Health care reform passes the house

By J. DeVoy

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Obviously, people have mixed feelings about this.  The National Organization of Women is upset that the final bill doesn’t do enough to ensure women’s right to choose abortion.  At the other end of the spectrum, Ferdinand Bardamu believes it will raise government expenses and taxes without doing anything to break the stranglehold of HMO’s over healthcare.  Roissy’s stream of consciousness rant ties together a number of points about the failure of democracy, which social realists have been pointing out for some time as well.

The winners: People over fifty.  Not yet in the tender embrace of Medicare, those with the highest expenses due to the problems of middle age, like high blood pressure, high cholesterol, diabetes and heart problems, will see the best returns when this program fully goes into effect.  People with preexisting conditions will also benefit tremendously and receive coverage they previously couldn’t afford, or even have an insurance company offer to them.

The losers: Young healthy people.  Though the mandated purchase of health care means every person is covered, it comes at a price.  For non-smokers with no pre-existing conditions, covering the risk for a broader range of people will result in higher insurance premiums than they would have paid before this plan.

The missed opportunities: The bill seems to have few non-medical provisions for preventive care.  Apparently, there are no tax credits or other incentives for purchases of gym memberships, exercise equipment, or other fitness initiatives.  Giving a few bucks back for submitting a doctor’s note saying how many pounds you lost last year, so long as it wasn’t the consequence of an amputation, would seem reasonable — though privacy advocates may take issue with it.  This seems like it wouldn’t cost as much as the $6,500-8,000 in credits going to people who buy houses, and would lower future health care expenses.  Finally, this would have been an opportune time to ban or tax High Fructose Corn Syrup on a national level, yet the government squandered it.  Given the corn and farming lobby’s vise-like grip on Congress – farm subsidies tell the story – the legislature’s failure to curtail its sale is predictable.  The first lurch toward such an initiative, by taxing soda, was originally proposed in the Senate’s version of the health care reform bill, but ultimately it was dropped from the final legislation.

19 Responses to Health care reform passes the house

  1. writerdood says:

    I’m kind of glad the Feds aren’t taxing soda. The states are considering it, (some of them), and if they were both doing it, well, who wants to pay two bucks for a coke? It’s bad enough already. And if you put the soft drink companies out of business, who’s going to pay for the television ads? Then TV will get shitty and… okay, it’s shitty already. Tax the soda.

    Personally, I’m switching to non-carbonated beverages.

    • J DeVoy says:

      […]if they were both doing it, well, who wants to pay two bucks for a coke?
      ‘Zactly. I kind of like diet soda for caffeine purposes, but could live without it.

  2. Justin says:

    Totally agree there should be more preventative measures, though an outright ban on HFCS seems a bit much. How about just getting rid of the subsidies.

    I have a problem with your winner category. People over 50 are more likely than young people to be making over $250,000 and thus will have to pay and extra 3.8% on their investments as well as higher premium on their cadillac plans. Also, older people’s rates are offset by the fact that they have to cover their kids until they are 26. I’m not sure it’s such a win for the over-50 crowd.

    • DMG says:

      They don’t HAVE to cover their kids until they are 26. They now have the option to do so. IIRC, most plans won’t provide coverage for a child over 18 and out of high school unless they’re in college. Even then, most plans cut them off by 23 even if they still allow it.

      I’d have to doublecheck on that, but pretty sure off the top of my head.

      • J DeVoy says:

        Exactly, and I think that’s an issue of state law. I had to go on my state’s insurance for two months between when I turned 22 and when I began law school and was covered by its health insurance. Some states go longer.

    • J DeVoy says:

      Yes, people over 50 are more likely to make more than 250k than people under it, but that’s still the top 1-5% of income for all Americans. http://www.ntu.org/tax-basics/who-pays-income-taxes.html And there are plenty of older people who didn’t want children or no longer support them financially. Also, your analysis assumes they have cadillac plans (what stupid, obnoxious GM trolling, too. Maybe they could have compared luxury to a brand that 1) wasn’t pure shit, and 2) actually luxurious). As for an additional 3.8% on investments, I’m not sure how that works and will interact with the capital gains tax – but rest assured, the wealthiest people aren’t earning income from the payroll tax, but earning it passively through investments – what another 3.8% does to their finances, and the conditions under which that excise provision will kick in, currently are beyond my knowledge of the matter.

  3. The reality of the matter is that the tax code is social policy. We can complain about it, but since everyone uses it as such, the whining can’t really be taken seriously. So it becomes legitimate to ask questions like, “Do we want to subsidize the production of High Fructose Corn Syrup?” It seems like bad social policy. I don’t think a soda tax is necessary. Just remove the subsidy.

