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Topic: Idea to help solve Healthcare problem in America
| Author | Message |
| chucho | Posted – 2/7/2008 8:54:08 AM | show profile I was thinking last night, as I shifted my views and decided that Hillary Clinton's Healthcare proposal is the best of all candidates because it's the closest to universal healthcare. What do ya'll think about this idea: Since the Republicans are always whining about how the poor don't pay income tax how about this: Instead of getting an income tax return, people who make less than the median income (and therefore get a return) get a health care voucher that represents EARMARKED funds that go into Medicare and Medicaid. I think this is a great idea because basically the government is telling you that your income tax return amounts to money you must personally reserve to help pay for your health care. For example, when I was working a crappy restaurant gig, I had no health insurance and I got about $1,000 or so back each year. I enjoyed getting that money, but if the government had given me instead a healthcare voucher, I would have gone for checkups and regular dental visits during that time. An income tax return applied only to healthcare costs could go a long way toward covering premiums for low-income workers. Sure, they don't get a check to do what they want with it, but then you can tell the Republicans that the poor are carrying more of the weight on healthcare costs -- that would help shut them up, because some of the more liberal pees woudl get all pissed off and say "but that's a tax on the poor!" and when you have both sides after you, it's a good sign that you're on the right track. I've had crappy jobs in the past, and I think I would have been OK with my federal income tax return being mandated toward my healthcare costs. Think about it: would you be willing to give up on getting an income tax return check if it allowed you to go to the dentist twice a year and help cover any deductibles? If a family plan deductible is $1,500 -- an income tax return would cover that (or most of it) and if you don't use it for a year, you'd have $3,000 in two years, etc. If you didn't have any major health problems for, say 5 years, and applied your income tax return to an earmarked voucher, you'd have $7,500 in reserve to cover healthcare costs. This woudl get your and your family regualr dental checkups and go a long way toward paying off a deductible in the event of a catastrophic health emergency. (This isn't the same as health savings accounts because the money could not be risked in the stock market -- perhaps the government could pay interest on the money and handle it like a trust, but the important thing here is to force people to stores money to help cover healthcare costs.) |
| Friends of Ron Mexico | Posted – 2/7/2008 5:37:07 PM | show profile I like Obama's piece,love, and hope message .. Has a guilty white person,i vote for Obama cause he makes me feel better .. I was torn at first.Whats worst???White racism or white sexism?? I think white racism is worse.Obama gets elected and i no longer have to feel guilty about being white!!! Obama will provide healthcare to all the poor... He will school those racist Republicans .. |
| beenthere | Posted – 2/7/2008 7:06:17 PM | show profile I like the thought behind this, but the issue is that some people will choose not to go to doctors. I have dental insurance but I do not use it. I hate dentists. So if I were to receive a voucher that mandated I receive dental care in place of a check, I would be furious. What if you were healthy all year and didn't need to see a doctor? I was without health insurance for almost five years and didn't really get sick. It was as if my body knew better. In that case, the voucher would be useless. The system needs to be revamped in its entirety, away from the idea that market forces control healthcare, where the rich can afford it and the poor cannot. All market forces do is emphasize the most profitable options in healthcare. It's why GPs are falling by the wayside. They can't make the same amount of money that specialists do. Why? Because specialists charge more, insurance companies make more money, and pay the doctors at a higher rate. Procedures amount to the same thing. For example, plans will pay for bariatric surgery, but not for a nutritionist and personal trainer, which would be thousands of dollars cheaper, not to mention healthier for the patient. We don't need government control of healthcare but we need some major regulation put in place. And don't get me started on the drug peddlers. |
| Mag Girl | Posted – 2/7/2008 7:21:40 PM | show profile agree, beenthere. I've often thought about how much cheaper healthcare would be overall with regulations concerning prescription drugs and if there were true incentives and benefits for preventative care, etc. that stop people from developing costly illnesses and conditions related to heart troubles, diabetes, etc. |
| noname1234 | Posted – 2/7/2008 7:36:23 PM | show profile I don't think there should be a voucher to pay for office visits -- the system should be geared to insuring people, so office visits costs individuals little or nothing (same as catastrophic care). I'm not sure about earmarking tax refund checks, since tax refunds vary depending on how many deductions you claim, etc. (Many people choose not to overpay taxes throughout the year and thus get no refund). I like the idea of encouraging people to get preventative care, though -- maybe a standard tax deduction if you provide proof of a dr's and dentist visit each year or something. |
