So when can I choose to opt out?

[Aqua Buddha 14,598]

5 hours ago, atomheartbevo said:

If the Democrats were competent, they’d figure out how to make this a major campaign issue this year and in 2020. 

Exactly.  Paul Ryan's entitlement "reforms" are wildly unpopular to the point the Obama campaign didn't hammer them because when they polled people about them, they didn't believe them.  (Cut taxes for the wealth to fund entitlement cuts.)

The Dems should have made Paul Ryan a campaign issue in every swing district in America like they've done with Pelosi.

[Nice Guy Eddie 13,515]

4 hours ago, JBJ said:

How? It is a losing issue.

Making it a major campaign issue would entail making a pledge to raise payroll taxes or to cut benefits (or both).

That's also why nothing gets done.

Agree. It can only be saved by lowering benefits and/or raising taxes. You can work on controlling costs but that won’t solve the problem.   Regardless that will be a tough sell on the campaign trail. 

[David Dennison 18,869]

13 minutes ago, Nice Guy Eddie said:

Agree. It can only be saved by lowering benefits and/or raising taxes. You can work on controlling costs but that won’t solve the problem.   Regardless that will be a tough sell on the campaign trail. 

Not if it's framed as a tax increase on the rich, which is basically what raising the SS limit is.

[Nice Guy Eddie 13,515]

4 minutes ago, David Dennison said:

Not if it's framed as a tax increase on the rich, which is basically what raising the SS limit is.

I’m referring to Medicare not social security.  Medicare taxes are not capped.

[David Dennison 18,869]

1 minute ago, Nice Guy Eddie said:

I’m referring to Medicare not social security.  Medicare taxes are not capped.

Ah. Well, the answer to that is Medicare for all and then the federal government can use its bargaining power to force down costs. In theory, anyway.

[CooterBrown 18,014]

There needs to be less people. 

 

We need more young people to pay for shit and grow the economy but we need less old people who are a drain on the economy.

 

Really, what we need is a version of Logan’s Run that gives you a death date based on your personal financial situation. $20M+ net worth = no limit. Les than $1M = 65 years old.

[Augustus 3,061]

On 6/5/2018 at 12:28 PM, Ted Lange said:

Sounds like a good time to cut the taxes on the rich more.  

Yeah the top 1% are only floating us 40% of the income tax revenue, while the top 10% pony up 70% of it.

Greedy, cheap bastards.

Edited June 7, 2018 by Augustus

[RPM 26,322]

1 hour ago, David Dennison said:

the answer to that is Medicare for all

This is the correct answer. 

[TexArcher 37,825]

On 6/5/2018 at 2:26 PM, David Dennison said:

Because neither system is going to fail. We will fix Medicare by raising contributions and, in the case of Social Security, eliminating the upper limit of income subject to FICA. 

In other words, your taxes are going to go up before anything ever happens to those programs.

 

This is exactly right.

Those programs are bulletproof for a long time because old people vote and there a shit ton of baby boomers.

[RPM 26,322]

22 minutes ago, Augustus said:

Yeah the top 1% are only floating us 40% of the income tax revenue, while the top 10% pony up 70% of it.

[TexArcher 37,825]

39 minutes ago, Augustus said:

 

Deleted, off topic.

Edited June 7, 2018 by TexArcher

[F250 28,777]

1 hour ago, David Dennison said:

Not if it's framed as a tax increase on the rich, which is basically what raising the SS limit is.

Is it really? I think a lot of people here max out of that tax without being rich.

 

[F250 28,777]

51 minutes ago, Augustus said:

Yeah the top 1% are only floating us 40% of the income tax revenue, while the top 10% pony up 70% of it.

Greedy, cheap bastards.

[Tennesseehorn 101]

10 hours ago, David Dennison said:

They myth of America being the greatest country on earth is pernicious. We love to think we're number one in everything when in reality, we are a middling (almost backward) western democracy cruising on nostalgia.

And yet just about everyone wants to come here.  Wait, You know what, the USA is horrible no one should come here, it’s bad, bad, bad.  

[David Dennison 18,869]

3 minutes ago, Tennesseehorn said:

And yet just about everyone wants to come here.  Wait, You know what, the USA is horrible no one should come here, it’s bad, bad, bad.  

Because the myth is so prevalent. Instead of saying we're the best, we should probably work on actually being the best. 

[DanRydell 799]

Is it really? I think a lot of people here max out of that tax without being rich.
 

A single-income household with the earner making $127k per year is earning more than about 85% of American households annually.

A married couple both maxing out of the SS tax are earning more than 97% of American households annually.

