Megabill implications for anesthesiologists

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Nah. It's great for nearly everyone. People in the United States are truly insulated from the misery that most experience in third world and second world countries.

It's truly comical at times.

I work at an FQHC. My patients have nice phones, the younger ones are wearing Jordan 1s, manicures, fake eyelashes, and all look like they get more then enough to eat. Sure they may not be rolling around in a cyber truck or BMW but their quality of life is reasonably good.
If you are comparing the US with everywhere else, you are correct. Our poor people have great quality of life compared to even middle class people in third/second world countries.

There are things that middle class Americans are worried that people in other developed nations do not even think of. These things are medical bills, paid family leave, college tuition for their kids etc...

But I would rather be in the top 5% in the US than most other countries.

I wonder why the wealth gap between the poor and the rich is getting wider and wider.

As I said before, these big spending laws tend to inflate hard asset price and prop up the stock market. We all know the stock market is a wealthy people game.

The wealthiest 10% of Americans own 93% of stocks even with market participation at a record high​




I don't like these big spending laws, but I am not complaining since the top 1% will leave me some breadcrumbs.

I had to send a 2k and 14k checks back to my state and the feds respectively after filling taxes. Hopefully, that won't be the case for the 2025 fiscal year. I will be MAGA like you if that happens.
 
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Becuase we work for our money. I don’t care if you make 200k-2 million. That income gets exposed to tons of federal income taxes. Any single person making more than 230k is already exposed to 35% incomes. Plus getting nailed with Obamacare Medicare surtaxes after 200k. What is their tax savings on trump’s tax plan?

1. Zero savings with auto loan interest deduction (new for 2025 law with limit on income)
2. Zero savings student loan deduction (nothing has changed with many presidents including trump on income limits)
3. Zero savings with standard deduction (most of us itemized anyways in our income tax bracket )
4. Zero savings with the 20% pass through deductions for self employed business (independent contractors) because they didn’t make any changes from the 2017 tax law which basically excludes doctors who have s corp

“Owners of Restricted Businesses (which includes physicians), however, can fully benefit from the 199A Deduction only if their taxable income is below $157,500 for single filers and $315,000 for joint filers. For taxable income levels between $157,500 and $207,500 for single filers, and between $315,000 and $415,000 for joint filers, the 199A Deduction is phased-out. Once taxable income levels reach $207,500 for single filers and $415,000 for joint filers, the 199A Deduction is completely denied.”

I can go on and on


Trump new tax law does practically nothing for most doctors.

Its just a giveaway to the wealthy.
 
Becuase we work for our money. I don’t care if you make 200k-2 million. That income gets exposed to tons of federal income taxes. Any single person making more than 230k is already exposed to 35% incomes. Plus getting nailed with Obamacare Medicare surtaxes after 200k. What is their tax savings on trump’s tax plan?

1. Zero savings with auto loan interest deduction (new for 2025 law with limit on income)
2. Zero savings student loan deduction (nothing has changed with many presidents including trump on income limits)
3. Zero savings with standard deduction (most of us itemized anyways in our income tax bracket )
4. Zero savings with the 20% pass through deductions for self employed business (independent contractors) because they didn’t make any changes from the 2017 tax law which basically excludes doctors who have s corp

“Owners of Restricted Businesses (which includes physicians), however, can fully benefit from the 199A Deduction only if their taxable income is below $157,500 for single filers and $315,000 for joint filers. For taxable income levels between $157,500 and $207,500 for single filers, and between $315,000 and $415,000 for joint filers, the 199A Deduction is phased-out. Once taxable income levels reach $207,500 for single filers and $415,000 for joint filers, the 199A Deduction is completely denied.”

I can go on and on


Trump new tax law does practically nothing for most doctors.

Its just a giveaway to the wealthy.
A giveaway at the cost of pretty poor individuals…
 
Becuase we work for our money. I don’t care if you make 200k-2 million. That income gets exposed to tons of federal income taxes. Any single person making more than 230k is already exposed to 35% incomes. Plus getting nailed with Obamacare Medicare surtaxes after 200k. What is their tax savings on trump’s tax plan?

