Wednesday, January 24, 2007
Bush health plan: will it help you?
The news media usually get the text of the State of the Union address about an hour before the president begins the speech. When it hit my inbox last night, I sat up straight. My pulse quickened. I clicked and scanned for any mention of health or medicine. I found them. There were six paragraphs on health care.

President Bush is proposing a new tax deduction for everyone who has health insurance. The goal is to get more people insured who otherwise couldn't afford it. It's a standard tax deduction - $15,000 for families and $7,500 for individuals. My first reaction? Great! I get a tax deduction courtesy of George W. Bush.

But, of course, it's a tax code initiative, so it's complicated. Right now, the money you and your employer pay into your health plan is exempt from income and payroll taxes. The president's plan would turn all employer-provided health insurance into taxable income. Whatever you and your employer pay for your insurance would show up on your W-2 form. Suddenly, health care seems almost as tedious as doing taxes.

So does this plan help or hurt people? For the 160 million Americans with employer-based coverage, there would be slight differences. The White House says 80% of employer plans fall below the $15,000 and $7,500 caps. They estimate an average tax decrease of .3%. So, people like me with a decent employer-based insurance plan would see negligible tax relief. One out of five people with employer plans have insurance coverage costing more than $15,000 and $7,500. For them, taxes would increase an average of .1%, according to the White House. All in all, the Bush plan gives people incentive to get lower-priced plans.

So far, the American Medical Association, the American College of Emergency Physicians and insurance groups have applauded Bush's plan to get more people insured. According to the White House, 3 million people will pick up insurance under this plan. But there are 47 million uninsured Americans, and critics say the president's plan doesn't help enough of them. After all, a tax deduction won't help the 43 percent of the uninsured who are so poor they aren't required to pay income taxes.

Democrats and labor unions say this proposal will encourage employers to stop providing health insurance. One nursing group points out that it provides tax incentives for purchasing cut-rate plans that traditionally have high deductibles and other out-of-pocket expenses.

According to some analysts, the time when your annual health care spending exceeds the $15,000/$7,500 tax deduction may happen sooner than you think. The standard deduction amounts are tied to inflation, not to health care costs, which have increased by double digits in recent years. Also, you may be harder hit if you live in an area where health care costs more, such as the Northeast, or if you work for a company with an older and sicker work force with higher premiums.

It's been almost 60 years since a commander in chief first mentioned health care in a State of the Union address. It was President Harry Truman in 1948. "Our ultimate aim must be a comprehensive insurance system to protect all our people equally against insecurity and ill health." Six decades later we're still struggling with that goal.

What do you think about health care in America? Will the president's plan help you? Is it a step in the right direction? Or will it cause more problems than it solves?
I don't know if the plan would help or hurt me in the short run because I don't know the price of my employer's health insurance. My company is self-insured, and I have no idea how they estimate the cost of each plan they offer. But it is very likely that as insurance cost increase, the cost of the plan will increase as well to the point that it'll exceed the proposed limits.

One thing I'd like to point out, however, that our employer-based health plans are not free or unfair to people who buy their own insurance. We pay for these plans already with our smaller salaries compared to people at the same skill level who don't get company-sponsored insurance. For example, as a software engineer who is a Fortune 500 company's employee I get health insurance, but I also earn significantly less than a software engineer with the same skills who works for my company as a contractor and does essentially the same work. Even if I am a project leader and he works for me, he still earns more. The difference in our salaries is much higher than what the cost of health insurance. So now, a contractor is going to be able to deduct the insurance he buys even though the cost of this insurance is already part of his much larger salary. Doesn't seem like levelling a playing field to me.

Faced with higher tax bills, many young and healthy people would opt for higher paying jobs without insurance. Some of them may buy their own insurance and some may not. Its being tax-deductible doesn't make it free and the mentality of many young people that they don't need insurance is not likely to change. Not only will this lead to fewer insured, this will also leave older people and those with chronic conditions in the employer-sponsored plans. Without young and healthy among the pool of the insured, the total cost of the plan will increase. So we'll have young people getting higher salaries and tax breaks and older people with smaller salaries and taxes.

