People's Mandate Healthcare for All Americans https://www.facebook.com/100036084640155/

Health
1

November 5, 2024-election day

Dear Mr. Kennedy,

As I write this, the polls are just opening in my area of the country. No matter what happens today, in yet another major battle of the now more than half-century of this country’s second, and bloodiest, civil war -that would be the one in which the Supreme Court of the United States fired the opening volley in January of 1973 when they handed down the Roe v. Wade decision- I hope you will keep this People’s Mandate proposal in mind. ( RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue - #187 by PeoplesMandate RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue - #203 by PeoplesMandate RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue - #209 by PeoplesMandate RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue - #199 by PeoplesMandate Economics for the people - #42 by FreedomLife Redirecting... Comments - In Bipartisan Panel, Kennedy Offers Solutions for America’s Chronic Disease Epidemic ) On behalf of the more than 60 million now, very young casualties of this most horrible war in human history, I pray, you will keep it in mind.

I say this because this idea is about healing…the bodies, minds, and perhaps most importantly, hearts, of individuals, AND this nation, as a whole. No matter who is declared the winner some time later today, this idea is still about healing…ALL of US. As has been noted more than a few times, no matter what color, gender, nationality, ethnicity, religion, financial status…or age…we claim, We all bleed, red.

With that in mind, I have a suggestion for you and Mr. Trump…OR Ms. Harris…OR, better yet, all three of you. Since this People’s Mandate is completely non-partisan, how about we turn it into the PEACE accords between the new, AND the old, Administrations, and let it become the treaty under which we agree to a cease-fire? How about we have a former President, the current Vice-President, and the nephew of a beloved former President—whose life was cut far too short, just like the 60,000,000+, in terribly troubled times not so unlike where we are now—bring this treaty, these accords, to the current, sitting President, and ask that he sign The Peoples’s Mandate-Healthcare for All Americans into law, very soon. The Wednesday before Thanksgiving would be ideal. (Think you can get that done, Congress? I’d be happy to come to Washington and help. All it will take is a simple change to campaign finance law—I’m sure Congresspeople are quite familiar with that, and a tweak to allowable advertising deductions for businesses under U.S. federal tax code. Perhaps, to speed things up a bit, you could suggest that part to the IRS, Mr. Biden?)

May the God known as LOVE bless you and keep you as s/he does all of us, as his, or her, Children, always.

Sincerely,

Lise Lund VMD

PS-In the long run, this proposal is about real “social security,” and a real, forever, TRUST Fund, to go with it, born out of giving, not taxes, as such a fund should be…

…especially in the United States of America

original proposal:
Healing America starts here. Healthcare funding for EVERYONE, equitably, in a uniquely American, permanent, way, requiring no new taxes, ever. This will be cross-posted to the economy category because the biggest problem with our healthcare system is how we are paying (too much) for it in the face of massively declining public health, especially among our children. With healthcare now costing roughly a fifth of the GDP, American life-expectancy is going down, chronic illness is epidemic, and, because of corporate capture, The People cannot trust federal agencies which were supposed to monitor and regulate to prevent this human rights catastrophe (born of greed, massive miseducation of the American public via the media marketing machine, and highly improper LEGAL intervention into American MEDICAL matters).

With a much-needed, simple change to campaign finance law, and a small change in federal business tax code for advertising expenses, this country can have permanently fully funded, high-quality healthcare for everyone paid for by our politics and the excess profits of our most successful businesses, not our taxes. This is an equitable plan that treats every individual equally (unlike the current system), regardless of economic or employment status, or any other (usual and/or peculiarly American) biometric. And it gets medical money out of the hands of lobbyists and Washington, permanently, so it cannot be stolen from future generations by turning it into war machine debt. Meanwhile it stabilizes the state banking system by having them, only, hold (on behalf of The People) and handle that fifth of GDP, every year, so the federally-chartered banking system cannot squander it and go running to Washington for yet another “bail-out.”

This is also COMPLETELY NON-PARTISAN, and so, stable, not subject to massive distortion and changes in prioritization every four to eight years (something that should NEVER happen to healthcare) in the face of ridiculous, and often corrupt, political party haggling and destructiveness (what has become our ongoing, never-ending, Second Civil War).

Hope I’ve piqued some interest.

Here’s the basic plan:
The People’s Mandate demands $0.50 of every dollar donated to any political campaign or purpose (including PACs, Direct party donations, local mayoral races, etc. any money directed to buy political influence of any kind), anywhere in the USA be immediately diverted to a National Health Savings account, held under the auspices of state banks, only, where it accumulates interest.

On a designated day in late November of each year (the Wednesday before Thanksgiving would be ideal) this money is re-distributed to the individual health savings accounts of all Americans. The individual accounts can only be debited by a medical provider designated by the individual patient who holds the account to pay medical bills, or more usually, to pay direct, local insurance between the doctor and hospital the patient intends to use when they need medical care.

Political money is well tracked and not tax-deductible. It is a huge vat of funding never before considered to be partially utilized to secure national healthcare. It should be. Given the inordinate amount of money spent on American politics, which increases constantly, and the fact healthcare has been at or near the top of the list of voter concerns constantly for more than thirty years, it’s pathetic, and an American embarrassment, and disgrace, it isn’t. If political donors have extra money they can afford to give away to buy political influence, they have money they can afford to give to securing national healthcare for everyone.

Imagine, EVERY CANDIDATE IN EVERY ELECTION, AND EVERYONE WHO WORKED FOR THEM OR SUPPORTED THEM, can feel proud on election day, no matter who wins, because they have made a massive effort that benefits ALL of America, already, before anyone takes office.

This process is completely non-partisan since it comes from both sides. No matter what happens in any given election cycle, national healthcare becomes more secured, especially so every four years during a Presidential cycle. Any politician who leaves office automatically donates anything left in their “war chest” to the national health savings account. They can’t redirect it to their replacement or back to the party. Term limits would vastly increase the national health savings account reserve.

There are other finer points and details, but this is the basis for a completely tax-free, uniquely American way of funding healthcare for all, permanently, and keeping decisions about medical care where they belong, between the patient, and his or her doctor and preferred hospital.

First Amendment.

This is the piece that will clinch the Mandate.

