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One thing that bothers me about taxes is that they are around 20-30% of profits. If you take on a business partner and give him/her 20%, you expect something i

One thing that bothers me about taxes is that they are around 20-30% of profits. If you take on a business partner and give him/her 20%, you expect something in return. What do we get for our taxes? Wars and social programs that will be bankrupt long before we can benefit from them. (roads, etc., are < 1%). I would be OK with paying the taxes for social programs if I thought those programs would be sustainable into my old age, but they aren't and nobody seems to care, even though this is widely known. So when you write the IRS a big check, you are paying for old people, and when you are old you will not receive the same treatment. By the way, most of the cost of healthcare is in areas where the money has very little yield, such as end of life care for the elderly, bypass operations, stents, and statins. If people actually had the opportunity to consider the value of healthcare, reform would be nothing like what it is now. Next time you see an old person eating bacon and eggs in a restaurant, picture that person's bypass operation, years of statins, and excessive end of life care that you are paying for... and think to yourself how perverse "reform" is. Meanwhile, there are millions of so-called "illegal immigrants" who can't even call the police if they are assaulted or abused (for fear of deportation) being left out of the reform. Most of your income taxes go to wars and medicare, and most of the healthcare reform goes to the practitioners who practice useless surgeries and interventions on a vulnerable population of elderly. The "reform" bills don't change anything, they just transfer even more of the wealth of young people to the elderly and their exploiters.

