Archive for Sunday, August 5, 2012


August 5, 2012


I would like to encourage everyone to read Insurance Commissioner Sandy Praeger’s answers to questions regarding health reform on page 6A of the Aug. 2 Journal-World. After reading her responses to questions, it is difficult for me to understand how people can be against the Affordable Care Act (derogatorily named Obamacare by its opponents). In my opinion, negative comments about the Affordable Care Act are based on politics and not what is positive for our citizens.

Finally, I would like to commend Commissioner Praeger for basing her beliefs about the Affordable Care Act on thorough study and responding in an unbiased way. I realize her responses may not be favorable to many conservatives in her political party, but thanks, commissioner, for having the courage to express what you know to be the truth.


jafs 5 years, 1 month ago

There are certainly some positive aspects to the ACA.

But, it's overly long and complicated, and structured so that we won't really be able to evaluate the consequences of it's full implementation for some time.

Even Ms. Praeger agreed that rising health care costs are a big problem, and one that's not sufficiently addressed by the bill.

Abdu Omar 5 years, 1 month ago

The ACA was enacted and we are the benefactors of such a bill. So, Republicans, if you are opposed to it, where is your plan? What do you have to say to the rising cost of health care? All you do is sit in congress and say "NO". What good is that? Do something!! Say "this isn't right so we must do this:". What is "this"?

tomatogrower 5 years, 1 month ago

I saw a bumper sticker on the back of a car, that had other conservative issue bumper stickers on it. It took the "Hope" icon, and changed it to "Nope". That says it all about these tea party conservatives. The party of no. No plan, no idea, no compassion, no humanity, no common sense, no truth.

Where is their plan? The only one I have ever seen is to get rid of abortion and gays and cut taxes for rich people. Oh, and make everyone convert to Christianity. Then is the world going to be a wonderful place? Bush's tax cuts for the rich hasn't been working out very well, why are they beating this poor dead horse? What has a gay person or a person of a different religion every done to you?

acg 5 years, 1 month ago

You hit it right on the head, tomatogrower! The baggers and righties don't have an alternate plan, they just don't want to approve ANY Obama plans. Some of them have even said their whole purpose is to shoot down any of Obama's initiatives. How is that helping anything? I don't mind people disagreeing with the way he wants to do things but have an alternative we can discuss like adults before throwing yourself down on the floor, crossing your arms and having a temper tantrum! "NO NO NO I DON'T LIKE THAT BROWN MAN'S PLAN SO I'M NOT GONNA DO IT!" And the part that really kills me is that no other democratic President has had this much of a hard time getting bipartisan legislation passed in our history! That tells me that a: the plans he has really affect the money boys and they are dead set against anything that might take money out of their fat cat pockets and b: they just can't cotton to having a man of color in office. So sad and pathetic. That as*hat Romeny doesn't have a chance of winning, so couple their really bad candidate with their horrible sense of what's right and wrong and I'm almost sad for all of them.

jayhawklawrence 5 years, 1 month ago

Sandy Praeger gave me some hope that intelligent, caring and qualified people actually exist in politics.

She makes going to the voting booth something I look forward to and this time around I really need that.

Laura Wilson 5 years, 1 month ago

She's the only Republican I've voted for in recent years. A sane, rational, smart woman who just wants to help all Kansans. Of course Brownie will try to destroy her for doing so.

msezdsit 5 years, 1 month ago

The billions spent on lying about the bill are bets that the bad information will help repeal the affordable care act before people actually realize the truth about the bill and it's benefits to them. Its literally a race. The politicians who are campaigning on repealing ACA are campaigning on the lies about the ACA and that their base believes them without questioning them. Their risk is that if Obama wins the election ACA will survive and the people that have been lied to will finally figure it out. All the politicians that are campaigning on the lies won't be able to buy a vote and finally will be run out of Dodge. Until then gridlock will continue. The clock will have run out on all the viral fanatical right wing nut cases before any civility can return to the political process. Until then expect the wackos like brownback to continue to systematically dismantle and destroy the society americans are so proud of and have worked for so long to build.

paulveer 5 years, 1 month ago

Why not? Well maybe some of us think that equal access to healthcare for all is a good thing.

parrothead8 5 years, 1 month ago

Poor people should only have access to sub-par healthcare. You stole that idea from Jesus, didn't you?