There was some flack, back at the beginning, about whether or not 50% of all the money used to buy political influence in this country would be enough money to fully fund healthcare. It definitely won’t fully fund profit-driven healthcare, because all the money in the world isn’t enough to satisfy that greed monster. We’ve been proving that for many years now as Americans shovel more and more dollars, a larger and larger percentage of our Gross Domestic Product (GDP) into the health system, AND LIFE EXPECTANCY FOR AMERICANS IS GOING DOWN!!!

Much of profit-driven healthcare could, should, and would be dismantled under the People’s Mandate. But unless and until that happens (this is capitalist America, after all), and since we know how power-hungry too many political people are, how much they lie and cheat and steal, and We the People are forever at risk because they also make their own rules (and break them with no accountability) there will be one more addition to the People’s Mandate.

Advertising is a flexible expenditure for businesses. It’s not a necessity. A business can continue operating without spending a nickel on advertising. Successful businesses, though, tend to spend quite a bit on it. So, the First Amendment to the People’s Mandate is as follows:

Henceforward it will be mandated that every business in America, including so-called non-profits (most of which haven’t really been non-profit for decades, e.g. hospital systems, pet charities, “causes” of all kinds), no exceptions, will, upon the filing of their federal AND state income taxes, send proof to the IRS and state revenue authorities (a receipt from the state bank that received it) 10% of that amount deducted under Advertising on the business’s tax return went to the national health savings account. (e.g. if a business buys a $10 ad, they simultaneously put a dollar in the National HSA–held by the state bank in the business’s jurisdiction).

In other words, 10% of all the advertising budgets for all the businesses in America will henceforward, off the top, go toward securing individual national health. Just like the 50% of all political budgets, this money will be held in trust in the state bank of their particular jurisdiction, to be distributed to individual health savings accounts of all Americans on that designated day in November of each year.

This is totally do-able. All it takes is the will of the People to do it.

2

This math doesn’t math.

The US currently spends about $4.5 trillion dollars on healthcare.
About $14,000 per person.

Let’s say you cut that in half to $2.25 trillion just with people being healthier.

That means taxes on political donations and corporate advertising are going to pay for that.
Corporate advertising in the US is, generously rounding up, $500 billion annually. You’re saying a 10% tax on that, so $50 billion.

Political donations are far less than that. I can’t get a good number but it seems well below $100 billion, but let’s just assume it’s $100 billion, and saying half of it now goes into this NHF, so everyone has to pitch in double to get the same effect boosting it to $200 billion, sending $100 billion to this fund.

That’s $0.15 Trillion on a $2.25 Trillion dollar healthcare bill.
Even if you were to cut that bill in half again, you’d still be over $1 Trillion dollars short (around $2800/person).

3

It is quite obvious you either did not read the entire proposal, or you failed to understand much of what is being discussed. Your “math doesn’t math,” (no matter what that means, exactly.)The U.S. currently spends roughly a fifth of GDP on “healthcare.” No one knows exactly what that means, either, because there is no federal definition of “healthcare.” However, it most assuredly includes the fifty cents on the dollar or more taken by independent, behemoth insurance companies, that provide no medical services of any kind, and interfere, questionably illegally, with patients getting procedures and services they need based on medical evaluations made on individuals the insurance company’s evaluator has never met, much less examined (I have been thus denied care, repeatedly, in a personal, life-threatening situation also involving an incompetent doctor–employed by the offending hospital in the situation because he was more “profitable” for the hospital than a properly qualified individual).

So, you can cut your starting number in half, at least, before we even start talking about improving American health. Add in bonuses and “golden umbrella” retirement packages and other percs routinely handed to upper tier insurance company employees, and dividends to shareholders (whose interests the insurance company employees ultimately work to serve, not sick and injured people) and it may well be the current tab can be reduced by 75-80% because it all goes away as the country gradually transitions over to the National Health Savings account system (that would be HSA–I have no idea what you are referring to with NHF, but it isn’t a part of this proposal–perhaps you should go find the one where it does appear and do some of your math “mathing” for them because it is inaccurate, inappropriate and counterproductive here.)

As a current Medicare recipient who actually looks at my statements, it appears to me that the insurance companies routinely keep closer to 90-95% of monies, taxes in this instance, the federal government is handing to them to provide for MY medical care. More than a few hospitals have been decimated to the point of having to close because this larceny by the wealth-ist, profit, not patient-driven system is allowed to go on as “business as usual.”

And insurance companies are just the start of how much money stops being drained from the healthcare system by profiteering, non-medical, ultimately banking and stock market leeches. Under the People’s Mandate, money put into the American national health system taken from political financing and corporate option choices for excess profits they are making to AVOID paying federal taxes–a completely different revenue stream that is NOT “taxes”–again, your discussion is inaccurate, inappropriate and counterproductive here–the money that is put into the HSA system stays in the system, other than what actual hands-on, patient care workers and support staff to the functioning-in-providing-health-help-directly-to-patients hospitals and doctor’s offices take home in a paycheck. (when a person dies, the money in their HSA is returned to the system that gave it to them in the first place–it does not become bequeathed property) That money pool will expand over time (protected in state banks where Wallstreet and “bailed-out” federal loan shark thieves and con artists can never touch it–ditto Congress and the war machine), allowing the definition of “health” to expand eventually to include things like a temporary disability stipend for food/housing/other basic necessities, instead of being siphoned off to be paid to already-wealthy “investors.”

“Insurance” --and there needs to be a different word for it because that one is completely toxic at this point-- becomes a cooperative arrangement between the patient and their chosen doctor and the hospital they intend to use in the event they need one. The hospital income is stabilized (as is a doctor’s whether s/he runs a private office, or, more commonly these days, a hospital affiliated one) because monthly payments are made directly to the hospital by the patient, from the patient’s personal HSA whether the patient is using the hospital or not, and the patient pays nothing extra to the doctor when they do see him/her because the doctor is also already being paid–in other words, a REAL HMO (health maintenance organization), not the fabricated baloney sold under that name by insurance companies because their marketing departments think it sounds better.

