General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsThe restraunteurs who have complained about Obama care do have one salient point
but their point is actually a great argument for single payer. Health care shouldn't be tied to employment and increasing the cost of employment always has problems attached to it (that doesn't mean one shouldn't do it, only that it does have some problems). But the fact is single payer was never an option directly due to the party these restraunteurs support. That makes their argument for all practical purposes that employers who do provide insurance and/or taxpayers should pay for the health care of their employees. I think that is the definition of not accepting personal responsibility.
The country, and for that matter business, would be way better off with a single payer system funded by a combination of taxes on people (sales or income) and taxes on business (income). Divorcing the funding from employment would be a wise thing.
bluedigger
(17,086 posts)"I have to eat shit at my job or I'll lose my health insurance".
ProSense
(116,464 posts)"The restraunteurs who have complained about Obama care do have one salient point but their point is actually a great argument for single payer."
I mean, that's not the point they're making, and there is no reason to attribute a positive rationale to their motives.
They're just greedy fucks who don't want to provide health care for their employees.
Little Caesars - Democrat Owned, $5 Pizzas, Full & PT Worker Health Insurance
http://www.democraticunderground.com/10021802678
dsc
(52,162 posts)and not a trivial one. As to the provision of benefits I actually went to the link and saw quite a few weasel words and a chart where they state themselves to be the same as Papa John's in the provision of benefits.
Health benefits
Both full-time and part-time workers at Little Caesars may receive health and wellness benefits. Qualified Little Caesars employees enjoy the health benefits of comprehensive medical, dental, vision, and prescription insurance. The company also offers a flexible spending account. Eligible Little Caesars employee may receive short and long-term disability insurance, as well.
What does may mean? Do they get a chance to buy in at the cost of the benefits? Do they pay some sort of proportion? I have no idea and think you might not have one either.
The fact is single payer would be far superior to what was passed and for the reason that labor intensive businesses are hurt more than capital intensive ones. But as I also said the fact is that these people didn't want that and thus are in effect arguing that businesses that do provide insurance should pay for medical care of employees that don't.
ProSense
(116,464 posts)You apparently have no idea how single payer would be paid for. It does not absolve businesses or employees from paying a tax.
Examples of how to pay for a national plan (this was a proposal by John Conyers)
How will the transition to the new system work?
The full conversion to a non-profit, single-payer universal health care program will not take place overnight once the bill is passed. The total transition time will be roughly a 15-year period. Important elements of the transition will include:
- Private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national health care program. The private companies will, however, still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures.
- Private insurance company workers who are displaced as a result of the transition will be the first to be hired and retained by the new single-payer entity. Any of the displaced workers who are not rehired will receive two years of unemployment benefits.
First, switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs. Those savings will be passed on through the system and allow coverage for all Americans. Additional savings in the overall cost of health care will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment.
Second, a "Medicare For All Trust Fund" will be created to ensure a dedicated source of funding in addition to annual appropriations. Sources of funding will include:
- Maintain current federal and state funding for existing health care programs
- Closing corporate tax loopholes
- Repealing the Bush tax cuts for the highest income earners
- Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
- Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners
- One quarter of one percent stock transaction tax
Obviously, this would be a hard sell in the current political environment, but single payer is more efficient and saves billions in the long run.
Here's another:
The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated. Employers would pay a 7.0 percent payroll tax and employees would pay 2.0 percent, essentially converting premium payments to a health care payroll tax. 90 to 95 percent of people would pay less overall for health care. Financing includes a $2 per pack cigarette tax.
http://www.pnhp.org/facts/what-is-single-payer
dsc
(52,162 posts)and most countries with single payer don't work that way. It would still be an improvement for even labor intensive businesses over the current system (especially small businesses) since the cost of insurance would go way down. To use myself as an example I make around 50k and my system says insurance costs them about 6k for me. So they would save on me even under this system. It should be noted that I would pay significantly more in years I were healthy under Conyers than I do now. I pay no premium and have fairly usual deductible/copay. If I had a family, then I would benefit under either system with my employer saving what they would on just me (they provide insurance premium free to employees but give no support to spouse or family).
Incidentally this system would be cheaper for an employer like Papa John's than even the fines under the ACA. Under the ACA the penalty is capped at 2k times (full time workers - 30). Let's assume that Papa John's pays $10 per hour and works employees 40 hours a week, 50 weeks a year. That works out to $20,000 per employee per year. Let's assume that Papa John's has 1000 such employees. (The more employees they have the more the mandate cost approaches being 2k per employee which would be 10%). Their total cost under the ACA would be 2,000 * 970 which is 1,940,000 for those 1000 employees. or $1,940 per employee. Under Conyers' system their cost would be 3.3% * 20,000 * 1000 which is 660,000 for those 1,000 employees or 660 per employee. The employee individually would pay 660. Note I used 3.3 since it is the increase in Medicare taxes, they are both already paying the 1.45%. All other taxes under conyers are divorced from employment and thus are not relevant to a per employee cost. Under the second system, Papa John's would pay 7% * 1000 * 20000 which is 1,400,000 or 1400 per employee while the employee would pay 2% * 20000 or 400.
Clearly Conyers offers the best deal by a long shot to the employer and to employee and employer together. The best deal for the employee is the second single payer system and that comes in second for them together. The ACA is in third place for the employer, third place for both together, and likely to be third for the employee since the employee still has to get insurance under this scenario and would likely pay more than 660 a year for that insurance even with subsidies.
Angry Dragon
(36,693 posts)ProSense
(116,464 posts)Show me where business owners are making a salient point regarding employer coverage and single payer.
They don't have a point. That doesn't mean single payer isn't the best system, but trying to link their greed and selfishness to any salient point is absurd.