Richard Heckler 5 years, 1 month ago

Obamacare will save $84 billion over the next 10 years. Why the opposition?

Medicare Single Payer Insurance for ALL would save $350-$400 billion annually. No Co-pays and No deductible. Why the opposition? Physicians for a National Health Program

Republicans favor a return to the worst case scenario which means large increases will still carry on. And insurance providers would be able to cut off clients at their will = dumb coverage.

50% of bankruptcies are due to medical bills in which victims had medical insurance. Are you still under insured?

Insurance providers are the "middle men" which adds big time NOT necessary expenses to health care. Why do we need "middle men"? The "middle men" do not provide health care.

Stuart Evans 5 years, 1 month ago

This is the problem. This bill was written for the insurance companies and the wall street banks that handle their investors. We are all pawns in their money making scheme; our well being means nothing to them.

Richard Heckler 5 years, 1 month ago

Let's Compare:

Single-Payer (HR 676 and S 703) Expanded Medicare for All Vs. Proposed Healthcare “Private insurance with Public Option”

verity 5 years, 1 month ago

Do they really believe it or do they just pretend to so they can pass it on and hope others believe it?

jafs 5 years, 1 month ago

Actually, I believe there are mechanisms in the bill to increase supply.

Also, that's one of the reasons they delayed implementation of a number of facets, in order to allow supply to increase a bit before demand increases so much.

Prices are a problem with our health care system, but I also find quality to be below where it ought to be.

jayhawklawrence 5 years, 1 month ago

I am afraid you do not know what you are talking about and it would take too much effort to attempt to educate you.

jafs 5 years, 1 month ago

See other's posts on the things I mentioned.

And, knowing there will be increased demand is a good reason to increase supply. In fact, it's the best reason.

jafs 5 years, 1 month ago

Enlightenment posted a link to guide you.

I don't want to get into a long debate about this - I know your position, and disagree with it. We want enough health care workers, but we also want them to be good, and well qualified. In the next few years, I predict we'll see a significant increase in folks working in health care in order to keep up with the demand that will come.

In fact, I've already seen the ads for training on tv. And, it's predicted to be an excellent field for folks to enter.

voevoda 5 years, 1 month ago

Liberty_One, I'm surprised that a free-market advocate such as yourself doesn't see the obvious answer: if there is more demand for medical professionals, more people will opt to pursue that career. And why is a free-market advocate such as yourself opposed to the idea that persons who command an expertise that is in great demand get to charge what the market will bear? Your previous posts suggest that you are all in favor of letting anybody who can sell a product that is in demand to get as rich as they possibly can be. Maybe you ought to get yourself a medical degree and prepare to capitalize on the profit waiting to be made. That is the only position consistent with the Libertarian economic philosophy you have claimed as your own.

Enlightenment 5 years, 1 month ago

You're assuming the AMA will not expand the number of people admitted to medical schools.

Enlightenment 5 years, 1 month ago

your logic is off, the increased demand will continue to make their service (training doctors) in high demand.

voevoda 5 years, 1 month ago

The AMA is not the government, Liberty_One. It's an organization of private citizens. If they have influence with medical schools, how is it the government's fault? And, as a free-market advocate, why should you be opposed to enterpreneurs defending their own interests, singly or in groups, even if that prices their services out of the reach of some potential customers? That is, if doctors can make as much money as they want charging a small number of customers high prices and eliminating competitors (in this case, by making it hard for potential competitors to get the necessary training), why shouldn't they do so? This is the free market you advocate, Liberty_One. If there's a problem, that's the source.

voevoda 5 years, 1 month ago

Liberty_One, The AMA isn't a "government assisted monopoly." Lots of physicians don't belong to it, and they practice perfectly well. Lots of physicians are trained in institutions where the AMA has no influence. These are just the facts. Of course, if the Obama health care plan involves the government assisting a private monopoly, that would make it in Mises terms (you do still claim to be an adherent of the Mises school, I presume) an "interventionist" (fascist) proposal. But when you posted on this topic on previous days, you labeled it as "socialist" and proponents of it as "Marxists." I guess that just proves that you don't even understand Mises economic theory very well.
There are plenty of examples worldwide of health care systems that are government regulated working very well, providing health care to just about everyone at prices they and the country as a whole can afford. Israel. Canada. New Zealand. Switzerland. etc. etc. Name even one country, past or present, in which a free market, with no government involvement whatsoever--no licensing, no regulation of drugs, no financial support for medical research, no underwriting of insurance, etc.--has produced high-quality health care to most of the citizenry at a price they can afford. Can't think of one? Neither can I.