deleted 17y ago
[deleted]
jeremymcanally 17y ago
The idea behind a big piece of the reform is to reward doctors who push preventative care over pills, surgeries, and continued treatment. Therefore (ideally) we will see less and less of these preventable surgeries since doctors and hospitals are striving to reduce their preventable and recurring care for patients (i.e., they get cash if they reduce it).
- gojomo 17y ago
  Can you provide a reference for this "cash benefits for doctors who reduce long-term costs" portion of the bill?
  - blasdel 17y ago
    I think this is one of the parts of the bill where the imperative and desired result is outlined clearly, but the mechanism to that end is left up to an independent commission to start implementing in the next several years. I think it's a very smart move: lets them avoid 'Big Design up Front' and the associated bickering + reification.
    - deleted 17y ago
      [deleted]
    - gojomo 17y ago
      This seems based on the idea the future will be braver at making tough choices -- and saying no to popular overspending -- than the present is. Is that the long-term political trend? More steely-eyed fiscal realism each year? Is our society today braver at telling organized lobbies (including suffering or fearful people), "no, that sounds nice but costs a lot more than the proven benefits", than it was a generation ago?
patrickgzill 17y ago
My one-sentence view of what is going to happen in America is that "repudiation is coming" - on multiple levels, people, organizations, maybe even states will say "sorry, we can't fulfill obligation X any longer, we are done paying" .
- patio11 17y ago
  Or, less extreme, changing the terms of the promise after the promise is made. Very few pension funds are so comprehensively mismanaged that they will not be able to pay any pensions, but very few are so competently managed that they will be able to pay all promised pensions, so look for them to do things like means testing to get out of their obligations. ("You spent the last forty years saving money by yourself!? Pfft, what do you need a pension for. Amscray, we've got people who actually need the money to look out for.") This is inevitable for social security, and I'm thinking the gold-plated public pensions (and many private ones) will follow suit.
- adolph 17y ago
  Case in point: "But even if the decision does leave some Arizona children without health-care coverage, Orient said, there is no alternative in the state's current financial situation. 'At a certain point, it doesn't matter how good you think a program is,' she said. 'If you can't pay for it, what are you going to do?'" http://www.azcentral.com/arizonarepublic/news/articles/2010/03/20/20100320arizona-kids-lose-health-coverage.html http://www.azcentral.com/arizonarepublic/news/articles/2010/...
coryrc 17y ago
And for anyone who doesn't believe you, here's Newsweek's take on increasing the burden on the young: http://www.newsweek.com/id/224020 http://www.newsweek.com/id/224020
jacoblyles 17y ago
My favorite proposed solution is "defined contribution instead of defined benefit", which would address most of the incentive problems and inequities you mention. In Washington, they call it "privatizing" and run you out of town.
kurtosis 17y ago
I find myself very sympathetic to your view - especially the part about not wanting to pay for wars. I have also frequently heard people claim that entitlement programs to support the elderly are "unsustainable" - but I honestly don't understand what this means. Do you mean that the costs of providing for our elders would grow without bound? Also, if you know of a nice explanation that presents the evidence that entitlement programs like social security are doomed I would be very grateful if you could provide some links. I would really like to know.
- Xichekolas 17y ago
  The entitlement unsustainability is entirely a problem of demographics. People are living longer and having fewer children, so the ratio of young working people (who pay) to old retired people (who benefit) is diminishing. The classic answers are to either increase FICA taxes or cut benefit levels... which seems idiotic, when the obvious solution (to me) is to just raise the eligibility age. Part of the problem is that people are living longer, and are mostly healthy and able to work longer, so raise the retirement age.
  - orangecat 17y ago
    Part of the problem is that people are living longer, and are mostly healthy and able to work longer You're right about the demographics, but I'm not sure this part is correct. Yes people are living longer, but it seems that a great deal of that is that when a 70 year old contracts condition A which used to be fatal, we can now often keep them alive at great expense until they die at 80 of condition B. It doesn't mean they'd be effective workers at 70. My "obvious" solution is to focus on curing aging, which is generally the fundamental cause of both A and B. Until that happens, means-test benefits. Warren Buffett doesn't need to be getting checks from the government.
    - jacquesm 17y ago
      'Curing' aging is really going to break the economy. Pension systems were not meant to take care of people for ever, if 'aging' gets cured then you can expect to work until you drop dead.
MartinCron 17y ago
