Why Are American Health Care Costs So High?

Best explanation I've seen of the problem with healthcare in the US. EVERYTHING is overpriced and costs to much and there is no sense in why things are charged except to screw over the patients and get as much money out of them as possible. Most interesting fact: We spend more on government provided healthcare in the US per capita than any other nation, but don't provide everyone with healthcare.

The Wealthy Pay the Exact Same in Federal Income Taxes as Everyone Else

I'd like to propose a change in an argument I've seen online a great deal.  I've been seeing this argument in one form or another for the past 15 years (at least since Steve Forbes ran for President in 2000).  The idea is that a flat tax would be a fairer system of taxation because currently the rich pay a higher percentage of their income than the poor or middle class.

What this argument totally ignores is the fact that the rich actually pay a higher marginal tax rate.  However, they pay exactly the same rate as a poor or middle class person for the same income.  For example, a single person with no dependents, up to the first $8700 in income has a tax rate of 10%, no matter how much subsequent income they earn, for income between $8700 and $35k everyone has an income tax rate of 15%, and so on, until you reach the top tax bracket and currently pay a 35% federal income tax rate.  One of the big issues is that most citizens truly do not understand marginal tax rates.  They believe, incorrectly, that if you are in the top tax bracket you pay 35% on all of your income.

Also, I'd argue that the lower income is more important to the taxpayer, that it makes sense the rates go up.  One way to look at this is to calculate the opposite of one's Return on Investment for these different groups of individuals or families.  A rich family will clearly save more and spend a lower percentage of their income than a poor one (note:  there are always exceptions).  Therefore, the money at higher income levels is not as valued as the money at lower levels, and to match the value, should be taxed at a higher rate.  BTW, yes, I know I'm reaching here; but that's the beauty of having one's own blog to write down your thoughts.


Caveat: This totally ignores looking at standard deductions as well as other deductions for which people are eligible.  This will be a big issue if Romney is elected, because he has stated publicly that he will eliminate many of these deductions in order to reduce overall rates; however, I did not include deductions for simplicity.  However, since the deductions are taken off the top level income, if you have enough you can drop your marginal tax rate below the $85k pretty easily depending on your income.

The other point that is missed in whether the rich are overtaxed, is the fact that we are currently near historical lows for the rich in terms of their marginal tax rates.  In fact, this guy ran the numbers and determined that:

 if you want to maximize growth, the top rate should be raised to about 64% and the tax burden on folks at the lower end of the income scale should be lowered.

Now before you say, but 50% of people pay no income taxes, the lower end rates in the analysis also included other taxes like Social Security and Medicare which are regressive taxes taken out of your paychecks as FICA.  Why is this important, because one of the main taxes the GOP has tried to raise is the FICA tax rate which was reduced as part of the stimulus package that Obama in the beginning of his first term.

So, when someone tells you that the rich already pay their fare share of taxes, you can tell them, they paid the exact same amount as everyone else.

Open Letter to my Family

I was thinking of sending this letter to members of my family that have said they will not vote for Obama.  I know it probably will not convince any of them; however, I'd like to know what others think.

I know election time is coming up and it is not a big surprise that I am voting for Obama.  However, I am writing this letter to ask you to vote for him as well.  I know that some of you did not vote for him in 2008 and some of you who did are switching over to Romney because you don't like how he implemented his policies over the last four years.  I do have one argument to make and if that does not convince you fine; but, I'd like you to consider one thing when you do vote for Romney.

My daughter.

Now I know many of you have or continue to have health issues.  And the fact that you don't see how "Obamacare" is most likely the reason you will have healthcare in your old age is beyond me.  If Romney and Ryan are voted in with a majority in Congress and the Senate (definite possibilities) and you have any pre-existing condition and buy your insurance on the open market, you will not be able to buy an affordable plan.  If you reach an out-of-pocket maximum which will become legal again if Obamacare is repealed, an expensive monthly treatment will soon eat into that lifetime maximum along with any hospital stays you may have.  If you are out of work or lose your insurance for 90 days, you will automatically not be eligible for an individual policy that excludes pre-existing conditions.

