When is a tax not a tax? When you call it a fee and don't charge it directly to the general public. The "Framework for Comprehensive Health Reform" proposal being circulated by Senate Finance Committee Chairman Max Baucus calls for a host of "fees" on the health care industry. Specifically, $2.3 billion a year (for 10 years) from drug makers, $4 billion from medical device manufacturers, $6 billion from the health insurance sector, and $750 million from clinical labs. The "fees" would be "allocated by market share," which experts read as a tax on revenues. Some of those costs may be difficult to pass on directly to consumers, but the companies would likely pass along as many additional costs as possible.
The industries are already fighting the fees part of the Baucus proposal. As it stands now, the bulk of the health care reform bill would be paid for by cuts in reimbursement rates. The fees/taxes would be on top of that. This may be good politics, but raising taxes to offset the costs seems at odds with the policy goal of reducing overall health care costs.
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As a physician, some observational points:
1.) People such as posters above are free to self-diagnosis based on websites versus seeing a specialist for the particular problem. It should be your choice. But if you get complications, then you owe up to them, not your neighbor, not another taxpayer.
2.) If you want government run, then you get ZERO choice. As a provider, I choose for you to "live or die," and you deal with it.
3.) Cancer is inevitable. People will get it and must suffer its consequences. Treatment for some is just trying to empty a sinking boat with a bucket. More important goals should be comfort care, not wasting thousands of dollars.
4.) Doctors don't drive unnecessary procedures. The influence of a drive-thru and obese culture on the medical profession has. People want a fix NOW, and don't go to doctors regularly for their chronic illnesses. Really, do you want to see a doctor that tells you to exercise at home, make sure you take certain meds daily...or offers a procedure or test to fix large behinds? The second one is easier for people.
5.) Insurance companies first of all drive cost. They spend most of their time denying payments. What other industry do people not get paid for what they do? And one where people who do nothing to provide actual care (ex: administrators with business degrees which are largely useless) get paid regardless of their contribution?
5.) Basic care should only include catastrophic care for young people or those who have dependents. However, the safeguard should be sterilization of those who have more than a certain amount of kids. Yes, it's socialists - what's better for society than your personal right to be a baby factory.
Why is there so much fuss on healthcare, medicare and SS? There is a easy fix.
Put all the gov't workers, congress, senators and the president on the same system we are on. Bet it would be fixed in a week to 10 days
I really do not want health insurance. Insurance by definition compensates in the event of an unlikely loss or damage. I can guarantee I and everyone else will want health care, generally on a regular basis throughout our lives, like food and water. I'd like to be able to ask a doctor or nurse a few questions now and then, and be able to get the appropriate prescription for a simple ailment I can diagnose myself without paying $1000 plus a month.
Major medical coverage for things like getting run over by a car is completely different and a valid form of insurance, like life insurance. It can be affordable, unlike health insurance, because it insures against something that isn't guaranteed to happen regularly.
When are we going to wake up and realize health insurance itself is a logical fallacy? Most of what health care providers charge hundreds of dollars for today can be done by an amateur with an Internet connection for free. How about we provide basic services to people who need them at their fair cost and separate out the big-ticket items for closer scrutiny? Please don't require me to buy insanely overpriced blanket "health insurance coverage" just so I can be afraid to see a doctor because I have no money left to pay for an office visit after paying the insurance premiums.
Why do we even have to think about increasing taxes to pay for health care?
If we really want to pay for healh care reform, maybe we could just drop 10% less bombs on Afganistan, and Iraq, and put off the upcoming wars with Iran, and Pakistan ?
Better yet, why don't we tell Israel to fight their own goddammed wars, and leave us to hell out of their problems?
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OK, I will get serious. The wars will not stop so long as there is any human resistance to the New World Order. So, as for health care reform, and how to pay for it.... WE CAN'T !
Congress is back in session and the smoke, mirrors, and trickle up effect are alive and well.
Get industry to do your dirty work, when things go bad haul them in for hearings, look like a hero while the general public continues to suffer. We just experienced this with the banking and auto industries. No wonder people fear a government run healthcare system. Car dealers are still waiting for their cash-for-clunkers rebates. Imagine how claims processing will go in a system many times larger.
Let's admit that much of the cost of health care are the regulations placed on the industry by the very people who say they are outraged by it. I think perhaps we should allow the insurance companies to sell insurance in whatever state they can. I also think we should consider tort reform and limit the amount of malpractice awards. What I would really like to see is open, public debate from the committees responsible for crafting health care reforms. Why is it that this health care has to be rushed through? Why isn't the process more open? These proposed changes could impact 1/6th? of our economy & shouldn't be rushed through just to solidify someone's legacy. I want health care reform as much as the next person, but it needs to be done carefully.
A few comments---
1)That they're looking to surcharge the health care industry tells me they've accepted the fact the industry, not the government, is better equipped to administer a health system that covers everyone.
2)The health care industry apparently does not need government loans to stay in business; so the government can't control them. Their only option is the you-won-but-I'll-make-you-pay political sledge hammer. Remember the 90% tax on AIG bonuses?
3)As you point out the idea of raising taxes rather than cutting costs says that they've probably finally accepted the fact that even their government option won't cut costs, it would only slow the rate of growth.
4)They finally decided that they can't change 30 years of health care abuses in a year and have gone back to their original campaign promise of providing health care for those who don't have, or have access to, health coverage.
Finally, they're suggesting surcharging everyone but the doctors. Haven't we been reading where the high cost of health care is in a large part driven by unnecessary procedures, tests and medication ordered or prescribed by doctors? How is it then the doctors are getting a pass?