http://www.usatoday.com/money/perfi/insurance/2010-04-29-healthirs28_CV_N.htm
IRS lacks clout to enforce mandatory health insurance
By Sandra Block, USA TODAY
The IRS processed more than 230 million tax returns last year, paid 127 million refunds and received about 68 million phone calls. The agency is responsible for enforcing a tax code that, at 71,000 pages, makes Anna Karenina look like a comic book.
Starting in 2014, the agency will have another task: making sure all Americans have health insurance. Under the law, Americans who can afford health insurance but refuse to buy it will face a fine of up to $695 or 2.5% of their income, whichever is higher. More than 4 million Americans could be subject to penalties of up to $1,000 by 2016 if they fail to obtain health insurance, the Congressional Budget Office said last week.
The IRS will be the enforcer — sort of.
HEALTH CARE LAW: Some trapped in pricey state plans
While the IRS can impose liens or levies, seize property or seek jail time against people who don't pay taxes, it's barred from taking such actions against taxpayers who ignore the insurance mandate. In the arsenal instead: the ability to withhold refunds from taxpayers who decline to pay the penalty, IRS Commissioner Doug Shulman said this month.
Still, compliance with the health reform law will be largely voluntary, says Timothy Jost, a law professor at Washington and Lee University. "By taking criminal sanctions and liens and levies off the table, the IRS' hands are tied, to a considerable extent."
The IRS is "being put in a position where it will be sending notices that will annoy people" and not much else, says James Maule, professor of law at Villanova University and author of the tax blog MauledAgain. "It's basically designed for failure."
Shulman said he believes most Americans will comply with the law. The experience of Massachusetts, which has required residents to have health insurance since 2006, would appear to support that view. In 2008, 98% of state tax filers who were required to provide health insurance information with their state tax returns met that filing requirement, and 96% had coverage, according to a preliminary report issued in December by the Massachusetts Department of Revenue.
But Massachusetts' health care law gives the Department of Revenue the authority to use its regular tax-collection powers to enforce the insurance mandate, says spokesman Robert Bliss. Through September 2009, the state had collected $12.9 million of the $16.4 million in penalties assessed in 2008.
'A dangerous expansion of the IRS' power'
In this political environment, even a defanged IRS stirs up powerful emotions. Among the concerns about the IRS' role in the health care reform law:
•The law will lead to a dramatic expansion of the IRS. The Congressional Budget Office has estimated that the IRS will need an additional $5 billion to $10 billion over the next 10 years to administer the health care law. That projection has fired up activists who believe the IRS should be downsized, or abolished.
Some Republican lawmakers have extrapolated from that estimate that the IRS will need to hire an additional 16,500 agents to enforce the health insurance mandate. Rep. Dave Camp, R-Mich., ranking minority member of the House Ways and Means Committee, called the law "a dangerous expansion of the IRS' power and reach into the lives of virtually every American."
The CBO report refers to the $10 billion figure as "administrative costs" and makes no reference to the number of employees the agency will need to hire. And enforcement is only one part of the IRS' responsibilities under the law. The agency will also be in charge of providing tax credits to small businesses, along with refundable tax credits to individuals who can't afford health insurance.
"The IRS is going to need additional resources, but in terms of health reform, probably the main focus is going to be on processing" the credits, Jost says.
The IRS has already started some of its administrative tasks. Last week, it began mailing postcards to more than 4 million small businesses and tax-exempt groups with information about a provision in the law that provides tax credits for small businesses. The tax credit, which takes effect this year, is designed to encourage small businesses to offer health insurance to their employees or keep the coverage they already have.
•The law will make it more difficult for the IRS to carry out its primary job of collecting taxes. Only 64% of taxpayers who called the IRS during last year's tax-filing season reached an IRS representative, according to a report by the IRS' national taxpayer advocate. The IRS' modest goal for this year was to answer 71% of taxpayer calls. Even more callers could have trouble getting through when the IRS takes on its obligations under the health care law, Sen. Charles Grassley, R-Iowa, said at an April 15 Senate Finance Committee hearing.
"Taxpayers trying to do the right thing regarding their tax responsibilities shouldn't have to be put on hold — or have to call back — because the IRS is now answering questions about health insurance," Grassley said.
The new responsibilities could also force the IRS to cut back on complex audits of sophisticated tax-avoidance schemes, such as illegal offshore accounts, Maule says. To handle the administrative tasks associated with the law, the IRS may need to divert experienced IRS agents who typically conduct these audits, he says. "This is going to make it easier for people who want to play the audit lottery game to get away with it."
Another potential problem: Administering the health care law will strain the IRS' already outdated computer and data-storage systems, says Pete Sepp, spokesman for the National Taxpayers Union, an advocacy group that supports lower taxes. "The IRS customer-service front end is already sagging, and the back end is not looking so hot, either," he says.
•The IRS does a poor job of managing social programs. Critics of the legislation say problems with the Earned Income Tax Credit, a federal program that provides tax rebates to low-income working families, illustrate the pitfalls of putting the IRS in charge of administering health care reform. The EITC program "has one of the highest fraud and abuse rates of any tax provision out there," Grassley said at the April 15 hearing. In tax year 2006, the latest year available, IRS made $10 billion to $12 billion in erroneous EITC payments, according to a study by the Treasury Department's inspector general.
IRS officials argue that the two programs are vastly different. The health care subsidies will go directly to insurers, not taxpayers, giving individuals little incentive to cheat, says IRS spokesman Frank Keith.
Jost maintains that the tax credits could encourage compliance, because taxpayers who refuse to provide information about their health care coverage will be ineligible for federal health insurance subsidies. That subsidy "is going to be pretty significant for lower-income people," he says.
Under the law, millions of middle- and low-income taxpayers will be eligible for subsidies to help pay for their health insurance. Taxpayers with incomes of up to four times the poverty level — currently $43,320 for an individual and $88,200 for a family of four — would qualify.
Matching documents
Starting in 2014, insurers will be required to send the IRS a document showing that the taxpayer has insurance coverage. The IRS will match taxpayers' returns with information it receives from insurers, and individuals who don't have insurance will receive a letter explaining how much they owe in penalties.
Those who ignore the letter could have the penalty withheld from their refunds — but that will only be effective if they're due a refund. Self-employed taxpayers, who are among the individuals most likely to go without insurance, often don't get refunds because their wages aren't subject to withholding.
Still, Jost believes the actual number of insurance scofflaws will be relatively small. People who receive health insurance through their jobs — about 57% of workers — won't be affected. Taxpayers older than 65 won't be subject to the new requirement because they're covered by Medicare. And many self-employed people, along with workers who don't have employer-provided coverage, meet the income requirements for tax credits, so they'll have an incentive to get insurance, he says.
That leaves doctors, lawyers, accountants and other self-employed people with high incomes, Jost says. Many of these taxpayers have complex tax returns that include numerous tax deductions and credits, Jost says. "Unless they are just deeply principled people who think this is the greatest offense in the history of this country, they are not going to want to mix it up with the IRS," he says.
And what will happen to taxpayers who defy the mandate? Not much, Jost predicts:
"I think it's going to be a small number of wealthy people who are going to be determined to fight this, and the IRS will just ignore them."
Keith disputes the notion that taxpayers who disregard the law will get a free pass. The IRS will have up to 10 years to withhold refunds from individuals who owe penalties, he says. Even if they aren't ordinarily due a refund, he says, "any time they overpay, those monies will be available."
