Government-provided catastrophic healthcare?

May 15, 2014 1:53:51 GMT pjohns1873 said:

Who gets to determine what constitutes a "reasonable" profit in a free society? (I really would not wish for you--or me--or President Obama, or anyone else, to make such a determination, and then impose it upon others.)

Also, it should probably be noted that many businesses are publicly traded.  If these businesses do not earn very large profits--profits exceeding Wall Street's expectations, even--the share price for these businesses will necessarily plunge, leaving both their officers and everyday shareholders to take a bath.

Is this really okay with you? 

Why does there have to be someone to delegated to determine what a reasonable profit is and impose it on others? Isn't the real question whether exploitation exists? We seem to be able to do that somewhat when it comes to "consumer protection" by prohibiting unfair business practices but incapable of doing it when it comes to "employee protection" very well when it comes to the cost of labor.

I can tell you that when I have to pay taxes so that the government can mitigate the effects of poverty where a person can't even afford to eat after working all week there is something wrong. I've tended to focus on taxation that reduces disposable income that can leave a person without enough money to buy food (or pay the rent or see a doctor) but there is unquestionable a problem that isn't being addressed.

Where does this idea come from that corporations must earn very large profits? The historical return on investment for the S&P 500 has been slightly more than 9% and I wouldn't call that a large profit. I've worked predominately for large aerospace corporations my entire life and they've typically targeted about 9% profit for the year and the actual profit has ranged from about 8% to 10% (they're pretty good at projecting profits). I've also worked for small companies where the owners based their business plan on a 33% profit margin but that also included their compensation as a "worker" of the enterprise.

The truth is that "investors" aren't predominately concerned with how much profit the corporation earns and pays out as dividends and/or re-invests in the corporation. They're concerned far more with how much profit they can gain from the sale of their stock to someone else and not to how much the corporation pays in dividends from profit. The "value of stock" is only indirectly related to the "enterprise" and it is the value of the stock that most investors are concerned with. Some stock investments are very profitable even though the corporation may never pay any dividends from profits.

We still return to the same problem when addressing healthcare for the people of the United States as there are fundamentally only three ways to address it.

The Individual Mandate.

The Employer Mandate.

The Government Mandate.

There isn't a "free lunch" so someone has to pay the costs and there are only three possible sources for paying the costs.

"Money" has value and it warrants a return and the return is relative to risk.

May 15, 2014 23:23:18 GMT pjohns1873 said:

Are you really suggesting that investors simply do not care whether a company makes marginal profits or very large profits; whether it beats the Street's expectations of falls short of these?

As concerning the "three possible sources" of healthcare insurance:  I simply do not believe that there should be any such thing as guaranteed healthcare insurance for any individual or family.  The longtime formula--with many people covered by employer-sponsored group insurance, others covered by privately purchased insurance, still others covered by either Medicare or Medicaid, and still others (unfortunately) declining to purchase any coverage--is a system that I would not wish to upend. 

I'm not "suggesting" but instead "stating" that most investors ultimately don't care about any specific reason so long as they profit from their stock ownership. The investors in a corporation that doesn't turn a dime of profit and doesn't even come close to meeting "market expectations" doesn't care one iota if the stock value doubles for some unknown reason and they sell at twice what they paid for the stock. What they investor predominately cares about is the "demand for the stock" that drives up the price of the stock regardless of the reason for the demand is. There are exceptions of course related to those that aren't interested in just "turning a profit" but instead are focused on the dividend payments but that is actually a small percentage of investors. Most care more about the trading value of the stock based upon the "demand" for the stock regardless of reason.

Your statement "still others (unfortunately) declining to purchase any coverage" is false. They're not "declining to purchase" but instead are "financially incapable of purchasing" health insurance.

May 16, 2014 23:23:39 GMT pjohns1873 said:

If a stock does not perform well enough to mollify professional investors--and especially if it underperforms the Street's expectations--these investors are very likely to sell that stock, en masse, and purchase others stocks instead. 

And I certainly do not see anything "false" (bold in original) as regarding my statement that some people have declined to purchase healthcare insurance.  Of those who are not covered by any sort of healthcare insurance (including Medicare and Medicaid), some, doubtless, are "financially incapable of purchasing" it (bold in original); whereas others have merely prioritized their spending in a way that has placed some non-essentials (including various gadgets and gizmos) ahead of healthcare insurance--which, admittedly, is not very glamorous, and is not much fun to have.    

Yes, there are those, predominately very wealthy individuals, that are stock speculators that buy and sell based upon short term market conditions. It can related to the annual report from a corporation but more often than not it really isn't. If it was related to the annual profit/loss statement these stocks would only be traded when the annual profit/loss statement comes out but that is not the case. It should also be noted that this has absolutely nothing to do with the "corporation" or jobs in America. These are "secondary financial transactions" that the corporation doesn't benefit from nor it is especially concerned with them. This relates to a few at the very top of the economic pyramid "playing the stock market" just like a high stakes gambler betting on the ponies.