Hospitals/doctors see no decline in their income when people get healthier, unlike the current system that starts to fail when the supply of sick people goes down. (Nor is hospital/doctor revenue stream disrupted by a patient’s employment status or general economy trends, good or bad. --as it should be for something so critical as healthcare) This stabilized income allows hospitals to reasonably plan for new technology expansions without needing to borrow money OR “build something,” needed or not, to, again, avoid paying that “profit” (in a non-profit in name only business) to the federal government in taxes. They could even set aside a portion of income not required to care for current patient load to provide bonuses to hard-working staff when the caseload sees a sudden increase. The stabilized income also allows for cooperative arrangements between hospitals with respect to caseload as opposed to the toxic competition going on now where patients and the staff trying to care for them are ultimately always the losers. And the stabilized income for hospitals and doctors will, in the long run, start to back-benefit the medical school system toward getting the ridiculous cost of medical education under some kind of control (and weed out applicants who are interested in a huge salary far more than someone’s broken leg).

Please, in the future, ask questions when you do not understand the discussion instead of mischaracterizing what is being presented as you explain why what you wrongly claim the plan to be about won’t work.

4

Yes, we do know what that “healthcare” number means, you can find it here:
[https://www.cms.gov/files/document/highlights.pdf]
(Other documents get into even further detail if you need it)

In 2022, according to (Centers for Medicare & Medicaid Services) healthcare was about $4.5 trillion dollars.

In 2022 (to keep consistent), GDP was $25.744 trillion
A fifth of that (20%) is $5.15 trillion, which is close enough to $4.5 trillion for these purposes.

Pick whatever number you want that you believe the national healthcare total spend annually would be because it’s irrelevant to my main point regarding how much revenue your funding sources will actually bring in.

I could only find two new taxes listed as your funding sources.

We might not be able to get an exact number here but we can reasonably guesstimate it’s in the tens of billions.

For example, this year (a presidential year), based on OpenSecrets data:
All candidates across all ballots combined took in about $7.8 billion
Federal Lobbying is around $4.5 billion
Super PACs (~2,500 of them) also took in about $4.5 billion
Other PACs took in around $250 million
The “Dark Money” spending seems to be around $500 million

https://www.opensecrets.org/federal-lobbying
https://www.opensecrets.org/political-action-committees-pacs/super-pacs/2024
https://www.opensecrets.org/elections-overview/totals-by-state
https://www.opensecrets.org/dark-money/top-election-spenders

If you sum all that up you get around $20 billion.

So let’s assume I missed a lot and all political donations are $100 billion.
If you think it’s way more than this, let me know what significant donation types you think I missed.

Also, you don’t seem to account for the idea that political donations are very uneven each year. Presidential years are worth a whole more than mid-term years, and mid-term years are worth a whole lot more than the other two “off years”.

But let’s be really generous, ignore that, and say every year is somehow the same as a presidential year at $100 billion in political donations. Further, let’s also assume everyone doubles their donations because of this new political donations tax, so donations are now $200 billion a year.

$200 billion dollars in political donations, half of which ($0.50 on the dollar) goes to the National Health Savings Account (I misnamed this National Health Fund (NHF) in my initial response, my apologies).

So every year, The National Health Savings Account receives $100 billion dollars from political activity donations.

We can quantify this number too.
Corporate advertising in the US is, generously rounding up, $500 billion annually. You’re saying a 10% tax on that, so $50 billion is added to the NHSA.
https://www.statista.com/outlook/amo/advertising/united-states

Unless there is another revenue source I failed to comprehend is actually there, or you can show that political donations dramatically exceeds $100 billion per year

Here’s what we have for annual revenue into the NHSA:

  • $100 billion from political donation activity
  • $50 billion in advertising

Comes to $150 billion annually into the NHSA.

You would have to reduce the national healthcare spend 97% to make this feasible. This is around $500/person/year gross total.

What I mean by “This math doesn’t math” is you can’t take percentages of programs that take in billions of dollars per year to fund things that cost trillions of dollars per year.

5

If those guesstimates on revenue/income streams aren’t sinking in, then let’s look at the costs side of the equation like you’ve been focused on.

Norway is generally considered the best nationalized medical provider and spends the most, at around $8,600/person/year.

UK, also a nationalized system, which is considered to spend the least per person (about half what Norway does) comes to ~$4,400/person/year.

That range of costs, applied to the US would be somewhere between 1.5 - 3 Trillion. Even if you could reduce the UK based number by half, you’d still be $500 billion short annually (and that’s based on an the above ultra generous and entirely unrealistic overestimation of the annual political donation taxes).

But let’s say you don’t like comparing us to European countries and you think somewhere in the US past when people were healthier is a better representation.

In 1950, the US spent about $13 billion on healthcare for around 200 million people. That’s around $65/person in 1950 dollars.
In 2024 dollars (due to inflation) that’s around $850/person.

In 1970 the US spent about $75 billion dollars on healthcare for around 225 million people. That’s around $333/person in 1970 dollar terms.
In 2024 dollar terms that’s around $2,700/person.

In both these cases, your funding sources, as estimated above still fall significantly short.

Even using a 1950s era standard of care as the target, the funding sources described (and generously overestimated) aren’t enough to hit even that target.

6

It seems I need to request you cease to criticize, with Googled, non-itemized, not-subject to public/independent audit, block quote$ on income/revenue and expenditures; mischaracterization/representation of the language and stipulations of the proposal; and irrelevant information- based on your lack of comprehension/appreciation of what is actually being proposed. Constructive criticism is welcomed, and will be addressed for the sake of everyone’s clarification. Your condemnations out of ignorance are not, and will likely not be addressed further beyond this reply.

This is a policy proposal you clearly do not understand, much less respect for its innovation of a novel revenue stream that addresses critical problems with political party gross overreach, shifting things in favor of The People; its insulation from fluctuations in, and stabilizing effect on the general economy; and its equitable consideration of the financial health needs of the population as a whole, during the current dangerous financial condition of the United States. It is about returning individual sovereignty and autonomy over one’s individual body–be that body female or male–to the individual, as has been considered a global human right since Nuremburg (i.e. the late 1940s). And it is about getting the Courts and inappropriate civil law, along with all attendant non-medical leveraging factors associated therewith OUT of American medical care, permanently. SCOTUS, state legislatures, and appropriate agencies have authority to regulate (and punish for non-compliance) what will NOT be done in practice, but there are no grounds for such legal entities to in effect grant unlicensed persons the “right” to dictate the practice of medicine by licensed professionals (unlicensed persons to include patients, marketing departments of all kinds, third-party “consultants” who have no legitimate relationship with a patient [including proof of positive identification of said patient] or that patient’s doctor(s), and no knowledge about the patient’s medical record and history.

