Health Care Reform: Should we all go per-diem?

aubreysmommy · Mar 29, 2010

When people who make a lot of money are just asked to pay their fair share like the rest of us working people, it is not stealing from the rich. And the WORKING poor (who sometimes work more than 1 job) who do not have insurance are not "laying on the couch" all day. There are quite a few people at the church I attend that have been laid off after working at a job for many years that are in their mid 50's and are on unemployment. Some can get on their spouses insurance but some have no insurance now and are really scared. This is not the poor lazy people who don't want to work and want the "rich" to support them, this is more a case of the insurance and big business getting out of hand and taking advantage of people. I believe that if the insurance companies are more regulated, they can profit a lot but also be fair. Why not have business working with government to provide something good for the country when it is a business who is providing a service that can result in life or death. We all disagree on how tax money should be spent and that is what is great about America is that we can have discussions, vote, agree or disagree. But we are all taxed and for good reason, to provide services, military protection, etc., for the American people. I am sure 99% of the people on this forum, myself included, have insurance. Why begrudge working families who cannot afford insurance or who are denied because they have once been sick or their baby is born ill to have the same thing we have? The POOR LAZY PEOPLE WHO LAY ON THE COUCH ALL DAY LONG already have Medicaid, so this doesn't even pertain to them. We are talking about everyday American families who work or who have been laid off through no fault of their own. So I think it sounds a little mean-spirited to say that slightly raising taxes on the upper income Americans who had their taxes slashed 9 years ago and who are paying less income tax proportionately that we blue collar or regular workers (under $200,000 a year) is stealing from the rich to GIVE to the poor when it is actually given insurance to WORKERS who cannot afford it or who are ill.

I can agree with some of what you say. (see, thats how I differ from a lot of people) I can see things from many different sides, as someone who grew up with NO money and NO insurance. But my parents never ever took any assistance from anyone, not saying thats a good thing, just saying. I did say that we needed to apply much stiffer regulations on the insurance companies, but we could have done that without the government doing what they are doing. I never said that I would personally want to walk around without insurance.........BUT........if I wanted to then it should be my right to do so. I am taking a wait and see approach with this. I've also looked at the major points of the bills, but even still, you are only seeing what someone else wants you to see. And, I am pretty sure I wasn't name-calling. I enjoy having an intelligent conversation about this. I want everyone to be as educated as possible about this, its just too bad that the only info that we get is what someone else wants us to know!

NickB · Mar 30, 2010

When people who make a lot of money are just asked to pay their fair share like the rest of us working people, it is not stealing from the rich.

These people who make a lot of money are paying almost 40% in taxes. Your working poor pay no taxes. Pretty sure that constitutes them paying their fair share.

Altra, BSN, RN · Mar 30, 2010

I was not necessarily thinking per-diem. At my hospital you get paid more an hour if you do not take the benefits. I was thinking if the hospitals are going to take our benefits away because of the new bill we should opt out before they do and take the better pay before it is not available because they will plan on paying us the same; just without benefits.

OP, can you clarify why you believe that hospitals (just hospitals? or do you mean employers in general?) are going to "take our benefits away"? And do you believe this will happen for all hospital employees or just nurses?

~Mi Vida Loca~RN, ASN, RN · Mar 30, 2010

It's an actual department. They give $100 bonuses if you keep your health "numbers" in the "good" bracket--if you're off, they will help you.
We have our "own" employee health--ARNPs staff if, if we're sick we can go there instead of our PCP for minor things.
Our daycare as aftercare for children and ELDERLY people...the system pays for part of it--to help the employees with stressful fam situations.
We have an onsite hair salon, nail salon, dry cleaners--we're waiting for the grocery store--that's all we need..lol...

This sounds a lot like of the perks the hospital has that I hope to work at and where I do clinicals. When I read over their benefits I was so shocked, never had seen employers that seemed to care so much about their employees before.