1. Zero savings with auto loan interest deduction (new for 2025 law with limit on income)
2. Zero savings student loan deduction (nothing has changed with many presidents including trump on income limits)
3. Zero savings with standard deduction (most of us itemized anyways in our income tax bracket )
4. Zero savings with the 20% pass through deductions for self employed business (independent contractors) because they didn’t make any changes from the 2017 tax law which basically excludes doctors who have s corp

“Owners of Restricted Businesses (which includes physicians), however, can fully benefit from the 199A Deduction only if their taxable income is below $157,500 for single filers and $315,000 for joint filers. For taxable income levels between $157,500 and $207,500 for single filers, and between $315,000 and $415,000 for joint filers, the 199A Deduction is phased-out. Once taxable income levels reach $207,500 for single filers and $415,000 for joint filers, the 199A Deduction is completely denied.”

I can go on and on


Trump new tax law does practically nothing for most doctors.

Its just a giveaway to the wealthy.
Again, how does 13-14 million in assets benefit from this.
 
A giveaway at the cost of pretty poor individuals…
The poor aren’t paying for anything anyways.
They will still get care. The creditors can’t go after someone who doesn’t have anything.

The calculated savings on Medicaid will not come to fruition Just like any calculation on any healthcare law. Including the ACA savings which pretty much zero savings.
 
It’s the top 1% of wealth that really benefits from these tax laws.

By wealth I mean those with stock and assets over 13-14 million.

I fail to see how having assets benefits from the law changes (outside of things like inheritance).
 
Again, how does 13-14 million in assets benefit from this.
People who don’t work don’t have any income taxes accessed at regular taxes

The more wealth they have from the 13-14 million range the more they save with the extension of the tax cuts. They were set to expire. Just like Obama extended the bush tax cuts

Its all a game that most henry do not benefit from

The wealthy do not pay federal incomes taxes a the percentage level the working Henry class pays
 
People who don’t work don’t have any income taxes accessed at regular taxes

The more wealth they have from the 13-14 million range the more they save with the extension of the tax cuts. They were set to expire. Just like Obama extended the bush tax cuts

Its all a game that most henry do not benefit from

The wealthy do not pay federal incomes taxes a the percentage level the working Henry class pays
Ok, you changed your tune.

Assets by themselves do nothing (as far as I can tell).

Agree, that these tax cuts would have an impact on those earners if they stay under stated numbers.

I would also argue that individuals who have that net worth are likely pulling close or more than the income limits.

True benefits go to corporations.
Not the individual (mostly).
 
I am certainly not a tax law expert and I am the first to admit that I am in the “processing” stages of the bill.
 
Ok, you changed your tune.

Assets by themselves do nothing (as far as I can tell).

Agree, that these tax cuts would have an impact on those earners if they stay under stated numbers.

I would also argue that individuals who have that net worth are likely pulling close or more than the income limits.

True benefits go to corporations.
Not the individual (mostly).
My tune is we need to tax everyone including the lower class and the upper class

This 40% pay no federal income tax and the super rich getting 2-3% tax break off the top

This has got to stop

The HENRY’s bare most of the tax burden as a percentage of their working income. It’s all true.
 
SALT cap to 40k is what truly benefits high income earners and this does fall into “assets” if we are talking about property taxes.
 
I agree with that statemet, but that is not where this discussion started.
We have no fiscal responsibility with either party.

if the republicans are wasting 3 trillion with this current bill. The next democratic administration will waste 5 trillion on the next 2029 bill.

It’s endless
 
SALT cap to 40k is what truly benefits high income earners and this does fall into “assets” if we are talking about property taxes.
It’s nothing. Because there is workaround for most high income earners anyways with the current 10k salt tax. And the new bill still allows the workaround
 
We have no fiscal responsibility with either party.

if the republicans are wasting 3 trillion with this current bill. The next democratic administration will waste 5 trillion on the next 2029 bill.

It’s endless
Disagree with your 2nd/3rd statements. Historically, republicans are more fiscally irresponsible than the dems.
 
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It’s nothing. Because there is workaround for most high income earners anyways with the current 10k salt tax. And the new bill still allows the workaround
Ya, but you don’t have to “work around” 40k.
Talk about adding to the deficit. Oof.
 
Ya, but you don’t have to “work around” 40k.
Talk about adding to the deficit. Oof.
what??

There was no cap prior to 2017! So you are saying it’s a savings?? With the cap?