Thursday, April 29, 2010
Monday, April 26, 2010
1970 Predictions From 1st Earth Day...
These are Predictions from the 1st Earth Day, made in 1970
"We have about five more years at the outside to do something."
- Kenneth Watt, ecologist
"Civilization will end within 15 or 30 years unless immediate action is taken against problems facing mankind."
- George Wald, Harvard Biologist
"We are in an environmental crisis which threatens the survival of this nation, and of the world as a suitable place of human habitation."
- Barry Commoner, Washington University biologist
"Man must stop pollution and conserve his resources, not merely to enhance existence but to save the race from intolerable deterioration and possible extinction."
- New York Times editorial, the day after the first Earth Day
"Population will inevitably and completely outstrip whatever small increases in food supplies we make. The death rate will increase until at least 100-200 million people per year will be starving to death during the next ten years."
- Paul Ehrlich, Stanford University biologist
"By...[1975] some experts feel that food shortages will have escalated the present level of world hunger and starvation into famines of unbelievable proportions. Other experts, more optimistic, think the ultimate food-population collision will not occur until the decade of the 1980s."
- Paul Ehrlich, Stanford University biologist
"It is already too late to avoid mass starvation."
- Denis Hayes, chief organizer for Earth Day
"Demographers agree almost unanimously on the following grim timetable: by 1975 widespread famines will begin in India ; these will spread by 1990 to include all of India , Pakistan , China and the Near East, Africa . By the year 2000, or conceivably sooner, South and Central America will exist under famine conditions....By the year 2000, thirty years from now, the entire world, with the exception of Western Europe, North America, and Australia, will be in famine."
- Peter Gunter, professor, North Texas State University
"Scientists have solid experimental and theoretical evidence to support...the following predictions: In a decade, urban dwellers will have to wear gas masks to survive air pollution...by 1985 air pollution will have reduced the amount of sunlight reaching earth by one half...."
- Life Magazine, January 1970
"At the present rate of nitrogen buildup, it's only a matter of time before light will be filtered out of the atmosphere and none of our land will be usable."
- Kenneth Watt, Ecologist
"Air pollution...is certainly going to take hundreds of thousands of lives in the next few years alone."
- Paul Ehrlich, Stanford University biologist
"We are prospecting for the very last of our resources and using up the nonrenewable things many times faster than we are finding new ones."
- Martin Litton, Sierra Club director
"By the year 2000, if present trends continue, we will be using up crude oil at such a rate...that there won't be any more crude oil. You'll drive up to the pump and say, `Fill 'er up, buddy,' and he'll say, `I am very sorry, there isn't any.'"
- Kenneth Watt, Ecologist
"Dr. S. Dillon Ripley, secretary of the Smithsonian Institute, believes that in 25 years, somewhere between 75 and 80 percent of all the species of living animals will be extinct." (even this was said in 1970)
- Sen. Gaylord Nelson (Al Gore must have read his book)
"The world has been chilling sharply for about twenty years. If present trends continue, the world will be about four degrees colder for the global mean temperature in 1990, but eleven degrees colder in the year 2000. This is about twice what it would take to put us into an ice age." - Kenneth Watt, Ecologist
I guess by now we are all supposed to be dead or at least gasping for breath. . “are we there yet?”
PS Challenge everything you read and half of that which you are told, irrespective of the source. In fact, the more credible the source, the more suspicious one should become. And yes, ride your bicycle more, turn off unused lights and don’t waste water. Oh, and one more thing, cut your toilet paper usage to one sheet per bowl movement. Now the smell will kill us.
"We have about five more years at the outside to do something."
- Kenneth Watt, ecologist
"Civilization will end within 15 or 30 years unless immediate action is taken against problems facing mankind."
- George Wald, Harvard Biologist
"We are in an environmental crisis which threatens the survival of this nation, and of the world as a suitable place of human habitation."
- Barry Commoner, Washington University biologist
"Man must stop pollution and conserve his resources, not merely to enhance existence but to save the race from intolerable deterioration and possible extinction."
- New York Times editorial, the day after the first Earth Day
"Population will inevitably and completely outstrip whatever small increases in food supplies we make. The death rate will increase until at least 100-200 million people per year will be starving to death during the next ten years."
- Paul Ehrlich, Stanford University biologist
"By...[1975] some experts feel that food shortages will have escalated the present level of world hunger and starvation into famines of unbelievable proportions. Other experts, more optimistic, think the ultimate food-population collision will not occur until the decade of the 1980s."
- Paul Ehrlich, Stanford University biologist
"It is already too late to avoid mass starvation."
- Denis Hayes, chief organizer for Earth Day
"Demographers agree almost unanimously on the following grim timetable: by 1975 widespread famines will begin in India ; these will spread by 1990 to include all of India , Pakistan , China and the Near East, Africa . By the year 2000, or conceivably sooner, South and Central America will exist under famine conditions....By the year 2000, thirty years from now, the entire world, with the exception of Western Europe, North America, and Australia, will be in famine."
- Peter Gunter, professor, North Texas State University
"Scientists have solid experimental and theoretical evidence to support...the following predictions: In a decade, urban dwellers will have to wear gas masks to survive air pollution...by 1985 air pollution will have reduced the amount of sunlight reaching earth by one half...."
- Life Magazine, January 1970
"At the present rate of nitrogen buildup, it's only a matter of time before light will be filtered out of the atmosphere and none of our land will be usable."
- Kenneth Watt, Ecologist
"Air pollution...is certainly going to take hundreds of thousands of lives in the next few years alone."
- Paul Ehrlich, Stanford University biologist
"We are prospecting for the very last of our resources and using up the nonrenewable things many times faster than we are finding new ones."
- Martin Litton, Sierra Club director
"By the year 2000, if present trends continue, we will be using up crude oil at such a rate...that there won't be any more crude oil. You'll drive up to the pump and say, `Fill 'er up, buddy,' and he'll say, `I am very sorry, there isn't any.'"
- Kenneth Watt, Ecologist
"Dr. S. Dillon Ripley, secretary of the Smithsonian Institute, believes that in 25 years, somewhere between 75 and 80 percent of all the species of living animals will be extinct." (even this was said in 1970)
- Sen. Gaylord Nelson (Al Gore must have read his book)
"The world has been chilling sharply for about twenty years. If present trends continue, the world will be about four degrees colder for the global mean temperature in 1990, but eleven degrees colder in the year 2000. This is about twice what it would take to put us into an ice age." - Kenneth Watt, Ecologist
I guess by now we are all supposed to be dead or at least gasping for breath. . “are we there yet?”
PS Challenge everything you read and half of that which you are told, irrespective of the source. In fact, the more credible the source, the more suspicious one should become. And yes, ride your bicycle more, turn off unused lights and don’t waste water. Oh, and one more thing, cut your toilet paper usage to one sheet per bowl movement. Now the smell will kill us.
Tuesday, April 20, 2010
Bryan Baumgart Unemployment encouraged! Incentives NOT to Work!!
http://online.wsj.com/article/SB10001424052702303828304575180243952375172.html?mod=WSJ_hpp_sections_opinion
APRIL 13, 2010.
Incentives Not to Work
Larry Summers v. Senate Democrats on jobless benefits.