Oh, and if you say, I'm already over 65 and receive medicare, they won't change mine.  Yeah, right.  Once everyone else sees that they have no chance to receive healthcare like the baby-boomer generation does, I'm pretty sure the rest of us will make sure that discrepancy goes away.  Also, I know the baby-boomers are considered the me generation, but "F.U., I've got mine", is no way to treat your children and grandchildren.

However, getting back to my daughter.  Do you really think there is a chance in hell that she will be able to get any form of health insurance after I stop working?  The only reason we are able to cover her is because I am on my large employer's group policy.  What do you think is one of the reasons I've worked there for over 19 years is?  Also, you say she receives some medi-cal to help offset many of her other medical expenses (copay and deductibles) we've faced over the past six years.  However, they have already stated that most states will receive 30% less in medicaid dollars if "Obamacare" is repealed.  Who do you think will be one of the first to be kicked off the medi-cal rolls, someone who uses medi-cal as supplemental insurance or someone who uses it for everything?

And if you think this is 20 years down the road, you are kidding yourself even more.  Yes, my Parkinson's is under control, but it is a deteriorating neurological disease.  While I hope for better treatments and possibly a cure in the next 20 years, I really have no clue how long I will be able to work.  My doctor gives me ranges of 10-20 years.  What happens to the rest of my (our) family after that?  Many of you know I have already begun discussing DBS with my neurologist.  Thank goodness I have insurance that will probably be willing to pay for this.  See my length of employment for reasons why.

As for another example, Romney's plan calls for making the Individuals with Disabilities Education Act, or IDEA, into a national voucher program.  Part of this program helps fund all the therapists and aides that are required by the school to meet the needs of children with disabilities.  Please, relatives who worked in education their entire lives, explain how a voucher program will assist my daughter in receiving the OT, PT, Speech Therapy, DHH and other therapies and assistance that she receives from the school district.  She currently receives a larger percentage than most children and with a broken neck, may require even more for the next few months.  Do you really believe any voucher program would allow for different monetary values per child and do you believe she'd continue to get these services in school.  Since we'd get vouchers, the school districts wouldn't need to hire anyone because they could then tell us to use outside providers.

Thanks for taking the time to read this.  If you're still going to vote for Romney fine.  But I hope you can come up with a better answer than I just don't trust Obama,  Because if you trust Romney more, we are at an impossible impasse.

Pre-existing Conditions and the Presidential Debate

If anyone with Parkinson's watched the debate last night on domestic issues and felt that their healthcare would be safe under a Romney administration, think again.  In fact,

Mitt Romney’s top advisers acknowledged that, as a result Romney’s plan to repeal Obamacare, people with pre-existing medical conditions would likely be unable to purchase insurance.

The fact of the matter is, that Obama even explained the details of Romney's plan better than Romney, right after Romney said that pre-existing conditions would be covered under his plan.  Obama said,

But let’s go back to what Governor Romney indicated, that under his plan he would be able to cover people with pre-existing conditions. Well, actually, Governor, that isn’t what your plan does. What your plan does is to duplicate what’s already the law, which says if you are out of health insurance for three months then you can end up getting continuous coverage and an insurance company can’t deny you if you’ve -- if it’s been under 90 days.

What that means is if you are not currently covered or you lose your insurance for more than 90 days, you're out of the system and have no way to get back in because of your pre-existing conditions.  I find it ridiculous that Obama had to explain to Romney how his health plan works. Although, it is not surprising that Romney did not accept the explanation.

Joe Biden vs Paul Ryan in Debates

I'm going to take a moment away from exercise and Parkinson's Disease to ask the question of whether the GOP is nuts to think that Paul Ryan will mop the floor with Joe Biden in the debates?  Did they not witness the 2008 Democratic Primary Debates.  Some of the best moments came from then Senator Joe Biden.

On Rudi Giuliani


On what it takes to get things done:


And probably the best response to any of the questions:


Joe Biden may make some gaffes, but I want the guy with a heart like below to be VP.