Health care
If Mr. Salazar wanted to tax his brain, instead of the people, he would address the underlying causes of our current health care system that is failing to meet the needs of American families. But it is much easier to just slap another tax on cigarettes and tobacco. After all smokers are in the minority. Consider these issues that are not being reported: SCHIP is funded not only on a 156% cigarette tax increase but a proposed tax that will decimate the premium cigar industry by raising the cap on cigar taxes an astounding 20,413%! No other product is subject to a tax rate that even approaches this level.
Many of the manufacturers and retail tobacconists that sell handmade cigars are small family businesses. This onerous tax is almost certain to bankrupt them. What about the children in Honduras and Nicaragua whose family’s livelihoods will be destroyed by this tax? Are their lives any less important? It is one thing to raise taxes reasonably to support a worthwhile social program. But no industry can be rationally expected to absorb such a drastic tax increase without going out of business. Cigars already fund the Colorado state coffers with a 40% state tobacco tax. You are in danger of killing the goose that laid the golden egg.
This letter has not been edited.
I just heard on the news that the dems want to now pay for health care for illegal's children. Just how much are they going to raise our taxes to pay for health care for everybody including illegals? Smoking of any kind is not PC so the Dems could care less about anything to do with it. Salazar doesn't care about anybody that is not liberal or illegal.
Posted by on July 30, 2007 02:26 PMSo the legislature passes this bill....and bush vetoes it....but its the democrat's fault?
Flawless reasoning, there.
Posted by Tbone on July 30, 2007 02:47 PMA bill that increases taxes on legal citizens to pay health care cost for an illegal immigrate is a bad bill to start with. Just because the legislature passed it doesn't change that fact.
Posted by jgd777 on July 30, 2007 04:16 PMI am not opposed to paying for the health of Colorado citizens, as that directly effects and impacts me. I do NOT believe that we should have a Federal system of health care (with this one caveat, I think we should have a standard of health care and the FDA is doing that now). I think that the citizens of their particular state should determine if they want to collectively pay for a bare bones system, or even an advanced system of health care. What a great marketing tool to attract businesses and employment.
I do agree with Mr. McCluskey, that to tax cigars at a rate of 20,413% is insane and borders criminal.
And I agree with jgd777 that an illegal should not receive tax-payer funded health care, ever. I can't go into Canada and get free health care, even though they have a single payer system, nor would I expect to.
Posted by Dan2 on July 30, 2007 05:20 PMAgreed on that, Dan2
Posted by Tbone on July 30, 2007 05:46 PMwhy not put a tax on fast food this time to fund the health care? they keep using smokers to fund kids health care when fast food is what makes them fat and not cigs. oh wait we had a pres who was wild over mcd's so cant do that.
Posted by on July 30, 2007 05:53 PMHow about doing a real penalty tax? We add a tax of one dollar on all drive through orders to take care of the fat crisis and the car pollution crisis.
Who cares if a few places go out of business? They should have planned better. Right?
If the United States does subsidize education for illegal children, it will end up being much better quality nation than if those children grow up uneducated. But many posters seem to have no interest in the future quality of our country, their only interest being in denying children what is essential to being a productive person in our country.
Dan 2 thinks it is OK for the government of Colorado to pay for health care of its citizens, but is opposed to having the federal government do that on a nation-wide basis.
Get this: he doesn't think he is affected or impacted by the way people in the other forty-nine states are treated. No further comment necessary for those who are aware of the real world around them and are aware of what has been taking place in that world for many years now. He apparently doesn't realize, for example, that the way people are educated, not in Maine or Mississippi, but much further away in the Middle East has a powerful impact on the United States and its inhabitants, including Dan 2.
Truth,
"If the United States does subsidize education for illegal children, it will end up being much better quality nation than if those children grow up uneducated."
Or we could just send them all back to where they came from. That would also improve the quality of our nation. Let their home countries worry about and pay for educating them.
Posted by on July 30, 2007 08:26 PMTruth.
The children of illegals are not barred from becoming educated. The taxpayer funded public school system bends over backwards to educate them. The question is how far do we go? You and Salazar want more. I want less. The battle is for my money, and i won't give it up without a battle.
No one doubts that an educated society is preferable to an uneducated one. However, the taxpayer obligation in the USA is to his fellow citizens, not to those who violate our law nor to the violators children.
