On That GOP Health Care Bill, and Tax Breaks

First, my initial thoughts, as rendered on Twitter.

Now, let me talk a little bit more about the part where I say “rich people don’t miss their taxes,” since I think there are people who may be reasonably skeptical about this. Warning: I’m going to talk about my money. Then I’m going to talk about other people’s money.

To begin: I pay taxes on a quarterly basis, because I’m self-employed and the IRS, alas not entirely unreasonably, questions whether self-employed people will keep track of their money for a full year in order to pay off one big tax bill. So every quarter, I pay taxes. And in each of those quarterly tax payments, I pay in taxes roughly what I grossed (and definitely more than I netted) in income from the entire four-and-half years of my first job out of college, working for a newspaper. Add up my yearly tax bill, and it’s close to what I grossed my first ten years of being a professional writer — and there was never a time in there I didn’t do okay; it was a solid continuous progression up the middle-class income ladder.

So these days, whenever I see how much I pay in taxes annually, my first thought is always something like HOLY CRAP that’s a lot of money. I could totally use that! As someone who grew up poor and has worked his way steadily up the income ladder, it’s a freakin’ huge amount in terms of the raw dollars.

And then I pay my taxes and I discover that anything I would have used that ridiculous wad of tax money for, I still have enough in my net income for. I literally cannot think of a thing I want — or need — that my post-tax income can’t handle. Because as it happens, even with federal, state and local taxes, my tax burden is reasonable. I don’t pay taxes in 1980, when the highest marginal federal income tax rate was 70%; I pay taxes in 2017, where top federal tax bracket maxes out at just under 40%. With state and local taxes, I have to break a sweat to have a total top marginal tax rate of 50% — and my real world taxes indebtedness doesn’t come anywhere near half my income, because of how marginal tax rates work and because like lots of people in my position I have a very smart accountant who finds me lots of deductions.

So even with literally the full (pre-deduction) tax burden someone in Ohio can pay — we max out all the marginal rates — there is more than enough left over for pretty much anything that we want to do, individually, as a couple or as a family. We save a lot, invest a bunch, and thus take that money out of the short-term income pool we use for bills, household spending and, uh, “consumer activity,” and we’re still just fine, thanks. I suppose it’s possible that we could spend so much of our post-tax income that we’re left with little or nothing and thus would wish we had some of the money that we paid in taxes back into our hands, but speaking from experience, this takes effort, and some willful stupidity about your money. Yes, I’m looking at you, Nick Cage and Johnny Depp. But if you’re not the sort of person who spends $30,000 a month on wine, you’re probably going to be fine.

We do just fine. The other people I know who have similar or better incomes than we have also do just fine. The ones I know with substantially better incomes than we have are also doing just fine. No one at my income level or better actively misses the money they spend on taxes, because they’re still rich after they pay taxes.

Would I like to pay less in taxes? When I look at the raw number of dollars I send to the IRS, sure. When I think about the actual impact on my day-to-day life having that money would make, versus the actual and positive impact on the day-to-day life of millions of other people, when people like me pay our taxes? Nope. I have certain (in more than one sense of that word) opinions about how those taxes I pay in should be used, and whether they are being used effectively, and whether I’m getting value for what I pay, to be sure. Those are different issues, however.

Cratering health care for millions in the United States (and crippling Medicaid in the bargain) in order to give people like me a tax cut means that we are taking something from people who need it, often desperately, to give something to people who don’t need it and may not even notice it in any substantial way. In the House version of this legislation, you have to make more than $200k to get any tax benefit from it; people with incomes between $200k and $500k a year would get a tax break of $510 on average. $510 is not a lot to get in return for asking millions of other Americans to be potentially priced out of health coverage, have lifetime insurance caps reinstituted, be denied for pre-existing conditions, get sicker and die earlier. And the roughly 95% of Americans who don’t make $200,000 a year won’t even get that.

Rich people don’t need any more tax cuts. They’re doing just fine. They will continue to do just fine. And no, their tax burden isn’t onerous. Trust me, I know. I live that tax burden daily. It doesn’t hurt. What does hurt is knowing that people I know and care for will likely die sooner and sicker than they should just so someone like me gets back a few more dollars they won’t notice. Don’t come at me with “but the rich earned those dollars.” Dude, I earned my dollars, too. I earned them in a country that helped me get where I am in part through taxes. I earned them understanding that getting rich came with an obligation to the society I live in and benefit from, an obligation discharged, in part, by paying a perfectly reasonable amount of taxes.

The motto of the United States is not, in fact, “Fuck you, I got mine.” It was, and should have remained, “E Pluribus Unum” — out of many, one. We’re all Americans. We all deserve the blessings this country can provide. This one is willing to pay his taxes for the benefit of the many.

115 Comments on “On That GOP Health Care Bill, and Tax Breaks”

  1. 1. This will be a contentious subject, I’m sure. Play nice with each other. Frothy people will be shown the door quickly, as I am on a book deadline and have neither the time nor patience for insults and nonsense. Yes, I am looking at some of you in particular.

    2. People who post “Well, you can always voluntarily pay more taxes, hurr hurr hurr” will find the Mallet applied to them. That’s the argument of unserious people and I won’t bother taking it seriously.

    3. Also, folks who wish to imply the ACA is hurtling toward financial disaster without noting all the ways the GOP on the state and federal levels has gone out of its way to make it untenable may also find themselves not being taken seriously. Assume that people here are not fresh off the turnip truck.

    4. Also also, this is not the place for you to pull out your cue cards on the desirability of the Flat Tax or any other silly taxation scheme that you think would be fabulous. For the purposes of this discussion thread, we’re living in the now.

    5. Also also also, and (for now) finally, if you wish to argue the plight of the noble, misunderstood wealthy in this country, please be aware that you’re currently on the site of one of those dear creatures, and that a) I can speak for myself just fine, thank you, b) that I may correct you based on my experience as one of those said dear creatures, if I believe you’re making a wild generalization about my kind, c) so please be aware, as should be obvious from the article at hand, that I can be skeptical we need to be treated at all tenderly.

  2. Well said. Except for “latter” where you meant “ladder”. But that’s a typo. Well said.

  3. I notice you still hire an accountant to minimize the amount of taxes you do pay. Do you think it is immoral/unethical when large companies try to find legal ways to pay as little as possible in tax?

  4. Wait, I thought the rich people were going to take that $510 and turn around and create jobs with it, thereby enabling those millions of low-income folks to get their own health coverage on the open market. Am I missing something?

  5. Well said! Many well off people have said they don’t need this ridiculous tax break-so why does congress want to pass it?

  6. I thought the motto was changed to “In God We Trust” a while back? And since then, it seems to have evolved into “In God We Trust to take care of the little people, because we sure as hell aren’t going to do it.”

    “E pluribus unum” was certainly a better motto…

  7. While filling out our tax form the past couple of years I saw this extra tax at the end of tax program interview and was slightly annoyed. I then realized what it actually was and knew that getting this bit less back from the money we had withheld that year had virtually no impact on my life at this time. So, I completely agree – I don’t need the tax break – there are a lot of people who need the benefit it provides them.

  8. Ah, but John, just think of all the *jobs* you could create with that extra money! The factories you might build, the, um, lawn maintenance business you could start, employing the poor masses with decent honest jobs (say, mowing political slogans onto hillsides), enabling then to live lives of dignity and self sufficiency, out from under the thumb of big government,

    I mean, really, isn’t it better to die of an untreated per-existing condition with DIGNITY, than to live with the shame of a government that FORCES them to get access to health care with OTHER PEOPLE’S MONEY??? For shame, sir, for shame. Next you’ll argue that the people living down river from my factory runoff are VICTIMS of my toxic waste, rather than selfish loafers who can’t be bothered to live somewhere up stream…

  9. James:

    Good catch. I have adjusted the text.


    I think it’s possible that certain laws could allow corporations or individuals to take tax breaks or deductions I would personally find immoral or unethical. In those cases I there’s not much I could do to stop them from taking the tax break unless taking advantage of that tax break somehow went against the corporation’s bylaws, and I was in a position to make noise about it, but I might work to change the law.