"The second way government assistance programs contribute to long-term unemployment is by providing an incentive, and the means, not to work. Each unemployed person has a 'reservation wage'—the minimum wage he or she insists on getting before accepting a job. Unemployment insurance and other social assistance programs increase [the] reservation wage, causing an unemployed person to remain unemployed longer."
Any guess who wrote that? Milton Friedman, perhaps. Simon Legree? Sorry.
Full credit goes to Lawrence H. Summers, the current White House economic adviser, who wrote those sensible words in his chapter on "Unemployment" in the Concise Encyclopedia of Economics, first published in 1999.
Mr. Summers should give a tutorial to the U.S. Senate, which is debating whether to extend unemployment benefits for the fourth time since the recession began in early 2008. The bill pushed by Democrats would extend jobless payments to 99 weeks, or nearly two full years, at a cost of between $7 billion and $10 billion. As Mr. Summers suggests, rarely has there been a clearer case of false policy compassion.
View Full Image
Associated Press Larry Summers
.
Mr. Summers is merely reflecting what numerous economic studies have shown. Alan Reynolds of the Cato Institute has found that the average unemployment episode rose from 10 weeks before the recession to 19 weeks after Congress twice previously extended jobless benefits—to 79 from 26 weeks. Even as initial unemployment claims have fallen in recent months, the length of unemployment has risen. Mr. Reynolds estimates that the extensions of unemployment insurance and other federal policies have raised the official jobless rate by nearly two percentage points.
Or consider the Brookings Institution, whose panel on economic activity reported this March that jobless insurance extensions "correspond to between 0.7 and 1.8 percentage points of the 5.5 percentage point increase in the unemployment rate witnessed in the current recession."
Or perhaps the Senate should listen to another Obama Administration economist, Alan Krueger of the Treasury Department, who concluded in a 2008 study that "job search increases sharply in the weeks prior to benefit exhaustion." In other words, many unemployed workers don't start seriously looking for a job until they are about to lose their benefits.
And, sure enough, the share of unemployed workers who don't have a job for more than 26 weeks has steadily increased, reaching a record 44.1% in March. The average spell of unemployment is now 31 weeks, even though the economy is once again creating more new jobs than it is losing. Democrats are slowly converting unemployment insurance into a welfare program.
Despite all of this evidence, Democrats seem to think that extending jobless benefits for another 20 weeks is a big political winner. Iowa Senator Tom Harkin recently roared, "Is there any compassion at all left with Republicans for people whose checks are going to run out?" New York's Chuck Schumer calls Republicans "inhumane."
But do these Senators really think it's compassionate to give people an additional incentive to stay out of the job market, losing crucial skills and contacts? And how politically smart is it for Democrats to embrace policies that keep the jobless rate higher than it would otherwise be? How many Democrats share Mr. Harkin's apparent desire to defend a jobless rate near 9% (today it is 9.7%) in the fall election campaign.
We should add that Republicans would rather not fight on these incentive grounds and are instead opposing the new benefits only because Democrats refuse to pay for them and want to add to the deficit. In other words, the GOP is merely asking Democrats to live up to their own "pay as you go" fiscal promises, since the total bill for these jobless benefits has now hit nearly $90 billion.
If Republicans were really cynical, they'd let the new benefits pass and run against the higher jobless rate in the fall. In any case, no one should be surprised that when you subsidize people for not working, more people will choose not to work.
An earlier WSJ.com version of this editorial contained a quote from the Federal Reserve Open Market Committee's January minutes that was accurate but taken out of context. It was removed during the editing process and wasn't published in the print version of the Wall Street Journal. However, due to a production error, the quote made it into the initial online version of the editorial.
Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit
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Related Stories.Consider Government's Many Disincentives to Hiring21 hrs ago .Unemployment Benefits Aren't Keeping Us From WorkYesterday 12:01 A.M. .Don't Blame High Unemployment on the Unemployed4/16/2010 .Summers on Demand4/15/2010 .Don't Blame Extension of Jobless BenefitsYesterday 01:44 P.M. .The SEC vs. Goldman Yesterday 12:01 A.M. Subscriber Content Read Preview
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APRIL 13, 2010.
Incentives Not to Work
Larry Summers v. Senate Democrats on jobless benefits.
"The second way government assistance programs contribute to long-term unemployment is by providing an incentive, and the means, not to work. Each unemployed person has a 'reservation wage'—the minimum wage he or she insists on getting before accepting a job. Unemployment insurance and other social assistance programs increase [the] reservation wage, causing an unemployed person to remain unemployed longer."
Any guess who wrote that? Milton Friedman, perhaps. Simon Legree? Sorry.
Full credit goes to Lawrence H. Summers, the current White House economic adviser, who wrote those sensible words in his chapter on "Unemployment" in the Concise Encyclopedia of Economics, first published in 1999.
Mr. Summers should give a tutorial to the U.S. Senate, which is debating whether to extend unemployment benefits for the fourth time since the recession began in early 2008. The bill pushed by Democrats would extend jobless payments to 99 weeks, or nearly two full years, at a cost of between $7 billion and $10 billion. As Mr. Summers suggests, rarely has there been a clearer case of false policy compassion.
View Full Image
Associated Press Larry Summers
.
Mr. Summers is merely reflecting what numerous economic studies have shown. Alan Reynolds of the Cato Institute has found that the average unemployment episode rose from 10 weeks before the recession to 19 weeks after Congress twice previously extended jobless benefits—to 79 from 26 weeks. Even as initial unemployment claims have fallen in recent months, the length of unemployment has risen. Mr. Reynolds estimates that the extensions of unemployment insurance and other federal policies have raised the official jobless rate by nearly two percentage points.
Or consider the Brookings Institution, whose panel on economic activity reported this March that jobless insurance extensions "correspond to between 0.7 and 1.8 percentage points of the 5.5 percentage point increase in the unemployment rate witnessed in the current recession."
Or perhaps the Senate should listen to another Obama Administration economist, Alan Krueger of the Treasury Department, who concluded in a 2008 study that "job search increases sharply in the weeks prior to benefit exhaustion." In other words, many unemployed workers don't start seriously looking for a job until they are about to lose their benefits.
And, sure enough, the share of unemployed workers who don't have a job for more than 26 weeks has steadily increased, reaching a record 44.1% in March. The average spell of unemployment is now 31 weeks, even though the economy is once again creating more new jobs than it is losing. Democrats are slowly converting unemployment insurance into a welfare program.
Despite all of this evidence, Democrats seem to think that extending jobless benefits for another 20 weeks is a big political winner. Iowa Senator Tom Harkin recently roared, "Is there any compassion at all left with Republicans for people whose checks are going to run out?" New York's Chuck Schumer calls Republicans "inhumane."
But do these Senators really think it's compassionate to give people an additional incentive to stay out of the job market, losing crucial skills and contacts? And how politically smart is it for Democrats to embrace policies that keep the jobless rate higher than it would otherwise be? How many Democrats share Mr. Harkin's apparent desire to defend a jobless rate near 9% (today it is 9.7%) in the fall election campaign.
We should add that Republicans would rather not fight on these incentive grounds and are instead opposing the new benefits only because Democrats refuse to pay for them and want to add to the deficit. In other words, the GOP is merely asking Democrats to live up to their own "pay as you go" fiscal promises, since the total bill for these jobless benefits has now hit nearly $90 billion.