Posted by Guess who on July 30, 2007 10:11 PMWhen did it become America's duty to educate and provide health care for the world? The only way to end the flow of illegal immigration is to remove the benefits for those that break the law to come here. I agree that health care is important and that the system is broken, but the solutions being suggested are unrealistic and costly. I personally cannot afford any more taxes. I keep hearing the arguement that we need a large migrant workforce to keep our economy afloat and then in the next breath I hear that we should provide opportunities for higher education for illegal immigrants. You can't have it both ways. If the migrant work force becomes college graduates, I doubt very seriously that they will want to pick lettuce. So, then we will need a few more million migrant workers and then they will demand to be educated and then we will need a few more million....and so on! If a living wage were paid to farm workers/hospitality workers, etc., sure the prices would go up. But if we, as a nation, are not paying for the health care and education of non-citizens, we can afford the price increases.
The government cannot continue to lay the cost of so many programs at the feet of tobacco. People are quitting in record numbers. Where are the funds going to come from then? And who is going to employ the tobacco workers that lose their jobs? Salazar (and the rest of congress) needs to look at solutions that spread the cost as well as the benefit.
Posted by idk on July 30, 2007 10:37 PMTruth:
And yet again, again!
“If the United States does subsidize education for illegal children, it will end up being much better quality nation than if those children grow up uneducated.” Come on, Truth. Thank you, 8:26 and Guess Who for answering this.
“But many posters seem to have no interest in the future quality of our country, their only interest being in denying children what is essential to being a productive person in our country”. Yet another huge illogical assumption.
“Dan 2 thinks it is OK for the government of Colorado to pay for health care of its citizens, but is opposed to having the federal government do that on a nation-wide basis.” So what?
“Get this: he doesn't think he is affected or impacted by the way people in the other forty-nine states are treated. No further comment necessary for those who are aware of the real world around them and are aware of what has been taking place in that world for many years now. He apparently doesn't realize, for example, that the way people are educated, not in Maine or Mississippi, but much further away in the Middle East has a powerful impact on the United States and its inhabitants, including Dan 2.”
??????????????????????????? So the education of Taliban freedom fighters should be paid for by Dan2? Or should we pay for their health insurance? Truth, please explain these leaps in affectations.
AF
8:19, I think you misread what truth wrote.
Posted by Sharon B. on July 31, 2007 11:00 AMGetting back to the letter----cig taxes fund all this feel-good stuff. The purpose of the taxes are to discourage smoking, so when people stop buying tobacco products, then the tax revenue dries up. Where will the money come from then?
Most of the people I know now buy their cigs from Indian reservations out East and avoid the punitive Colorado taxation. This also puts small tobacconists out of business and dry up the taxes.
I have faith that our government will find something else to tax to replace the tobacco revenue.
Posted by TL on July 31, 2007 11:04 AMTruth:
"If the United States does subsidize education for illegal children, it will end up being much better quality nation than if those children grow up uneducated"
If they can't legally work in the US, what difference will their education level make?
Posted by KW on July 31, 2007 12:35 PMMomma said ” Who cares if a few places go out of business? They should have planned better. Right?”
Here’s a Republican fiscal-conservative and Social-Conservative style answer for you.
Yes, they are dealing in gluttony which is a sin and the costs of this gluttony is being passed on to taxpayers and insurance companies. The glutton and those who facilitate them have no right to take our money and if they poorly thought out their business plan and failed to plan for being caught out and taxed according to the burden they place on everybody else, then they deserve to go out of business. The weak will die and that’s the natural order of things, but the weak – including gluttons and bad business, have no right to sponge off those who are strong.
What’s more, is we know that individuals who smoke or eat improperly damage not only themselves and reduce their productivity – thus wasting the tax money that went into supporting their education and protection, but they also cause their offspring to be more sickly, to be less productive, and a burden of taxpayers thus perpetuating the cost of the weak smoker or glutton themselves.
So not only do we bear the burden of their loss of productivity and health costs, but we are also burdened with that of their offspring.
Unless these individuals are prepared to waive all future Medicare/Medicaid, Social Security, and other costs and bear their costs on their own shoulders alone and also pay back the proportion of unrealized investment that taxpayers contributed to their education and protection, then taxation of all gluttons and smokers is the only recourse to recover the investment which they have willfully damaged.
"So the education of Taliban freedom fighters should be paid for by Dan2? Or should we pay for their health insurance? Truth, please explain these leaps in affectations.
AF"
Boy, AF, talk about flying leaps into the absurd; I suggest you see if you can recover some damages from your teachers for the lousy job they did. I presume you are aware, despite the appearance many of your posts give about your state of knowledge, of the madrasas. You think they haven't had an impact on America, including you and Dan2? As I was saying before this nitwit came into view, the education people receive in each of the fifty states has an impact on all Americans. Hell, the education they receive half a world away in the Middle East has an impact on all Americans.
Uh..Bango..
Sarcasm?.... . Please tell me you were doing it too. Thanks
Momma, mostly sarcasm but there are some cultural issues to be discussed in this country that never seem to surface.