[Aqua Buddha 14,598]

In the interest of keeping the wolves at bay, we should trim the military budget and raise taxes if that what it takes to shore up SS and Medicare.  The olds have shown themselves to only vote their self interest and fuck everyone else.  If we're at the point 10 year from now where we're facing very tough choices bases on the choices we didn't make now, the olds will fuck us over.

Our only hope is the millennials and the Gen Xers get woke at the same time and vote to cut SS and Medicare and by that I mean, not tomorrow or some grandfathered date but immediately.  That means you got $1,800/month this year and next year you get $1,600/month.  Sorry, gramps.  Oh, and your Medicare premiums just went up.

Problem is the Gen Xers need SS and Medicare to take care of their parents.  

[GopherRock 1,765]

Considering this is a Texas message board, I'm surprised this hasn't shown up yet in this thread.

[CooterBrown 18,014]

A single-income household with the earner making $127k per year is earning more than about 85% of American households annually.

A married couple both maxing out of the SS tax are earning more than 97% of American households annually.

Yeah but 127k isn’t equal everywhere. The people earning that are mostly living in expensive cities where that is middle class and in a few cases, working class. They are supporting the rural shitholes where 127k makes you a 0.1%er.

[atomheartbevo 89,683]

8 hours ago, JBJ said:

How? It is a losing issue.

Making it a major campaign issue would entail making a pledge to raise payroll taxes or to cut benefits (or both).

That's also why nothing gets done.

You can scare the shit out of plenty of people about Medicare and Social Security who are just starting to hit retirement age - make them think things are going insolvent just as they are hitting the homestretch.  

[F250 28,777]

47 minutes ago, Aqua Buddha said:

In the interest of keeping the wolves at bay, we should trim the military budget and raise taxes if that what it takes to shore up SS and Medicare.  The olds have shown themselves to only vote their self interest and fuck everyone else.  If we're at the point 10 year from now where we're facing very tough choices bases on the choices we didn't make now, the olds will fuck us over.

Our only hope is the millennials and the Gen Xers get woke at the same time and vote to cut SS and Medicare and by that I mean, not tomorrow or some grandfathered date but immediately.  That means you got $1,800/month this year and next year you get $1,600/month.  Sorry, gramps.  Oh, and your Medicare premiums just went up.

Problem is the Gen Xers need SS and Medicare to take care of their parents.  

Generation X will most definitely get fucked on this one.

[F250 28,777]

55 minutes ago, DanRydell said:

 

A single-income household with the earner making $127k per year is earning more than about 85% of American households annually.

A married couple both maxing out of the SS tax are earning more than 97% of American households annually.

Well 85% of Americans are fucking poor because 127k ain't shit. I don't even think that qualifies as Alabama rich.

 

[Spankytoes 1,741]

1 hour ago, DanRydell said:

 

A single-income household with the earner making $127k per year is earning more than about 85% of American households annually.

A married couple both maxing out of the SS tax are earning more than 97% of American households annually.

 

And? Both my wife and I make more than that individually and I guarantee that we pay more City, State and Federal taxes than 97% of American households. Not to mention a much higher cost of living than we did in TX. 

I for one hope SS depletes and the world burns. People have had their head in the sand for far too long about the government taking care of them in their old age while parking their leased Beamer in the 3rd garage spot of their perfectly manicured mini mansions. If you can’t get at least 60% of your annual income out of your 401K at retirement, and see SS as gravy, you suck at finances. This wasn’t some dark secret.

Edited June 7, 2018 by Spankytoes

[DanRydell 799]

And? Both my wife and I make more than that individually and I guarantee that we pay more City, State and Federal taxes than 97% of American households. Not to mention a much higher cost of living than we did in TX. 
I for one hope SS depletes and the world burns. People have had their head in the sand for far too long about the government taking care of them in their old age while parking their leased Beamer in the 3rd garage spot of their perfectly manicured mini mansions. If you can’t get at least 60% of your annual income out of your 401K at retirement, and see SS as gravy, you suck at finances. This wasn’t some dark secret.

And most Americans would see raising your taxes (and probably those of most of us on this board for that matter) as a tax increase on the rich.

[Spankytoes 1,741]

53 minutes ago, CooterBrown said:

 

Yeah but 127k isn’t equal everywhere. The people earning that are mostly living in expensive cities where that is middle class and in a few cases, working class. They are supporting the rural shitholes where 127k makes you a 0.1%er.

 

Este. We’re Middle Class, possibly Upper, at best.

[Spankytoes 1,741]

2 minutes ago, DanRydell said:

 

And most Americans would see raising your taxes (and probably those of most of us on this board for that matter) as a tax increase on the rich.