    My own instructions to my accountant, in terms of tax breaks and loopholes, were “If it’s solidly legal and established, great. If it’s questionable or stretching the definition of law, let’s not.” This has done reasonably well for me over the years.

  10. I may be the minority here, but I am GLAD to pay my taxes — other peoples’ taxes helped me acquire an education that allowed me to move up the class ladder, too. (Wasn’t as poor as you back in the day, am not as wealthy as you in the now — I think! But another rung or two up, which allows me to travel, which I love). I certainly wish less of my taxes went to corporate subsidies and more went to education, health (especially mental health, which is needed), infrastructure, culture and the arts…but I have to keep voting in people with my priorities to get that. In general, though, I have a paid-for house and a paid-for car and I can put my own kids through college, so, yeah, I have all I need. A $30,000 golden toilet seat is definitely not something I would waste my hard-earned money on.

  11. I remember when “Fuck you, I got mine.” became this country’s motto during the Reagan years. Some things never change, despite the efforts of some very good people. *Sigh*

    I find it fascinating (in a sick way) how many conservative people complain about (non-conservative) politicians taking away their money to help the poor, yelling “It’s unconstitutional!”, when the very first words of the Constitution say the reason for this county to be formed was to make sure that everyone was helped:

    “We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.”

  12. Yeah, pretty much the same. I’m not even very close to the point at which I might see the nominal reduction in taxes, but most of my friends are going to be screwed if this one actually comes into effect.

    Whereas if we’d just kept the individual mandate and such, it’d probably be… well, okay-ish anyway.

    Big take-home lesson for me: The insurance model is completely wrong for health care.

  13. For several years my small business tanked with the economy. In fact, for 3 years we took no salary, the business just barely kept above water. During that time I was able to get ACA insurance with a hefty subsidy, at about a quarter of the previous cost of private insurance. Last year, our business recovered so much that most of my subsidy evaporated. I’m still only paying about half of what private insurance would cost, and the coverage is much better that what I could get otherwise.

    In other words, the cost reductions were there when I needed them, and now that I don’t need them so much, I’m doing well enough that I’m okay with the higher premiums. Not that I wouldn’t prefer to have that money for other uses, but I know I’m expensive to insure (lots of medical conditions) and it’s fair that I spend a decent portion of my budget for healthcare. For me at least, the ACA worked exactly as it was intended to, and it would go on doing so without the Republicans messing about with it.

    I’ve found that when people who have tight budgets list their expenses, they rarely include healthcare as a monthly item, the way they do rent, or clothing or transportation. They treat it like a one-off catastrophic expense, like a tornado or a flood. They don’t budget it, or if they do, they budget inadequately. If we had single payer, that monthly expense would be part of our taxes and we’d all be better off. Well, except for the billionaires, and for them my empathy is limited.

  14. As long as we don’t allow the poor to own guns, what’s the worst that can happen?

  15. I have parents/friends/family that have insurance costs that will become astronomical if things change (and they are already burdensome as is). I don’t necessarily agree with all of “Obamacare” but what is being proposed is exponentially worse in almost every conceivable way.

  16. Even if you ignore the sentiment, “E pluribus unum” is still a far better motto – for no other reason than because Ben Franklin nicked it from a Latin poem about making salad dressing.

  17. Agreed. My take-home pay is plenty, especially when DH is making enough to bump us into the 33% tax bracket.

    For people reading this, wondering, but what can I do? Indivisible has suggestions for people in red, blue, and purple districts. https://www.indivisibleguide.com/resource/stop-trumpcare-june-action-plan/

    I don’t want to put in too many links into this comment, but if you go to ouramendments dot org , you can add amendments to the voting which will slow it down. To quote:
    “Republicans are using a special process called “reconciliation” to jam through TrumpCare. This means they only need 50 votes, instead of the usual 60, to pass it. But the trade-off is that they have to allow an unlimited number of amendments. Any Senator can file as many amendments as they want and then call them up for a vote on the Senate floor during a period called “vote-a-rama.” Democratic Senators can and should plan thousands of amendments and keep them going until Republicans agree to have public hearings on the bill.

    “By introducing tens of thousands of amendments, Democrats can slow down the process enough to draw necessary attention to Senate Republicans’ secret process and the disastrous impacts of their TrumpCare bill.”

  18. Even us well off people might get gored by AHCA, since caps are back. And it’s REALLY easy to exceed those caps with one serious illness.

    (And, of course, pre-existing conditions are not a MEDICAL stricture. It’s purely a business tactic, used mostly to avoid paying out for what people paid for.)

  19. We sold a business five years ago and paid an ungodly amount of taxes on it. Like you, it was more than I had made in a number of years of my life. And it still only amounted to a 20% rate on the whole thing.

    I’d like a new deck and a new kitchen. I’ll trade that so my mom (and your mom, too) can keep her Medicaid every time. I can console myself while I cook meals in my existing kitchen, and eat them on my existing deck, which is more than a whole lot of people can do right now.

  20. I currently work for two billionaires who cash $5,000 checks for spending change bi-weekly. Most of their expenses (travel, cars, etc.) are chalked up to their corporate accounts. And, like Scalzi they pay three full time people to do nothing but handle their taxes and family finances so I really don’t see how a miniscule $510 tax break will be of any benefit to them in any way. But somehow the Republicans in Congress are more concerned about poor people cheating Medicaid or getting undeserved welfare or Planned Parenthood funds potentially be used for abortions. Totally Mind Boggling!

  21. Nice cat picture. Were you trying to Sugar coat that Twitter thread? (Sorry, couldn’t resist.)

    As a person who will be mostly (if not completely) screwed if the AHCA passes, I completely agree with you. Maybe the more idle rich could cut back on that wine budget a little to make up for not getting that tax cut. (In your case, even though you said you wouldn’t miss the tax cut, I’d be willing to send you some Coke Zero on a regular basis to make it up to you.)

    I get my insurance through my employer, and thank goodness I do because before ACA passed I would not have been able to get coverage at all (I’m diabetic). My insurance company has a habit of deciding that medications I’m on – such as insulin – are actually over-the-counter medications so they won’t cover them, which can be bad enough.

    But now I’m in end stage renal disease (diabetic complication). If they pass AHCA and lifetime coverage caps go into effect, I may well find myself having to decide whether I can afford to burn through the coverage to get a kidney transplant and have no medical coverage for the rest of my life, or just live for as long as possible on dialysis until the coverage runs out.

    Not a choice I want to have to face, frankly, and not one anyone should ever have to.

  22. Soulflower:

    To be clear I don’t pay three people full-time to deal with my money (I know you knew that, but in case anyone else was confused).

  23. Speaking as one of the vulnerable, thank you. We cheerfully (if painfully) pay our bit too, and for exactly the same reasons.

  24. Tax cuts schmax cuts, it’s the spending cuts that are going to kill people. And, no, those two things don’t have to go together, go read up on Modern Monetary Theory.

  25. Enfin je vois que dans les revolutions l’autorité toujours reste aux plus scélérats


    Bon Chance, Mon Ami.


  26. Like you, I live in Ohio, and, like you, I make my living as a novelist. Gov Kasich and the state GOP have given me a big fat tax cut because all the jobs I’ll create with that extra cash on hand. (Note to the governor: I have created no jobs with this windfall.) Unsurprisingly, the promised economic boom did not happen. Consequently, the state legislature had to fill a $2 billion budget hole. They did not do this by raising my taxes. Instead, they cut $2 million from Medicaid. It’s like this perfect storm of cruelty. If you read the Senate bill, there’s all this talk about state-level ‘flexibility” and “innovation.” It’s like burning down somebody’s house and giving them the flexibility to live under whatever bridge they choose.

