Butters 0 #1 June 8, 2009 Senate considers curbing tax-free status of employer-provided benefits QuoteThe idea of limiting the tax break for employer-provided insurance gained momentum last week, when Obama told senators that he’d consider it as one ingredient of the health insurance reform bill he wants Congress to pass by early August, when the Senate starts a one-month recess. QuoteObama’s new openness to the idea stands in contrast to what he said six months ago as a presidential candidate, when he harshly criticized his Republican rival, Sen. John McCain, for proposing that employer-provided benefits should be taxed. "That looks dangerous." Leopold Stotch Quote Share this post Link to post Share on other sites
lawrocket 3 #2 June 8, 2009 How many times can Obama flip-flop before getting called to task. Sure, it's a break from Bush (who never bent on anything - which is detrimental) but what is Obama sticking with? I am starting to believe that Obama is and was a committed socialist, but knew he couldn't get elected as a socialist. By the way - what will taxing benefits do to accpetance of them? I know my thinking: why would I take taxable benefits when I can get taxable cash? It's like winning a car on a gameshow and having to come up with the taxes or just taking the same value in cash and paying taxes on it. And yet, here is a sneaky way to get private medical to hurt a lot more and make government medical the lesser of costs. My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
NWFlyer 2 #3 June 8, 2009 QuoteHealth insurance ‘haves’ to pay for ‘have-nots’? You say that as if it's not already happening today. How do you think hospitals pay for all the "uncompensated care" that comes through their ER doors? The costs of the entire system, including charity care, are spread across those who are actually paying into it. This proposal just makes it more direct."There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke Quote Share this post Link to post Share on other sites
Butters 0 #4 June 8, 2009 Quote Quote Health insurance ‘haves’ to pay for ‘have-nots’? You say that as if it's not already happening today. How do you think hospitals pay for all the "uncompensated care" that comes through their ER doors? The costs of the entire system, including charity care, are spread across those who are actually paying into it. This proposal just makes it more direct. It was the title of the article. Did you read the article? The point of the article is that employees who receive health insurance benefits from their employers could be taxed for those benefits ..."That looks dangerous." Leopold Stotch Quote Share this post Link to post Share on other sites
NWFlyer 2 #5 June 8, 2009 Quote It was the title of the article. Did you read the article? The point of the article is that employees who receive health insurance benefits from their employers could be taxed for those benefits ... This is Speakers Corner. You don't expect me to actually read, do you? "There is only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." -P.J. O'Rourke Quote Share this post Link to post Share on other sites
wmw999 2,590 #6 June 8, 2009 Quote This is Speakers Corner. You don't expect me to actually read, do you? Well, you have to read the posts, so that you can criticize the spelling, grammar, and paragraph structure.Wendy P.There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown) Quote Share this post Link to post Share on other sites
TomAiello 26 #7 June 8, 2009 Wasn't this McCain's proposal, back during the campaign? And didn't Obama slam it as a "trillion dollar tax increase" or some such? Except that McCain wanted to tax the benefits, and then give every american a tax credit to go buy insurance with, if I recall correctly. While Obama wants to tax the benefits and then keep the cash for the government. In economic terms, it makes a lot of sense to tax employee benefits (like employer provided insurance) as income. It encourages people to seek out the least costly insurance alternatives (because they realize that they actually are paying for them). Which makes it more likely that health "insurance" will actually become insurance (for catastrophic events), with high deductible policies (and savings reserved for health expenditures by individuals) that kick in to cover unforeseen occurrences, rather than the current system where we call our health plan "insurance", but it acts nothing like insurance. I highly recommend this book for a thoughtful discussion of the economics of our current system, and some good ideas for reforming it to provide affordable, quality healthcare for everyone without spending more tax dollars.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
kelpdiver 2 #8 June 8, 2009 QuoteWasn't this McCain's proposal, back during the campaign? And didn't Obama slam it as a "trillion dollar tax increase" or some such? Except that McCain wanted to tax the benefits, and then give every american a tax credit to go buy insurance with, if I recall correctly. While Obama wants to tax the benefits and then keep the cash for the government. Kind of reminds you of the elder Bush with his "no new taxes, pledge." The problem with McCain's proposal was credibility. His party already brought us that ridiculously useless HSA. Most of us have the FSA where you have to guess in September how much you'll spend on health care the following year. Underestimate, and you spend taxable dollars. Overestimate, and the money is wasted (or spent on 5 pallets of bandaids on Dec 31st). Why can't it roll over too? Only people here (and on Fox) continue to insist that Obama will propose a change that would tax all benefits without any credit. I know it makes you warm and fuzzy, but it's not reality. He has yet to even make a proposal and will certainly not make that one. Even his proxies in Congress will not. Quote Share this post Link to post Share on other sites