Enlightenment 5 years, 1 month ago


To strengthen the availability of primary care, there are new incentives in the law to expand the number of primary care doctors, nurses and physician assistants, including funding for scholarships and loan repayments for primary care doctors and nurses working in underserved areas. Doctors and nurses receiving payments made under any state loan repayment or loan forgiveness program intended to increase the availability of health care services in underserved or health professional shortage areas will not have to pay taxes on those payments.

Enlightenment 5 years, 1 month ago

Take your Libertarian goggles off so you can see more clearly. Of course colleges will make more money because they will train more students in the medical field due to the increase demand. The ACA is offering the incentive to the students to attract them to the medical field.

Enlightenment 5 years, 1 month ago

Libertarian, you're sadly mistaken with your logic, which has been proven incorrect. Your comments have been about the shortage of medical staff as a result of the ACA. Instead of critiquing, let's hear your alternative. Time for you to offer something to the conversation instead of criticizing.

voevoda 5 years, 1 month ago

Medical colleges aren't getting rich, Liberty_One, even if they are accumulating wealth to plow back into their operation. And the medical colleges aren't the government, just as the AMA isn't the government. Face it, Liberty_One, this problem of the availability and affordability of health care isn't the government's fault. Finally, our government is trying to fix it--which is more than the private sector has ever been able to do, anywhere, any time. And governments in other countries have made very great strides in fixing this problem for their citizens--witness Mitt Romney's recent observations about the Israeli health care system.

George Lippencott 5 years, 1 month ago

Of course the Affordable Care Act (Obama Care) is a desirable initiative. Who can fault making medical care available to all our citizens? The law has already broadened available services by addressing the most egregious abuses under our present medical insurance system. In the future it will make sure basic medical insurance is available to many who do not have access to it today. Additionally it will establish another substantial entitlement through subsidies for families with insurance making upwards of $88K per year (about 80% of us.)

Like all good things, the AFCA will cost money. Those costs will appear in our monthly payments for our insurance, in the costs of goods purchased from businesses that provide health insurance, increases in taxes for existing federal medical programs to fund the new services and a substantial cost for the subsidies for medical insurance. When you strip away the gimmicky in the CBO estimates for the program and add in the costs to the states and individuals we are looking at an annual bill between 100 and 300 billion dollars. In short a middle income citizen will need to contribute something between $500 and $5,000 a year through the various components mentioned above to fund the new law.

So when you ask your question as to who can be against it the answer is the 50% of the citizenry who will have to pay a substantial sum for it with little improvement in their own medial services

Enlightenment 5 years, 1 month ago

Lots of guesstimates with those number ranges. Here are some real facts.

• Preventive benefits that are newly free of cost to people with Medicare, such as wellness visits and cholesterol checks. Last year alone, 32.5 million Medicare beneficiaries used at least one preventive benefit without a deductible or co-pay. • Closing the prescription drug "donut hole" coverage gap. More than 5.1 million seniors and people with disabilities have saved more than $3.2 billion in 2010 and 2011 on prescription drugs, an average of $635 each; • Investing more resources in health care fraud-fighting efforts. Four years ago the federal government announced that it had recovered just over $1 billion in Fiscal Year 2007 due to anti-fraud efforts; this February, federal officials announced that for 2011, that amount is $4.1 billion, and $10.7 billion over three years, both all-time highs with the help of the Affordable Care Act.

Enlightenment 5 years, 1 month ago

And to think, billions of dollars in savings just from one element of the ACA (fraud). Better yet, millions of folks will get medical insurance. When the cost of the ACA comes into play, we also need to look at the $billions lost due to bankruptcy and foreclosures resulting from peoples' inability to pay for medical costs.

