I went to stay with an old friend and his family for the 4th of July holiday weekend a few years ago. The house next door was a little overgrown because my friends’ neighbor had gone into a nursing home. A year or so later I was back visiting for the weekend when the neighbor’s son was moving into the house after his father died. I heard a similar story with a neighbor of mine, when both parents spent time in a nursing home before they died. When the last parent died their only asset was a house, which was later sold, and the proceeds split among their offspring. In both cases I wondered why the state was in the business of protecting inheritances for families who turned to Medicaid for their parents’ long-term care.
Category: Public Insurance
Tuesday Links – 19 March 2024
- In testimony before the House Ways and Means Committee, the Alliance for Connected care rebutted three myths:
- Telehealth Does Not Lead to Increased Fraud
- Telehealth Has Not Been Shown to Drive Overutilization
- Telehealth Has Not Been Shown to Increase Spending
- Older patients with diabetes do better if they have the means to pay for care (health insurance, higher income or higher wealth).
- For years contraceptives could only be sold by prescription. People can now buy oral contraceptives on Amazon.
The Good (and Bad) of Remote Patient Monitoring
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.
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.