Can someone logically explain this?
Tuesday, July 25, 2017 9:16 PM
I was reading an article Bernie Sanders proposed for a single payer health care that would supposedly save money for middle class Americans. I'm not understanding the math.
Here is a link.
http://www.politifact.com/truth-o-meter/…
Basically Bernie proposes all kinds of taxes to pay for everything but let's say you add a 12% payroll tax on a worker making 70,000 a year and Bernie says this will save the worker thousands a year in health care. He is currently paying $147 per month because he is single and this also covers some life insurance and vision and dental so medical alone is more like less than 1000 a year because his employer is covering most of it.
The payroll tax increases decreases his net pay 12%. Let's just say 10% tax. That's $7000 less per year. He was only paying about $1000 a year for medical before Bernie's big savings. Now he's paying an extra $7000. If the company was paying an extra 6000 per year to cover the employees medical that's only near break even assuming the employer passed along the savings in medical.
Does the math make sense to anyone other than a Bernie supporter? I read elsewhere Bernie planned to raise a bunch of other taxes just to help us out since he's such a nice guy and we don't need pay checks anyway. Just give it all back to the government. Actually I did read a single payer system might reduce administrative expenses 10% but that would be if our government ran efficiently. If you thought congress ran efficiently, bernies plan has a chance to save some money.
Here is a link.
http://www.politifact.com/truth-o-meter/…
Basically Bernie proposes all kinds of taxes to pay for everything but let's say you add a 12% payroll tax on a worker making 70,000 a year and Bernie says this will save the worker thousands a year in health care. He is currently paying $147 per month because he is single and this also covers some life insurance and vision and dental so medical alone is more like less than 1000 a year because his employer is covering most of it.
The payroll tax increases decreases his net pay 12%. Let's just say 10% tax. That's $7000 less per year. He was only paying about $1000 a year for medical before Bernie's big savings. Now he's paying an extra $7000. If the company was paying an extra 6000 per year to cover the employees medical that's only near break even assuming the employer passed along the savings in medical.
Does the math make sense to anyone other than a Bernie supporter? I read elsewhere Bernie planned to raise a bunch of other taxes just to help us out since he's such a nice guy and we don't need pay checks anyway. Just give it all back to the government. Actually I did read a single payer system might reduce administrative expenses 10% but that would be if our government ran efficiently. If you thought congress ran efficiently, bernies plan has a chance to save some money.
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I was just wondering if anyone here knew the breakdown and if Bernie's numbers made any sense if you didn't add taxes to everything and everyone else other than a payroll tax increase. Other nations pay a lot less per person so I thought what could we do different?
Now if employers do spend 12000 per single employee per year on health care, a 10% tax increase could result in an even bigger pay increase to offset the big tax increase. I'm just asking. Not sure if anyone here knows how much employers pay for a high deductible plan. Probably only a concern if denocrats take over full control in 4 years and it's up for debate again.
However if someone could explain a method to reduce costs that even a congressman or congresswoman could understand it, someone could tell them. A method using valid numbers and lots of examples. Obviously our current congress isn't interested in universal health care. Saving money though, yes they are. I suspect Bernie used fake numbers but I was wondering.
Concerning healthcare, is it any wonder that Congress exempted themselves from the Obamacare mandates? I don't have the answer, it's very complicated, but I can't imagine the government being the solution.
It my simplistic way of looking at it, it comes down to competition vs. no competition. You just have to allow competition to exist.
Also, smaller companies can form a consortium that can negotiate for the larger pool. Insperity is an example of a company that includes this as part of their outsourced HR service offering.
I found an interesting comparison on Medi-Share and Samaritan Ministries that are supposed to be kind of like that:
http://samaritanministriesreview.com/sam…
It looks like they both control costs by excluding certain lifestyle-related conditions such as from drugs/alcohol.
I have health and dental from the exchanges now, and really, the only use they have been so far has been their negotiated rates with providers. I think the dental plan might have covered my second cleaning this year, but for the first one, there was a waiting period so they wouldn't pay for anything.
Having lived in Canada and tried to see a doctor there, I would stay away from any Bernie Sanders plan. I remember talking to a guy who was super pissed that his girlfriend had to wait two days for a gallbladder surgery. I looked it up and in Canada it was something like a 4 month wait, and in the UK was 6 months.
Food for thought why not demand that Congress pass a law that requires them to abide by and live with whatever laws and actions they enact on us.
