Good Morning America, how are you ...

[uwe]

Ask German insurance companies whether they believe mandatory health insurance is a bad thing and they'll laugh saying "no, it it has been our business model for the last 100 years". It's a huge market. And at the same time the communal state health insurances which exist side by side with the private insurers have become a fixture too. Germany has a threeway system, you are mandatorily insured with the communal state health insurance or you can opt out to one of the private insurers called replacement insurers ("Ersatzkasse") here who offer for the same premium slightly better services. Lastly, if you are above a certain income, you are allowed to insure yourself privately in which case you have to pre-pay medicine and private practice treatment but get reimbursed 90% of it with hospital stays being paid by the insurers directly. About 15% of the population are privately insured (yours truly included), but once you drop below a certain income you are automatically insured again by the communal or the Ersatzkasse insurers. The big advantage of the last two is that coverage extends to non-employed spouses and children while private insurance has only an individual coverage. Which means that a well-paid bachelor will pay less if he insures himself privately, but a family father of four would pay less under the communal and Ersatzkassen insurance regime where the premiums are decided by what you earn as opposed to the individual risk you and your family members bring.

In any case: no health insurer has ever gone broke in Germany!

[Denis]

I'm relieved to be able to discuss such topics intelligently with everyone here!

One thing I would like to say about many of these issues, and this is NOT a popular opinion, is that all those tax breaks for the middle class (of which I am a part), should be dropped or minimized. The middle class being the largest sector of the American citizenry and benefitting from the most services, it's expected that we should have to pay taxes to receive those services, especially since "investments" by states and the federal government have not gone well.

We've gotten into a nasty position in which "tax" is a forbidden word unless you are calling the other side names. People (and politicians) seem to forget that taxes pay for an incredible amount of services the federal and state governments provide the citizens. The tax cuts put in place by the previous administration at the same time we were fighting two unfunded wars was catastrophic to the economy. The current administration is in the awful position of now having to keep those tax cuts in place. Like I said earlier, if those clowns in Washington were to realize that they aren't their for THEIR job security, they would do what is right to get this nation back on track by making some hard decisions.

Like everyone else, I'd love to keep all the money I earn and still get free police, emergency, health insurance, eye and dental care and have a nice National Guard, Army, Navy and Air Force to protect my free and easy lifestyle, but I'm smart enough to know that this stuff has to be paid for and I think many people (citizens and politicians alike) have forgotten this. After all, I can't walk into Harry's Guitar Shop and walk out with that Gibson Explorer on the wall without paying for it. Why should other things be different?

[Freuds_Cat]

Very enjoyable read gentlemen  Interesting insight into how Americans see the politics of their own country. Of course we only get to see things through the eyes of the exporting journalists and media companies who all have their own agendas so its refreshing to see it through your eyes.

[Barklessdog]

We've gotten into a nasty position in which "tax" is a forbidden word unless you are calling the other side names. People (and politicians) seem to forget that taxes pay for an incredible amount of services the federal and state governments provide the citizens. The tax cuts put in place by the previous administration at the same time we were fighting two unfunded wars was catastrophic to the economy. The current administration is in the awful position of now having to keep those tax cuts in place. Like I said earlier, if those clowns in Washington were to realize that they aren't their for THEIR job security, they would do what is right to get this nation back on track by making some hard decisions.

Dammed if you do, dammed if you don't. Our state, Illinois is heading toward California, as in going bankrupt. They are talking about 3 day school weeks, already laying off teachers, cutting services, everything.

I think everyone should have health care that covers everything with no limits. Unfortunately there is no money to pay for it, at least at the costs here today. Our companies largest expense is health insurance. We can't afford to hire full time employees because of that, so our company has not grown and we are now in the position we are in.

I do not think either party in our government is not being funded by corporate interest groups, who basically call the shots for what happens. Both parties are the same in that respect.
Companies fund both parties so it's a win- win for them. I do not see this changing anytime soon and our country is paying for its personal / corporate greed & "Me Generation".

You look at the ant colony China, they are looking a 1000 years down the road, where we only look at the years corporate profit statements and the political term- put off ugly stuff for someone else, it gets you fired or not re-elelcted if you face things. How much money and how long is China going to fund our country & deficit?

There is no answer on how to fix things and even if you had one, you can bet a half of people here will be against it.

[uwe]

I'm relieved to be able to discuss such topics intelligently with everyone here!