I like driving too, but don't focus too narrowly on roads. I think you're getting benefit from more than < 1% of taxation. Public education helps everyone. Research helps everyone. Having a criminal justice system helps everyone (well, the non-violent drug offenders would disagree). Having a strong civil legal system helps everyone. Meat inspectors help everyone. Financial regulators help everyone. You could even say that knowing that we don't have senior citizens starving and dying in the streets as helping everyone. I like knowing that I live in a society that takes care of many of the less fortunate. I'm not saying that government is good at solving every problem, but focusing on just roads, wars, and old people is very narrow.
- startuprules 17y ago
  I would dare to say that our government sucks at solving any problem. A few examples: U.S. Teens Trail Peers Around World on Math-Science Test http://www.washingtonpost.com/wp-dyn/content/article/2007/12/04/AR2007120400730.html http://www.washingtonpost.com/wp-dyn/content/article/2007/12... U.S. prison population dwarfs that of other nations http://www.nytimes.com/2008/04/23/world/americas/23iht-23prison.12253738.html http://www.nytimes.com/2008/04/23/world/americas/23iht-23pri... Lehman Cooked The Books Prior To Collapse; Geithner And NY Fed Implicated http://thelibertyguardian.com/2010/03/lehman-cooked-the-books-prior-to-collapse-geithner-and-ny-fed-implicated/ http://thelibertyguardian.com/2010/03/lehman-cooked-the-book... Let's face it; our government is setup to help the big corporations.
  - MartinCron 17y ago
    Oh, come on, that's just confirmation bias. Our government solves lots of problems. A few counter-examples: People love Medicare. It helps keep old sick people from financial ruin. That's a good thing. Lots of banks have failed in the last few years, but government-run programs (FDIC, mostly) keep the fallout from damaging citizens. The United States is home to many world-class research institutions, many of which receive government grants. Bernie Madoff was running a huge ponzi scheme to defraud investors, but was eventually caught, by the government, and sent to prison. The military and US AID have helped save lives and assist in reconstruction of post-earthquake Haiti. FAA regulators have made air travel extremely safe. NHTSA and other regulators have improved the safety of cars and saved countless lives. The Parks department has conserved millions of acres of winderness for people to enjoy for generations. The Endangered Species Act has literally saved species from disappearing from the planet. The National Science Foundation helps fund RadioLab, the best thing on the radio.
Daniel_Newby 17y ago
"Next time you see an old person eating bacon and eggs in a restaurant, picture that person's bypass operation, years of statins, and excessive end of life care that you are paying for..." Cardiovascular disease is mostly caused by carbohydrate consumption and inactivity. The Feds subsidize these, and health care "reform" will make the problem worse.
- grandalf 17y ago
  Not to nitpick, but I think it's mostly caused by refined carbohydrate consumption, high fructose corn syrup, smoking, and obesity.
  - sailormoon 17y ago
    In other words, the exact opposite of what your parent post said. And fyi HFCS is refined carbohydrate.
    - vixen99 17y ago
      Right and it's vital for people to know this. For anyone who wants to know more I recommend starting with http://articles.mercola.com/sites/articles/archive/2003/03/26/fructose-part-four.aspx http://articles.mercola.com/sites/articles/archive/2003/03/2... Mercola is not an original researcher but he does substantiate his views ('Soda should almost be illegal to give to children. I can't think of any reason or justification to continue such a disease-promoting practice') with links to the many peer-reviewed publications.warning against its use. This sorry story of HFCS, obesity and ill-health is gathering momentum. . http://www.ajcn.org/cgi/content/abstract/79/4/537 http://www.ajcn.org/cgi/content/abstract/79/4/537
    - grandalf 17y ago
      Well, it's not as if eating lots of fatty (high calorie density) food doesn't also result in obesity. I think that implicit in your expression of dissent to what I initially wrote is belief in the fallacy of "good fats".
jamiequint 17y ago
"most of the healthcare reform goes to the practitioners who practice useless surgeries and interventions on a vulnerable population of elderly" A lot of doctors don't want anything to do with medicare patients because they are often breakeven at best and in many cases a net loss. They are many times required to care for these patients in order to maintain hospital accreditation programs that allow them to look attractive to patients with insurance (where the hospital actually makes some profit). It is good to pay attention to healthcare availability, but no sustainable solution can ignore the cost side. Excess litigation has played a significant role in the massive overinflation of healthcare costs. Flooding hospitals with patients with government insurance - likely to be net-negative income for hospitals - is going to destroy the healthcare system faster than it fixes it.
stretchwithme 17y ago
I think you see things very clearly. Such is the quagmire of a declining democracy where most people are intent on shifting the costs of their decisions to everybody else.

