Had A Thought About Health Care.

[demgurl]

I was driving home this afternoon and I was listening to NPR. They talked about the mayor of Detroit who was imposing a fat tax. All the fast food would now have an extra tax on it. Some thought it unfair but I think most people do not care one way or another. Do you know much this 5% sales tax will raise for Detroit? 17 million dollars a year!

Holy cow was my first thought. Then I realized that this money was just going to go back into the same old system and nothing substantial would be done with it. The mayor justified it saying that puts a tax on the system because these foods are bad for you. This is all good but how does that help offset the bad effects that fatter people cause to the system in general?

I guess my thought was someone could put themselves out there as a candidate for mayor and run on a platform of extra tax for alcohol, tobacco and fast food.

I do not think most of us would notice 5%. I bought a 12 pack of beer today and it was about $10. 5% added onto the $10 would only be $.50 extra. I would not even notice that.

Your platform would be that you are going to work out a system that would provide health care for everyone in that city. If you make, say, under $30,000 there could be a sliding scale to this. Then you could work out a system for anyone who makes over that amount. Perhaps it would even be something where it could be as cheap as $50 per person in a family.

It would effect so many aspects of that city. Employers, who already offered employees health care could now put that money toward more salary and even still offer health care. Employers who don't already offer health care might offer it (now that it would be affordable). There could even be some tax incentives for the businesses to do so.

It would certainly effect the economy since a lot more people would want to move to that city.

The paperwork for the entire city would be overwhelming and city government is NOT an insurance organization so perhaps it could be worked out so that the city hires doctors throughout the area on a full time basis. There could be certain doctors at hospitals as well as clinics. Heck, we already have some clinics set up for Medicare people anyway. There could be internships for clinics where college students could go to get credit but serve the city at the same time. There could be student loans and if you graduate with certain grades and serve the city for five years, the loans would be erased.

Imagine a whole city of people getting free/cheap health care. I am not an economist and maybe these are all just pipe dreams but this is truly something this country needs. If our government does not act on it then someone has to. There was a time when we took care of our own when the government did not. Imagine the publicity for such a city especially if we could enforce this is the democratic party's way of doing things. It could change so many things.

Anyway, putting out there to see what you all thought. Could something like this work? I guess it could since I am originally Canadian and it works up there. I am excited about this concept. What do you all think?

[Tandalayo_Scheisskopf]

1. 3rd Rail Politics.

Everyone wants something for nothing, while they get nothing for something.

You want health in the nation? Stop propping up corporations with no-tax policies and allowing them to skate on everything.

It's class warfare we are in. It's time we started fighting.

[mdhunter]

2. There's a problem with sin taxes

Well, at least one - and that is the perverse logic that you implement taxes on things you ultimately want to see people doing less of, but you become dependent on people continuing to do these things to bring in revenue. In the ultimate, you could be stuck needing to encourage more cigarette buying to keep the funding stream for your clinics up. This is especially true when the tax rate become punative and people actually begin altering their behavior.

In North Carolina, a state with a low cigarette tax (for obvious reason), there is zero political will to raise those taxes more than about 15% (and even this is a stretch). Why? Because people have done the calculus and have determined that is the point of equilibrium where no net tax revenue is lost. So you'll have fewer people smoking, due to the higher price, but everyone else pays a bit more, so it's the equillibrium point. A little higher and more people stop smoking than you make up for in everyone else's higher taxes. So while even jaded NC state legislators know that smoking less is desirable, depriving state government of money is even less so.

Anyway, there's an easier way to raise the money. Jack up the corporate rate by 5-8 points, tack an additional 2-3% on luxury goods, another 5-8% on gas and charge a sliding scale premium, exempting up to 200% FPL of $20 a month on every $10,000 of yearly income up to a limit of $400 a month.

That's my plan and I'm sticking to it.

[demgurl]

5. mdhunter.....

I agree that there is a problem with this but I think that it can be supplemented in other ways as well. I agree with taxes on corporations. I also thought of housing taxes, etc.....Plus it would also be supplemented by a certain amount being paid in each month by families.

I just think that if other countries make it work than a city could make it work. And just think of the effect it would have on insurance companies. If we could get this started in ten key cities, the insurance industry would really take a hit. They would feel the pressure and have to come down in their prices just to try and prevent it from spreading too far. It would have an amazing domino effect on health care costs across the country.

[noamnety]

3. Let me toss out some numbers for you

The proposal would raise $17,000,000 a year.

The United States spends an average of $5,000 per person per year on health care.

So using that number, $17,000,000 could provide total health care to 3,400 people.

Detroit has an estimated 16,000 homeless people.

[demgurl]

4. lefern....

Actually the proposal in Detroit will bring out the 17 million. Not sure what it would raise here. That proposal would not include the other sin taxes of alcohol and tobacco.

For a lot of lower income people, they are already getting free health care via Medicare.

The government has already set aside the money and has funds for them.