Using the current expenditure of a fifth of GDP on healthcare is grossly inaccurate as a baseline target for what revenues are actually needed because it does not differentiate what we would be paying for healthcare, even amidst the current mis-advertised and promoted mixed bag of medical marvels and outright, ongoing (often fear-driven), blatant malpractice, were all the profiteering leeches removed (e.g. health insurance companies and overpaid and “bonused” top tier executives of Big Pharma, its cohort, Big university research profiteers, the same in Big corporate medicine conglomerates, and all shareholders and unnecessary benefactors of same).

On the revenue stream, income side, let me ask, first of all, how many corporate/business tax returns have you signed as the filer in your life? What do you know about the massive manipulations which go on internally in many, many businesses insofar as what is legitimately able to be claimed as “advertising” on a business return? Everything you’ve discussed in that direction indicates the answer is zero, to both questions.

Your estimate of “corporate” (which does not include all business types under US tax code) advertising budget for the country is ridiculously low. Businesses routinely divert current profits into “advertising” to avoid paying taxes–that “advertising” is not always reflected in the line item with that heading on a tax return (let the 50,000 new IRS agents start by working on that) and inside non-profits, virtually everything is “advertising” because they risk losing their non-profit status if it isn’t. How many large non-profit organizations have you been bookkeeper to? Again, I assume zero.

For-profit businesses and so-called non-profits all do this to AVOID paying federal income taxes. AGAIN, as I stated before, this proposal DOES NOT ADVOCATE THE CREATION OF ANY NEW TAXES, NOR DOES IT ATTEMPT TO UTILIZE CURRENT TAX REVENUE (in a country $35trillion in debt) TO PROVIDE FOR NATIONALIZED HEALTHCARE. (If I were running a business behind this proposal, I would be having my attorneys drafting a complaint against you for defamation and libel. I suggest you knock it off.)

The 10% of advertising match is a diversion of expenditures (that could be required under business tax code in the same way that employers are now obligated to pay matching FICA taxes on behalf of employees—whether the business is showing a profit or not, whereas most businesses that do not have a decent profit margin, do not spend much on advertising, and so, would not be subject to the type of punitive match that is the requirement to pay FICA taxes–that go into the Treasury and general revenue, NOT the mythical Social Security “Trust Fund”). So, since the People’s Mandate is a diversion that does NOT ever enter the U.S. Treasury (where it can be squandered by a spending-addicted Congress), the monies remain protected in the National HSA as held by multiple state banks in all 50 states. AND, it earns interest while there (completely missing from your calculations–and something that does not happen to any taxes, ever, especially current FICA taxes). Also, since I’ve seen fit to mention FICA taxes in this discussion, proper implementation of the NHSA to individual HSA system would, over time, eliminate the need for FICA deductions from individual employee paychecks and for employer matches (and also, the federal government now handing over billions of tax dollars to insurance companies to “manage” Medicare).

The revenue shifts, in a positive direction, from this effect alone are enormous, and quite obviously, not even considered in your “analysis.”

Meanwhile, what European countries spend per person or what we’ve spent fifty to seventy years ago is COMPLETELY IRRELEVENT to this proposal and any discussion of it. So, please, Mr. Fair cease and desist in decrying what you quite obviously do not understand. Ask constructive questions by all means, and I will attempt to answer them. But stop with the irrelevant, website quoting, know-it-all who in reality knows nothing, negativity. It is injurious to both public and private health.

7

I believe that when putting forward a radically new and innovative proposal for how we as a nation operate, it is constructive for the good faith actor to try and reasonably guesstimate the effects and put concrete numbers around those estimates so that decisions makers and reviewers can have the best, easiest to digest, information we can make available so they can make an informed responses.

I believe quantifying the estimates around what the new annual spends will be, and the estimated annual inflows of revenue from the proposed sources is likely to be, as best we can guess, is a constructive endeavor. This will also tell us if we need to get more revenue sources, how much we guess people might need to pay out of pocket for shortfalls, or maybe we don’t need as many revenue sources as we originally thought, or maybe the costs might be higher than we’re currently thinking…

  1. I am assuming that you would agree that once this new system is in place, economists will be able to quantify the total sum the American People will be spending on products and services eligible for payment using their HSAs… I would like to see an estimated answer from you for “how much will the American people in aggregate spend per year, in numbers of dollars, under this proposed healthcare regime?” We start with the range of $0 (eliminate 100% of all healthcare costs for all people) and $4.5 trillion dollars (the amount we’re spending now) per year, and we know both of these numbers are completely not even close, so let’s do better and narrow that range. Let’s assume we can reduce the current “healthcare costs” by up to 80% which is slightly higher than the estimated claims stated in the proposal. That puts the range between $1 Trillion and $2 Trillion in aggregate per year. Do you agree that this is a reasonable range for the total national healthcare costs per year under the proposed system? If not, what range do you believe would be more accurate (and if you can provide your reasoning why up to 80% off of $4.5 Trillion is not a good estimation, that would be helpful)?

  2. I would like to see an estimated range of how much money, in numbers of dollars, the proposed revenue streams are likely to generate for the NHSA. Do you believe this number is simply too impossible to figure out because we don’t have access to enough data and therefore there is no way at all to put a ranged set of bounds on it so we can make a guess at it at all?
    There are two revenue sources based on two different kinds of spending in the country mentioned; political donations and business advertising. If we can make a guess at it:
    How much money do you estimate the country spends on political donations on average per year? How did you get that number?
    How much money do you estimate the country spends on advertising per year? How did you get that number?

If you would like me to walk through with you methods for making such estimates, DM me. This is not a trick or a gotcha or anything like that. I genuinely believe these numbers can be reasonably guesstimated and you get to make all the decisions for how that estimation is done so you can know that the estimates are reasonable.

1 Like
8

Mike, In answer to your Question #1, economists will be able to quantify what the National Health Savings Account—a true “savings” (for the proverbial “rainy day”) system [which, over the years, will remain always under the control of individual Americans and State banks, only] is spending on health preservation and improvement-related goods and services on behalf of the American people.