If you ask Americans what constitutes a “good death” most list the following:
- Freedom from pain
- Not being a burden to their family and society
- Having medical staff who listen to their wishes
- Dying at home
Here’s some nasty facts:
- over 50% of Americans die in excruciating pain
- A quarter or more of Americans will have their life savings depleted when a family member goes through a terminal illness
- Over 50% of terminally ill patients will have DNR orders ignored or be subjected to procedures and regimens that they expressly didn’t want
- Over 50% of those who wanted to die at home will nevertheless be dragged off to hospital and die there
We spend over 25% of the budget on the last two years of life, often prolonging life for no good reason and often against the desires of the patient.
We spend more than any other country per capita, and we rate nowhere near the top of the list as far as care for the elderly, humane care for the terminally ill, infant mortality, and a range of other items.
In amongst this we have an insurance-based healthcare system so we prioritize clinical care over preventative care, and the safety net is very spare if you have congenital disease or anything that can be listed as a prior condition or on the “b-list”.
To cap it, we have a system of training that leans heavily towards diagnostics and simply ignores prognostics. So ask a doctor what your chances are and how long you will live and they uniformly give you a rosier picture than will usually turn out to be the case.
You can easily be put on a painful and costly chemo therapy that would last for two years only to die a few days later. Spending your last few days on earth hugging the toilet and vomiting your lungs loose seems a poor deal. Since education is also a “for profit” industry, the average doctor leaves college clutching their qualification in one hand and over $200,000 debt, then they go sign up for malpractice insurance that easily reaches $100,000 per year, and for a neurologist can easily be double.
So to match income and costs they can’t spend more than 15 minutes per patient, and the prognosis that you get (if you get one) will be done in an average of 15 seconds.
If that wasn’t all, we have a consumer culture that is making us sick by the hundreds of thousands. We eat too much and the wrong foods, we smoke, we take drugs that harm us, we don’t exercise enough and when we do it is often harmful in other ways.
If that didn’t clinch it, we have two warring political parties both in the pocket of big pharma and insurance companies, and the debate always prevents anybody from talking seriously about preventative healthcare and access to information.
The poor healthcare choices get passed down to children. Obese parents tend to have obese children, parents that smoke cause long-term damage to their babies even before they are born, and parents who regularly took pain medications and a range of other substances will also cause long term and sometimes irreversible health problems to their children. The generation now in K-12 will have a lower life expectancy than their parents, mainly due to obesity.
This is not a situation that can be solved with better HSAs or better insurance policies, and it can’t be approached with an “every man for himself” frame of reference (not that I am accusing you of this).
For my money, we can learn a lot from Bango's meaty comments.
I think the good hospice programs take Bango's concerns seriously. They emphasize home care when it is available. They provide for home care visits and for respite care for the sake of the caregivers at home to give them a chance to rejuvenate from the stressful task of caring for a dying loved one. They restrict themselves to palliative care rather than therapeutic care. They tenderly hold the hands, and hearts, of both patients and family. They give the patients the freedom to talk about the fact that they are dying if they care to, something many families can't quite bring themselves to do. Most of all, if they are like the one I volunteered at for several years, they provide a wonderful depth of love warmth and understanding to both the dying patient and to his/her family.
Posted by Truth on July 31, 2007 07:28 PMJim McCluskey is right on: "If Mr. Salazar wanted to tax his brain, instead of the people, he would address the underlying causes of our current health care system that is failing to meet the needs of American families."
For an analysis of how government policies have decimated health care, see freemarketcure.com and the Colorado organization Freedom and Individual Rights in Medicine at WeStandFirm.org.
Posted by Brian T. Schwartz on July 31, 2007 10:00 PMThanks Bango. I think one item you missed, or I missed is the fact that no matter what healthcare is available there will always be people who don't use preventative care. That has been observed in Canadian and other single payer systems as well as in people who have excellent health insurance. Sort of a case of individualism moving away from good sense.
The other problem is one I look at a lot and can't find any good solution because there really isn't one. A lot of people, no matter what their health insurance, can't afford to be sick. Hourly workers, like my husband, lose more than the cost of medical care, they lose their pay for all the time they are ill. Many have no paid leave of any kind and will only treat illness when they literally can't walk in the workplace door.
No program will solve this problem because mandating paid sick leave will cause extreme damage to small businesses and the large businesses know how to get around such measures by sub-contracting or using only part time help. Trucking companies get around any rules for payment by paying by the load or by the mile. No miles...no pay and no one will ever be able to fix that problem because it would raise the costs of almost everything so high that we would think 4 dollar gasoline was a bargain.
