Do The Wealthy Pay Their Share?

Monday, April 25, AD 2011

Having linked last week to some discussion on whether the US is really becoming “Of the 1%, by the 1%, for the 1%”, I was struck by this chart, which I saw a link to this morning, over at Carpe Diem, showing top marginal income tax rates versus percentage of income tax paid by the top 1% of earners since 1980.

However, I thought it would be a lot more interesting if the chart showed the percentage of total income earned by the top 1%, and also showed the total federal tax liability (including Social Security and Medicare) rather than the just the income tax. Luckily, all this information is available easily on line. (Percent of taxes paid. Percent of total income. Historical tax tables.)

Here’s the chart I produced with that data:

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6 Responses to Do The Wealthy Pay Their Share?

  • I thought only SS had a cap. Medicare does too?

  • Medicare does not have a cap — but it’s only about a third of what SS withholding is, so the amount of payroll tax on income above the SS cap is pretty low. (I should have been clearer on that.)

  • Employers (small businesses/rich people) match-pay employees’ SS taxes, probably also medicare taxes. Is that in the lines above?

    Here’s a tax where the (evil) wealthy are not paying their share: food/fuel inflation.

    Bastiat: “All taxes ultimately fall on the consumer.”

  • I don’t think 2.9% (Medicare tax) is pretty low. it may be relatively low, as compared to the 12.4% (10.4 in 2011) for so-called social security (OASDI), but it is still substantial. I am using the full amount, employee and employer confiscations, because that is the only honest way to look at it – this is the total cost of confiscation, whether or not it shows up on a paycheck or not.

    That is significant. There is absolutely no moral stance in charging people different rates for any reason. This is blatant discrimination! It is an outrage. It does not respect diversity. It is totally intolerant. it is unfair, unjust and just plain mean. In other words, it is the antithesis of the stated, so-called ‘liberal’ (progressive) dogma.

    When you go to a grocery store do they ask for your citizen identification number, aka SSN? Do the want a disclosure of your income, assets, liabilities, etc.? No. They don’t care. All they want to know is do you have $4 to purchase a gallon of milk or not. They don’t change the price or anything else based on your quintile. They just charge for the milk and if you want to leave with it, they expect the same exact payment they would from anyone else. Fair, non-discriminatory.

    If government is necessary, if it is good, if it is just, then it should cost us all the same. A flat fee, not a percentage.

    Does that mean I think the wealthier should not contribute more to their communities and for the benefit of those less materially fortunate than they? No. But that is Charity and not state taxation.

    So, do the wealthy pay their share? Some pay WAY MORE! Others, through political manipulation, like George Soros and Barack Obama, pay much less than they appropriate. Thieves can be very wealthy and even very poor, either way, they are violating God’s commandment against appropriating someone’s private property.

  • The top 1% of earners pay 40% of Federal income taxes. It seems some believe the top 1% steals 18% of aggreagte national income from undocumented migrants; poor, unwed mothers with three to six half-brothers/sisters who never met any one of their three to six fathers; ex-convicts; et al.

    You may gain graces through charitable (Corporal Works of Mercy) works paid with your money and your time. You may not gain graces by confiscating/taxing someone else’s money and giving it to your dependent voting blocs, sanctimonious Robin Hoods.

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3 Catholic Hospitals To Close Allegedly Because Of Obamacare?

Monday, October 11, AD 2010

CatholicVote is mounting a campaign to bring attention to 3 Catholic Hospitals that are closing. The CEO said that ObamaCare “absolutely” factored into the decision.

This is certainly a troubling concern, made more so by the allegations that the White House, the local media, and Sr. Keehan have tried their best to quiet the story.

However, one has to be cautious. The report that CV apparently relies on is based on a doctor’s opinion-a doctor that does not appear to have any knowledge of the actual discussions at the hospitals in question. This unnamed doctor alleges that it is due to Obamacare restricting the ability of the hospital to collect Medicare reimbursements and thereby making its debt unbearable.

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8 Responses to 3 Catholic Hospitals To Close Allegedly Because Of Obamacare?

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  • I agree with the overall gist of your post but I feel obliged to say that “unbearable debt” and “not profitable enough” are two quite different financial states. Your use of the phrase “not profitable enough” seems intended to imply that greed might be a factor. Exactly how much debt should Americans, catholic or otherwise, have rammed down their throats before they resist? Should we wait until the Greek debt crisis, with its concomitant violent civil unrest, looks like amateur hour compared to our own economic collapse? I do however agree that pro-life issues are a separate issue, and even more important, in this particular context.

  • Ugh, pardon my grammatical pratfall in that last sentence. Hopefully my point still came through.

  • Your use of the phrase “not profitable enough” seems intended to imply that greed might be a factor.

    I understand why you might think that, though it was not intentional. I only meant “not profitable” enough in order to have the resources to pay back its debt. I’m not accusing the hospital of short-changing patients in order to make a bigger buck somewhere else.

  • While Obamacare may not be a factor in the hospitals’ decisions, I can tell you non-profit hospitals are very afraid of what health care reform will do to revenues.

    The cover of a hospital administration magazine recently had its cover story about the potential threat to non-profits that health care reform holds. The cover photo was of a Catholic hospital.

  • Here’s from the CEO of the involved hospitals:

    “”Actually we’re doing well. We’re ahead of budget for the year. It’s more that when we look out over the landscape of health care over the next five years and the needs of these facilities, the needs of this community, we understand a different level of investment will be needed than what we can do on our own,” Cook said.

    They said much of that required investment is the result of the health care reform bill passed in Washington.

    The CEO said it means the need for more spending and less federal reimbursements.

    “Health care reform is absolutely playing a role. Was it the precipitating factor in this decision? No, but was it a factor in our planning over the next five years? Absolutely,” Cook added.”

  • Philip:

    Do you have a link for that quote?

    I’m a little confused by the quote, but it sounds like the hospitals think they’re required to expand services/facilities and combined with the other investment the hospital needs to do, the budget isn’t there so they want to bring in private investment to take over so the investment in the community can occur.

    While that may be a little more damning of Obamacare, it’s still a very tenuous connection. After all, they say the planning began before Obamacare, suggesting that much of the investment couldn’t be afforded even if Obamacare was passed.

    Regardless, CV needs to produce a lot more evidence before making the claims it’s making. A sentence quote isn’t enough.

Senator Kay Hagan Just Does Not Get It

Saturday, August 21, AD 2010

Miss Kay Hagan is doing a poor job of defending the “merits” of ObamaCare to a mother who has sick children.  In addition to her sick children, her and her husbands benefits have been cut down or eliminated in order to comply with ObamaCare.

Yet Miss Hagan insists on pushing for more European style socialism.