The American people are not “paying” nor “spending” anything under this design because the money in the system was put there for their use …or not… (i.e. to continue to be saved by the individual because they do not currently have a need to purchase healthcare beyond what they are currently paying into a cooperative with their preferred personal doctor and whatever “general” hospital system with which they choose to affiliate in the event they are in need of hospital-based services, along with fees for any medications they need to take chronically which, in most cases, are likely contracted for and purchased in bulk by the HSA from the producing pharmaceutical company), but do anticipate having an increased need as they age, or because they are considering elective health costs, such as pregnancy—which involves a woman and a man, and so, affects two accounts, or purely cosmetic surgery (which will have to be applied for and approved to be paid out of the HSA), or they are conscientiously seeking to see their HSA account balance increase to know there is money in there to meet basic life needs in the event of unemployment, or disabling injury, or some other significant disruption in their personal cashflow/assets such that they can “get by” until that situation is resolved) …put there for their use by way of specific laws that affect political donations and business advertising.

Keep in mind, as you learn about this better system for providing for healthcare, the people do not “own” the money paying for it because they did not earn it, or acquire is in any of the other usual ways that Americans come to hold income and assets. The individual holder of an American Health Savings Account (AHSA—this should probably become the official acronym for the individual HSAs?) is required to be the answering accountant to that account, who must keep track of its income and expenditures, and file a report with the NHSA system about that accounting, annually (which, up until 5-10 years of age will probably need to be done by a parent or legal guardian, but as soon as the individual child holder of an AHSA has learned enough math and has the comprehensive ability to grasp what an AHSA is and how it works when taught about it in school, s/he should be filing their own annual accounting with a parent/legal guardian/teacher? co-signing until at least age 18).

The money in an individual American Health Savings Account is effectively “loaned” (for lack of a better word) with accruing interest on any unspent portion, and to be paid back only up to whatever amount is left at the end of the “loan” period, to the individual, by the country for the duration of the individual’s lifetime (which IS the “loan period”), from confirmed conception to grave. At the end of that lifetime, the money in an individual American Health Savings Account reverts (immediately and automatically upon a required death certificate being sent to the State bank where it is held) to the holding State bank, and will be added to the annual distribution to be made on the ensuing Wednesday before Thanksgiving.

The answer to your Question #2 is not “impossible” but I continue below as I do to have you start to understand why it is so difficult, currently, to provide the numbers you very reasonably request. I’m hoping you’ll agree to continue working on this with me, for the sake of our country, and ALL of our People.

As I hope you’ve noted, I applauded your latest remarks. I’m guessing it was my information about FICA taxes and the national debt in my previous postings that may have convinced you to believe I might just know what I’m talking about on how this country is, and has been, abusing everyone by mis-managing OUR money (and that of multiple future generations), right down to how we spend to try to preserve Life itself, and that there are better ways to do things that might just save US from going down in infamy from becoming the country that declared GREED was not only “good” (thank you Wallstreet), but also “god.”

I have had so many replies to you screaming around in my head, I didn’t know which one to put up first. So, I took a couple days to try to sort out this unbelievably, and intentionally (on the part of the “wealth-ists” who are profiting the most from it) complicated mess.

I was going to start with a personal story that took place just this week between myself, my current health insurance company—that I have to have, and have to “choose,” and potentially have to PAY for, every year between October 15 and December 7, according to plans available in my ZIP CODE, when I’m on Medicare, which is supposed to be, and is ADVERTISED by the government as universal (though obviously age-prejudiced) nationalized healthcare—the ONLY version the United States of America has ever seen fit to provide to some of our People. Got that? And, PS, those incessant television commercials being put up by the insurance companies to get my “business” as a senior citizen, for health coverage I’m supposed to get automatically, as a “right” under our laws, are ALL advertising, but how much do you want to bet what is spent on those commercials, coming from yours, my, and everyone else’s TAX dollars does not appear in ANY of the health insurance companies’ line item deduction for “advertising” on their business tax returns?

Anyhow, the personal story is about my receiving a fraudulent bill from the hospital I use for $104, which I paid (because their bills are always dated such that if you don’t pay them immediately, they start accumulating late notices), but I also questioned the bill. I confirmed with my insurance company that the bill was, indeed, fraudulent, and indicated I wanted a refund. Long story short—because I’ll put the details in the next post-- ~75days later, I have spent approximately 8.25 hours of my Time on this, still do not have one nickel of my money back, and by very (extremely) conservative estimate, “the system” has spent $672.92 of U.S. “healthcare” dollars on it…to this point…b/c the second ins. Co. agent I talked to is tracking the issue and will call me back again in December to make sure it’s been resolved—by way of the ins. Co. forcing the hospital to file a second claim- to pay me $84 of the $104, while I am at liberty, and expected, to call the ins. Co again if I don’t see $20 back from the hospital within ten days. Got all that? All of it, according to economists, comes under the heading of “healthcare costs,” but NONE of it did anything to improve anyone’s health, and, if anything, did some damage to me and the people I needed to speak to about it by way of having all of us suffer from stress and things which ensue therefrom like increased blood pressure.

But first, here, I’m going to make my main response to your most recent effort’s Question #2 with the following: This is a slightly edited FaceBook post I put up in response to a meme which questioned why doctors don’t try to figure out what is causing symptoms of disease (the short answer is because insurance companies won’t let them) instead of just prescribing pills that make symptoms go away, but do nothing about the underlying disease-

“Quick fix treatment of SYMPTOMS, not diseases, has been an obscenity of mass malpractice that’s been going on in this country for about fifty years, ever since we started advertising drugs on television (we are still one of the only two countries on earth that allows prescription drug advertising on TV). OTC drugs are largely aimed at symptoms (headache, upset stomach, constipation, heartburn, cold SYMPTOMS, etc.) which can have any number of disease processes behind them. It was possible to sell far more OTC drugs than prescription ones because of television. So, Big Pharma, in typical American capitalist greed, wanted to make more money (it didn’t matter to the marketing department whether they were helping or hurting people doing it–though they lied to themselves and told themselves it was all “help” because medicines were “good,” and always designed to help people). This is the seed of the disaster of an over-priced healthcare system with people largely self-diagnosing (based on their medical education from television and now Google U) that is overseeing American life expectancy going DOWN for the past twenty years.