Yes, there are a few individual that do have the income necessary to purchase health insurance and/or pay for medical services but they're a rather small percentage when we look at income percentiles and other information.

Based upon the 2010 statistics 50% of Americans have less than $33,000 in annual income and a substanial percentage of these are earning less than $25,000 per year and trying to raise a family. As I recall the average private insurance for a family was over $7,000/yr before "Obamacare" (and has gone up since then) and these families simply can't afford that expenditure. An individual policy ran about $5,000/yr. 

Even a "Top Income Earner" with $33,000/yr in income trying to raise a family of four would have a very difficult time being able to afford a $7,000/yr private insurance policy.

We have roughly 40 million Americans that are collecting SNAP benefits because they can't afford to feed their families and most of these are the working poor in America. We could probably double that 40 million to 80 million where the additional 40 million have enough income to eat (but not much more than that) and they couldn't afford private insurance but fortunately many have employer or government provided health insurance so they do have coverage.

The fact is that there are tens of millions of Americans that don't have insurance and simply can't afford it. This has nothing to do with having the income for frivolious expenditures but instead it's that they don't have the income, period.

Those are the Americans that Congress needs to address. Stop trying to pretend that they don't exist because they do exist and that problem must be addressed.

"Obamacare" addressed them but we do agree that it is a costly method that increases taxation as well as increasing the cost of the insurance. The flip side is that Republicans haven't offered any proposals that would provide for these Americans.

May 17, 2014 23:56:04 GMT pjohns1873 said:

I quite agree with your (apparent) disdain for high-powered stock speculators--I am a buy-and-hold kind of guy, myself--but it is not merely these people who are dumping stocks that underperform market expectations. If it were, the decrease in any stock's value would be insignificant. And that is simply not the case.

And I remain entirely unaware of anyone who might "pretend" that low-income Americans simply "don't exist." The real question is how many uninsured Americans really fall into this category, and how many would just prefer to spend their income in more glamorous (or, at least, more entertaining) ways than the purchase of healthcare insurance.   

When it comes to who holds investment assets I would suggest you read the following:

www2.ucsc.edu/whorulesamerica/power/wealth.html

You will find a table in there that shows the Top 1% own slightly more than 50% of all investments in the US while the bottom 90% only own 12% (predominately in 401K or IRA mutual funds that are long term investments).

There is a problem though and that is that we group everyone in the Top 1% together when, in fact, we need to address the Top 0.1% with over $1 million/yr in income that are the ones that really have the "money" and are the "investors" that effect the stock markets. The following article provides so valuable information on the Top of the Top 1%ers.

blogs.reuters.com/david-cay-johnston/2011/10/25/beyond-the-1-percent/

As for "how many" low income individuals actually exist that can't afford health insurance or health care services we know that it's at least all of those collecting SNAP benefits because, according to economists, they don't even have enough income for food much less health insurances. Since most SNAP recepients are "working Americans" and many that are just above the SNAP guidelines can barely afford to provide food we can roughly estimate the number to be somewhere between 40-80 million Americans. As noted some of those have employer provided health insurance but that is not all that many.

We can also refer to some of the information provided in the two links I provided because in the first I believe it establishes that the "adujusted "gross" income for 50% of American households in only about $15,000/yr and how many people can afford $4,000 for an individual insurance policy or aroung $8,000/yr for a family insurance policy when they only have $15.000 in gross disposable income?

It may not be something you choose to believe but the truth is that the studies all indicate that those that don't have insurance is overwhelmingly because they can't afford it and not because they're spending their money on something else. The belief that the poor have smart phones, Ipods, and drive Cadillacs is really a false stereotype. It's like the false stereotype of "welfare moms" sitting around the house all day pumping out more children to collect more welfare benefits or the flase stereotype that "immigrants" come to the US to have children and/or to collect welfare benefits.  

May 18, 2014 21:07:46 GMT pjohns1873 said:

Certainly, there are some who simply cannot afford healthcare insurance. I would never suggest otherwise.

But why would you suggest that it is just some "false stereotype" to assert that others--especially among "The Young Invincibles"--would rather spend their (somewhat limited) resources upon more enjoyable assets, rather than upon healthcare insurance? 

I don't claim that the "The Young Invincibles" don't exist and they do represent "irresponsible" individuals that place society at risk because they refuse to be personally responsible. What I do claim is that they are statistically irrelevant because they are an extremely small group in the statistical data.

