do you like your medical insurance?

[maat55]

On the surface, I would say yes. But until you have an major event, who knows how good it is?

[LivingAlmostLarge]

I agree maat, but I think you have an idea with coworkers issues.

[swanson719]

See this is where I have a big problem getting on board with taxing employer provided health care to subsidize those without. And it's not from a selfishness viewpoint. In fact, I would rather pay double what I currently do for medicair than have employer provided benefits be taxed. That would be more equitable, and do less harm to the employer benefits, because people with good benefits wouldn't lose them because of the cost to the employer imposed by the gov't - rather, they would just pay more taxes in general, or more to medicair. It's not a selfishness thing in regards to not being willing to pay a little more to help someone else out, it's a selfishness thing in that I'm not willing to give up my quality of care because someone else found themselves in a position of not being able to take care of themselves.

HSA's people - a $5,000 HSA will cover your typical family with no pre-existing condition for a year, and counts as a tax deduction. Working at McDonalds full time will cover that.

Even upon all of this, my biggest problem with taxing employer based healthcare is that it penalizes those who need it most. If we tax medical coverage as though it counted as income, we would have to tack the $500,000 and counting that my employer has covered in medical bills so far this year. Together, my wife and I net about $50,000. Put us in the tax bracket for $550,000. We would have to declare bankruptcy because of the taxes alone. Taxes for married filing joint is 35% on the income over $372,950; plus $100,894.50. So our tax liability would be roughly $293,394.50 with us having a real gross income of roughly $60,000. The idea of taxing employer based health coverage as a dollar for dollar match on income would leave us with a single year of health coverage costing us just in taxes more than double our mortgage. To talk about life savings being drained because someone lost their job and got sick, this would drain our life savings and bankrupt us because my wife is sick and I have a secure job with good employer provided coverage. Is it selfish that I think taxing employer provided coverage is a crock?

This plan simple won't work, because those who need medical coverage the most would be left out in the cold. For those with routine care, this looks good on paper. But what happens when you get old and sick, have diabetes and lose your kidney function then have to go on dialysis which averages $40,000 a month in the US? Will you be able to cover $300,000 in taxes in a single year ever in your life? Probably not.

Lets say we're just going to tax 10% of what's provided by your employer. So for me, $50,000. So now that bumps me into the next tax bracket of 25%on the income between $67,900 and $137,050; plus $9,350. That puts me at a tax liability of $110,000 while I make $60,000 and net $50,000. Well now I'd still be grossing $60,000 and paying $36,850 in taxes, leaving a net of $23,150. This plan, if implemented at even a 10% tax rate, still effectively cuts my income in less than half of the current net I make today all because we actually have good employer coverage in the most secure job in America and we have a very real need for coverage. And it's selfish to oppose this plan?

If we tax employers who provide coverage for those in need it effectively forces all employers to either not cover those who need it most and only cover those with routine issues, which then leads to discrimination lawsuits, or they reduce coverage across the board to the point that you need to purchase private insurance to augment employer based, or the most likely, and the idea behind this tax, they drop it altogether and force their employees to utilize a gov't run healthcare plan.

[cschin4]

I think people are overusing the system. Do relatively healthy people need to be on 20 different medications? It seems absurd. I cannot believe the number of pills people take daily and the frequent doctor visits for everything under the sun. Just my opinion but I think most people would be healthier if they stayed away from the doctor and learned to accept minor illnesses and problems and deal with them. Flame away.

[Goldy1]

I am not familiar with any details of taxing medical benefits. I guess I assumed the premioum would be taxable.
There are too many people without and too many issues. You have to have compassion for people with preexisiting conditions.
For instance, hypertension runs in my family. I don't eat read meat, do drugs, drink, smoke. I am thin and walk daily. Heck I dont' even drink coffee, but my readings make me less than a perfectly healthy person. So is it fair it's held against me? No not really.
Plus you don't have o worry about using your insurance and getting labeled as a sick person when the employer is paying it.