  27. This is from Belgium, one of those countries with mandatory social security. I am, like our host, self-employed. My personal social security payments are 20-22% of my gross income after deductions. If I were employed, my employer is obliged to pay between 15% and 35% social security on top of my gross wage. I myself pay 13,07% social security out of my gross wages.
    So the math is: I’m self-employed and earn 50k a year after deductions = I pay 10-11k social security for that year. I’m employed and earn 50k after deductions: I myself have to pay 6,5k social security out of those 50k, while my employer has to pay 7,5-15k social security on top of my 50k wages.

    And I’m totally fine with that. Because that money is used to pay for my hospital bills, my unemployment benefits, my pension, etc. My dad turns 79 this week; a few years ago he had an emergency bypass operation. 95% or so of that bill was paid by social security, he only had to pay 5%.
    If he’d had to pay every penny of it, he and my mom would’ve had to sell their house. Because both of them had had to leave school at age 14 and spent their entire lives working at low wages, spending everything they got to give their children a better education, their savings are minimal.

    I don’t care if there are people out there that the system provides for when they personally don’t really need it. For every one of them the system helps one hundred or more who really, really need it when misfortune falls upon them.

    Every system has its drawbacks, of course. Ours has lots of them. But as our host has so eloquently said: “we all deserve the blessings this country can provide”. The same goes for mine as well. And that’s why I’m more than willing to pay social security, even taxes.

  28. Strangely, there are those in this country who seem to believe the poor have more healthcare options and the elderly more money than they need. Therefore, it is imperative that more money be transferred away from these people and delivered to the top income brackets.

    I know. Makes no sense. But then, have you seen who somehow won the last election for President?

  29. It is hard not to use overheated rhetoric when thinking of how to react to what these people are trying to do with their “health care” plan. They are consciously and knowingly acting in favor of the wealthy class at the expense of the health and welfare of the lower and even the middle classes to such an extent that it seems clear that people will needlessly suffer and even die because of this. There is something radically depraved about their moral sensibilities as it relates to our need to respect our common humanity. I cannot tell you how much I despise them.

  30. I’m glad you made sure to state explicitly that you DON’T NEED that tax cut money. I’d like to see some progressive politicians make that same point — that the tax cuts are going to people who already have enough money. Admittedly, it’s probably difficult to get anyone, no matter their income, to admit they have enough.

  31. You reject a tax cut for “the rich,” yet you refrain from advocating any tax increases on “the rich.” That adds up to an odd defense of the national status quo on federal taxes.

  32. Soulflower,

    The $510 savings that Mr.Scalzi mentioned was the average for people with an annual income in the 200K to 500K range. As these two guys are billionaires, I presume their annual incomes are many times that amount (at LEAST in the tens of millions). Those two people will see a savings of a good deal more than $510 in savings from off there taxes from this bill, but Mr. Scalzi’s point stands as to how much of a material difference it will make in how they live their lives.

  33. Pedro:

    Our gracious host probably didn’t opine on tax increases for “the rich” because they weren’t germane to the discussion of the AHCA (aside: is it improper to refer to it as “CheetoCare”?). In any event, trying to get a tax hike on “the rich” through the 115th Congress is about as likely as successfully piloting the Knock Nevis through the Panama Canal.

    What’s on the table right now is a petty tax cut being paid for through shredding the American medical care system. Makes me wonder if the tax cut is the primary purpose, or if it’s an added benefit and the primary purpose was to rain misery and sickness and death on the “undeserving”.

  34. Bravo for 2,4 (especially, please look up regressive in the dictionary) & 5. We’re lucky enough to be in the same general region of the tax code, and the tax cut won’t make any difference to us. It will make a lot of difference (in dollar terms) to the 0.01%, but the rest of us won’t notice the tax cut.

    The AHCA is an abomination but if the red states keep voting against their own economic interests out of tribal fanaticism, it’s going to pass. Heck, I vote against my economic interest all the time, but I’m doing OK. It’s almost at the point #Calexit makes sense…

  35. I am disabled, with strategically placed tumors that create random seizures guaranteeing I will never work a “normal” job, and receive diability for now (fingers crossed). I just want to tell all you people here today “Thank you” for your humanity. It means a lot.

  36. Funny thing… I don’t make a lot of money. 30k-40k depending on the amount of overtime (12hr. x 7 days). But I’ve not minded the taxes I’ve paid. Actually I usually pay a bit more and get a refund, but it’s not a BIG refund overall. Sure, I could use that money a lot, yet it’s money that gets me roads, safe water, fire, ambulance and police, it paid my way in the military, and I don’t mind paying for some unknown neighbors healthcare.

    I’m not an individual, I’m a CITIZEN! That means that I know only have rights, I have obligations to my fellow citizens. I know… I know… UTOPIAN! But lets get real. As citizens of the USA, we not only have rights (as mentioned above) we also have obligations. Our country can only be as strong as the weakest/poorest amongst us, and right now, WE are pretty weak what with the whole “Get sick, die quickly” attitude of some of those in our midst. So, I’m glad to get a refund most years, but the money (most of it) that isn’t refunded? I may wish I could say where it gets spent, but I don’t regret it getting spent on things that makes anyone’s life better… well unless it is corporate welfare, and when Wally World or BMW can get a colonoscopy, mammogram, or prostate exam, we can talk about helping them out.

  37. Oh, and of course, the tax cut is retrospective to the beginning of this year (per Forbes, amongst others).

    It’s a tax cut, eviscerating healthcare is just a side-effect.

    “The AHCA 2.0 eliminates the NIIT’s 3.8 percentage point surtax immediately and retroactively to the beginning of 2017”

  38. $500 in savings? Seriously? I wont even notice that.
    To the people who complain about “It’s my money!”, well, I dont have children, but my property taxes are used to fund public schools. For their children.
    Can I have it all back? Please??

    Taxes are the dues that we pay to live in a civil society.
    I love educating children.

  39. As I say to everyone I meet: “Taxes. How we pay for stuff.” And then I mention other countries’ tax rates and how relatively light ours is because we DON’T pay for universal health care and preschool and new parent leave, etc. We had a library trustee who wanted to close the building because he never used it (those were dark days). Never mind the thousands of residents who DID use and need and value the library.

    Thank you, thank you, thank you, Mr. Scalzi.

  40. ‘The motto of the United States is not, in fact, “Fuck you, I got mine.” It was, and should have remained, “E Pluribus Unum” — out of many, one. We’re all Americans. We all deserve the blessings this country can provide. This one is willing to pay his taxes for the benefit of the many.’

    Beautifully put, thank you.

  41. $500? That’s it? I am genuinely gobsmacked.
    I’m not going to create any jobs with $500. I’m not going to start a business with $500.
    And here’s the thing that gets me more: those $500 bucks, all by themselves, aren’t going to cover anyone’s medical care, at least not in a meaningful way. i mean, maybe I could donate it so a few kids get their shots, but it won’t cover anyone’s dialysis, or insulin, or dental care, or home health aid or school aid or anything.

    Once, those $500 were one board among many in a bridge to health. Now they’re just a stick.

  42. nicoleandmaggie had a wonderful idea, which bears repeating and emphasis: Since the ‘reconciliation’ schtick (which reduces the number of votes necessary for the bill to pass) allows an unlimited number of amendments, let’s amend that fucker. The ouramendments.org site which nicoleandmaggie cited, is specifically set up for “TrumpCare will not fuck up [name of specific person]”-type amendments… but oh my dear sweet lord, there are so friggin’ many possibilities.

    The Angry Cheeto is really big on executive orders; imagine amendments which make specific executive orders null and void.

    The Angry Cheeto wants to gut funding for basic research; imagine amendments which restore funding for that research.

    And so on, and so forth.

  43. John — minor nit: the current AHCA will gut MedicAID, not Medicare. Not to worry, Paul Ryan will be coming after Medicare once this abomination is passed, but still …

    Medicaid pays for 60% of the costs of the elderly in nursing homes, BTW. and about 50% of the births in this nation.

    I’m with you in the 1% — born working class, never poor, but not rich. With good luck I wound up in a career that let me make a good living, invest wisely, and retire with an actual real live pension. I pay more in taxes every year than my dad ever made in wages in a year, even adjusting for inflation.