(Hat Tip:  Culture War Notes)

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2 Responses to Senator Kay Hagan Just Does Not Get It

  • She had to pass the bill so we could see what was in it.

    Remember in November.

  • I have just returned from a week’s vacation, staying with long-time friends in Switzerland.

    Here is what I know about their healthcare system: (My friends are, BTW, very happy with their health care).

    First-of-all, health insurance in Switzerland is absolutely mandatory! Virtually no exceptions!

    And, no, it’s not “Socialized Medicine”.

    You buy health insurance from private insurance companies and you go to your own private physician/health care provider. Your monthly premium can vary based on deductibles which you choose.

    Insurance companies cannot by law make a profit on the basic coverage which they must offer to all. And applicants cannot be rejected based on prior medical conditions.

    Where insurers can make a profit is on supplementary coverage, such as
    private rooms, etc.

    And, yes, there are co-pays.

    In Switzerland there is no Medicare.

    My friends are both in their late sixties and they participate in the mandatory insurance to the tune of what we here in the USA pay, about $13K per year. This includes their daughter who lives in Africa, three people.

    For the most part employers do not provide tax-favored medical insurance coverage to employees unlike here in the USA.

    One more thing: There is a government subsidy to those people whose insurance costs more than 8% of their income.

    Would this work in the USA?

Who's Gonna Grab the Third Rail?

Tuesday, August 10, AD 2010

That’s a line from a brief but astounding post by Kevin Williamson of NRO, which I’m reproducing in full here:

A little perspective from the debt commission:

“The commission leaders said that, at present, federal revenue is fully consumed by three programs: Social Security, Medicare and Medicaid. ‘The rest of the federal government, including fighting two wars, homeland security, education, art, culture, you name it, veterans — the whole rest of the discretionary budget is being financed by China and other countries,’ [Alan] Simpson said.”

Three programs — Social Security, Medicare, and Medicaid — consume 100 percent of federal revenue, and everything else is paid for with borrowed money.  This is why we cannot balance the budget by cutting military spending, foreign aid, food stamps, etc. There is not going to be a serious project to address our deficit/debt problem without deep, painful entitlement reform, and the longer we wait to admit that fact and get going on it, the worse it is going to be.

So, who’s gonna grab that third rail? George W. Bush tried and got hammered — an example that few if any in Washington are eager to follow.

Indeed. I think if this is going to happen, it’s going to have to come from the people (tea parties, perhaps?), because it seems suicidal for any politician to take it on without considerable popular support.

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3 Responses to Who's Gonna Grab the Third Rail?

  • Really? So FICA and Medicare withholding represent the entire federal revenue stream? Whatever happened to the federal income tax and other revenue sources?

    The reality is that we are being set up. The federal government is looking for ways to default on what it owes and it will be far easier to default on what it owes its own people through social security than what it owes foreign banks. Defaulting on foreign loans will affect its credit rating and ability to further borrow while leaving retirees high and dry will just hurt retirees.

  • Finaly someone has outlined the major problem of our deficit spending..Without borrowed money in the term of t notes, we would be bankrupted in regards to income. IT IS TIME for means testing and benefits of those who really do not need SS survie. A cap on those with a certain substainable income need to be removed from SS and Medicare needs to have a schedule of benefits and of premium cost similar to the income tax tables based on 1040 results of income each year to determine premiums and benefits. There will be the normal hue and cry, but our representatives need the backbone to make it happen.

  • They will never solve anything.

    Nearly that entire first paragraph is incorrect. SS and Medicare are (even today) fully funded out of specific FICA and Medicare taxes, not out of general (personal and corporate income taxes, excise taxes, etc.) tax revenues. In fact, the SS surpluses are spent in vote-buying gov programs, and the SS trust fund gets in return nonpublic US debt instruments that can only be repaid from new taxes. The fit hits the shan when the SS taxes paid in are insufficient to pay SS (30,000,000 baby boomer) benefits and the guv needs to tax we the people to repay worthless debt to pay SS beneficiaries.

    I’m too depressed to continue.

Value Added Tax Will Not Solve Budgetary Woes

Tuesday, April 20, AD 2010

There has been a fair amount of useless discussion among pundits and Obama administration officials about a Value Added Tax, a National Sales Tax, the mainstay of the crumbling welfare states in Europe.  I say this discussion is useless, because Congress would never pass it, as the 85-13 vote in the Senate on an anti-Value Added Tax non-binding resolution indicates.

Today in the Washington Post Robert Samuelson explains why a VAT wouldn’t solve our budgetary woes:

The basic budget problem is simple. For decades, the expansion of Social Security, Medicare and Medicaid — programs mostly for the elderly — was financed mainly by shrinking defense spending. In 1970, defense accounted for 42 percent of the federal budget; Social Security, Medicare and Medicaid were 20 percent. By 2008, the shares were reversed: defense, 21 percent; the big retirement programs, 43 percent. But defense stopped falling after Sept. 11, 2001, while aging baby boomers and uncontrolled health costs keep retirement spending rising.

Left alone, government would grow larger. From 1970 to 2009, federal spending averaged 20.7 percent of the economy (gross domestic product). By 2020, it could reach 25.2 percent of GDP and would still be expanding, reckons the Congressional Budget Office’s estimate of President Obama’s budgets. In 2020, the deficit (assuming a healthy economy with 5 percent unemployment) would be 5.6 percent of GDP. To cover that, taxes would have to rise almost 30 percent.

A VAT could not painlessly fill this void. Applied to all consumption spending — about 70 percent of GDP — the required VAT rate would equal about 8 percent. But the actual increase might be closer to 16 percent because there would be huge pressures to exempt groceries, rent and housing, health care, education and charitable groups. Together, they account for nearly half of $10 trillion of consumer spending. There would also be other upward (and more technical) pressures on the VAT rate.

Does anyone believe that Americans wouldn’t notice 16 percent price increases for cars, televisions, airfares, gasoline — and much more — even if phased in? As for a VAT’s claimed benefits (simplicity, promotion of investment), these depend mainly on a VAT replacing the present complex income tax that discriminates against investment. That’s unlikely because it would require implausibly steep VAT rates. Chances are we’d pay both the income tax and the VAT, making the overall tax system more complicated.

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6 Responses to Value Added Tax Will Not Solve Budgetary Woes

  • As for a VAT’s claimed benefits (simplicity, promotion of investment), these depend mainly on a VAT replacing the present complex income tax that discriminates against investment

    And there’s the rub. I would have no objection to the VAT if it replaced income tax. But it never has – both the income tax and VAT have grown ever larger in European countries. The VAT simply allows a government addicted to spending to expand even further, like a junkie obtaining a new supplier.