Enlightenment 5 years, 1 month ago

Here's a few more ways the ACA will save money, contrary to your "beliefs."

Health Care Reforms from the Affordable Care Act Savings from law's enactment through 2016: 1.Reducing excessive Medicare payments to private insurers who operate in Medicare Advantage: $68 billion

2.Reforming provider payments, including improved productivity. Advantage: $85 billion

  1. Improving patient safety through the Partnership for Patients. Advantage: $10 billion through 2013

4.Cracking down on fraud and abuse in the Medicare system, and getting the best value for Medicare beneficiaries and taxpayers for durable medical equipment. Advantage: $7.8 billion

5.Additional provisions, including the net effect of expanded benefits, lowered payments for hospital acquired conditions, readmissions reductions, and adjustment to premium subsidies. Advantage: $41 billion

voevoda 5 years, 1 month ago

Mitt Romney has praised the Israeli system. Obama's ACA shares some characteristics with it, and maybe with the Republicans' help (led by Romney, of course), the current law can be revised along the lines of the Israeli system. A bi-partisan plan.

Dan Eyler 5 years, 1 month ago

Regardless of what our insurance commissioner has to say real life changes being imposed on the healthcare industry will be nothing short of disastrous. The cuts being imposed on healthcare and hospitals will easily reach 20 to 25 percent in the next 5 years. Imagine the business you work for announces a 20% cut to the bottom line. A perfect example was the leaked email from St. Lukes Hospital in Kansas City just a couple of weeks ago. A prestigious hospital in our area. They are cutting 100 million dollars from their budget and it must be completed by the end of 2012. Just the tip of the iceberg. Imagine every hospital in the nation having to reduce overhead by 20%. Nurses being changed out for aids with as much as a 1 nurse to 5 aids. Access to doctors will decrease dramatically. Reduced staff causing lack of access to services. Layoff for healthcare workers is coming. So may of you are so fixated on pretending there will be better healthcare for all when in all reality we are in the early stages of the end to quality healthcare as we know it. Unlike our insurance commissioner, those in healthcare such as myself are witnessing the decline first hand.

Robert Schehrer 5 years, 1 month ago

What about all the additional revenue the hosipals will have because all their clients will now be paying clients, instead of having to write off all the folks that currently don't have health insurance and show up at the hospital for health care, but never pay for it.

George_Braziller 5 years, 1 month ago

ACA resulted in me getting a rebate on the health insurance premiums I paid in. The act requires that insurance companies spend 80% of total premiums on health care services and keep no more than 20% for administrative costs and profit. My insurance company only spent 74% on health services so I received a rebate for 6% of what I paid in last year. It was a nice sized check.

George Lippencott 5 years, 1 month ago

Enlightenment Wow, I wish I could buy a new Prius and declare the savings in gas sufficient to eliminate the cost of the car. 1. Any savings that result from the AFCA will be used to address (as we must) the annual escalations in health care costs not the basic cost of services. Only a naïve person would believe you can add 12 million people to the health care equation for nothing. Just take the annual cost per person of health care in the US and multiply by 12 million and then explain why all these people are free? 2. 2. You are correct that in the long haul preventive services may reduce costs. They may also increase costs as people live longer and require care longer. The bottom line is that a heavy slug of medical cost comes from treatment of the illness that eventually kills us. We are still going to die from something and that costs will still be there however long the preventive services might prolong life 3. You listed savings in the amount of $100 Billion or so. According to the web those are 10 year savings (CBO estimate). So by my reckoning that would be $10 Billion a year. A nice down payment on the annual costs of the program but certainly way too little to appreciably offset the costs to the consumer/taxpayer.

Enlightenment 5 years, 1 month ago

And yet you have no alternative solution to the runaway cost of health care in the US. Bipartisan collaboration would be beneficial to improving Obama's ACA so as to make it more palatable for the naysayer conservatives. But, it seems as though conservatives would rather continue paying more for inferior and biased healthcare system currently in place.

