(no subject)

[ksmith]

One aspect of John McCain's platform that hasn't received much attention is his plan to tax employer-paid health benefits as income. Bob Herbert talks about it in his NYT column today. All taxpayers would receive a refundable tax credit to help them pay for coverage. I do recall reading a couple of years ago that one reason Toyota chose to build a plant in Canada rather than in the US was because they didn't have to worry about health care coverage for Canadian workers--it did save them a significant amount of money. But. Canadian workers have a fallback, a healthcare system that, while it may have its faults, covers everyone. McCain's plan would leave the current for-profit system in place. I can't help but think that a substantial number of folks are going to be cast adrift.

Comments

[sci-o-biscuits.livejournal.com]

I, for one, will be hurt by further tax (or gas/utilities/food/etc) hikes, along with my son. I went without health insurance for years. I've been lucky to have coverage during the past two years, and if they start taxing it...this will bite into what little we have left to cover expenses.

[kristine-smith.livejournal.com]

I would wonder if--don't laugh--employers would pass along to employees at least a portion of the money that they would have paid in premiums. That money is already counted as part of a compensation package.

[sci-o-biscuits.livejournal.com]

Employers offering to do something for employees without being coerced...oh my.

YARRRRRRRRRR

(there's go the laughter, I just couldn't hold it in!)

(and no, I don't REALLY laugh by shrieking YARRRRRRRRR)

[touchstone.livejournal.com]

Actually, I've heard plans like this suggested by progressives, also, under the theory that taxing the health benefits of those who receive them but giving the tax credit to EVERYONE has the net effect of transferring money from those with insurance to those without - and many of those who are without are in low-paying, hourly-wage jobs that don't offer good health options in the first place. So it arguably benefits low-income households. The real kicker is the tax credit. If it's not big enough, or if it fails to come through, it's pain all across the board.

As a side issue, I think it would be a good thing if those of us who were getting employer-supported insurance were SEEING how much it costs. When it's being paid for us out of sight, we don't have as good an understanding of how much health care really costs. Driving home the facts in that regard might inspire more people to see it as a problem (and give people a better understanding of what the folks without employer-supported insurance are facing). Mind you, making the dollar value of those benefits visible doesn't have to involve taxing them :)

I agree with the op-ed that this is something that should be getting more visibility and discussion, but I'm not sure I agree with the analysis of the consequences. I think I'd like to hear commentary from several different sources before I decide.

[kristine-smith.livejournal.com]

True--it's hard to know what the real ramifications will be. Who foresaw the current Wall Street fallout when they changed the rules back in 1999?

The 800-lb gorilla in this room is the *true* cost of services and care. Supposedly the amount that insurance companies pay is bargained down, with the uninsured getting billed for the true cost of services. But is it the true cost, or the true cost plus whatever they can shift over from the bargained down rate? How much does a appendectomy really cost? A blood panel? Diabetes test strips?

[touchstone.livejournal.com]

*nod* And even once you know what that expense is, WHY does it cost that?

There are some serious systemic, economic problems in the way we deliver health care (even setting aside insurance and how patients manage to pay for their care). How can we structure things so that doctors don't have to pay such a vast amount for malpractice insurance to protect against baseless lawsuits, while still making it easy for people to get redress for wrongs in cases of real malpractice? What about medical school costs that leave new doctors scrabbling for the highest-paid jobs they can find so they can keep up with their loans? How can we correct the economics of pharmaceutical production so that people can afford the drugs they need, but we don't discourage investment in new research? How are we going to deal with the increasingly-severe shortage of trained nurses?

If some of those problems were fixed, would it give us a bit more slack to work with in untying the insurance knot? I don't know. Maybe.

[mcurry.livejournal.com]

McCain's plan would leave the current for-profit system in place. I can't help but think that a substantial number of folks are going to be cast adrift.

It almost certainly will. They just don't actually care. If the magical market fairy says a person can't afford health care, well, too bad, but the magical market fairy is never wrong, right? It's pretty sickening.

Oh, and more analysis of McCain's plan is here: http://www.prospect.org/csnc/blogs/ezraklein_archive?month=09&year=2008&base_name=mccains_health_care_plan_a_ful#109189 (http://www.prospect.org/csnc/blogs/ezraklein_archive?month=09&year=2008&base_name=mccains_health_care_plan_a_ful#109189). Scary stuff.

[touchstone.livejournal.com]

There's some good detail in there. Thank you!

[mithriltabby]

Ezra Klein: “What’s the difference between a hockey mom under an Obama presidency and a hockey mom under a McCain presidency? Under a McCain presidency, there won’t be hockey moms, because they can’t afford to let their kids get hurt in a contact sport.”

The Wonk Room notes that the rising cost of health care will rapidly outstrip McCain’s tax credit.

[jemck.livejournal.com]

I recall reading an analysis of the economic woes of both Ford and General Motors a while back*, explaining how healthcare costs for their US employees and retirees was pretty much what's been putting them in the red.

Hence cutbacks to their manufacturing and design capacity in the US rather than here in UK/Europe where we have state healthcare - of various kinds depending where you live, obviously.

* husband works in car manufacturing here in the UK, so such things catch my eye.

[kristine-smith.livejournal.com]

Eliminating employer-provided health insurance may lead to greater profitability for corporations and allow more of them to keep jobs here in the States. But tossing folks into the free market maw to find individual coverage just isn't sound, humane, or, in the end, cost-effective.

The whole system really needs to be dismantled from the bottom up. But the whole 'actual costs' part is never adequately addressed, because that's where the profit comes from.

[jemck.livejournal.com]

Absolutely. I agree, insofar as I understand the US healthcare system from over here in the UK - that's to say, mostly from watching ER and some of the Morgan Spurlock documentaries. So, imperfectly at best.

Also, over the years, I've had a few conversations with pals who've been offered jobs in the US by whatever industry they were working for. The possibility of husband applying for a US job came up once. In every case but one, the issue of healthcare has been the deal breaker, whether that's involved employee benefits or taking out private insurance.

The exception being a young couple with no children, and no plans to have any, and he went to work in the international banking sector in New York. Needless to say, I'm awaiting an update there!