  • A VAT wouldn’t replace the income tax, but it would replace income tax increases, which is the only other plausible source of the extra revenue we need.

  • If a political climate existed to pass a VAT BA, and if the Democrats can’t do it with the majorities they command now I find it difficult to imagine such a political climate, I guarantee you that the VAT taxes would ever increase, that the politicians would spend every cent raised in new spending and that reckless borrowing would continue. At least that has been the experience in Europe:

    “One trait of European VATs is that while their rates often start low, they rarely stay that way. Of the 10 major OECD nations with VATs or national sales taxes, only Canada has lowered its rate. Denmark has gone to 25% from 9%, Germany to 19% from 10%, and Italy to 20% from 12%. The nonpartisan Tax Foundation recently calculated that to balance the U.S. federal budget with a VAT would require a rate of at least 18%.

    Proponents also argue that a VAT would result in less federal government borrowing. But that, too, has rarely been true in Europe. From the 1980s through 2005, deficits were by and large higher in Europe than in the U.S. By 2005, debt averaged 50% of GDP in Europe, according to OECD data, compared to under 40% in the U.S.

    Thanks to the recession and the stimulus, U.S. federal debt held by the public has now reached about 63% of GDP and is headed higher, but the OECD forecasts that the 30 wealthiest nations will see debt burdens “exceed 100% of gross domestic product in 2011.” Debt levels in France, Germany, Spain and Italy are expected to have increased by 30 percentage points of GDP from 2008 to 2011. Greece has a VAT rate of 21%, but its debt as a share of GDP is 113%.

    The very efficiency of the VAT means that it throws off huge amounts of revenue that politicians eagerly spend. The VAT thus becomes an engine of even greater public spending. In Europe, average government spending was about 30.2% of GDP when VATs began to spread in the late 1960s. Today, those governments are more than 50% larger, with spending of 47.1% of GDP on average. By contrast, U.S. government spending (federal and state) rose to 35.3% from 28.3% as a share of GDP in the same period.”

    http://online.wsj.com/article/SB10001424052702304198004575172190620528592.html

  • I don’t think it’s likely but a VAT along with an income tax cut might be political feasible. You can probably massage the numbers and sell it as a net tax cut.

    I’d love to replace all or part of the income tax with a VAT but I have no faith in the government getting it right. I’ve become convinced that ever-increasing bureaucracy is what will bring America down.

  • If a political climate existed to pass a VAT BA . . . I guarantee you that the VAT taxes would ever increase, that the politicians would spend every cent raised in new spending and that reckless borrowing would continue. At least that has been the experience in Europe.

    Actually this *hasn’t* been the experience in Europe. It’s true that VAT rates has tended to go up after its introduced; however, this increase in revenue has been at least partially offset by reductions in taxes elsewhere. Thatcher, for example, raised the VAT to offset decreases in the income tax while simultaneously cutting spending. The same thing happened in New Zealand in the 1980s, Canada in the 1990s, and (to a lesser extent) Australia in the 2000s.

  • The very efficiency of the VAT means that it throws off huge amounts of revenue that politicians eagerly spend.

    This argument would apply equally to any kind of tax simplification, including the Flat Tax, the Fair Tax, the Reagan tax cuts, etc. It would also apply to income tax cuts to the extent that they are justified on supply side grounds.

60-40: The Party of Jackson Creates A Jacksonian Moment

Monday, December 21, AD 2009

By a vote of 60-40 early this morning in the Senate, the Democrats, with not a Republican vote, voted to cede power to the Republicans in 2010.  The Democrats thought they were voting to invoke cloture on the ObamaCare bill, but the consequences of the passage of this bill, assuming that it passes the House, will likely be to transform a bad year for the Democrats next year into an epoch shaping defeat.  As Jay Cost brilliantly notes here at RealClearPolitics:

“Make no mistake. This bill is so unpopular because it has all the characteristics that most Americans find so noxious about Washington.

It stinks of politics. Why is there such a rush to pass this bill now? It’s because the President of the United States recognizes that it is hurting his numbers, and he wants it off the agenda. It might not be ready to be passed. In fact, it’s obviously not ready! Yet that doesn’t matter. The President wants this out of the way by his State of the Union Address. This is nakedly self-interested political calculation by the President – nothing more and nothing less.

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26 Responses to 60-40: The Party of Jackson Creates A Jacksonian Moment

  • Possibly.

    The president did campaign heavily on insurance reform. I can see his impatience to get something done. Continuing the delay would do little more than look like defeat. And since the GOP never had any alternatives, keeping the status quo would, in fact, also be painted as defeat.

    So we move ahead, as it were, and as you say, corporate America is well-positioned to benefit in some way from all this. Surely they weren’t going to stand to be put out of business with government insurance.

    As for the 2010 elections, they are still a long way off. If we had a solid third or fourth party option, I’d join you to say the Dems should be tweaked. But voting for do-nothing, sit-on-their-hands Republicans? Please. They’ve shelved themselves even in the pro-life side of this debate. It’s been Stupak and Nelson leading the charge. The GOP is standing pat with their hand as dealt. Let’s see how that plays out before handing the election to them eleven months ahead of the fact.

  • “They’ve shelved themselves even in the pro-life side of this debate. It’s been Stupak and Nelson leading the charge.”

    Todd, the Stupak Amendment only passed because every Republican in the House but one voted for it. The Democrats in the House as well as in the Senate are overwhelmingly pro-abortion as the forthcoming battle over the Stupak Amendment in the House will reveal.

    As for Republican alternatives, they have had several including this one.

    http://online.wsj.com/article/SB124277551107536875.html

    What the Democrats are about to do is massively unpopular with the American people, as has been so much of what they have enacted this year. Rarely has a political party so quickly stepped off into a political abyss as the Democrats have been in the process of doing throughout this year.

  • And since the GOP never had any alternatives,

    I guess if you repeat a false assertion it eventually becomes truth.

  • “They’ve shelved themselves even in the pro-life side of this debate. It’s been Stupak and Nelson leading the charge. ”

    Uh What about Cao?

    That being said no one is going to pay attention to what GOP Prolifers say. We (as a party) are pretty much poiwerless right now. That is why the action is the Democrat party and it segments

  • Todd,

    Apparently you didn’t follow the House. There was a GOP Alternative that the CBO scored as cheaper and more efficient at reducing the deficit. The GOP Alternative included an actual exchange allowing for the purchase of health care policies across state lines (thus creating greater competition), enacted tough Medical Liability Reform (TORT) that would reduce inefficiencies in the practice of medicine caused by defensive medicine, and it would increase some of the privatization of Medicare seen in the popular Medicare Advantage Program (a program that now only will exist in 3 counties in Florida).