If Republicans were really cynical, they'd let the new benefits pass and run against the higher jobless rate in the fall. In any case, no one should be surprised that when you subsidize people for not working, more people will choose not to work.
An earlier WSJ.com version of this editorial contained a quote from the Federal Reserve Open Market Committee's January minutes that was accurate but taken out of context. It was removed during the editing process and wasn't published in the print version of the Wall Street Journal. However, due to a production error, the quote made it into the initial online version of the editorial.
Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved
This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit
www.djreprints.com
More In Opinion
EmailPrinter FriendlyOrder ReprintsShare: facebook
Digg
StumbleUpon
Viadeo
Orkut
Yahoo! Buzz
Fark
del.icio.us
MySpace
.
Related Stories.Consider Government's Many Disincentives to Hiring21 hrs ago .Unemployment Benefits Aren't Keeping Us From WorkYesterday 12:01 A.M. .Don't Blame High Unemployment on the Unemployed4/16/2010 .Summers on Demand4/15/2010 .Don't Blame Extension of Jobless BenefitsYesterday 01:44 P.M. .The SEC vs. Goldman Yesterday 12:01 A.M. Subscriber Content Read Preview
.Immigration Reform: The New Third Rail 4/16/2010 Subscriber Content Read Preview
.New Data Will Give Clues To U.K. Election13 hrs ago . .
Related Videos. 2/23/2010 AM Report: Jobless Rate Hits New High . 2/23/2010 AM Report: Job Losses Accelerate . 2/23/2010 News Hub: Health-Care Debate Moves to Senate Floor . .
.Back To . .
Back To..MSN Money Homepage.MSN Money Investing. .Video .previous next JER: Nuclear Security Summit, Are We Any Safer? 5:25 . JER: N.J. Governor Takes on Teachers' Union 5:45 . He's a Dreamer, He's a Realist 3:15 . .
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US Faces Sever Shortage Of Doctors!
http://online.wsj.com/article/SB10001424052702304506904575180331528424238.html?mod=WSJ_hpp_MIDDLENexttoWhatsNewsSecond
APRIL 12, 2010.
Medical Schools Can't Keep Up
As Ranks of Insured Expand, Nation Faces Shortage of 150,000 Doctors in 15 Years.
By SUZANNE SATALINE And SHIRLEY S. WANG
The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.
Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.
That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.
The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.
The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.
Related VideoMedical Training in Second Life (04/12/10)Getting Doctors, Hospitals to Use Electronic Medical Records (01/26/09)Faces of Health Care: A Doctor is in the House (12/22/09).
A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.
Proponents of the new health-care law say it does attempt to address the physician shortage. The law offers sweeteners to encourage more people to enter medical professions, and a 10% Medicare pay boost for primary-care doctors.
Meanwhile, a number of new medical schools have opened around the country recently. As of last October, four new medical schools enrolled a total of about 190 students, and 12 medical schools raised the enrollment of first-year students by a total of 150 slots, according to the AAMC. Some 18,000 students entered U.S. medical schools in the fall of 2009, the AAMC says.
But medical colleges and hospitals warn that these efforts will hit a big bottleneck: There is a shortage of medical resident positions. The residency is the minimum three-year period when medical-school graduates train in hospitals and clinics.
There are about 110,000 resident positions in the U.S., according to the AAMC. Teaching hospitals rely heavily on Medicare funding to pay for these slots. In 1997, Congress imposed a cap on funding for medical residencies, which hospitals say has increasingly hurt their ability to expand the number of positions.
Medicare pays $9.1 billion a year to teaching hospitals, which goes toward resident salaries and direct teaching costs, as well as the higher operating costs associated with teaching hospitals, which tend to see the sickest and most costly patients.
Doctors' groups and medical schools had hoped that the new health-care law, passed in March, would increase the number of funded residency slots, but such a provision didn't make it into the final bill.
"It will probably take 10 years to even make a dent into the number of doctors that we need out there," said Atul Grover, the AAMC's chief advocacy officer.
While doctors trained in other countries could theoretically help the primary-care shortage, they hit the same bottleneck with resident slots, because they must still complete a U.S. residency in order to get a license to practice medicine independently in the U.S. In the 2010 class of residents, some 13% of slots are filled by non-U.S. citizens who completed medical school outside the U.S.
One provision in the law attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary-care or general-surgery residencies. The slot redistribution, in effect, will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services.
From the ArchiveOpinion: How to Fix the Doctor Shortage (01/04/10)Health Blog: Would Adding Residency Slots Solve the Primary-Care Shortage? (11/27/09)Opinion: The Coming Shortage of Doctors (11/06/09)Health Blog: Obama: 'Severe Shortage' of Primary Care Doctors (08/11/09).
Some efforts by educators are focused on boosting the number of primary-care doctors. The University of Arkansas for Medical Sciences anticipates the state will need 350 more primary-care doctors in the next five years. So it raised its class size by 24 students last year, beyond the 150 previous annual admissions.
In addition, the university opened a satellite medical campus in Fayetteville to give six third-year students additional clinical-training opportunities, said Richard Wheeler, executive associate dean for academic affairs. The school asks students to commit to entering rural medicine, and the school has 73 people in the program.
Journal Communitydiscuss..“ As a specialist physician I will suggest that until primary care physicians can earn 70-80% of what most specialists make without killing themselves, there will be no incentive for the best and the brightest to go into primary care. ”
.—Michael Brennan.
"We've tried to make sure the attitude of students going into primary care has changed," said Dr. Wheeler. "To make sure primary care is a respected specialty to go into."
Montefiore Medical Center, the university hospital for Albert Einstein College of Medicine in New York, has 1,220 residency slots. Since the 1970s, Montefiore has encouraged residents to work a few days a week in community clinics in New York's Bronx borough, where about 64 Montefiore residents a year care for pregnant women, deliver children and provide vaccines. There has been a slight increase in the number of residents who ask to join the program, said Peter Selwyn, chairman of Montefiore's department of family and social medicine.
One is Justin Sanders, a 2007 graduate of the University of Vermont College of Medicine who is a second-year resident at Montefiore. In recent weeks, he has been caring for children he helped deliver. He said more doctors are needed in his area, but acknowledged that "primary-care residencies are not in the sexier end. A lot of these [specialty] fields are a lot sexier to students with high debt burdens."
APRIL 12, 2010.
Medical Schools Can't Keep Up
As Ranks of Insured Expand, Nation Faces Shortage of 150,000 Doctors in 15 Years.
By SUZANNE SATALINE And SHIRLEY S. WANG
The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors.
Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges.
That shortfall is predicted despite a push by teaching hospitals and medical schools to boost the number of U.S. doctors, which now totals about 954,000.
The greatest demand will be for primary-care physicians. These general practitioners, internists, family physicians and pediatricians will have a larger role under the new law, coordinating care for each patient.
The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007.
Related VideoMedical Training in Second Life (04/12/10)Getting Doctors, Hospitals to Use Electronic Medical Records (01/26/09)Faces of Health Care: A Doctor is in the House (12/22/09).
A shortage of primary-care and other physicians could mean more-limited access to health care and longer wait times for patients.
Proponents of the new health-care law say it does attempt to address the physician shortage. The law offers sweeteners to encourage more people to enter medical professions, and a 10% Medicare pay boost for primary-care doctors.
