finknottle

Based on my quick reading of pages 180-192 (and I may be wrong), you are not forced. But you do pay a payroll tax (0% up to 250K, 2% up to 300k, 4% up to 350k, 6% up to 400k, 8% thereafter). This is a new tax (assuming they are not going to do away with the existing medicaire and medacaid payroll taxes). You do get a tax credit of up to 50% of what you pay, reduced by (1) the multiples of 20k your employees make, and (2) the number of employees over 10. More significantly, the 'gold plated insurance plans' stuff has morphed. They deem Highly Compensated Employees anyone whose compensation exceeds 80k, and their taxes do not count for the tax credit. The bottom line is that a small business with a payroll of 400k is going to fork over 32k in new taxes that they didn't have to before.

1-4 are slanted but believable, 5 started to worry me, and 6 on was clearly crazy talk. So I took a quick skim myself, at the small business section. I have a small consulting company and expect to opt out as we each get their own insurance. The first thing I noticed is that in addition to referenced taxes unspecified in the section I was reading, an opt out company gets hit with tax on wages of 8% (p183), reduced for small businesses with a total payroll less than 400k. It appears at first blush that a microcompany such as mine will get a 50% tax credit for that tax. But the credit is phased out as the average wages exceed 20K - *I think* it is reduced by a percentage point for each multiple of 20k, but it is written in taxeese so I can't be sure (p189). The credit is also reduced if you have more than 10 employees (not my situation - the point is they get you coming or going. High averages and few employees? Lower percentage. Low averages but high number of employees? Lower percentage.). More alarmingly, no credit shall be granted for the taxes paid on highly compensated employees which - and I think this is a departure from the normal regulations - they define as only 80k in compensation. (p190) So - in my admittedly quick skim, I see that I am going to pay a new 8% wage tax, and get none of it back as a deduction or credit. And rather than have the taxes affect only 'gold plated plans,' it hits all of my employees. They make lavish 80k+ salaries, and typically have Kaiser Permamente individual plans. So if I opt out, I pay a new 8% tax on my payroll. If I opt in, I still pay an 8% tax on payroll. If this is true, I'm pretty concerned. And I've only spent 5 minutes looking at the bill!

I bet that's what the Romans were saying circa 400 AD. A government competant to build the world's greatest empire is surely competant enough to continue to manage the economy, the infrastructure, and barbarian immigration (hey - we are all children of immigrants!).

As opposed to what - the military? HUD? Welfare? Politicians have come and gone, promising to balance their budgets through elimination of waste in various places. Show me one program where a politician promised significant savings through the elimination of waste, and then actually delivered. Or are you saying Obama will be the first ever to deliver on this economic feat?

Gee, we've never heard that before! It's amazing how much free money there is out there.

I would argue otherwise. Why people become wacko is a pet interest of mine. I don't believe they start out with goofy beliefs. Rather, they typically start with legitimate mainstream concerns. It is when they see their concerns stifled and ignored by social institutions that they become radicalized, and seize on the goofy ideas floating out there as the only tools they have. Take immigration. Does an 'average moderate' think the north american highway is some plan to flood the nation with illegal immigrants? Probably not. But when a person is concerned about the money spent on illegal immigrants at the expense of citizens, and his concerns are ignored by the political class and branded a racist by the media, he begins to get frustrated and angry. His only allies are on the fringe, and he begins adopting their arguments and ideas because there are no moderate voices to represent him. Before you know it, he is bringing up the highway and half a dozen other fringe talking points he wouldn't have even heard of a year ago. People are worried about what health reform will mean. That's a mainstream concern. Reform is being fashioned behind closed doors (several sets, ironically), with no public discussion - just a rushed timeline and the hard sell. The frustration and sense of railroading is getting to people, but the media has refused to aknowledge it. As their alienation and anger grows they are beginning to grab on to whatever rock they can throw - whether it be about the czars, the bonuses, or whatever. In other words, these are not all simply nutcases - there is a class of 'mainstreamers' who are being alienated and radicalized by the heavy-handed process being adopted.

I believe that if you see unapproved child-rearing, you are supposed to alert flag@whitehouse.gov.

Frivolous, no. But they are wedded. Lawyers are a critical constituency of the Democratic Party - together with academics, media, unions, and minorities - and not one to be ignored. They donate, and fill the politician ranks. They know where their bread is buttered. In general the Democrats are more in favor of regulation and litigation. The more regulation there is, the more lawyers you have to employ. It's not unlike tax accountants - the more convoluted and loop-hole ridden the tax system, the more valuable they are. Expanded government is a boon to lawyers, whether in or out of government. And the Democrats have consistently been against tort reform - limiting the right to sue for past injustices is an ideological anathema to the party.