I just think the national government will never institute health care for one and all and since it will not start at the top, we need to put pressure on them by starting at the bottom and soon others will be crying out that if is works for one city it should work for all.

[noamnety]

7. My point

That 50 cents doesn't feel like much to you - because it isn't much. In terms of the city's budget, it's .0004% of the budget - even if you add an alcohol tax, it's a drop in the bucket.

We would get more bang for the buck if we controlled health care costs to begin with such as being able to negotiate for prescription drug costs or providing preventative care rather than this nonsense of hospitals only being required to treat you once you reach the point where your disease is urgently life threatening.

And insteaad of trying to fund health care bake sale style - 25 cents here, a dime there - with a regressive tax, we ought to be repealing the tax cuts for the rich.

I'm not sure what city you mean when you say "here" - I thought in your original post you were talking specifically about Detroit even though you were in Canada, so I guess I misunderstood you there.

[demgurl]

8. lwfern....

I grew up in Canada where this does work.

The story about Detroit inspired me to think about this.

I truly agree that we need to control all costs to begin with but it would seem that the lobbyists have this country out of control.

I totally agree about the tax cuts for the rich being repealed.

I guess I feel sort of helpless right now because of this deal with Andy. I grew up in a place where nobody went without health care. The longest line I ever waited in was 20 minutes in the E.R.

I am thinking big government won't handle this since they never have. So instead of implementing it from the top down, I thought perhaps it could be started at the bottom with one small city. If countries around the world can do it, why can't one city do it?

I am not sure how it would work and it is not exactly free since higher income would be donating so much each month. It could work something like this:

Up to $30,000 it is free.
$30,000 - $40,000 - $50/month per family member
$40,000 - $50,000 - $75/month per family member
$50,000 - $60,000 - $100/month per family member
$60,000 - $70,000 - $125/month per family member
$70,000 - $80,000 - $150/month per family member
$80,000 - $90,000 - $175/month per family member
$90,00 - $100,000 - $200/month per family member
$100,000 - $150,000 - $400/month per family member
$150,000 - $200,000 - $600/month per family member

It is almost like a wealthy health tax for the rich. That would be non-negotiable and could not be deducted like the rest of the tax money.

More than just free health care, it is making it affordable health care as well. A good percentage of the people below $30,000/year are on Medicaid anyway. I know we were when we were that low.

There could be some sort of a voucher system.

Or if an official were so motivated, they could just go to an insurance company and ask what kind of deal they could get for 30,000 people. They might have the power (with possible tax incentives even) to go ahead and offer a group plan to whoever wanted to participate in this.

I am just throwing out ideas. I am not a genius (obviously) and I am not an economist (as stated before). All I know is that other places make sure citizens have health care. I think someone needs to step up to the plate in a big way. A program like this would get lots of attention and would surely be noticed. It might actually reform our entire system.

Just throwing out ideas and I appreciate the feedback.

[Cleita]

6. This penalizes the poor many who can only afford

fast food. Many poor who are homeless, or live in a rented room and don't have anything to cook on have to rely on fast food to survive.

[demgurl]

9. Cleita....

I do understand some folks have to rely on this but perhaps we could teach them how to get along better without the fast food. For a family of four fast food would be a minimum of $13.

That same family could go to the grocery store and get bread, mayo, cheese and ham for less.

Here:
Bread : $.99 (possibly cheaper at outlets?)
Mayo : Small bottle $2
Cheese:(generic) $1.99
Ham (lunch meat) : $2.50
Soda (2 liter generic) : $1.50

You have a grand total of about $8 - $5 less than the McDonald's fast food AND you have leftovers! So another meal would be about another even $10 or so dollars and you just paid $8 for both. And the store food is much healthier. That family just gave themselves more money for their needs.

There is also the food bank and the soup kitchen that these people can rely on.

I am not heartless and I do wish everyone had food, health care and homes. I wish our government would get off their butts and stop lining their pockets.

[Cleita]

12. But they don't.

Many of those with marginal housing, and quite a number of the homeless, have jobs and have to rely on the fast food outlets to eat their breakfast and lunch. Their jobs most likely are not close to food banks and soup kitchens.

Any of these consumer taxes, tax the poor more than the rich. No matter how noble your ideas are, the fact is you are putting an extra burden on the low wage earner.

Again you are blaming the victim. The people you should be after are the fast food outlets themselves and make them serve healthier food. There are other ways to cook a hamburger other than on a greasy grill.

[demgurl]

13. Cleita.....

I may be putting a bigger burden on the victim but please do not say I am blaming them. Most of the time being in dire straits is nobodies fault. At one point in time my husband lost his job through layoffs - no fault of his own. We were about to lose our house due to no money for mortgage payments except my husband got a job at the Th hour.

Where I lived in Canada there was no real homeless problem. I only saw one person in my entire life up there and that person may not have been homeless. He looked like it and went around sniffing glue all day but I am still not sure whether he had a home.

