Free healthcare.

[Jims5543]

Originally posted by vash
can somebody break it down for me? why cant we give EVERYONE equal coverage? i mean everyone!!!. rich folks, poor folks and all of us shmucks in between. goverment funded healthcare. am i missing something? in cuba, nobody owns a car newer than the effen 80's, but everyone gets healthcare. make a blanket system that covers everyone, but if you have the extra money, you can "buy" a better service. why not?

You are wrong on that. My very good friend is Cuban, he came to the US in the Boat Lift and his older brother did not want to go, he felt Castro was good for Cuba.

My friend was able to visit his brother for the 1st time in 20 years a few months back. He was able to financially I should say.

When he got back he was devestated by what he saw. There is a definate cast system in Cuba, everyone does not get great health care, the poor get crappy health care in dirty dank facilities.


To further Moses' observation, when my 3 y/o was very sick (there is a thread on here somehwere) his Primary care Pediatrition told us to go to the Emergancy room once evening after hours.

When we got there the place looked like a Mexican city, people piled up in the hallways, rooms full, it was nuts.

I turned and walked out. The nurse got pissy with me too, I told her I woudl rather keep him home comfortable and wait for the doctors office to open in the morning rather than wait in there for 5+ hours.

Emergency rooms are now used for general care rather than emergencies.

[berettafan]

Originally posted by Moses

I eat the expense because I am not allowed to deduct charitable services on my income taxes.

***you never got paid for this service and therefore never reported income for it which means you did not pay tax on it. NOBODY is allowed to take a deduction for time donated, not just you. if you incurred an actual expense you most certainly CAN and DO deduct it on your tax return.***

Nor am I allowed to claim financial loss for my time out of the office and the lost income due to cancelled appointments.

***Again, no income received, reported or subject to tax so no deduction***


Nor am I allowed to deduct my loss as "bad debt" when the patient doesn't pay me.

***you either never booked a receivable and therefore did not report the income OR you did book a receivable and pay tax on the income in which case you are absolutely allowed to reduce your receivables by that amount and thereby take a deduction***

your complaint that you should not have to work for free is legitimate BUT the claim that you are forced to recognize and pay tax on income never received is not.

and for the record i agree that you should not have to spend time treating illegals when there are tax paying citizens waiting in line behind them. it is one of my biggest issues with illegals.

[KFC911]

Moses, you're a good man doing good work and are in a position to see things that many of us can't even begin to relate too. In your opinion, what is a "workable" solution to the healthcare scenario that you have described...is it "Medicaid", or ???

[berettafan]

Originally posted by Jim Cesiro


To further Moses' observation, when my 3 y/o was very sick (there is a thread on here somehwere) his Primary care Pediatrition told us to go to the Emergancy room once evening after hours.

When we got there the place looked like a Mexican city, people piled up in the hallways, rooms full, it was nuts.

I turned and walked out. The nurse got pissy with me too, I told her I woudl rather keep him home comfortable and wait for the doctors office to open in the morning rather than wait in there for 5+ hours.

Emergency rooms are now used for general care rather than emergencies.

x100,000,000,000,000

we are bringing this bull**** on ourselves by letting this nonsense go on!

[berettafan]

Originally posted by Moses
In todays case, this premature baby could cost hundreds of thousands of dollars to care for. This was probably preventable with good prenatal care.

We can't even get our own citizens to look after themselves properly and it costs us all big time (smoking, bad eating habits, unprotected sex). The above point by Moses is a really, really big deal IMO.

[Noah930]

True, barettafan. Moses doesn't get paid by the patient, so he can't deduct the cost of services rendered like another business cost (i.e. rent). But at the same time, the inequalities are: 1) he's not getting paid for his efforts, 2) he can't say "no"--either when the patient shows up in the ER/hospital, or even when signing up for privileges at the local hospital, 3) the costs he has involved in the patient's care (like the rent he has to pay when the patient shows up in his office for post-procedure care) can't be deducted, 3.5) his malpractice insurance carrier (and malpractice ain't cheap for what he's doing--possibly in the low 6-figures annually, even with a clean record) isn't distinguishing this patient as a freebie, 4) his care for this patient precludes his ability to take care of other, paying patients, thereby actually indirectly reducing his income.

Not to mention the uncompensated stress of taking care of a medical situation like this, the social inconvenience, sleepless nights, etc.

And he still has to fret that if this person--who's probably not responsible enough to take proper medical care of herself and her baby during the pregnancy--has some sort of less than perfect baby (what if she's a smoker/druggie/drinker/malnourished/etc), his "thanks" may be in the form of a lawsuit.

[Noah930]

Oh yeah, his Governator also wants to toss on an extra 2% income tax for all physicians in California to help pay for said indigent population's health care.