TomAiello 26 #9 June 8, 2009 QuoteOnly people here (and on Fox) continue to insist that Obama will propose a change that would tax all benefits without any credit. I will be very pleasantly surprised if it happens that way. I envisioned the receipts going to create a NHS-like entity. If they actually went back to the folks buying health plans, that would be much better.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
PLFXpert 0 #10 June 8, 2009 QuoteHis party already brought us that ridiculously useless HSA. Care to elaborate on the ridiculously useless part? Genuinely curious.Paint me in a corner, but my color comes back. Quote Share this post Link to post Share on other sites
kelpdiver 2 #11 June 8, 2009 QuoteQuoteOnly people here (and on Fox) continue to insist that Obama will propose a change that would tax all benefits without any credit. I will be very pleasantly surprised if it happens that way. I envisioned the receipts going to create a NHS-like entity. If they actually went back to the folks buying health plans, that would be much better. My bet remains that nothing will change this year. I think something has to change - our system is spiraling down into a black hole. But reengineering a live system that 300M Americans use is not easy or cheap, and the current state of the nation doesn't appear to allow for it. You may have seen the recent emergence of proposals to tax soda and junk food to pay for it, but that just smacks of desperation. It won't raise much money and piss people off. Any taxation on existing work provided benefits will do the same. It's a lot easier to sell people on a notion that reform will magically erase the administrative costs. But if you start the process by asking everyone to pay, most people are going to say, no thanks. The current system still works reasonable well for the employed who do not have one of the preexisting conditions (prior cancer, for example). And those people still represent the majority. Quote Share this post Link to post Share on other sites
kelpdiver 2 #12 June 9, 2009 QuoteQuoteHis party already brought us that ridiculously useless HSA. Care to elaborate on the ridiculously useless part? Genuinely curious. Can only be used to purchase the limited, high deductable health care plans. You would then place the savings into an account to pay for the higher incident costs. Certainly for some people, these plans are the best choice, but for many, it's not. I think the hope was to encourage the use of these plans, which would then appear to lower the cost of health care. But end result is greatly limiting people's options, esp to change as their needs do, and favoring one set of people. The tax breaks around health costs are wildly inconsistent and unfair. Premiums under an employer plan are pretax. Lose your job and pay for COBRA, now they're post tax. (I believe in the current trillion dollar recession bill, there is support) So on a common 75% employer pay, I go from spending 75-120 pretax to spending 300-450 post tax. Huge difference. 1099 workers can deduct in full, while W2 employees/contractors cannot. Unless they use the limited set of options within the HSA. In this context, there is a fairness to removing deductions for all. Or giving them to all. But done badly, this turns into a tax shelter, so you end up with a max credit. IE, the McCain plan that the Democrats may try to emulate. Quote Share this post Link to post Share on other sites
mnealtx 0 #13 June 9, 2009 QuoteQuoteOnly people here (and on Fox) continue to insist that Obama will propose a change that would tax all benefits without any credit. I will be very pleasantly surprised if it happens that way. I envisioned the receipts going to create a NHS-like entity. If they actually went back to the folks buying health plans, that would be much better. One of the companies I did contract work for had a similar setup - they gave us 'x' amount of benefit money each month (enough to cover the basic insurance costs), and we had a 'menu' of choices in regards to insurance coverage. In essence, the company was covering the cost of the basic insurance, and anything over/above that was paid for by the employee, pre-tax.Mike I love you, Shannon and Jim. POPS 9708 , SCR 14706 Quote Share this post Link to post Share on other sites
TomAiello 26 #14 June 9, 2009 QuoteI think something has to change - our system is spiraling down into a black hole. Personally, I was very surprised to hear Obama cite the Mayo clinic, because it's my belief that encouraging more healthcare to follow the Mayo model would be a giant leap forward in quality, accompanied by a significant cost savings. The basic reason we don't have more Mayo type organizations is government intervention--Medicare reimbursement scales penalize the model at the expense of other models (more procedures=higher reimbursement). The only people who have a real interest in reducing cost and increasing quality (a la Mayo) are the people who have to foot the bill--the taxpayers, or the individual consumers. In our current, largely government funded system, the providers have a strong incentive to over-provide, so that they can bill more.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
