ADSOFT

Health Bill Passed, will economy now pick up.

Recommended Posts

I was just stating my opinion on how the economy will tank now that the health care bill passed. I didnt feel I was off topic, and I gave my supporting claims. The funding required for it will take a ton of money out of the pockets of poeple who didnt even get to vote on it. I am currently finishing up Medical school. Everyone that works for hospitals will be getting the shaft in all of this. The economy will not bounce back up when its getting chopped off at the knees. Poeple will not want to go out and spend when their paychecks will be less. Just my 2 pennies. I stayed on the topic of economic side of it this time I hope. But this is what I personally see while on clinic duty

Share this post


Link to post
Share on other sites

One thing I do not understand about the act:

Why is an individual allowed to make 200K before getting hit with higher taxes, but a couple gets nailed at 250K? I wonder what affect this will have on the wedding business?

Share this post


Link to post
Share on other sites
One thing I do not understand about the act:

Why is an individual allowed to make 200K before getting hit with higher taxes, but a couple gets nailed at 250K? I wonder what affect this will have on the wedding business?

It won't affect it at all. There are a ton of marriage penalties that are much worse! The ones I find the most egregious:

- Marginal tax rates have a built-in marriage penalty. Mathematically, married couples get penalized the most when they have two incomes that are equivalent to one another.

- Passive activity loss limitation has a huge marriage penalty (apparently if a single guy makes $100k he is rich and has to suspend and carryforward any rental property losses, whereas if a married couple makes the same $100k, they must be rich.) In other words, married or not, $100k begins phase-out.

Policy on this falls down politicial lines too. I'm going to estimate that we pay an extra $3000 due to my wife and I being married. We just seem to fall in that sweet spot where we get bamboozled. It is a real treat.

Share this post


Link to post
Share on other sites
It won't affect it at all. There are a ton of marriage penalties that are much worse! The ones I find the most egregious:

- Marginal tax rates have a built-in marriage penalty. Mathematically, married couples get penalized the most when they have two incomes that are equivalent to one another.

- Passive activity loss limitation has a huge marriage penalty (apparently if a single guy makes $100k he is rich and has to suspend and carryforward any rental property losses, whereas if a married couple makes the same $100k, they must be rich.) In other words, married or not, $100k begins phase-out.

Policy on this falls down politicial lines too. I'm going to estimate that we pay an extra $3000 due to my wife and I being married. We just seem to fall in that sweet spot where we get bamboozled. It is a real treat.

Hmm... but when the gays are denied marriage/civil union, one of the things they complain most about is that there are over 1300 legal and financial benefits of marriage to which they can never have. Maybe the grass isn't always greener on the other side?!

Share this post


Link to post
Share on other sites

Most of those rights can be created by contract (MOST but certainly not all). I work with two guys who have been together for over 20 years. Both make well over $100k annually on W2 (closer to $150 w/ bonuses). If they ever tied the knot, they'd get demolished. From a tax perspective, being married sucks!!!

Share this post


Link to post
Share on other sites
Guest usctrojanalum

sweet I'm 24 years old and my girlfriend keeps bugging me to marry her, maybe I can use how we will get obliterated in taxes as a reason to not get married lol.

Share this post


Link to post
Share on other sites
sweet I'm 24 years old and my girlfriend keeps bugging me to marry her, maybe I can use how we will get obliterated in taxes as a reason to not get married lol.

Maybe.... but the door swings both ways. I'm in that opposite sweet spot. My wife hardly works anymore. Her not getting paid much essentially helps to shield my [our] tax liability.

And, don't forget all the other benefits... cheaper insurance: all kinds from auto to homeowners to life to health--which is what this thread was initially about; family discounts on everything from vacation packages to museums to baseball games; hospital visitation rights; right to retirement assets under ERISA... and all the paperwork it saves by eliminating the necessity for aforementioned contracts, including automatic rights of survivorship, etc.

It's also been shown that a major correlation in wealth building is to get married young and stay married. This is allegedly more important than earning a high income or having advanced/professional degree. This comes with a caveat: don't get divorced! That can be quite expensive.

Share this post


Link to post
Share on other sites
This comes with a caveat: don't get divorced! That can be quite expensive.
Probably the best advice!

Share this post


Link to post
Share on other sites

My biggest problem with the health bill is that the government is jerking with the tax code again. The tax code has become little more than a tool for politics.

This creates business inefficiencies in the largest corporations because they simply don't know what the hell to make of things.

So, if a company, based on previous rules of tax credits, actually expanded operations and hired more people and changed their business, then pulling the same credits back now is a HUGE, F**CKING deal. Now, they have a burden they didn't count on because they thought they had more future operating income, which one can assume to be part of long-range planning.

If one of those "evil" corporations simply pocketed the income by not committing to more expansion or employment, then that company (probably a profit-hungry capitalistic demon) will be better off.

The lesson is: when the government gives you a tax break, they'll just take it away later, so you had better simply pocket the extra dough while you have it. If you use it to fund your operations, you'll end up getting screwed..... [like AT&T to the tune of $1B this year alone]

But, this is a problem I have with ANY frequent changes of the tax code......

