Supreme Court Says Buy Health Insurance Or Be Taxed More. Do you agree?

Since the government passed the EMTALA in 1986 which requires all hospitals that treat Medicare patients to treat everybody that has a medical emergency, even illegal aliens and the uninsured, hospitals have been losing tens of billions of dollars every year. To keep from going bankrupt, hospitals have been forced to raise their rates for services to an outrageous level. That is why hospitals will charge $25 for an aspirin in the ER. A two hour visit to the ER that required a cat-scan will cost $13,000. Because of our antiquated health care system, hospital and doctor costs have been increasing at the rate of over 900% in the last 30 years. In 1980, all monies spent on health care in this country came to $256 billions, and by 2010 those expenditures reached $2.6 trillions. The CBO projected that if the PPACA were not passed, the cost of health care would reach 25% of GDP by 2025, just 13 years away. That would be about $5 trillions a year, or 25 cents for every dollar spent on EVERYTHING in this country going for health care. That is the PRIMARY reason why the Patient Protection and Affordable Care Act was passed, to address those out of control costs for health care. In 2014, 99% of Americans will have health insurance as prescribed by law. What that means is that hospitals will increase their profits, health insurance companies will increase their profits, and everybody will get paid for health care services.
When everybody gets paid, the out of control costs this country sees now will decrease.

Something had to be done, and the problem had been growing for decades with no real solution, which is why I support the PPACA. The law is hardly perfect, but it is 1000 times better than doing nothing other than a tax credit for health care savings accounts, which would not have addressed the ever increasing costs of health care.

Well, that has been the problem. Health insurance premiums have been increasing every year. The reason for this is the absurd method of compensation to hospitals and doctors. As you probably know, hospitals and doctors are reimbursed by insurance companies in a scheme called "cost-plus", started by Blue Cross in 1947. Cost-plus allowed physicians to be reimbursed according to "reasonable and customary" charges, and hospitals were reimbursed on a percentage of their costs plus a percentage of their working and equity capital. This system permitted doctors to charge whatever they wanted, knowing they would be reimbursed, and created a perverse incentive for hospitals to increase costs because that meant increased income. Patients have no reason to show restraint, because the money spent belongs not to them but to a third party. The cost-plus system inevitably led to higher health care costs.

Cost-plus reimbursement worked like this: If Blue Cross patients accounted for 25 percent of a hospital's patient days, Blue Cross reimbursed the hospital for 25 percent of its total costs. That's total operating expenses, from rent to security guards to everything. If Medicare patients accounted for 30 percent of the hospital's patient days, then Medicare paid the hospital 30 percent of its total costs. Other insurers reimbursed in much the same way.

This has been the primary driver for the out of control health care costs in this country, and those costs have sky rocketed from $256 billions in 1980 to $2.6 trillions in 2010.

As to the answer to your question, if the CNA's insurance premiums exceeds 9.5% of her income, then she will be eligible for a tax credit. If she has a family of four making $26,000 a year, 9.5% of her income would be $2,470, and if her insurance premiums or out of pocket expenses were $4,129, then she can write off $1,759 off her tax returns. If she were single and making $26,000 and her insurance premiums were $921, then she would have no write offs or deductions.

The point of the PPACA is to make health care AFFORDABLE for everybody. If a person makes $200,000 a year, then they can afford health insurance. The CBO projected that by 2025, in just 13 years, if the PPACA were not passed, health care would cost 25% of GDP on a yearly basis. That would be about $5 trillions a year, and those kinds of costs would be unsustainable in this country. Health insurance premiums would be double what they are today.

So you are suggesting that a mother of four should make do on

Here is the break down
26,000
-
6500 (taxes + ss+medicaid)
-
4,129 (health insurance)
+
1,759 (tax writeoff)

------------------

Is that right?

A single woman earning 26,000

-65000 (taxes, ss medicaid)
-3,000 (health insurance)
----------------------

Is this right?

You see I have been this woman before. I don't drink, or use drugs and never have. I tread on life softly and I am healthy and I made the decision to not have health insurance, when I was young, because it would have made the difference between groceries and electricity.

I earn a nice wage currently. I have very good health benefits. I just remember that there was a time in my life that the amount of money you seem to view as chump change was my daily bread.

And I am going to tell you right now that the kinds of people that come into my lab using blood products and expensive trauma services because they got into a drunken brawl are not going to be carrying health insurance. You are not going to be able to make them. They don't care about tax write offs. The probably don't work anyway, and they won't be filling out tax forms come April. The person that you are going to be hurting is the woman that is mopping up the mess the thug makes on the ER floor.