Meanwhile, a number of new medical schools have opened around the country recently. As of last October, four new medical schools enrolled a total of about 190 students, and 12 medical schools raised the enrollment of first-year students by a total of 150 slots, according to the AAMC. Some 18,000 students entered U.S. medical schools in the fall of 2009, the AAMC says.
But medical colleges and hospitals warn that these efforts will hit a big bottleneck: There is a shortage of medical resident positions. The residency is the minimum three-year period when medical-school graduates train in hospitals and clinics.
There are about 110,000 resident positions in the U.S., according to the AAMC. Teaching hospitals rely heavily on Medicare funding to pay for these slots. In 1997, Congress imposed a cap on funding for medical residencies, which hospitals say has increasingly hurt their ability to expand the number of positions.
Medicare pays $9.1 billion a year to teaching hospitals, which goes toward resident salaries and direct teaching costs, as well as the higher operating costs associated with teaching hospitals, which tend to see the sickest and most costly patients.
Doctors' groups and medical schools had hoped that the new health-care law, passed in March, would increase the number of funded residency slots, but such a provision didn't make it into the final bill.
"It will probably take 10 years to even make a dent into the number of doctors that we need out there," said Atul Grover, the AAMC's chief advocacy officer.
While doctors trained in other countries could theoretically help the primary-care shortage, they hit the same bottleneck with resident slots, because they must still complete a U.S. residency in order to get a license to practice medicine independently in the U.S. In the 2010 class of residents, some 13% of slots are filled by non-U.S. citizens who completed medical school outside the U.S.
One provision in the law attempts to address residencies. Since some residency slots go unfilled each year, the law will pool the funding for unused slots and redistribute it to other institutions, with the majority of these slots going to primary-care or general-surgery residencies. The slot redistribution, in effect, will create additional residencies, because previously unfilled positions will now be used, according to the Centers for Medicare and Medicaid Services.
From the ArchiveOpinion: How to Fix the Doctor Shortage (01/04/10)Health Blog: Would Adding Residency Slots Solve the Primary-Care Shortage? (11/27/09)Opinion: The Coming Shortage of Doctors (11/06/09)Health Blog: Obama: 'Severe Shortage' of Primary Care Doctors (08/11/09).
Some efforts by educators are focused on boosting the number of primary-care doctors. The University of Arkansas for Medical Sciences anticipates the state will need 350 more primary-care doctors in the next five years. So it raised its class size by 24 students last year, beyond the 150 previous annual admissions.
In addition, the university opened a satellite medical campus in Fayetteville to give six third-year students additional clinical-training opportunities, said Richard Wheeler, executive associate dean for academic affairs. The school asks students to commit to entering rural medicine, and the school has 73 people in the program.
Journal Communitydiscuss..“ As a specialist physician I will suggest that until primary care physicians can earn 70-80% of what most specialists make without killing themselves, there will be no incentive for the best and the brightest to go into primary care. ”
.—Michael Brennan.
"We've tried to make sure the attitude of students going into primary care has changed," said Dr. Wheeler. "To make sure primary care is a respected specialty to go into."
Montefiore Medical Center, the university hospital for Albert Einstein College of Medicine in New York, has 1,220 residency slots. Since the 1970s, Montefiore has encouraged residents to work a few days a week in community clinics in New York's Bronx borough, where about 64 Montefiore residents a year care for pregnant women, deliver children and provide vaccines. There has been a slight increase in the number of residents who ask to join the program, said Peter Selwyn, chairman of Montefiore's department of family and social medicine.
One is Justin Sanders, a 2007 graduate of the University of Vermont College of Medicine who is a second-year resident at Montefiore. In recent weeks, he has been caring for children he helped deliver. He said more doctors are needed in his area, but acknowledged that "primary-care residencies are not in the sexier end. A lot of these [specialty] fields are a lot sexier to students with high debt burdens."
Bryan thinks Civil War Looming...(my likely scenarios)
Millitias with WMD's planning assaults. Bricks and threats and assaults on Congressman! It is clear there are MANY more examples of movement toward a looming civil war.
Gov. Perry of Texas claims succession is a possibility he is considering. 17 other states follow Texas by declaring sovereignty! Over 30 states file lawsuits against federal gov't. regarding the healthcare bill. Many soldiers including officers refuse deployment based on Obama's citizenship (or lack of proof thereof). The extreme division Obama has brought...proof in the polls, tea party movement, etc. I'm telling you...and I've been saying it for quite some time...I'm pretty confident we are heading to a civil war. Not like the one in the history books. The millitary is too powerful for our militias and I highly doubt the fed. gov't. is dumb enough to attempt to go door to door (it's been tough cranking in Iraq and would be FAR tougher here). But I see no reason why self sufficient states such as Texas and Alaska couldn't succeed and refuse federal taxes and lead the way for 30-40 more red states. For the most part it could be done without too much bloodshed but it would leave our country split in two! Then the "blue" country would attempt to keep businesses there and tax the crap out of them to provide entitlements and handouts for all the moochers that would come a runnin to the state for free food, shelter, clothing, healthcare, education, cell phones, abortions, etc. And the "RED" country would go back to what our forefathers intended and you better believe all the businesses and doctors, etc. would relocate there! The "RED" country could drill for it's own oil off the coast of Texas and Alaska and LA., etc. It would THRIVE and DOMINATE and the "blue" country would fall to it's own liberal policies pretty quickly kind of like the USSR in the cold war. It probably wouldn't be long before they would be asking to join the "RED" country again!
Gov. Perry of Texas claims succession is a possibility he is considering. 17 other states follow Texas by declaring sovereignty! Over 30 states file lawsuits against federal gov't. regarding the healthcare bill. Many soldiers including officers refuse deployment based on Obama's citizenship (or lack of proof thereof). The extreme division Obama has brought...proof in the polls, tea party movement, etc. I'm telling you...and I've been saying it for quite some time...I'm pretty confident we are heading to a civil war. Not like the one in the history books. The millitary is too powerful for our militias and I highly doubt the fed. gov't. is dumb enough to attempt to go door to door (it's been tough cranking in Iraq and would be FAR tougher here). But I see no reason why self sufficient states such as Texas and Alaska couldn't succeed and refuse federal taxes and lead the way for 30-40 more red states. For the most part it could be done without too much bloodshed but it would leave our country split in two! Then the "blue" country would attempt to keep businesses there and tax the crap out of them to provide entitlements and handouts for all the moochers that would come a runnin to the state for free food, shelter, clothing, healthcare, education, cell phones, abortions, etc. And the "RED" country would go back to what our forefathers intended and you better believe all the businesses and doctors, etc. would relocate there! The "RED" country could drill for it's own oil off the coast of Texas and Alaska and LA., etc. It would THRIVE and DOMINATE and the "blue" country would fall to it's own liberal policies pretty quickly kind of like the USSR in the cold war. It probably wouldn't be long before they would be asking to join the "RED" country again!
A rant from Bryan on Obamacare:
Just wanted to throw in my 2 cents (I know again) for what it's worth on the recent passage of the healthcare bill. I know some of you tend to be more liberal and favor the democrats side so I want to be as sensitive as possible even though I'm REALLY ticked about what was allowed to happen through shady backroom deals, threats and intimidation.
First of all, I want to say that the problem of being denied coverage because of pre-existing conditions is something I can relate to since Type 1 diabetes runs in the family. Therefore, insurance for my family has always been a problem.