~Mi Vida Loca~RN, ASN, RN · Mar 30, 2010

When people who make a lot of money are just asked to pay their fair share like the rest of us working people, it is not stealing from the rich. And the WORKING poor (who sometimes work more than 1 job) who do not have insurance are not "laying on the couch" all day. There are quite a few people at the church I attend that have been laid off after working at a job for many years that are in their mid 50's and are on unemployment. Some can get on their spouses insurance but some have no insurance now and are really scared. This is not the poor lazy people who don't want to work and want the "rich" to support them, this is more a case of the insurance and big business getting out of hand and taking advantage of people. I believe that if the insurance companies are more regulated, they can profit a lot but also be fair. Why not have business working with government to provide something good for the country when it is a business who is providing a service that can result in life or death. We all disagree on how tax money should be spent and that is what is great about America is that we can have discussions, vote, agree or disagree. But we are all taxed and for good reason, to provide services, military protection, etc., for the American people. I am sure 99% of the people on this forum, myself included, have insurance. Why begrudge working families who cannot afford insurance or who are denied because they have once been sick or their baby is born ill to have the same thing we have? The POOR LAZY PEOPLE WHO LAY ON THE COUCH ALL DAY LONG already have Medicaid, so this doesn't even pertain to them. We are talking about everyday American families who work or who have been laid off through no fault of their own. So I think it sounds a little mean-spirited to say that slightly raising taxes on the upper income Americans who had their taxes slashed 9 years ago and who are paying less income tax proportionately that we blue collar or regular workers (under $200,000 a year) is stealing from the rich to GIVE to the poor when it is actually given insurance to WORKERS who cannot afford it or who are ill.

This is something I read years ago that has always stood out to me. Thought it was fitting here.

This is a VERY simple way to understand the tax laws. Read on - it does make you think!!

Let's put tax cuts in terms everyone can understand.

Suppose that every day, ten men go out for dinner.

The bill for all ten comes to $100.

If they paid their bill the way we pay our taxes, it would go something like this.

The first four men -- the poorest -- would pay nothing;

The fifth would pay $1:

the sixth would pay $3;

the seventh $7;

the eighth $12;

The ninth $18.

The tenth man -- the richest -- would pay $59.

That's what they decided to do.

The ten men ate dinner in the restaurant every day and seemed quite happy with the arrangement -- until one day, the owner threw them a curve.

"Since you are all such good customers," he said, "I'm going to reduce the cost of your daily meal by $20."

So now dinner for the ten only cost $80.

The group still wanted to pay their bill the way we pay our taxes.

So the first four men were unaffected.

They would still eat for free.

But what about the other six -- the paying customers?

How could they divvy up the $20 windfall so that everyone would get his "fair share?"

The six men realized that $20 divided by six is $3.33.

But if they subtracted that from everybody's share, then the fifth man and the sixth man would end up being *paid* to eat their meal.

So the restaurant owner suggested that it would be fair to reduce each man's bill by roughly the same amount, and he proceeded to work out the amounts each should pay.

And so the fifth man paid nothing, the sixth pitched in $2, the seventh paid $5, the eighth paid $9, the ninth paid $12, leaving the tenth man with a bill of $52 instead of his earlier $59.

Each of the six was better off than before.

And the first four continued to eat for free.

But once outside the restaurant, the men began to compare their savings.

"I only got a dollar out of the $20," declared the sixth man.

He pointed to the tenth. "But he got $7!"

"Yeah, that's right," exclaimed the fifth man.

"I only saved a dollar, too.

It's unfair that he got seven times more than me!"

"That's true!" shouted the seventh man.

"Why should he get $7 back when I got only $2?

The wealthy get all the breaks!"

"Wait a minute," yelled the first four men in unison.

"We didn't get anything at all.

The system exploits the poor!"

The nine men surrounded the tenth and beat him up.

The next night he didn't show up for dinner, so the nine sat down and ate without him.

But when it came time to pay the bill, they discovered something important.

They were $52 short!

And that, boys and girls, journalists and college instructors, is how the tax system works.

The people who pay the highest taxes get the most benefit from a tax reduction.

Tax them too much, attack them for being wealthy, and they just may not show up at the table anymore.

