Saturday, August 22, 2009
Health care polling, part III (click here)
I've been gleaning my way through public opinion polling on the health care issue. Here are a few notable results from a SurveyUSA poll of 1,200 adults released on Thursday:
In any health care proposal, how important do you feel it is to give people a choice of both a public plan administered by the federal government and a private plan for their health insurance?
58% Extremely important
19% Quite important
7% Not that important
15% Not at all important
(Extremely + Quite = 77%)
Do you have a health plan, that is, are you covered by a private health insurance plan or by a government program such as Medicare, Medicaid, or Tricare?
85% Yes
13% No
Public Policy Polling, August 14-17 (.pdf) 909 adults
Do you think the government should stay out of Medicare?
39% -- Yes (45% of those older than 65; 59% of self identified conservatives and 62% of McCain voters and self-identified Republicans)
46% -- No
15% -- Not Sure
I think I left off with 'the reading of the tenative House Bill' somewhere around page 195 or something like that.
Page 194, line 10 begins to explain the 'extent' IRS information can be allowed TO the "Health Choices Commission" in order to carry out subsidies. In other words if one is receiving a subsidy to help pay for their health insurance the Health Choices Commission has a right to know some information to validate appropriate measures for such subsidies.
I believe what this section of the bill DEFINES from Page 194, line 10 through Page 197, line 6 is the LIMIT of access the Health Choices Commission has to 'invasion of privacy' quite frankly. It sums it up well by quoting Page 196, lines 3 through 15.
‘‘(B) RESTRICTION ON USE OF DISCLOSED INFORMATION.—Return information disclosed under subparagraph (A) may be used by officers and employees of the Health Choices Administration or such State-based health insurance exchange, as the case may be, only for the
purposes of, and to the extent necessary in, establishing and verifying the appropriate amount of any affordability credit described in subtitle C of title II of the America’s Affordable Health Choices Act of 2009 and providing for the repayment of any such credit which was in excess of such appropriate amount.’’.
This provision of the bill sets 'limits' on government access to IRS return forms. I think the way this will work is simple. If a taxpayer is getting a health care subsidy, the list of these folks are sent to the IRS and in return there is information returned to the commission to validate the degree of the subsidy. This provision limits, and EXTREMELY limits the degree the Health Commission can have access to private information. The commission is NOT given blanket authority to rummage through IRS information for anyone for any year. End of that myth.
Page 197, beginning with line 7 discusses the 'excise tax' on high earning individuals. It discusses the 'changes' in the IRS code that would enforce such tax.
Subtitle D—Other Revenue Provisions
PART 1—GENERAL PROVISIONS
SEC. 441. SURCHARGE ON HIGH INCOME INDIVIDUALS.
(a) IN GENERAL.—Part VIII of subchapter A of chapter 1 of the Internal Revenue Code of 1986, as added by this title, is amended by adding at the end the following new subpart:
‘Subpart B—Surcharge on High Income Individuals
‘‘Sec. 59C. Surcharge on high income individuals.
‘‘SEC. 59C. SURCHARGE ON HIGH INCOME INDIVIDUALS.
‘‘(a) GENERAL RULE.—In the case of a taxpayer other than a corporation, there is hereby imposed (in addition to any other tax imposed by this subtitle) a tax equal to—‘‘(1) 1 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $350,000 but does not exceed $500,000,
and on Page 198, line 1 through 6:
‘‘(2) 1.5 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $500,000 but does not exceed $1,000,000, and ‘‘(3) 5.4 percent of so much of the modified adjusted gross income of the taxpayer as exceeds $1,000,000.
Hm. I would say, it would be in the best interest of the people of the USA to reclaim their economic strength as soon as possible to 'faciliate' the growth of millionaires. Wouldn't you say? Yep. This is the excise tax that will assist in the funding of the new laws governing health insurance. There isn't much sense to 'making law' if there is no enforcement and people are allowed to 'break the laws.' Now is there? So, what will occur with these excise taxes, I am assuming, is some beefing up of the personnel at the IRS to 'begin AGAIN' to chase down those that don't like to pay taxes regardless of their ability. Yep.
