U.S. Politics: The Bipartisan Dismemberment of the VA

[all swedes are racist]

7 hours ago, DireWolfSpirit said:

I think a high percentage of U.S. workers are in denial over the amount they are paying for the healthcare they are getting. Disdain for taxes is regularly complained about, but for some odd reason among a lot of workers they are less outraged over this burdensome amount of pay they never see because its dedicated to healthcare in the compensation package. Ive spoke with numerous workers in the past who arent even aware of how much of their total compensation package is dedicated to healthcare coverage. They dont even realize what they never see. To them its a hidden cost, I think this goes a long ways towards explainng why the outrage is not as great as you hear over taxes, they see those numbers on their paystubs more regularly, its more transparent. 

I think the countries problems from exhorbitant healthcare costs are as great or greater than our issue of over taxation. Its like invisible straws breaking the collective camel herd. And I still maintain your average worker under estimates the diverted amount of his/her compensation that goes for that exhorbitantly expensive healthcare coverage.

Huh? What are you talking about? Pretty sure most pay stubs have a pretty clear, itemized list of deductions. 

[lokisnow]

I have never had a paycheck detail employer contributions to healthcare. Or employer contributions to withholding taxes (social security, Medicare, medicaid, disability).

The only itemized list I see are the contributions I make to the aforementioned as an employee.

Because of this 90%+ of employees are unaware the employer pays even a penny not detailed on their paycheck.

So if an employee is contributing $80 pre tax to health insurance, they think that is the cost of their health insurance,  they have no idea the employer is paying an additional $400 on their behalf until they see a new and hortifying number on cobra. And many then believe cobra is just a way for the employer to screw them over more or exploit them more when they've been fired, a lot of employees still don't make the connection that cobra represents the cost of health insurance. 

 

[all swedes are racist]

Ah, getcha

[DireWolfSpirit]

@lokisnow and @The Great Unwashed 

That is exactly what I meant, thank you both for more clearly explaining it.

[lokisnow]

it wasn't until my mid to late twenties that I discovered there is an employer side contribution to withholding taxes. I was utterly incredulous that an employer had been paying additional money on my behalf into social security et al. 

I think I probably learned about it through this perpetual thread.

It wasn't until my early twenties when I quit my first (professional) job to take my second job that the HR person explained cobra to me and that my employer had been paying this very high amount in health insurance and I would have to pay that to continue my health insurance. I was apalled and again had no idea that they had been paying more than what I was paying.

And I'm pretty highly educated and fairly plugged into matters of social welfare policy, but these sorts of wonky details were never ones that even occurred to me as being possible, plausible or realistic. 

seriously, my employer is doing something to benefit me? that's absurd. they'd never do that, they're my adversary on all matters of compensation, right?

[James Arryn]

13 minutes ago, lokisnow said:

it wasn't until my mid to late twenties that I discovered there is an employer side contribution to withholding taxes. I was utterly incredulous that an employer had been paying additional money on my behalf into social security et al. 

I think I probably learned about it through this perpetual thread.

It wasn't until my early twenties when I quit my first (professional) job to take my second job that the HR person explained cobra to me and that my employer had been paying this very high amount in health insurance and I would have to pay that to continue my health insurance. I was apalled and again had no idea that they had been paying more than what I was paying.

And I'm pretty highly educated and fairly plugged into matters of social welfare policy, but these sorts of wonky details were never ones that even occurred to me as being possible, plausible or realistic. 

seriously, my employer is doing something to benefit me? that's absurd. they'd never do that, they're my adversary on all matters of compensation, right?

Of course the relationship is adversarial...do you suppose their contribution came about voluntarily? This is like crediting the police with your Miranda rights.

[Martell Spy]

There's a large tax break as well for the employer contribution.

[DireWolfSpirit]

Back to my point though, there are more than a few people that think the $40-50 a week they see being contributed, as the full expense of coverage that may cost closer to $400-500 a week. Many people would probably be thrilled with a raise of even a quarter of the cost of that healthcare coverage. The net effect of this extraordinary burden American workers are bearing, is that its a huge downward drag on wages. The overall cost of employees has steadily risen for a few decades, while the wages have lagged, because the healthcare costs of that employee has ballooned as a portion of the compensation pie. There's simply less left over to actually be dedicated towards the employees wage. 