Depression, which has as its root, fear, -in an age of global terrorism-- as the underlying disease, is one of the grossest examples of what happens when all you do is treat the symptom instead of making the effort to understand the underlying dis-ease. Published estimates that at least 60% of the U.S. population is on some kind of anti-depressant are undoubtedly grossly UNDER-calculated.

The Big marketing LIE for anti-depressants was, “You have a chemical imbalance in your brain.” The anti-depressant was supposed to “fix” that. Got news for everyone–A chemical imbalance in your brain is how we THINK. “They” have been, literally, attempting to have people stop THINKING (and just shut up and do as we are told). It’s called totalitarianism. The politico-medical coup that has put this regime in place, must go. And Donald Trump is NOT the person to have do it (nor would Kamala Harris have been), because he (and she) don’t have enough/any insight into this medical disaster (They’re undoubtedly, largely TV/Google U. medical school graduates, too.)

Bobby Kennedy’s movement has the best chance of turning a new page, but he’s got to beware of his own TV/Google U diploma, and also his so-called “elite” university education, too. Trusting Big Education is part of the conspiracy that has brought us doctors acting as drug pushers (very expensive ones) for Big Pharma for decades.

Just handing out drugs instead of having doctors do their job of finding the underlying cause of illness makes far more money for the so-called “health” insurance companies AND Big Pharma. Big health insurance needs to go. Big Pharma needs to be severely reined in, particularly with respect to its marketing efforts."

https://www.facebook.com/100036084640155/

9

I did notice, and no, it wasn’t anything like that at all.
You requested constructive questions which you said you would attempt to answer. So, taking you at your word, I supplied constructive questions. I figured you were applauding the fact I requested constructive questions from you rather than supplying evidenced back answers to my own questions. I assumed you just didn’t like the tone I used in supplying my original analysis and you wanted more of a dialog.

You still haven’t supplied a single dollar number, as I asked in my questions, to support any of the three claims we discussed.

My comments stand, until you can show me how your numbers work here, the math on this still doesn’t math.

10

One of the ways I believe we might be talking past each other here is your entire focus seems to be on how this affects people at a more individual level. I am not denying it’s a transformative idea, however I am not looking at how wonderful this is for individuals. I am looking to evaluate the macroeconomic feasibility.

While I don’t think you’re intending to, you are proposing two major changes with this policy. One is about how we fund healthcare, the other is about how we approach healthcare. I’m not caring so much about how we change the approach to healthcare (which seems to be your focus), lots of people have ideas on that. I’m focusing in on the monetary policy being proposed for how we pay for it. The ideas in this proposal can be separated and perhaps we use the funding policy from this one to pay for a different policy change on approach. Or vice versa, we take a different monetary policy scheme to fund this approach change. Either way, I was looking at the specific macroeconomics of the monetary policy being proposed.

In the facts sheet I linked to on where that $4.5 trillion number comes from you have a breakdown of how much money comes from which sources. You could cherry pick the expenses you think are actual “healthcare” in your mind and create a new base from which to work and then modify to add or remove things as you see fit to get a new number…

You are asking the reader to do a lot of work to see a number that it appears you haven’t been willing to put in any effort at all to estimating, even for yourself. You then claim everybody else estimating these things is shit at their jobs and our current “sick care” system sucks and anyone, like myself, who disagrees with your analysis clearly doesn’t comprehend what you’re proposing because if they did, they couldn’t possibly still disagree.

I haven’t seen you place a single constraining estimate on the annual advertising spend or the political campaign donations revenue… They are definitely less than 100% of US GDP… They are each certainly less than the estimate of what we currently spend on the healthcare industry annually of $4.5 trillion… They are definitely less than the total annual gross revenue of the companies paid to do advertising (which we can see as a macroeconomic industry number). Are they less than $1 trillion each, how about combined?

You also have a lot of assumptions being made in your analysis, like the idea the father will use his HSA benefits to pay for a mother’s pregnancy (technically we should probably charge the HSA of the unborn child - it’s their birth after all)… Do you plan on requiring paternity testing to ensure we’re taking from the right father’s HSA? Can anyone just step in and say “put the bill for those healthcare services on my HSA for that other person”? I don’t really want answers to these questions, they’re rhetorical to me at this point. Show me macroeconomic numbers that work and these become more relevant.

As I understand your description, the NHSA is distributed equally, each period, into each citizen’s HSA bank accounts (which btw doesn’t address non-citizens, or even think about how to address the problem with reaching the unbanked in society. It also seems to assume the banks are trustworthy custodians who will do this work to track and transact on these accounts for no profit whatsoever (I didn’t see any references to how the banks will be paid for their services in this system)) then individuals will accumulate wealth into those HSA accounts during periods they are more healthy than periods where they spend more. What happens when the immediate costs exceed available funds for an individual? Can their HSA account go negative and draw on future contributions?

A single cancer battle can cost small fortunes likely draining the HSAs of an entire family if it’s prolonged enough. My son has had 4 open heart surgeries since he was born and will continue to have his condition monitored for the rest of his life. Three of those surgeries were within his first 90 days. His HSA would have been empty at that point in his life. So then I assume you’d say my son could draw from mine and his mother’s, maybe even his grandparents… I hope you can see that even at the individual detail levels this all gets very thorny, very quickly and costs can easily exceed HSA savings for some situations.

Again, these are all rhetorical points and questions at the moment.

Before any of those details would even be a relevant part of the discussion for me, I was more interested in the dollars coming in and the dollars going out and saying “I don’t see how this system creates enough revenue annually to sustain itself without resulting in massive increases in out-of-pocket spending by individuals to make up the shortfall even if they were significantly healthier as is required for this proposal to work”.

Lastly, and I haven’t focused on this because it seems beside the main points, you seem to think that the word “spend” only means money that comes from your own out-of-pocket monies, that the word “tax” only means the money the government takes into its own accounts or that it’s somehow not a “tax” when the government mandates companies to direct their money in a particular way. I believe the way you avoid using these terms is highly inaccurate.

People on EBT SNAP benefits “spend” money on food even though the money is put there for them to use by magical government means. Children “spend” their parent’s money, employees “spend” money from their corporate expense accounts. When people use money at hospitals they “spend” money through their HSAs even if they never see a single dollar of it pass through their own hands or account control.

