Is trump making medicine great again?

[Strider_91]

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Trump Plans to Seek Tax Rate of 15% on Owner-Operated Companies

If this happens and actually goes through how difficult would it be for EM docs who are currently W2 to become 1099 and incorporate?

15% tax rate sounds pretty good...

 

[deleted109597]

Probably close to impossible for the employed folk. I only know one company that used to give people the choice of W2 vs 1099, and they were just bought by USACs.

 

[southerndoc]

Would still have to pay traditional tax rates on your salary (which you need to use market average for your area).

 

[Strider_91]

Would still have to pay traditional tax rates on your salary (which you need to use market average for your area).

There would still be significant savings and the "average" salary seems pretty hard to find every firm has different numbers.

 

[bravotwozero]

If you're an IC who has a pllc setup as an s corp, you stand to gain massively from this tax cut, as this is the exact kind of corporation targeted in the tax cut. You will pay standard taxes on the employee portion, that is true.

The real question is will he be able to get it done? For better or worse, congress has thrown monkey wrenches and obstructed just about everything he's tried to do so far. I don't think there will be Enough bipartisan support for this.


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[doctalaughs]

While I'm all for paying less taxes (I would stand to benefit incredibly from this rate cut) how would this be paid for? Adding massively to the deficit without cutting other programs is not a great idea.

And I don't believe the BS about "growth" offsetting the loss of revenue. That is pure speculation.


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[Strider_91]

While I'm all for paying less taxes (I would stand to benefit incredibly from this rate cut) how would this be paid for? Adding massively to the deficit without cutting other programs is not a great idea.

And I don't believe the BS about "growth" offsetting the loss of revenue. That is pure speculation.


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Because people would be more likely start businesses and less likely to be employees. People almost always work harder when they are working for themselves. This would help healthcare because people may actually start going back into small private practices instead of feeding the large bureaucratic machines that skim off the top.

 

[VA Hopeful Dr]

Because people would be more likely start businesses and less likely to be employees. People almost always work harder when they are working for themselves. This would help healthcare because people may actually start going back into small private practices instead of feeding the large bureaucratic machines that skim off the top.

As the owner of one of those small private practices, I doubt it. Its not the tax burden that made people stop doing this, it was the regulatory burden.

 

[Strider_91]

As the owner of one of those small private practices, I doubt it. Its not the tax burden that made people stop doing this, it was the regulatory burden.

It didn't have to do with reimbursement rates going down and then making less money? That was always the sense that I got. I woulda thought that being taxed at 15% instead of 39% would motivate people not to sell out. But I'm not a business owner (yet) so I basically have no clue what I'm talking about

 

[GeneralVeers]

Never going to happen for two reasons:

1. In order to pass they have to use reconciliation. This will never get scored as "revenue neutral" by the CBO, hence they can't use reconciliation. Dems will oppose any and all "tax cuts for the rich" even it it generates jobs and would help the country.

2. Special interests spend a lot of money lobbying to keep their favored tax breaks/loopholes. Passing Trump's tax reform will piss off all of these corrupt special interests.

It's a real shame. Right now is a once in a lifetime chance to fix our corrupt and wasteful tax code.

 

[The Knife & Gun Club]

Because people would be more likely start businesses and less likely to be employees. People almost always work harder when they are working for themselves. This would help healthcare because people may actually start going back into small private practices instead of feeding the large bureaucratic machines that skim off the top.

Depending on who's numbers you look at, this tax cut would cost the US 3-9 trillion dollars. In the abstract, yes lower taxes grow the economy. But will they grow the economy by so much that they generate 3-9 trillion in tax revenue from these businesses alone?

I'm continually confused by this administration. They have the opportunity to do some really great things, but instead seem to just seem to be proposing things that piss off key allies with almost surgical precision.

 

[deleted274002]

For better or worse, congress has thrown monkey wrenches and obstructed just about everything he's tried to do so far. I don't think there will be Enough bipartisan support for this.

There really hasn't been a whole lot of obstruction as there as been Trump not getting his own party to do what he wants. ACA repeal was defeated in the House, where there is no filibuster.

While I'm all for paying less taxes (I would stand to benefit incredibly from this rate cut) how would this be paid for? Adding massively to the deficit without cutting other programs is not a great idea.