kelpdiver 2 #15 June 9, 2009 QuoteQuoteI think something has to change - our system is spiraling down into a black hole. Personally, I was very surprised to hear Obama cite the Mayo clinic, because it's my belief that encouraging more healthcare to follow the Mayo model would be a giant leap forward in quality, accompanied by a significant cost savings. Tom, what do you mean when you say the Mayo model? When I think of that name, I think of the very expensive Executive medical checkup visits where you get outstanding attention for a day or two, at a considerable price. There are a couple growing commercial ventures emerging where a simple menu of common services are offered at a fixed cash price. Flu and vaccination shots, high school physicals, the usual stuff. The prices seem quite reasonable, and you don't have to wait days to get an appointment. (at least not thus far - staffing is well sized for demand) For the uninsured, or those of us who rarely seek care (coupled with a high deductable plan), these may be the way to go. Quote Share this post Link to post Share on other sites
TomAiello 26 #16 June 9, 2009 Mayo is actually a good bit cheaper than most places. The interdisciplinary approach can cut out a lot of needless tests, because a specialist can often rule things out without the couple thousand dollars of testing that a generalist (or another specialist) might need to reach the same issue. There's an excellent article here, on the topic. It's long, but well worth the time.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
lawrocket 3 #17 June 9, 2009 You've just described a benefit of an HAS. Fundamentally you pay cash for treatment below the deductible. If you ask the doctors, they'll usually take less because they get cash now and no overhead for insurance billing. If you could get $100 now, or $120 in sixty days after working out the billing, etc., most will take the cost-free cash now. The HAS just made that payment less and tax free. I'm charge d significantly less per month. For my premium. I save money every year on health care with it. I haven't encountered the COBRA angle, though. But then I've got $11k in my HSA right now. My wife is hotter than your wife. Quote Share this post Link to post Share on other sites
justinb138 0 #18 June 9, 2009 Have your read any of that author's books? The two I've read (Better, Complications) I really enjoyed. Quote Share this post Link to post Share on other sites
jcd11235 0 #19 June 9, 2009 QuoteIf you could get $100 now, or $120 in sixty days after working out the billing, etc., most will take the cost-free cash now. I think most businesses would prefer the 120% simple interest rate and take the $120 in sixty days. That's a pretty respectable return.Math tutoring available. Only $6! per hour! First lesson: Factorials! Quote Share this post Link to post Share on other sites
DrewEckhardt 0 #20 June 9, 2009 You do know that the government is the biggest health insurance company in the US, with Medicare and Medicaid covering over 80 million people between them? We're already paying for the "have nots" We're already paying a lot for the have-nots. In fact, as of 2005 we were spending more to insure them than Canada and France were to cover everyone. This completely disregards what insured and cash customers spend to cover the write-offs amongst the people who decide not to buy insurance and who can't get private insurance due to pre-existing conditions. Quote Share this post Link to post Share on other sites
PLFXpert 0 #21 June 9, 2009 QuoteYou've just described a benefit of an HAS. Fundamentally you pay cash for treatment below the deductible. If you ask the doctors, they'll usually take less because they get cash now and no overhead for insurance billing. Agree, except on the latter--for me--I have discovered I actually pay less if I let my doctor bill insurance. Not only do I hold onto my cash longer, but the doctor will typically adjust their fees lowering my bill by 40-to-80 percent.Paint me in a corner, but my color comes back. Quote Share this post Link to post Share on other sites
TomAiello 26 #22 June 9, 2009 QuoteQuoteIf you could get $100 now, or $120 in sixty days after working out the billing, etc., most will take the cost-free cash now. I think most businesses would prefer the 120% simple interest rate and take the $120 in sixty days. That's a pretty respectable return. There is a very real chance that the collection in sixty days will be zero. The non-payment rate in medicine is staggering. And that's even true among people with health insurance. Insurance companies pay late, underpay, and sometimes don't pay at all, leaving the doctor stuck with the bill, and the patient thinking he already paid. This is one of the big reasons that some doctors are experimenting with "cash for service" (no insurance accepted, all payment up front) models--it reduces their workload by guaranteeing collections, and also eliminates a vast amount of paperwork.-- Tom Aiello Tom@SnakeRiverBASE.com SnakeRiverBASE.com Quote Share this post Link to post Share on other sites
kelpdiver 2 #23 June 9, 2009 QuoteQuoteIf you could get $100 now, or $120 in sixty days after working out the billing, etc., most will take the cost-free cash now. I think most businesses would prefer the 120% simple interest rate and take the $120 in sixty days. That's a pretty respectable return. You seem to have missed the part "working out the billing." Labor isn't free. Quote Share this post Link to post Share on other sites
Butters 0 #24 June 9, 2009 QuoteYou do know that the government is the biggest health insurance company in the US, with Medicare and Medicaid covering over 80 million people between them? We're already paying for the "have nots" We're already paying a lot for the have-nots. In fact, as of 2005 we were spending more to insure them than Canada and France were to cover everyone. This completely disregards what insured and cash customers spend to cover the write-offs amongst the people who decide not to buy insurance and who can't get private insurance due to pre-existing conditions. Did you bother to read the thread?"That looks dangerous." Leopold Stotch Quote Share this post Link to post Share on other sites
