HEALTHCARE UPHELD!

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There are a lot of good parts to the Affordable Health Care Act.

Trying to put some limits on the ability of insurance companies to 'pre-exist' people.

Extending coverage to the children of people who are covered, including young people of college age.

And especially, limiting the ability of insurance companies to kick people out ('lemon-dropping,' which was a term I heard used by former Alaskan Senator and 2008 Democratic presidential candidate Mike Gravel).

All the same, I understand where people are coming from when they object to:

We take a complex system and just overlay one more layer of complexity.

Doing away with the pre-existing condition ploy made good sense.

ruveyn

http://en.wikipedia.org/wiki/Cigarette_taxes_in_the_United_States

http://www.medicalnewstoday.com/releases/113934.php

http://www.ttb.gov/tax_audit/atftaxes.shtml

Interestingly enough, the federal tax you pay on cigarettes can properly be referred to as an excise tax, an indirect tax, or a tax penalty for smoking that has the potential impact of reducing the rate of smoking, but that federal tax penalty you pay on cigarettes is being used as an indirect tax to fund children's health insurance programs as detailed below, including dental benefits and treatments of mental illnesses, as well as expanding coverage to immigrant children and immigrant pregnant women.

This was actually part of Chief Justice Roberts opinion:

http://www.elpasotimes.com/newmexico/ci_20969483/big-changes-way-after-health-care-reform-decision




So while one can avoid the $695 federal tax penalty for not purchasing health insurance for themselves through adjusting withholding taxes, the only way to avoid the annual $737 federal tax penalty for smoking two packs of cigarettes daily, to fund health insurance, would be to quit smoking. Per the link, state excise taxes on cigarettes are taxed separately and they are also used to fund social welfare programs including health insurance programs for those determined in need.



Well beyond and above federal excise taxes on cigarettes are the state excise taxes that range up to $4.35 per pack in New York, that also has an additional $1.50 local tax added in New York City, for a grand total with the $1.01 federal excise tax of $6.85.

For what is referred to by some as Romney care, state excise taxes on cigarettes were increased $1 a pack to cover unexpected costs in health insurance in that state, increasing the tax to $2.51 per pack.

States use their federal excise taxes from cigarettes and liquor to fund social welfare programs. State excise tax on Liquor in the state of New York exceed $1 on a 750ML 80 proof bottle with lower excise taxes on beer and wine. Federal excise taxes are over $2 on a 750ML 80 proof bottle with lower excise taxes on beer and wine.

As one can see in the most expensive state, New York, one could drink a bottle of liquor every week and only contribute to social welfare programs at the rate of $156 a year. However if a person living in New York City was a 2 pack a day smoker, they would be contributing $2500 a year in federal excise tax penalties for smoking to fund social welfare programs including health insurance for the impoverished in that city as well as for children whom are US citizens, pregnant immigrants and immigrants across the nation.

That's well above the maximum potential cap of $2,250 that a family is required to pay for the tax penalty, per the healthcare reform act if they make a choice not to purchase insurance.

Considering that Massachusetts raised their state excise taxes up a $1 a pack to cover unexpected costs to cover affordable healthcare in that state, there is really no reason to believe that other states will not do the same, those states that oppose health care reform have already imposed higher cigarettes taxes to fund social programs in their states including medicaid, and when Obama increased federal excise taxes to support health care insurance for children, including immigrant children that decision was applauded by fox News. Including opinion within that article that federal excise taxes on cigarette smoking should be increased more to support health care reform.

http://www.foxnews.com/politics/2009/03/29/single-largest-cigarette-tax-hike-goes-effect-wednesday/

If enough people do avoid the penalty the government has plenty of other ways to fund the program through indirect taxes, including the 25% of the general public whom consume cigarettes, as well as any other product, including gasoline, if they wanted to go that route, which is not likely for obvious political reasons, but still a potential if enough people avoid paying the penalty or do not participate.

Believe me I know how hard it is to quit smoking, my father is 80 and has been smoking 2 packs since he was 13, but he has certainly done his part in funding health insurance programs for the needy.

Per the facts provided in this post, it's likely you are already paying more than a $700 tax penalty per year through excise taxes on cigarette smoking to cover health care for others, even if you have smoked less than a pack a day, for a significant number of years, and all it will take is another legislative effort and pen stroke of Obama to raise it another $1 pack, if considered needed to further fund healthcare reform, if enough people avoid the tax and/or do not participate.