And I don't believe the BS about "growth" offsetting the loss of revenue. That is pure speculation.


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Exactly. From what I've read, even Republicans aren't going to get behind this because there are no spending cuts to go along with it. It will just explode the deficit after 8 years of it coming down.

Never going to happen for two reasons:

1. In order to pass they have to use reconciliation. This will never get scored as "revenue neutral" by the CBO, hence they can't use reconciliation. Dems will oppose any and all "tax cuts for the rich" even it it generates jobs and would help the country.

2. Special interests spend a lot of money lobbying to keep their favored tax breaks/loopholes. Passing Trump's tax reform will piss off all of these corrupt special interests.

It's a real shame. Right now is a once in a lifetime chance to fix our corrupt and wasteful tax code.

The link between tax rates and job growth is tenuous at best. I think ultimately what will doom his tax reform will be Trump's own incompetence. Government isn't a business and we're seeing now more than ever that simply wanting something to be done isn't going to cut it.

 

[The White Coat Investor]

I can't tell you how awesome that change would be for me personally. It would reduce my tax burden by 2/3rds.

That said, I don't see how it can happen as the media is framing it now. Everyone will just figure out how to be a corporation. It's not THAT hard to incorporate.

 

[Strider_91]

I can't tell you how awesome that change would be for me personally. It would reduce my tax burden by 2/3rds.

That said, I don't see how it can happen as the media is framing it now. Everyone will just figure out how to be a corporation. It's not THAT hard to incorporate.

Not hat hard? Doesn't it just take a couple hundred bucks and the ability to log on to legalzoom.com? Lol

 

[enalli]

Serious question: how many of you who stand to gain from this proposal would then go on to directly create more jobs vs. saving and retiring earlier/richer?

 

[The Knife & Gun Club]

Not hat hard? Doesn't it just take a couple hundred bucks and the ability to log on to legalzoom.com? Lol

I incorporated myself in college because I was an idiot in college. And even idiot me found it embarrassingly easy.

Under this plan wouldn't everyone just incorporate themselves, leading to a pretty significant problem?

 

[bravotwozero]

Serious question: how many of you who stand to gain from this proposal would then go on to directly create more jobs vs. saving and retiring earlier/richer?

I would pay off my loans a lot quicker, buy a new house and possibly a car. So maybe new construction jobs from a house? Other than that, likely would not be hiring anyone and focusing on early retirement / financial independence


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[southerndoc]

I incorporated myself in college because I was an idiot in college. And even idiot me found it embarrassingly easy.

Under this plan wouldn't everyone just incorporate themselves, leading to a pretty significant problem?

Not everyone is eligible to incorporate. It's only if you're a 1099 independent contractor. Those who get a W-2 wouldn't be eligible to incorporate.

Edit: If you are incorporated, you pay yourself a salary on a W-2. The portion of your salary on the W-2 would be taxed as ordinary income. The remainder would be taxed at 15%.

 

[dav86]

Serious question: how many of you who stand to gain from this proposal would then go on to directly create more jobs vs. saving and retiring earlier/richer?

I would never make hiring decisions based upon this tax plan. I'd profit off the money saved, pay off debt and become FI faster. This is why these type of tax plans almost universally fail. Greed almost always wins out.

 

[deleted547339]

Serious question: how many of you who stand to gain from this proposal would then go on to directly create more jobs vs. saving and retiring earlier/richer?

Why is that a bad thing? If you retire, that makes a job opening. And retirees have nothing on the hands but time and money.

Edited for typo.

 

[Strider_91]

This also may encourage young physicians coming out of residency to go into a small private practice. The less bureaucratic a setting, the better the healthcare experience usually is in my opinion. Also job Satisfaction is increased for the physician and there would be less burnout.
Seems like all good things.

 

[GeneralVeers]

The debt is going to go up regardless of what we do. That is because Social Security and medicare will continue spiraling out of control and no politician is willing to suffer the wrath of the old people to fix it.

Given that the debt is unaddressable, I'd rather have a tax cut. That money is much better served in my pocket than going to the government.

A tax cut will create jobs and boost economic growth. Will it add to the deficit? Who cares at this point.