We constantly hear about stagnant wages in the U.S. Yet rarely does the link get made or pointed out, that a prominent reason for slow wage growth is that healthcare costs are squeezing out wage growth. Its been a problem for twenty plus years and sometime it seems like people have their collective heads in the sands over the way they fail to focus on the real culprit on sluggish wages (its healthcare costs, not foreign competition). The high healthcare expenses enable all the foreign competition thats a vicious circle for American business and ultimately American wages. 

All our policy makers seem to do is gloss over or deflect the reality and fail to deliver any solutions to this year after year imo.

[ThinkerX]

Never had an employer health care plan.  Long succession of low hour/low pay jobs followed by entry into the wonderful world of a USPS contractor.

 

But from the previous posts, it seems like most of the posters here have been somewhat insulated from just how much the medical providers are screwing over everybody in the country.

 

Again, you want to make healthcare affordable, you attack the costs directly with draconian price controls.  Screwing around with insurance accomplishes little.

[Ormond]

17 hours ago, Triskan said:

@lokisnow  I had never had an employer do what my current one does, but they do show us how much they contribute to our healthcare. It's not on a paycheck, but there's like a portal that we can access with all kinds of info about insurance, retirement, etc...and they show it there.  My employer is a large entity, so maybe that's why they can pull this off, but I seriously pay like $20 a month for health insurance while my employer pays like $600 or $700.

Now the flip side to that I suppose is that maybe my salary is a bit lower since the healthcare benefit is so generous.  But it's hard not to see those numbers and not be appreciative. 

The university I work for sends out a paper notification in the mail once a year of what one's "total compensation" was for the previous year, which includes all of the employer's social security and health care costs. Though that doesn't insure that most people study that in detail or have any real understanding of what it means. 

[DireWolfSpirit]

I think since the ACA has passed theres now a box on your W-2 or W-4 that lists the value of your annual coverage which is a thing now because people are asked to declare they have coverage when having your taxes done. This must be part of the process to verify your not elgible for the penalties for not participating in U.S. healhcare either through your employer or the exchanges. I have actually had people ask me through out the year what that number represented, many not having a clue it was the total value/expense of the coverage they had.

So yes the information is disclosed, its just more of the head in the sand type attitude you see over it. These same people that were oblivious to having $15,000 - $20,000 in compensation diverted towards healthcare coverage are always acutely aware of the $12,000 - $20,000 they had diverted towards taxation. This has amazed me for years. 

I have come to the concluson over the years that many workers just associate this entire burden as taxes, they skip over much thought of where all that money goes( how the compensation pie is really divided) and just rely on the mantra of being/saying they are over taxed. Actually it's much worse than they imagined as some/more of them become aware of the cumulative amount of the compensation package diverted (taxes + HC coverage) away from wages. 

I have skipped any talk of pension/retirement plans because I think we could consider these deferred wages and most people have a rough idea what they have dedicated towards that. Wheras I still see this confusion from people over how great the actual HC coverage burden actually is. Which as another poster mentioned earlier, is even greater than that, when we consider the additional burden of taxation dedeicated towards medicaid/medicare/workmans comp, etc. at the end of the day these all are can be viewed as a diversion from wages that your typical worker could see as "take home pay".

Going off memory from a news headline Healthcare as a % of the GNP is now over 17%, oh here it is- 

US Health Care Costs Surge to 17 Percent of GDP | The Fiscal Times

The Fiscal Times › 2015/12/03 › Federal...

Dec 3, 2015 - While total U.S. spending on health care increased 5.3 percent last year – topping $3 trillion overall – health care funded by the federal government rose by 11.7 percent, to nearly $844 billion in 2014, compared to a 3.5 percent increase in 2013, according to an annual report on health care costs released Wednesday by ...