It’s like me telling u my soon to be 3rd year 26 yo medical school nephew is paying $800/month for healthcare via exchanges once he comes off his parents plan. And I told my sister to rig his salary she pays him to pay him 25k so he can get subsidized healthcare via the exchange for $400-month

So he’s “savings” $4800 a year! Right.

No. There is no cost savings because its costing the govt $4800 when he does it.

And if we were back under pre ACA rules. He would have only paid $200/month being healthy

That’s how much the govt waste under any democratic or republican plan

Salt tax potential savings and ACA potential savings.
Nothing.
 
Didn’t Clinton have a surplus?
Yes. But he also drew wonderful cards. Massive productivity gains from the growth of the internet and boomers hitting their peak earning years, continued rise of two income households, peace dividend from fall of Soviet Union. He gets kudos for not screwing it up. Solid job on the economy. Poor human being.
 
Yes. But he also drew wonderful cards. Massive productivity gains from the growth of the internet and boomers hitting their peak earning years, continued rise of two income households, peace dividend from fall of Soviet Union. He gets kudos for not screwing it up. Solid job on the economy. Poor human being.
Than the stock market tanked (it peaked Jan 1 2000) with the AOL/time Warner merger.

It’s all a house of cards.

Took the nasdaq 10-12 years to recover from Clinton

Does anyone link Clinton to the economy crash of both 2001 and 2008? Nope. Because Americans are pretty dumb

Bush 41 doesn’t get enough credit for Clinton’s success. He had to recover from Reagan’s economy.

It’s all about timing and luck as well.

That’s why I don’t really give any one President complete credit for anything.
 
what??

There was no cap prior to 2017! So you are saying it’s a savings?? With the cap?

It’s like me telling u my soon to be 3rd year 26 yo medical school nephew is paying $800/month for healthcare via exchanges once he comes off his parents plan. And I told my sister to rig his salary she pays him to pay him 25k so he can get subsidized healthcare via the exchange for $400-month

So he’s “savings” $4800 a year! Right.

No. There is no cost savings because its costing the govt $4800 when he does it.

And if we were back under pre ACA rules. He would have only paid $200/month being healthy

That’s how much the govt waste under any democratic or republican plan

Salt tax potential savings and ACA potential savings.
Nothing.
You have a real hard time sticking to the discussion @aneftp

I could care less about 2017, 2007 or 1897.

I care about the day before and after the bill passed.
 
You have a real hard time sticking to the discussion @aneftp

I could care less about 2017, 2007 or 1897.

I care about the day before and after the bill passed.
No. I am telling u there was no cap in 2016 with salt

And magically the govt makes this 10k cap estimating the “revenue increases by the 10k cap” which never come to fruition because of the workarounds

It’s all magic accounting

The 40k cap still won’t put any dent in the budget either because the salt workarounds. The govt is not collecting any significant extra revenue with the salt cap for the 2025 tax bill.
 
No. I am telling u there was no cap in 2016 with salt

And magically the govt makes this 10k cap estimating the “revenue increases by the 10k cap” which never come to fruition because of the workarounds

It’s all magic accounting

The 40k cap still won’t put any dent in the budget either because the salt workarounds. The govt is not collecting any significant extra revenue with the salt cap for the 2025 tax bill.
I know and I don’t care. 🤦🏼‍♂️

We are talking about 2025 not 2016.
 
Nah. It's great for nearly everyone. People in the United States are truly insulated from the misery that most experience in third world and second world countries.

It's truly comical at times.

I work at an FQHC. My patients have nice phones, the younger ones are wearing Jordan 1s, manicures, fake eyelashes, and all look like they get more then enough to eat. Sure they may not be rolling around in a cyber truck or BMW but their quality of life is reasonably good.
“Poor” in America is a joke. Every person I’ve ever operated on “without money” has never had to forego any real medical care. It’s not like other countries where people “without money” actually don’t get care. And I’m including socialized countries “with free healthcare.” The reality is that healthcare in America is subsidized by the “upper class,” just not by a formalized method of socialized healthcare like other countries.
 
I know and I don’t care. 🤦🏼‍♂️

We are talking about 2025 not 2016.
Most anesthesia doctors do not get any benefit with 2017 tax law salt. And most anesthesia doctors do not get any benefit with 2025 salt law cap.