I think Republicans are the worst enemies of Trump. Every single Republican who won't get behind the tax bill needs to be voted out of office next year.

 

[bravotwozero]

Social Security is 'spiraling out of control'? Really? According to who?


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[Trail Blazer]

Social Security is 'spiraling out of control'? Really? According to who?


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I think this is what he's referring to:

How $100 of Your Taxes Are Spent: 8 Cents on National Parks and $15 on Medicare

 

[GeneralVeers]

Social Security is 'spiraling out of control'? Really? According to who?


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Is The Social Security Trust Fund Real Or Fiction? Who Cares?

At any rate you can't pay pennies on the dollar into a system for 30 working years of your life, then expect to get back a large amount to cover retirement for 30+ years. The whole system was designed to be used only for ~5 years or less because most people died at age 65 or before when it was started.

 

[deleted274002]

A tax cut will create jobs and boost economic growth. Will it add to the deficit? Who cares at this point.

https://fas.org/sgp/crs/misc/R42729.pdf

Taxes and the Economy: An Economic Analysis of the Top Tax Rates Since 1945 (Congressional Research Service, 2012)

"The results of the analysis in this report suggest that changes over the past 65 years in the top marginal tax rate and the top capital gains tax rate do not appear correlated with economic
growth."

Just for clarity, this report from the Congressional Research Service is referring to the fact that the top marginal tax rate 65 years ago was 90%. As of the writing of the report, it was 35%. Top capital gains rate was between 25-35% between the 1950's to the 1970's. As of the writing of the report, it was 15%.

 

[Apollyon]

Is The Social Security Trust Fund Real Or Fiction? Who Cares?

At any rate you can't pay pennies on the dollar into a system for 30 working years of your life, then expect to get back a large amount to cover retirement for 30+ years. The whole system was designed to be used only for ~5 years or less because most people died at age 65 or before when it was started.

Just as a note - life expectancy was 67 when the retirement age was set at 65. Otherwise, carry on.

 

[GeneralVeers]

Just as a note - life expectancy was 67 when the retirement age was set at 65. Otherwise, carry on.

My guess was off by a couple of years. I didn't bother to look up the precise life-expectancy in the 1930's. My point is still valid.

 

[RustedFox]

I think this is what he's referring to:

How $100 of Your Taxes Are Spent: 8 Cents on National Parks and $15 on Medicare

Can I has the text of the article, plz?
I don't want to subscribe.

 

[Trail Blazer]

Can I has the text of the article, plz?
I don't want to subscribe.

Attached

 

[Apollyon]

My guess was off by a couple of years. I didn't bother to look up the precise life-expectancy in the 1930's. My point is still valid.

Yes, your point is still valid. Wasn't denying it.

 

[Dre8]

I wasn't a Trump guy before this, but if he gets this tax plan through, I want to make him the only President on Mt Rushmore. I will bust ass for 3-5 years and crush everything financially, pay off my debt and stash away cash.

And lol at "how are we going to pay for a tax cut?" crowd. You don't pay for a tax cut...that's how the takers of society frame things. It's fine if you want to pay a tax rate twice as high because it is not good for the national debt to pay less, but you're probably a *****. Or you probably have not worked a real job in EM yet, because if you have, you'd see that you are being fleeced by the government. The bankers and stock folks have it rigged for themselves, but now we might actually be able to get in on that action. Usually we get screwed with tax increases because we were previously not paying our "fair share." Hooray!

 

[throckmortonDO]

so I need to be a 1099 with an S corp and claim a portion of my earnings as dividends to pay the 15% quarterly, is that the only way to do this? if so W2 employees ( like I am currently) are still in the 32-38% bracket correct?

 

[Siggy]

I wasn't a Trump guy before this, but if he gets this tax plan through, I want to make him the only President on Mt Rushmore. I will bust ass for 3-5 years and crush everything financially, pay off my debt and stash away cash.

And lol at "how are we going to pay for a tax cut?" crowd. You don't pay for a tax cut...that's how the takers of society frame things. It's fine if you want to pay a tax rate twice as high because it is not good for the national debt to pay less, but you're probably a *****. Or you probably have not worked a real job in EM yet, because if you have, you'd see that you are being fleeced by the government. The bankers and stock folks have it rigged for themselves, but now we might actually be able to get in on that action. Usually we get screwed with tax increases because we were previously not paying our "fair share." Hooray!