Ironically, I had a hard time finishing that sentence. At one point I wrote [insert favorite bogeyman here]. I don't particularly think the Republicans are wedded to big oil, but I think the left does and that's all that matters for my point.

It won't change anytime soon. The Democrats are as beholden to the trial lawyers as the Republicans were to Big Oil.

Is that your way of saying that you believe that everybody has a right to have society pay for their medical care? And I'm sorry, but society is valuing people for belonging to a socio-economic strata only is the sense that they are valuing those who pay for services. It is no different than saying that academia values those from a certain socio-economic strata (hint: those with tuition checks), or that your neighborhood liquer store values a certain socio-economic status. So if you are resentfull that shopkeepers don't like customers with no money, or that they prefer the customers with the most, your only recourse is to either ensure that everybody has the same amount, whether they are unemployed or working, 25 or 100, or else mandate that shopkeepers provide identical goods and services to everybody regardless of whether they pay anything.

Do you believe that a person's medical benefits should never be allowed to run out? That as long as there is a dying person somewhere and a healthy person working somewhere else, that money should go to the dying? Basically, do you believe that people have a right to have society pay for their care, or should their medical care be based on what they pay for?

His speaking out is interesting given that he is a strong supporter of both health care reform specifically and Obama generally. http://www.salon.com/opinion/feature/2009/08/10/pharma/

You can buy stock in Japanese automakers.

Talk about a low bar! By dint of running out of money, the cash for clunkers is a great success... in the same way that welfare or stimulus handouts are successfull when everybody cashes their checks. I bet if we double the subsidy, we'll run out of money even faster, giving the administration a great success to trumpet! I don't follow your math, but since nobody looked at it I'll take a stab. The program allocated 1 billion for trading in cars with 18 mpg or less. You get $4,500 if the new car is 10 mpg or better. If it is 4 mpg or more better, you get $3,500. Here is the rosiest scenario: everybody trades in for cars which are significantly more fuel efficient (and thus getting the full $4,500). Then 222k cars are traded in. Assume the old ones are driven 7k miles a year and get 15 mpg. Assume the new ones get 30 mpg and are still driven 7k miles a year. Then each driver saves 7k/30 = 233.3 gallons a year. This saves the nation 233.3 x 222k = 51.8 million gallons a year. So in the scenario most favorable to savings you are still off by a factor of two - no great sin for the back of an envelope. But what is going on macro-economically? If gas is $4 a gallon then our one billion dollar investment pays itself off after 1000/51.8*4 = 4.83 years. But if gas is $2 a gallon (a more realistic number over the next five years), it takes 9.66 years to pay for itself. These numbers are not bad, if that's all there was to the investment. But it isn't. Cars are not free to buyers after the rebates are factored in. A new one averages $28,400. Let's assume that these clunkers have a generous trade in value of $3,400 (just to make the math easier). Then average cost of the upgrade becomes $25k. So we are collectively investing 222k x 25k = $5.6 billion dollars, to save 51.8 million gallons of gas a year. For the individual, this deal makes sense: they are investing $20.5k and saving $466-932 a year, an annual return between 2.3-4.5%. Plus, they get a new car out of the deal. With CD rates below 2%, it's a great investment, and we shouldn't be surprised that the eligible are lining up at the trough. But for the nation, this isn't so impressive. Put aside the ethical issue of collectively investing in something whose payoff goes exclusively to the eligible - those fortunate enough to have a clunker. We are investing $5.6 billion dollars to save $116-232 million dollars a year. Our collective investment is earning a return of 2.1-4.2%. Not bad, but not great for a nation who is themselves borrowing to pay for it. Let's look at a much more pessimistic scenario: cars getting 16 mpg, traded in for ones getting 20 mpg, and earning a rebate of $3,500. Then 286k cars participate. Instead of using 7k/16 = 437.5 gallons a year, they use 350. This saves the nation 87.5 x 286k = 25 million gallons a year. Looking at is only as a $1 billion dollar investment, the investment pays for itself in 10 years if gas averages $4 a gallon, and 20 years if it is $2. Let's assume that these more modest 20 mpg cars average $23,900 instead of $28,400, and the trade value is still $3,400. Then an individual is investing 23.9k - 3.4k - 3.5k = $17,000. He uses 87.5 gallons a year less, and saving between $175 and $350. The annual return is 1-2%, on par with a CD - still a good investment. But the nation is spending 286k x (23.9k - 3.4k) = $5.9 billion dollars to save 25 million gallons a year, or $50-100 million dollars. This is an abysmal return of 0.8-1.7%. This return is less than half the interest rate we would have to pay on treasuries issued to cover the subsidies. So - in what sense is this program an economic success? Regardless of whether we are looking at the optimist or pessimist scenario, a ten year treasury issued to cover this program pays about 3.5% in interest, and a twenty year note pays 4.3%. So we are paying more in interest than we are saving in consumption. In what sense is it a good investment for the country?

