Governement Healthcare...

[fluffhead]

I've never had a problem using up our childcare account, and we max it every year.
But I don't see why we just couldn't deal with it on our tax return. The whole thing adds a level of bureaucratic complexity, and additional expenses that employers need to pay to the administrative entity.
The nice thing I have to say about the health care FSA is that they're tied into the insurance co, and after a copay, they automatically credit my bank account w/o me having to file a claim.

[Pollyanna]

In addition, there may be small, immediate changes to the way we obtain private insurance now. Among other things, the House is considering including a provision that severely curtails our ability to use pre-tax flexible health spending accounts--which, of course, means a higher effective tax rate.

The new healthcare coverage for us will actually punish you if you use a FHSA. You will have higher deductibles and premiums if you opt for for a health spending account.

Of course the State has to change the insurance offerings because Napolitano spent our State into the ground. Now she's in charge of our borders, SCARY!!

[GrayMatterWife]

A lot of people in my office seem to use flexible spending accounts for childcare. I think that's different from health savings accounts. I had the option of one but never used it.

My parents love their HSAccount. Geez, between their glasses, contacts, inhalers, etc...

We don't have one right now, but assuming that the tax advantage remains, we may get one later, when the kids need braces, glasses, etc.

[GrayMatterWife]

But there isn't real competition in health insurance currently. Most employers only offer one plan. There are huge regional differences in what's available. Etc etc.

I still think that competition is not the be all and end all of public good. It works great for some things. Not so much for others.

Sorry--should have been clearer. I was referring to competition re: which plan an employer would offer, to entice employees and be competitive. My employer offers BlueCross/Blue Shield, DH's offers United Healthcare, etc. But, eventually, these just won't be offered, period. Employers will turn to the public option and stop offering private insurance.

[Sheherezade]

We have a HSA now that is tied to our new high deductable insurance plan. It is actually a pretty good system. We put in money pre-tax and we get to keep it forever in the HSA. (It doesn't expire at year's end.) We can use that account for any health expense. We pay a large amount out of pocket each year before the insurance kicks in from the HSA but we have a lower insurance rate for the actual policy. So far, I have used the HSA a lot to pay for things like IUD (less than deductable last year) and my son's knee brace (less than deductable this year). It is surprising that for a family that is relatively healthy we have managed to spend thousands each year for the last two years!!

As for the public plan slipping in to socialized medicine, the AMA fact sheet addresses that question next on the list....and then the idea that employers will simply drop the private insurance option. It seems to be the typical route of criticisms. I personally feel that the private option will still exist as it does in Europe....in fact I think it has grown in Europe so that people can have options to the socialized plan. Employer based health insurance grew here from competition for workers. It was a perk offered to employees --- like stock options, etc. It wasn't "the norm" before 1950. You just didn't have coverage. I think that employers will still use "better" health benefits to lure good employees - but if they don't then people will have an available option.

[Sheherezade]

Oh...and I agree Sally ....in this house insurance companies are public enemy number one. DH spends an inordinate amount of time trying to convince them that they should pay for cancer treatments for their clients. You know....the people that have been faithfully giving them money year after year, only to get stiffed when they need expensive care. I would WELCOME regulation of the insurance companies.

Cleveland seems to have nothing but insurance companies though....I'm worried about all these people that work them. It has become a HUGE industry.

[GrayMatterWife]

I think that employers will still use "better" health benefits to lure good employees - but if they don't then people will have an available option.

I really hope you're right!!

The funny and sadly ironic thing would be, of course, that such a result would achieve the exact opposite effect from that which Obama and the Lefties want. They want to achieve a more "equalized" society by artificially altering the standard of living for those with means, to subsidize the standard of living for those with lesser means. This would create a sharply dual-tracked standard of living in terms of health care: people who have great educations and many opporuntities will be able to obtain gold-plated health care, while everyone else will be relegated to government dependence.

Frankly, bluntly, and harshly speaking, on one hand, this is not my problem. I'm a lawyer married to a neurosurgeon. We are the very definition of people who have the means to have choices. While we may not be rich, we have the professional skills to enable us to call our own terms of employment (including benefits). On the other hand, it really bugs me that the Government believes that certain people who be eternally tethered to the Government. The War of Poverty was a failure. It created two (going on three) generations of people dependent on the Government. It was a bad plan for distributing welfare. It will be a bad plan for distributing healthcare.

[Pollyanna]

DH spends an inordinate amount of time trying to convince them that they should pay for cancer treatments for their clients. You know....the people that have been faithfully giving them money year after year, only to get stiffed when they need expensive care. I would WELCOME regulation of the insurance companies.

So do people think the government will be any better in this regard? Just curious what people think.

[Sheherezade]

Medicare is now. Maybe that will change? I know that DH doesn't spend time arguing for care with the government for patients covered by government dollars.