Are you seriously suggesting that, while running a deficit, we should make the deficit larger because, "why try to close it and you're probably a ***** if you think we should balance the budget"?

To use your words, if you don't think that you should spend more than you earn, you're probably a *****. You could have made an argument that capital gains should be higher. You could have made an argument that if your company reimbursment is stocks, you should pay taxes on the stocks, but you didn't. You just threw up your hands at the thought of a balanced budget and said, "Screw everyone else, I want mine even if it destroys the country."

 

[southerndoc]

so I need to be a 1099 with an S corp and claim a portion of my earnings as dividends to pay the 15% quarterly, is that the only way to do this? if so W2 employees ( like I am currently) are still in the 32-38% bracket correct?

Correct.

 

[Dre8]

Are you seriously suggesting that, while running a deficit, we should make the deficit larger because, "why try to close it and you're probably a ***** if you think we should balance the budget"?

To use your words, if you don't think that you should spend more than you earn, you're probably a *****. You could have made an argument that capital gains should be higher. You could have made an argument that if your company reimbursment is stocks, you should pay taxes on the stocks, but you didn't. You just threw up your hands at the thought of a balanced budget and said, "Screw everyone else, I want mine even if it destroys the country."

lol I didn't say that. But you clearly are in the "yet to get fleeced by the government" category.

if I pay myself $400,000 and pay a high tax rate, but everything after that in my s corp and gets taxed at 15% ... I don't think I'm destroying the country.

 

[doctalaughs]

lol I didn't say that. But you clearly are in the "yet to get fleeced by the government" category.

if I pay myself $400,000 and pay a high tax rate, but everything after that in my s corp and gets taxed at 15% ... I don't think I'm destroying the country.

I think Trump's plan is crazy, even though I've been "fleeced" at the highest marginal rate for years.

I have no problem if he ends up lowering my rate to 15% - I would welcome it. However, that money has to come from somewhere else and I've yet to hear from his administration where that is. If his tax plan was coupled with huge cuts in wasteful government programs I think conservatives all over the map would be jumping with joy.


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[Dre8]

I think Trump's plan is crazy, even though I've been "fleeced" at the highest marginal rate for years.

I have no problem if he ends up lowering my rate to 15% - I would welcome it. However, that money has to come from somewhere else and I've yet to hear from his administration where that is. If his tax plan was coupled with huge cuts in wasteful government programs I think conservatives all over the map would be jumping with joy.


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That's the rub lol. The first cuts would probably go to Medicare reimbursement (and defense)... So I figure we should enjoy the low taxes no strings attached for a few years before the reckoning comes.

 

[doctalaughs]

That's the rub lol. The first cuts would probably go to Medicare reimbursement (and defense)... So I figure we should enjoy the low taxes no strings attached for a few years before the reckoning comes.

I guess. But then you better stock that extra tax saving into gold and guns then, because the "reckoning" might be pretty bad.


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[Siggy]

lol I didn't say that. But you clearly are in the "yet to get fleeced by the government" category.

if I pay myself $400,000 and pay a high tax rate, but everything after that in my s corp and gets taxed at 15% ... I don't think I'm destroying the country.

Wait, you didn't say something about not figuring out how to cut taxes without exploding the deficit? Let's go to the tape!

And lol at "how are we going to pay for a tax cut?" crowd. You don't pay for a tax cut...that's how the takers of society frame things. It's fine if you want to pay a tax rate twice as high because it is not good for the national debt to pay less, but you're probably a *****.

Yep, you literally said that we don't have to cut expenses, despite not even being able to cover our current expenses, before we cut taxes. As long as we're spending more money then we're bringing in, we have to figure out a way to pay for what we have before we decide that the government needs less money.

 

[Dre8]

Wait, you didn't say something about not figuring out how to cut taxes without exploding the deficit? Let's go to the tape!



Yep, you literally said that we don't have to cut expenses, despite not even being able to cover our current expenses, before we cut taxes. As long as we're spending more money then we're bringing in, we have to figure out a way to pay for what we have before we decide that the government needs less money.