 

Which is bullshit. I don’t classify myself as “rich”. I never understood the mentality of people wanting to punish others for having more pieces of paper than they do. It’s all relative. Especially the 1%, who apparently should be punished for being too successful. Gen X and under should be prepared for what’s ahead. Baby Boomers created their own problems.

[DanRydell 799]

Which is bullshit. I don’t classify myself as “rich”. I never understood the mentality of people wanting to punish others for having more pieces of paper than they do. It’s all relative. Especially the 1%, who apparently should be punished for being too successful. Gen X and under should be prepared for what’s ahead. Baby Boomers created their own problems.

Anyone who thinks they’re middle class while earning more than 97% of Americans has zero credibility as an arbiter of bullshit.

[Spankytoes 1,741]

4 minutes ago, DanRydell said:

 

Anyone who thinks they’re middle class while earning more than 97% of Americans has zero credibility as an arbiter of bullshit.

 

Except I’m right...

http://longisland.news12.com/story/34738225/report-middle-class-income-higher-on-li

If you are a family of 4 making $80,000 a year, you qualify for Section 8 housing in Nassau County

[Guest]

If they raise my taxes for SS or Medicare, I'm one of the first to join the mob that forms in my city to fight.

[Celery Man 20,962]

Except I’m right...
http://longisland.news12.com/story/34738225/report-middle-class-income-higher-on-li
If you are a family of 4 making $80,000 a year, you qualify for Section 8 housing in Nassau County

You or your wife individually earn more than the AMI for a family of four in Nassau. Each earning higher than what would qualify you for partial rent assistance there for a family of eight, if the waitlist was open I guess? I don’t know anything about is, but your link didn’t contain any information and I was curious.
https://affordablehousingonline.com/housing-search/New-York/Nassau-County

[Anastasis 23,474]

Oh good, we're going to do the whole should middle class be determined distributionally or functionally discussion again. 

Edited June 7, 2018 by Anastasis

[Anastasis 23,474]

9 hours ago, Aqua Buddha said:

In the interest of keeping the wolves at bay, we should trim the military budget and raise taxes if that what it takes to shore up SS and Medicare.  The olds have shown themselves to only vote their self interest and fuck everyone else.  If we're at the point 10 year from now where we're facing very tough choices bases on the choices we didn't make now, the olds will fuck us over.

Our only hope is the millennials and the Gen Xers get woke at the same time and vote to cut SS and Medicare and by that I mean, not tomorrow or some grandfathered date but immediately.  That means you got $1,800/month this year and next year you get $1,600/month.  Sorry, gramps.  Oh, and your Medicare premiums just went up.

Problem is the Gen Xers need SS and Medicare to take care of their parents.  

Just implement sliding scale means test for SS. Substantial Medicare reform to move it to a fundamentally catastrophic coverage system open to all. More than a few folks gonna feel a pinch that they might not have planned for during retirement, but everybody gonna have a feel the pinch one way or the other. 

[BurntOrange&White 39,934]

Oh good, we're going to do the whole should middle class be determined distributionally or functionally again. 

The argument that never ends

[Aqua Buddha 14,598]

Myself and everyone my age I know would gladly pay more in taxes if it meant SS and Medicare were stable.  For one thing, we don't want our parents living with us.

Wait until huge wave of people need long term care/assisted living/nursing home and realize Medicare doesn't pay for that.

[Anastasis 23,474]

1 minute ago, Aqua Buddha said:

Myself and everyone my age I know would gladly pay more in taxes if it meant SS and Medicare were stable.  For one thing, we don't want our parents living with us.

 Wait until huge wave of people need long term care/assisted living/nursing home and realize Medicare doesn't pay for that.

Thing is I don't think that there is a tax your way out of this. That's a short term solution. You have to reform the benefits.  Which requires congressional action. Which means it will end up more fucked than we already are. 

Edited June 7, 2018 by Anastasis

[Brisketexan 105,151]

19 hours ago, JBJ said:

How? It is a losing issue.

Making it a major campaign issue would entail making a pledge to raise payroll taxes or to cut benefits (or both).

That's also why nothing gets done.

Because every solution is some version of "let's take what we have, and tweak it."

Most of us have driven a truly shitty car at some point in our lives.  It's got 10 jillion miles, the floorboards are rusted through, the exhaust vents right into the cabin, etc. etc.  We patch it, use duct tape and baling wire, and keep it going much longer than it should.  But at some point, the answer is unavoidable -- THAT car needs to be taken out back, shot, and buried.  And we need to get a new car.  Maybe not a Mercedes, but something good and reliable, that actually reflects modern technology (airbags, crumple zones, that sort of stuff).