What's the difference between my opening paragraph and the one in the article? Nothing, really. Both are illegal. So what is the point of the article? It is not enough that we have laws against retaliation towards union organizing, nor that we have an organization dedicated to prosecuting for it. We need to change the system to make organizing automatic, on the assumption that all of our laws and regulatory bodies are not up to the task of ensuring that the debate is coercion-free. Ok. When the unions are willing to back card-check legislation that automatically decertifies a union whenever a list of purported signatures are turned in by management, then let's talk.

I think they are arbitrarily assigning traits, and have it backwards. Self-reliance, resilience, dominating and energetic are associated with conservativism, while victimization, indecisiveness, feafullness and (arguably) rigidness are associated with liberalism. So if anything, they are guilty of missing the boat. If, as they claim, these traits correlate they way they say from childhood into adult political leanings, the scholarly question they should have asked is why conservative children (self-reliant etc) switch to become political liberals (vicitimized, fearfull etc), and while liberal children (victimized) switch to become conservative adults.

I wonder what fraction of the Buffalo population pays income tax?

There was an interesting and subtle poll recently done which revealed that a majority of the public believes that Congress does not understand the issues well enough to competantly work on it.

Would you rather they get paid for this inefficient work or would you rather they get paid unemployment? We are claiming on one hand that the recession is so serious that we need to extend welfare and unemployment benefits etc as well as create jobs for their own sake, independent of whether they are economically viable. We are claiming on the other hand that the Health Care System is inefficient and that by eliminating all of these paper-pushers we will realize much of the desired savings. And finally, we are claiming that both are so important that they must be done now, simultaneously, without time for public discussion. A slimmer insurance industry means layoffs and more people on the public dole... which ultimately means a larger Democratic constituancy, I suppose.

Which brings up another under-discussed point. The administration likes to point to Minnesota as an example of better health at lower costs, in comparison to places like southern Texas. And yet factors like diet, lifestyle, environment and even genetics are never raised for their impact on collective health.

Dunno. I was refering only to the company subsidy of insurance (the remainder paid by the employee) which normal companies pay. It's relevant here because it is another few percentage points of an employees salary that people don't realize companies pay, and the current debate over making it taxable means that the compensation a company must pay for an employee goes up all that much more.

I don't know how much of a problem the malpractice rates actually are - both sides paint drastically different pictures. But to your point about testing. While preventive testing has been a mantra for some time, this reform rails against unneccessary testing and looks to a uniform (and presumably provenly optimized) standard of treatment. I suspect the threading of the needle will be this - the government body advising on standards lowers recommended testing in order to help generate the type of savings they need politically, under the guise of eliminating costly and inefficient testing. To keep the resulting rise in malpractice insurance in a litigious society in check, they need to step forward and make those recommendations mandatory so as to indemnify the medical establishment. Maybe the annual prostrate exam will become a thing of the past.

Fair question. By overhead I am refering primarily to the cost of the facilities, equipment, and the costs of running a business (compliance, insurance, etc). These are particularly significant in the medical business. But let's look at your flunky. It may look like they are only taking your temperature, but they are actually trained, as are the people taking your blood and so forth. Because we want a highly regulated medical world, they must be accrediated and not (like your laborer) someone off of the street - that drives their salaries up. And let's not forget that take home pay is not the real cost to the business. A practice employing a nurse has to pay payroll taxes, medical benefits, and ensure that nurse against malpractice. So at the end of the day, that nurses time probably *does* cost the practice $50+ an hour. Interestingly enough, the market for nurses is more like the free market than that for doctors (who limit the supply). If they were making too much money, there would be plenty of people going into it - and yet we have a shortage!

I made the numbers up on the fly - my intention is only to get people to go through the exercise of costing out what they consume, in actual services rather than annual premiums. All the congressional jiggery-pokery in the world won't change the fact that if you go see a doctor, you consume a very expensive man-hour plus overhead. When you have emergency surgery, there are a team of doctors, nurses, and technicians that must be paid, as well as the facilities and tests. All too often people who complain about rates complain *not* in the sense of what they pay versus what they expect to consume, but rather what they pay versus what they think they have a right to pay. We can argue about whether we over-consume, whether middlemen and paperpushers are jacking the costs up, or whether prices are subsidizing free-loaders, but at the end of the day we are buying specialized services that are intrinsically very expensive. And it is foolish to believe that the core expense can be significantly reduced without limiting the services we consume.