When telephones began to appear in American homes and businesses physicians were one of the early adopters. As health insurance began to spread patients became more reluctant to pay out of pocket for services not covered by their health plans. For their part, health insurers were reluctant to reimburse for services outside the usual and customary practices. At some point midcentury doctors stopped routinely talking to their patients on the phone because nobody wanted to pay them for the service. If you stop and think about it nothing could be more inconvenient – and antiquated – than having to make a doctor’s appointment to record routine health information. What if your car speedometer could only reveal your speed once you pulled back into your driveway, and then only one snapshot in time during your most recent trip. Over time payer reluctance to reimburse for telemedicine began to slowly change and covid accelerated the transition.
Category: Public Insurance
Biden’s New Tax Proposals
The Biden budget would … apply a 3.8% tax to pass-through income of more than $200,000. (Didn’t Mr. Biden promise not to raise taxes on Americans earning less than $400,000?)
Mr. Biden also wants to increase the surtax on earned and unearned income [from 3,8%] to 5% for couples earning more than $450,000 ($400,000 singles). On top of that, he calls for raising the top rate on ordinary income to 39.6% from 37%. This would raise the top effective marginal rate to 44.6%, and it would kick in at $450,000 instead of the current $693,751.
It gets worse. Mr. Biden also wants to apply the top 44.6% rate to capital gains for anyone earning more than $1 million—effectively doubling the current 23.8% tax on capital gains.
Pile on state income taxes—which reach as high as 14.8% in New York City and 13.3% in California—and many Americans would pay nearly 60% of their income to the tax man.
Saturday Links
- What a ransomware cyberattack is doing to the heath care system.
- Almost every government intervention in response to Covid was wrong.
- Biden’s budget: no plan for Social Security.
- Canadian health minister: You have a duty not to purchase private care: “Going and paying your way out of your circumstances creates a terrible malady for our system.”
- After the collapse of cost-plus financing, private payers began to pay the same way Medicare pays.
Another Example of How Hospitals Employing Physicians Harms Patients
In the game of who can gouge patients and employer health plans more, hospital systems are mailing their physician employees’ patients ominous news, hoping to force insurers to pay more for services. Your physicians likely do not share in any higher fees, although you may have higher cost sharing for their services. I have yet to get such an email or letter in the mail, but I have read several articles over the years when various Dallas-area hospital systems talk to the media about dropping BlueCross of Texas or something similar.