That's where we are with our entire healthcare system.  The way we have of paying for it is a 1972 Pinto with 2 million miles.  Let's ditch that, and at least buy a sensible Camry from the late 90s.

[Anastasis 23,474]

Just now, Brisketexan said:

That's where we are with our entire healthcare system.  The way we have of paying for it is a 1972 Pinto with 2 million miles.  Let's ditch that, and at least buy a sensible Camry from the late 90s.

Problem is that the people who are in charge of the purchase decision making are all getting their pockets greased by the mechanics that keep the Pinto running, the guys selling new tires, and the texaco station that gets to top that old gas guzzler up every day. 

[Brisketexan 105,151]

35 minutes ago, Anastasis said:

Problem is that the people who are in charge of the purchase decision making are all getting their pockets greased by the mechanics that keep the Pinto running, the guys selling new tires, and the texaco station that gets to top that old gas guzzler up every day. 

....and....to continue the metaphor....we've taken an approach as voters that puts in power folks who are championing an era when American cars were truly great, like the Edsel.  We're going BACKWARDS.  But the guys who sell shitty cars and parts to repair them and leaded gas are doing GREAT.

[Anastasis 23,474]

Just now, Brisketexan said:

....and....to continue the metaphor....we've taken an approach as voters that puts in power folks who are championing an era when American cars were truly great, like the Edsel.  We're going BACKWARDS.  But the guys who sell shitty cars and parts to repair them and leaded gas are doing GREAT.

I don't think that's anything particularly new. The prior administration did more to enable the entrenched interests than anything else. All the major cost centers were spared. Pharma, Hospitals, Devices. Compare MCO stock prices in 2008 to 2018. Across the board ~800-1000% growth despite the government screwing them on the major backstops of Obamacare. I actually see some limited progress on aspects that have potential to bend the curve. FDA director making real moves to reduce road blocks to generic entry, HHS director taking on drug pricing (and some of the ideas actually make a lot of sense, others not so much). There was a lot of bluster about taking on PBMs, but that doesn't appear to be going anywhere, seems they need the PBMs to drive their front on drug pricing. I am not sure how much they will actually accomplish before we have a new admin. but if you look closely there is some novel political rhetoric.  Not sure anything comes of it, because entrenched interests are entrenched.   

[XYZ 2,154]

The criminal medical industry will continue to suck more and more of the nation's GDP until there's nothing but a carcass left, ironically.

[Brisketexan 105,151]

27 minutes ago, Anastasis said:

I don't think that's anything particularly new. The prior administration did more to enable the entrenched interests than anything else. All the major cost centers were spared. Pharma, Hospitals, Devices. Compare MCO stock prices in 2008 to 2018. Across the board ~800-1000% growth despite the government screwing them on the major backstops of Obamacare. I actually see some limited progress on aspects that have potential to bend the curve. FDA director making real moves to reduce road blocks to generic entry, HHS director taking on drug pricing (and some of the ideas actually make a lot of sense, others not so much). There was a lot of bluster about taking on PBMs, but that doesn't appear to be going anywhere, seems they need the PBMs to drive their front on drug pricing. I am not sure how much they will actually accomplish before we have a new admin. but if you look closely there is some novel political rhetoric.  Not sure anything comes of it, because entrenched interests are entrenched.   

Definitely agreed with the bolded.  Hell, I still suspect that the real vision for Obamacare was to serve up a poison pill, with the only viable antidote being some version of single-payer.

Obamacare on its own was a Frankenstein's monster using some really shitty body parts.

There are numerous other models out there that work, to varying levels of effectiveness.  We don't need to re-invent the wheel.  Shit, we an steal some decent ideas and make them even better.  Instead.....we buy new sun visors for the Pinto  and declare "there....THAT will fix it."

[PittsburghTiger 6,188]

1 hour ago, Anastasis said:

Problem is that the people who are in charge of the purchase decision making are all getting their pockets greased by the mechanics that keep the Pinto running, the guys selling new tires, and the texaco station that gets to top that old gas guzzler up every day. 

And they don't have to drive a Pinto.

[David Dennison 18,869]

51 minutes ago, Brisketexan said:

Definitely agreed with the bolded.  Hell, I still suspect that the real vision for Obamacare was to serve up a poison pill, with the only viable antidote being some version of single-payer.

Obamacare on its own was a Frankenstein's monster using some really shitty body parts.