  4. Marc says:

    I think you meant to reference Medicare in your “winners” section. Medicaid is for poor people, not old people.

    And as a preventative measure, I would say that just providing encouragement for people to get an annual physical would have the largest impact for the level of effort. Not that I think taxing HFCS or encouraging people to go to the gym are bad things, per se… But if you get more people into the doctor’s office for very basic care / testing / information distribution, a lot of good will come of it.

  5. jfischer1975 says:

    You left a very important group out of the losers category:  people who like to look good.  The current bill mandates a new 10% tax on indoor tanning services.  That’s some fucked up shit for us pale folks.  Thanks, Obama — did you quit smoking yet, asshole?

  6. MikeZ says:

    I was reading about the tanning services tax, I suppose it may make as much sense as a smoking tax (pays for its eventual medical costs). But a) it just seems so completely random, I hadn’t heard anyone complain about the massive medicare debt created by tanning services and skin cancer, b) It seems so petty, can there really be that much money involved here.

    • J DeVoy says:

      I looked into this quickly: Melanoma is estimated to cost Medicare $249 million annually, and each individual with the disease cost, on average, an additional $28,000 in diagnosis-to-death expenses. It seems like low-hanging fruit because prevention could reduce expenses by 60%. http://www.mdconsult.com/das/news/body/190706761-2/mnfp/0/217061/1.html?nid=217061&date=all&general=true&mine=true

      • MikeZ says:

        I can certainly believe that number, but I’d say you need evidence of tanning salons leading to medicare costs. Now I’d certainly believe that somebody who goes to a tanning salon every day will probably get skin cancer.

        I don’t believe the verdict is back on whether going to a tanning salon prior to your carribean vacation is beneficial. Certainly seems like it is to me personally.

        The mayo clinic http://www.mayoclinic.com/health/tanning/AN00589 actually says it may not be beneficial* but I think there assumptions may be severely flawed. If I am going to Mexico I WILL be doing a lot of swimming and I WILL be on the beach between 10AM and 4PM. Sure I will re-apply sunscreen but the snorkeling will remove it. It comes down to whether turning your skin light brown for two weeks is better than Turning it bright red for one week, then brown for the next. I know which one is more fun.

        *They also call SPF 4 non-beneficial but isn’t that 400% better than nothing? Sure it isn’t SPF 15 but writing this off seems biased.

      • MikeZ says:

        That said I may be biased the other way as I work in a large office in Massachusetts. I can pretty much tell none of the 400+ of us goes to a tanning salon regularly, but perhaps my sample set isn’t indicative of the normal population.

  7. […] $136.2 billion package of spending cuts and new taxes — though not including new taxes on soda and cigarettes, which the legislature previously […]

  8. Atticus says:

    Interesting you should mention opportunities for fitness and dietary initiatives. You may not have seen it, but the bill does actually require restaurants to begin posting calorie counts on their menus, which is a huge win for people concerned about unhealthy food. I was recently in NYC, which requires the same thing, and had breakfast at Cosi. It was an illuminating experience.

    http://www.washingtonpost.com/wp-dyn/content/article/2010/03/23/AR2010032300497.html

    • J DeVoy says:

      The Dunkin Donuts I visited in Philadelphia Int’l Airport (there aren’t enough visible shudders of discomfort to suit that sentence) had the same thing. I don’t know quite how much value it has. Admittedly, a gym membership or fitness equipment tax credit is self-interested, but would push marginally fit people into possessing either.

      • Atticus says:

        I was amazed how many calories are in those Cosi breakfast sandwiches (700+ for some). I got oatmeal instead (~100)and saved myself around 1/4 of my recommended daily caloric intake on the spot.

        None of this stuff is going to prevent slobs from being slobs. But at least it lets well-intentioned people choose healthier items without having to look up every single menu item on the internet. In other words, much like a gym subsidy, it’s going to assist people who are already interested in fitness.

        • J DeVoy says:

          I agree with you(!) and was surprised that eating a donut had about 1/2-1/4 the calories of a “munchkin,” which is basically a donut hole. You’re right, though, in that slobs will be slobs who don’t grasp the significance of the calories they eat. After cutting out carbs and processed foods on a paleo-type diet of roughage, berries and lean meats, it’s a challenge to hit 2k Calories in a day.

  9. […] I’m not entirely sure – it demonstrates why healthcare reform is toothless without preventative measures to ensure a healthier population.  Advertising the store’s eagerness to accept government […]

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