    I call this bill, this effort by the GOP an abomination before any God you choose to name. I cannot in any way understand how any human being in this country can look at the effects it will have and still call themselves a Christian. (I specific Christian because about 80% of Evangelical Christians voted Trump in the last election, and they are the base of the GOP in general.)

    If you are one of the lucky ones who thinks, “Hey, not my problem, my company pays for my insurance.” Guess again — many health care analysts think the effect of this bill will be to destroy the private market providing employer health insurance as well, primarily by allowing the re-imposition of lifetime caps, higher premiums for pre-existing conditions, and elimination of the list of required coverages.

    Health care is 1/6 of our economy. This bill will destroy the nursing home industry and bankrupt many rural hospitals.

    Like John, I’ll be okay with my big tax cut. And I’m old enough that I will probably die before the worst of the effects destroy this country. But my niece and nephew and their kids won’t. And even the money left over when I die might not be enough to save them.

    And, frankly, I don’t want to live in a third world country ruled by warlords in gated castles with private armies. Plutocrats who can ignore the laws.

    Google “disabled protest at McConnell’s office” for some truly horrifying pictures and video. People will die, and that is no exaggeration.

  44. The one amendment that stood out for me was the one stating that Congresscritters kept their ObamaCare insurance. (This from the ACHA amendment that they had to enroll under the bill submitted by the GOP.)

    If I didn’t need to pay taxes, what I’d spend on? Oh, what I owed for by plastic charges. (Alcohol and books don’t buy themselves.) But wait, there is that term. What was it? Oh, yes. Interest charges.

    One one hand, there is money for public roads, public utilities, police, fire fighters, air control, and other things. You know, civilization stuff.
    On the other hand there is ‘stockholder value’. Which in reality translates to the CEO’s Golden Parachute.

    Taxes don’t bother me.

  45. Perhaps we should note that the government-provided monopoly called copyright enables authors to make their money. Shouldn’t successful people have to pay for this service?

  46. Scott Petersen — pretty sure copyright and patents were mentioned in the Constitution, so the enforcement of them is paid for by our taxes, just like every other law enforcement activity is paid for by our taxes.

    See, one of the advantages of living in a democratic country is that there are things called the common good, like law enforcement, defense, roads, clean water, public schools, health and safety regulations that insure we don’t all die of botulism and so on and so forth. These things make life worth living. The cost of providing these things is taxes.

    Now, there can be discussions about over-regulation and how ‘fair’ taxes are, but those are discussions we can have as a free people governing ourselves.

    Upthread someone mentioned something about taxes on money that is earned. Yes, we tax money that is earned. What we need to do more of is tax money that is UNEARNED. Once upon a time interest and dividends were in fact a part of the middle class retirement funding, but not so much any more. Most people in the top 1/2 of 1% make most of their money from ‘rents’ like dividends and interest. The GOP keeps nattering about the “Death Tax”, which means people like the spawn of the Waltons, and for that matter the Trumps, including POTUS, get a huge windfall from inheritances.

    Inherited wealth is one thing driving income inequality. “Family Farms!” is used as a smokescreen, but I fail to see how the third generation of Waltons should live on billions and billions while poor people starve and the elderly are thrown out of nursing homes.

    I propose (for Pedro) a modification to the Estate Tax that would not tax any estate up to $50 million. 50-100 has a 50% tax rate, 100-1billion has a 75% tax rate, and a billion and up has a 90% tax rate.

    But tax CUTS are all the GOP has time for.

    So they are disguising a huge tax CUT for the WEALTHY as a health care reform bill.

    John, you live in Ohio. Senator Portman is a possible “NO” vote. Please call him. I call Rand Paul’s office once a week. McConnell, the cowardly weasel, isn’t accepting calls, not even to voicemail.

  47. Once basics like food, shelter, heat, and sex are up to satiety the only thing left that one can use resources for is status. One can compete for status against those above your class, within your class, or below your class. These high-end tax cuts don’t (as Our Gracious Host points out) materially aid their beneficiaries. They don’t alter their status relative to others at or above their status.

    The only effect they have to that class is to enhance their status relative to others who are already below them both by giving the high-status relative benefits and by piling additional suffering and death on those who are already getting more than their share of both.

    I don’t speak French; if I did I could better phrase the statement that this is the opposite of noblesse oblige.

    Oh, yeah: they also claim to be Christian. Some would call that blasphemous.

  48. Well said, Mr. Scalzi.

    The United States has been at war for 15 years; at the height of the Cold War (the Eisenhower Administration) the top bracket was 90 percent and every physically fit male – including the scions of the 1 percent – was subject to the draft for active service, in wartime and peacetime.

    Trump is a draft dodger and the Republicans are filfth.

  49. $500… Wow, I just blew that much on Legos this evening. (Yes, for me and the wife). Just goes to show how little this matters… To even a middle class family. Now at the cost of not providing health insurance to my aunt and uncle (who run their own business)? I’ll pay those taxes and not even notice. Of course my family is below that thershold but I’m with John on this.

  50. Speaking as a local government employee who has an up close and personal ringside seat to what it means to be old, sick, and poor, (with a side of Alzheimers for extra angst!) I find the “I got mine” club to be appalling.

    Speaking as an accountant, with a pretty good idea of how uncollectible medical bills are dealt with by local governments, the likely result of cutting federal subsidies to health insurance is an increase in local government spending on healthcare. Plus, side effects like more people losing jobs because of illness, retiring earlier, getting sicker, delaying preventative health care until the problem gets bigger, etc. All of those result in increased government spending, as well.

    So, even to a completely heartless bastard, the subsidies are a good deal.

    But of course, cutting the subsidies will save money. Really. Just like tax cuts create higher tax receipts, because we are always miraculously on the right side of the Laffer point in some sort of fiscal Xeno’s paradox. “well, to get below the Laffer point, we’d have to get halfway to the Laffer point… Thus, tax cuts always pay for themselves!”

  51. 1) “And then I pay my taxes and I discover that anything I would have used that ridiculous wad of tax money for, I still have enough in my net income for. I literally cannot think of a thing I want — or need — that my post-tax income can’t handle.”

    You’re a small-business with no overhead. Try being a small business with either a brick-and-mortar location or warehouse or both. Then you have to pay property taxes, rent, utilities, etc. Try being a small business with employees. Then you have to pay salary, healthcare, unemployment insurance, etc.

    Try being an investor. You’re privileged, John, in that you have a business model with virtually zero overhead.

    2) “Cratering health care for millions in the United States ”

    Obamacare expanded coverage to *maybe* 10 million. Many millions more lost their doctor and coverage (which exposed the outright lie Obama made “If you like you’re doctor, you can keep your doctor”). Tens of millions more had their rates skyrocket (which Obama promised to do to electricity rates; not health insurance). To the point that they cannot even SEE their doctor anymore.

    Case in point: Me. Before Obamacare my insurance was $150 month. After, it’s $450 a month. I literally cannot afford to both see my Doctor (and I’m disabled so I NEED TO SEE HER) and eat. I usually have to email her surreptitiously to get prescriptions renewed. Which got her into trouble. Which means I now literally have to choose between eating and having my life-preserving prescriptions (THANKS OBAMA!)

    Obamacare is a abject failure, and is destroying the healthcare market and many, many lives. If the GOP can save it from the assault your completely incompetent president did to it; bring it on!

  52. John, the subject of health care in America has been of particular interest to me most of my life and getting more important every year. I made it the capstone of my senior year in college (my major was economics) and bent most of my papers towards health care and/or education as well. I know you’re not on my facebook so I’ll just drop two points I’ve made (I’m helping my readers by going over McConnell’s bill and posting each point)

    In his version, McConnell acknowledges the devastation that will happen if the AHCA passes by creating a “stability and urgent need” fund specifically for insurance companies to help people who are otherwise SOL once medicaid is cut, risk pools are deregulated, and pre-existing conditions are no longer protected. This means there’s $15B for the 2.2M people who will be kicked off or priced out of being covered. You know how much $15B divided by 2.2M is? It’s about $7000. Think about how much coverage $7000 will buy someone with a pre-existing condition. A couple of months maybe? A couple of weeks?