 

While our tax burden as a % of GDP looks to be around 24%- http://www.taxpolicycenter.org/briefing-book/how-do-us-taxes-compare-internationally

 

^^^ Due to those burdens, taken cumulatively, your average U.S. worker starts out with only 59 cents of each dollar left from which he/she must divide up their salary and retirement wages ( net and deferred ). Is it any wonder there's mass unrest over slow wage growth? Most of us are carrying around a massive 40% burden ( with very few prospects that this burden will be lessening in the near future, especially as the boomer demographic ages.)

 

So long story not so short, how many of us hear our policymakers offering plans and ideas on how to lessen these burdens on workers and employers? What would the net effect be if we could start each worker off with 70 cents of that dollar instead of 59 cents?

[BloodRider]

On 8/18/2016 at 1:07 PM, R'hllors Red Lobster said:

https://www.washingtonpost.com/news/post-nation/wp/2016/08/18/justice-department-says-it-will-end-use-of-private-prisons/

US Justice Dept says will end use of private prisons over the next five years. 

Thats... kind of a big deal. 

That is fantastic!

[Swordfish]

On 8/19/2016 at 5:48 PM, Martell Spy said:

 

No, it's not a complete fix, but is a fix. We likely need to expand the subsidies for low income people who don't qualify for Medicaid, for example. And the current problems with Obamacare in certain states have made a stronger argument for the public option. There are problems with certain state groups. The law is working great here in Washington state because we have a large and somewhat prosperous population. We have sick people here, they just get absorbed into the group. 

It's a bit like pre Obamacare for people that didn't have healthcare through a job or Medicare and Medicaid. Healthcare wasn't working well for those people. They were being left out of all the large groups with bargaining power. 

shifting these issues underneath the rug is exactly what the Republican party is doing. They refuse to offer a real plan with real numbers. They are refusing to govern.

 

Well... No.  The problem is cost.  Simply throwing more tax money at the problem does not resolve the issue of cost.

 

On 8/19/2016 at 7:29 PM, Triskan said:

 

I do wonder whenever there's a story about how ObamaCare is going what exactly the haters think they're winning, and this Aetna thing is a prime example of that.  If you're keeping a daily ledge on how the law is going I would agree that it's not "good" that Aetna is dropping out of a lot of markets (laying off the issue of to what extent it was a political rather than business decision).  But what do haters think is going to happen?  A cascade of every insurer dropping out and a future President signing a bill to repeal the law?  Seems extremely unlikely. 

People that hate on government health care hate on ObamaCare almost to a rule when in might just be their last, best chance to avoid government healthcare.  The world is a twisted place.

 

Fascinating to me is the part where pointing out any issues that are not gushingly positive about the ACA is interpreted by people who carry the water on this as 'hating'.

So...  Lot's of interesting, twisted things to think about when to comes to the ACA I guess?

I think the prospect of individual insurers continuing to drop out is not only real, but fairly likely.

Just as many people predicted years ago.

 

 

 

 

[White Walker Texas Ranger]

Is there a politically feasible way to cut costs? You can reduce the amount of healthcare people consume, but then you get into that whole "death panel" shitstorm, or you can reduce the amount that providers charge, but there are a whole lot of stable, good paying jobs in the healthcare industry.

[Jo498]

there obviously is a way to cut the healtcare cost to some extent because the US has the most expensive healthcare system in the world but it is not the healthiest country in the world by some stretch. But you are certainly right that with every other sector one should keep in mind that healtcare also provides decent jobs.

[ThinkerX]

5 hours ago, White Walker Texas Ranger said:

Is there a politically feasible way to cut costs? You can reduce the amount of healthcare people consume, but then you get into that whole "death panel" shitstorm, or you can reduce the amount that providers charge, but there are a whole lot of stable, good paying jobs in the healthcare industry.

Bit of a republican truism, but true all the same: fraud and unethical profiteering is rampant at all levels in the medical system.  Bring that under control, you could probably cut costs a fair bit without screwing folks out of their health care jobs.  However, more of a modest fix, and one certain to be fought tooth and nail by entrenched interests. 