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Probably a valid point. Lady who cuts my hair is from Germany, and she tells me the German healthcare system has both a private insurance market and a government-run component. Everyone must have health insurance and there is something like 8% payroll taxes on every employee. I think the UK also has a private insurance market. Having both allows affluent people to buy their own insurance and have the best doctors and surgeons.
I think MDs should be very highly paid, and having single-payer (only) might push doctors into the middle class. We don't want that. The best doctors and surgeons should have the option to opt out of the government-run system. OTOH, there should be some type of medicare-for-all so that the poor do not end up dying in the emergency room.
We spend way too much of GDP on healthcare. Something has to be done. Obama tried his best to appeal to the GOP with this Romney-like system, and it's not working.
Your past 2 comments directed towards me... I agree, you are preaching to the choir there.
Sixty-eight times Trump has promised to repeal Obamacare:
https://thinkprogress.org/trump-promised…
Sure didn't happen on day one. LOL!
It really is a complicated issue. Just went through the process of finding an orthopedic surgeon for my wife, and having the option to chose a doctor anywhere in the country was wonderful. And he did the surgery within 3 days of arrival. With *only* single-payer, you're not going to have that kind of choice or service.
An extra 10 or 12 % tax taken out of a paycheck if say the pay was 70000 would be minus 7000 in pay, employer could bump up pay by 400 or so a month so that Bernies plan would increase the amount I spend on health care. I thought his numbers didn't make sense. That doesn't even include copays and deductibles I would probably have to pay as well for actual visits.
The problem is insurance costs as charged by insurance companies keeps going up. In the last several years, I probably visited a regular doctor only 3 or 4 times yet I'm spending thousands. Insurance cost is too high in this country. Congress should come up with a plan for everyone legally here and then have an optional plan for everyone to pay extra for better faster care and then congress lives by it as well. They are in charge. They are the plumber on call to fix the problems. They own it. Trump owns it whether he knows it or not. They are being stupid if they think they don't. They need to do the right thing even if it costs more then work on tax cuts that get paid for with extra economic growth. Just my two cents.
Ya got that right, @Shark, exactly. Problem is that Trump only thinks 140 characters at a time and he doesn't know what the fuck he's talking about.
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Last post, and I'll stop dominating the discussion.
I think that's not true. Democrats would be more than willing to fix the failings of Obamacare. But that requires more funding from taxing the top 2% ( a lot of this money comes from taxing certain capital gains). It would make the GOP look incredibly foolish after railing against Obamacare for 7 years.
U.S. spends, what, 1/6 of GDP on healthcare. That's 16.7%. Senator Sanders was suggesting a a 12% tax for Medicare for all. Which is about 70% of what we spend as a nation, back of the napkin. So it seems "in the ball park." Yeah, we as a nation spend too much.
The low HDHP both you and I see, are probably because we are healthy, young, don't smoke tobacco, don't see the doctor, aren't suffering for 2 or more chronic diseases (i.e., allergies, borderline bloodpressure or cholesterol, depression, diabetes, COPD), nor do we have a BMI of 36 or whatever the typical American has.
add:~35%, for tobacco numbers
Employer contribution:
HDHP(HSA eligible), single: 4600-5700/yr (less this year)
same, but family: 12300-13000/yr (less this year)
Employee contribution:
HDHP, single, $32/bi-week(was $70 more, last year)
HDHP, family. $70/bi-week(Was $70 more, last year)
$3200 deductible single, $6500 deducible, family
new for 2017, employee will make employer contribution to HSA, half in may, half in nov:
$750/single, $1500 family.
my contribution is still $35/bi-weekly (the price difference to me between HDHP and PPO 2 years ago).
Employer contribution:
PPO, single: 6000/yr
PPO, plus spouse, 12000-14000/yr
PPO, family, 14000-17000/yr
Employee contribution:
PPO, single, $64/bi-weekly
PPO plus spouse, 129/bi-weekly
PPO, family, $194/bi-weekly
tobacco numbers are ~35% more.
Politically, I think Democrats would like to fix the system, but I don't think they know really how in a way that would, culturally, be acceptable to the American people. I don't think the British NHS would work here, there are details about it that would horrify Americans. Even the Canadian centralized system would have problems here. On the other end, Republicans and Libertarians are in a fantasy land where the magic-of-the-market will fix all of the problems.