deleted 17y ago

[deleted]

jeremymcanally 17y ago

The idea behind a big piece of the reform is to reward doctors who push preventative care over pills, surgeries, and continued treatment. Therefore (ideally) we will see less and less of these preventable surgeries since doctors and hospitals are striving to reduce their preventable and recurring care for patients (i.e., they get cash if they reduce it).

gojomo 17y ago
Can you provide a reference for this "cash benefits for doctors who reduce long-term costs" portion of the bill?
- blasdel 17y ago
  I think this is one of the parts of the bill where the imperative and desired result is outlined clearly, but the mechanism to that end is left up to an independent commission to start implementing in the next several years. I think it's a very smart move: lets them avoid 'Big Design up Front' and the associated bickering + reification.
  - deleted 17y ago
    [deleted]
  - gojomo 17y ago
    This seems based on the idea the future will be braver at making tough choices -- and saying no to popular overspending -- than the present is. Is that the long-term political trend? More steely-eyed fiscal realism each year? Is our society today braver at telling organized lobbies (including suffering or fearful people), "no, that sounds nice but costs a lot more than the proven benefits", than it was a generation ago?

patrickgzill 17y ago

My one-sentence view of what is going to happen in America is that "repudiation is coming" - on multiple levels, people, organizations, maybe even states will say "sorry, we can't fulfill obligation X any longer, we are done paying" .

patio11 17y ago
Or, less extreme, changing the terms of the promise after the promise is made. Very few pension funds are so comprehensively mismanaged that they will not be able to pay any pensions, but very few are so competently managed that they will be able to pay all promised pensions, so look for them to do things like means testing to get out of their obligations. ("You spent the last forty years saving money by yourself!? Pfft, what do you need a pension for. Amscray, we've got people who actually need the money to look out for.") This is inevitable for social security, and I'm thinking the gold-plated public pensions (and many private ones) will follow suit.
adolph 17y ago
Case in point: "But even if the decision does leave some Arizona children without health-care coverage, Orient said, there is no alternative in the state's current financial situation. 'At a certain point, it doesn't matter how good you think a program is,' she said. 'If you can't pay for it, what are you going to do?'" http://www.azcentral.com/arizonarepublic/news/articles/2010/03/20/20100320arizona-kids-lose-health-coverage.html http://www.azcentral.com/arizonarepublic/news/articles/2010/...

coryrc 17y ago

And for anyone who doesn't believe you, here's Newsweek's take on increasing the burden on the young: http://www.newsweek.com/id/224020 http://www.newsweek.com/id/224020

jacoblyles 17y ago

My favorite proposed solution is "defined contribution instead of defined benefit", which would address most of the incentive problems and inequities you mention. In Washington, they call it "privatizing" and run you out of town.

kurtosis 17y ago

I find myself very sympathetic to your view - especially the part about not wanting to pay for wars. I have also frequently heard people claim that entitlement programs to support the elderly are "unsustainable" - but I honestly don't understand what this means. Do you mean that the costs of providing for our elders would grow without bound? Also, if you know of a nice explanation that presents the evidence that entitlement programs like social security are doomed I would be very grateful if you could provide some links. I would really like to know.

Xichekolas 17y ago
The entitlement unsustainability is entirely a problem of demographics. People are living longer and having fewer children, so the ratio of young working people (who pay) to old retired people (who benefit) is diminishing. The classic answers are to either increase FICA taxes or cut benefit levels... which seems idiotic, when the obvious solution (to me) is to just raise the eligibility age. Part of the problem is that people are living longer, and are mostly healthy and able to work longer, so raise the retirement age.
- orangecat 17y ago
  Part of the problem is that people are living longer, and are mostly healthy and able to work longer You're right about the demographics, but I'm not sure this part is correct. Yes people are living longer, but it seems that a great deal of that is that when a 70 year old contracts condition A which used to be fatal, we can now often keep them alive at great expense until they die at 80 of condition B. It doesn't mean they'd be effective workers at 70. My "obvious" solution is to focus on curing aging, which is generally the fundamental cause of both A and B. Until that happens, means-test benefits. Warren Buffett doesn't need to be getting checks from the government.
  - jacquesm 17y ago
    'Curing' aging is really going to break the economy. Pension systems were not meant to take care of people for ever, if 'aging' gets cured then you can expect to work until you drop dead.

MartinCron 17y ago

I like driving too, but don't focus too narrowly on roads. I think you're getting benefit from more than < 1% of taxation. Public education helps everyone. Research helps everyone. Having a criminal justice system helps everyone (well, the non-violent drug offenders would disagree). Having a strong civil legal system helps everyone. Meat inspectors help everyone. Financial regulators help everyone. You could even say that knowing that we don't have senior citizens starving and dying in the streets as helping everyone. I like knowing that I live in a society that takes care of many of the less fortunate. I'm not saying that government is good at solving every problem, but focusing on just roads, wars, and old people is very narrow.