[berettafan]

noah your statement about deducting the 'cost of services' is incorrect and item #3 is incorrect. if Moses writes a check for a bsns expense it gets deducted. the only thing not getting deducted is his dontated time and, as mentioned, none of us can do that. if you or i or Moses go to our local church and hand out soup to the needy we get no deduction for you time. however if Moses has to pay tolls on his way to the hospital for emergency treatment of an illegal who shot himself with a nailgun while doing a ***** job building a crappy house in a major subdivision (can you tell i'm bitter about this subject?) he most certainly CAN deduct that cost.

the rest of your post is common sense and as i stated i feel it is a complete misuse of talent forcing docs to treat illegals and it is theft to not pay them for such treatment.

i believe stories like Moses' should be front page news and something needs to be done YESTERDAY about it.

[Chocaholic]

Originally posted by berettafan
i believe stories like Moses' should be front page news and something needs to be done YESTERDAY about it.

I haven't seen the movie, but I'll be this little tidbit was overlooked in "Sicko".

[sjf911]

I too have spent many sleepless nights and suffered the loss of paying patient time at the expense of the indigent. It is the hidden dark side of the "business" of medicine. In the past, income from paying patients made this much more tolerable and also, the demand was less. Now, however, the number of indigent patients is climbing (legal or illegal) and reimbursement by "paying patients" (really third party insurers) has declined to the point that we are at a crisis. Many physicians are now exploring alternatives which typically mean specialty hospital association or no hospital affiliation at all. Many of us by virtue of specialty will always be tied to conventional hospitals and the associated demand for indigent services. Do not forget that the hospital is typically un-payed for this as well and this is where the dollars get very large.
Like all other social ills, this one does not have a simple solution. There are also competing interests especially with the illegals and the cheap labor demand that they fill. You cannot solve this without taking on much of what is ill with society, government, and "Big Business". We are all collectively responsible.

[Noah930]

Originally posted by berettafan
noah your statement about deducting the 'cost of services' is incorrect and item #3 is incorrect. if Moses writes a check for a bsns expense it gets deducted. the only thing not getting deducted is his dontated time and, as mentioned, none of us can do that. if you or i or Moses go to our local church and hand out soup to the needy we get no deduction for you time. however if Moses has to pay tolls on his way to the hospital for emergency treatment of an illegal who shot himself with a nailgun while doing a ***** job building a crappy house in a major subdivision (can you tell i'm bitter about this subject?) he most certainly CAN deduct that cost.

the rest of your post is common sense and as i stated i feel it is a complete misuse of talent forcing docs to treat illegals and it is theft to not pay them for such treatment.

i believe stories like Moses' should be front page news and something needs to be done YESTERDAY about it.

Sorry, barettafan. You're right. The costs can be deducted. But there's no income coming in to cover them. Moses is asked to step aside and dismiss his fee. But the creditors whom Moses owe aren't similarly asked to do so.

[911teo]

Originally posted by Wayne at Pelican Parts
Please show me some financial numbers to corroborate this statement.

-Wayne

This system as it is cannot provide free health care because it would collapse....

It needs to be reformed.

We do not need a GP that sees you for 15 mins (because he needs to meet a quota number before he gets reimboursed) and sends you to a specialist (who is more expensive but you don't care because you have insurance) that orders a non necessary procedure (just to be sure because if he/she misses something they'll get their ass sued).

Nobody really cares because the GP gets his reimbourse, the patient sees the specialist and gets the best ever possible care, the specialist gets paid by the insurance and the insurance company raises the rates to cover for more costs.

So no as it is the health care system in the US is impossible to have free, but as someone mentioned above you could have a basic system avaliable to everybody (the state in this case is the big insurer that takes on the risk) and then a "plus" system for people that want to pay for it.

But then there are always problems.. for example do u pay all the doctors the same? Do you pay a hearth surgeon the same as a pediatric? What if someone is better than the other? With a system that is controlled by the state you eliminate the market forces that determine the various compesations.

So all of a sudden one important factor of the drive towards excellence is taken out of the equation....

Yes you could allow doctors to open "private" clinics where the citizens that can pay could go... But then why allow some doctors to go whilst others get stuck in the public system....

It's not so easy.

[berettafan]

Originally posted by Wayne at Pelican Parts
However, they are active participants in our economy, and this cheap (cheaper) labor helps to reduce the costs bourne by everyday Americans.

Theoretically, the cost savings in hiring these people get passed on to the buying customers (although in a hot housing market with little competition, they probably end up in the builders' profit statements).

not to get off the medical topic here but i feel these two statements are at odds. thoughts, arguments?