They don't give a shit about people's health care access and they certainly do not support single payer.
dsc
(52,162 posts)GM and other car makers were huge supporters of single payer to name one example. For the admittedly greedy reason of wishing to dump their retirees insurance for which they still pay. BTW I do say that since the businesses don't support single payer they are indeed greedy and irresponsible.
Angry Dragon
(36,693 posts)You need to read the post again
ProSense
(116,464 posts)Business opposition to health care is not based on any "salient point."
The notion that health care shouldn't be employer based is a concept that has nothing to do with their objections. They would be equally liable for payroll taxes to support single payer under existing proposals.
Angry Dragon
(36,693 posts)stance ............ and not even realizing that you are doing it
dsc
(52,162 posts)since presumedly they wouldn't be the only funding source. Incidentally, I don't recall payroll taxes being the only method of funding single payer. If it were, there still would be a big savings for many businesses in that single payer is cheaper. In addition, businesses who pay for their retirees health care would benefit since they would no longer have to do that. Most single payer systems do not rely on a payroll tax but on a VAT tax to pay for them. Here I think it would have to be a combo of sales taxes on people and income taxes on business. The fact is labor intensive businesses do get more of a burden under the current system which is both unfair to those businesses but also bad for those workers.
So you're proposing an even more regressive form of taxation to help relieve the burden on these business?
dsc
(52,162 posts)and let's look at that for a second. First under all of the insurance plans some cost falls on employees. In another post I costed out all three of the ACA, the Conyers plan, and the second system for employee and employer assuming 1000 employees making 20,000 each. Conyers cost $660 for both employer and employee plus other taxes that were unaffected by number of employees. The second system cost employers 1400, employees 200. The ACA cost employers 1940 per employee and cost the employees whatever they end up having to pay on the exchange for insurance. Now what would a sales tax end up costing those employees?
http://en.wikipedia.org/wiki/Value_added_tax
Looking at the info at the above link the VAT is either lower or non existent for many necessities. So let's assume that we have a 10% sales tax applicable to everything except domiciles and food (by far the most common exemptions). Let's assume that our workers spend 400 a month on housing and 200 on food. that comes out to 7200 a year leaving 12,800. Assume another 1000 in taxes which of course can't be spent on goods and you have 11,800. If you exempt other things it could be even lower. but here the sales tax would be 1180. I did also suggest a tax on business income though and this suggests the 10% rate maybe too high.
David Zephyr
(22,785 posts)Little Cesars can do it. Excellent example.
dsc
(52,162 posts)the link was less than clear on this. They say that full and part time workers may get health care benefits. Does that mean they are offered a chance to buy in at the cost of the benefits? Does that mean they are offered the chance to pay the difference between their hours and full time? Does it mean that they are given the benefits as if they were full time? I don't know, neither do you. But if you look at the chart they provide they say they are equal to Papa John's in that regard which suggests that at best they are asked to make up the difference.
truthiness918
(2 posts)except I can't predict the future and am not sure how the whole thing would work... BUT, I am so torn on this healthcare thing. 1. I was feeling ill almost 2 years ago (at the end of this month). I went to the doctor and they did blood tests. Three days later I am in to see an Oncologists. My cancer was growing so fast, even waiting a few weeks would have been terminal to me. With single-payer and universal health, I would have likely (just going off of the par levels of the other countries) would have died leaving my 3 children without a parent.
Same would have gone for my son who was born with a heart condition. When he had to go in, it took about 9 days to get him in to a pediatric cardiologist which resulted in an immediate surgery that saved his life.
I dont know. I'm one person with two incidents that would have chanced being fatal. I'd love to learn how my assumptions or fear is unwarranted though.
tyne
(1,248 posts)They pay their employees minimum wage...which barely keeps them out of poverty. Then, they won't provide them health insurance. The employees can't afford to insure themselves. Then they bitch about those very same employees as "takers".
Smilo
(1,944 posts)and it is the right wing that would be happy to introduce those same death panels to America.
Emergencies are treated expediently in all countries with nationalized healthcare. I can speak of the UK - and yes it does have its faults - but those with cancer and other life-threatening illnesses are treated quickly and with compassion and it doesn't cost them their life savings. The Brits love the NHS.
What would have happened if you had not had insurance to pay for your healthcare?
What most countries that have a system of nationalized healthcare do have is excellent preventive care.
doc03
(35,346 posts)like 1948 and it was the Republicans that knocked that down. The Republicans instead wanted health care made part of employment where unions could bargain for health care as a part of their labor contract. Well that worked fine for decades until Raygun started his war on unions.
Now what do we have something like 7 or 8% union membership.
dsc
(52,162 posts)Kennah
(14,273 posts)He got passed that which he could get passed. For a number of reasons, ACA lays the foundation for Single Payer. This might be one of those areas where people are correct to speculate the President was gambling on a huge chess move.
States will set up exchanges, but some states are refusing so the Feds will do it for them. I suspect the Federal exchange will be one will pool rather than one for Louisianna, another for Texas, and so on. This will be a real live laboratory experiment in which we get to see whether the Federal government can do a better job than State run exchanges. Based on my limited understanding of Single Payer in other nations, this might be the case of healthcare in the UK versus healthcare in Switzerland.
Expanded medicare, if all the states had opted in, would have covered, upwards of 50-60% of the population, based on a conference call I sat in on with folks from state agencies from most of the states several weeks after SCOTUS ruled. Closer to Thom Hartmann's Medicare Part E, FOR EVERYONE!
Then there is MLR, or Medical Loss Ratio. Already some small insurance companies are bailing, which I would presume will increase the number of people in exchanges.
I heard Hartmann today predict within 10 years we will have Single Payer.
dsc
(52,162 posts)but the sad fact is that the businesses that are loudly complaining now should look in some mirrors as to why they are being asked to foot the bill now.