    The fact you declare there was no GOP alternative indicates in fact that you are just taking your talking points from the DNC.

  • The president did campaign heavily on insurance reform. I can see his impatience to get something done.

    Start that truck and drive it into the ditch. You’ll be getting something done!

  • Will Todd and all – Obama-worshipping imbeciles – also blame Bush for tens of thousands of small businesses that go bust because of this requirement and the excess taxes they will impose?

    “The Democrats’ government takeover of health care will increase premiums for families and small businesses, raise taxes during a recession, cut seniors’ Medicare benefits, add to our skyrocketing debt, and put bureaucrats in charge of decisions that should be made by patients and doctors. The bill also authorizes government-funded abortions, violating long-standing policies prohibiting federal funding of abortion. That’s not reform. My message to the American people is now is not the time to give up. Now is the time to fight harder. When the American people are engaged, Washington listens. Now is the time to speak out, more loudly and clearly than ever, against this monstrosity.”
    John Boehner (R-OH) 21 Dec 2009

  • In true Jacksonian fashion, the country fired the Republicans in 2006 and 2008 because they bungled the war in Iraq and allowed the economy to sink into recession. They might soon have another Jacksonian moment, and fire these equally useless Democrats for hampering the recovery, exploding the deficit, and playing politics with health care.

    The big difference is that Americans saw the death toll mounting in Iraq and the economy going down the toilet. Americans won’t see the effects of ObamaCare in 2010. In fact, a not-yet-implemented ObamaCare should be an electoral asset. “You get health care! You get health care! Everybody gets health care!” The GOP may see gains in 2010, but it won’t be because of ObamaCare.

  • With only 34% of the people saying that passing ObamaCare is better than doing nothing restrainedradical, I think this bill is an anchor which will take Democrat electoral prospects straight to the bottom next year.

    http://www.rasmussenreports.com/public_content/politics/current_events/healthcare/december_2009/just_34_say_passing_health_care_bill_is_better_than_passing_nothing

  • “Will Todd and all – Obama-worshipping imbeciles …”

    With insightful analysis like this, I feel confirmed that conservative Catholics have as much of a sense of a pulse on the nation as they do when they feel a coconut. When you can’t distinguish between voting while holding nose or political worship (we sure had a lot of that with Bush II) we might as well turn to tea leaves than attend carefully to your analysis. Not everybody thinks like you guys do, comprende?

    The president invested a lot–and some might rightly say too much–in health insurance reform. One might even say he backed himself into a corner on this. By your account, Mr Obama was a loser any way he tried to put a face on this. Alternate proposals aside, he had no incentive whatsoever to caucus with the GOP on this. None.

    As for congressional elections next year, get serious. The House is ensconced in the land of incumbentia. And the Senate is reliving the 2004 election. I can’t see the GOP taking back the Senate, especially if the economy recovers in any way, and the Afghan surge remains a non-disaster.

    2012 is another story, but the GOP has yet top surface a viable national candidate.

    Interesting that you picked Jackson as your theme. Wasn’t that when the Whigs ascended to major party status? They had to wait till 2016–I mean 1840, right?

  • “The House is ensconced in the land of incumbentia. And the Senate is reliving the 2004 election.”

    Wrong on both counts Todd.

    The Democrats are defending quite a few vulnerable seats in the House which McCain carried last year, and many more which Bush carried in 2000 and 2004. Traditionally Republican districts will be swinging back to the GOP next year. Incumbency after the fiasco this year I doubt can be regarded as a positive in competitive districts. The Democrats are also beginning to be plagued by retirements from Congress, a sure sign of a party in trouble in the next election cycle.

    In the Senate I see the Republicans taking Senate seats in Arkansas, Connecticut, Colorado, Nevada, New York (Gillabrand’s seat), North Dakota, Pennsylvania, Illinois, Delaware and either Washington or Wisconsin. I see them holding all their seats and Lieberman caucusing with the GOP in 2011. If Linda Lingle, popular Republican governor of Hawaii, gets into the Senate race she might topple 85 year old Inouye who has served in the Senate since I was 5 years old in 1962. It is hard to imagine Evan Bayh losing in Indiana, but if the political winds are gale force against the Democrats I think there is a small chance he might.

    The Whigs Todd first gained control of Congress in the election of 1834, the year after it was formed. The Whigs were formed as a reaction to the policies of Old Hickory.

  • I don’t know about the Senate, but it would be surprising to see the GOP pick up less than 20 seats in the House. That doesn’t net them a majority, but that’s a worst case scenario. It’s folly to make a firm prediction, but at the current course I think many of the Blue Dogs better start looking for alternative employment. As for the “incumbentia,” that’s funny in light of the recent spate of Democrat retirements. Perhaps they lack Mr. Flowerday’s acute political acumen, but I suspect that might have a better sense of where the country is heading.

    I don’t see a ten-seat pickup for the Senate. There are a couple of very shaky GOP-held seats at the moment, and even considering the possible voter backlash against the Dems, I wouldn’t bet the house on the Republicans holding on to them.

  • I see three Republican seats as offering the Dems possibilities for a switch: the open seats in Missouri and Ohio and Burr in North Carolina. I think 2010 is going to be a strong GOP year in Ohio. Ohio went strongly for the Dems in the last two election cycles and buyer’s remorse has set in. I’ll be shocked if the GOP doesn’t hold the seat. Burr is a weak incumbent, but I think the GOP will have a great election night next year throughout the South. Missouri will be a battle, as open seat elections in that state tend to be. I think the GOP will hold on, but I think that is their shakiest current seat.

  • Don’t know about the comment on politiucal acumen–aside from local politics, I try to stay as apolitical as possible. I wouldn’t say that eleven months with a volatile economy, and who-knows-what on the international front makes for an easy prediction of what is to come.

    The Dems still have eleven months to make a case to stay in power. If some third party in Iowa wants to make a case for my congressional seats, I’m willing to listen. I’m not inclined, like some other progressives, to stay home to make my point next Election Day. I’ll continue to hold my nose and pull the blue lever, but not because I think they’re generating the best ideas.

  • Must correct Mr. McClarey.

    The Republican Party in New York has suffered a secular decline in the calibre of the people they run for about thirty years now. It has left Upstate, conventionally a Republican preserve, represented in Congress almost entirely by Democrats. One exception is a fellow from Buffalo who is a man of genuine accomplishment in private life. (By what accounts have appeared in print, the Republican State Chairman, Stephen Minarik, was partial to him as a candidate because he could ‘self-finance’. The late Mr. Minarik always had his priorities).

