The Commonwealth Fund published this research paper called 'U.S. Health Care from a Global Perspective'. It makes you really, really think about what the U.S. spends vs what it actually gets on healthcare overall as a country. The numbers and findings are staggering to be honest. And pretty disheartening. A serious and fundamental change is desperately needed here.
They compare many key metrics to 13 other 'high-income' countries, being:
Australia, Canada, Denmark, France, Germany, Japan, Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom.
The most salient point made - The United States spends far and away the most on healthcare vs any of these countries. And their findings show that we get considerably less for spending by far the most, as a country.
Check out this graph of what countries spend on healthcare, as a % of their GDP:
And we don't even have universal healthcare, just a patchwork system of programs to help Americans get health insurance access and discounts and coverage and whatnot. So why do we continue to operate like this? If it's so obvious we are spending more and getting far less, why can't we have a serious conversation about universal healthcare, as other countries employing it are having better results across the board than us?
Check out that study and let me know what you think.
I just listened to Dan Carlin (podcaster/historian) talk about the nature of our healthcare system in the U.S. on his 'Common Sense' podcast. I highly recommend checking out his latest episode called 'Unhealthy Numbers'. You can download it free on his website, or listen for free on his podcast through iTunes or an Android podcast app.
Anyways, it makes me want a universal healthcare system in this country even more. We spend more than any other country on healthcare, yet we get far less in return. What in the world is going on here? I had a similar feeling after reading Steven Brill's 'Bitter Pill: Why Medical Bills Are Killing Us'. If you are more into reading than listening, that is the best piece I have found yet to explain why our system is so in dire need of fundamental change.
Didn't realize this, but different states have different filing dates for state taxes, as well as different dates when you file for an extension as well. That is, if you live in a state that requires you to pay states taxes. No need to worry if you live in Alaska, Florida, Nevada, New Hampshire, South Dakota, Tennessee, Texas, Washington and Wyoming.
For 2017, state filing breaks down like this:
State Tax Filing Deadlines - Due Dates for State Income Tax Returns and Tax Extensions
As for federal filing, it's not April 15th this year, it's April 18th. And if you are filing for an extension to pay, that date to pay will be October 16th, 2017. Just keep in mind you still have to file by 4/18, the extension just gives you more time to pay (if you happen to have a bill).
Called the 'American Health Care Act', some popular things remain, other don't. Here are some key points of the Republican's proposal to replace Obamacare that are being talking about most:
1) Individual mandates go away
2) You can stay on your parent's plan until 26 still
3) Medicaid expansion goes basically unchanged until beginning of 2020
4) Pre-existing conditions still cannot disqualify you from coverage
This proposal is the early stages. They still haven't done the official math to see how much it costs, and how many folks it will actually cover. It also includes stiffer penalties for lapses in coverage, and proposed a much different route of giving out tax credits for health insurance, over the current subsidy method -
What do you make of this proposal? Does it stand a chance of becoming law? Which parts do you think will be re-tooled before an official version makes it all the way to law is maybe a better question, as I doubt this first revision gets through completely untouched.. Trump has already said he is open to negotiation on the topic.
We do have an update on this. The 'American Health Care Act' has just been proposed; it's the GOP answer to what they will rpelace the ACA with. It proposes to leave the Medicaid expansion program for the most part as is, until the beginning of 2020. Per NPR:
Medicaid stays the same-ish until 2020. In the 32 states plus D.C. that expanded Medicaid under the Affordable Care Act, people who are eligible can continue to enroll until Jan. 1, 2020, under the Republican bill, if it becomes law. But that bill proposes to eventually switch Medicaid from being open-ended coverage to a per-person allotment for new enrollees.
Here's a truncated version of the address, via PBS. For those of us that aren't wanting to sit through 45 minutes of clapping.
