Time for the Grown-Ups to discuss Healthcare Spending…
The basic question posed by the Wall Street Journal headline this morning is really “What’s a free lunch worth?”
They point to a Congressional Budget Office report: “CBO Sees 24 Million More Uninsured, $337 Billion Deficit Cut in Coming Decade With GOP Health Plan.”
Let’s do the math together, shall we?
Let’s take the savings ($337 B) and divided by the uninsured (24-million) see what the answer is and whether the estimate is reasonable since we like that word a lot when comes to spotting holes in our thinking.
So it’s $14,041.67 per person.
Since there are usually 10-years in a decade, the CBO is estimating $1,404 per person per year for healthcare — of the uninsured.
I’m arguing with myself over the “reasonableness” of this number.
Remember, most of the uninsured are not people at retirement age – or older. These gray folks like us are mostly covered by Medicare.
And it’s axiomatic that your medical spending goes up at a nonlinear rate as you approach the end-of-life. (It’s OK –EoL brings the end of taxes, too.)
Paul Ryan is quoted over here as saying “If we don’t pass my bill, the system is going to collapse.:”
Ryan, unfortunately, is a typical politician – and not a particularly admirable one so far.
Worse? Washington is in something of a hostage-taking mode on healthcare since the insurance industry/business model has convinced the weak-minded that giving perhaps 20% of our healthcare budget to overhead and profit of insurance companies is the only way to go. “Why look at all them health insurance jobs!” they moan.
The U.S. government spends about $100-million a year on healthcare for active duty military.
There are (about) 1.174 million enlisted plus another 224-thousand active duty officers. That doesn’t count 580-thousand civilians.
Let’s round it off to 1.4-million. Then, let’s double it because I think we can assume that there is is a lot of spousal and child healthcare in this – so maybe the figure is closer to 3-million covered active.
But it doesn’t stop there: We have to toss in a further million, or so who are getting healthcare (Tri-Care) and other V.A. benefits, too.
It might round that off to 4-million. Pencils out to $25,000 per YEAR per patient.
I’d have to dig a lot more numbers out, but it seems to me that either a) V.A. is spending too much OR b) the CBO numbers could be low, if anything.
Which then circles us back around to the original problem: How do we do a better job of delivering healthcare to everyone?
As the old saying goes: We don’t have any problems more revenue won’t fix. This is a fine example.
I can’t cite current figures, but Canada – often held up as a role model on national healthcare – spent about $11,000 per family – and this was back in 2015.
That pushed pushes out to $2,750 per person.
The REAL problem with Canadian healthcare is at some point, they will have to pay the ACTUAL costs because that’s how budgets work. So picture basic Canadian income taxes then toss in $11,000 for an average family just to handle healthcare.
Not exactly a pretty picture.
So Let’s Solve It!
The problem with healthcare, when comes down to it, is something we touched on in the Coping section yesterday when we were talking about Daylight Time. (We don’t say “savings” with that because no one “saves” time. It’s just another government over-reach.)
The fundamental question has to do with the 10th and (missing) 16th Amendments.
Did States delegate the power to CentGov to decree everyone MUST buy healthcare to the FedGov? (Justice Roberts said it’s a tax, remember.)
Sure, if we were loaded (like the State of Alaska was for a while with oil tax revenue) it would be fine to have total healthcare. Toss in a universal gym membership and tanning cards, too.
But the Budget is far from “fine.” It’s a wreck.
I think about government healthcare as being something that should be scaled according to the Nation’s financial condition.
We need more money coming in.
If we were to wipe out the Balance of Trade deficit, for example – which runs $40-$50 billion per MONTH, then sure. We would all get healthy.
The ugly fact of Healthcare is that it has been reduced to a single bill that doesn’t look at the entire budget picture and come to realistic answer to the over-all problem.
Remember Rubberstamp Ryan pushed Obama’s globalism plans.
Picture an airline flying along at F?light Level 37 (37,000 feet). The crew notices a problem with the right wing/. As the cabin decompresses and people begin to instantly die from cold and a lack of oxygen, the pilot turns to the co-pilot and says “This is just ;like the approach to healthcare reform.” As the plane crashes toward a very small landing.
Point? Sure: You can’t fix one wing at a time. You need to consider the outgo when trying to spend income that isn’t here.
If the U.S. were to tax imports at the differential between the cost of such goods being made America and the cheap-o overseas rates, life would be wonderful.
The problem (which no one talks about) is that universal healthcare from some of these Asian countries – and Mexico – is not considered nor required when tariffs are set on cheap-o goods.
Then – compounding our national stupidity – there’s the World Trade Organization which really benefits the rich One Percenters more than the rest of us.
I would argue – and I think it’s a convincing case – that if we are going to enforce a Healthcare program in these (prior to Obama) United States, then we must simultaneously move to impose a tax on imported goods to level the trade playing field.
Tariffs should be set after adjusting labor both here and abroad for Worker Purchasing Power Parity plus Quality of Life (QOL).
The problem, you see, is bigger than healthcare.
There is the corporate tax angle.