The bill goes on to discuss Separate Returns and any confusion of 50%, etc. But this is exceptionally interesting and why everyone in the USA should be interested in being millionaires that assist SAVINGS in health care reform. Page 198, line 21 through Page 199, line 19.
Now when reading these first few lines and one might one of the folks considered to be a high income individual, it really wants to make anyone's hair stand on end. Because, beginning with any year after 2012 the excise tax will go up. EXCEPT. And pay attention to the EXCEPTION. If there is Health Reform SAVINGS.
‘‘(c) ADJUSTMENTS BASED ON FEDERAL HEALTH REFORM SAVINGS.—
‘‘(1) IN GENERAL.—Except as provided in paragraph (2), in the case of any taxable year beginning after December 31, 2012, subsection (a) shall be applied—
‘‘(A) by substituting ‘2 percent’ for ‘1 percent’, and ‘‘(B) by substituting ‘3 percent’ for ‘1.5 percent’.
‘‘(2) ADJUSTMENTS BASED ON EXCESS FEDERAL HEALTH REFORM SAVINGS.—
‘‘(A) EXCEPTION IF FEDERAL HEALTH REFORM SAVINGS SIGNIFICANTLY EXCEEDS BASEAMOUNT.—If the excess Federal health reform savings is more than $150,000,000,000 but not more than $175,000,000,000, paragraph (1) shall not apply.
‘‘(B) FURTHER ADJUSTMENT FOR ADDITIONAL FEDERAL HEALTH REFORM SAVINGS.—If the excess Federal health reform savings is more than $175,000,000,000, paragraphs (1) and (2) of subsection (a) (and paragraph (1) of this subsection) shall not apply to any taxable year beginning after December 31, 2012.
Read that mess carefully now. Because what that says is if there is significant savings according to a 'scale' set by the House, there will be NO increases in the Excise Tax. Nice. Why? Because many of the people that are doctors and the like are people that have the opportunity to INCREASE the savings to Health Care Reform AND have the opportunity to fight fraud.
So, what seems like at least the first three years of the new law there will be a consistent excise tax required. However, in the fourth year and beyond if the cost of the new laws don't show HEALTH CARE SAVINGS there will be an increase in those folks that make between $350,000 and $1,000,000. That is interesting to me.
See. If I knew I had the knowledge to effect a SAVINGS in the health care industry, I would be out there pushing my expertise to every MD and health care person, including hospital administrators I could find. It would provide a 'profession' for people with such ability and knowledge, produce new millionaires or better said, "high income individuals." It would provide incredibly 'smart' incentives to those folks for providing such a service AND it would stimulate other folks to FIND health insurance fraud. I would think every administrator that has incomes over $350,000 would institute measures within their health 'industry' organizations to weed out fraud and report it.
You know, these legislators ain't dumb folks. They know exactly what they are doing. I like it.
The bill goes on from here with more definitions regarding what a health care savings is and how it will be measured. They don't really use the word 'measured' so much as 'studied.' The figures will be studied to produce an understanding of actual Health Care Reform savings. I think the word study opens up possibilites to better define 'as time goes on' what is a savings. If there were iron clad rule making, it might leave out yet to be discovered savings. The beauty about American Health Care is that it is 'open ended.' There are always opportunities to 'practice' medicine with better outcomes depending on peer review and peer practice. So, what might occur after three years of the new law are burgeoning strategies to make Americans healthier and 'effect' savings. Those savings might be 'incremental' in the beginning but extend in 'actuality' over decades. So, by 'studying' the savings more weight can be made to new practices that have long term results, follow? Another good idea. It encourages all venues of change for the better, not just 'quickie' results. Excellant.
continued in entry below...