Share this post


Link to post
Share on other sites

Summary for those of you playing at home:

Congress, having passed this new law, is now asking corporations to testify how it actually works. [because, of course, they have no idea themselves, having not read much of it, and likely not understanding the parts they did read......]

Share this post


Link to post
Share on other sites

My second biggest problem with the bill is that it does little to address costs.

It's WAY PAST TIME that people start calling out health providers [doctors and hospitals] on COST rather than calling out insurers on profits..... Health providers have been getting a huge, free ride for decades and you can only publicly flog the insurers for so long before there is no profit left. And, costs will still be sky high until the providers come down...

Share this post


Link to post
Share on other sites
It's WAY PAST TIME that people start calling out health providers [doctors and hospitals] on COST rather than calling out insurers on profits

I have a hard time seeing providers as the only bad boys and bad girls.

Cost of med school, malpractice insurance, complying with insurance company edicts and mandates, and voila the providers are going to raise their prices over time.

Isn't that basic economics?

Share this post


Link to post
Share on other sites
I have a hard time seeing providers as the only bad boys and bad girls.

Cost of med school, malpractice insurance, complying with insurance company edicts and mandates, and voila the providers are going to raise their prices over time.

Isn't that basic economics?

I am just about to graduate med school. You should see the dollar amount of student loans I have. 8+ years in school brings alot of expenses. Malpractice insurance is at an all time high due to everyone being trigger happy to sue. As any doctor working in a hospital, they dont set the pricing of exams and procedures. The hospital does. Private clinics I have no information on because I have no worked in one. A real doctor is there to take care of the patients, not to squeek every dollar out of poeple. Just as any other product on the market, you also pay for the research put into it.

Thank you for pointing this out

Share this post


Link to post
Share on other sites
I have a hard time seeing providers as the only bad boys and bad girls.

Cost of med school, malpractice insurance, complying with insurance company edicts and mandates, and voila the providers are going to raise their prices over time.

Isn't that basic economics?

Sure, but they are raising prices an average 6% above and beyond "intensity" and "utlization"...

When I say providers, I mean doctors, clinics, labs... AND hospitals [primarily hospitals]

Here is an overly simplified 9 minute video on this very topic:

And, if you like that, the same gentleman has setup a bipartisan, common sense Web site [that I strongly agree with] at http://www.fixthehealthcarebill.com.

Share this post


Link to post
Share on other sites

MDs deserve to be paid and paid well. I know one who is in his residency. He is almost 30, married with one child, paid like a janitor (nothing against janitors, really), and NEVER sees his wife. He will have three more years of this, then he does a one year fellowship. He has more or less given away 12 years to pursue his specialty. Not only is he deserving of any last penny he earns due to limited earning years & time served, but as a society, wouldn't we want the absolute best people in these important positions? The best and brightest generally have alternatives, so they need to paid well to draw them into these careers.

I suppose thoughts on the bill itself are inappropriate, so I'll hold back...

Share this post


Link to post
Share on other sites
MDs deserve to be paid and paid well. I know one who is in his residency. He is almost 30, married with one child, paid like a janitor (nothing against janitors, really), and NEVER sees his wife. He will have three more years of this, then he does a one year fellowship. He has more or less given away 12 years to pursue his specialty. Not only is he deserving of any last penny he earns due to limited earning years & time served, but as a society, wouldn't we want the absolute best people in these important positions? The best and brightest generally have alternatives, so they need to paid well to draw them into these careers.

I suppose thoughts on the bill itself are inappropriate, so I'll hold back...

People who go into most areas of medicine to make money are bad at math. There is a joke in Securities Law, "If you find an investment that only has physicians investing in it, that is prima facie evidence of fraud." Meaning they are the only ones dumb enough to invest in said investment.

From personal experience it appears to be true and the con men know this well.

If you are bad at math you have two options in this world, law or medicine.

Share this post


Link to post
Share on other sites

I agree with you that doctors should be paid well. Unfortunately, the hospital organizations are often large corporations who are more interested in profit. Doctors work very hard and long, long, hours while some corporate fat cat sits at a desk and makes more money. It's a real mess...

I have worked as a temp at a prominent medical center and got to know many of the doctors personally. I really sympathize with them.

And all of the times I have needed medical care, the doctor bill wasn't the highest charges, it was the equipment usage charges that were astronomical. I have also worked as a claims processor for an HMO and I have seen hospitals bill over $200 an hour just to use the waiting room! I know people like to blame HMOs for the high prices of medical care, but it's much more complicated than that.

Share this post


Link to post
Share on other sites
...but it's much more complicated than that.
I agree. First rate medical care is expensive no matter how you slice it. But people don't see medical care as a tangible good, so they don't value it. I know people who own two luxury vehicles and a vacation home that have their kids on state run (ie subsidized by the taxpayer) medical insurance. They say they "can't afford" medical coverage. No kidding. A $1000/month in your driveway and another $1800/month for the vacation property tends to put a damper on your wallet.