Enlightenment 5 years, 1 month ago

Moderate, I'm sorry for your ignorance and that you expect immediate savings and are not willing to allow the ACA to present it's benefit over time. It seems as though you're content continuing to pay a ridiculous amount of money to health care each year and hope that you will always have employer based health care insurance and that the insurance companies don't find a reason to drop you or find a loop hole to avoid payment. Currently, health care costs are increasing nearly twice that of GDP. The ACA will help reduce the insane health care cost increases, but it's going to take a bipartisan effort to truly bring down costs.

Flap Doodle 5 years, 1 month ago

In breaking news, HR 676 is still dead like fried chicken.

George Lippencott 5 years, 1 month ago


Sorry numbers seem to hurt you so much. I agree that we need to reduce annual cost increases in health care to close to normal inflation. Dictating cost reduction is not the way to do that. Almost every time we have tried that approach we end up with a shortage of whatever we constrain (like corn right now). It will be medical services in the future if we are not careful.

There are all sorts of proposals to reduce medical costs some of which are in the AFCA. I SUPPORT MOST OF THOSE as I said in the opening of my post. Automatic records, best practices and the like are good starts. Tort reform would sure help. Both sides of the aisle have good ideas. Loyalty to constituents should not limit our ability to compromise.

That said, I totally reject your inference we need all of the AFCA in order to control costs. The entitlement for example does little of that and what it might do is overwhelmed by the costs to all of us. You are simply arguing that a massive income transfer program reduces cost. It certainly will for some at the expense of most of the rest of us.

If you are a loser it is not surprising that you oppose the program. Why not a win-win?

Enlightenment 5 years, 1 month ago

Moderate, numbers really don't hurt me, but the facts appear to negatively impact your justification for discrediting the ACA. I too do not believe the ACA is perfect but it is a big jump in the right direction. Also, health care is so complex and intertwined that in order for it to be successful, one can not pick and choose elements of the act that we like.

Automatic records, best practices, and tort reform are good ways to reduce costs, but they make up such a small portion of the overall cost. Lawsuits, account for less than 1% of the overall health care cost.

I agree with your comment, "loyalty to constituents should not limit our ability to compromise." Unfortunately, the parties have created an environment that polarizes the nation, such as the health care debate.

BTW, your "loser" comment is quite telling of your maturity and your ability to comprehensively understand what the ACA is capable of providing. If necessary, I for one am willing to pay a few extra hundred dollars to allow more people insurance coverage that includes no deductible services and no fear of coverage refusal.

George Lippencott 5 years, 1 month ago

Well enlightenment,

It is clear that we do not share a common notion of what constitutes sufficient justification for one to accept a proposition. I demand independent sources and am quite capable of adding numbers I believe are reasonable estimates. That is what I have done. You have refuted none of my numbers – as broad as they are - with anything other than generalities and emotion.

Now you have resorted in the past two posts to attacking me as ignorant and juvenile because I disagree with you. That is a standard liberal tactic when they can not support with detail the numbers they throw about.

Now from my intuiting of the emotion in your posts, you are a true believer and want desperately the AFCA to solve all medical problems. I would be a fool if I did not want the same outcome. Unfortunately for me the numbers do not add and the wished for outcome remains elusive. There are elements of the AFCA that I like and want preserved and there are elements I want terminated. There is no legitimate reason we can not do that.

More importantly, my family, who worked hard for 40 years to acquire medical insurance, will now suffer significant cost increases if not serious reductions in medical services. This on top of large social costs for climate issues, poverty issues, employment issues and the like. Now, I too am willing to see my taxes/social costs go up a few hundred dollars a year for the benefit of all. Unfortunately, I see them going up more than an order of magnitude greater each year to pay for the AFCA, the traditional entitlements and the near trillion dollars Mr. Obama has added to our annual deficit.

We will be losers – not little losers - big losers. Just about anybody that has worked a lifetime in a professional capacity will be badly gored by the Democratic Party Platform as currently pronounced. So we are talking enlightened self interest motivating my concerns. But enlightened self interest is more than a sufficient and appropriate reason to oppose something.

Alyosha 5 years, 1 month ago

Turning to ad hominem attacks is not what only liberals do. It's a human trait. To impute that only one political party/philosophy resorts to suspect argumentative techniques is itself a suspect rhetorical technique, and needless in the case of the particular argument you're trying to advance., Moderate. Evidence abounds on this site showing rightists' use of ad hominem attacks in the absence of being able to ethically argue a point.