You just said the 40k salt tax adds to the defecit

it doesn’t

Just very few people impacted it barely moves the needle.

I’m talking about 2025!
 
Becuase we work for our money. I don’t care if you make 200k-2 million. That income gets exposed to tons of federal income taxes. Any single person making more than 230k is already exposed to 35% incomes. Plus getting nailed with Obamacare Medicare surtaxes after 200k. What is their tax savings on trump’s tax plan?

1. Zero savings with auto loan interest deduction (new for 2025 law with limit on income)
2. Zero savings student loan deduction (nothing has changed with many presidents including trump on income limits)
3. Zero savings with standard deduction (most of us itemized anyways in our income tax bracket )
4. Zero savings with the 20% pass through deductions for self employed business (independent contractors) because they didn’t make any changes from the 2017 tax law which basically excludes doctors who have s corp

“Owners of Restricted Businesses (which includes physicians), however, can fully benefit from the 199A Deduction only if their taxable income is below $157,500 for single filers and $315,000 for joint filers. For taxable income levels between $157,500 and $207,500 for single filers, and between $315,000 and $415,000 for joint filers, the 199A Deduction is phased-out. Once taxable income levels reach $207,500 for single filers and $415,000 for joint filers, the 199A Deduction is completely denied.”

I can go on and on


Trump new tax law does practically nothing for most doctors.

Its just a giveaway to the wealthy.


Were people actually expecting something else?
 
We are in a zero sum game with taxes for us henry even with new tax laws for 2025

Most blue collar states with state income taxes will
See the AMT (which the democrats created) come roaring back and capturing more tax revenue with the salt cap to 40k

Don’t you guys understand

We neither benefit with any tax law. It doesn’t matter who is running the show. The Dems will add more taxes to us. And the republicans bill doesn’t do jack for us.

We henry are in no mans land in terms of benefits of tax law changes.

It’s only when u get to 10-15 million when money starts working for you where do don’t have to work much or at all.
 
“Poor” in America is a joke. Every person I’ve ever operated on “without money” has never had to forego any real medical care. It’s not like other countries where people “without money” actually don’t get care. And I’m including socialized countries “with free healthcare.” The reality is that healthcare in America is subsidized by the “upper class,” just not by a formalized method of socialized healthcare like other countries.


If it’s so great to be poor, I don’t know why everyone here is trying to be rich. I mean if you’re rich, you have to subsidized poor people. Right?
 
If it’s so great to be poor, I don’t know why everyone here is trying to be rich. I mean if you’re rich, you have to subsidized poor people. Right?
We tell that to ourselves so we can feel better.

Let's see if by the end of 2026 that my brokerage account will double.
 
Most anesthesia doctors do not get any benefit with 2017 tax law salt. And most anesthesia doctors do not get any benefit with 2025 salt law cap.

You just said the 40k salt tax adds to the defecit

it doesn’t

Just very few people impacted it barely moves the needle.

I’m talking about 2025!
I pay a lot of SALT. This will definitely decrease my taxable income and, therefore, cost the government money.
 
Where will US debt to GDP be in 4 years and are we comfortable with the number?

I’ve made my nut, the only thing that concerns me is some sort of inflationary spiral.
 
If it’s so great to be poor, I don’t know why everyone here is trying to be rich. I mean if you’re rich, you have to subsidized poor people. Right?
Everything is relative.

You can’t depend on the top 1% to pay 40% of taxes. The math doesn’t work to fund all these programs.

The top 10-% pay 90% of federal taxes collected.

I’m a big proponent of the flat tax with zero deductions. That eliminates all the stormy Daniels deductions some people take. Including putting tjeir 12 years old on their payroll and throwing lavish parties (tyco) and writing it off
 
I pay a lot of SALT. This will definitely decrease my taxable income and, therefore, cost the government money.
U go right back into the amt tax loop than.

The govt knows this. The amt is one of the worst tax laws ever created for upper middle class people. And the Dems own that.

It’s just that the govt has become so dependent on capturing that revenue over the years. It became part of the regular budget wjen it was never intended to hit middle and upper middle class people.

J
 
Nah. It's great for nearly everyone. People in the United States are truly insulated from the misery that most experience in third world and second world countries.

It's truly comical at times.