There are numerous other models out there that work, to varying levels of effectiveness.  We don't need to re-invent the wheel.  Shit, we an steal some decent ideas and make them even better.  Instead.....we buy new sun visors for the Pinto  and declare "there....THAT will fix it."

Medicare works. Everyone should have it. 

[Anastasis 23,474]

4 minutes ago, David Dennison said:

Medicare works. Everyone should have it. 

And it should be restricted to catastrophic coverage, with options to purchase supplemental plans on an open market, not tied to employment, and with sliding scale subsidy based on appropriate means testing. 

[David Dennison 18,869]

Just now, Anastasis said:

And it should be restricted to catastrophic coverage, with options to purchase supplemental plans on an open market, not tied to employment, and with sliding scale subsidy based on appropriate means testing. 

No, it shouldn't be that. There should be no means testing whatsoever. It should be like Medicare is right now but for all ages.

[Anastasis 23,474]

No means testing for the catastrophic component, open to a public option for the supplemental plans, but think that some level of means testing needs to be a part of the supplemental component whether it is private or public.  The reality is that you need to create a competitive insurance market at some level. Scaling Medicare FFS to the entire population would be a nightmare. I would actually prefer something that looks like Medicare Advantage for the supplemental component, which already has certain subsidies in place for qualifying individuals. 

[David Dennison 18,869]

Just now, Anastasis said:

No means testing for the catastrophic component, open to a public option for the supplemental plans, but think that some level of means testing needs to be a part of the supplemental component whether it is private or public.  The reality is that you need to create a competitive insurance market at some level. Scaling Medicare FFS to the entire population would be a nightmare. I would actually prefer something that looks like Medicare Advantage for the supplemental component, which already has certain subsidies in place for qualifying individuals. 

I'm for whatever gets us to single payer and reduces the role of private health insurance companies. Health insurance should have never been tied to compensation, and the fact that it is means corporate America is too scared to come out in favor of any plan that will eliminate its role as health insurer for most Americans. If they weren't scared to losing employees, they would dump their plans in a heart beat. We need something to completely replace employer based health insurance. The only entity capable of such a heavy lift is the state.

[Brisketexan 105,151]

6 minutes ago, David Dennison said:

I'm for whatever gets us to single payer and reduces the role of private health insurance companies. Health insurance should have never been tied to compensation, and the fact that it is means corporate America is too scared to come out in favor of any plan that will eliminate its role as health insurer for most Americans. If they weren't scared to losing employees, they would dump their plans in a heart beat. We need something to completely replace employer based health insurance. The only entity capable of such a heavy lift is the state.

This represents perhaps my biggest political shift in my lifetime: I (begrudgingly) have reached the point where I support some version of single payer.

It comes down to this: healthcare has a baseline cost of service.  THEN, it has factors that add to the ultimate cost of consumption of those services.

In a private system, it's the cost add-on of corporate bureaucracy, and a profit motive (and note that  the profit motive is not just  reflected in end-line corporate profits, but in compensation and various other  funnels installed  throughout the chain).

In a public system, it's the inherent inefficiency of giant programs, especially government programs, and some level of corruption/graft.

I'm most interested in the final calculation of the best overall results for society at the lowest possible cost.  And I think that points us to some version of single payer, probably with some sort of buy-up option for those with the means to do so.

[David Dennison 18,869]

4 minutes ago, Brisketexan said:

This represents perhaps my biggest political shift in my lifetime: I (begrudgingly) have reached the point where I support some version of single payer.

It comes down to this: healthcare has a baseline cost of service.  THEN, it has factors that add to the ultimate cost of consumption of those services.

In a private system, it's the cost add-on of corporate bureaucracy, and a profit motive (and note that  the profit motive is not just  reflected in end-line corporate profits, but in compensation and various other  funnels installed  throughout the chain).

In a public system, it's the inherent inefficiency of giant programs, especially government programs, and some level of corruption/graft.

I'm most interested in the final calculation of the best overall results for society at the lowest possible cost.  And I think that points us to some version of single payer, probably with some sort of buy-up option for those with the means to do so.

Medicare is the most popular health care delivery system in the country. We know how to do this. The problem is that we have one political party hell bent on scaring people with absurd notions of death panels in a naked attempt to protect the shareholders of billion dollar insurance companies. 

[Anastasis 23,474]

From my perspective, one of the most significant problems facing healthcare is price transparency and the clouding between the consumer decision making and costs of care which undermines a market dynamic, and the perverse incentives that our reimbursement system has created. There are a number of factors that have brought us to this place, not least of which is government involvement via Medicare in healthcare in the first place. I am not convinced that more FFS Medicare is the answer to the problems as I see them.