I read some stuff about the gov wanting to fine people for being uninsured. I had to rearead that to make sure I wasn't imaging things. I dont' trust buying my own insurance (even if I do so )b/c of the pre existing clauses so they hopefully will come up with some kind of universal payer thing if they want to start fining people that prohibits not covering pre existing illnesses.

[swanson719]

There has been talk of both in congress. More often, they talk about eliminating the tax exemption of employer covered health care premiums. In a group rate, the premiums cost less because more participate, making an employer sponsored plan more affordable for everyone in it. Under the proposed system, it would then tax either the employer or the individual (yet to be worked out) for the premiums, counting it as income. The other idea being tossed around is to tax the benefits in full, or at some percentage.

Taxing the premiums as income doesn't eliminate the group rate concept, but rather adds more red tape to the mix. Rather than the employer just paying it and not worrying about it, they would then have to track each individuals cost and issue a tax statement accordingly, seperate from W-2s. This then would force employees to get lesser coverage at a better cost, or drop coverage altogether for those in a low income situation.

Good coverage would go out the window because no one would be able to afford it. They asked Obama in an interview if he would be willing to stick within the limits he proposes for gov't run health care and he said ver batim that he would want the very best care for his family, effectively a no. So if it's not good enough for politicians and their families, then why do they propose to implement that system for us? To me, that's to say we're inferior than our leaders. What happened to lead by example? How does Obama tell his daughters they get a different plan than the people he leads? Because he's better? One would argue that he is no better or worse, that we are all equal in Gods eyes. When your toilet goes out, who are you calling? A plumber, not the president. We have a need for both, and both deserve the same level of care.

[maat55]

I agree maat, but I think you have an idea with coworkers issues.

True, I would guess the more workers, the more you will know. Our insurance is through my wifes small bank, not many workers to go by.

[markusk]

Even upon all of this, my biggest problem with taxing employer based healthcare is that it penalizes those who need it most. If we tax medical coverage as though it counted as income, we would have to tack the $500,000 and counting that my employer has covered in medical bills so far this year. Together, my wife and I net about $50,000. Put us in the tax bracket for $550,000. We would have to declare bankruptcy because of the taxes alone. Taxes for married filing joint is 35% on the income over $372,950; plus $100,894.50. So our tax liability would be roughly $293,394.50 with us having a real gross income of roughly $60,000. The idea of taxing employer based health coverage as a dollar for dollar match on income would leave us with a single year of health coverage costing us just in taxes more than double our mortgage. To talk about life savings being drained because someone lost their job and got sick, this would drain our life savings and bankrupt us because my wife is sick and I have a secure job with good employer provided coverage. Is it selfish that I think taxing employer provided coverage is a crock?

This plan simple won't work, because those who need medical coverage the most would be left out in the cold. For those with routine care, this looks good on paper. But what happens when you get old and sick, have diabetes and lose your kidney function then have to go on dialysis which averages $40,000 a month in the US? Will you be able to cover $300,000 in taxes in a single year ever in your life? Probably not.

This is not related to the OP, but I have to agree with Goldy1. I thought the idea of taxing medical benefits involves taxing the monthly premium that goes toward your insurance? So if your employer is contributing $500/month ($6000/year), then that money is counted as income and taxed at your tax rate.

Healthcare reform is complex, so I don't pretend to have all the answers. But at a certain level, taxing healthcare premiums make sense to me. First of all, more money is available to cover more people. Second, you will now be very aware how much your health insurance is actually costing you. As a result, maybe you'll make better life choices or be more picky in chosing a cheaper alternative when getting imaging studies, medications, etc. Third, since it's going to be taxed anyway, perhaps you'll negotiate an actual pay increase (get a raise) versus getting better health insurance (which drives up healthcare cost for everyone).

Getting back to the OP, I personally would get hit very hard by getting my very generous healthcare package taxed. As a physician, I am part of a group practice. My co-pay is $5 for everything including medications and vision. Includes dental, but is basic. I can add my parents (in-laws too) to my insurance regardless of pre-existing conditions. When I retire, my healthcare is paid for 100% until I die, spouse too -- I realize that under the present "fee for service" healthcare system, if everyone had my generous healthcare coverage, healthcare cost would go thru the roof!