I work at an FQHC. My patients have nice phones, the younger ones are wearing Jordan 1s, manicures, fake eyelashes, and all look like they get more then enough to eat. Sure they may not be rolling around in a cyber truck or BMW but their quality of life is reasonably good.
Except for those 36 million people living in poverty in the US?
 
If your household makes more than 600k, salt 40k does not help you much.
Correct. These guys who wrote the tax laws know how to stick it to the HENRYs.

Doesn’t matter if it’s republican or democrat

Notice phase out for EV income limits 150k/300k even with Biden tax cuts in 2022

Obamacare 200/250k surtaxes.

Now 500k phase out in 2025 salt cap 40k
I mentored the section 199a phase out 20% deductions at around 150 for doctors still in the 2025 tax law.
 
Except for those 36 million people living in poverty in the US?
The poverty rate percentage has remaining roughly the same (it does fluctuate a few points depending on recessions) the last 47/48 hears years between 50% democratically controlled presidents and 50% republican controlled presidents.

What does that tell you?

Both parties have no clue what to do.
 
Most anesthesia doctors do not get any benefit with 2017 tax law salt. And most anesthesia doctors do not get any benefit with 2025 salt law cap.

You just said the 40k salt tax adds to the defecit

it doesn’t

Just very few people impacted it barely moves the needle.

I’m talking about 2025!
Explain to me how raising the SALT tax from 10k to 40k doesn’t add to the deficit.
 
I pay a lot of SALT. This will definitely decrease my taxable income and, therefore, cost the government money.

The bill is designed to hurt those with high earned income. Well, not really hurt, but just not help. You won’t see much if any increased SALT deduction because you have high earned income. It’s the truly wealthy (those who don’t have/need/want high earned income bc they don’t have to work for a living) who will benefit from all of those added deductions.

All the kushners and trumps of the world will create so many business deductions for themselves they’ll have 0 earned income, take advantage of all the tax deductions, and continue to increase their billion net worths by more billions.

Meanwhile the high income earners like you and I will continue to hold up this country on our shoulders. Especially with a diminishing middle class and an increasing number of uninsured Americans.
 
Where will US debt to GDP be in 4 years and are we comfortable with the number?

I’ve made my nut, the only thing that concerns me is some sort of inflationary spiral.
They built so many financial bombs in to this thing to cheat it through reconciliation it is going to be even worse. It seems like a sizeable minority of the *****s who voted for it are under the impression that none of the Medicaid cuts that ostensibly offset these tax cuts will actually be allowed to happen (ie fixed in a budget bill later). What will happen to the debt then? No spending cuts but huge tax cuts... They raised the debt ceiling to 40T too with nothing in this bill to increase economic activity.

I would be more concerned about impending civil upheaval and unrest being stoked by the people at the top, especially when all the promises of prosperity fail to appear. These tax cuts will look pretty useless if the civil contract starts to fall apart.
 
Explain to me how raising the SALT tax from 10k to 40k doesn’t add to the deficit.
You still don’t get it.

90% of people take the standard deduction.

So now let’s look at the remaining 10% who do take the deduction

It’s mostly likely 60/70% of those people are already self employed like doctors. Right?

So let’s take example my brother in California with say 100k salt deduction in 2017-2024

10k limit. So the govt expected to “save” money 2017-2024. Right? By capping it and disallowing the 90k

I’m just using a super basic example. It’s a little more complicated.

But as Lee Corso of espn always says “Not so fast, my friend!" ”

My brother uses the salt tax workaround there by bypass the salt tax cap 2017-2024.
So the govt never collected any extra revenue they were expecting

So there extra collections is $0!!

So now you have the new tax law for 2025 increasing salt tax deduction to 40k. The law still doesn’t capture my brother so he’s gonna to do the same exact thing in 2025-2029.

So the govt tax extra tax collection is $0 again for 2025 tax year.

It’s a zero sum game for the govt. they weren’t collecting any extra revenue in 2017-2025. They aren’t gonna to collect extra revenue in 205-2029. So it neither adds or worsen the defecits because
1. So many people use the salt workaround
2. Very people it even affects to add positive or negative to the tax collections revenues. It’s a rounding error for the govt in terms of budget calculations.

Unlike ACA which Obama projected tax penalties would collect tax penalties from uninsured and it didn’t collect a penny.

