Open thread March 12, 2013 Dan Crawford | March 12, 2013 8:30 am Tags: open thread Comments (17) | Digg Facebook Twitter |
I heard someone say that health care in the United States now costs 8 thousand dollars per year per person.
I don’t know if this is true. It seems like a lot to me.
The following is not a proposal, just an effort to create a basis for thought.
Suppose your health care “expected costs” over a lifetime are that 8000 dollars per year or about 600,000 dollars over a life expectancy of 75 years.
If you paid for those costs over a 40 year working lifetime, you would have to pay 15,000 dollars per year.
Average pay is about 45,000 dollars per year, so you would have 30,000 left for other expenses.
Now suppose you are going to need to “save” enough to have 20,000 dollars per year for a life expectancy of 20 years after you retire. That’s another 400,000 dollars, or about 10 thousand a year. You would pay 5 thousand of this, and your boss would pay another 5 thousand if it was paid for through Social Security. OR you could think of it as you paying the whole ten thousand… but then you’d have to add the 5,000 your boss pays to “your” income to arrive at your “real” income of 50,000. Either way, after you have paid for your medical care and your retirement, you are left with about 25,000 dollars per year for “other things.”
Now, the question is can you live on that? Are you being hurt? Does it help to remember that your grandparents got buy on a good deal less than that in “real” dollars and still had to pay for their medical care and their hopes of retirement?
I think you can. And I think you should not feel sorry for yourself. Being able to retire with security, and having your medical care “taken care of” are great luxuries… a much higher standard of living than workers have ever had. The hard thing for you to get used to is that you are not as rich as you thought… even on 45k per year… and that your money is going in large part to keep you (and your kids) alive and healthy. Maybe a little less on plastic toys.
I would expect the price of houses to come down.
OR, you can insist that the rich pay for it. I would humbly suggest you do this by organizing for higher wages and better laws to restrict predators in high places… rather than count on making them pay higher taxes.
So you thought you are living in a democracy. Think again. What was good for thirteen small and similar colonies isn’t working out so well for fifty very different states. The NY Times had a pretty good review of this issue yesterday, and its about time. The article: http://www.nytimes.com/interactive/2013/03/11/us/politics/democracy-tested.html?pagewanted=all&_r=0#/#smallstate
And its graphic representation: http://www.nytimes.com/interactive/2013/03/11/us/politics/small-state-advantage.html
There are eight states with barely 1M citizens (or less) each and they have eight times the Senatorial clout as does NY with close to ten million citizens. That representational distortion is greater still for California and Texas.
Add to that the aggressive and pervasive gerrymandering that is epidemic and yet more representational distortion has crept into out political life. It’s not for no reason that so many of our elected officials often seem like idiots, often caught making self defeating, foot in mouth disease, types of comments.
Then take into account the gross distortions of issues provided by privately funded think-less tanks. Or should we recognize them as the propaganda generating organizations that they are? And we are well on our way to taxation without representation for the many and representation with little taxation for the few. How much does it cost to buy two Senate seats in Wyoming?
The NIH recently did a study of US deaths involving drugs & alcohol, obesity and diabetes, lung disease, heart disease, infant mortality, injuries and homicides, HIV and AIDS, and found what they called “a pervasive pattern of shorter lives and poor health” crossing all socioeconomic lines.
People 40 years ago didn’t have the diagnostic/treatment tools of today, such as CT scans, which are costly (and probably overbought; every hospital thinks they have to have one). But to say that we should be happy to settle for the health care of the 1960s is like saying “Grandma got Grandpa’s overalls clean in a #2 washtub, on a scrub board”, and expect that we should do so, too, just because it’s possible.
Cancer used to be a “go home and die” proposition, heart disease was often diagnosed by a fatal heart attack before 60, the only chronic conditions treated were mainly hypertension and insulin dependent diabetes, which was about the only kind we knew about.
I’m sure we could all live below our means to some extent, but to say we should be content to have what our forebears had, just because they survived is silly.
Medical care is one of the least transparent business arrangements we can enter. We don’t really know who the best surgeons are, or what they charge for each procedure, because there is a “sticker price” and a price that’s negotiated by insurance or Medicare. More hospitals are chosen by the availability of convenient parking than by the competency of staff. And if you’re doctor shopping, don’t forget to ask the surgeon how much he/she is “rewarded” by the device manufacturer or the provider of the chemo. That is a whole other side of the “industry” we’re not meant to know about.
just to be sure
I did not suggest we settle for the health care of the sixties. I said exactly the opposite:
if health care is going to cost so much (because it works?) we might have to learn to pay for it and count is as an improvement in our standard of living, even nicer than a new car.
living being nicer than not living most authorities agree.
coberly, $8000 per year per person sounded like a lot to me, too…i tried digging thru the PCE component of GDP but didnt find it….so i just googled; wikipedia quoted 2010 OECD per capita for US @ $8,233 & 2009 WHO figures at $7,960; it’s 17.6% of GDP in any case…
cuba, with the same life expectancy, spends $478 per person, on a purchasing power parity basis…but i dont think they have insurance companies down there…
Ok, I confess, this part tripped my trigger (obviously in error)
>>>>Now, the question is can you live on that? Are you being hurt? Does it help to remember that your grandparents got buy on a good deal less than that in “real” dollars and still had to pay for their medical care and their hopes of retirement?