In addition, small businesses who don't have such a large pool of employees may have expensive plans not because the plan is so fantastic but simply because the very few people they employ happen to be older. So now these older and maybe sicker people will have to pay taxes. How is it right?
YES, I BELIEVE IT WILL HELP A LOTS.
I HAVE ALL OF THE CONFIDENCE IN THE PRESIDENT. I WAS REALLY ENCOURAGED BU HIS SPEECH LAST NIGHT. I LIKE HIS IDEAS AND SUPPORT THEM.
It doesn't sound like it will help me. Insurance companies dictate who, how, and if we can be treated, not the doctor. I am insured with my work, but my husband can't have insurance and we both be doubled covered, which would cut our out of pocket expenses. So I have to cover the whole family. Insurance rates keep going up, but our wages here in Utah don't go up to cover the increasing insurance rates. Our insurance every year changes to cost us more and the insurance covers less. As we get older we are in our 50's there isn't any security for us in the way of health care. Unless we are so poor that only medicare will cover you. That's not taking care of the aging baby boomers. As you get older our bodies need more attention and care, yet we are discouraged to go to the doctor because it costs too much, or don't get prescriptions because they cost too much. Insurance companies have too much control, and some of the people making the decisions at these insurance companies have NO medical training or background, how and why are they allowed to make health choices regarding an individuals best possible care???
For the Bush administration everything is seen through the lens of tax policy. Remember during the 2000 campaign and after the election? The administration line was that the strong economy and the surplus meant we had to have a big tax cut. Then the economy and the surplus quickly went into the toilet, but the prescription was the same; we needed a big tax cut.

The Bush proposal is not about health care coverage at all. It is about the appearance of action while all the while giving the country more of the same.

People aren't chosing not to buy health insurance because they can't deduct the purchase. They aren't buying health insurance because they can't afford it in the first place.
I don't like having to pay income tax on the portion I pay for.
I worry about this proposal on health insurance for three reasons:
-It is not far-reaching enough; the poor who do not even make enough to pay income tax will not see any difference;
-With taxes paced with inflation, but with health care costs rising at an almost exponential rate, I worry that this tax cut will not keep pace with the cost of insurance.
-If we must start merging our health insurance expenses with our taxes, it becomes far more complicated. I am reminded of the medicare prescription benefits that became so much more complex in the last year.

And finally, we must ask this question: how will this proposal affect companies' willingness to provide insurance for their employees?
Government and insurance companies together makes it so difficult and expensive to get medical treatment in USA UK or CANADA that people at large who do not have medical benefit cover through their work, are unable to get regular medical check up. Same prescription medicine are available at cheaper rate in third world country like India and the whole health care system is such simple there, that any one including foreigners can get the medical advice, help and medicine from world class doctors easily. Politicians should be stripped of medical benefit cover and should be placed in hourly wage employee class so that they will understand better the need of appropriate medical system in these countries. Just this VIP class perks does not help them understand problems one face when they have not enough medical cover.
I just recently began looking at my income numbers this past week, and I feel this plan will definetly fall short for most. I am not one of them, but after researching, and crunching some numbers, I realized that this plan was most likely something pulled out of a hat in time for the State of the Union.
You all ofcourse know that your president is trying to win your support for his war in Iraq...

Since the majority of the world has Healthcare as their primary concern, president Bush already won the majority of the vote through only addressing this "one" topic.

In fact, I believe that he can have a war with any nation in the world, and somewhere...(without much effort), he will find the majority vote.
Another Bandaid on a very sick & dying Healthcare system.
This does not even begin to address the healthcare problems of the US and only stands to demonstrate that our adm & leaders are unwilling to face our healthcare delimina.
And of course, anybody running for office, that proposes a Universal Single payer system, will be called Hillary Care before they are even out of the gate for the race.
When will America realize that we already ration healthcare by lack of affordability & access. That insurance companies dictate our care, not the Drs nor even good medical practice!
The basic fact is that the United States will remain 6th in terms of quality health care while having the most costly health care in the world.

In common terms, this is called a ripoff. Americans should be enraged.

Nothing has changed - what else would we expect from this president?
Well I have been trying to figure out who this is going to help and it is not me. My Husband and I cover each other in order to be able to afford health care. this is going to put or taxable incon=me way above the credit allowance and agin we will end up paying more fedral taxes at the end of the year. Now this is supposedly supposed to give opeople an incentive to go out and get health insurance, not the people that can't afford health insurance are barley making enough money to live day by day on. So how are they going to make monthly preimiums when they dont; have it.