 

Same also applies to the defense and intelligence industries - didn't I see an article or three lately mentioning TRILLIONS of missing dollars with zero idea where they went?  Hmmm...in this case, the POTUS, as chief executive and supreme bureaucrat, could probably order a major top to bottom audit and find out what happened. 

[aceluby]

7 hours ago, ThinkerX said:

Same also applies to the defense and intelligence industries - didn't I see an article or three lately mentioning TRILLIONS of missing dollars with zero idea where they went?  Hmmm...in this case, the POTUS, as chief executive and supreme bureaucrat, could probably order a major top to bottom audit and find out what happened. 

Audit will never happen.  Covert operations aren't line items in a budget, nor would we necessarily want them to be.  To think they don't know where this money went is naive.  They know, they just don't want to say where.

[White Walker Texas Ranger]

There are not literally trillions of dollars missing. There are accounting errors and cover ups that add up to trillions of dollars. If a supply clerk fudges a number by $5, and then somewhere up the line, someone else has to fudge numbers by $5 again to make up for it , then that's $10 in errors and fudging.

It's still really bad, but it adds up to 'only' tens of billions in missing money, not trillions.

[Swordfish]

15 hours ago, White Walker Texas Ranger said:

Is there a politically feasible way to cut costs? You can reduce the amount of healthcare people consume, but then you get into that whole "death panel" shitstorm, or you can reduce the amount that providers charge, but there are a whole lot of stable, good paying jobs in the healthcare industry.

 

There isn't.  People are always going to demand their obama phones, and the politicians are always going to trade them for votes.

That's been one of the main criticisms of Obamacare (and single payer) since forever,  because if you want to implement these programs, you HAVE to implement 'death panels' to control costs, which no one is going to be willing to do.

 

 

 

10 hours ago, ThinkerX said:

Bit of a republican truism, but true all the same: fraud and unethical profiteering is rampant at all levels in the medical system.  Bring that under control, you could probably cut costs a fair bit without screwing folks out of their health care jobs.  

Fairly certain this is patently false.  Please provide evidence of this.

[ThinkerX]

8 hours ago, Swordfish said:

Fairly certain this is patently false.  Please provide evidence of this.

 

We have had entire threads dedicated to this in years past.  Have you somehow forgotten?

For starters, pretty much the entire pharmaceutical industry.   Remember that greedy idiot who inflated the price of the one pill set by something like 700% last year?  Extreme example, but common throughout the industry.  And the boardroom types behind these pills have little or no regard for others.  I don't have television any more, but I do visit the folks place now and again where the channel is always set to Fox.     There, I pay as much attention to the commercials as I do the actual shows. 

 

So, every half hour there is a set of prescription drug adds - the ones that start off ' feel this? well you may suffer from such-and-such.  But don't worry, we have this wonderful new pill...and then zip to the end where there is a lightning quick spiel about possible side effects, often far worse than the supposed disease.   Next cycle, well there is a notification about pending class action lawsuits against the wonder pills from a couple years ago.  And it just continues. 

 

And no, I don't buy the 'research' excuse.  The 'research' is solely directed at profit, making each new wonder pill just a hair different from its predecessors.

 

That's pills.  The other thing is billing practices.  Don't you remember the big cost comparison studies?  Hospital 'A' charges $20,000 for a given procedure, while Hospital 'B' across town charges $2000, and Hospital 'C' three towns over charges $60,000.  Nor is this isolated.  It is across the board, all procedures.  And our insurance/Medicaid system is set up to encourage this sort of criminal behavior.  My view, knock those prices down to the low mark with draconian price controls.  If some complication warrants an increase, then they better be able to justify that as well.

 

Even hit me a few years ago.  Went to the emergency room for road rash after piling up but good on the bicycle.  They slapped a soft bandage on me, gave me some over the counter pills, and some cleanser.  When, the bill came, they tried to tell me that stuff - available for maybe $20 at the store - was worth well over $200.  That on top of the $2000 bill, though I saw a grand total of two doctors for all of ten minutes.  I took advantage of the poor persons discount and got that tab dropped 75%.  Other people here have very similar stories.