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Overlooked in the furor surrounding Paul Ryan's Medicare proposal — a plan that wouldn't start until 2023 and even then would affect only new beneficiaries — is a just-published study in the Journal of the American Medical Association (JAMA) suggesting that, well, Ryan might be right. The study finds that a voucher-type system might noticeably reduce costs compared with traditional fee-for-service Medicare.
Three Harvard economists, including a prominent fan of the Obama health care overhaul, did the study.
The study compared the costs of traditional Medicare with Medicare Advantage, a voucherlike program that now enrolls about 25% of beneficiaries. Medicare Advantage has cost less for identical coverage. From 2006 to 2009, the gap averaged 11% between traditional Medicare and voucher plans that, under the proposal by Ryan, would serve as a price benchmark.
The central issue here is whether the runaway cost of the health sector, comprising nearly one-fifth of the economy, can be controlled without eroding medical quality. Almost all agree that the delivery system — hospitals, clinics, doctors and nurses — should be reorganized to lower the price and eliminate unneeded care. The question is how.
One group favors marketlike mechanisms. Consumers would receive vouchers — payments or tax credits — to buy coverage. The theory: As people shop for low-cost and high-quality plans, competition forces the delivery system to restructure. Hospitals, doctors, insurers create more efficient networks with more coordinated care than today's fee-for-service system.
By contrast, fee-for-service reimburses doctors and hospitals for services they perform; this encourages unneeded tests and procedure...
...We obviously can't transplant Singapore's approach wholesale to the United States. But the reason we can't emulate even some of Singapore's success has to do with that iron law of health-care politics: Every dollar of health-care "waste" is somebody's dollar of income. As a stable advanced democracy, we're so overrun by groups with stakes in today's waste that real efficiency gains are perennially blocked.
Any hope for something better starts with tallying the price of today's paralysis. Think about that $2 trillion the next time you see states, citing budget woes, shut the door to college on tens of thousands of poor American students. Or when the next firm moves jobs overseas because health costs here are soaring. Or when the next bridge collapses. Thanks, Medical Industrial Complex!
We return now to our regularly scheduled political battle, which (no matter the outcome, according to some projections) will leave health costs headed to more than 20 percent of GDP by 2019.
That works all the way down the line.
Example:
I make more money than that homeless guy even if a greater % goes to taxes.. Oh noes, I can't buy the latest smartphone.
Sorry if you missed my pointYou might use a better example -- I think smartphones for the most part are made in China. But there are several domestically-produced items that would result in job losses domestically if enough people had to cut back on their purchases. That's fiscal policy in action -- tax cuts if possible for the people you need to SPEND. That's why the middle and lower brackets would keep their Bush tax cuts.
It's just Economics and Fiscal Policy. These are good things to look up in Wikipedia or elsewhere, if you aren't familiar with them. They are completely outside the realm of ideology, or at least they should be. Both Republicans and Democrats need to demonstrate the willingness to use the appropriate fiscal policy, regardless of the potential political fallout. Republican refuse to do what prudent fiscal policy would indicate, only to please big donors. That's irresponsible.
Sorry if you missed my point
No, I don't admit to it, and I don't think any of the other posters are guilty, either. Proof: we (civilly) refer to them by their actual names, and of course are only describing what they are actually voting for (and against) in Congress.
The proof is always in their voting records.![]()
Look, my point, which you are so painstakingly trying to avoid, is that one can vehemently disagree with what a politician does and believes, and not hate them. You no more hate Ryan than I hate Obama or Holder.
As for your claim of civility, I'm not even going near that one.
But I'm nice to YOU, aren't I?![]()
I'm completely ok with raising taxes on the rich but not until we get the 50% of Americans not paying taxes contributing as well.
There is no 50% of the population that doesn't pay taxes.
-Dan.
Just out of curiosity, if we were to raise the top income brackets taxes by 10% how much does the thread think the rest of societies taxes be raised?
I'm completely ok with raising taxes on the rich but not until we get the 50% of Americans not paying taxes contributing as well.
Your right, it's 46.4% according to the Tax Policy Center. I don't have the proper clearance to post a link but you can find it with Google. Also to be perfectly clear on what I'm saying I am talking about federal income tax.
Your right, it's 46.4% according to the Tax Policy Center. I don't have the proper clearance to post a link but you can find it with Google. Also to be perfectly clear on what I'm saying I am talking about federal income tax.
So, what I'm getting is that nobody can pay another dime in taxes except for the Top Quintile, whom according to the Tax Policy Center make an average of $251,746 a year and already pay 69.7% of federal income tax receipts.
If you look at the demographic makeup of the top quintile we aren't talking about a vast segment of society rolling around in Maybachs. We're talking about people who made their money from a variety of different ways, they are doctors, lawyers, entrepreneurs, and people in finance. Many of them hold advanced degrees and work just as harder, if not harder, than the rest of the population.
There is an admitted need on my part for the government to collect more tax revenue but demonizing the people who already pay a hefty share of the federal income tax isn't going to solve anything.
So, since the first question went over so well let's pose a hypothetical. How about instead of jacking up the taxes on the wealthy we take away the Top Quintiles Social Security benefits when they retire, setting up certain parameters of course (i.e. earning $251,746 in only one year wouldn't constitute being in the top quintile.) Would this be acceptable to people in favor of more taxes on the wealthy?
Seems you really did miss the pointThat's why Vylo said, "Yep." It really IS IT that you would have to cut back on your purchases. That's a big deal, because in the aggregate, that is how the economy would slow down, and unemployment would go up even higher. That's exactly how that happens.