If I did not have this generous package, I either would have negotiated a much higher salary or not taken this job in the first place. As it is, some of my friends in the same field have a higher income than I, but if you factor in the benefits, I am way out ahead.

[LivingAlmostLarge]

Definitely, me too! I think my DH and I would have opted for a HDHP and MUCH higher salary if they tax benefits.

I might change my mind now with a baby on the way, but we have ridiculous benefits.

[Goldy1]

I am no bleeding heart liberal but I have compassion for other people. I dont' have compassion for stuff like credit card debt and being over your head on a mortgage due to stupud mistakes, but we are talking healthcare, not a free ride in life or anything extravagant. WE are talking not having to worry about your nest egg or having to spend it all on healthcare when you get laid off or get sick.

[swanson719]

I equate credit card debt, being behind on your mortgage, and not having health insurance as the same thing: lack of personal responsibility. To me, there is no difference. Either you are responsible enough to take care of yourself and those around you, or you aren't. Medical coverage can be had via an HSA for the regular joe at a price everyone can afford. The exception to this is those with pre-existing conditions. I don't see where it is the governments role to provide medical insurance. They don't provide auto insurance, why should they medical? The gov'ts role is to make medical coverage available, which it currently is. At what cost, that's a different story. But why not let market factors force the change rather than gov't dictating it? Have we ever seen our government be efficient? I don't have a whole lot of confidence in our gov'ts ability to handle domestic issues, given the trillion dollar debt.

[markusk]

Off the OP, but....at some basic level, the question of healthcare is a philosophical question: Is healthcare a basic human right or a privilege.

[DebbieL]

I equate credit card debt, being behind on your mortgage, and not having health insurance as the same thing: lack of personal responsibility. To me, there is no difference. Either you are responsible enough to take care of yourself and those around you, or you aren't. Medical coverage can be had via an HSA for the regular joe at a price everyone can afford. The exception to this is those with pre-existing conditions. I don't see where it is the governments role to provide medical insurance. They don't provide auto insurance, why should they medical? The gov'ts role is to make medical coverage available, which it currently is. At what cost, that's a different story. But why not let market factors force the change rather than gov't dictating it? Have we ever seen our government be efficient? I don't have a whole lot of confidence in our gov'ts ability to handle domestic issues, given the trillion dollar debt.

I just don't get this. Maybe it's because I am a Canadian. I feel that medical care is a right (and it is here). I cannot imagine living somewhere that it isn't. Nobody here has to worry about being wiped out financially by illness. What about the people you mentioned that DO have a pre-existing condition? Are they able to get insurance at an affordable price? I'm just glad I don't have to worry about that stuff (and contrary to what many in the US seem to think, we actually have good care here - although there can be a bit of a wait for elective type, non emergency procedures - I wouldn't trade the system for anything).

[swanson719]

People with a pre-existing condition in the US are usually covered by medicair, and for those that aren't, they get hosed by cobra or other independent providers. In my situation, I'll end up spending 22 yrs on active duty in order to provide for my family given DW's medical. It's not something I hold over her head - I made the choice to marry her, knowing full well of her disease. You do what you must to care for those you love.

Can the system be better? Yes, but I don't think the gov't needs to intervene to the point they are. Maybe change malpractice law so that there isn't so much defensive medicine. Make it that insurers cannot cover cosmetic or other elective surgery. Force those who are a high risk, repeat offenders to pay more the same we do with auto insurance. Why should a professional stunt man or extreme sports person pay the same rate as an office worker?

The system can stand improvement and change, but the underlying point I'm trying to make is that it doesn't need to be mandated by rule of law and enforced by the government. We haven't reached the level of Upton Sinclairs "The Jungle" that was the meatpacking industry. Given the correct market factors, medical will work itself out, because the populace will not let it crash.

[LivingAlmostLarge]

Debbie, a lot of americans feel that way but not all. I believe healthcare is a right, not a personal responsibility.

But that's why we have a system every man for himself.

The problem? When you have get sick suddenly you WANT help.