RALFocus Wrote: The property tax deduction and the mortgage interest deduction have had an undetermined impact on the pricing of housing. The American home is now marketed as a dual purpose residence and tax shelter. One wonders if housing would be less expensive if the "tax shelter" component had never existed and by how much. 5%? 10%? $33 billion in tax savings by 35 million people means an average savings of less than $1,000. Given that rising house prices (along with rising student debt, medical coverage etc) are making it harder for young families to afford homes I doubt that our society has benefited from these tax deductions. I also doubt that the effect can be easily undone.
Good point. Tax breaks on taxable goods, property and services all face this issue. Haven't really thought to seriously about that, but I should going forward.
Makes a lot of sense that if whatever industry that has the consumer getting a tax break on their goods/services can then, at least in some cases, artificially inflate that market by slowly raising prices because of said tax break... damn. Obviously this is what happened in large part with student loans and healthcare. But I never really made the connection with other industries.
If I am understanding your point correctly, that is.
I'm no fan of block grants because they will almost certainly not be fully funded and that leaves the most vulnerable among us with very little options if they get sick.
To answer your question about what will happen - I continue to believe that nothing major is going to happen to Medicaid. It's too entrenched and Republicans in states whose populations rely disproportionately on Medicaid to receive healthcare will have a hard time voting to take away healthcare from their constituents unless they are prepared to commit political suicide.
I won't be surprised if some minor tweaks are made to the program to try to give the appearance that the Republicans are doing something with the program, but I would be pretty surprised if they are able to do wholesale changes to the program because it's just too politically toxic to take away peoples healthcare (as Republicans are currently finding out with the Obamacare repeal debate).
I think that sounds about right. I haven't read hardly any single Republican wanting to take Medicaid away altogether. Everyone seems on board to keep it, it's just a matter of deciding what's the best way to fund it.
Whether you fall on the left, right, middle or completely off the spectrum of politics altogether, the issue of properly funding Medicaid exists. And all 50 states along with the federal government need to continuously revamp, expand and amend the process to make sure it works.
Enter the Trump administration. Republicans have been saying for years that they are going to repeal and replace Obamacare. And now that they have the power to theoretically do so politically, Medicaid is also going to have to be dealt with.
So, how should the federal government approach the issue of funding Medicaid going forward? 46 governors and the Trump administration just recently sat down and talked about the country's future in regards to healthcare. And Medicaid is certainly a large portion of the concern here.
Seems Republicans are in favor of block grants to states, giving each state a set amount to fund Medicaid, and leaving the states to fund the rest of the program themselves. This seems good in some ways, and risky in others. The good being there will be less bureaucracy for the states to get approval on how they allocate funds, making states more nimble and able to implement programs (ideally) much more streamlined and efficient, catered directly to their own state's unique health care needs.
The bad of block grants is that states will have less funds earmarked specifically for Medicaid, leaving the door wide open for them to not allocate enough state funds into the Medicaid program to make up the difference sufficiently, and citizens will be left suffering and holding the bag (poor/partial coverage, exaggerated co-pays and other expenses that would've otherwise been handled by the program).
Per Capita Caps is another idea being suggested, for how the federal government will supply funds to the states. It's essentially the same idea as block grants, it's just that the $$ is generated from how many people in any given state are currently in need of the program. So the same idea, limited funds but less red tape.
I know little about the Democrats view on this subject, as I haven't felt the need as much to research it, as they are honestly not in power federally at the moment. So didn't seem as necessary to know. But I imagine many are for the federal government funding as much of Medicaid as possible, and making the process uniform and quality controlled across all 50 states.. is that about right?
What do you think the Trump administration will do with Medicaid expansion and proposed changes? Also, ideally what do you think the administration SHOULD do?
Loaded question, I think. Depends a lot on what they plan to replace the break with. If they just cut the tax break and did nothing else to the tax rules/code, then it would definitely hurt everyone. But if they raise some deductions here, cut some tax breaks there.. it will have to all be added up, and be different for everyone.