When the government mandates an entity must use their funds in a particular way, you can call it a fee, you can call it a tariff, you can even call it a “transfer”, but when government agents are eventually going to knock down your door and you ultimately will wind up imprisoned if you don’t comply, it’s effectively a “tax”.

Ultimately you are going to require the US or State governments to force compliance with the laws that result from enacting this proposed policy when some business says “Nah, I’ll keep my money, thanks for suggesting I participate though.”

The simplest to understand term for government enforced spending is a “tax”. In this case, it’s a corporate spending tax or political donation tax.

All three of the numbers we’ve been focused on here can be estimated, even if badly estimated with a huge range. We have macroeconomic data available through many sources to help estimate the most significant part in my eyes which are the revenue sources. Those revenue sources seem to be the area you are least interested in attempting to nail down. It seems to me that you believe it’s like this gargantuan component of our economy that dwarfs all our other spending.

Marketing and Advertising is something we as individuals definitely can see a lot of, and the amount of money in political donations are clearly something we all wish we had less of, but I don’t think either of these numbers in actual economic terms are anywhere near as much money as you seem to think they are.

Again, my estimates suggest that political donations are currently around $10 billion on an annualized basis (I was generous and made it 20x that). On advertising $500 billion seems right to me, we could even double it to $1 trillion (10% of that is $100 billion).

There are knowable constraints here. Please stop telling me how great you think this system will be, and guesstimate how big you believe the numbers for these revenue sources actually are, please.

11

Medical care, health, IS, and always will be, about the individual, and each individual, unique “Life.” The point I’ve made in at least a half dozen ways already during our exchanges, here (and there are many more ways to illustrate it) is, if you are not looking at how a service system is utilizing public OR private money to attempt, at least ostensibly (because there are lot of unknowns, and unpredictable variables in medical science–that’s the “medical arts” part–and a truth too many people, both inside and outside the system, do not want to acknowledge, much less understand), to, first and always, protect/preserve/improve individual Life, you are wasting your time (and math) trying to evaluate its feasibility. If it’s not about the individual, first, it is not a system anyone should want. I understand why you want numbers. I want you to understand why numbers, as a first, or only, evaluation criterion is not the proper perspective from which to pass judgment on “feasibility” because the numbers we have in aggregate, at this point, are extremely misleading. The problem, for starters, with the numbers/dollars, is there is no mandate they be extended equitably to each individual who is in need (or, in no small part to any sick or injured individual, at all).

The system must be demanded to act responsibly with the money being fed into it, no matter where the money comes from and no matter what the amount. Under the People’s Mandate, that demand for responsibility is made on the actual user of health services, so everyone will be obliged to learn a whole lot more than most people want to be bothered to understand now about healthcare costs, and thus, feasibility. And that will be taught from a very young age. We then decide, as a UNITED nation, going forward, how healthcare dollars will be both generated and spent, while still allowing for individual variation and need in what is purchased in the form of health services and goods.

How about, instead of DM and privately, we do this here, on this national forum, instead, so everyone can think about it and get their first lesson about “feasibility.” We need credible sources that can tell us/US:
-in detail, the operating cost of every health insurance company in America (or anywhere else if it feeds on the American “healthcare” system–ALL of it-

  1. the salaries/wages/private contractor fees/bonuses/retirement packages/real goods and services supplied cost equivalent–including their health insurance/fringe benefits like use of a car, or company frequent flyer miles, or the reserved executive suite, etc., etc., etc. paid to every person who gains income or non-income assets/benefits from health insurance “businesses,” plus things like FICA tax matches being paid and any accruing retirement savings plans, stock options, pensions, and the like, all of it listed by job description and salary bracket. This is the only place to start to evaluate how reasonable or ridiculously inflated the macro numbers are.
  2. the cost of buildings, new and old, how they were contracted, were there bids?, what was the real estate cost?–could something less expensive been done, or was the new building built to “look better” or “richer”? (which is advertising ) when the older offices were sufficient but the company decided looking newer and better would get them more “business,” so it was a better way to compete with the other companies supposedly supplying the same things to the American people, and diminish profits rather than paying federal income taxes on the health insurance company’s profits to the $35 trillion in debt-hasn’t had (or attempted) a balanced a budget in years federal government. What does it cost to maintain these buildings?-lights, heat/AC (were newer ones designed and constructed to minimize/diminish these infrastructure costs, or do the grand entryways look like you are walking into a five-star hotel like most of the larger insurance company buildings and hospitals, for that matter, look like these days?–attempting to give the impression of “wealth”-, cost of custodial/maintenance staff if not included with #1 above, cost of materials and goods used for maintenance and “work” done in the buildings itemized down to the last HVAC filter or IT hardware/troubleshooting or water supply system access bill, coffee and anything else the company supplies FOC to employees while working, COMPUTERS, PHONES, PRINTERS, COPIERS AND FAXES, record-keeping facilitation and housing, desks, tables, chairs, microwave ovens, paper products (in both the bathrooms and the boardrooms and anywhere in between), “office supplies” including pencils, pens and paperclips right down to the last staple, along with estimates going forward on upkeep items like paint, new carpeting/flooring, superfluous interior design accoutrements (because the old ones were starting to look shabby, etc., etc., etc…
  3. How much of yours, my, and everyone else’s tax revenue has the federal government handed over to health insurance companies since 2010 to subsidize what was already proven to be a failed system (high deductible policies to supposedly allow for lower premiums–you DO NOT want me to get started on this one–it makes poorer people who work for themselves or in a low profit-margin small business of under 50 employees pay insurance companies for healthcare they cannot AFFORD to use) by the time the ten thousand un-read pages of the Affordable Care Act was signed into law?
  4. how much of yours and my and everyone else’s tax revenue has been handed over to insurance companies to “manage” part C of Medicare since that debacle of fiscal incompetence began?
  5. …and then, once you get your totals, recognize, under The People’s Mandate all of these “helps no sick or injured person one iota with their recovery,” costs (and much more) go away as part of what America is spending on “healthcare.” Feasibility? Hospital billing offices no longer need to file claims with these behemoth, greed leeches because the hospital already has a steady income and operating budget cashflow to sustain good care being offered to its average case load (the hospital being tailored in every way to serve the needs of its known population in its own geographic area), and isn’t wasting time billing an insurance company that knows absolutely nothing about the patient or their locale and circumstances for five times what a pack of suture actually costs, the hospital often being told a “coding” was incorrect or a service/item is not covered under the patient’s “plan” (that the insurance company is at liberty to change at any time, for any reason, and dismiss all argument by stating “coverage does not guarantee payment”) and having to re-submit claim after claim, hoping to maybe get enough from the insurance company to break even at cost on it (I will describe actual hospital billing numbers in a future post–the same one where I will elaborate further on my still-missing $104) (PS–the hypothetical hospital I’m describing here got its suture, as well as the rest of its medical supplies from a cooperative contract directly with the suture (or any other supply item) producer worked out under the NHSA system–no six “middleman” medical supply companies, or salesmen and advertising from same, necessary).
  6. Again, feasibility? Imagine what could be done if the HSAs, just for the first year, had this much money NOT being spent on unnecessary “management” and supply chain “handling” put into them as a one-time start-up.