belgarion · Mar 31, 2010

This is something I read years ago that has always stood out to me. Thought it was fitting here.
This is a VERY simple way to understand the tax laws. Read on - it does make you think!!
Let's put tax cuts in terms everyone can understand.
Suppose that every day, ten men go out for dinner.
The bill for all ten comes to $100.
If they paid their bill the way we pay our taxes, it would go something like this.
The first four men -- the poorest -- would pay nothing;
The fifth would pay $1:
the sixth would pay $3;
the seventh $7;
the eighth $12;
The ninth $18.
The tenth man -- the richest -- would pay $59.
That's what they decided to do.
The ten men ate dinner in the restaurant every day and seemed quite happy with the arrangement -- until one day, the owner threw them a curve.
"Since you are all such good customers," he said, "I'm going to reduce the cost of your daily meal by $20."
So now dinner for the ten only cost $80.
The group still wanted to pay their bill the way we pay our taxes.
So the first four men were unaffected.
They would still eat for free.
But what about the other six -- the paying customers?
How could they divvy up the $20 windfall so that everyone would get his "fair share?"
The six men realized that $20 divided by six is $3.33.
But if they subtracted that from everybody's share, then the fifth man and the sixth man would end up being *paid* to eat their meal.
So the restaurant owner suggested that it would be fair to reduce each man's bill by roughly the same amount, and he proceeded to work out the amounts each should pay.
And so the fifth man paid nothing, the sixth pitched in $2, the seventh paid $5, the eighth paid $9, the ninth paid $12, leaving the tenth man with a bill of $52 instead of his earlier $59.
Each of the six was better off than before.
And the first four continued to eat for free.
But once outside the restaurant, the men began to compare their savings.
"I only got a dollar out of the $20," declared the sixth man.
He pointed to the tenth. "But he got $7!"
"Yeah, that's right," exclaimed the fifth man.
"I only saved a dollar, too.
It's unfair that he got seven times more than me!"
"That's true!" shouted the seventh man.
"Why should he get $7 back when I got only $2?
The wealthy get all the breaks!"
"Wait a minute," yelled the first four men in unison.
"We didn't get anything at all.
The system exploits the poor!"
The nine men surrounded the tenth and beat him up.
The next night he didn't show up for dinner, so the nine sat down and ate without him.
But when it came time to pay the bill, they discovered something important.
They were $52 short!
And that, boys and girls, journalists and college instructors, is how the tax system works.
The people who pay the highest taxes get the most benefit from a tax reduction.
Tax them too much, attack them for being wealthy, and they just may not show up at the table anymore.

This happened some years back. During one of Congress' "soak the rich" moods a 10% excise tax was placed on the purchase price of large luxury yachts, cars, and furs. The thought was that it would bring in revenue at the expense of the wealthy and not affect the working class. WRONG!

In their zeal to pass a "feel good" measure our brilliant Congress forgot that rich people didn't get that way by paying out money they don't have to. People who could afford these high dollar items simply stopped buying them in this country and went overseas. In the boat building sector alone, dozens if not hundreds of small business in the marinee industry went out of business. Since the businesses closed, the employees no longer had jobs and were therefore no longer paying taxes. This loss of this tax money was more than double the amount the excise tax had been projected to bring in.

One of the problems I have with this bill is that we won't know the true cost until we start seeing the results of the unintended consequences. Since I work in a small facility it is very possible that our benefits will go away. Will we be better or worse off if we have to go into a pool? Who knows? How many people will decide to not purchase insurance because the fine is less than the cost? While those with preexisting conditions will now have coverage available, for the first few years they will be placed into "high risk" pools, with high risk meaning high cost. Will they be able to afford it even with subsidies?

The list of questions is just like a government form. Every answer leads to 20 more questions.

tewdles, RN · Mar 31, 2010

Certainly this bill is not perfect...I am not sure we have ever had "perfect" legislation right out of the box. Heck, even the constitution required amendments...

Change is rarely comfortable for many people. Some people get down right fearful at the prospect of what another might consider minor change in routine or ritual. However, discomfort with change does not mean that change should not happen. The bottom line is that the only thing that doesn't change is the fact that everything changes. Part of what makes this republic so amazing is that it is designed to change according to the needs of the populace within the framework of the constitution.

No matter what a health reform bill might have included there would be people who would be afraid, people who would be angry, people who would be apathetic, and people who would be happy. The old management saying is that you can't make all of the people happy all of the time...it sure seems like it is much easier to make a few really angry and before you know it you have a whole bunch of unhappy employees because of shared but not always factual information.

I believe it was past time for us, as a nation, to re-examine how we care for the health of our citizens. This is the greatest country on the face of the planet...we can do better than we have of making health care more affordable and accessible for all, IMHO.

Man In Black · Apr 1, 2010

Are you insane? These people who make a lot of money are paying almost 40% in taxes. Your working poor pay no taxes. Pretty sure that constitutes them paying their fair share.

Warren Buffet would certainly disagree with your statement. I don't have much time for the poor billionaires argument.

Tom: You've talked about in your office, for example, you pay a much lower tax rate with all of your wealth than, say, a receptionist does.
Warren: That's exactly right, Tom. And I-- I think the only way to do it is with specifics, and-- and - and in our office, 15 people cooperated in a survey out of 18. I didn't make anybody do it. And my total taxes paid-- payroll taxes plus income tax-- and the payroll tax is an income tax. It's based on income.
Tom: Yeah.
Warren: Mine came to-- 17.7 percent. That-- that was the-- that was line 61 I think-- or, no, line 43-- is the percent of taxable income, plus payroll taxes, 17.7 percent. The average for the office was 32.9 percent. There wasn't anybody in the office from the receptionist on that paid as low a tax rate. And I have no tax planning. I don't have an-- I don't have a-- an accountant. I don't have tax shelters. I just follow what the U.S. Congress tells me to do.
Tom: Why do you think that there's not more outrage about that?
Warren: I-- I don't think people understand it. For one thing, you'll see a lot of surveys that say the rich, the top one percent pay this much of the income tax. Now I think what people don't realize is that almost one third of the entire budget comes from payroll taxes. And payroll taxes on income, just like income taxes are taxes on income.
And the payroll tax is over $800 billion out of two and a trillion, or something like that. And people don't understand-- they-- they-- that the rich pay practically no payroll tax.