As long as you are smoking, and I hold no judgement against the individual right to smoke, it's likely at some point the government will be able to receive an additional $695 from you, if you avoid the first $695.

Those in lower income brackets that do smoke and receive social welfare benefits, are definitely paying back in to the state and federal excise tax pot to cover those general benefits for all. Rarely would they get credit for that though, although some are actually unwittingly sacrificing their health so others may have health care, including themselves, eventually.

Health insurance companies do cover programs to help people to stop smoking, but it appears that it is such a powerful addiction, that a core 25% population will always exist of smokers. Certainly enough to fund a lot of health insurance programs for the needy, well above the potential several hundred thousand individuals, that do what it takes to avoid paying the health care reform penalty.

And no, I can't imagine health insurance companies, under any circumstances charging individuals the same amount under healthcare reform whom smoke as opposed to those that don't smoke, however they will have to cover individuals with chronic conditions such as COPD associated with smoking, as a preexisting condition, whereas that was not required before for private insurance policies.

That is a huge benefit for smokers that have succumbed to that chronic illness, that requires much more than the type of care that one is going to receive in a temporary stay per an emergency room visit.

And eventually when it precludes the ability to work, and one is found permanently disabled, they will eventually be covered under medicare and/or medicaid, regardless if their state chooses to participate in medicaid expansion. Much better though in the long run for hospital costs, if one is covered and receives preventative care, rather than waiting until the bills run into the hundreds of thousands of dollars, and perhaps millions of dollars because of chronic illness, covered in the last 6 months of life, through medicaid coverage and permanent disability expected to lead to death.

That is the way the system is set-up to work before health care reform was enacted; it's not an intelligent system. Health care reform comes far from perfecting it, but it is certainly an improvement that can already be measured empirically.

States that refuse medicaid expansion dollars, know full well that they can raise additional dollars if needed through excise taxes, on those whom consume cigarettes and alcohol, particularly in those red states, where it is considered a sin tax, for a minority of those that consume to excess, and don't get much influence in politics.

They are already doing it to subsidize the programs in their states. The politics associated with this is mean spirited, uncaring, and eventually a win-win situation for the states politicians in red states, as they will be able to pass the costs of the expansion or maintenance of social welfare programs, as "sin taxes" on to those whom consume cigarettes and alcohol, many of which are in the income brackets needing healthcare, through medicaid expansion.

One of the ways to slow this from happening is to quit smoking, but that is not a realistic goal for many individuals receiving no medical help to assist them among the minority of long term smokers, that are able to successfully quit smoking. It's a catch 22 situation for some.

The tax penalties for smoking are incredible, if one considers an individual in New York City can pay $2500 a year, smoking 2 packs of cigarettes a day, to support health care for citizens and non-citizens nationwide.

If they could stop smoking that would allow them to cover almost the entire cost of government subsidized health care premium coverage for their family of 4 if they are 40 years old making $47,000 a year. It's a choice but I understand how hard it can be to make it for 25% of the general population whom are of age to purchase cigarettes.

The Amish.

Unfortunately many in the rest of the country are largely modern nomads in a very large technologically advanced complex society whom depends on a well spring of assistance from others through taxation from their fellow citizens.

If you utilize roads, you take part in the benefit of federal excise taxes imposed on others through the purchase of fuel. And, you share in that responsibility if you purchase fuel. But no one has the ability to build the road on their own, it takes the combined effort of citizens of states and across the nation to make it happen.

The issue with health care is it is getting too expensive for citizens to purchase on their own and it is seen as a necessity for the welfare of the nation. There was no choice but to address a crisis in society, and health is certainly as important as roads for the general welfare of citizens in the US.

The excise tax for refusing to purchase healthcare is paltry compared to other excise taxes posed on citizens every year, to ensure the general welfare of all individuals in the country. Roads and bridges are always a good example, because most everyone depends on them for survival, in a modern nomadic society, where cars have replaced beasts of burden. And the oasis most depend on is the highways and the gasoline stations that fuel the vehicles, as well as construction of roads and bridges, that most everyone depends on for subsistence.

