It is both simple and complex: Taxes and the very wealthy

[nate]

These were family practices that only had one person doing it to go with one doctor

[mp170.6]

These were family practices that only had one person doing it to go with one doctor

 

My family practice doctor has two women handling insurance claims full time.  That's in addition to another lady answering the phones and making appointments. 

 

One person office staff might be common in lower volume offices, but definitely not where I go. 

[Jay]

I ran into that Rx issue before.  Once I filled a prescription at Walgreens, it was about $8.  I went to Walgreens because my wife broke her arm and she needed pain meds in the middle of the night. Generic hyrdocodone I guess.

 

A couple of weeks later I went and filled it at our local mom and pop pharmacy, they said it was $13 or something.  Same exact prescription. So then the woman says let me check and see the price without your insurance and then magically the price dropped to $8.

 

Not sure what was really going on there.

[nate]

If all this is true, why don't insurance companies send mailers and get the word out, so customers don't get ripped off at the pharmacy?  As you said, it's very common. 

 

They do in fact.  Interesting that you mention that because one of the biggest efforts by my company and most major insurers the last few years has been member education.  We have majorly reworked our SBCs and send out basic plan information in a separate postcard.  We also post the information online and have online tools to estimate costs as well as ways to lower costs.

 

One thing that we have been doing is partnering with pharmacies to offer lower rates and easier pickup/claims.

 

We have found that blasting mailings and calls are not very effective.

 

Also, in the situation that occurred with you, my company if it identified the issue or if you called in we would issue a check to you for whatever extra you paid.  We would then rework the claim with the pharmacy to get the money back that we sent you.

 

The other problem with plan documents is that they are still legal contracts that are regulated and approved by the DOI so they can only be so simple.

 

If you have suggestions though I would like to hear them.

 

One other thing for everyone here with health insurance... our call centers are always there as member advocates.  It greatly benefits health insurance companies to have educated members.  We have nurses on staff, etc to tell you if you should wait for an apt or go straight to the ER for example, or if there are alternatives to the expensive prescription drug your doctor just prescribed you, etc.

 

I can only speak for my company but I know the other major companies have made similar efforts.

[nate]

My family practice doctor has two women handling insurance claims full time.  That's in addition to another lady answering the phones and making appointments. 

 

One person office staff might be common in lower volume offices, but definitely not where I go. 

 

They likely have not embraced technology or maybe the Dr just wants to employ more people...

[Tank]

I don't have a "tax policy," mt - except that the wealthy should be taxed more, in some cases much more, and this wealth re-distributed downwards. But I wouldn't stop there. I would also scrap Obamacare (which sucks, imo) and replace it with a single-payer system, paid for the wealthy. Free health care would help the middle class immensely. As would improved infrastructures, and other domestic improvements that could be made with all the billions I'd be Robin Hooding from the wealthy.

 

I have no idea about specific tax plans or policies. I'm speaking in general principles. If there is a way we could reduce taxes for the middle class and not take away from social programs, then of course. But I also see nothing wrong with all of us pitching in on public and social services, and I have no problem with paying money that helps those in need.

 

you know how society gets pissed at wealthy people who hide their money off shore so it won't get taxed? well what do you think is going to happen if the tax rate for upper wage earners increases?

 

one thing about the wealthy - they don't like other people trying to take away their money. i don't think the middle class is too keen on it, either.

[Tank]

You missed the first part of what I said.

 

Teenagers younger than 18 get stuck paying taxes they have no say in.  They can't vote and our lawmakers don't care what they think anyway.  Hence, the "taxation without representation" reference. 

 

The same argument could be applied to people who are mentally incompetent due to age or disability.  The state sales sax is punitive enough; adding a Federal sales tax on top of that would be awful. 

 

they get a say when they're old enough to vote, just like the rest of us.

 

i don't think this is a significant issue, to be honest.

[Tank]

They likely have not embraced technology or maybe the Dr just wants to employ more people...

 

i would imagine the volume of patients has a great deal to do with how many people work in the office. i'm sure a doctor in glendale is likely to see more patients daily/weekly/monthly than a doctor in mequon, wisconsin, for instance.

[nate]

i would imagine the volume of patients has a great deal to do with how many people work in the office. i'm sure a doctor in glendale is likely to see more patients daily/weekly/monthly than a doctor in mequon, wisconsin, for instance.

 

Not really.  One doctor can only see so many patients per day.

[Tank]

if a doctor's office has four doctors working in it, then the volume of patients is likely to be higher than an office with only one doctor in it.

 

i feel like i'm stating the obvious here.

[nate]

Right... I was talking about single doctor family practices.

[Tank]

okay, we got it straightened out. 

 

i still think it all depends on volume and that's going to depend on location. 

[nate]

Yeah.  We also had 2-3 doctor practices in our work group.  None of them had more than 2 assistants.

[Blarg]

teachers are forced to pay athletes salaries just by subscribing to cable since it's not an a la cart system.