[radwife]

I'm listening to a webcast right now about the proposed healthcare reform and they just showed this slide about how they are going to pay for the plan. I thought was interesting considering the recent comments on the flexible spending accounts....looks like potentially the tylenol might not count anymore...


Tax revenue sources from House bill

Proposal 10 year revenue estimate*

Surtax on higher income families: $544 billion

•

1.0% on modified AGI $350,000 to $500,000

•

1.5% on modified AGI $500,000 to $1 million

•

5.4% on modified AGI over $1 million (Pelosi has commented on only having the tax on $1M and above)

Delay election for use of worldwide interest allocation rules relating to foreign tax credit calculations until 2020: $26 billion

Limit certain tax treaty benefits: $7.5 billion

Codify economic substance doctrine: $3.6 billion

Over-the-counter (OTC) medicine not eligible for reimbursement under Flexible Spending Account (FSA), Health Savings Account (HSA), Health Reimbursement Account (HRA) $8.2 billion

*JCX-33-09

[GrayMatterWife]

I'm listening to a webcast right now about the proposed healthcare reform and they just showed this slide about how they are going to pay for the plan. I thought was interesting considering the recent comments on the flexible spending accounts....looks like potentially the tylenol might not count anymore...


Tax revenue sources from House bill

Proposal 10 year revenue estimate*

Surtax on higher income families: $544 billion

•

1.0% on modified AGI $350,000 to $500,000

•

1.5% on modified AGI $500,000 to $1 million

•

5.4% on modified AGI over $1 million (Pelosi has commented on only having the tax on $1M and above)

Delay election for use of worldwide interest allocation rules relating to foreign tax credit calculations until 2020: $26 billion

Limit certain tax treaty benefits: $7.5 billion

Codify economic substance doctrine: $3.6 billion

Over-the-counter (OTC) medicine not eligible for reimbursement under Flexible Spending Account (FSA), Health Savings Account (HSA), Health Reimbursement Account (HRA) $8.2 billion

*JCX-33-09

Sounds like the usual Leftie response: Punish the rich, those bastards! Play the envy card and make people hate those who have what we don't! Don't encourage people to WANT to become rich and succesful; don't incentivize self-improvement and empowerment...make them feel like it is someone else's fault that they don't have what the rich do! And then, f**k the rich! That will fix the injustices of society!! Make them pay!

It's the economic version of the "race card."

[SuzySunshine]

We have an HSA which is very nice to have - we'll see how it goes with the baby being born this year, that was not the plan.

We never used the Flexible Spending account I just didn't like the idea of losing it at the end of the year - how are you supposed to guess things like that?

[DCJenn]

I don't know, I'm a Leftie. I don't want to punish the rich. According to the poverty level comparisons, I AM rich.

But, I'd really like my neighbor who has severe and chronic asthma to be able to be covered by a health care plan. Seriously. I mean ultimately, when he's in the hospital with an infection in his leg that won't heal because of the massive amounts of steroids he takes, I pay for that hospital visit ANYWAY. My property tax goes in part to the hospital district. My federal taxes goes in part to medicaid and medicare.

Ideally, he'd be able to actually SEE his pulmonologist regularly and not when he's in crisis and he'd be able to pay for his medications. We'd prevent the massively bad crisis situations that require that he be in the public hospital for three weeks.

or the artist in my neighborhood who has brain cancer but can't afford treatment so the other artists in the 'hood are having a fundraiser.

These people are income producing respectable members of the community who cannot afford private health care, and in Pete's case has a 'pre-existing' condition that precludes getting insurance in most cases anyway.

Jenn

[GrayMatterWife]

I would WELCOME regulation of the insurance companies.

That's an interesting comment. Some folks in DC having been trying to change the focus of the reform efforts from "reforming healthcare" to "reforming health insurance." Maybe it's a distinction without a difference, or maybe it's important. Not sure.

[Sheherezade]

I think it has a lot more to do with insurance and tort reform than health care. (Says the doctor's wife! ) As DH said last night, the "health care" we offer here is actually pretty good. It's access (because we block people with high costs and an insurance based system) and defensive medicine/frivolous lawsuits that stand out in our system as flaws. I don't think many people think that our doctors are bad. Thank goodness for that. It's the pay structure and the Frankensystem that has developed over the last 70 years that needs work.

Actually, that IS what this bill is doing. They are offering a new type of coverage. Insurance. I think the healthcare debate gets clouded because when we talk about government doing healthcare it can mean two things: Government running hospitals (hasn't ever been proposed) and government running insurance (often proposed in various methods). It is (really) the insurance that is being reformed - but that will affect doctors if they depend on it for payment. Of course, they don't have to participate in the governement plan (AMA fact sheet) so a doctor could just not take government patients and only do private insurance. I had a dentist once that only took cash. :shrug:P

Since our government already insures the sickest population (the elderly) through Medicare, it would be good to also insure some healthy people. Can you imagine basing your insurance company on strictly people over 65? Premiums would be crazy to account for predictable risks.