I think you can. And I think you should not feel sorry for yourself<<< It sounded too much like my conservative cousin, who seems to think I should eat beans and rice every day so I can “take care of myself and quit relying on the nanny state”, an attitude that wants to believe any kind of societal insurance, let alone safety net, is a cardinal sin. In this era where costs of everything we need are going up and the wages we are paid keep stagnating or going down, it’s really hard to look out 10-20 years and think, “what’s the point?” So, again, I apologize for the misinterpretation.
i am not a conservative. but one way or another you are going to pay for your health care and retirement or do without.
i think the best way is through Medicare for all, and Social Security.
What I don’t think will work is expecting someone else to pay for it.
Mainly I was hoping to get people to first, understand what they are paying for. and second, to think of that as in improvement in their standard of living worth far more than a new Lexus every year.
maybe we should look at the Cuban model.
Other people have suggested that, and I think they are right.
But my purpose her was just to get people to think clearly about the first step: what are we paying for. and, is it worth it.
I think that IF it did really cost that much to live in reasonably good health an extra ten or twenty years, and not have to work for the boss when you are old, it would be worth it.
I get frustrated with the people who run around talking about the high cost of health care (and Social Security) without understanding that these things are far more valuable to them than whatever it was they bought at Wal Mart with their payroll tax rebate.
now, obviously if you are paying twenty times as much as Cubans are for the same “value”, you might want to look into cost savings.
That is going to be a huge political fight, a fight that will not be won by fairy tale thinking.
[the fairy tale is “health care is a right, so someone else should pay for it.
there might be some justice, and certainly some Christian virtue, in that, but as a matter of the behavior of human beings, it’s not going to happen that way.
even in Cuba where “the government pays for it” it does because the people (arguably) have decided that “they” are willing to pay for it themselves, using the government as the purchasing agent.)
sorry to run on but
here in America the people who say “the government should pay for it” don’t want to pay for the government.
they want to tax the rich. i guess that would mean that if medical care is costing each worker 15000 a year prorated over a working life time, making the rich (top 1%) pay for it would cost those rich 15 hundred thousand a year each. that ‘s the sort of money even the rich would notice.
moreover, after they have decided “the rich” should pay for it, they want to eliminate the rich (as a class).
i need to say again, though no one believes me, i am NOT endorsing the Ryan Romney Peterson Boles Simpson view of these things.
I think that last point, about the people wanting the rich to pay for it, is a bit of a stretch. I don’t know that I’ve ever heard anyone make that bold a statement against the very wealthy. What I do know from what I’ve read in widely diverse sources is that the people who make up the lower 95% or so would like the rich to pay their fair share. Granted there will be divergent views as to what that means, but it is widely accepted that it’s not happening now. He who benefits most from the economic structure that our government provides and protects is he who owes the bigger share of supporting that government. The term progressive taxation is hackneyed and useless. It’s fair share of the burden based on one’s benefits received.
This is quite new to me. Thanks for the information.
Audit in UAE
what people say they want, and what they say they want are often two different things.
you won’t get many people to say in so many words they want the rich to pay for their dinner.
but when it comes time to end the evil Bush tax cuts… they say… yes, but only for people who make more money than i do.
and when they could fix social security for eighty cents, they say, no, make the rich pay for it.
i already know about the evil rich. what stops me from beating them is the folks on the left who say “ni.”
“…but when it comes time to end the evil Bush tax cuts… they say… yes, but only for people who make more money than i do.”
When such an attitude becomes prevalent it may very well be the result of the recognition that the middle is being squeezed unmercifully both in terms of their earnings losing ground and their tax bight never seeming to be reduced by more than chump change. And that latter experience is felt in a context of news reports of the substantial tax savings of the wealthiest Americans and the corporations that provide that wealth.
Changes in the tax system should be based on fair share, which should be determined by benefit received, not from what adjustments can be made to a current system. Note that the Bush tax cuts were legislated to laps, but the change that was put through recently was described as an increase rather than a restoration to a prior level which the first reductions were supposed to intend. And again, the wealthiest got the greatest share of that ten year tax hiatus. All that the middle got was lost income and lost employment.
but first, politically you don’t stand a chance when you are saying “tax the other guy but don’t tax me.”
and second, as long as that is your internal sense of “justice” you don’t stand a chance.
“Changes in the tax system should be based on fair share, which should be determined by benefit received”
I am not sure it is that simple.
For SS and healthcare it probably is. That means increasing taxes on everyone if we want everyone to have more benefits.
What about roads, education, military, EPA? Do business owners benefit more from these than non-business owners, or do we need them because we have business owners? I think so, but am not sure how to quantify it.
I also think there is room for discussion about taxing the rich because they simply have too much power.
agreed that “the rich” have too much power. but it’s not “all” of the rich. and those who have too much power are rich because they have too much power.
i am not sure taxing them will work to curb their power. honest regulations might.
and no, this does not mean i am against taxing the rich.
i am against “taxing the rich” as a mindless one size fits all answer to everything. pretty much in the same category as “cutting taxes” as a mindless one size fits all answer to everything.
otherwise i agree with you entirely.