Lol I was responding to your zinger, "Screw everyone else, I want mine even if it destroys the country." I want to be clear in agreeing with your derogatory point about me: I certainly want my tax cut even if expands the deficit. However, you seem to think that it will "destroy the country." It won't.

And I appreciate that you seem to have some solid values wanting to balance the budget. If that were ever a serious goal of any President, then I'd probably agree. But no one tries to balance the budget anymore. And no one will thanks to Medicare and Defense spending. And with N Korea going nuts right now, no one is going to cut defense. So we are going to have a lot of debt and huge deficits for a long time. So if I now have a chance to really, really take care of my family (and a cut to 15% after I pay myself through my soon to be created S Corp will do just that), I'm going to support that all night and all day. And sleep very well for it.

 

[Siggy]

Lol I was responding to your zinger, "Screw everyone else, I want mine even if it destroys the country." I want to be clear in agreeing with your derogatory point about me: I certainly want my tax cut even if expands the deficit. However, you seem to think that it will "destroy the country." It won't.

What happens to a country that can't pay it's bills?
I'm all for cutting fat out of the system where possible. I'm all for, for example, stopping invading other countries (how much money have we thrown away in Iraq? Joint Strike fighter?). We throw another $25 billion at paying farmers not to farm. There's plenty to cut if you can get past the political consequences that will allow us to balance our budget, pay back debt, and then ultimately cut taxes.

And I appreciate that you seem to have some solid values wanting to balance the budget. If that were ever a serious goal of any President, then I'd probably agree. But no one tries to balance the budget anymore. And no one will thanks to Medicare and Defense spending. And with N Korea going nuts right now, no one is going to cut defense. So we are going to have a lot of debt and huge deficits for a long time. So if I now have a chance to really, really take care of my family (and a cut to 15% after I pay myself through my soon to be created S Corp will do just that), I'm going to support that all night and all day. And sleep very well for it.

Yep, and if anyone thinks that President Bannon... I meant Drumpf is actually going to do anything towards balancing the budget, they were lied to. Also, while I don't fault anyone for limiting their tax burden (hate the game, not the player), I can't support tax cuts given the current environment, especially non-revenue neutral tax cuts. The collective US family is deciding to take more time off from work, but to continue going to Lawry's Steakhouse every week for dinner.

 

[GeneralVeers]

Yep, and if anyone thinks that President Bannon... I meant Drumpf is actually going to do anything towards balancing the budget, they were lied to. Also, while I don't fault anyone for limiting their tax burden (hate the game, not the player), I can't support tax cuts given the current environment, especially non-revenue neutral tax cuts. The collective US family is deciding to take more time off from work, but to continue going to Lawry's Steakhouse every week for dinner.

Lawry's is a prime rib house not a steakhouse.....

Also I want the tax cut. The money is better served in my pocket. It is MY money after all, I worked for it. The government just steals it through threat of force from me, then wastes it on programs and services that I am morally opposed to.

 

[Siggy]

Lawry's is a prime rib house not a steakhouse.....

Also I want the tax cut. The money is better served in my pocket. It is MY money after all, I worked for it. The government just steals it through threat of force from me, then wastes it on programs and services that I am morally opposed to.

Steals? Well, you also gave, at a minimum, your tacit consent (Locke) by staying here. You're free to move to another country if you think taxation is theft so that you feel that the government isn't committing a crime against you (or do you have a different legal definition of "steal"?). You're free to petition the government to cut expenses and balance the budget too. However, "Screw everything, let it burn as long as I've got mine" isn't exactly a way to run a country.

 

[KGflyboy]

Steals? Well, you also gave, at a minimum, your tacit consent (Locke) by staying here. You're free to move to another country if you think taxation is theft so that you feel that the government isn't committing a crime against you (or do you have a different legal definition of "steal"?). You're free to petition the government to cut expenses and balance the budget too. However, "Screw everything, let it burn as long as I've got mine" isn't exactly a way to run a country.

I think you are completely missing the points of people who respond to you and taking their words out of context. No one here wants to "let it burn." When you say things like that it indicates your own political bias is preventing you from understanding anyone's point of view. You are twisting the words of everyone else to make it sound like they hate the country and and don't care about the well being of others.