| UGoGirl | Posted – 2/7/2008 11:14:52 PM | show profile We just need France's healthcare system, and childcare assistance, and shortened hours for workweek, and long vacations... if it's good enough for France by God it's good enough for us! |
| chucho | Posted – 2/8/2008 9:22:08 AM | show profile First of all, the person who make snarky comments about Obama -- Hillary Clinton's Health Plan is actually more "invasive" (if that's what you wanna call it) because Obama's plan is optional and Hillary's is compulsory (and both promise to reduce costs, which is very important for these plans to work at all). To the other person talking about the voucher would be useless to healthy people who fear dentists (or whatever) -- this idea is that the voucher would compound. So if you don't have health bills for 5-10 years, your income tax return would compound, and by the time you do need, say, 15 root canals because you didn't go to the dentist for 10 years: you'd have 10 years of income tax returns owed to you to cover that bill. The problem with Obama's plan I that people, like the person here who doesn't think s/he needs healthcare (this is common among people under the age of 30, would become a burden on the rest of us when s/he gets hit by a car, or 10 years form now, need medically necessary root canals because of not going to preventative care. I dunno. I guess the liberals could call it a "tax on the poor" and the Republicans would call it "big government" -- and, quite frankly, I feel very comfortable with a plan that angers both extremes :) I think most good ideas aren't favored by the polar opposites. |
| Mag Girl | Posted – 2/8/2008 10:43:19 AM | show profile chucho, I am not so sure about the idea of the government holding on to tax refund money over the course of several years like that for future use. And imagine the paperwork nightmare that would be involved with tracking what individuals are "owed." It would be worse than the IRS. |
| noname1234 | Posted – 2/8/2008 12:34:02 PM | show profile Trying to morph a tax refund into a personal medical savings account wouldn't work, because tax refunds are not something that even lower-income taxpayers get equally and predictably (depends how you handle your taxes over the course of the year). Plus, a tax refund amounts to an interest-free loan from taxpayers to the government (the govt doesn't pay you interest on the time period they held on to the tax funds you overpaid) -- why should individuals' medical savings accounts be funded with an interest-free loan they gave the government? |
| beenthere | Posted – 2/8/2008 1:31:05 PM | show profile The main issue with this idea is that it penalizes people whose employers do not offer health care and forces a mandate on their wages. If this were instituted, wouldn't it be possible for employers to opt out of insurance altogether because of government regulation on income? What if I believe in holistic medicine and do not want to take my own wages--my refund--to put into a system I will never use? I've already paid taxes, along with everyone else. Don't penalize me further. What if I need surgery at $6,000 and my return/voucher is $1,500? Will I be denied access to care? People who have a higher rate of return will be eligible for more care, whether by costliness of procedure or number of office visits. It effectively sets up yet another barrier between the wealthy and the poor. It does not solve the issue but instead offers a stop-gap measure that at face value seems plausible. We don't need handouts. What we need is effective regulation of medical and drug industries, insurance plans that employers can afford to offer employees, and the continuation of Medicare and Medicaid plans. |
| chucho | Posted – 2/8/2008 3:15:00 PM | show profile Actually, I shoudl be clear that this idea would be part of a Clinton or Obama-like plan, not the sole solution. I don't think it would be that complicated because we already pay into FICA and the gov't has to track our payments throughout our life to come up with a monthly social security check at 65, right? Also, most wage workers fill out a simple tax form and get a decent check back. I don't know anyone who is a wage worker that is eligible for a tax return isn't aware of their tax return. The amounts of the checks would differ, but anyone making over $3,000 a years gets something back. I think the biggest problem is for people who really depend on that annual check to make ends meet. But I do think, especially for families, that part of "making ends meet" is paying for healthcare anyway. These are all valid point, but one thing that is disturbing are these people who say "what if I beleive in holisitc medicine?" or "I don't go to the dentist" or "doctors? I'm 26 and in perfect health!" These are the people -- as you perhaps noticed in the debates -- that are the problem with Obama's plan. They're the ones who woul opt out of any insurance. The problem with that is that these people end up burdening the system when they do get struck with health problems. They're the health care equivalent of people who drive uninsured cars, get into accidents and cost other people money. Put it this way: in Europe and Canada they have very high taxes to pay for their better healthcare systems. So withholding income tax returns and mandating that they be used to cover healthcare costs is just like instituting socialized medicine. To the person who said: what if your cost is $6,000 -- your $1,500 tax retuns wouldn't cover that. It would cover all or most of the deductible on a healthcare claim on insurance. This isn't aimed at replacing insurance, it's aimed at providing earmarked funds for covering the out-of-pocket expenses. You'd still have insurance under a Clinton or Obama-like plan. Though I suppose you cuold, like Obama, make it voluntary -- but what happens to "Mr. Holistic" when he gets diagnosed with Stage One Colon Cancer? Or gets hit by a -- well -- an uninsured driver? Is he going to continue to drink Chamomile tea to cure his ailments and not burden the rest of us with his heath care costs? :) |