All these tax projections collections by cbo trump Obama bush are all BS.

The only way to capture real taxes is flat tax with no deductions.
 
You still don’t get it.

90% of people take the standard deduction.

So now let’s look at the remaining 10% who do take the deduction

It’s mostly likely 60/70% of those people are already self employed like doctors. Right?

So let’s take example my brother in California with say 100k salt deduction in 2017-2024

10k limit. So the govt expected to “save” money 2017-2024. Right? By capping it and disallowing the 90k

I’m just using a super basic example. It’s a little more complicated.

But as Lee Corso of espn always says “Not so fast, my friend!" ”

My brother uses the salt tax workaround there by bypass the salt tax cap 2017-2024.
So the govt never collected any extra revenue they were expecting

So there extra collections is $0!!

So now you have the new tax law for 2025 increasing salt tax deduction to 40k. The law still doesn’t capture my brother so he’s gonna to do the same exact thing in 2025-2029.

So the govt tax extra tax collection is $0 again for 2025 tax year.

It’s a zero sum game for the govt. they weren’t collecting any extra revenue in 2017-2025. They aren’t gonna to collect extra revenue in 205-2029. So it neither adds or worsen the defecits because
1. So many people use the salt workaround
2. Very people it even affects to add positive or negative to the tax collections revenues. It’s a rounding error for the govt in terms of budget calculations.

Unlike ACA which Obama projected tax penalties would collect tax penalties from uninsured and it didn’t collect a penny.

All these tax projections collections by cbo trump Obama bush are all BS.

The only way to capture real taxes is flat tax with no deductions.
you are excellent at word salad. 👌🏽
 
You still don’t get it.

90% of people take the standard deduction.

So now let’s look at the remaining 10% who do take the deduction

It’s mostly likely 60/70% of those people are already self employed like doctors. Right?

So let’s take example my brother in California with say 100k salt deduction in 2017-2024

10k limit. So the govt expected to “save” money 2017-2024. Right? By capping it and disallowing the 90k

I’m just using a super basic example. It’s a little more complicated.

But as Lee Corso of espn always says “Not so fast, my friend!" ”

My brother uses the salt tax workaround there by bypass the salt tax cap 2017-2024.
So the govt never collected any extra revenue they were expecting

So there extra collections is $0!!

So now you have the new tax law for 2025 increasing salt tax deduction to 40k. The law still doesn’t capture my brother so he’s gonna to do the same exact thing in 2025-2029.

So the govt tax extra tax collection is $0 again for 2025 tax year.

It’s a zero sum game for the govt. they weren’t collecting any extra revenue in 2017-2025. They aren’t gonna to collect extra revenue in 205-2029. So it neither adds or worsen the defecits because
1. So many people use the salt workaround
2. Very people it even affects to add positive or negative to the tax collections revenues. It’s a rounding error for the govt in terms of budget calculations.

Unlike ACA which Obama projected tax penalties would collect tax penalties from uninsured and it didn’t collect a penny.

All these tax projections collections by cbo trump Obama bush are all BS.

The only way to capture real taxes is flat tax with no deductions.

I am honestly trying to understand what you are saying. What is the “work around”?
 
U go right back into the amt tax loop than.

The govt knows this. The amt is one of the worst tax laws ever created for upper middle class people. And the Dems own that.

It’s just that the govt has become so dependent on capturing that revenue over the years. It became part of the regular budget wjen it was never intended to hit middle and upper middle class people.

J
So republicans could do almost anything they wanted with this bill but just couldn’t shake that nasty democrat AMT huh?
 
I am honestly trying to understand what you are saying. What is the “work around”?

2017 and 2025 tax laws still allow the work around

“Since the passage of the TCJA, numerous states have taken a closer look at — and implemented — the workaround to the $10,000 cap. To date, more than 30 states have authorized SALT cap workarounds for some PTEs.”


The specifics vary by state, but for some PTE owners — including S corporations, some limited-liability companies (LLCs), and partnerships — the SALT cap workaround may enable them to indirectly deduct state and local taxes they’ve paid beyond the $10,000 SALT cap.”
 
So republicans could do almost anything they wanted with this bill but just couldn’t shake that nasty democrat AMT huh?
The Dems can’t even get rid of their own Amt. it’s like they created the virus and can’t contain it over 5 decades.
 
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