The ACA was the Democrats attempt to implement the Republican system (Romneycare), but without the public option, to get 60 votes. But if Democrats could get credit for implementing the republican's best ideas, why would anyone vote republican, lol (*ducks*).
Medicare, for a government run system, is rather popular, culturally acceptable to most Americans, and already in place. We could, if we wanted to, roll the other federal programs into it (Congress, Medicaid, *maybe* the VA), raise taxes ~12% to pay for it. Even with the increased tax bill, most Americans would probably come out ahead, including the $70,000/yr income example Sharkhunter gave. Of course, the system would still allow for the Tuscl $350K club with Money, who want better care to be able to buy it, much like today where those over 65 with money can pay for better care if they want it. Avoiding the "Why can't I buy what I want with my own money?" cultural problem that just about every other nationalized (socialized) healthcare problem would have if implemented in here. :)
Workers Compensation Insurance, closely related to health care costs are astronomical that are imposed on businesses large and small, they pay out only if forced too and there is a legal component to this which is rife with fraud and so many abuses its disgusting.
Auto Insurance rates skyrocketed in the last 14 years, if you have the audacity to make a claim for a loss that you have paid for they hit you with additional costs, damn they pull credit reports and cherry pick customers, redlining as needed to suit their profits.
Home owners Insurance, one of the worst offenders of all, you paid for the coverage the amounts are spelled out in your contract that won't prevent them from denying a claim on a technicality, if perchance you get lucky and they offer you a settlement for your loss the amount offered is usually not enough to cover the loss incurred, most home owners when pursuing a claim need to hire an adjuster just to get a fair shake from the Insurer that has already pocketed their money.
There are many more types of insurance and I don't have the patience or energy to go into more detail than I have so let me just wrap this up and make my point, the Congress of the United States , the Senate and most of the other branches of government has been purchased lock stock and barrel by the consortium of insurance companies that have been stealing premiums from the ratepayers for years and until we get a real sheriff in the White House and some Honest Representatives, this is going to continue unabated and our health care system will never be available to help American citizens wholeheartedly until these thieves are run out on a rail !
The hospital or clinic "chargemaster" must be an evil person, who was bullied in school. To make up rates like those most get billed ...
I'm with sharkhunter, in the near term, I see HDHP+HSA at he only viable way for the individual to have a say.
Most of Senator Sanders' "free stuff" for millennials wouldn't have passed Congress. I don't think free college and free healthcare is possible, but I at least the guy might have had our backs. Too many of the young people think that socialism is some happy hippy version of sharing rather than the dark reality.
Too bad we can't send corrupt, bought'n'paid politicians to jails or death row. It might send a message. Ditto for corrupt corporate executives. Martha Stewart seems to have a better attitude after going to Camp Cupcake for 9 mos.
Employer contributions, $1500 deductible family, 2 million lifetime max, 9 month grace period each year for pre-existing conditions w/e we switched plans to 'save' money
PPO, family, 8000-12,000/yr, healthy, typically employee
PPO family, for pre-existing conditions: 24,000/yr (typical), some 48,000/yr or 54,000/yr (!!).
PPO family, for "uninsurable" persons: one was $180,000 (60+ yo male, active but health problems, one of our 5 founders of the company). another was $240,000/yr, 60+ yo male, cancer survivor, one lung removed and only 2/3 of other lung left, lung issues unrelated to cancer, another one of our 5 founders.
I did not misplace the decimal point.
We were happy to had the two highest premium candidates off to medicare, when we could. Back then, I doubt an insurance co would insure them outside of a group plan (pre-Obamacare).
For the 180,000/yr and the 240,000/yr guy, the employee contributions were the same as everyone else.
Wasn't it Margret Thatcher (and TiredTraveler) who said, "The problem with socialism is you eventually run out of other people's money."
We need a system that can handle cancer treatments. Not sure what to do about the "pre-existing conditions" people. We used to pre-Obamacare, pay like 24K-54K/yr for some of these people. It was insane. I think "pre-existing conditions" might just be a euphemism for "I need someone else to pay for my healthcare for me."
Most of those people, when I would chat with them, had at least one chronic condition that required ongoing care or medications. Many, themselves, often got to the 7-8% MAGI where they could start to deduct healthcare expenses on IRS 1040 long form. So, they would grateful for any assistance they got from us. They knew any help was a blessing.