    As my readers know, I’m on disability but trying like hell to get a “real” job since I graduated ten months ago. Because of the current state of health care coverage, I have realized that I cannot afford to gamble with my health by getting a job in any sector except the public. I have pre-existing conditions that make me high-risk. I also take maintenance medications that allow me to function as a “normal” person – without my daily meds I would quickly be hospitalized and incapable of working at all. It is medication and regular specialist visits which allow me to be able to get a job. Therefore, I *must* have a job that gives full coverage. This obviously narrows the pool of jobs I can apply to or hope to get. I cannot take the risk that I will accept a job and then have the insurance company deny me coverage. You see where that would go…

    Suddenly, I have to choose between becoming a fully contributing member of citizenry, or being hospitalized, possibly dying. Yes, health coverage is THAT important to some of us.

    So these “repeal and replace” bills have more far-reaching consequences than people know; those of us who are on the disability realm, who are trying to pull ourselves up by our bootstraps and become functional citizens who contribute to society, we face a hurdle that could not only deny us a living, but effectively KEEP us dependent upon the state.

    And McConnell knows that full well. He knows what he wrote. He knows who it will affect. He doesn’t care. He’s smiling.

  53. <sarcasm>At least with the Republican healthcare plan, there won’t be any death panels, they won’t need any.</sarcasm>

    Doc Stat: It is true that Obamacare did not help everyone, and some people have higher premiums and higher deductibles, in part because Obamacare mandated additional benefits like covering pre-existing conditions, maternity coverage, mental health coverage and keeping adult children up to age 26 on their parents’ coverage. Furthermore, the intent was to limit the number of people in the situation of much higher premium costs by having the states increase the number of people eligible for medicaid subsidies, but many states chose not to increase medicaid coverage, and most if not all that did not were run by Republican governors and legislatures. While Obamacare apparently did not help your financial situation, it’s not an abject failure because it helped millions who did not have and could not afford health insurance before Obamacare was in place. It’s not destroying the healthcare market, it’s generally not affecting the employer sponsored or government markets, and the personal markets are fine in some states but not very good in others. If Republicans in Congress had been willing to work on fixing the parts of Obamacare that needed fixing instead of only attempting to repeal it over 50 times in 6 years, (and they knew in advance that each attempt would fail), and successfully defunding a few key provisions, it may well have worked for you too.

  54. and to the gentleman who said millions lost their care and doctor? Actually it was more in the thousands but the point is true: many people did lose coverage and the ability to see their preferred doctor. Because they were sold inept plans that were little more than scams. Many Senior citizens found out that the plans they had been paying for so diligently effectively covered them for a couple of doctor visits and nothing else. Because before the ACA insurance companies could create whatever plan they wanted and charge whatever they wanted. Before the ACA, back when I was married, we paid $700 a month for our family health care. After the ACA? we paid about $900. Because the companies we bought from were legit companies that gave us excellent coverage. Believe me, I have done a lot of research on this.. the people who “lost coverage” did so because either they had bought plans that did not cover actual health needs OR their employer was buying insurance from companies that did not give adequate coverage. you may think its okay to allow companies to sell inadequate care to people who dont’ know better but I don’t.

  55. From my perspective, living in the UK, which has the National Health Service, I feel much safer here than I would in the USA. I work as a freelance electronics designer, (the visble thing I have designed is the electronics for the laserlights on the hire bikes in London). To the best of my understanding, the healthcare a freelance in the USA can afford leaves one open to more risk than I would like – unless one is very well paid.

    I have had years when there wasn’t enough work, and we partly lived on our savings. Other years I have worked from morning til late evening most days, and added to the savings. Even in the bad years, I knew that if I had a life threatening disease, I could get medical treatment even though not very rich. Yes, there are problems with the NHS. It fails some people, in some areas it is inefficient, and many people wish it were done better. It is reported that there are people who use the system in dishonest ways to line their own packets. It is, unfortunately, in the nature of human institutions not to be perfect.

    The tax rate is fairly high, though obfuscated by complexity. I have friends and relatives whose lives have been saved by the NHS, and I’d much rather have their company than the extra money.

    BUT, I am not happy when I learn that the tax I pay also contributes to public officials paying themselves tens of times what I get paid, nor am I happy with variable rates of tax, so that someone like myself, whose income fluctuates from year to year, pays a whole lot more tax than someone who gets paid the same amount of money evenly over the years. Ideally the tax system would be simpler and also not punish those whose income is not secure from year to year. Preferably public officials would not be able to pay themselves more than a low multiple of the national average income. Human institutions – imperfect.

    There is a practical problem, in that any government that tries to tax the rich very heavily will find that they go somewhere else, and tax revenues fall. I don’t know where the ideal balance is, and I doubt anyone does. I do not know enough about the US tax system to have a well founded opinion about whether the tax rate for rich people is near a level at which this would be an issue, but intuitively I doubt it.

  56. (The view from very late at night. I may think something different after some sleep.)

    It isn’t just about taxes, at least I’m pretty sure it’s not. Maybe not even mostly. Look at the misogyny of the bill: someone badly wants poverty, misery, and death among women from the middle class down, and especially the people of color who are predominantly poor. Oh, the money’s nice, to be sure. And these people hate women, sure. But I think this is about purifying the race and culling the unfit: brutal eugenic fascism.

    I think there is fanatical fascism behind this, and until we recognize that, we will be handicapped in our fight against it.

    (Maybe more tomorrow.)

  57. “Voting with your feet” works both ways. I live in the UK and am married to a US citizen. If I wanted to, I could live and work in the USA, where there are many good opportunities in my professional field. I will not do this, because I refuse to trust my life and my family’s lives to the US healthcare system.

    I am perfectly willing to pay higher taxes in the UK. It gives me peace of mind to know we are entitled to medical treatment under the NHS, with no additional charges and no questions asked about our eligibility.

    Blog post I wrote on the UK tax and healthcare experience: http://blog.iainroberts.com/2015/04/birth-and-taxes.html

    @Doc Stat:

    The OP was talking about the tax cut from the AHCA. If a business owner will benefit from that tax cut, then by definition he or she has a personal income of more than $200,000 per year. So the business must be doing pretty well, even with all its overheads (many of which can themselves be written off against tax).

    Struggling small business owners are another story altogether. Are they over-taxed, especially in comparison to large corporations? Maybe so, but either way it’s not very relevant to the AHCA.

    As for your experience with Obamacare, I am truly sorry to hear about it. At best, Obamacare an unsatisfactory compromise, as even the law’s defenders acknowledge. But to the best of my understanding, the AHCA is likely to make things worse for you, and will certainly make things worse for a great many other people.

  58. At the risk of being condescending, as a Canadian, my heart is breaking for folks south of the border. A decade of Conservatives in Parliament was very frustrating and at times took things from our society (like Kyoto) that mattered, but it was nothing compared to this stuff.

    I fear for your guys. I hope it turns around soon.

  59. “Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune the cost of which should be shared by the community.”

    – Nye Bevan

    A true patriot is one who pays his taxes with a smile.

  60. $500?! Five hundred dollars? That’s not a tax cut, that’s an insult. I’m marginally poor. I could use $500, sure, but even for me, that’s actually less than one paycheck (biweekly). I’d NOTICE an extra $500, sure I would. Might decide to replace my glasses this year instead of next. Or replace my ancient desktop tower with something that has components from this decade. Or actually go to Origins next year. Not all of them though. But if I were making 10 times as much, I’d never even notice it. Not a chance. But our worthless, shiftless collection of soulless scumbags in Congress will make damn sure their golfing buddies get it. But don’t you worry, this is just the first little cut. I’m sure they’ll keep coming up with more until it adds up to real money.