http://www.cnbc.com/id/21553857/

You pay a much higher proportional taxrate for a much smaller piece of the commons.

Man In Black · Apr 1, 2010

Social security is broke and I have no idea if it will be there when I retire. I have worked 30 years so far (including the military) and I may not have any SS for myself. So I would choose some other example to use if I were you. Actually it would have been fine had the gov't not used the excess for other things. Even as they speak about it going broke they continue to use the excess.
.

CBO has scored this bill. It saves 1.2 trillion over the next 2 decades.

SS is not broke see:

But even if the president's pessimism about America's potential proves warranted, his scare stories are not. As this chart clearly demonstrates, even if we do absolutely nothing to change the system or prevent economic growth from slowing, Social Security checks will never stop flowing, and benefit levels will always be higher than what today's retirees enjoy. The Social Security pessimists have been proven wrong again and again in the past, and even under their "doomsday" scenario, the system can continue to exist in its present form while still providing a decent benefit to all.

We have to fix health care to fix the federal, state and individual budgets.

kcochrane · Apr 1, 2010

CBO has scored this bill. It saves 1.2 trillion over the next 2 decades.
SS is not broke see:
We have to fix health care to fix the federal, state and individual budgets.

=====================================================

First of all this article is from 2004 - and just a bit antibush . And as I stated before SS would have been find had no one (both sides) touched the surplus that it produced for years and years. It today still continues to produce somewhat of a surplus, but that money is swept away for other projects.

This is from the CBO website itself and it is 2004:

http://www.cbo.gov/doc.cfm?index=5530&type=0&sequence=2

By contrast, federal revenues dedicated to Social Security are expected to remain close to their current level--about 5 percent of GDP--over that period. As a result, outlays are projected to begin exceeding revenues in 2019, with the gap growing ever wider thereafter. Even if outlays for Social Security turn out to be lower than expected and revenues higher, a gap is likely to remain.
Only four approaches to closing that gap are possible, each of which has its own drawbacks:
The benefits that are scheduled to be paid to future recipients under current law could be reduced, lowering Social Security's contribution to their income.
The taxes that fund Social Security could be raised to draw additional resources from the economy to the program.
The resources consumed by other federal programs could be reduced to cover the gap between Social Security's outlays and revenues.
The federal government's borrowing could be increased, which would be another way to draw more resources from the economy to Social Security. That borrowing would need to be repaid by future generations, however, either through increased taxes or reduced federal spending.

I'll see if I can find something more current.

kcochrane · Apr 1, 2010

I'll see if I can find something more current.

This is more current form the SSA website. Lots of data..not a better picture.

http://www.ssa.gov/OACT/TRSUM/index.html

The financial condition of the Social Security and Medicare programs remains challenging. Projected long run program costs are not sustainable under current program parameters. Social Security's annual surpluses of tax income over expenditures are expected to fall sharply this year and to stay about constant in 2010 because of the economic recession, and to rise only briefly before declining and turning to cash flow deficits beginning in 2016 that grow as the baby boom generation retires.

Lots of data here if you have time on your hands.

BTW as I have ALSO stated before, I do think we everyone should be able to obtain a basic health care plan at a price they can afford. But I think the middle class is going to get screwed on this bill. Looks good on paper now, but as with any other gov't run program....it will become more and more costly.

Since taxes start now to "save up" for the implementation - I wonder will they borrow from those $$$ just like they did from SS. That is why I bring it up. Then they will be screaming about how broke it is and how we need to increase taxes, reduced benefits, etc.

NickB · Apr 1, 2010

Warre Buffet would certaily disagree with your statement. I don't have much time for the poor billionaires argument.
http://www.cnbc.com/id/21553857/
You pay a much higher proportional taxrate for a much smaller piece of the commons.

You use Warren Buffet? What a joke. I'm talking about people like doctors and lawyers and small business owners who make under $500,000. They break their backs going to school for 12 years or saving pennies in order to start a business. It's very easy to look at what they have now and call them rich and say they can afford to pay more.