I get charged for local sports access separate from my base fios services. Had the same surcharge when we had dish network. Maybe you should read your bill more closely or quite stealing the neighbors.

[ten ocho recon scout]

The problem with flat-tax, Stradling, is that the poorer you are, the worse it is. Let's say its 20%. If you make 40K a year, your salary goes down to 32K, while if you make 200K a year, your net goes to 160K. Clearly the person making 40K is more impacted by the flat-tax than the person making 200K.

Again, the country was in much better shape when the very wealthy were more heavily taxed. I'm not saying go back to 90%, but it should be much higher at the top and taper off.

gonna play devils advocate with you here AJ (and let me preface by saying i agree with your views on this a lot).

While it may be true the flat tax hits the lower income harder, what really is the "fairness" of changing that? Meaning, why is it ok for someone whos making good money to get a specific chunk taken from them but not for one on a lower income. Especially when considering what taxes go towards (hospitals, police/fire, schools, roads etc), is it accurate to say the higher incomes are getting more out of the system? In most cases id say its the opposite.

A little off topic, but while there are of course people born into privileged lives who got a head start, thats not always the case. So the message becomes almost "you can work hard and make more, but youll lose more to taxes than if you stay where youre at". I get hit harder for overtime almost to where it becomes standard rate after taxes (40 percentish tax rate on OT). I dont get why i owe more for working more.

Again, i lean a lot towards what you are saying. I believe the taxes need to be adjusted from where they are now. It would likely benefit the nation as a whole, so im for it. But i still cant think of a reason why either i or my neighbor should pay more into taxes based on income. If we live next door to each other (and i have no idea what my neighbor makes or really does for work, just making up a scenario), we both recieve equal service. Our kids will go to the same schools, the same fire department will come if our house catches on fire, the same road leads to our house.

I cant give an answer to fix it, im not nearly as up on it as a lot of you in this thread. I just dont see why someone should almost be punished for being more successful thn someone else

[arch stanton]

For those who wonder why I work overseas, Form 2555 is a great document.

[ten ocho recon scout]

in police academy 2, when steve guttenberg was arresting someone, he told them "you have the right to cable tv. you have the right to sing the blues."

so yes.

damn, nice pull tank

[juansavage1]

Funny how some nostalgia for the fifties is ok.

[Stradling]

Funny how some nostalgia for the fifties is ok.

Not funny really. Just because you prefer archaic and hateful nature of yesteryear doesn't mean we all should.

[juansavage1]

The left's primary concern is equality of after-tax income. That preoccupation will lead to a lot of stupid, unfair decisions.

Think of any service you contract or product you buy or organization you join or course you take. Do you want their operating principle to be equality?

As long as people got their money honestly, who cares if they make more?

Edited December 22, 2015 by Juan Savage

[ten ocho recon scout]

I'd say mostly everyone under 250k is overtaxed. My parents made maybe 40k combined when I was in elementary school and now 20 years later they crack 200k. Their lifestyle is modest and they keep up with housing rentals just for the write-offs, no profit.

Married young and had kids too quickly they are rags to riches. But if they didn't have my grandma's 600sf guest house to raise me and my brother they never would have been able to educate themselves to get to where they are today. They would've been stuck working 2 jobs in order to pay the rent and daycare bills. They couldn't have set money aside to buy a starter home, which became a bigger home, and then a brand new huge house. The money they've made off personal equity since the mid 90's is enough to retire on.

Point is they were both LUCKY and smart, but still couldn't have done it without family support(free shit). Not everyone has a family foundation to lean on and we can't have families starving in the streets when they could be our doctors and sheriffs.

thats a very good point, and one a lot of people miss. If youre in a bad situation at home its a lot tougher. Not ompossible, but tough. And like you said, your parents had the help of someplace to stay in order to save money (and do better later in life).

At the same time, if your parents didnt have that support, IMO a big part of that is on them (obviously using your parents as a hypothetic here, not pointing fingers at your parents in real life). What im getting at is that i understand people make mistakes and have a kid too early, but its a personal choice. Ive lived most of my life as a bachelor and have found condoms to, well, do as theyre advertised. People who have more than one kid too early made their own bed. Again, your parents (and others like them) at least had family to help, and i dont have a problem with that. The same as if someone lives at home in their 20s to go to school. But i think society more than adequately gets the message out to people (from an early age) to wear condoms, not do drugs, etc. For those who choose to ignore that, thats on them

[ten ocho recon scout]

People are seals in the water. Land is success. The shark is cold reality. Whats the difference between the seal's success or cold reality?....

Nature has a plan, and sometimes it sucks.

[mrwicked]

f*ck taxes.

[juansavage1]

Not funny really. Just because you prefer archaic and hateful nature of yesteryear doesn't mean we all should.

Ooh, hater. Good argument. 

[Schildog]

I get charged for local sports access separate from my base fios services. Had the same surcharge when we had dish network. Maybe you should read your bill more closely or quite stealing the neighbors.

Yeah I don't get charged that with uverse. So suck my balls.