    I will offer better than even odds the Republican sachems will arrange for the nomination of some seedy lush who has been making cruddy little deals in Albany for 25 years, because that is who they know and that is their idea of a normal person. Kristin Gillibrand will then eat him for breakfast.

  • I always hesitate to disagree with you Art, but I think that next year it will be anything but politics as usual. As the uprising in New York 23 indicates, there are plenty of Republican voters fed up with precisely the type of machinations you describe.

  • Evidently former Governor Pataki seems poised to make a run at Gillebrand. Yeah, good luck with that. Had Rudy run, he probably would have won that seat, but evidently the Senate was too low a prize for the guy who still seems to have some delusion that he will be president one day. Pataki might be viable, but that would be a race where I would weep few tears if the Republican lost.

    I can see the GOP holding onto the aforementioned seats if it’s a real good year, but it will be tough. They have to hold serve, then win pretty much every toss-up state currently held by the Dems. That’s a tall order, though that’s basically what the Democrats did in 2008.

  • If Pataki’s on the ballot, I’m writing-in the name of my insurance agent’s dog.

    Giuliani ought to retire from political life and attend to mending fences with his children. Putatively, he has told intimates that positions in legislative bodies look unattractive after you have sat in the mayor’s chair producing actual ‘output’. The thing is, as Mayor of New York, he has been among the most accomplished political figures of the post-war period. Most of the presidents we have had over the last sixty years are men of lesser significance. He is 65 years old now and should quit while he is ahead.

  • “If Pataki’s on the ballot, I’m writing-in the name of my insurance agent’s dog.”

    I am certain the dog would do less harm than either Pataki or the incumbent, and would probably have more charisma.

  • That is one cute canine!

  • Parker Griffith, Democrat Congressman from Alabama, is switching to the GOP. He is the first Blue Dog to do so this Congress; he will not be the last.

    http://hotair.com/archives/2009/12/22/breaking-blue-dog-flips-to-gop/

    Some Democrats can clearly see the electoral ice berg their party is careening towards.

    Merry Christmas Speaker Pelosi!

  • That’s fairly major news. These retirements/party switches are usually a good indicator of significant electoral upheaval – they certainly were in 1994, 2006, and 2008.

  • I don’t think Arlen Specter’s switch indicates an upheaval.

  • It indicated that Specter knew that Toomey would clobber him in the primary. Now Toomey will clobber him in the general.

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Obamas Speech: Dem Health Care Bill Now, With Or Without GOP

Wednesday, September 9, AD 2009

[Updates at the bottom of this posting as of 3:03am CDT on AD 9-10-2009]

President Obama’s speech covered many topics, lets first layout our President’s plan:

I. Keep the health insurance you have now.

1.  Pre-existing symptoms or disabilities no longer will disqualify anyone from coverage.

2.  No spending caps set by insurance companies.

3.  No drop in coverage in the middle of an illness.

4.  Limit on out of pocket expense.

5.  Minimal requirements of coverage.

II. Public Option & Exchange

1.  When losing your job you have the Public Option if you can’t afford insurance.

2.  Insurance exchange markets will be required for insurance companies to participate in.

3.  Tax credits for small businesses.

4.  In theory this will not lead to a government take over.

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39 Responses to Obamas Speech: Dem Health Care Bill Now, With Or Without GOP

  • For me the oddest statement in the President’s speech was the claim that “I will not sign a plan that adds one dime to our deficits – either now or in the future. Period.” I’m not sure this can even by classified as a lie, as lying requires an intent to deceive, and I can’t imagine Obama thought anyone would believe him when he said this (so then why did he say it?)

  • I think President Obama actually believes that statement he said about not a single dime towards our deficits.

    So I’m not sure if he can be accused of saying a lie. But if it does happen, does it qualify as a lie after the fact?

  • This proposal doesn’t come off as “reform.” Rather, it comes off as more of what we currently have: tons of regulations that introduce more cost and curb competition.

  • It’s not clear that Obama could even hold true to his promise for the length of his speech. Nine paragraphs after making his “not one dime . . . Period” pledge, he says that his plan would cost $900 billion, and that “most” of this would be offset by cuts in existing health care programs. Perhaps by most he means $899,999,999,999.91? Or maybe he means his pledge literally. He won’t sign a bill if it adds exactly a dime to the deficit, but if it adds billions that’s okay.

  • For full disclosure, I am not an expert on how the Health Care industry works.

    With that said I do like the first portion of his speech that says pre-existing symptoms or disabilities no longer will disqualify anyone from coverage, no spending caps set by insurance companies will be allowed, coverage won’t be dropped in the middle of an illness, there will be a limit on out of pocket expense, and there will be minimal standards required in basic coverage.

    I’m not sure if this will make insurance costs go up, drive companies out of business, and eventually result in a single payer system over a period of time.

    But if this is possible without any of the above scenarios, I like it!

  • Tito, on another thread I was calling you out, takin it back now.
    Really! If we could fix the pre-existing condition and employer control thing in healthcare, who could argue?

  • Master C,

    I was busy typing up this posting when you left that message.

    I like the portion I outlined, but without the public option.

    If some regulations could be set up for the insurance industry without the public option then that would be ideal!

  • We need this change…YESTERDAY!

    Millions of Americans presently have no health care, others who do, when faced with an illness go bankrupt, and others find out that suddenly they don’t have any healthcare at all and still others are covered but face high costs.

    I’m 52 years old..and my job was outsourced 4 years ago.
    Thankfully I have family but I pay $450.67 per month and my Asthma inhaler costs…$211.00 OUT OF POCKET.

    Others are in worse shape.

    Any Catholic that cannot see the good in this isn’t Catholic!

  • P. Edward Murray,

    I certainly sympathize with the problems that you are facing.

    Though I have to say that just because some of us oppose certain points of President Obama’s speech doesn’t make us not Catholic.

    If you could explain why then we have a starting point, but just simply saying this doesn’t make it so.

    Also you can’t force others to pay for something they don’t want to pay for nor are required to pay for.

  • “Primary school taunting”?

    No, he just told the truth. Would that Palin and FOX NEWS would do the same.

  • Mr. Murray,

    I have no health care. I pray that my health does does fail. I haven’t had a full-time job in nearly a year. I do fear bankruptcy if I experience any health programs.

    That said, anyone who tries to get me health care on the backs of dead babies is not doing me any favors. I’d rather face financial ruin than see one more baby slaughtered.

    In Christ,
    Steve

  • Heather,

    Denying that there are End-of-Life-Decision panels, aka, Death Panels?

  • Steve,

    First, I know quite well where you are..I’ve been out of a job for 4 years…

    I thought I had finally found a good company to work for and was promoted a Team Leader at our Panasonic National Diagnostic Center. So I was part of the management team lowest level.