Health care excise taxes, in this new act, are one of the few that one can reasonably avoid, but as posted earlier, if one smokes, drinks, or is subject to any indirect tax through their consumption of goods, there are alternative means of excise taxes that are already being used to ensure that the general welfare of those in the country and the health of the society does not fail, including access to affordable health care for those that need assistance in purchasing it, similarly as some help their fellow citizens by purchasing larger shares of gasoline, that in part, builds roads and bridges, required for subsistence gaining activities.

And even if one does not drive or use gas, they still depend and benefit on those roads and bridges, along with those excise taxes contributed from others through the purchase of fuel, as those road and bridges drive the entire economy, that in part provides subsistence to everyone, except for those self sufficient small sub-cultural societies, like Amish country. Whom are among those who get to say no to many of the shared taxation efforts in the larger arena of society, but instead they willingly share in a collectivist manner, for the good of the whole, much smaller society. It would never work on a scale as complex and diverse as the rest of the country, in the US.

The methodology behind taxation is no more a method of stealing than the collectivist methods used by the Amish, just a more complex methodology for sharing in a complex society, where rules and regulations, and taxes are required to maintain the general welfare of that much larger technologically advanced complex society.

But there are some pretty good options out there if one wants to attempt to integrate in these smaller societies that don't have access to telephones, electricity, or the internet. Most people will take full taxation over that option, once they have gotten use to those luxuries of an extremely complex society that requires taxation to maintain a healthy society.

Modern nomads require a modern nomadic infrastructure for survival; it won't work without taxation unless one lives in a hugely rich country supplying the rest of the world with the subsistence driving fuel currently used by most; those in a country like Kuwait, a small oil rich country, that has an abundance of a shared resource, highly in demand, across the globe.

If they run out, or if the world finds an alternate source to fuel economies, it's back to an older nomadic way of life, or substantial taxation which is a much more likely scenario. It's hard to go back. Part of the reason that health care reform is here to stay now, barring that always potential possibility of unforeseen crises.

Last edited by aghogday on 01 Jul 2012, 9:54 pm, edited 1 time in total.

Good for them! They are Upright people.

ruveyn

Yes I agree, they chose to stay in the past, and it appears not to have been such a bad idea, until some get a taste of what the rest of the world has to offer and then it's hard for some to go back.

It's really interesting that Autism rates are 1 in 29 in males measured through diagnostic statistics in classes for the developmentally delayed in New Jersey, and measured as a disorder with community wide scans at 1 in 295 in Amish Country. Also, compared to 1 in 38 overall among school scans in South Korea.

Before community wide scans were done it was estimated at 1 in 15,000. Whatever the genetics are behind autism disorders that appear to be fairly consistent across countries, but the environment per those Amish people appears to make a significant environmental difference of some kind.

To me the answer seems like common sense. Our modern way of society is still an unproven experiment while they stuck with what was evidenced to work.

A common element among 24 other peaceful societies identified by Anthropologists in the world, not too far from conflicted areas in Africa and other areas of the world. The common elements are relatively small low density population, homogenous societies, among those that are willing to share the responsibilities of life, without significant internal or external conflict, or even authoritarian leadership.

The way of the wolf pack in nature, outside of human captivity, not an evidenced easy life, but an evidenced more peaceful way of life and cooperation.

more "peaceful" for all members 'cept for the omegas who frequently are booted out in lean times to become starving "lone wolfs."

Yeah, hardly seems like insurance if the company just trots out 'pre-existing condition' (or one of probably three dozen other excuses) whenever you need to actually file a claim.

the american scheme or racket of insurance, as it is commonly practiced, is primarily to insure that the insurance companies make a fat profit, come hell or high water. insuring their clients are actually made whole is merely an afterthought.

I have bigger issues with the health care reform bill than health care. find a copy of the bill and read it what you have been told about is trivial compared to what it really does.http://www.gpo.gov/fdsys/pkg/BILLS-111h ... 590enr.pdf this is the 900 pages that started not the total in the end. Sorry couldn't make quick link work.

Last edited by johnny77 on 04 Jul 2012, 1:01 am, edited 1 time in total.

Obama's health care plan was very good when he proposed it. Then the congress and all the special interest groups turned it into this bloated joke that only helps the wealthy corps get ridiculously wealthier AND gives them carte blanche to increase fees at will and lower service quality.