The place healthcare reform needs to be regulating insurance companies and Hospitals. Hospital are supposed to be none profit right? also what they charge for a bandaid outrageous. The other area thar need gov't. regulation Drug companies. Make it affordable.
I am certain Bush's plan will not effectively solve the problem of high cost health insurance. Furthermore, as with so many of Bush's tax plots and plans, it would quickly create an additional tax burden, not relief, on middle-class and lower-income working families.

I work in a human services job that serves mainly low income families. With my salary just edging me into a lower-middle-class income range myself, the healthcare benefits I receive are crucial, defraying (but not eliminating!) the high cost of even routine preventive care.

In addition to the already widely accepted "invisible" payment for health insurance that occurs by accepting lower salaries when benefits are included, there are "employee contributions" automatically deducted from paychecks. Wouldn't that mean that under Bush's plan, I would be paying *twice* for the "privilege" of having healthcare benefits through my employer if payments I make are now viewed as income earned?

Furthermore, I know that annual increases in the cost to my employer of purchasing the plan have ranged from 8% to 12% in the past few years, while my salary has been growing at a very small cost of living allowance of 1% to 2%. Clearly, these kinds of insurance rate increases far outstrip the rate of inflation, and the cost to my agency of providing insurance has had a direct impact on their ability to fund employee wage increases. I can't imagine the Bush plan would adequately address skyrocketing percentage increases without passing the cost on to taxpayers.

What would be far more equitable and effective plan would be to require accountability of the insurance companies around hefty annual rate increases and other spiralling costs.

And of equal importance is to shift responsibility to the federal government, whose job is "to promote the general welfare" of its people. I would think even a corporate system would have a vested interest in maintaining the health of its work force in order to increase and ensure productivity. But I also think that with the vast resources available in this, the wealthiest industrialized nation on the planet, a basic focus on providing for the health and welfare of our citizens would simply be the humane thing to do.
You hit it right down with your statement that a tax deduction won't help those who are too poor to even pay taxes. I am disabled, in poor health, and receiving only money from a private long-term disability insurance I had purchased years ago. My insurance premium is over $750/month which is the majority of my income. I have to dip into what little money I had saved for retirement just to pay the premium so it looks like I'm about to join those 47 million uninsured Americans. It does not appear, either, that the President's plan would help much of anyone, poor or otherwise. I agree with your respondent who suggested the politicians should be stripped of medical coverage and placed in an hourly wage class - frankly, I'd be happy just to see them work 5 days a week!
For nearly 20 years I was a single mother, sometimes working 3 jobs to keep health insurance for my children. A tax deduction was a JOKE for me. I got every penny I paid in taxes back on my $40,000 a year income. The 2 children I had and the mortgage I paid gave me all the deductions I needed. I needed health care. The country needs Nationalized health care. MD's lobby against this because they stand to lose the 3 condos they have in Hawaii and the Caribbean, while Americans struggle between the choice of taking a child to the doctor or eating this week. The best medical care I have ever received is government run--the Veterans Administration Health Care. They are a model for Nationalized Health care!
Bush's plan is filled with problems. Again, he is shooting from the hip with little thought to outcome, just like his war.
We need universal health care not driven by profit - for example Traditional Medicare - simply expand it to cover 65 and under - and we have a social provision to 65 and older and the disabled, that has worked but currently is being undermined by the privitization of Medicare - AKA Medicare Managed Care Plans AND PART D Drug Plans -especially pushed under this administration. CEO's of Managed Care Plans need not apply - go get another parasitic position to support your insane incomes - total greed profit driven medicine and phamaceutical games will jeopordize access to health care for all, if we don't have the wherewithall to stop it. Bush's plan doesn't address these serious issues - it's just another bandaid on a gapping wound.
The changes proposed to health care are just as bad as all the other plas the Bush administration has come up with. The only people it will help in the long run is the Health Insurance company - they probably have a well paid lobby group. People who are uninsured are that way because health insurance is too expensive. All the Bush plan will do is make it more profitable for companies to buy cut rate insurance and pass the buck to employees in the form of higher deductables and co-pays. If the Bush administration really cared about the American public and the health of uninsured americans they would regulate Health Insurance costs. I'm sick and tired of the old, lame argument that U.S Health Insurance is so much better because our care is top of the line. I have been around the world and treated at Doctors around the world. I had care equal to US care in French Polynesia and it was free, 100% free. That is something to think about.
I don't understand this plan enough to fully evaluate who it will help and how. I do know it won't help me or anyone else I know. Everyone I know who doesn't have insurance falls into 3 categories:
1. too poor - & thus don't pay enough taxes to benefit.
2. don't want to pay - these are the people who consider themselves healthy and don't want to spend the money even if there is some offset in costs; These people are usually young and don't have a lot of assets. If they have to go to the hospital, the hospital just passes the costs on to consumers.
3. Those who the insurance companies won't insure. This covers a lot more people than you might think. My sister is a healthy 27 year old who can't get private insurance for whatever reason.