[berettafan]

and btw, for those that have zero exposure to the medical biz-You wouldn't believe the mountain of b.s. paperwork and codes and billing nonsense that docs have to negotiate thanks to insurance company rules. it really is excessive.

[sjf911]

Actually, there are a couple of things that probably would have a significant effect on long term health-care demand that could be achieved today.
1. Ban all tobacco advertising and quadruple the tax on products.
2. Ban all alcohol advertising and quadruple the tax on products.
3. Categorically define "junk food" and ban all advertising and add punitive taxes.
4. Ban the solicitous use of alcohol and tobacco products in the productions of our entertainment industry.
5. Define a national program to reduce motor-vehicle use and enhance walking and bicycle commuting.
6. Close every last "all you can eat" buffet.
7. Eliminate NaCl from food production.
8. Eliminate all dairies and dairy products.
9. Eliminate all feed-lots and resultant feed-lot fat animals.
10. Remove all "junk food" and associated advertising from schools.
11. Require licensing and testing before parenthood is allowed.

[Tobra]

Originally posted by Porsche-O-Phile
Yep. "Anchor baby". An incentive for illegals to get pregnant as quickly as possible once here, because once they have their hellspawn, they can't be kicked out.

They come here pregnant to deliver child here, on the advice of the Mexican government

Berettafan, you are a bit confused. Moses' time has value. He gives this time to an indigent patient for nothing. He incurs risk and expense at the same rate treating this person as he does treating anyone else. While donating this time, he could be doing something else, fishing, driving his car or what he usually does during business hours, see patients who do pay him for his time.

In the extreme case, he spends 100% of his time seeing indigent folks. The non-deductible cost in this case would be 100% of his income, his expenses do not change.

Is this helpful? I ask because it is quite clear in reading your comments that you don't understand this well at all.

No, those two statements by Wayne are not contradictory. Savings are realized by reduced labor costs, these savings are passed on to final consumer at between 0% and 100%

[911teo]

Originally posted by berettafan
not to get off the medical topic here but i feel these two statements are at odds. thoughts, arguments?

As a system the American economy benefits from cheaper labor. Wether it is the contractor, the consumer, the big fat Wall St company that makes the $$$ it does not matter.

And as long as the $$$ made on the back of cheaper labor is reinvested in the American economy then all is good.

The problem arises when the profit is reinvested outside America (read investments in China). Then the net net is more difficult to calculate.

Someone will say that even if you put money into China you'll have the benefit from cheaper prices for the goods. But the benefit has now been diluted as a chinese worker has to be paid and a company (American) has to make a profit.

So in a closed economy the cheaper commodity (labor in this case) is good. But in an economy that is allowed to invest outside then it is not a zero sum game.

[911teo]

Originally posted by sjf911
Actually, there are a couple of things that probably would have a significant effect on long term health-care demand that could be achieved today.
1. Ban all tobacco advertising and quadruple the tax on products.
2. Ban all alcohol advertising and quadruple the tax on products.
3. Categorically define "junk food" and ban all advertising and add punitive taxes.
4. Ban the solicitous use of alcohol and tobacco products in the productions of our entertainment industry.
5. Define a national program to reduce motor-vehicle use and enhance walking and bicycle commuting.
6. Close every last "all you can eat" buffet.
7. Eliminate NaCl from food production.
8. Eliminate all dairies and dairy products.
9. Eliminate all feed-lots and resultant feed-lot fat animals.
10. Remove all "junk food" and associated advertising from schools.
11. Require licensing and testing before parenthood is allowed.

Well then we'd fall in a communist or fascist state...
Not really they ideal solution uh?

[berettafan]

Originally posted by Tobra
Berettafan, you are a bit confused. Moses' time has value. He gives this time to an indigent patient for nothing. He incurs risk and expense at the same rate treating this person as he does treating anyone else. While donating this time, he could be doing something else, fishing, driving his car or what he usually does during business hours, see patients who do pay him for his time.

In the extreme case, he spends 100% of his time seeing indigent folks. The non-deductible cost in this case would be 100% of his income, his expenses do not change.

Is this helpful? I ask because it is quite clear in reading your comments that you don't understand this well at all.

when he works for free he has no income; there is no 'deduction' for missing income. you don't pay tax on income you don't have. furthermore if you incur expenses in your business for a job in which you end up getting stiffed on you can still deduct those expenses.

I understand it very well thank you. i only posted to correct small details in a portion of Moses' post from an accounting/tax standpoint.

Moses is being forced to donate his time. that is the $$ discussion in a nutshell. he is not losing ANY tax deductions by doing so nor is he paying tax on income he never received.

[berettafan]

Originally posted by 911teo
Well then we'd fall in a communist or fascist state...
Not really they ideal solution uh?

i dunno, when that list is referring to a mother/father and their kids it's called good parenting.