Healthcare -- My Paradigm Shift

As most paradigm shifts occur, mine comes due to very difficult personal issues.

Out of school my first job (the one which I am still employed) is in a very small firm that hasn't provided health care coverage for its employees. I don't curse my employer -- small employer health care plans are about as affordable as the individual employees providing their own insurance. It was soon after this that my doctor noted that my second child didn't gain sufficient weight in her first year, the doctor noted concerns that she may be susceptible to host of different conditions. In this case my wife and I were left with prayer and faith as the strongest source of comfort -- it worked our daughter is robust and healthy. Now my one year old son has been diagnosed with a possibly debilitating disorder known as leukodystrophy (there are several classes of this disorder and the doctors are still uncertain as to the exact type) Fortunately, CHIP enrollment opened again and the income requirements have raised to a level that my children finally qualify.

However, it has been a heart-aching experience over the past year being unable provide my son with all of the health care that his caring physicians have suggested. Not to mention lacking health insurance on my wife and myself has been frightening at times, lets just say I exercise religiously and I drive extremely cautiously. There are many benevolent organizations that have provided my son with therapeutic services virtually cost free, for all of which I am extremely grateful. These events have led me to question my long-held stance that health care needs to remain a fully privatized venture.

Although, I am well acquainted with inefficiencies of a few despised Federal agencies I'm growing (in small steps) to believe that nationalized health care my not be as bad as I have sometimes lamented. I'm not suggesting that the idea of Walter Reed Medical Center's nationwide doesn't repulse me, but a system in which anyone can get (grantedly sub par) health care as opposed to no health care is gaining some appeal to me.

I still have some strong points in opposition. The horror stories of VA medical centers are one example, and the needed increases in tax revenue to pull off such a policy shift are colossal. I heard somewhere the absurd suggestion of a "fat" tax, an idea in tax policy that may create a whole host of new eating disorders.

Something needs to be done to provide affordable health care to all Americans, I'm afraid we all know the answer and for some of the reasons cited above we are loathing to admit it.

Health Benefits, Equality, and the 2008 Presidential Election

Every campaign year many campaigns use accessible, affordable, and equitable health care as a campaign promise. If we can or are to make health coverage equitable and obtainable for everyone, the question is how? I am of the school of thought that this should be done without us dragging our efficient and advanced free market health care system to the depths of Canadian health care or as Pete Ashdown once erroneously said the efficient model of VA hospitals. (Do we really want Walter Reed Medical Center's infamous building 18 to become a norm of American Health Care?)


However, health care coverage in this country is no where near accessible, affordable, and equitable for all Americans. For instance small employers health coverage is extremely unaffordable due the way group plans are written -- the smaller the group the bigger the per employee premium is. In many cases it is worse than that, employers who can't afford the extremely expensive small group plans leave their employees purchasing health care as individuals. Here is where the income tax code currently falls short of providing the desired equity we Americans so desperately seek. From a taxation standpoint, if you are covered by an fairly large employer-sponsored plan you receive pretty solid benefits, otherwise you may are hosed one way or another. Here is a breakdown of Health care and taxation:

Employees Covered by Employer

-- No income tax on premiums paid from wages
-- No FICA and Medicare tax on premiums from wages
-- No State income tax on premiums from wages
-- Employees of a large employer receive coverage at very little cost
-- Employees of a small employer pay significantly larger premiums.

Self-Employed Coverage

-- Premiums are deducted from Adjusted Gross Income (AGI)
-- Nearly the same effect as employee's covered by an employer.

Employees who have to cover themselves

-- Premiums are not deducted from AGI
-- Taxes are paid for FICA and Medicare on wages used to pay premiums
-- Premiums can be deducted as a severely limited itemized deduction (A floor of 7.5% of AGI in most cases taxpayers do not have enough medical expenses to deduct)

In this regard President Bush's recent health care tax proposal in the 2007 State of the Union address, would be a step in the right direction. The proposal plans use the Internal Revenue Code to allow those taxpayers who self-fund their own health insurance would pay no FICA, Medicare, or Income tax on the wages used to purchase health insurance. The change would also require those who benefit from larger-employer plans to recognize some income on some of the premiums covered by their better large-employers health plans. The proposal would level the playing field between those who have large-employer health care coverage and those who have pricey small-group or self coverage. This is one of the most innovative ideas I have heard regarding health care. Due to the fact that the rabid anti-war movement has the Bush administration on the ropes regarding Iraq, a meaningful and innovative domestic policy change like this has little chance of passage.

I do hope to hear more innovative ideas like this from the current field of presidential candidates on both sides of the isle.

(P.S. I wrote an similarly titled earlier post that was inspired by a year-old OneUtah post, which I erroneously and unbelievably thought was current. I guess that's what happens when you live in a cave for the 1st four months out of the year.)