Enlightenment 5 years, 1 month ago

Ha, that was not an ad hominem attack. I simply thought your comments were based on ignorance. The definition of ignorant is "lack of information," which appears to be an appropriate choice of words. Also, it appears you believe that labeling people losers is ok for you, but yet I'm still the one considered being unable to ethically argue a point and resort to alleged ad hominem attacks.

jayhawklawrence 5 years, 1 month ago

You could not have come up with a better title for this letter.

It really does seem to come down to Fact based vs. Faith based logic.

When facts and logic threaten deeply held beliefs, people become very defensive and close their minds. I think for these kind of people they need to believe in a Satan called "Liberals".

It explains for them where evil comes from.

George Lippencott 5 years, 1 month ago

The bill will be paid by all those paying taxes at the time the bill comes due. Shortly, the costs of the entitlements will no longer be paid by payroll taxes. The general fund will be hit and hit hard. That fund is paid by the upper half of the middle class - heavily composed of - you guessed it - boomers.

They got to pay once for those before them and with SS for themselves and now for themselves again. Only Medicare of the generally accepted entitlemenst is pay as you go.

If we really believe in all the hype then how can we complain when the largest driver is becoming Medicaid( when all sources are counted)

Enlightenment 5 years, 1 month ago

Unless you are in the cohort that earns over $200,000/year, which is only 5% of the population, your premiums will likely not go up simply because of the ACA.

The Congressional Budget Office estimates that private health insurance premiums will increase by 5.7 percent each year, on average, from 2012 until 2022. But premiums would be getting more expensive with or without the Affordable Care Act. The budget office has estimated that, relative to what would happen in the absence of the law, premiums in the individual insurance market will be a little higher, employer-sponsored insurance premiums for big companies will be a little lower and employer-sponsored insurance premiums for small companies will stay about the same.

So I believe your estimate of paying up to $5,000 more per year because of ACA is unfounded. If the ACA did not exist and nothing changed, you would still pay several hundred dollars each year just in coverage and thousands more in actual medical cost. As such, I believe that the ACA is a start in the right direction.

Also, explain to me how your family struggled for 40 yrs to get medical insurance. It reads as if you are jealous because people that will get insurance because of the ACA.

George Lippencott 5 years, 1 month ago

I have not mastered this new version of the blog world. What is below was a response to you but the system roiled it up into a typical Merrill mess.

We are adding 12 million people to the system, requiring a number of positive changes in coverage and establishing a new entitlement. Intuitively all of that must cost somebody something.

You seem to be arguing that my costs will be no worse than they would have been from normal medical inflation. (Although you also seem to argue that Obama Care will slow or stop that inflation)

I have presented a range of cost based on Mr. Obama at the low end to some of the luddites at the high end. Our insurance has already increased attributable by the provider to Obama care.

To answer your latest allegation that we are also jealous of the new insurance subsidy let us reason together. If we are unaffected as you claim, why would we be? If we are now going to pay upwards of $5,000 a year to provide insurance to others while paying close to $8,000 for our own, you are absolutely right. We are not, however, jealous, we are angry that once again we are sourced for other people’s benefits while having to pay for the same benefit ourselves.

The program is one thing - the lying about it is an entirely different and disgusting element.

George Lippencott 5 years, 1 month ago

And no, we do not make $200,000 a year. We are squarely in the middle of the upper half of the middle class. Why does that matter. Is this more greed surfacing?

tbaker 5 years, 1 month ago

There are a lot of things that could have been done to increase the number of people with access to healthcare, maintain and/or improve its quality, and reduce healthcare costs (the stated goals of the President and Democratic Congress) that all cost the tax payer absolutely nothing. None of them were tried. Creating massive new government bureaucracies and imposing huge new tax increases have a long history of total failure. Common sense says we try these other approaches first. We can’t afford the failed government we have, let alone a much larger one.