I am sure my plan would enrage some as it also puts 'taxes' (insurance premiums) on the very wealthy.

Taxes will be levied no matter what. The gas taxes will soon make a lot more people poor or homeless. Perhaps we need to find a new way to help our homeless. I am all for everyone being able to afford everything that counts as a necessity.

In Canada, my province also had the highest amount of unemployment. Families lived together in extended situations. It was quite common for three generations and perhaps four to live together. I remember one of my friends having to go next door to 'borrow' tea because they had no money for food and that would be their 'meal'. I got on the phone with American Express and ordered her a card and sent it up to her. I made sure she had food every single night.

We are part of I guess what you would call the low wage earners since we have not been able to afford insurance in over three years. We are just over that line where we can get help from the government but too little to earn the outrageous fees insurance companies ask.

The government is not going to ask the health insurance folks to back off - their palms are way too greased. People are not going to give away health care. Perhaps it works in Canada and other areas because they are not so disconnected and they can reply on each other.

Too many people are dying from not having insurance. And when the pResident is the one that passed a bill that if someone can't pay you can kick them out, it does not seem like there is much chance he will stick up for us.

Perhaps in tackling the insurance issue, we would also need to revamp the way we take care of our poor and homeless.
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I have always wondered about base closings. There are so many apartments on bases. It is a whole city into itself. I wish we could offer these up to homeless people and set them up somehow. Nearby towns could set up their soup kitchens there. People would have shelter and schools. We could set up transportation to and from the base for those that have none. I don't know, this is also a rough sort of idea but it is better than handing it over to people to build nuclear energy plants.

I see a need and I am just trying to craft all the ideas. The homeless are more susceptible to sickness and can not afford doctors. If they are homeless, they probably do not have Medicaid. They need this more than we do. And believe me, with all the pain I am in everyday, I really need it.

We could just raise taxes all the way around I guess. That and premiums would work.

Perhaps it could be something where taxes didn't need to be raised but that people in the city (clinics) were called on to put forth so many volunteer hours per clinic. Of course I am sure that would mean other peoples expenses would go up. It would be something where you get free/prorated health care.

If we, at DU, came up with a great group insurance plan that would be wonderful for us but it does not address all the people it does not take care of.

I am not sure how we could make this work without taxes. Canada does it through taxes. Is there any country that does not do it through taxes? How do they make it work? I am really trying to feel my way through this. Thanks for all input and suggestions.

[Telly Savalas]

10. The problem with instituting such a program at a municipal level...

is that it's easy to move in and out of the city. Any social program will have people that pay into it more than they benefit and vice versa. So rich people who would pay more heavily into the program would be apt to move to Auburn Hills or wherever, and on the flip side poorer folks from the burbs would be encouraged to move into the city to reap the rewards of the program. Hence over the long-term such a program would be unsustainable. (As opposed to Canada, where the Bay Street bigwigs have little choice other than to stay in the country and meet their financial responsibilities, and the border makes it unfeasible for Americans to flood the country seeking cheap health care.)

Furthermore, any form of a sales tax is regressive. Marginal propensity to consume goes down as income goes up, hence rich people pay a smaller percentage of their income in a sales tax than do poor people. In particular, a "sin tax" on fast food would be extremely unjust because one of its biggest targets would be the homeless. It's not like you can smooth it out by putting something on the 1040 form to reimburse those below the poverty line, because homeless people in general don't file.

Not to mention the pointed raised by another poster on this thread that slapping a tax on beer, smokes, and Big Macs simply won't raise enough revenue to pay for universal health care.

Sorry to be a Negative Nelly, but we need to think big on the issue of health care. I firmly believe that a national single-payer system should be the flagship issue of the Democratic Party. We can pay for the thing by restoring a progressive income tax structure like that of the Eisenhower era, closing loopholes in the tax code, and eliminating corporate welfare. This issue gets at the heart of the difference between the "Me first, fuck everybody else" philosophy of the GOP and the "we're in this together" philosophy of our party. If we can sell our vision of the nation to the electorate, then support for universal health care will naturally follow.

[area51]

11. single-payer healthcare

If I understand correctly, we are already paying enough in taxes to have single-payer healthcare; the money's being stolen by govt. & given to the military budget. There's no need to add an extra tax.

[demgurl]

14. area 51.....

So how do we address this? What can we personally do to get the government to give back the money to the people?

I have told my husband time and time again that I am amazed no one is shouting about the SS 'crisis'. I have not heard a single person bring up the fact that we might not have a crisis if all of the freakin' money was there. When you take money from a person and say it is for one thing and then use it up on something else, that is fraud. They need to pay back all of our money. But that is SS and not what we are talking about here.

Perhaps what we really need to do is the same thing repugs did. Sneak people in that have hidden agendas. Get them in at the lower levels and have them work their way up. In about 10-15 years these operatives will be in the higher ranks of government and we can start doing good for the country again.