Preventative care is a good idea and Kaiser preaches it but makes certain that they charge so much you can barely afford to follow doctor's orders and/or fill prescriptions.
If it were really so cost effective to be pro-active you can bet Kaiser would do it. Right now they DO have no co-pay mamograms and diabetic eye exams because those diseases are more expensive to treat than to discover or prevent.
As for adding a tax to fast food...it already costs twice as much or more than good food you cook yourself. No one will change because of the cost. That is why the government is balancing programs on the back of tobacco sales because those sales seldom go down much and many people just spend more and grumble.
I know I"m looking forward to a change in our insurance next year...the company safety manager listened to me when I outlined the benefits for MSA programs and they are submitting the paperwork to get one started. Our insurance agent doesn't sell them but he spent five hours last week explaining how to set one up. They will spend about 30% less and the workers will have a choice of Kaiser or MSA. Most of them are asking my husband about it now and he told them to call me. I am very busy answering questions and encouraging them to do the math. Most of them are young and won't have any heavy medical expenses other than insurance or accidents in the near future so they will have a large balance in their accounts if they need it.
Can you say success?! Of course I am headed for Medicare disability. Doctors all ordered me to stay home and avoid stress and conflict. Four heart attacks in six months and five surgeries mean I'm out of the workplace. I'd go to Blackhawk and play cards but I cheat (not really but my hobby many years ago was slight of hand magic and I cna still deal you any card I want to out of the deck). Therefore this playpen is my only outlet for sanity. It's our little secret. OK?
Momma said ”If it were really so cost effective to be pro-active you can bet Kaiser would do it.”
It would be worth doing even if it cost more since you can plan for prevention easier than reaction, but only in large scale.
The basic problem is one of revenue and cost for the individual provider.
It certainly isn’t in Kaiser’s interests to embark on a campaign to do basic dentistry across the nation in order to reduce other more costly outcomes like cardio-vascular disease since only a small proportion of those treated will be their subscribers, and trimming down the program to address only their subscribers then loses the economies of scale and makes it less attractive to Kaiser.
So Kaiser will do as much preventative work as makes sense if viewed only from the perspective of their own P&L considerations.
This is the same “silo” effect that you can see inside companies where a division may look great in its KPIs but when viewed from a company-wide perspective its behaviour may start to look detrimental and irrational.
Kaiser and each of the individual insurers and providers are behaving rationally when you view their actions in terms of their individual P&L, but the sum of their actions is irrational when viewed either from a national level or an individual patient’s perspective.
As for HSA, I have looked at those offered to me, and funny enough the numbers never work out. Either I need to be much sicker or never be sick at all for them to work.
I am sure they work fine for the folks on either end of the bell curve, but my suspicion is that they were designed to not work for the centre two or even four standard deviations because that’s how they are making a profit.
Let’s not forget that any insurance is designed to make a profit, which means that they pay out less than they bring in even when administrative, marketing, and sales overhead is added to the cost. That means that the cost of buying it must on average be significantly higher than the protection it provides.
Bango
We are talking about a whole company that will usually save about a third over conventional insurance with the MSA option.. Now we, my husband and I, will probably not save that much but we will have the opportunity and that is what matters. As for the preventative savings argument the problem is that even if it makes a small sense it depends on the individual to participate and studies in single payer systems as well as in insurance situations has shown that we don't opt for prevention.
I am quite well versed with the dental/cardiac connection as when they implanted the pacemaker/defibrillator last month they took one look at my teeth and got an oral surgeon in to deal with two teeth that didn't hurt but had infections in them that reached into the sinus cavity. They thought it might have had a lot to do with my earlier problems this year too.
We bought the Comfort Dental insurance lst year and they immediately told us they couldn't treat me because I was a diabetic with heart problems. They also refused to refund the insurance (1 year pre-paid) but that is under litigation.
As for medical insurance..I'll take my chances with an HSA thanks.
Good letter though. You are a great poster even when I think you're wrong. Maybe we can get a few more people who have more interest in light than heat so we can get a better system.
Posted by momma y on August 1, 2007 12:06 PMThe illegal parents can pay for the health care of their own children, just like they pay for their big SUV's and F-150's. Pass by any of the Mexican clinics in Denver and suburbs,
the cars parked at those clinics are no junkers.
Momma, thanks for the kind words, but I suspect we differ less than you might suppose.
I fully agree that some people simply do not change their behaviour, and that effective preventative-care programs need to be constructed with that understanding.
There are two more facts that I would put on the table:
- The big changes in mortality rates and life expectancy historically were related to healthcare and social changes, not clinical innovations
- We spend only 5% of the healthcare total of around $900 Billion on preventative efforts, so we really aren’t balancing this properly.