The insurance is to be forced upon people in 2014. I'm working real hard to get the heck out of the USA before then. I'm not sure if they'll ask me to pay for that insurance if I live overseas ...if they do they can have my citizenship back and good riddance.

It was never a good plan even reading the original!! It was a way to sneak a bunch of crap past America.

Here is a link to the full version of the bill. What is it about it that concerns you, as an individual? Yes it is a long read and complex, but there are not many sources of legal code written for the reading enjoyment of the general public.

http://housedocs.house.gov/energycommerce/ppacacon.pdf

Here is a link to a good summary of the timeline implementation, subsidy calculators, etc., that can all be found under the interactive feature header. It is provided by a third party bi-partisan foundation. It's summarized well in a way that most anyone could understand, particularly with the interactive map that provides real world scenarios for how the new law impacts individuals, families, small businesses, large businesses, and corporations.

http://healthreform.kff.org/timeline.aspx

This information has been made available on the internet ever since the bill passed, anyone with the time and effort on their hands could read it and analyze any potential consequences applicable to their lives, if they wanted to.

What is is it that is bad about it? The insurance companies were projected to become much richer with no reform instituted. And while insurance premiums are potentially projected to go higher than the CBO projections at the beginning of the process, they were expected to double for the average American sponsored coverage by their employer by the year 2020, to over $24,000 for a family of four. The most expensive option possible under this plan, comes nowhere near to that projected figure.

People that are afforded plans by their employer that exceed 8% of their income, that they cannot afford are exempt from paying a penalty. Only 1 percent of Massachusetts citizens pay a penalty for the penalty in that state, where that plan is not nearly as generous, per exemptions that the national health care reform act provides.

Beyond this, while the insurance companies would obviously prefer this plan over a public option or a single payer plan, the insurance lobby funded an over $100 million dollar covert effort against it at the same time to avoid the enforcement the new health care reform act requires that insurance companies must re-invest a minimum 80% of revenue collected back to improve programs for their customers, or they must refund that money back to customers each year.

That result is effective August 1st of this year where the insurance companies that did not meet the standard are going to refund approximately 1.1 Billion dollars back to customers and employers across the country. My insurance company in my state alone is going to have to refund close to 27 million dollars back to their customers, because they did not meet the the standard required in the new health care reform act.

This hasn't been a highly advertised requirement/benefit of the plan until recently, nor has the fact that the insurance lobby funded an effort against the health care reform act in part because of it become known until recently, but one could find this requirement that insurance companies now face, if they looked deep enough in the 2700 pages that constitute the law, two years ago.

One can bet that insurance companies were fully aware of it, before the insurance lobby funded over a hundred million dollar covert effort against the passage of the health care reform act as it exists now.


http://www.forbes.com/sites/rickungar/2012/06/25/busted-health-insurers-secretly-spent-huge-to-defeat-health-care-reform-while-pretending-to-support-obamacare/

While technically everyone is required to purchase insurance coverage in 2014, if they don't meet applicable exemptions, which are numerous, no one is being forced to either purchase or even pay a penalty by criminal penalty, levies, or liens. The most the IRS can do per the laws that are applicable is sue for double the penalty owed, and the only way they could collect it is through government reimbursements back to citizens such as tax refunds or stimulus checks that were provided several years back.

US citizens living abroad are exempt from the requirement to purchase the insurance, and in fact, they are not allowed to purchase it. The sections in the 2700 page law that govern this are referenced in the link below. I referenced the actual law, in the previous post, if you want to verify it with the actual law.

http://www.ciab.com/WorkArea/DownloadAsset.aspx?id=2102

http://factcheck.org/2012/06/how-much-is-the-obamacare-tax/

Whatever happens with health care, it will just be really expensive and out of reach of the poor, just like it is now. States are already figuring out ways to get out of expanding Medicaid. Parts of this health care act that could really help people who need it the most - the poor without insurance - are just going to get hacked away while the expensive penalties and taxes will remain, not to mention expensive policies.

The Poor will have to learn to exercise, stop smoking (or not start to smoke), not to indulge in alcohol, not to eat and drink nutritionally dubious food and to guard their bodies carefully. Isn't that just horrid?

ruveyn