  61. I am American, and grew up, was educated, and had my first jobs there. Then I moved to Canada for a new job. To Quebec, the most socialist of provinces. And even with my high socialist taxes here, we pay less in taxes + benefits than what we paid in the good ol’ US for far better services of all sorts, great health care, and the knowledge that these things are available to everyone, not just the wealthy. And we don’t wait years when we are sick–DH needed a test for health reasons (which can also be used to screen apparently healthy people) that has a 2 year waiting list. The doctor wrote on the referral “must be done in 3 months” and lo and behold, we skipped the line. Ditto for a friend with cancer–same day service as needed for his disease for various tests that normally have waitlists. There are people who fall through the cracks here, but it is (mostly) bad luck rather than a function of how much money you have to spend.

    It is personally horrifying to me that the main point of the AHCA seems to be to divert money for essential, life sustaining services for less well off Americans to wealthy people who do not need it. That said, I also know a few “Masters of the Universe” types. For some of them, too much is never enough, and therefore, a tax cut is just what they “need” to help keep up with the Joneses. There are people who really think that $1 million is not all that much money anymore, and that they can’t live the life to which they aspire on it. Every so often there will be a profile on these people in the NYT or WSJ. This is who the GOP is courting. There are unfortunately enough of them to make a difference.

    My one hope is that after this travesty passes, single payer becomes more likely, since the GOP will be demonstrating to Democrats that 1) you can use reconciliation to do something like “Medicare for all” with 51 votes and no hearings, 2) you don’t actually need the input of industry to get a bill passed, and 3) public-private partnerships take a long time to hammer out and can still be destabilized by an unfriendly government, so it is better to go with a system you can control completely.

  62. It’s quite simple; insurance for profit is immoral. The fact that it’s backed by the party of Jesus blows my mind. I find it very hilarious(or scary) that their political platform is directly in contradiction with their religious beliefs. Single payer is what is needed. Raise taxes and take care of people. Stop building so many Jets, reduce the salary of congress and pay for peoples healthcare.
    This way, people don’t have to worry about moving from job to job. It frees people up to move where they want; it also 1)takes the burden off of corporations(snowflakes) 2)forces them to pay better salaries because people aren’t sticking around for the shitty raises, they are sticking around for the health insurance which in turn makes 3)competition for workers go up, putting the power into the workers hands(this is why corporations are against gov’t insurance, they know it will give the working class a leg up on them)

  63. @Joe Smith: The Republican party is filled with religious people who are compassionate as long as it’s not involuntary with the recipients being the wrong type of people.

  64. My American wife was sort of shocked how much money of her first paycheck here in the Netherlands would go to taxes. Then she said she’d be happy to pay them, considering what we get back for it in healthcare, social security, improved infrastructure, etc.
    She’s been pretty clear she does not want to leave our socialist dystopia to go back to the states. Not that things over here are perfect, far from it, but at least we have a government trying to make it work (even if they disagree on the how), rather than one that seems bent on destroying the idea of health care for all of its people.

  65. Joe Smith, it’s not really at all unusual for a person’s espoused religious beliefs to be in direct conflict with their actual beliefs, as demonstrated by the things they do. Jesus himself spent quite a bit of time discussing that very truth.

  66. http://www.npr.org/2017/06/07/531886684/the-kansas-tax-cut-experiment-comes-to-an-end-as-lawmakers-vote-to-raise-taxes

    The assertion in Kansas was that tax cuts would lead to hiring. But in reality, the cuts would reduce a small business tax by a couple thousand a year, which is way too small an amount to pay an employee per year.

    Not to mention, businesses hire new employees based on DEMAND for their product. Not based on available cash. Tax cuts go straight into business owner pockets, not out to new employees.

    We have direct, immediate evidence in Kansas that the entire republican economic platform for the last few decades (tax cuts create jobs) doesnt work. Only someone horrible at business would actually believe it. But then, we have a horrible businessman as president now, who is bad at numbers, refuses to learn, and likely a sociopath, so it shouldnt be too surprising they’re still pushing flat earth theories.

  67. “Don’t come at me with “but the rich earned those dollars.” Dude, I earned my dollars, too.”

    I recently had pointed out to me the observation that earning money and having money are in fact two different questions. As Andrew Ryan puts forward in Bioshock, “Is a man not entitled to the sweat of his own brow?” Yes, says I, and that’s the problem. No one man has that much sweat.

    There’s a point where you are comfortably well off and you can more or less afford everything you need – a just reward for valuable work – and everything beyond that, well, that’s money that is far less valuable in your bank account than in the hands of people who need it. Holding onto it, then, is depriving the needy of it. You’ve earned that money! It is immoral to keep it, to hoard it in trust funds or investments or private jets or really anything that helps you gather more money you don’t need and drain it further from people who do. I’d go so far to argue that there’s something quite broken about a system where that vast imbalance in value of work can even happen.

    “There is a practical problem, in that any government that tries to tax the rich very heavily will find that they go somewhere else, and tax revenues fall.”

    I think this is a threat, but I also think that if the very rich go elsewhere and take their ball with them, the structures that were keeping them rich will either still be there, fattening the government’s coffers, or they’ll collapse, and opportunity will be available for new players.

  68. Doc Stat:

    “Try being an investor.”

    Well, in fact, I am, both in the stock market in general and in terms of direct founder-level equity in more than one company, at least one of the latter, incidentally, qualifies me as being a part owner of a small business with actual overhead.

    You’ve made the classic blunder of assuming that a) I talk about all my business here and conversely, b) nothing goes on in my life that I don’t discuss here.

    So, speaking as an investor and a part owner of a small business with overhead, yeeeeeah, I don’t see any reason to alter what I wrote in the piece.

    Also speaking as an investor, I’m also aware that capital gains are taxed at a substantially lower rate than income, i.e., that this is largely another tax break that goes to the financially well off rather than the working or middle classes; only half of Americans invest at all, and the top 10% of Americans, in terms of income, invest substantially more than anyone else does. I’m also aware that an investment surcharge for high income investors goes away if these bills pass, giving the very rich another tax break at the expense of everyone else. So there’s that.

  69. “Once basics like food, shelter, heat, and sex are up to satiety the only thing left that one can use resources for is status.”

    But…but books! And cats, chocolate, outings with friends. Basically personal enjoyment. All for the higher taxes and definitely against the AHCA, but fun and status aren’t the same thing.

  70. I’m a physician in Canada. I had to pay in taxes at the end of the year because I did more extra work than usual. The conversation with my husband went:
    Me: “I owe X amount!”
    Husband: “Um, I’m in the hospital right now. You’re paying for my care.”
    Me: “And my salary…”
    I happily paid my extra.
    I’ve read American textbooks that have chapters on how to invoice patients and what to do if they don’t pay. It turns my stomach. I get annoyed here sometimes that patients don’t always show up for appointments because they consider care to be “free.” But that’s a small complaint compared to the negatives of your system.

  71. I suspect there is a certain portion of the rich that DO miss that money: the ones who would use it to fund PACs to lower their taxes even further (or do other sorts of political spending to increase their influence). And I suspect D.C.Sessions has it right when he/she says a lot of that is in increasing their status.

  72. I’m another person who once didn’t have enough money and now does. And being able to afford everything you actually need, and then get to decide which luxuries you can squeeze in (vacation travel is a luxury), does make all the difference. I get a lot from government for my taxes, most obviously transportation infrastructure and national and local defense, and considering how little I pay, it’s a bargain.

  73. On a practical front, the only thing I can think of to do about it is to take that $510, assume it’s a good estimate for what I’d save on taxes, and donate it to Planned Parenthood. I’m sure there are other charities who will do their best to fill in the gaps this horrible bill leaves, but that’s one I know works.

  74. Someone mentioned the amendment process and reconciliation upthread. It’s worth noting that all amendments have to be ruled relevant to the bill under consideration, and that that ruling is made by the senate parliamentarian. If the parliamentarian says no, they’re thrown out without consideration. And as the saying (mostly) goes, the Parliamentarian works for the Tsar.