And I have to admit that I don't know that much about health costs. I know nurses and CNAs get worked to the bone. They are certainly making budget cuts in labs. If there is money to be scrimped, trust me, it is getting done--at least in not-for-profit hospitals.

I know good and well how expensive health-care costs are in the US. In fact, in spite of the fact that my insurance was supposed to pay 100% of all health-care I receive,within my hospital's system, I got zinged $2000.00 in additon, when I received health-care four years ago. Fortunately I had the money in savings, but when I was young, I would not have.

In addition, $75.00 per month is too much for a young person in a low paying job. I don't pay that much. I pay roughly $13.00 a month for my health-care insurance, in spite of the fact that I earn much more than the young CNA working her rear-end off at the low end pay of health-care workers.

And it is much too expensive for anyone who who doesn't have a job. Now you mentioned that 99% of the uninsured now, will be insured by 2014. How? By criminalizing them? Because this is not acceptable. The young CNA with a take-home pay of $19500 is going to be paying for health-insurance (which at her young age, she likely won't need) and even if her insurance is $75.00/month, that is still going to come out of her monthly expenses--more likely food bills, since food bills are more flexible than rent and utilities.

Nonworking people won't be able to pay for insurance at all. Are you willing to criminalize them? And I guarantee you that most of the people who use very expensive trauma procedures in the ER are not going to have jobs. They might earn income, but it isn't taxable. And they aren't going to care about being criminalized. They aren't going to care about carrying insurance.

The other group of high frequency use of ERs are people who use ER for routine medical care. I want to even say, they use it for nothing. They come in for nonmedical uses, and bring their children in for issues that I would have prescribed bed-rest and chicken soup for my own children. They are not going to be insured either. The state, whether federal or state, will still be paying for the medical care of them and their children

I understand that your "John" should carry insurance. He also shouldn't drink. He should be penalized for drinking and driving. The alcohol industry should be penalized for selling a nuisance product.

But I think this fellow is rare among the uninsured folks. I think that most uninsured folks are unemployed, or earning minimal wages, and this law, which criminalized them for not having insurance, is going to be placing an undue burden on struggling folks.

The PPACA makes health insurance affordable to poor people, whereas now they don't have any insurance at all. That is the primary reason why the rich and powerful United States is 49th in the world in infant mortality rates. The poor country of Cuba has a better infant mortality rate than that of the US. Cuba, as of 2011 has an infant mortality rate of 4.83 infant deaths per 100,000 live births, while the United States has a rate of 5.98 deaths per 100,000 live births. This is according to the CIA World Book of Facts.
https://www.cia.gov/library/p...
I see no reason why the US should not be in the top ten countries in the world with the lowest infant mortality rates. The primary cause is that the uninsured do not receive proper pre-natal care, and after the PPACA goes into effect in 2014, they will receive proper pre-natal care, and our infant mortality rate will decrease. The same thing applies to life expectancy. The US is 50th in the world in life expectancy rates at 78.49 years. I would like to see the United States in the top ten countries with the highest life expectancy, along with Monaco, Macau, Japan, Singapore, San Marino, Andorra, Guernsey, Hong Kong, Australia and Italy, all of which have rates of 81.86 years or higher.
https://www.cia.gov/library/p...
The United States is the greatest country in the world, and I believe it's time that our health care statistics reflect that greatness.

While you are thinking about the reasons why other countries have higher life expectancy rates and lower infant mortality rates, you might want to compare the US health care system to that of Japan. In Japan in 2005, 51.5% of Japanese babies were born in hospitals, 47% in private physician-run clinics with fewer than nineteen beds, 1.0% in maternity homes, and 0.2% at home. Yet Japan has the second lowest infant mortality rate in the world, with 2.21 infant deaths per 100,000 live births in 2011, compared to the US with 5.98 infant deaths per 100,000 live births. The US has almost three times the infant death rate. In Japan, primary and secondary level maternity hospitals and clinics do not use epidural analgesia, and independent midwifery homes never use analgesia, so there may be something to your pitocin and cytotec use theory. Also, Japan spends half what the US spends as a percent of GDP on health care, at 8.2%, while the US spends over 16%. Also, Japan has the third highest life expectancy rate in the world, while the US is 50th.

The PPACA makes health care affordable and available to the poor like no other legislation in history, and it will lower the ever increasing health care costs in this country, which was exactly the point of the law. While the legislation is hardly perfect, it is far better than any other serious proposals made in the past. The PPACA will do for the poor what Medicare did for the elderly in 1965. Prior to 1965, health insurance was not affordable for seniors, just as it is not affordable to the poor today. All that will change in 2014, and I look forward to it happening. Today the health insurance companies control availability and access to health care, and their monopoly will end in 2014, while they still will make decent profits for themselves and their stock holders.