The joke is that most younger people would be much better off with a very high deductible plan in an HSA than they would under the new federal law.

Medical insurance is BROKEN because the insurance model is designed to pool risk of catastrophic loss. In other words, the recipient of care pays for most everything below some threshold amount. The insurance kicks in when the threshold is hit to eliminate finnacial ruin if one should be plagued with an expensive medical issue. We're so far away from that now, and the new federal law (purposely) pushes us even further away from that model.

Share this post


Link to post
Share on other sites
MDs deserve to be paid and paid well. I know one who is in his residency. He is almost 30, married with one child, paid like a janitor (nothing against janitors, really), and NEVER sees his wife. He will have three more years of this, then he does a one year fellowship. He has more or less given away 12 years to pursue his specialty. Not only is he deserving of any last penny he earns due to limited earning years & time served, but as a society, wouldn't we want the absolute best people in these important positions? The best and brightest generally have alternatives, so they need to paid well to draw them into these careers.

I suppose thoughts on the bill itself are inappropriate, so I'll hold back...

He isn't deserving of every last penny he makes if he makes it by ordering unnecessary tests or by practicing "entrepreneurial medicine".

Something many doctors/providers unfortunately do....

Unnecessary care kills 30,000 Americans every year, estimates Dr. Elliott Fisher of Dartmouth Medical School—and that figure includes only Medicare patients.

http://www.newsweek.com/id/234514

There is a clear overutilization of expensive and useless procedures. Private insurers are often helpless to fight this, due to successful lawsuits by patients [urged on by providers] for refusing such unnecessary care.

Additionally, I'm sure you're familiar with the study of McAllen and El Paso[http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=all]

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

Providers really need to be called out for costs--not that they are the only ones responsible for the 9% trend in increased healthcare costs, but they are the worst offenders and yet somehow they fly under the radar of the layperson. The AMA must have an amazing public relations department.

Share this post


Link to post
Share on other sites

Most definitely.

A lot of huge expenses are also due to the ramifications of an unnatural diet (like hydrogenated oils and high fructose corn syrup) and and bad habits such as smoking. Just these have caused huge expenses. These issues, while maybe not the "cause" per se, are certainly contributory to the situation we now find ourselves in.

But, agreed as to the unnecessary procedures part. There is little in the way of preventative care. It's easier to stop a problem when it's little, but if one doesn't have the cash to pay for the procedure, it can be left waiting until it becomes a major problem. Then, one is prescribed medicine, which causes severe side effects - and the solution to that is more medicine to counteract the side effects from the previous medicine! Oh, I could go on....

In other words, from what I can see, the medical establishment has turned from keeping people healthy, to becoming a profit hungry behemoth. But, as I said, it's more complicated than that. One cannot simply point fingers in one direction.

Share this post


Link to post
Share on other sites

If you are bad at math you have two options in this world, law or medicine.

Is the lack of math skills of lawyers the reason why some lawyers have been able to bill more than 25 hours in a day? 8-)

Share this post


Link to post
Share on other sites

First of all, I am in nursing school right now and the one part of every test is the (drug dosage) math calculations! (Except me! I am a math whiz) so not everyone in the medical field is mathmatically impaired!

MDs order "unnecessary" tests because they have to CYA so YOU don't get a multimillion dollar settlement from a lawsuit because "a test existed" that "could" have identified your condition earlier.....*and* also because we insist on more tests.

The issue is multifaceted. It is too easy to blame those "greedy" doctors, lawyers, consumers and/or insurance companies or for-profit hospitals.

Here is the reality:

OB/GYNs are a 'dying' breed. Most get out because they cannot afford the malpractice insurance. The family physician is also a dying breed. They do not earn enough to make it worth the trouble.

Registered Nurses are treated like they are simply glorified waitresses or the doctors servant...BUT, if the MD prescribes the wrong drug or too much of a drug, if the NURSE doesn't catch it, it is HER career and license that are terminated! The NURSE isn't just "playing on the computer". She is documenting everything done or said that day to protect the patient, the hospital (from lawsuit), the doctor and him/herself! You are not the nurse's only patient. By the time she is done doing vitals on each patient and passing the medications, it is time for the next round! Most nurses live on their feet. While you or your loved one is whining that the nurse didn't immediately answer your call bell, she is down the hall saving the life of another patient who coded. And for ALL the grief and abuse the nurse gets....the pay starts @~$20 - 22/hr.

There are MANY things that can change, but IMHO, I would have suggested a step by step approach.

My hubby lived with his now ex-w in Australia. They have socialized medicine. Doesn't cost you a penny to see the doctor or get hospitalized. You also cannot sue the doctor if they cut off the wrong limb. They didn't care about "beauty" so his kidney stones earned him an 18 in diagonal scar. His appendectomy, a 6 in scar.

Whether or not it costs the consumer when they show up for treatment, SOMEONE has to pay for it. NONE of this will be "free" socialized or otherwise.

Share this post


Link to post
Share on other sites

Ah...guy.... this is a political discussion. Sorry, I have to close the thread.

Share this post


Link to post
Share on other sites
Guest
This topic is now closed to further replies.