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The Bernie Bros and sisters are coming to Republicans’ rescue


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#21 indy

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Posted 13 August 2017 - 08:58 AM

But a tax deduction only works in tandem with your tax bracket. Anybody in that band of income will get no benefit for that deduction because they are in a marginal tax rate of 10%, so writing off a $15000 policy (which is what a family of 4 is going to cost) does nothing to make that policy affordable. If you can't pay for the premiums in the first place, a deduction doesn't really do much for you. On the other hamd, it does a lot for people who could already afford the premiums and were going to buy it anyway.

#22 JackD

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Posted 13 August 2017 - 09:41 AM

I agree that deducting the premiums is hardly going to solve the problem but it wouldn't hurt especially if the income level eligible were capped. The ACA subsidies undoubtedly are more effective. Then there's the whole other side of attacking medical care costs. That too needs to happen in conjunction with policies to cover everyone in some way.

#23 andydp

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Posted 13 August 2017 - 10:17 AM

View PostJackD, on 13 August 2017 - 09:41 AM, said:

... Then there's the whole other side of attacking medical care costs. That too needs to happen in conjunction with policies to cover everyone in some way.

If I may digress for a bit let's take an extremely simplistic review of the manufacturing process:

Raw material comes into the factory, processes are done, finished product goes out the door. The objective in all of manufacturing is to minimize the number of processes.

Look at health care:

Raw material (patient) comes in, processes are done, healthy patient leaves. Objective in Health care is to MAXIMIZE the number of processes a patient undergoes. whether its to minimize risks of malpractice suits or make money for the MD.

That's why its very difficult to minimize costs in health care.
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#24 golden_valley

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Posted 13 August 2017 - 10:52 AM

View Postandydp, on 13 August 2017 - 10:17 AM, said:

If I may digress for a bit let's take an extremely simplistic review of the manufacturing process:

Raw material comes into the factory, processes are done, finished product goes out the door. The objective in all of manufacturing is to minimize the number of processes.

Look at health care:

Raw material (patient) comes in, processes are done, healthy patient leaves. Objective in Health care is to MAXIMIZE the number of processes a patient undergoes. whether its to minimize risks of malpractice suits or make money for the MD.

That's why its very difficult to minimize costs in health care.

Yes and the consumer is not well informed about the product purchased, both insurance and the medical care itself, to figure out if the treatment and cost is appropriate and reasonably priced.

#25 Progressive whisperer

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Posted 13 August 2017 - 11:03 AM

Hence pay by result rather than pay by process, although tgen you have to deal with patients who are unlikely to have a good result still needing quality treatment.

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#26 Progressive whisperer

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Posted 13 August 2017 - 11:05 AM

View Postgolden_valley, on 13 August 2017 - 10:52 AM, said:



Yes and the consumer is not well informed about the product purchased, both insurance and the medical care itself, to figure out if the treatment and cost is appropriate and reasonably priced.

It's almost as if profit motive and market forces AREN'T a good fit to medical care? Who could know!

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#27 golden_valley

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Posted 13 August 2017 - 11:27 AM

View PostProgressive whisperer, on 13 August 2017 - 11:05 AM, said:

It's almost as if profit motive and market forces AREN'T a good fit to medical care? Who could know!

Who knew it was so complicated!

#28 D. C. Sessions

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Posted 13 August 2017 - 11:49 AM

View PostJackD, on 13 August 2017 - 08:46 AM, said:

It's not mostly the wealthy who buy individual policies. Mostly it's people unable to qualify for medicaid and without employer benefits like healthcare.

The context was "top marginal brackets." If you want to narrow it to billionaires, sure -- but your ordinary two-earner 5% couple (like PG and her husband) are very much there, and they (like single practitioner doctors and lots of others) have little choice. For them, the deduction is worth several times what it is to the genuinely poor to struggling (and I've been in both groups.) Since we don't have any 70% brackets any more a deduction doesn't really do much to change the affordability for anyone, but it's a nice regressive handout.
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#29 D. C. Sessions

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Posted 13 August 2017 - 11:53 AM

View PostJackD, on 13 August 2017 - 09:41 AM, said:

I agree that deducting the premiums is hardly going to solve the problem but it wouldn't hurt especially if the income level eligible were capped.

Thus my comment on deduction madness in the USA. How about just flat-out having a credit? Cap the value of the credit and be done with it. Our tax code would get a whole lot more reasonable if we converted all (or at least most) of the deductions to credits, possibly at a revenue-neutral rate like 15% or so.
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#30 indy

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Posted 13 August 2017 - 12:17 PM

The credit needs to be something that advances the money, not refunds it in April.

We just need to think up something that works like that.

#31 JackD

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Posted 13 August 2017 - 01:08 PM

"Something that advances the money": that's what the ACA subsidies try to accomplish.

#32 drdredel

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Posted 13 August 2017 - 07:12 PM

View PostLFC, on 12 August 2017 - 07:41 PM, said:

Seriously? I can understand universal health care being a goal of the party (and I'd bet it is supported by nearly every if not every Congressional Democrat) but if you don't swear fealty to achieving through single payer (and ONLY single payer) then you might not really be a Democrat? The end isn't enough, you must take an oath for the means of achieving it as well. [insert slow head shake]

This thinking is exactly why the Democrats are doomed to snatch defeat from the jaws of victory.

No no, that's what I meant by "of some stripe". Yes - I may be using "single payer" too narrowly. I wasn't implying that everyone has to get on board with a very specific approach to health care that is exactly like XYZ. But the ethos is that we need to wrangle the system down to reduce costs, make the whole thing more transparent, stop the gouging, and create a bargaining position from which to negotiate reasonable compensation for the medical establishment and have a system where people who need medical care get medical care without *any thought of "how much will this cost me?".

I know the devil is in the details but is it not reasonable for the Democrats to assert that if you're not worshiping that devil you don't belong in the club?
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#33 LFC

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Posted 15 August 2017 - 09:45 AM

View Postdrdredel, on 13 August 2017 - 07:12 PM, said:

I know the devil is in the details but is it not reasonable for the Democrats to assert that if you're not worshiping that devil you don't belong in the club?

As I said before I'm pretty sure that virtually every Democrat is on board with universal healthcare. It really was the "single payer" term that was my issue in the statement. But the Bernie folks ARE making the point that is MUST be single payer because that's what Bernie says. I think it's unrealistic to expect it to function well in this country and even more unrealistic to believe that we can go from where we are today to single payer in one great leap. It's almost as if none of them ever bothered to study the national opposition to Obamacare at the time.

Of course this is the point that many of us are making over and over again. The Sanders faction of the left seems to abhor pragmatism and willingly embrace a whole range of ideas that are virtually non-starters and some (many?) of which don't even add up as pointed out on TRS several times during the primary campaign. The last thing the Democrats need is a loudmouth who has the same grasp of fiscal reality as Paul Ryan except for the left instead of the right.
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