My worry with single payer (Bernie's medicare for all) is if I pay my 12% tax on my $60,300. Does that mean I get *unlimited* healthcare for that 12%? If so, people are going to opt for surgery as Plan A (and a magic cure) maybe a lot of Opiods and skip past "cost effective" Plan B things like physical therapy, personal strength exercises, and leaning to survive with a little pain?
Although it was fiction, recall the A&E television show "Breaking Bad" was about a HS Chemistry teacher who starting selling meth in order to pay for his cancer chemo treatments. Sort of funny, if that's the solution to spiraling costs.
Shark, what did you pay for your last Dr.'s visit? Mine was a clinic, where I finally gave in after 5 weeks with a nagging cough. It was a viral infection (no antibiotics), but I did get a steroid Rx. That helped. $50 copay, visit was $230, I got a kick back 8 weeks later saying I owed $130 more. So ins only covered $50 of the $230 bill. I should have just paid the cash price: $172.50, would have been slightly cheaper that way. Live and learn!
https://www.vox.com/policy-and-politics/…
We spend more on health care than the other industrialized countries do, with their Universal Health Care, covering everyone. Emergency Room care is universal, it is reactive and inefficient, it is expensive, and it is medicine designed to prevent litigation.
Wages are not etched in stone, but nor do they appear out of a vacuum. They are negotiated in a competitive market place. Now taxes can be applied in various manners, but the wages will be renegotiated to accommodate this.
So taxes on employers are usually really taxes on employees. Taxes on employees reduce their numerical pay, but they also take market pressures off of housing costs and the costs of keeping up with the Joneses. And then when the government gets money, it does not use it to inflate the stock market or deposit it into tax free havens. It spends it. And this creates jobs and market demand for goods and service. Likewise any increase in the money in the hands of poor people, also gets spent.
The real issue is just what portion of the GDP is the government.
This is the Keynes issue.
https://en.wikipedia.org/wiki/Keynesian_…
And then once you have decided on such matters, then how the taxes are applied and how the post tax pay is distributed, can then be decided.
So if you say that a guy getting $70k of gross pay will now be paying an additional 10% tax, this does not mean that his market adjusted disposable income or his standard of living will be reduced by that much. It may even be improved. Most of these things are set up as downwards wealth transfers.
And then, what kind of a world do you want to be living in, one where things might be okay for you, but where lots of people have nothing, except the sight of cops and civilians with guns, keeping them in their places?
SJG
News Flash: Steve Bannon was influenced by the notorious fascist occultists Julius Evola and Rene Guenon, and related groups of reactionary Catholics.
https://www.democracynow.org/2017/7/26/j…
I had great insurance as a union member and continued to pay union dues until I was no longer able to be covered in Florida by the union, I do have a quality health plan but still nowhere as cheap as what you are stating.
Health should be a right, not a privilege.
Everyone can see Health Insurance is a scam.
The health industry should not be a for profit industry, where 90% of the money is profit and administration, and only 10% goes to dealing with the health issues...
https://www.vox.com/2017/7/28/16054694/s…
LOL!
http://www.cbsnews.com/news/senators-rec…
One last point this president promised us cheaper and better health care he has not delivered on either, cheaper, or better, that isn't fake news either.
It's well known that we have to pass bills so that we can find out what is in it.
Just ask Nancy Pelosi.
I thought i read 75% would drop it if they could. I think there should be something but penalizing people with fines forcing them to take it seems a bad idea.
Generally functioning market clearing prices require information free flowing from both sides (informed seller and informed buyer).
@ime, though from a libertarian sense, I get what you are saying about fines and forced participation. Do you agree with the EMTALA, Reagan signed? If you think, and I think you do, is it because it doesn't confiscate any of your property. Fair point, plus no one forces anyone to really go to the ER. Do agree with Medicaid expansion? (funded giant axes on capitals gains)
Is madating the 3X pricing cap, madating coverage cor pre-existing conditions, children until 26 on parent's plan, charging the sexes the same prices, mandatory maternity care, mental health coverage, no annual or lifetime maximums, ... or these in the minds of those for limited government ... are these too much regulation?
@ime, do you feel the republican model of: unless you opt for continuous coverage, insurance co.s can charge you 35% rate hike for failing to provide continuous coverage? Do you see this as a mandated fine? Or rather do you see it as a personal choice and personal responsibility with consequences? I am thinking the latter. I just want your thoughts.
