

no, I will admit, you are correct about the general fund.

not trying to use a strawman statement, but doesn't infrastructure support and maintenance - for roads, etc - come from state funds, including local state tax, gas tax, etc.?

Just cause sb247 makes claims doesn't make them accurate. Military spending is federally funded. Infrastructure spending is federally funded. Police and fire training and equipment are all federally funded. Clean air and water are federally regulated.

 

[deleted480308]

Just cause sb247 makes claims doesn't make them accurate. Military spending is federally funded. Infrastructure spending is federally funded. Police and fire training and equipment are all federally funded. Clean air and water are federally regulated.

I'm a little unsure where you got the idea that I don't think military, infrastructure, and federal regulations are funded primarily via the federal income tax....can you elaborate?

I will note however that in the areas I've lived, fire/police are largely funded via local property tax mileage rates. There are federal grants that come about for various things now and then but the general budget is local.