Peak United States

How do we know if we’re in decline? What are signs of slippage? Do mirrors help? What about comparisons to other people and places?

What psychological barriers prevent us from acknowledging our decline?

Why, despite being very well educated and very comfortable with numbers, do I not understand our tax system well enough to prepare my family’s taxes? Why do I have to pay an expert to prepare them?

Why are there 1,000+ deductions? Why is Congress so susceptible to accounting firms’ lobbyists? And realtors’ lobbyists? Why hasn’t there been meaningful tax reform since 1986? Why does our tax accounting system benefit members of Congress more than their constituents? Why do well-to-do, stock owning citizens, pay less in taxes than others? Why do most other developed countries have far more simple, fair, and efficient tax systems? Why aren’t more people agitating for answers to that question? Why have citizens allowed their representatives to defend the status quo for 30+ years?

Why, despite being very well educated and very comfortable with numbers, do I not understand my health insurance? Why am I told what my doctor visit, biopsies, surgical consultation, and minor surgeries all cost a few weeks afterwards? What if restaurants didn’t have menus, but instead, just told you what you owed after you ate? Why are there initial charges and secondary “what insurance allows” charges? Why does Kaiser-Permanente make me go to a “surgery consultation” when the surgeon said it was unnecessary, “but Seattle won’t let us do our own scheduling”? Why was I charged $206 for the unnecessary 20 minute “consultation”?

Why is Congress so beholden to medical insurance lobbyists? Why do many other developed countries have far more simple, comprehensive, and efficient health insurance systems? Why are so many citizens resigned to health insurance pricing and paperwork lunacy? Why do citizens continue to elect representatives who preserve the medical insurance status quo?

How does anyone of sound mind claim that the U.S. is “the greatest country on God’s green earth” when our tax and health insurance systems are fucked up way beyond our compromised legislative body’s ability to fix them?

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Sentences to Ponder

From Three Reasons for Those Hefty College Tuition Bills:

According to the Bureau of Labor Statistics, in 2014 the median worker with a bachelor’s degree (and no advanced degree) earned $69,260, compared with $34,540 for the median worker with only a high school diploma.

From Federal Health-Insurance Exchanges See Nearly Six Million Apply for 2016 Coverage:

Analysts said lackluster enrollment that trends toward sicker and older consumers could prompt some carriers to leave the exchanges: The biggest U.S. health insurer, UnitedHealth Group Inc., said last month that it is re-evaluating whether to sell plans on the marketplaces because of losses on policies sold on them.

From The home-grown threat:

Since 9/11, over 400,000 people have been killed by gunfire in America and 45 by jihadist violence, of whom half died in two shootings: one carried out by a Muslim army doctor in Texas in 2009, the other in San Bernardino.

[Highly recommended. The single best ISIS-related thing I’ve read in recent weeks.]

 

What the Affordable Care Act Gets Wrong

Poor form to be contrarian following a week liberals can’t stop celebrating, but count your blessings I’m done writing about golf. For now at least. I always reserve my right to tap my inner Alan Shipnuck.

Thursday night near the end of another spirited training ride. Soft spinning on North Street, two friends and I head for home. One is a well-to-do 59 year old who just retired. His very nice lake home is paid for and he and his wife just returned from another trip to Europe. Euro vacations aside, as his threadbare cycling gloves illustrate, he’s actually on the frugal side. He says he can afford the vacations because of the gloves. Decades of having made very good money no doubt help too.

“You’ll never guess what medical plan I’ve signed up for,” he says. “No clue,” I replied. “Medicaid!” “Wait, you’re 65?!” “No, I’m 59, that’s Medicare. I was surprised to learn I qualify for Medicaid because I have no income now.”

Quick google search. Medicaid is “a U.S. government program, financed by federal, state, and local funds, of hospitalization and medical insurance for persons of all ages within certain income limits.”

I was stunned. He told me a person can make about $20k/year and still qualify for Medicaid. He hardly has any capital gains because he hasn’t sold any assets for a long time. Apart from his international vacations, I’m guessing his expenses are minimal and he’s living off of savings that he previously set aside. I’m not sure how he’s sheltered his wife’s income.

Then he tells me the adult son of a mutual cycling friend is also getting “free” Medicaid despite the fact that he has a very large trust fund that must consist of tax-free municipal bonds.

Undoubtedly, if my friends are doing this, so are other high wealth/low income people. Especially those whose income stems largely from tax-free municipal bonds. Why isn’t anyone writing about this gigantic loophole and what we should do to close it?

More generally, why does the Affordable Care Act (ACA) use income as it’s sole reference point instead of some combination of income and wealth? The same can be asked about the IRS and college financial aid offices. When it comes to health care premiums, college financial aid, and taxes more generally, it’s far better to be wealthy than to have lots of income. Just ask Mitt Romney. My guess is, and I’d love a more tax savvy reader to enlighten us on this, IRS agents, ACA bureaucrats, and college financial aid officials are unable to determine people’s total wealth with any certainty.

Why not ballpark it though I wonder. If the government knew my friend owned his home outright, would it compromise his Second Amendment rights to privacy? How do we balance well-to-do people’s right to privacy with public policies that, through subsidies, take from those of modest wealth and give to those with considerably more?