Right now 1/6 of GDP is paying for all this. I don't think one can get that level of spending in line with other countries because nothing exists in a vacuum. I do suspect -- as many physicians have -- the at the United States subsidizes much of he rest of the world. If we tried to gets our costs way down it possible the costs in other counties would go up or medicine would stagnate.
The days of your doctor saying, take two asprin and call me in the morning are long gone.
Obamacare lives:
http://nymag.com/daily/intelligencer/201…
"While elections swing back and forth between right and left, there is a reason that the United States is a more humane place today than it was 25 or 50 years ago. Social Security, civil rights, Medicare, Medicaid, and Obamacare have survived. Legalized child labor, supply-side economics, and unlimited pollution have withered. Ideas that bring real improvement to peoples’ lives have more staying power than ideas that do not."
Then, first dollar coverage became the norm, partly because it was tax advantaged. Suddenly, insurance company bureaucrats were involved in every treatment. Insurance clerks told doctors how to practice medicine. Doctors fought back by hiring their own bureaucrats. Patients got caught in the middle.
In some countries, single payer systems were implemented instead. That means bureaucrats make all the medical decisions for you. They ration care and literally decide who lives and dies. This is what the VA health system has become.
Over a long life, I much preferred the major medical approach. I found a doctor I liked, decided how often to see him, and paid modestly for service. Every decade or so, I ended up in the hospital and reconciled the bill with my insurer when I was discharged.
I don't know the answer I have always worked and bought insurance and not always the cheapest plan. I don't pretend to know what is best for other people.I don't see the government as very efficient, partially based on my first hand experience working for the Federal Govt a few years ago.
We have crooked politicians, greedy insurance companies and an industry with few players. I think if given the chance the free market could come up with better and new alternatives.
You guys might get rid of the mandate, maybe. But Medicaid and cap-gains taxes are very popular with rural Trump supporters.
I have always had my own health insurance. Since I was 18 in college, my mom said I was on my own, so I bought a plan and have paid my own way ever since (I'm 39 now).
@ime do you honestly think someone earning $12-15/hr can budget enough money to pay my plan?
Like it or not the govt is in healthcare (Medicare, Medicaid, VA). I agree it is ineffective the. But how can the working class afford the rates doctors and hospitals charge? Are you honestly proposing the 'skibum plan' of 'I worked and got mine, so f-u?" If your wife or daughter needed surgery (like mine does) do you just have $7K in savings lying around? Maybe you all do and that's my problem (I have no savings). Just curious. Twice I had money in savings: once $4K and once $1K. Gone both times. Medical bills.
I'd like a different way, ideals aside, we need to work with what we have.
Medicaid along at lot of those 22M is VERY popular. Everyone I know who got coverage under Obamacare is on Medicaid.
My (single) mom used to do that when we were kids in the '80s when she worked as a retail sales associate. When we got sick, she took us, and wrote them a check and when we needed a Rx at the pharmacy, she paid cash from her purse. It's hard to do that now. Seems almost quaint.
What is your idea of a conservative bill to replace Obamacare? Or have you thought it through?
I think the hard pill to swallow is that Obamacare IS already a moderately conservative bill, that uses the privat market, with subsidies, and expands Medicaid for the working poor, with some insurance market regulations. Moderately conservative. Passed by a Democrat.
1. It's free for many. Medicaid is largely $0 out-of-pocket so there is no patient incentive to control cost and no Doctor incentive. I read that 30% of Medicaid patients have prescriptions for opiod pain pills. Patients are happy, doctors are happy, and the taxpayer pays.
2. Bureaucrats. A huge percent of the premium cost goes toward insurance company administrators watching doctors and medical clinic staff justifying procedures.
3. Lawyers. It is estimated that 25% of medical procedures are unnecessary but performed defensively to keep from getting sued.
4. Technology. Hospitals and clinics buy state of the art technology to attract doctors and patients, then must find a way to pay for the equipment.
As far as insurance companies go you are preaching to the choir we realize that over 20% of every dollar spent for healthcare ends up in the coffers of an Insurance company, but the folks that vote for these corrupt politicians, over and again think that it's going to be different when they vote for a blowhard like Trump, guess what the joke is on you, he ain't any different than advertised.