Everyone agrees that there needs to be some changes made to health insurance, but it is clear that the problems such as pre-existing conditions could have been addressed without infringing on all of our individual rights, putting the government in charge of yet another basic need (and we all know how crappy the quality of government run programs are) and raising our taxes and our children and grandchildren's taxes to pay for this almost $1 trillion dollar program! (Do you have any idea just how much a trillion dollars is?) (Can you think of even ONE government run program that isn't now in debt, and the quality isn't terrible?...post office, medicaid, medicare, social security, public education, etc.) According to FactCheck.org all of our insurance pemiums are to go up now anyway!!
Sure there are a few good things in the bill, but there are TONS more of terrible things in it. I want the good things just like you, such as not being denied because of pre-existing conditions and lowering premiums, etc. It's just that it was pretty obvious that all of that (and much more that needed to be fixed) could have been done without hurting our country the way this will!
This rediculous bill doesn't even address most of the most problamatic issues with our healthcare system, such as tort reform to deal with the frivolous lawsuits that run our medical costs up and in turn insurance premiums through the roof! So many problems and very few addressed and at what cost? Our freedoms!!! Over 30 states now have filed lawsuits so far because our Constitution protects us from being forced by the government to purchase something we don't want (such as crappy gov't. insurance). This is the first time in American history that we are now required to purchase something from the government or face criminal penalities. It was going to be up to 10 years in prison but was now dropped to fines and penalties.
There is a reason that in the latest cnn polls before the bill passed, only 25% of voters wanted it to pass. The rest of us all wanted to start over and do it right. Did you know that Obama himself admitted he didn't know what was in the bill and wouldn't until later after he signed it. His actuary admitted he didn't have time to read it yet either. There is a reason that obama, pelosi, reid and congress have dropped to the lowest levels in polls to date! 29% for Obama, 11% for congress, 11% for pelosi, 8% for reid! There is a reason that it took shady deals such as the cornhusker kickback, louisiana purchase, extra water allotments to senators in california, extra money for airports for Stupak (the pro-life democrat in charge of the group of 12 holding out), threats to charge ethics violations on dems that vote "no", refusal to campaign for any dem voting "no", etc. etc. etc. In short: They criminally used OUR taxpayer money to buy off votes to pass a bill we OPPOSED!!! How can anyone be ok with that?
And how can anyone in their right mind continue to support this President who has broken EVERY promise he has ever made! And the greed for power is unrivaled! Lets take a look at his Presidency so far:
He has now taken control of the healthcare industry (which alone is 1/6 of economy), housing industry, majority of banking industry, auto industry, student loan industry (yes he snuck that one into the healthcare bill...putting the gov;t. in charge of the student loan industry and putting over 30,000 bankers out of jobs). Next he will push Cap & Trade before Nov. elections which will raise our utility bills through the roof and give him partial control over all sectors of industry. From there...who knows, if he can before Nov. election he would probably shoot for the oil industry, and then food, grocery, etc. Prince Obama has now made himself the closest thing the US has ever had to a dictator! Only diff: we are now ruled by several (obama, reid, pelosi) instead of just one. But don't be fooled...they all answer to the Prince!
What else has he done since taking office? Oh yeah...broke his promise to bring home troops and end war...to date he has depolyed more troops than he has brought home! He broke his capaign promise where he said he was against spending freezes but then recently calling for a spending freeze (to look good) but then passing an almost $1 trillion dollar healthcare package anyway. He has called for increased funding for nuclear program. He has not dealt with Iran's nuke development but instead condemns Israel and refused to let them do what is in their best interest of national security! He condemns them for wanting to protect themselves from Iran who has vowed to remove Israel from the face of the earth. He has broken promises on transparency by refusing to put bills up for public viewing for 5 days before signing, refusing tv coverage over healthcare, stimulus, bailouts, etc. and refusing to post where our tax dollars (bailout $) has gone. He ignored promises of bi-partisanship and unity(we are now more divided than our country has EVER been), and called for secret meeting with democrats and without inviting republicans, ignored the will of the people that elected him by passing HUGE spending bills and raising taxes against the wishes of the people (stimulus, bailouts, healthcare). Only 25% of voters wanted healthcare bill passed! Instead of curbing spending he has voted to raise the debt limit several times so he could spend more. Reaching the new debt limit and voting to raise it even further several times now. He has already spent more than every President in US history combined (even adjusted for inflation). He has increased spending in EVERY category except for education where funding has been cut and many schools closed and teachers laid off (including here in OPS). We now spend more paying off our interest on our debt (mostly to China) than we spend on any other program period, including welfare, social security, the wars, etc.!!! He promised to cut pork barrel spending but the stimulus bill was lined with more pork than any other bill in US history! This healthcare bill had plenty too! He has made shady backroom deals and used threats and intimidation to pass unpopular bills against the wishes of the people who elected him! Not one promise kept so far!!!
Worst President in US history?! YOU DECIDE!!!
And back to health insurance...do you realize that currently those who truly can't affored health insurance are covered under Medicaid and Medicare and it is illegal to turn anyone (even illegal aliens) away from the ER. There is a tremendous number of free healthcare clinics all over. Almost ALL of the uninsured in the US is either eligible for Medicare but chooses not to enroll, or can afford health insurance but choose not to get it. It WAS there choice because we USED TO BE a free country! Not any longer. http://visionsfromthehorizon.blogspot.com/2008/04/who-are-uninsured-in-america.html This democratic party has become the most racist party I have ever seen. Making a ton of our minority population (among others) competely dependent on them for their basic needs (food, shelter, clothing, cell phones, healthcare, etc.) The people are now incapable, afraid to, or unmotivated to actually pull themselves up and reach their potential. The democrats extended unemployment benefits from 22 weeks to 99 weeks now. That is over TWO years you are allowed to sit there and get paid for not doing work from tax money stole from those that DO work. What happened to "Give a man a fish and he'll eat for a day, teach him how to fish and he'll eat forever"?!!!!
And what next anyway? We keep spending OUR tax money bailing out failing companies instead of forcing them to make changes and get better or go under and be replaced by better companies. What next? Oil prices too high so use our tax dollars to take over all the oil companies so you can control prices? Then electric and gas companies? Then grocery stores? Farms? You know?!!!! He already took over housing, banking, auto, school loans, healthcare, and already controlled retirement, education, some of healthcare, post office, etc. Where does it stop? You can't see how we are slowly becoming a socialist nation? And with more and more wealth being redistributed...a communist nation?! I looked at current tax rates which are now to go WAY up under Obama and I see that out of our paychecks we currently have to give 27% to the federal gov't. (27 cents out of every dollar we make) and we give a little over 6% to the state of Nebraska. That means that we give over 33 cents out of every dollar we make right up front. Then we get charged an additional almost 7% on every dollar we spend (sales tax) and even more than that on every dollar we save (property tax, retirement account tax, death tax, etc.) Then we have other taxes on EVERYTHING from phone bills, internet, gasolines, our food being heated or served, or any other service, etc., etc.