One thing I would like to say about many of these issues, and this is NOT a popular opinion, is that all those tax breaks for the middle class (of which I am a part), should be dropped or minimized. The middle class being the largest sector of the American citizenry and benefitting from the most services, it's expected that we should have to pay taxes to receive those services, especially since "investments" by states and the federal government have not gone well.

We've gotten into a nasty position in which "tax" is a forbidden word unless you are calling the other side names. People (and politicians) seem to forget that taxes pay for an incredible amount of services the federal and state governments provide the citizens. The tax cuts put in place by the previous administration at the same time we were fighting two unfunded wars was catastrophic to the economy. The current administration is in the awful position of now having to keep those tax cuts in place. Like I said earlier, if those clowns in Washington were to realize that they aren't their for THEIR job security, they would do what is right to get this nation back on track by making some hard decisions.

Like everyone else, I'd love to keep all the money I earn and still get free police, emergency, health insurance, eye and dental care and have a nice National Guard, Army, Navy and Air Force to protect my free and easy lifestyle, but I'm smart enough to know that this stuff has to be paid for and I think many people (citizens and politicians alike) have forgotten this. After all, I can't walk into Harry's Guitar Shop and walk out with that Gibson Explorer on the wall without paying for it. Why should other things be different?

Amen to that! What a relief to read it.

The principle of society is that we are all somehow better off in a community that shares burdens and responsibilites than if we'd be running through the jungle by ourselves.

I'm in the lucky position of being a law firm partner that could afford, say, living in a gated community and sending his kids to private schools. I wouldn't even need health insurance, short of revolving heart transplants I could pay my medical bills out of pocket. But I don't want to live in a gated community and I didn't want my kids to grow up in a community where they take it for granted that everyone's dad is either an investment banker, a lawyer, a dentist or a medical doctor. They are aware that they are well-off, but they are also aware that not everybody is and that that says nothing about how talented, gifted, hard-working or industrious they are.

I have a 40+% income tax burden, if you add indirect taxes such as eg VAT (19% in Germany) to it, then my tax burden is probably closer to 60%. It doesn't pain me to pay those taxes, I still live well, thank you, and I'm still privileged to be able to do nonsense like buying at whim ugly eighties basses nobody else wants. I have never invested in a tax-saving scheme in my life. I grew up here using those roads, having that police protection, getting those polio shots for free, going to school and university for free etc and, by some lucky twist, I benefitted from all that and it contributed to the position I'm in today which is only in part based on my talents (if any) or my persistence (I can be incredibly lazy) or my great genes (my father, an engineer, said to me, ever his supportive self, when I was 18: "You have two left hands and are totally technology-challenged, frankly, I can't see you doing anything with your life except studying law."), most of it is just plain Forrest Gump style luck, how else can I explain that I've seen people more talented than I and working harder fail?

So - this will make some of you wince, I know   - I see my tax burden as a ... debt I'm repaying to society!
Sorry, Ayn Rand (and Neil Peart), I had to get that out!



PS: Is "the state" an incredible money waster? Yes. But even before Lehman I had lost faith that private entities, once they reach a certain size and (ir)responsibility, are any better. "The state" just generally wastes money more evenhandedly.

[Pilgrim]

And no matter what posturing you hear about how Congress has stuck it to the insurance companies, the companies are very happy about the outcome. As well they ought to be, since they poured hundreds of millions of dollars into lobbying.

Ain't that a fact!  If everyone has to buy, then the insurance companies have a captive market and will automatically set rates that assure they make as much or more money than ever.  No one has talked about that, have they?

This is one aspect of the law that I expect will be an ongoing issue.  There is a certain tension between the "everyone must buy" (which I doubt is really enforceable on a practical basis) and the fact that some people cannot buy and therefore will need public support or outright public-funded health care.  I expect there to be a lot of re-definition of how that part will work.

And I want to chime in with Denis and Uwe about taxes.  

There was a very interesting story on NPR a few months ago that examined the dialogue around taxes in the US.  The person interviewed made what I thought was a nice point; he asserted that starting in the 80's, the Republican party had done an excellent job of re-casting the terms of public debate, making the word "taxes; increasingly negative.  He saw this as s cornerstone of their rhetoric and message, and opined that they have succeeded so well that now "taxes" are automatically regarded as bad.  I agree with this observation.

This is in contrast to the view that Uwe offers - and which I share.  