Richard Heckler 5 years, 1 month ago

Medicare Single Payer Can Save $400 billion Annually Physicians for a National Health Program

IMPROVED Medicare Single Payer Insurance for ALL would cover every person for all necessary medical care 24/7 to include:

Wellness /prescription drugs / hospital / surgical / outpatient services / primary and preventive care / emergency services / dental / mental health / home health / physical therapy / rehabilitation (including for substance abuse) / vision care / hearing services including hearing aids / chiropractic / medical equipment / palliative care / long term care

No deductibles / No Co-pays

Richard Heckler 5 years, 1 month ago

How much is the sick U.S. health care system costing you? By Joel A. Harrison

Paying through the Taxman

The U.S. health insurance system is typically characterized as a largely private-sector system, so it may come as a surprise that more than 60% of the $2 trillion annual U.S. health care bill is paid through taxes, according to a 2002 analysis published in Health Affairs by Harvard Medical School associate professors Steffie Woolhandler and David Himmelstein.

Tax dollars pay for Medicare and Medicaid, for the Veterans Administration and the Indian Health Service. Tax dollars pay for health coverage for federal, state, and municipal government employees and their families, as well as for many employees of private companies working on government contracts.

Less visible but no less important, the tax deduction for employer-paid health insurance, along with other health care-related tax deductions, also represents a form of government spending on health care.

It makes little difference whether the government gives taxpayers (or their employers) a deduction for their health care spending, on the one hand, or collects their taxes then pays for their health care, either directly or via a voucher, on the other.

Moreover, tax dollars also pay for critical elements of the health care system apart from direct care—Medicare funds much of the expensive equipment hospitals use, for instance, along with all medical residencies.

All told, then, tax dollars already pay for at least $1.2 trillion in annual U.S. health care expenses. Since federal, state, and local governments collected approximately $3.5 trillion in taxes of all kinds—income, sales, property, corporate—in 2006, that means that more than one third of the aggregate tax revenues collected in the United States that year went to pay for health care.

Recognizing these hidden costs that U.S. households pay for health care today makes it far easier to see how a universal single-payer system—with all of its obvious advantages—can cost most Americans less than the one we have today.

Medicare must exist in the fragmented world that is American health care—but no matter how creative the opponents of single-payer get, there is no way they can show convincingly how the administrative costs of a single-payer system could come close to the current level.

More on this matter:

George Lippencott 5 years, 1 month ago

One more time. Your entire premise is based on a massive savings in health care cost from adding twelve million more insured, providing all sports of new services and establishing a massive entitlement program. In your world all of that is costless because we become more efficient. 1. I am going to pay for 12 million new “insured” through the overall healthcare system. That amounts to about $90 billion in costs to be paid by somebody. Some of that has already been found its way into our private insurance. Despite the comment about no contribution our carrier, a public entity, has acknowledged an almost 10% add for Obama care requirements last year. That of course goes on forever. 2. That 7% escalation quoted amounts to about $500 Billion per year. That is where I allocate all potential savings from Obama Care. These savings do not cover the basic 7.6 trillion costs of health care– they do help reduce cost growth - the part of Obama Care we support.. 3. A new entitlement is added that subsidies medical insurance for those making up to $88K per year. The cost of that entitlement – which is the majority of my estimates, must be paid by someone. Mr. Obama initially estimated that at essential a trillion over ten years To get that to zero he used a $500 billion cut in Medicare (if real somebody loses something). He also used the savings you reflected earlier to offset part of the rest and assumed that better care would eliminate costs for the rest. Being the Luddite that I am, I do not accept the “savings” and get my low estimate of $100 billion per year directly from Mr. Obama. Of course those estimates did not address individual cost, state costs and the doc fix, to mention a few. Some groups (not your friends) have estimated these costs at as much as 2.5 trillion for ten years. There is my range of costs. I will bet you dollars to donuts if we were discussing a “fighter plane” estimated to cost 2 Billion you would be disputing that number and suggesting something close to 4 billion. It never ceases to amaze me that some people will accept anything that supports what they want but are highly skeptical of things they do not want. Perhaps you can find one major program that has managed to come in on budget. Why do you believe this one is different – because you want it? Your entire argument has evolved to I am not going to pay more. Fine, I will make a deal with you. We put your money where your mouth is and you get to pay for all the increases in our health care over the next ten years (that includes costs to maintain current coverage). Would you still argue that nobody will pay more if you had to pay??

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