    One day I came in and learned that my entire office was to be sold. We were. And we were led to believe that we would just move to another location.

    That didn’t happen.

    At one point, we had 75 people working at our facility.

    All the remaining jobs were outsourced to Manila.

    I blame GWB and all Republicans..they didn’t give a care.
    To all of them…outsourcing is just another way of making more profit.

    And that is why I will never vote for another Republican as long as I live.

    The lie and cheat period. They only care about themselves and other rich …very rich people.

    As far as abortion is concerned you needn’t worry because this is what the president said…

    “And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.”

    And to anyone else reading…

    We are living in a Depression…currently I have a brother & sister-in-law out of work. I have an Aunt & Uncle..both in their sixties…out of work and they are trying to start business.

    Millions of Americans are in the same boat as Steve and I and if you aren’t yout of work you should be counting your blessings because it isn’t over yet.

    Being unemployed for a long time is very hard but I’m also

  • I’m also caring for my 74 year old mother who has cancer and is still working and is partially disabled with a bad back so I must take her to work and back in a wheelchair.

    This is what George W Bush did.

    I know this is where Jesus wants me to be..to take care of my mother…something that many middle aged Americans face..caring for their elderly parents.

    We need this change and we need the jobs to come back.

    If this doesn’t happen then God help us because there is going to be a heck of a revolution!

    Say the Chaplet of Divine Mercy!

  • Tito…

    Have you ever heard of

    “A living will”?

    Please don’t tell lies.

  • P. Edwards Murray,

    There will be abortion funding in the bill. You know better that the public option will offer coverage for abortion.

    This is your first warning. If you’re unable to keep your emotions in check and call me a lier one more time then you will be banned.

    You know there are End-of-Life Panels, aka, Death Panels, in one of the two congressional bills.

    I can tell you my sob story as well, but I’m not here to score cheap political points.

    If you really believe a revolution will occur if this bill doesn’t pass then you are beyond logic and reason.

    If this bill does go through, one thing is for certain, we’ll have an entirely new executive and legislative branch come 2012. That is change that I can believe in.

  • Personally having witnessed the outrageous statements at my former Parish…St. Ignatius of Antioch Yardley PA..statements made just after the election…that voting

    “The Economy” was wrong and that “Jesus would have something to say to me” I left that Parish in disgust.

    Picking up my mother from her weekly Adoration, I noticed some flyers saying that this health care would include abortion….

    Which it didn’t then and won’t now.

    I’m of the opinion that The American Catholic Church is really split…many proclaim themselves to be Catholic and are more Republican than really Catholic.

    And some are really Catholic.

    I don’t know about you, but I was brought up to believe that being a Christian was more than abortion…

    Did not Jesus say “Feed my Sheep”? Did he not say that if a man has no “cloak” to give him yours? Did he not say to give your money to the poor?

    Do we not sing a song “Whatsoever you do to the least of my brothers, that you do unto me”?

    Yes we sing that song and Pope John Paul II talked about
    “A Consistent Ethic of Life”?

    So remember…

    Your vote is an action and actions speak louder than words.

    Is it better to vote for one who says they are pro life but clearly discounts everything else that Jesus has said?

    For the record, I believe in a “Consistent Ethic of Life” and I am a practicing Catholic and a Democrat.

    One final note…

    When I left St. Ignatius I could hardly believe that any priest or deacon could have said such a thing. Clearly sometimes priests forget that they live by charity.

    The Deacon in question…his other job..is a

  • Tito,

    I will not remain here and will never bother you again.

    Say a Chaplet of Divine Mercy

  • P. Edward Murray,

    You are more than welcome to say your peace, but please say it in charity.

    It seems you are the one struggling with your Catholic identity vs. being a Democrat.

    As for me I am not a Republican nor do I vote a clean GOP ticket.

    I’ve donated all of my money to the local democratic party and have voted for many democrats, yet I vote as a Catholic, not as a republican nor democrat.

    The life of a human being, especially an innocent child, is the utmost important issue.

    If you feel that getting a free bottle of aspirin forcibly paid by someone else is more important than the life of an innocent child, then that is between you and God.

    I’ll put you and your family in my evening prayers.

  • Catholic Anarchist,

    Your disrespectful comments and vicious attack on the writers of this website will not be tolerated.

    It is comments like yours that the American people are fed up with the way you and your ilk demonize those that protest President Obama’s health care bill.

  • “He chastised those that would dare say the Public Option would eventually take over the Health Insurance Industry.”

    A Kool-Aid stand was set up in the lobby for those who have yet to see the light. Name ONE government program that has ever gotten smaller.

    Buehler…BUEHLER…ANYBODY ?

  • “Any Catholic that cannot see the good in [ObamaCare] isn’t Catholic!”

    “I’m of the opinion that The American Catholic Church is really split…many proclaim themselves to be Catholic and are more Republican than really Catholic.”

    “For the record, I believe in a “Consistent Ethic of Life” and I am a practicing Catholic and a Democrat.”

    Taken at face value, these comments add up to saying, essentially, that one must be a Democrat in order to be a “real” Catholic (never mind the Democrat-sponsored legalized murder of all those dead babies).

    “Any Catholic that cannot see the good in [ObamaCare] isn’t Catholic!”

    So, then, unless you support this particular version of health care reform, prepare yourself to be denied the Catholic funeral that that paragon of Catholic virtue Teddy Kennedy received.

    “I’m of the opinion that The American Catholic Church is really split…many proclaim themselves to be Catholic and are more Republican than really Catholic.”

    Mightn’t there be an even greater number that proclaim themselves to be Catholic that are more Democrat than really Catholic? There’s a whole generation of Catholic Democrat politicians, for example, that ignore Church teaching on fundamental issues such as abortion, euthanasia, and marriage. It’s funny: I see very few pro-life Catholics who proclaim themselves members of the Republican Party as readily as this gentleman proclaims himself a Democrat. Tito’s not a Republican. I’m not a Republican. And even those who are self-proclaimed Republicans tend to be willing to vote against the party when it comes to a “pro-choice” candidate (witness Catholics Against Rudy). Sad that we don’t see that same commitment from Catholic Democrats.

    “I don’t know about you, but I was brought up to believe that being a Christian was more than abortion… Did not Jesus say “Feed my Sheep”? Did he not say that if a man has no “cloak” to give him yours? Did he not say to give your money to the poor? … Do we not sing a song “Whatsoever you do to the least of my brothers, that you do unto me”? … For the record, I believe in a “Consistent Ethic of Life” and I am a practicing Catholic and a Democrat.”