  75. Thank you.

    We’re not in the 1, 2, or 3%… I suspect we weigh in somewhere around the 6% or so, but I haven’t actually checked. Middle class, a little careful with our money, but we do all the middle class things like invest, own a house, etc. I also see, daily, all the things my taxes go to: police, roads, education, libraries, water systems, and yes, healthcare. I am happy, quite selfishly, to pay for all those things by way of taxes. Are there things I don’t want my taxes going for (Lavish weekend golfing retreats for chief executives of the nation, perhaps)? Sure. But for the most part, I generally feel I benefit–from having healthier people around me, from having roads to drive on, from having public transportation and a defense system that is ready to defend me when the Aliens Attack, etc. And from not losing people I love and admire when the medical equivalent of a twopenny nail is available.

    When did my country become so mean-spirited?

  76. Other than a few personal anecdotes I’ve read not a single defense of the AHCA that says it will improve our national health care system–that on balance we will have a more effective, more efficient health care system with the AHCA in place instead of the ACA.

    Not a one. Not a politician, lobbyist, talking head in the print media (I don’t watch cable TV so I can’t say about them), industry/trade association/medical association rep, anyone. I think that’s telling.

  77. I’m not as well-off as you, but doing well enough that I would get one of these tax breaks from the proposed bill. I still think it’s morally reprehensible. When I tell my representatives that I am a supposed beneficiary of their actions and I still don’t want it, they assure me that Obamacare is “a disaster” (never saying for whom, but based on what they are changing, probably for me and people like me.) I am horrified that I can’t say “don’t do this for me; I don’t want it.” And it’s so freaking short-sighted to believe that because I am in the pool of lucky people now, I’ll stay there forever. Even if I didn’t want to preserve access health care for those who need it now, which I do, I may very well end vulnerable in one way or another down the line through pre-existing conditions, lifetime caps, exclusion of essential benefits, or job loss. And if by some stroke of luck I stay secure until I die, without doubt someone I love will need help.

  78. Oddly enough the only really socialist medical care system in America is the VA; and though there’s a lot of anecdotal evidence of how limited it can be, it removed a malignant skin cancer from my shoulder within a month, which I think is good going.

    The real problems with American health care show up when you compare it to Britain’s NHS, also a subject of bitter complaints over funding. They both get about the same results, give or take: child mortality is higher in the US, but cancer survival times are longer – but the American system takes 15 percent of GDP and the UK system around 10. That’s 5 percent of GDP which various insurers, pharma companies, HMOs etc. stand to lose if the system is reformed. They aren’t ever going to accept that loss, and they have the money (curiously enough) to keep things as they are. One of the reasons Obamacare came unstuck was the need to placate current providers with exemptions.


  79. For those obsessing over that $500 figure that John quoted: people making ‘only’ $200,000 – $500,000 a year are not remotely the demographic that Congressional Republicans are interested in benefiting. Most of the money obtained from gutting Medicaid and the ACA subsidies will go to people with incomes much, much larger than that – their tax cuts will run to the tens and hundreds of thousands or even millions of dollars. Details given in the link in John’s piece above.

  80. This isn’t repeal and replace. Trumpcare is just tweaking Obamacare to make it meaner.

    The “good” news for me, is that it won’t affect me all that much. I have a bronze plan that pays absolutely nothing until I meet the deductible, and then it pays everything. This is my first year on that plan (since I retired in November), and I worried about the deductible, but the very first time I had prescriptions filled, I met my $6500 deductible (for a three-month supply), so my doctor visits, lab work, and all the rest of my prescriptions for the rest of the year are covered.

    My only experience with nationalized healthcare was when I was stranded in England due to the volcano Eyjafjallajökull in Iceland, which canceled almost all flights in and out for a couple of weeks. I had my prescriptions, but not enough for an extended stay. I had to pay £60 to see a doctor, but when I asked how much I’d pay for the meds, the doctor told me to not say anything and there would be no charge. (Technically, there was a way to charge me, but it was too much work for her to do it.)

    This is not a good bill. Whether it passes or not, I hope that those who vote for it pay a high political price for supporting it (by losing their seats the next time they are up for reelection), but if the ACA was a step toward single payer, the AHCA won’t change that trajectory.

  81. Regarding knowing people who are more likely to die, it would be interesting if the CBO were required to score the bill not just on short-term effects like how many people will lose their health insurance, but long-term ones like the change to the country’s average life expectancy. Then the debate could shift to something more like “Do you support this bill knowing that Americans would live, on average, two months less” (or whatever the average would be).

  82. There’s a nice bit over on Stonekettle station. “Is health care a right?”.

    I wish we would stop talking about how many are covered and start working on bringing down our health care costs. Cover everyone, Hospitals, doctors and drug companies get a hair cut. Health insurance companies can go pound sand, and offer services to the very rich.

  83. Years ago I came to Canada for grad study and ended up marrying a Canadian. Both of us have family scattered across both countries and have ourselves worked in both the US and Canada. Currently we are in Canada and will probably remain. At one time after the implementation of the ACA, we talked about moving back to States. But not happening now, my husband has a preexisting condition and there is no way we could afford the medical insurance or handle the uncertainty that you have to accept as part of the US health care system.

    As others have mentioned above, taxes are higher here (and more complicated for me, since as dual citizen, I have to file in both countries), but the peace of mind that comes from knowing that you, and everyone around you, has access to decent medical care makes those extra taxes worth every penny and then some.

    The system is not perfect here (or in any single payer system) by any means, but at least in a single payer system everyone starts from a premise that access to minimum amount of health care is a social good, is in the interest of the state, and will allow all citizens their best shot at life, liberty and the pursuit of happiness.

    I really don’t understand why anyone would think either of the two plans proposed by the Senate or House are good idea on any level — politically, economically, socially.

  84. I am a board member at a non-profit nurse practitioner clinic and the thing that worries me is the discussion of Medicaid “Reform”. I just pulled an initial visit bill from a recent patient and of the $220.50 that was charged out Medicaid only paid us $90.53 due to their ever lowering provider compensation rates. Medicaid “Reform” is code for 2 things, cutting people off of Medicaid and/or reducing Medicaid payments to providers.

  85. Something even more sickening is the favorite GOP technique for getting rank-and-file R voters to royally screw themselves: Guess who they’re referring to when they contrast “the (undeserving) poor” with “working Americans”?

  86. John, I am (or have been) in a similar situation. I have always suspected it is a matter of visibility. When one pays quarterly, you have to make out that check, which is quite large. It definitely gets your attention and really brings the amount into immediate focus. When your taxes are paid by withholding, you see it on a check stub, but it is for 2 weeks and most people don’t look at the stub, they look at the check. Out of sight out of mind. The grumbling only gets focused once a year at tax time. They look at taxes paid and think “I could have replaced my 12 year old car”, I looked at it and say “I could have bought a couple of houses with that, wait more stuff to take care of naw”.

    Similarly, with health insurance, most people are insured through their employer. They are cognizant of their copays and uncovered expenses. Many if not most, have no idea what this stuff costs. I have acquired health insurance in almost every mode available except ACA pools. Currently through one of my S-Corps I pay, for a family of 4 (ages 60, 56, 18, ,18) with a high deductible (5k per) in SoCal, about $25k per year, for premiums alone. And this is a PPO but not a gold-plated policy with hot and cold running nurses (not that there is anything wrong with that).

    Most folks are actually reacting to what they see or don’t see. I would rather pay more in taxes and have a vibrant economy with everyone doing well (and thus nourishing a vigorous investment landscape) than pay less taxes, in an economy where everyone is living pay check to paycheck. Much along the lines of good business is not screwing the other guy good business is where everyone does well.

  87. And I suspect D.C.Sessions has it right when he/she says a lot of that is in increasing their status.

    He, not that it matters. Also, no relation to Jefferson (Davis) Beauregard [1] Sessions III — which matters a great deal.

    But…but books! And cats, chocolate, outings with friends. Basically personal enjoyment.

    Granted. But books, and cats, and chocolate, and even outings all have fairly modest satiety levels. Levels far, far short of the “four houses and a private jet” level.