Accounts Receivable Tax, Building Permit Tax, Cable Television Tax, Capital Gains Tax, CDL license Tax, Cigarette Tax, Corporate Income Tax, Court Fines (indirect taxes), Dog License Tax, Federal Income Tax, Federal Unemployment Tax (FUTA), Fishing License Tax, Food License Tax, Fuel permit tax, Gasoline Tax (42 cents per gallon)(State MA 28 cents), Hunting License Tax, Inheritance Tax Interest expense (tax on the money), Inventory tax IRS Interest Charges (tax on top of tax), IRS Penalties (tax on top of tax), Liquor Tax, Local Income Tax, Luxury Taxes, Marriage License Tax, Medicare Tax, Property Tax, Real Estate Tax, Septic Permit Tax, Service Charge Taxes, Social Security Tax, Road Usage Taxes Truckers) (Added to delivery charge), Sales Taxes, Recreational Vehicle Tax, Road Toll Booth Taxes, School Tax, State Income Tax, State Unemployment Tax (SUTA), Telephone federal excise tax, Telephone federal universal service fee tax, Telephone federal, state and local surcharge taxes, Telephone minimum usage surcharge tax, Telephone recurring and non-recurring charges tax, Telephone state and local tax, Telephone usage charge tax, Toll Bridge Taxes, Toll Tunnel Taxes, Traffic Fines (indirect taxation), Trailer registration tax, Utility Taxes, Vehicle License Registration Tax, Vehicle Sales Tax (Every time sold & re-sold), Watercraft registration Tax, Well Permit Tax, Workers Compensation Tax
COMMENTS:
Not one of these taxes existed 100 years ago and our nation was the most prosperous in the world, had absolutely no national debt, had the largest middle class in the world and Mom stayed home to raise the kids. What the hell happened???
***It seems to me that after considering ALL this we are lucky to keep even 25 or 30 cents out of every dollar we make! The government takes the other 70 to 75 cents out of each dollar made yet that still isn't enough! (and if you are hard working enough to make more than we do, you pay MUCH more than 27% in federal income tax!) And it is ALL being raised under Obama's watch!
Can you honestly tell me that just because he is a democrat or whatever else it is about him that appeals to you (that he gives nice speeches about unity or bi-partisanship or hope or change) or whatever....can you honestly tell me that you are okay with what he is doing? According to articles I have read, this Cap & trade he is going to pass next will raise your electic and utility bills by AT LEAST 300%!!! How much more are you willing to take from this clown?! It's not a Republican vs. Democrat thing! You know as well as I do, that the Democrats are COOKED in the next couple of elections. This country is all but certain to have a Republican President with likely a supermajority in the house and senate.
Interest on your school loans is being raised to help fund this healthcare by the way. And the quality of healthcare is already beginning it's decline as it did in Canada and UK. Their is a reason one of Canada's Premier's came to Florida for his heart sugery and claimed, "just because I went into politics doesn't mean I gave up my right to choose the best healthcare available for myself and my family." The quality dip is beginning. Wal-greens has stated it will not accept any new medicaid, and the MAYO clinic which Obama called, "a national model for efficient health care" began dropping medicare patients and won't accept any new ones. You will see more and more of the same just as in Canada and UK. There will be a shortage of doctors and clinics and hospitals and pharmacies as like in Canada you will have a 3 year wait for hip sugery or you will have to pay to fly somewhere else with better healthcare! Heck...Hawaii attempted Gov't. Healthcare just for children and it went bankrupt within 7 months. What makes us think it will succeed on a national level?! We can only hope it DOESN'T succeed! It's time to drop the apathy on this one before it's too late. Maybe even help "Atlas to shrug" by ushering up a movement to get as many folks as possible to visit their doctors as often as possible for nothing to bankrupt this program as quickly as possible before it causes any permanant damage! Then we can go back and start some REAL reform on healthcare without putting one more of our basic needs into the hands of the government!
Bryan
First of all, I want to say that the problem of being denied coverage because of pre-existing conditions is something I can relate to since Type 1 diabetes runs in the family. Therefore, insurance for my family has always been a problem.
Everyone agrees that there needs to be some changes made to health insurance, but it is clear that the problems such as pre-existing conditions could have been addressed without infringing on all of our individual rights, putting the government in charge of yet another basic need (and we all know how crappy the quality of government run programs are) and raising our taxes and our children and grandchildren's taxes to pay for this almost $1 trillion dollar program! (Do you have any idea just how much a trillion dollars is?) (Can you think of even ONE government run program that isn't now in debt, and the quality isn't terrible?...post office, medicaid, medicare, social security, public education, etc.) According to FactCheck.org all of our insurance pemiums are to go up now anyway!!
Sure there are a few good things in the bill, but there are TONS more of terrible things in it. I want the good things just like you, such as not being denied because of pre-existing conditions and lowering premiums, etc. It's just that it was pretty obvious that all of that (and much more that needed to be fixed) could have been done without hurting our country the way this will!
This rediculous bill doesn't even address most of the most problamatic issues with our healthcare system, such as tort reform to deal with the frivolous lawsuits that run our medical costs up and in turn insurance premiums through the roof! So many problems and very few addressed and at what cost? Our freedoms!!! Over 30 states now have filed lawsuits so far because our Constitution protects us from being forced by the government to purchase something we don't want (such as crappy gov't. insurance). This is the first time in American history that we are now required to purchase something from the government or face criminal penalities. It was going to be up to 10 years in prison but was now dropped to fines and penalties.
There is a reason that in the latest cnn polls before the bill passed, only 25% of voters wanted it to pass. The rest of us all wanted to start over and do it right. Did you know that Obama himself admitted he didn't know what was in the bill and wouldn't until later after he signed it. His actuary admitted he didn't have time to read it yet either. There is a reason that obama, pelosi, reid and congress have dropped to the lowest levels in polls to date! 29% for Obama, 11% for congress, 11% for pelosi, 8% for reid! There is a reason that it took shady deals such as the cornhusker kickback, louisiana purchase, extra water allotments to senators in california, extra money for airports for Stupak (the pro-life democrat in charge of the group of 12 holding out), threats to charge ethics violations on dems that vote "no", refusal to campaign for any dem voting "no", etc. etc. etc. In short: They criminally used OUR taxpayer money to buy off votes to pass a bill we OPPOSED!!! How can anyone be ok with that?
And how can anyone in their right mind continue to support this President who has broken EVERY promise he has ever made! And the greed for power is unrivaled! Lets take a look at his Presidency so far:
He has now taken control of the healthcare industry (which alone is 1/6 of economy), housing industry, majority of banking industry, auto industry, student loan industry (yes he snuck that one into the healthcare bill...putting the gov;t. in charge of the student loan industry and putting over 30,000 bankers out of jobs). Next he will push Cap & Trade before Nov. elections which will raise our utility bills through the roof and give him partial control over all sectors of industry. From there...who knows, if he can before Nov. election he would probably shoot for the oil industry, and then food, grocery, etc. Prince Obama has now made himself the closest thing the US has ever had to a dictator! Only diff: we are now ruled by several (obama, reid, pelosi) instead of just one. But don't be fooled...they all answer to the Prince!