    It’s ironic that whevever someone proclaims themselves to have a “consistent ethic of life”, it is almost ALWAYS the unborn who get short shrift, whose right to life is given a lower priority than whatever other policy issues happen to more closely coincide with that person’s own preferences. They proclaim a concern about “the least of these our brothers” without a hint of irony that they’re leaving out of the equation (or at least minimizing) the least of the least of these – the unborn.

    I agree that we should all have a consistent ethic of life. That universal access to health care – in whatever form it is delivered – is part of that consistent ethic. But as long as our culture accepts a legal regime that fails to recognize the inherent humanity in the least of the least of these our brothers, such a consistent ethic of life is impossible. And, quite frankly, a government that provides legal cover for the murder of the innocent is unfit to run anything remotely resembling health care.

    And besides, how dare anyone believe that their other policy priorities somehow take precedence over the very right to experience life that is endowed by the Creator upon the unborn? With apologies to Charles Dickens, it may be, that in the sight of Heaven, the millions of poor children in the womb have a higher priority in seeing the light of day than does someone in having the government pay for their “free” health care. So, yes, let’s have a consistent ethic of life, but let’s get our priorities straight about what that means, and stop using it as a tool for ignoring abortion in favor of a particular party’s big government agenda.

  • “It is comments like yours that the American people are fed up with the way you and your ilk demonize those that protest President Obama’s health care bill.”

    Tito. I know. You’re going to start thinking I’m singling you out. But…the reverse happens just as frequently and just as viciously. And at least on this blog, the latter tends to be quite tolerated.

    Jay,

    I agree. Catholic Democrats really do not live up to their vocation as Catholics. Many are cowards. Many use the “seamless garment” as cover for voting for pro-choice candidates without even resisting pro-abortion legislation while performing some sort of intellectual gymnastics to distract attention from such a reality. But really, we are told that they are really pro-life because they are reducing the number of abortions by expanding access and/or funding to it.

    But…I think concerns that “other issues” — and I’m not talking about everything else on the “progressive” agenda — are unfortunately neglected, or voting for pro-life Republican candidates, which some Catholics imply is mandatory (even you choose to try to opt to not vote for anyone at all over voting for a Democrat), might strike your conscience as endorsing a number of policies that you simply do not agree with and do not believe is good for our country.

    In a sense, there is a sentiment that I don’t totally endorse — but I am very sympathetic to — is that many left-leaning Catholics feel boxed in. It is practically non-negotiable that you support a party that you fundamentally do not agree with and whom we tend to be suspicious about in regard to their commitment to actually stopping the evil of abortion — and I’m not saying the Democrats are the solution. I’m not trying to draw failure of one side to excuse the other. I am merely saying, these concerns — valid or not — usually are dismissed or there is a legitimate sentiment that right-leaning Catholics either totally reject such considerations or really don’t care. Whether that’s true or not is one thing, but it can seem that way. I repeat: it can seem that way. I’m not sure.

    But to the plight of an orthodox pro-life Catholic Democrat, I am very sympathetic. Obviously, I am one. I did not vote for Obama, but if he were pro-life, I probably would have campaigned for him.

  • If Obama were pro-life (and I mean TRULY pro-life, not Harry Reid “pro-life”), I would probably vote for him, just to reward the Democrats for nominating a pro-lifer.

    If the Democrats ever wised up to the fact that being pro-life was actually a political benefit to them, then we could really do something to end abortion in this country, and Democrats would likely become a permanent majority.

  • Eric,

    I know you personally so don’t worry, your intentions are pure and I need someone like you (I have many) to help keep me on the straight and narrow.

    Your comments and critiques of me are appreciated and spiritually humbling.

    🙂

    …and yes, it does go both ways, though for the moment, in my humble opinion, the GOP, conservatives, independents, and moderates are getting more of it than the liberals and democrats.

    In Jesus, Mary, & Joseph,

    Tito

  • Obama spent a rather long time last night composing what I believe will be remembered as the epitaph for ObamaCare. I have never seen a more inept performance by a President addressing a joint session of Congress. He is approaching lame duck status in his first year in office with his party in overwhelming control in both chambers of Congress. In the teeth of an economic and fiscal crisis of vast proportions there is effectively no one directing the ship of state. God help us.

  • Picking up my mother from her weekly Adoration, I noticed some flyers saying that this health care would include abortion….

    Which it didn’t then and won’t now.

    With respect, Mr. Murray, that’s simply not true. It did, and it does, as Michigan Representative (and Democrat) Bart Stupak recognizes.

    http://www.time.com/time/printout/0,8816,1918261,00.html

    But you are absolutely right that health care is a human right, and you should have coverage. I just wish the pro-abortion pols would stop jeopardizing the possibility of health care reform with their games.

  • I think there are flaws in Obama’s proposal, I would prefer that any public option only be state- or region-level co-ops, and I’m sceptical of its ability to control healthcare costs as long as most healthcare is fee-for-service. But overall, I think it has a lot of good in it. I wish some pro-life Republicans like Chris Smith would tell Obama that they’d vote for it if it includes the Stupak amendment. With around 20 pro-life Republicans in the house supporting it and the 20 Dems who wrote the letter on abortion and healthcare, that would be enough to pass it and give it some bipartisan credentials, which Obama wants, and it would protect life.

  • You’re right about that, Zak. If the Dem leadership would be willing to maintain the status quo of no federal funding for abortion by including the Stupak amendment, then health care reform would pass with bipartisan support and the blessing of the USCCB.

    I think it telling, however, that the administration that promised to find “common ground” on abortion is not even willing to maintain the Hyde Amendment status quo, despite its being the overwhelming majority view of the American people that tax dollars should not pay for abortions.

  • I think Zak is in the ballpark with the co-ops, but as a Catholic I would rather forget the state/regional level (implies government run) and take it a step further and suggest the the Catholic Church take the lead and reclaim the moral high ground by establish CATHOLIC Co-ops at the diocesan/parish level.

    There are the beginnings of such a move in the diocese of San Antonio TX by the Catholic Medical Association – see:

    http://www.cathmed.org/issues_resources/blog/new_guild_in_san_antonio_forming/

    Imagine a network of Catholic medical clinics around the country (and world) like the Tepeyac Family Center

    http://www.tepeyacfamilycenter.com/

    and Divine Mercy Pharmacy

    http://www.dmcpharm.com/

    Also – Catholic hospitals (like many colleges) need to reclaim their Catholic identity.

  • JB, I like that idea.

  • What these folks who keep talking about a consistent ethic of life don’t seem to get is this very simple concept:

    A consistent ethic of life begins with life.

  • Jb,

    a step further and suggest the the Catholic Church take the lead and reclaim the moral high ground by establish CATHOLIC Co-ops at the diocesan/parish level.