| noname1234 | Posted – 2/8/2008 4:53:04 PM | show profile To me, the most important thing is the goal: health care, both preventive and acute and chronic treatment, should cost any American little or nothing out-of-pocket. I don't think people should be forced to save money in any special account to cover out-of-pocket expenses, because there shouldn't really BE out-of-pocket expenses, for the most part. It's been years since I got a signficant tax return, since I started adjusting my deductions to try to balace it out. I prefer to keep my money myself and earn interest on it throughout the year than give the government an interest-free loan. Unless there was a way to guarantee that every single taxpayer would get a refund of a certain size -- in other words, require every taxpayer to give money to the government that the govermnent puts aside for them in a special account -- it's still hard for me to see how this would be fair and equitable, and help solve the problem of lack of insurance. If the strategy is to use private insurance companies rather than expand Medicare to all Americans, why not just require everyone buy private insurance, have the government regulate in some way the insurance companies, and allow people to subtract the what they spent on insurance premiums from their tax bill? |
| beenthere | Posted – 2/8/2008 6:32:55 PM | show profile churcho you are missing the point entirely. You will be taking my wages to pay for healthcare. NOT my taxes. Huge difference. I've done medical editing for a long time. I get the system. Your proposal, again, although it is well meaning, does not solve the problem, but instead redistributes it. The reason most people do not have health care is because it is so expensive. Forcing them to give up wages does not solve the problem. The answer lies in finding a way to lower the costs (hence government regulation), not redistributing the monies to continue this disgusting display of greed. Here are two editorials from today's Sun-Sentinel. One is a report on why the Canadian system isn't always best. "In Canada, single-payer health care is more headache than panacea" at: http://www.sun-sentinel.com/news/opinion/ sfl-chanmed08forumsbfeb08,0,6236669.story "Single-payer health care is an idea whose time has come" at: http://www.sun-sentinel.com/news/opinion/ sfl-grabermed08forumsbfeb08,0,6833442.story There was a documentary called Dead Meat (view it at http://onthefencefilms.com/video/deadmeat/) that also exposes the weaknesses within the Canadian system. One example is a woman who was put on a waiting list for non-lifethreatening surgery for years. She ended up addicted to painkillers--she still needed surgery and now had a drug problem that needed treatment. There are flaws in the Canadian system, although from my experience those that present it as the pristine option really don't understand how the system really works. They think everybody gets all the care they need--not true. What is needed is a combination system, through regulation that allows choice, access to care that focuses on prevention not big bucks treatment, and lowered costs, including healthcare worker's malpractice insurance, hospital costs, insurance reimbursement, and drug company profit and control over brands until they can be offered as generics. Among other things. The system is being complicated with myriad factors that need correction. Taking wages from poor people will never solve the problem. Trust me, sweetie, I am not one of "those people." I just understand what's going on. |
| catlondon | Posted – 2/8/2008 6:45:21 PM | show profile First of all, the idea that access to health care should be tied to employment is just stupid--for both employees and employers. The government shouldn't be involved in healthcare but IBM should? It's just dumb. People spend a good portion of their lives not working--as children, as senior citizens, when they become disabled or are laid off--when you really think about it, it's just stupid. That said, there are some countries that have a workable mix of public and private insurance. I have a sibling who lives in one. The basic health needs and any emergency/catastrophic/etc. needs are covered under the universal care. People like my sibling who can afford it, then purchase private insurance so they can also have quicker access to elective surgery or private rooms or what have you. The rich and influential will ALWAYS get the care they need and get the best quality. The question is will the most vulnerable get the care they need and do they have to "deserve" it and who gets to decides who "deserves" it. |
| catlondon | Posted – 2/8/2008 6:53:22 PM | show profile BTW. I read the Sun-Sentinel article. What do you suppose would have happened to the Canadian with the tumor if Canada WOULDN'T pay the U.S. hospital bill for her? She wouldn't get health care in the U.S., or she would have to pay for it herself. Would your American based health care provider pay for you to go to a foreign country for surgery? |