What else has he done since taking office? Oh yeah...broke his promise to bring home troops and end war...to date he has depolyed more troops than he has brought home! He broke his capaign promise where he said he was against spending freezes but then recently calling for a spending freeze (to look good) but then passing an almost $1 trillion dollar healthcare package anyway. He has called for increased funding for nuclear program. He has not dealt with Iran's nuke development but instead condemns Israel and refused to let them do what is in their best interest of national security! He condemns them for wanting to protect themselves from Iran who has vowed to remove Israel from the face of the earth. He has broken promises on transparency by refusing to put bills up for public viewing for 5 days before signing, refusing tv coverage over healthcare, stimulus, bailouts, etc. and refusing to post where our tax dollars (bailout $) has gone. He ignored promises of bi-partisanship and unity(we are now more divided than our country has EVER been), and called for secret meeting with democrats and without inviting republicans, ignored the will of the people that elected him by passing HUGE spending bills and raising taxes against the wishes of the people (stimulus, bailouts, healthcare). Only 25% of voters wanted healthcare bill passed! Instead of curbing spending he has voted to raise the debt limit several times so he could spend more. Reaching the new debt limit and voting to raise it even further several times now. He has already spent more than every President in US history combined (even adjusted for inflation). He has increased spending in EVERY category except for education where funding has been cut and many schools closed and teachers laid off (including here in OPS). We now spend more paying off our interest on our debt (mostly to China) than we spend on any other program period, including welfare, social security, the wars, etc.!!! He promised to cut pork barrel spending but the stimulus bill was lined with more pork than any other bill in US history! This healthcare bill had plenty too! He has made shady backroom deals and used threats and intimidation to pass unpopular bills against the wishes of the people who elected him! Not one promise kept so far!!!
Worst President in US history?! YOU DECIDE!!!
And back to health insurance...do you realize that currently those who truly can't affored health insurance are covered under Medicaid and Medicare and it is illegal to turn anyone (even illegal aliens) away from the ER. There is a tremendous number of free healthcare clinics all over. Almost ALL of the uninsured in the US is either eligible for Medicare but chooses not to enroll, or can afford health insurance but choose not to get it. It WAS there choice because we USED TO BE a free country! Not any longer. http://visionsfromthehorizon.blogspot.com/2008/04/who-are-uninsured-in-america.html This democratic party has become the most racist party I have ever seen. Making a ton of our minority population (among others) competely dependent on them for their basic needs (food, shelter, clothing, cell phones, healthcare, etc.) The people are now incapable, afraid to, or unmotivated to actually pull themselves up and reach their potential. The democrats extended unemployment benefits from 22 weeks to 99 weeks now. That is over TWO years you are allowed to sit there and get paid for not doing work from tax money stole from those that DO work. What happened to "Give a man a fish and he'll eat for a day, teach him how to fish and he'll eat forever"?!!!!
And what next anyway? We keep spending OUR tax money bailing out failing companies instead of forcing them to make changes and get better or go under and be replaced by better companies. What next? Oil prices too high so use our tax dollars to take over all the oil companies so you can control prices? Then electric and gas companies? Then grocery stores? Farms? You know?!!!! He already took over housing, banking, auto, school loans, healthcare, and already controlled retirement, education, some of healthcare, post office, etc. Where does it stop? You can't see how we are slowly becoming a socialist nation? And with more and more wealth being redistributed...a communist nation?! I looked at current tax rates which are now to go WAY up under Obama and I see that out of our paychecks we currently have to give 27% to the federal gov't. (27 cents out of every dollar we make) and we give a little over 6% to the state of Nebraska. That means that we give over 33 cents out of every dollar we make right up front. Then we get charged an additional almost 7% on every dollar we spend (sales tax) and even more than that on every dollar we save (property tax, retirement account tax, death tax, etc.) Then we have other taxes on EVERYTHING from phone bills, internet, gasolines, our food being heated or served, or any other service, etc., etc.
Accounts Receivable Tax, Building Permit Tax, Cable Television Tax, Capital Gains Tax, CDL license Tax, Cigarette Tax, Corporate Income Tax, Court Fines (indirect taxes), Dog License Tax, Federal Income Tax, Federal Unemployment Tax (FUTA), Fishing License Tax, Food License Tax, Fuel permit tax, Gasoline Tax (42 cents per gallon)(State MA 28 cents), Hunting License Tax, Inheritance Tax Interest expense (tax on the money), Inventory tax IRS Interest Charges (tax on top of tax), IRS Penalties (tax on top of tax), Liquor Tax, Local Income Tax, Luxury Taxes, Marriage License Tax, Medicare Tax, Property Tax, Real Estate Tax, Septic Permit Tax, Service Charge Taxes, Social Security Tax, Road Usage Taxes Truckers) (Added to delivery charge), Sales Taxes, Recreational Vehicle Tax, Road Toll Booth Taxes, School Tax, State Income Tax, State Unemployment Tax (SUTA), Telephone federal excise tax, Telephone federal universal service fee tax, Telephone federal, state and local surcharge taxes, Telephone minimum usage surcharge tax, Telephone recurring and non-recurring charges tax, Telephone state and local tax, Telephone usage charge tax, Toll Bridge Taxes, Toll Tunnel Taxes, Traffic Fines (indirect taxation), Trailer registration tax, Utility Taxes, Vehicle License Registration Tax, Vehicle Sales Tax (Every time sold & re-sold), Watercraft registration Tax, Well Permit Tax, Workers Compensation Tax
COMMENTS:
Not one of these taxes existed 100 years ago and our nation was the most prosperous in the world, had absolutely no national debt, had the largest middle class in the world and Mom stayed home to raise the kids. What the hell happened???
***It seems to me that after considering ALL this we are lucky to keep even 25 or 30 cents out of every dollar we make! The government takes the other 70 to 75 cents out of each dollar made yet that still isn't enough! (and if you are hard working enough to make more than we do, you pay MUCH more than 27% in federal income tax!) And it is ALL being raised under Obama's watch!
Can you honestly tell me that just because he is a democrat or whatever else it is about him that appeals to you (that he gives nice speeches about unity or bi-partisanship or hope or change) or whatever....can you honestly tell me that you are okay with what he is doing? According to articles I have read, this Cap & trade he is going to pass next will raise your electic and utility bills by AT LEAST 300%!!! How much more are you willing to take from this clown?! It's not a Republican vs. Democrat thing! You know as well as I do, that the Democrats are COOKED in the next couple of elections. This country is all but certain to have a Republican President with likely a supermajority in the house and senate.
Interest on your school loans is being raised to help fund this healthcare by the way. And the quality of healthcare is already beginning it's decline as it did in Canada and UK. Their is a reason one of Canada's Premier's came to Florida for his heart sugery and claimed, "just because I went into politics doesn't mean I gave up my right to choose the best healthcare available for myself and my family." The quality dip is beginning. Wal-greens has stated it will not accept any new medicaid, and the MAYO clinic which Obama called, "a national model for efficient health care" began dropping medicare patients and won't accept any new ones. You will see more and more of the same just as in Canada and UK. There will be a shortage of doctors and clinics and hospitals and pharmacies as like in Canada you will have a 3 year wait for hip sugery or you will have to pay to fly somewhere else with better healthcare! Heck...Hawaii attempted Gov't. Healthcare just for children and it went bankrupt within 7 months. What makes us think it will succeed on a national level?! We can only hope it DOESN'T succeed! It's time to drop the apathy on this one before it's too late. Maybe even help "Atlas to shrug" by ushering up a movement to get as many folks as possible to visit their doctors as often as possible for nothing to bankrupt this program as quickly as possible before it causes any permanant damage! Then we can go back and start some REAL reform on healthcare without putting one more of our basic needs into the hands of the government!
Bryan
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