Don't really know what the solution is but what we got now ain't working for everybody, I'm OK Random is OK Skibum is OK, I don't know about the rest of you, but at my age 63, I wish good outcomes for you younger people.
My politics are not liberal, but I am progressive, I think you people that are so anti-progressive are ignoring the facts, that is the real problem.
I think that's our Health Care system in a nutshell.
SJG
Given a choice between making a medical decision with my doctor, an insurance company, or the federal government, I'll take the doctor every time.
And you doctor has been government run ever since he first applied for his medial license.
SJG
Deconstructing Gurdjieff, Tobias Churton
https://www.youtube.com/watch?v=o2cSaBCb…
SJG isn't often right but even a broken clock is right twice a day, medical decisions that you make with your doctor follow strict government guidelines so yeah the government is influencing your medical care like it or not
I think if they had the use the product they are foisting upon the rest of us, I have a hunch, a pretty strong hunch, Congress would fix most of the problems if they had to live with them too.
So Congress exempting themselves is complete and total B.S., IMO.
All it takes is one grandma getting high quality care in and out of hospitals for what turns out to be the final year of her life to break the system. How many 20-somethings have to buy coverage and pay premiums for care they do not wind up using to pay for the care delivered to one such grandma? 10? 15?
I cannot imagine anyone advocates withholding care to their own grandma. The question is, how are we going to pay for it when she cannot? Have the gub-ment pay?? WE ARE the government. Everything they spend was once ours.
If we demand pharma become not-for-profit, we will likely stifle innovation. If we demand doctors accept pay cuts, we will wind up with mediocre doctors. If we demand tort reform, we risk reckless behavior without meaningful consequence.
I cannot see any way out of the morass. If we, as American citizens are going to demand the best health care in the world, we are going to pay more than the rest of the world -- one way (premiums, copays, etc.) or the other (taxes). It is a zero sum game. Every dollar goes somewhere.
I agree about the insurance companies. All they seem to do is, look at the annual medical billing codes from Medicare, then say, "nope, that's too complex," and they try to do their own. Realize it's a ton of work and they'll have to do it year, after year. Then they see Medicare does it each on schedule. So like that sitting beside you in class, he copies your homework, except he just marks up the prices 1.4X if not higher (since the hospitals and physicians won't accept Medicare reimbursement rates from the rest of us)
So it's not like the insurance companies are doing much to justify being in the middle of it. The best way to reduce consumption is not through a bean-counter but at the Physician-->Patient interface. But too many patients don't want to take the time or effort or they don't want to question their doctors. But it's the only way it will get done. But the insurance cos. have to go.
It's easy, "Say Doc, this treatment here, this is only marginally more effective that this other one here. Let's not do it." :)
I get what you are saying. I would like high performing medical, that is prudent, yet thrifty, but not cutting corners. You know, the Ben Franklin 'Poor Richards wisdom' version of Blue Cross/Blue Shield.
Looking at the typical employer and employee contributions for a PPO plan at the Kaiser foundation the rates for a family of four are:
PPO 5570 / year Worker, 13433 employer.
High deductible 4289/ year worker, 12865 employer.
These rates seem a bit low compared to the prevailing costs where I live. It's closer to $8000 to $10000 for a family plan adding in the HSA. Which seem to be the biggest rip offs.
A person earning $80,000 per year at 2.2% tax. His rates under Bernie's plan would be 1760 per year, with 5360 for the employer. If his wife makes the same as him that comes to 3520, and 10,720 split among two employers. So both end up being less.
Now for a single young person making the same amount, his rates will go up, although the employers expense rate will drop slightly.
Here's another thing to consider:
I remember doing analysis of HMO's, Regular Insuring in the US vs single payer in Europe in manufacturing and office jobs in Economics in College back in the early 90's.
European companies typically had an advantage to the their U.S. counterparts, in medical costs than, in some industries it was over a 2 for one advantage.
Obamacare has survived because it's working. Yes, it will need some additional legislation to stabilize the exchanges. It preserves some of the best features of the free-market and allows doctors to make a very good living. The only losers under Obamacare are some young, healthy people and the top 2% who see some of their investment income taxed. Warts and all, it's probably a better system than single-payer which would push doctors into the middle class and stifle innovation by pharma companies.
Some of the rants against Obamacare represent thinly-veiled racism. Hard-core Libertarian types who resent having their taxes going to lazy parasites who don't look like them. And the fact that Obama is not white feeds into that racism.