Taxes are the cost of living in a society such as ours; the question is NOT whether they are good or bad; that is irrelevant and the wrong question, because they are necessary.  The relevant questions are "how many taxes", "at what levels", and "to pay for what?"  We need a more open and open-minded debate about those questions.

[Nocturnal]

I have a cousin who's husband is in trouble right now with the IRS (and a couple of other gov. agencies) for tax evasion and a couple of other fraud charges. Why you would choose to put yourself and your family thru this kind of nightmare is beyond me.  I think that there are some tax laws that seem a little less than fair, but I agree with the sentiment that you HAVE to pay taxes or a lot of the services we are used to having will disappear. I don't mind paying my fair share, but I do mind people trying to get out of paying them but not having a problem reaping the rewards that the taxes provide.

In a semi-related tax story, if the local 1 cent sales tax vote isn't passed it will be a detriment to all of the schools in AZ. My wife will get a pay cut along with teachers, and a TON of things taken for granted in the educational system will go away. It will also hurt all city and state services including police forces. I don't think most people really realize just how much taxes cover. I know I didn't have a clue until recently.

[gweimer]

Even my 100 level economics class in school made clear the point that governments cost money, and that money comes from taxes.  Now, if they could reduce the size of goverment, maybe we could stabilize the tax rates for a while.   Too many people that complain about high taxes also complain about the need for more public services.  Pick a side.   

[Pilgrim]

Right!  The thoughtless (should we say idiotic?) approach of many is shown when they make arguments that boil down to: Don't you dare get government into medicine, and while you're at it, don't you dare mess with Medicare or Medicaid.

There is a clear lack of understanding about what taxes pay for.

[Highlander]

So - this will make some of you wince, I know   - I see my tax burden as a ...debt I'm repaying to society!
Sorry, Ayn Rand (and Neil Peart), I had to get that out!

"Who is John Galt...?"

[OldManC]

If you wonder why some yanks abhor the idea of government being in charge of anything it doesn't HAVE to be, consider this; while the bulk of the new bill will not be implemented until 2014, a huge selling point was that two provisions would help 'the children' immediately. One being raising the age limit for dependent coverage to 26 so that adults could stay on their parents' insurance policy a bit longer. The second was mandating that insurance companies grant coverage to any children that apply (through their parents, I'm sure) for insurance without 'discriminating' against pre-existing conditions. That's fine and well, except they didn't include those mandates in this 2000+ page bill! Yeah, that doesn't inspire much confidence in me for what my government can do for me and mine re health care...

[lowend1]

To name but a few:
Medicare is broken
Medicaid is broken
The Post Office (USPS) is broken
The VA is broken
ACORN is broken
...and the common thread is?

[Lightyear]

If you wonder why some yanks abhor the idea of government being in charge of anything it doesn't HAVE to be, consider this; while the bulk of the new bill will not be implemented until 2014, a huge selling point was that two provisions would help 'the children' immediately. One being raising the age limit for dependent coverage to 26 so that adults could stay on their parents' insurance policy a bit longer. The second was mandating that insurance companies grant coverage to any children that apply (through their parents, I'm sure) for insurance without 'discriminating' against pre-existing conditions. That's fine and well, except they didn't include those mandates in this 2000+ page bill! Yeah, that doesn't inspire much confidence in me for what my government can do for me and mine re health care...

George, give up your work from home thing and run for congress - I've got the first $100 check ready to go in the mail

[Lightyear]

I won't address the cspan issue since that's already been covered, and you're right.

But again, this is not going to be anything like the VA and Medicare. The feds are not running anything, they will be dictating to private, for-profit insurers. IMO this will help some people but only make things worse than they are now for most people. But it won't be a government entity.

And no matter what posturing you hear about how Congress has stuck it to the insurance companies, the companies are very happy about the outcome. As well they ought to be, since they poured hundreds of millions of dollars into lobbying.

No matter what the issue or which party is in power, we have the finest congress that corporate money can buy.  

To what ever level they will be involved in health care they will make it worse, IMO.  I challenge anyone to please tell me something that the federal government does really well - with the exception of the military, thankfully.  I seriously look for the feds to further entwine themselves further into the medical system.  Some of the uber lefties in congress are already harping about single payer again 

[Lightyear]

One last thing - if this is such a great thing then why have the politicians made sure that they will be explicitly exempt from it

Hell, even Jim Jones joined in at the end with his disciples