So, in my mind, this plan just puts a band-aid on the scratch above the gushing wound.
It doesn't help those on SSDI w/ limited income and food stamps that are reduced when there is a small increase in SS benefits...go figure?
Food goes up and they take away more than they give? Have you tried to eat sensibly on 20$ per week? Thank goodness for food pantries and giving organizations here in Clearwater, Fl.
I have Mental Illness, no hospitalizations for 4 yrs. and a loving caring physician who goes the exta mile! It is no wonder so many are homeless, and need afforadble housing and monies directed for care.
Just ask how many people in Washington D.C. have family members with Mental Illness or who are suffering themselves.
We need to support the Campaign for the Brain!
Going from what I've read here, it will cause more problems. My family already has a health insurance company that covers little with high deductibles. If this incourages more employers to drop health care, then more people are going to be without.
I was initially confused as to why Democrats opposed this plan, other than it not being their idea, since it basically is a form of income redistribution (see Jim Webb's rebuttal for their views on that issue). Then I realized, unions have some of the most generous health plans in the country. My Dad is a retired UMWA (mineworkers) member, and he rarely pays a penny for any Rx or other health care treatment for him and my Mother. I wonder if the incredibly generous health-care plan covering government workers (please, with the benefits they enjoy now, don't call them "public servants" anymore) would also fall under this plan.
I am a health care provider in Connecticut (a psychiatrist). I'm 59 years old. For as long as I can remember, I've felt very strongly that we should have free national health care for everyone. It's really just that easy. We are the only civilized country to be in the sorry state of this poor availability of health care; also, when healthcare in the United States is compared to that in other countries, we rank very low.
It will be nightmare for small business ownere not to be able to deduct the health insurance premiums.Small business got to provide health insurance to attract employees. So another blow to small business.
Looks like the big money insurance and drug companies have scored again. President Bush's plan does not address the artifically bloated costs of health care. Prescription drug prices often are several 100 times the actual cost of production. The nurse to patient ratio has become so high that many leave the field from the stress of not having time to provide the care as they were trained, rising wages and lowering care. Currently a person without insurance is charged more for the same procedures. If an insurance company can negotiate a price that is "reasonable", then it would be logical to assume that the same price would apply to all. Those who can afford the least, are charged the most.

I worked for a company that exposed it's employees to abestos and other carcenogenics until the government stepped in. What incentive will companies have to ensure and protect their work force's health when providing health insurance isnt' required?

Before an employer adds the "cost" of health insurance to my taxable paycheck, I want an audit of exactly how that figure was derived. ERISA's allow for projected costs and not actual expenses. How much is for "administrative"? The lessons in fancy figuring in large corporations has shown how many friviolous expenses can legally be accrued. I want my paycheck and taxes to reflect the same profit margin built into hospitals, pharmacies, doctor practices, and insurance administrators.

Our right to good health is an unalienable right to be protected.
Everyone should have the same cost, access, and quality - rather like receiving electricity and telephone services.
I think it's very clear that insurance providers have more power than any company in the United States. Just look at how they brought the tobacco companies to their knees. Next: Fast food and then alcohol.
I think the health care in America is not up to standards. I do not think that President Bush's plan is realistic. We have citizens (low-income and veterans) who are walking time bombs because the health care system seem to be more about "business" than "health" I think it will be more problems because there is not enough preventive programs to help those areas with high pollution and other environmental problems
I found a very good prescription discount card that ANYONE can have for $4.50 a month. It's at www.rxdrugcard.com. They even post drug prices on the website.
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