We should also consider the fact that because "The Young Invincibles" do place the taxpayers at risk because we'd have to pick up the costs of health care for them if they do have a major illness then it provides an argument for the "individual mandate" that would force them to be financially responsible. They can afford the insurance so why should I be at risk financially as a taxpayer if they refuse to purchase the insurance?

May 19, 2014 17:46:59 GMT pjohns1873 said:

May 19, 2014 11:44:34 GMT ShivaTD said:

I don't claim that the "The Young Invincibles" don't exist and they do represent "irresponsible" individuals that place society at risk because they refuse to be personally responsible. What I do claim is that they are statistically irrelevant because they are an extremely small group in the statistical data.

We should also consider the fact that because "The Young Invincibles" do place the taxpayers at risk because we'd have to pick up the costs of health care for them if they do have a major illness then it provides an argument for the "individual mandate" that would force them to be financially responsible. They can afford the insurance so why should I be at risk financially as a taxpayer if they refuse to purchase the insurance?

I suppose we will just have to agree to disagree as regarding the plenitude of Young Invincibles.

As for you argument that their irresponsibility serves as an argument in favor of the individual mandate:  I believe that it serves, with far greater force, as an argument in favor of a single-payer system (UHC).  (No, I would not favor such a system; but it would be far less flawed than ObamaCare is, in my opinion.)

Considering that 1/2 of the US income earners have a total gross income of Less Than $33,000/yr and an adjusted gross income of around $15,000/yr it doesn't give them a lot of money to spend on anything.

There are a lot of people advocating the "single-payer system (UHC) and we must realize that is the only actual proposition on the table besides Obamacare. As you noted a single-payer system does have fewer flaws and like you I oppose it as well.

The fact that it is the only other "player" in the game scares me which is why I've consistantly hoped that Republicans would offer a proposal that will provide health care for the tens of millions that simply can't afford insurance. They wouldn't even accept the expansion of Medicaid that excludes any possibility of any of the "Young Invincibles" being covered.

I still believe that a well crafted "employer mandate" (e.g. provide insurance or contribute to a "private" fund that their employees can draw from to purchase insurance) would address virtually all working Americans and then cover working age unemployed Americans under Medicaid is the simpliest solution. 

As it is the Republicans have offered nothing except for those that can already afford to purchase insurance and that leaves tens of millions without health services provided for by insurance.  

Right now the only two players in the game are Obamacare and Single-Payer and that should worry us both.

May 20, 2014 15:48:50 GMT pjohns1873 said:

Your thinking, as regarding the need for some sort of UHC--however it might be funded--when listed as a categorical syllogism, appears to go something like this:

Major premise:  It is a moral imperative for government to do good things for the citizenry.

Minor premise:  Healthcare insurance for all would be a very good thing.

Conclusion:  It is a moral imperative for government to ensure that healthcare insurance for all is provided.

But I have a real problem with the major premise.

I believe, very strongly, in the words attributed (variously) to Thomas Jefferson or Henry David Thoreau:  "That government is best which governs least."

Or, to put it another way:  The very finest government ever created by humankind, in its very finest hour, was merely a necessary evil--it was preferably to anarchy, and the (inevitable) resultant chaos--but it was certainly nothing any more noble than that. 

You misinterprete my position and arguments. Let me try to clarify.

We cannot allow a person to go without necessary health care services and those services must be paid for. There are no "free lunches" where the health care services don't cost anything. When it comes to working Americans are three ways to fund these services.

1) The individual can pay for these services but that is dependent upon their income that for over 95% of Americans comes from employment. Basically the employer has to provide enough compensation to the worker so that worker can afford the health care services. If the worker does not receive enough compensation then they will have to rely on either 2 or 3 below in whole or in part.

2) The employer can pay for these services for their employees.  

3) The government can pay for these services but it must collect taxes from the "workers" that receive compensation from their employers or directly from the "employers" to fund the expenditure. 

When we follow the "money trail" it always takes us to the "employers" and the only issue is which employer is going to ultimately fund the costs. It can either be the "direct employer of the worker" or it can be the "employers of other workers that are taxed" but the funding always originates with the "employers" one way or the other.

In 2013 health care expenditures were roughly $3 trillion in the United States and that "bill" must be paid by someone and ultimately it takes us to the employers.

Personally I oppose wealth redistribution and when one employer doesn't provide for the basic needs of their workers, such as with health care, then somone else has to pay for the costs. That is "wealth redistribution" and the entity that ultimately benefits from the wealth redistribution is the "employer" of the worker that doesn't provide for the "necessary expenditures" of their workers.  

I oppose UHC (i.e. a single-payer system) because that is wealth redistribution and instead support an "employer mandate" that eliminates wealth redistribution to provide for the health care needs of the workers.