 

[doctalaughs]

Lawry's is a prime rib house not a steakhouse.....

Also I want the tax cut. The money is better served in my pocket. It is MY money after all, I worked for it. The government just steals it through threat of force from me, then wastes it on programs and services that I am morally opposed to.

I somewhat agree with you. I also will gladly take the tax cut if by a miracle he gets it passed.

However, the (thin) amount we know about his proposed tax cuts is an extremely misguided way to do so. Even if we doctors take a totally selfish view, I can't think of a worse way to cut taxes.

On the personal side, he would be allowing a massive cut to those lucky enough to be independent contractor or have the means to convert to an s-corp. But medicine is rapidly becoming a W2 game as things consolidate and physicians are becoming employees private practices die.

Meanwhile, many billionaires, hedge fund managers and other wall-streeters still have ways to pay an effective tax rate of 10% in many cases.

How about reducing the top marginal tax rate to 25% and making it impossible to pay less no matter what accounting tricks you play?


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[Siggy]

I think you are completely missing the points of people who respond to you and taking their words out of context. No one here wants to "let it burn." When you say things like that it indicates your own political bias is preventing you from understanding anyone's point of view. You are twisting the words of everyone else to make it sound like they hate the country and and don't care about the well being of others.

I never mentioned the well being of others. Where have I said that social programs need to be expanded? Argument 404 error, quote not found. What I have said is that cutting revenue without cutting expenses... when those expenses are already more than the revenue... is simply not going to work. This is basic math. This is basic finance.

Let's try this another way. What happens when your house hold expense is greater than your house hold income... and you already carry a significant amount of debt?

Oh, and twisting of words? I'm not the one who is calling taxation theft. Veers is the one who brought that argument in. I can provide a direct quote if you need me to.

 

[KGflyboy]

I never mentioned the well being of others. Where have I said that social programs need to be expanded? Argument 404 error, quote not found. What I have said is that cutting revenue without cutting expenses... when those expenses are already more than the revenue... is simply not going to work. This is basic math. This is basic finance.

Let's try this another way. What happens when your house hold expense is greater than your house hold income... and you already carry a significant amount of debt?

Oh, and twisting of words? I'm not the one who is calling taxation theft. Veers is the one who brought that argument in. I can provide a direct quote if you need me to.

You are still doing it. Your post mentions something about wanting to expand programs and the well being of others. Where did that come from? Certainly not my post.

You clearly accused supporters of this tax cut of wanting to "let it burn." Those were your words. That's clearly extreme hyperbole and political bias. As far as I can tell, no one here wants to let anything burn. You made that up.

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[Siggy]

You are still doing it. Your post mentions something about wanting to expand programs and the well being of others. Where did that come from? Certainly not my post.

Provide the link where I advocated increasing social programs? Seriously, provide the direct quote where I advocated increasing expenses in this thread. [hint, you won't find it]

You clearly accused supporters of this tax cut of wanting to "let it burn." Those were your words. That's clearly extreme hyperbole and political bias. As far as I can tell, no one here wants to let anything burn. You made that up.

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Sure... when they don't want to make the tax cut revenue neutral. Again, show the logic in "we're in a deficit with a large debt, so lets cut income more without cutting expenses." You still haven't answered the question about what would happen to your household if your house was spending more than it brought in and you decided to cut your income without cutting expenses.

Mind you, this entire line of discussion started because someone thinks that only "*****s" (his words) believe in a balanced budget and paying down the debt. (This is what a link and citing your sources looks like in cause you're confused on the topic)

 

[Dre8]

Provide the link where I advocated increasing social programs? Seriously, provide the direct quote where I advocated increasing expenses in this thread. [hint, you won't find it]


Sure... when they don't want to make the tax cut revenue neutral. Again, show the logic in "we're in a deficit with a large debt, so lets cut income more without cutting expenses." You still haven't answered the question about what would happen to your household if your house was spending more than it brought in and you decided to cut your income without cutting expenses.

Mind you, this entire line of discussion started because someone thinks that only "*****s" (his words) believe in a balanced budget and paying down the debt. (This is what a link and citing your sources looks like in cause you're confused on the topic)

You are definitely doing it again