Here we have major corporations screaming bloody murder about how high the U.S. tax rates are yet IRS has only limited authority to deal with the multinationals that use international tax dodges and havens to avoid (or ridiculously minimize) corporate taxes in most countries.
Remember I lived and worked in the Cayman Islands for a couple of years – and I have a pretty good handle on how the International Tax Shuffle is danced. Really, do 40 of the 50-largest banks in the world need to be serving a total market of 60-thousand people unless there’s a lot of dodging going on? Well, there is.
Corporations should all pay the same “end-to-end” tax rates as U.S. domiciled corporations..
Go back to last year and how the E.U. moved against Apple on just this point. Read “The Inside Story of Apple’s $14 Billion Tax Bill.” Interesting stuff.
The simple version of this avoidance game works is simple: Since I will use a couple of dummy shell companies to illustrate, seems only right that they be named after myself:
Ure Industries buys cell phones from our Ure Industries Ltd in Grand Turk for $100 per phone. They sell at a small profit (retailing net is $110) so $10 in taxable income in the USA.,
The Foxcommy Division of Ure International, Inc. manufactures the phones in China for $20, sells them to Ure Industries Limited, Grand Turk, for $22 – and thus pays China a corporate tax of 10% ($2) profit from making the phones.
Follow me here: Did you see the cutout?
Ure Industries Ltd in Grand Turk in the Turks and Caicos made a tax-free bundle.
They buy the phones all day long from China for $22. And they resell them to Ure Industries America for $100 and that $78 of pure profit is tax-free since it was “earned” manipulating paper in a tax haven country.
I made it simple because I used Ure throughout. But in real life no way. The companies have interlocking directors, perhaps, but the names are varied to hide avoidance.
Sadly, the Fools on the Hill don’t get after end-to-end taxes. If they did, our foreign goods income might be higher, but so would our consumer prices – so it’s a balance there. The E.U. has moved against such schemes, though – they need dough to build-their-burgers, so to speak.
But with lobbyists essentially buying votes in D.C.? Do you really think Washington will land the airplane and look at the whole aerodynamic problem?
N o chance, at least YET.
They’re going to crash the plane.
And as is goes down, the usual pathetic crooks will blame one another (and the president) when the fact is, we need something the Trump Administration has the brainpower and horsepower to do, but are up against the Ryans and butt-kissers/ and coverers on the Hill.
With no Trade Deficit, we could pay $1`,875 per month for each of those 24-million who (wring your hands with me brothers and sisters) wouldn’t be covered. Yes, PER MONTH!
Revenue is the answer.
We need to sit back, review the Big Picture first, and then fix healthcare to the degree we have money to spend, not to the degree the democrats can subvert Trump via the Obama “second White House” where the leakers might be on speed dial.
Cynical view? Me? Oh, hell yeah. GTFU.
We now return you to the usual data with a side order of slime for breakfast.
Data du Jour: PPI-FD
Producer Prices, Final Demand is where we sometimes get a glimmer of ‘inflation in the pipeline.”
“The Producer Price Index for final demand increased 0.3 percent in February, seasonally adjusted, the U.S. Bureau of Labor Statistics reported today.
Final demand prices rose 0.6 percent in January and 0.2 percent in December. (See table A.)
On an unadjusted basis, the final demand index climbed 2.2 percent for the 12 months ended February 2017, the largest advance since a 2.4-percent increase in the 12 months ended March 2012.
In February, over 80 percent of the advance in the final demand index is attributable to a 0.4- percent increase in prices for final demand services. The index for final demand goods moved up 0.3 percent.
Prices for final demand less foods, energy, and trade services rose 0.3 percent in February, the largest increase since a 0.3-percent advance in April 2016.
For the 12 months ended in February, the index for final demand less foods, energy, and trade services climbed 1.8 percent.
Final Demand Final demand services: The index for final demand services moved up 0.4 percent in February, the largest advance since a 0.4-percent increase in June 2016. Nearly 70 percent of the February rise can be traced to prices for final demand services less trade, transportation, and warehousing, which climbed 0.5 percent.
The indexes for final demand trade services and for final demand transportation and warehousing services advanced 0.4 percent and 0.3 percent, respectively.”
Dow futures are down about 70 as the market dare not rally until after tomorrow’s Fed rate hike decision.
Bitcoins are $40 over gold this morning if you’re among the people trusting your future to a hard drive.
One of our cynical readers points out that “named storms” may be a way for insurance outfits to slide on claims. Tisk, tisk – such cynicism, really!
5,000 flight cancellations so far.
It’s About the Surveillance State
You probably already knew this, b ut when the NY Times says “White House Says Trump’s Wiretap Claim Was Meant More Broadly” you can bet democrats have something to hided or gloss over.
Like the Hillaryites meeting with the Ruskies? Damn! There goes the cynicism alarm again!
Big Day Tomorrow
Fed Decision, CPI and a barrel of monkeys (played by the House). Up for subscribers at 7:55 on www.peoplenomics.com as always.
Wonton soup for breakfast? Seems like hot soup would be a show of solidarity with the snowed in. Cold at the ranch overnight, too: 34.