    A fantastic idea. Unfortunately the current regulatory environment (ie. massive government intrusion) makes such an idea very difficult to implement.

  • Matt,
    I don’t know if it would be hard for a diocese to set up a healthcare coop that Catholics could buy into except for government demands to cover certain things. The trouble I see is when the co-op refusedto pay for contraception and gets in trouble with the government like Belmont Abbey College. One fears the government might also eventually mandate that insurance plans participating in its exchanges cover abortion too.

  • Zak,

    agreed, but there’s a lot of other issues in the state level regulations as well regarding non-discrimination and covered procedures, etc.

  • Matt – what came to me as I read your response is to reaffirm what I said about reclaiming the high ground.

    The battle cry of the feminist movement all these years has essentially been “this is MY body” – (sounds vaguely familiar), The regulations (and health care “reform”) have been a steady march towards telling people of faith that “your body has to follow our rules” regarding contraception and abortion – especially when we’re paying the bills.

    Their “solutions” to every problem is always more and more of the same thing that got us into the problem in the first place, and things continue to get worse. It’s like a person that beats their head against the wall every day because it feels so good when they stop.

    I believe that places like the Teyeyac Family Clinic and DM Pharmacy were raised up by God to say to the world “we’re getting off this merry go round”, and the result speak for themselves.

    Many of the Dr’s across the nation that have stopped prescribing contraceptives and referring / performing for abortion have initially seen their practices suffer – only to come roaring back stronger than before.

    To me – the logical place to put these kinds of places is where the people are – in the diocese. That’s how the non-profit Catholic Hospitals got their start – we need to get back to our roots.

    God will do the work if he can just find a “few good men (and women)” to enlist. Now is the time to be bold – not timid. Remember the walls of Jericho !

  • Jay,

    I’m not sure if the absence of abortion would win the bill any new votes. As far as I can tell, people object for various other reasons. But you might be quite right.

    In regard to insurance, I’ve always thought the Knights of Columbus should offer health insurance. I think Catholics would buy it in swarms.

  • In regard to insurance, I’ve always thought the Knights of Columbus should offer health insurance. I think Catholics would buy it in swarms.

    Amen, brother knight.

    Though at this point they are probably effectively barred from it by the fact that you can’t offer health insurance across state lines. If that were removed, and voluntary associations could form pools in the same way as employers, I would think we could see a huge amount of positive change right there.

  • Eric, Darwin… I agree, the KofC seems like an excellent means of offering health insurance. As Darwin aptly noted, they are prevented from doing so by the regulations preventing insurance across state lines. Additionally, removing health insurance coverage as an employment benefit would serve to assist in this endeavor. Voluntary associations with interstate portability… sounds like a winner to me.

How to Get There from Here

Tuesday, July 28, AD 2009

There’s been much discussion of late about what other country’s health care apparatus the US should consider emulating, and in such discussions France is often mentioned. Now, all cheerful ribbing against the French aside, their health care system is not nearly as “socialized” or nearly as afflicted by treatment denials and waiting lists as those of the UK or Canada. It is also rather more like the system that the US already has, in that it is a hybrid public/private system, though in their case there is a guaranteed base level of coverage everyone has through the government (funded via a hefty payroll tax — not unlike Medicare) which most people supplement with private coverage. Most doctors are in private practice, and 25% do not even accept the public plan, just as some practices in the US do not accept Medicare. However, everyone does have that minimum level of coverage, and the French spend a lower percentage of their GDP on health care than the US (11% versus 16%) which when you take into account that France’s GDP per capita is a good deal smaller than that of the US (which is the polite, economist way of saying it’s a poorer country) works out to the US spending about twice as many dollars per person on health care, while still not having universal coverage.

So what are we waiting for? Why don’t we go enact the French system here right now? Why doesn’t Obama put on a jaunty beret, dangle a cigarette coolly from the corner of his mouth, hoist a glass of wine, and just say, “Oui, nous pouvons.”

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9 Responses to How to Get There from Here

  • Well done Darwin,

    Many factors in health care. One is physician salaries as pointed out in other posts. Many factors in physican salaries as you point out including the high cost of medical school and indirect malpractice costs. If those aren’t addressed while cutting physician salaries, problems will most certainly follow.

  • Dear God… someone finally stopped talking about British and Canadian health care and realized that are quite a number of schemes to reach universal coverage and single-payer systems aside (I don’t feel like having that go-round), France is a pretty good model.

    Moreover, I think if we attacked education (costs) and provided greater assistance to medical students (not just with public funds), we could slightly lessen doctor salaries — as health care costs go down and depending on their specialty.

  • And by ‘lessen’ I don’t mean put caps on it via legislation.

  • Related to this but in a more general sense: I think that dealing with a situation like this (in which it becomes necessary to drive a group of people’s income down for the common good) the impersonal nature of markets is generally more socially acceptable than government action. I don’t think anyone would tolerate reducing doctor pay 30-40% by fiat, even when they generally make a lot of money. But creating the conditions for it to gradually reduce due to market pressure doesn’t have the same antagonistic edge.

    Just had to get the market plug in. 🙂

  • 30 – 40% again seems not to take into account malpractice costs let alone medical school. Maybe your figures take into account malpractice costs. But if not, using your figures, a specialist in the US averages 230k vs 149k in France. Subtract the average 55k for malpractice and you get a difference of 175 vs 149. Excluding medical school costs you’re now talking about a 14% difference, not 30 – 40.

    What’s the average malpractic attorney’s pay?

  • Actually just Googled it. In 2006 it was 100k.

  • I guess, I’m not sure how stuff like malpractice insurance is usually accounted for. Do doctors always have to pay it out of pocket (thus out of their personal pay) or is it often payed by their practice as a business expense?

    Either way, significantly reducing the malpractice lottery would have a salient effect on health care prices — not just in allowing for health care providers to charge less, but also reducing the number of extra procedures which are done for tail covering purposes rather than medical effect.

  • Depends on the practice. Those that are stand alone pay out of their own pocket. Those in large practices or hospital based practices get it paid for. But that will be considered part of compensation and usually salaries are lower to reflect that. Either way, there is a cost to income from malpractice premiums.

  • The cost of malpractice insurance is inflated by insurance companies, just as insurance companies inflate the cost of medical insurance. But the big issue is that usa doctors and hospitals do not like to be held accountable for their bad medical practices and poor outcomes. Their private for profit medicine ranks 37th in outcomes compared to other countries, which rank muych better using national health programs. Malpractice costs would clearly go down if usa outcome rankings improved. The fact that france ranks number one, having the best outcomes, while paying their doctors much less, is all just a further indictment of our private medical system in the usa.