startuprules 17y ago
I would dare to say that our government sucks at solving any problem. A few examples: U.S. Teens Trail Peers Around World on Math-Science Test http://www.washingtonpost.com/wp-dyn/content/article/2007/12/04/AR2007120400730.html http://www.washingtonpost.com/wp-dyn/content/article/2007/12... U.S. prison population dwarfs that of other nations http://www.nytimes.com/2008/04/23/world/americas/23iht-23prison.12253738.html http://www.nytimes.com/2008/04/23/world/americas/23iht-23pri... Lehman Cooked The Books Prior To Collapse; Geithner And NY Fed Implicated http://thelibertyguardian.com/2010/03/lehman-cooked-the-books-prior-to-collapse-geithner-and-ny-fed-implicated/ http://thelibertyguardian.com/2010/03/lehman-cooked-the-book... Let's face it; our government is setup to help the big corporations.
- MartinCron 17y ago
  Oh, come on, that's just confirmation bias. Our government solves lots of problems. A few counter-examples: People love Medicare. It helps keep old sick people from financial ruin. That's a good thing. Lots of banks have failed in the last few years, but government-run programs (FDIC, mostly) keep the fallout from damaging citizens. The United States is home to many world-class research institutions, many of which receive government grants. Bernie Madoff was running a huge ponzi scheme to defraud investors, but was eventually caught, by the government, and sent to prison. The military and US AID have helped save lives and assist in reconstruction of post-earthquake Haiti. FAA regulators have made air travel extremely safe. NHTSA and other regulators have improved the safety of cars and saved countless lives. The Parks department has conserved millions of acres of winderness for people to enjoy for generations. The Endangered Species Act has literally saved species from disappearing from the planet. The National Science Foundation helps fund RadioLab, the best thing on the radio.

Daniel_Newby 17y ago

"Next time you see an old person eating bacon and eggs in a restaurant, picture that person's bypass operation, years of statins, and excessive end of life care that you are paying for..." Cardiovascular disease is mostly caused by carbohydrate consumption and inactivity. The Feds subsidize these, and health care "reform" will make the problem worse.

grandalf 17y ago
Not to nitpick, but I think it's mostly caused by refined carbohydrate consumption, high fructose corn syrup, smoking, and obesity.
- sailormoon 17y ago
  In other words, the exact opposite of what your parent post said. And fyi HFCS is refined carbohydrate.
  - vixen99 17y ago
    Right and it's vital for people to know this. For anyone who wants to know more I recommend starting with http://articles.mercola.com/sites/articles/archive/2003/03/26/fructose-part-four.aspx http://articles.mercola.com/sites/articles/archive/2003/03/2... Mercola is not an original researcher but he does substantiate his views ('Soda should almost be illegal to give to children. I can't think of any reason or justification to continue such a disease-promoting practice') with links to the many peer-reviewed publications.warning against its use. This sorry story of HFCS, obesity and ill-health is gathering momentum. . http://www.ajcn.org/cgi/content/abstract/79/4/537 http://www.ajcn.org/cgi/content/abstract/79/4/537
  - grandalf 17y ago
    Well, it's not as if eating lots of fatty (high calorie density) food doesn't also result in obesity. I think that implicit in your expression of dissent to what I initially wrote is belief in the fallacy of "good fats".

jamiequint 17y ago

"most of the healthcare reform goes to the practitioners who practice useless surgeries and interventions on a vulnerable population of elderly" A lot of doctors don't want anything to do with medicare patients because they are often breakeven at best and in many cases a net loss. They are many times required to care for these patients in order to maintain hospital accreditation programs that allow them to look attractive to patients with insurance (where the hospital actually makes some profit). It is good to pay attention to healthcare availability, but no sustainable solution can ignore the cost side. Excess litigation has played a significant role in the massive overinflation of healthcare costs. Flooding hospitals with patients with government insurance - likely to be net-negative income for hospitals - is going to destroy the healthcare system faster than it fixes it.

stretchwithme 17y ago

I think you see things very clearly. Such is the quagmire of a declining democracy where most people are intent on shifting the costs of their decisions to everybody else.