    [1] General in charge of the attack on Ft. Sumter

  88. The tax burden at the top end is even less than you say, because you fell victim to another of the classic blunders, conflating marginal rates with total tax rate. One has to make over $466,950 (married filing jointly) to be taxed at a marginal rate of 39.5% – but that’s the marginal rate for income over $466,950; on your first 466,950 of income, you pay a tax of $130,578.50, for a rate of 27.96%.

    Social Security (6.2% of the first $118,500) adds another 1.57%, and Medicare (uncapped) another 1.45%, meaning someone in the top tax bracket is paying 30.98% on the first $466,950 of income. I don’t think there are any jurisdictions where the state and local taxes add up to 20% of your income (not to mention that state and local taxes are deductible from taxable federal income, and the max $7347 you pay in social security taxes represents a decreasing percentage of income as income increases).

  89. Techgrrl1972 said, “I propose (for Pedro) a modification to the Estate Tax that would not tax any estate up to $50 million. 50-100 has a 50% tax rate, 100-1billion has a 75% tax rate, and a billion and up has a 90% tax rate.”

    Thanks! I’ll be sure to run it by my accountant.

  90. dglnj:

    I was about to say “I DID NOT” because I am famous for snarking at people who do not understand marginal tax rates, but I see that in at least one place it’s unclear. I’m going to go tweak and clarify that. YOU ARE UNSNARKED ON A TECHNICALITY.

  91. As well as being a moral abomination, the bill is horribly short-sighted. Think of all the small businesses that won’t be started because people can’t get health coverage, the lack of mobility caused by being tied to your work by health insurance.

    My husband and I are immigrants to the US, from Australia and Ireland respectively. The ACA was a major factor in him setting up a small business. Most of his clients are overseas, so he’s literally importing money into the US – enough to put us in the top 5%. That $500 tax break would be meaningless to us – it’s not even half of what we currently pay per month for (non-Cadillac) insurance for our family.

    Loss of coverage is a different matter. Two years ago, I was diagnosed with thyroid cancer. I’m now fine, but on medication for the rest of my life. We’re not bankrupt, because of the ACA. We didn’t have to worry about being denied coverage because of a pre-existing condition.

    We are thinking long and hard about returning to either Ireland or Australia if this health bill or anything like it passes. We’d face higher taxes and imperfect health systems, sure, but also healthcare we can access. And some other country can benefit from the money we import.

  92. As well as being a moral abomination, the bill is horribly short-sighted. Think of all the small businesses that won’t be started because people can’t get health coverage, the lack of mobility caused by being tied to your work by health insurance.

    Those are not bugs, those are features. To those high on the ladder, upward mobility is a threat. Plus, raising the cost of quitting keeps the bargaining power of the peons from becoming a problem and, of course, they have one more reason to do anything to please you and avert your wrath. Which is sweet.

  93. I will briefly add a link to my post on the essential fascism of the bill: The Culling of the Unfit. It’s really not just about taxes: someone, several someones,has a vision of a purified American with women enslaved and without black or brown people, without weakness or illness.

    So this is only the beginning. We need to find out whose idea this was and fight very hard.

  94. One one extreme we have universal health care / single payer health care for all with many expecting a free ride. On the other extreme folks propose no government involvement in health care and each individual pays for the full insurance cost to the insurance company of their choice, but with few exceptions for those who truly cannot provide for their own health care. Obamacare reached too far to the left and is proving to be a failure. The GOP crew is struggling to pull Obamacare back at least some … and likely too far to the right extreme. We truly need to find a point in the middle that can be supported by most Americans. Maybe the GOP folks need to have their say for a time to result in an eventual compromise position more acceptable to a majority.

  95. As long as our politicians work for Big Money Corporations, what is good for the country won’t matter.

    ObamaCare is in no way too far left. It is a Republican plan, written by the Big insurance companies which is disliked because Democrats and Obama took credit for it. Every other modern country has a health care which gives far better care (for the nation) at far less cost.

  96. “One one extreme we have universal health care / single payer health care for all with many expecting a free ride.”

    How is ‘what most countries do’ an extreme? There’s so much further you can go beyond universal health care; how about in-home births with midwives who come out, as France does? A baby kit issued to every child, like Finland? Coverage of increasingly expensive tests and procedures? And you’re conflating ‘universal’ with ‘single-payer’ healthcare.

    The problem with ‘one the one hand/on the other hand’ kind of thinking is that sometimes, one hand is completely wrong. There’s no effective free-market solution for healthcare because there’s no way to induce meaningful competition. That’s why the Republicans have had eight years to come up with an alternative, more effective plan, and the only thing they came up with, in all that time, is repealing the previous one.

  97. The ACA is RomneyCare with some tweaks for a national market; the GOP has used their own pro-insurance industry concept as a way to gin up their PWT tools for a decade… and those same pissants who voted for a draft dodging blowhard will bend over and beg to be a tool because they like it that way.

  98. @Gary, Obama did not pull too far to the left, he basically implemented the healthcare plan devised by the Heritage Foundation, a conservative think tank, in response to Clinton’s plan to change healthcare, and was originally implemented in Massachusetts when Mitt Romney was governor. What happen next was that in order to ensure that Obama would be a one term President, the Republicans castigated the ACA because it was big and complex and until it actually got implemented, it was easy to fear monger against it. Once the Republicans gained control of the House, they immediately started stonewalling the implementation, preventing and substantial corrections to the implementation, and ultimately defunded a couple of provisions that would have help stabilize the markets in states that are having issues. The GOP is basically attempting to completely defund the ACA (under the guise of returning Medicaid to the states), which will probably bring us back to worse than it was when the ACA got implemented because of the deep cuts to Medicaid and the other stuff they’ve been doing to break the ACA.

  99. All this money talk and no mention of the science of happiness….since the richy richy already have all the bottom of Maslow’s pyramid ( in spades) starting with food and shelter, what is left to want but happiness?
    A bigger car or house or six golf club properties or exclusive hotels, according to studies, does not really do it. Like rats still looking for cheese they already have all this climbing over each other to get more and I do not see one genuinely happy, freely open joyful face.

    Who looks happy? In the rich set it is Warren Buffet and Bill Gates. Giving it all away and feeling genuinely happy. Oh, and John. He looks happy, but then he has Krissy in his corner, so he shoiuld be.

    According to social scientists, that is predictable. Making others happy makes us happy. Plain and simple. We are wired that way. When you start any recovery program a major part to regain a healthy mind is to practice thinking of others.

    So paying taxes, when I know it pays for Headstart, low income housing and health care, medical clinics, National Park Rangers, NASA, medicare for my grandmother, medicade for that injured neighbor, FEMA when the tornados rip up crop barns and schools….well, it is a good thing that my tax money buys. And I am happy.

    It is not my job to decide who deserves it. It is my job to share my good fortune and be grateful.

  100. The ACA wasn’t perfect. It was a bit of a kludge in order to try to satisfy as many people as possible and court Republicans (though that didn’t work, and at this point never does and should probably be discarded as a goal of any productive legislation.). It could certainly stand to be improved–a public option in every state would be a nice start.
    But it’s miles better than anything a Republican president/congress is going to offer in this political climate.
    The next step (for those of us in the US) is to put pressure on our Senators. Monday morning bright and early call your Senators–you can use the Congressional Switchboard number; they’ll be able to put you through: 202-224-3121. If you have phone anxiety, you can e-mail; look up Senator’s e-mail addresses here: https://www.senate.gov/senators/contact/
    If your Senator is a coward who isn’t taking calls, write a letter to the editor of your local paper about how your Senator is out of touch and deliberately turning their back on their desperate constituents. Groups near you will be organizing protests: your local Indivisible branch is likely to have some idea where and when.
    We don’t have to sit still for this.

  101. “Don’t come at me with “but the rich earned those dollars.” ”

    I never understood this argument. Everyone earned their money. Everyone pays taxes. There seems to be an implied intent here that they earned it *more* than poor people did, so the poor should pay taxes and the rich shouldnt.

    Its almost as if people making this argument lack any empathy and simply cannot view the world of people as their fundamental equals.

    You know, sociopaths.

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