All the broken, wasteful, and worse than worthless pieces and parts of the system have to be identified and extracted before anyone can do a true accounting of what we are spending in this country to provide actual, beneficial, hands-on (or at least nearby and concerned about the individual) health help.

From the original presentation of this proposal:

If you want to read about some of the macroeconomics of this disturbing fact you can start with the book Deaths of Despair and the Future of Capitalism by Anne Case and Angus Deaton, two highly regarded professors of economics and public affairs at Princeton, and Princeton and additionally USC respectively. Throughout my reading of their work, I wanted desperately to interject many of my observations and experiences with this profit-driven instead of patient-driven health system as a licensed MD (albeit of a different sort–still subject to all of the same regulatory rules plus a few additional ones, out of an even more expensive professional education, while likely to never earn a tenth, in an entire career, of what most MDs can expect to be getting by the time they reach their first position out of residency–we are starting to see “deaths of despair” among veterinarians, just as we have, tragically and in appalling numbers, among veterans for many years now–the VA being another distinct, and should not be, peculiarity (and often disgrace) of U.S. healthcare). I wanted to discuss these authors’ conclusions with them as that doctor, and also as a patient, and as a highly informed patient advocate in this current U.S. medical system (both professors are intimately familiar with nationalized medicine as offered in most other modern wealthy nations–as am I being only myself, second generation American–from Norway–one of the countries you brought up as an example because of what they spend per person on healthcare).

All of the above experience is inevitably influenced massively by what the money gods have decided to spend or deny this week, or any week, and what mis/deficient information and outright lies they are putting forth via mass media advertising (and indoctrination instead of education–e.g. that girls can decide they are really boys, and boys can decide they are really girls, and the medical system can make that so for her or him, for free, to “help” them, medically–when, in fact, these CHILDREN have been irreversibly harmed, for life.) to make more money for this arguably insane, as well as hideously overpriced system, not to protect/preserve/improve anyone’s health.

You cannot make decisions about what something is worth, i.e. “feasibility,” when you don’t know what’s inside the package being offered for purchase, nor about all the alternatives that are out there (including doing nothing when that is the appropriate course of action–I am now ten years out of declining cancer treatment for a cancer my own education and experience told me I likely did not have–ten years, and four oncologists later–a separate post about that whole ordeal is definitely in order at some point–cancer “treatment” and better education about what cancer is and why it occurs is a dire need in this country, because the story being taught in medical schools and told by mass media and well-meaning, but often grossly misguided charitable organizations to the country at large needs to be corrected),…out there that will serve individuals as well, or better than what is inside the package, but the purveyors of the package don’t offer the alternatives because the purveyors don’t see a way to make it “profitable” for “them.”

…and after all, American healthcare, under pure capitalism, is about profits, first, and patients and everyone else later…if at all.

12

Okay, let’s take them one at a time, from easiest to hardest.

  1. How much money, in number of dollars terms, do you believe are donated to political activity, on an annualized basis, that you believe would be covered by the proposed 50% notatax?

I propose $10 billion on an annualized basis.

That comes from $20 billion in presidential years (based on data from opensecrets.org), $10 billion in mid-term years (I just made up out of thin air that it was half), and $5 billion in off years (again made up that these are half of a mid-term year). Which combined (20, 10, 5, 5) is $40 billion over a four year cycle. Which makes for a nice round estimate of $10 billion when annualized over four years.

What do you think?

13

Sounds reasonable. Need to ask, are you only including federal in these guesstimates?
As noted in the original proposal,

“anywhere in the USA” is key. EVERYONE gets on board with this—UNITED States of America (so it is taught at a grassroots level from the beginning, not as an edict from on high, i.e. Washington.–people in my neck of the woods tend to ignore Washington and its edicts quite a bit–another topic for another day…but has a lot to do with who just won an election). I’m asking, because if you are not including state and local, your numbers need to be a little higher (maybe quite a little), and I’m asking because, like the Electoral College, it allows big and small places, rich and poor people to feel equally proud after EVERY election that they’ve made an effort and a contribution toward national good health. That becomes a bonus to EVERYONE (i.e.“UNITED” again–yes, I am going to keep using that word–if you like it, great, if you don’t, get over it, OK :wink?), every time, regardless of who gets elected. The bragging rights on that alone may see an increase in political donations going forward. (PS on the notatax <<luv that moniker for this, aspects–I bet it won’t be long (if at all) until you don’t have to halve the numbers–i.e. the big donors who have been buying Washington for years to get what “they” want have enough money to just write twice as big a check).

Also from the original post,

At least it’s supposed to be, and I think we can somewhat count on that because the main two sides are always monitoring each other, trying to catch the other ones cheating. Under the PM-HfAA this should be encouraged–let’s put political bickering to use to Heal America, no? And if it is being monitored as required, you should be able to get very exact figures on how much we’re talking about…from somewhere–maybe we check with a Congressman’s office on that one? If I get a chance, today, I’ll try to track down someone in my little town who can answer the local question.

Next feasibility question? (and thank you for this)

And had another thought this afternoon–Lobbying. I took a very quick look at your link. I’m guessing maybe your $10 billion is campaign donations only? The proposal says,

listing PACs but not lobbyists, and it also says,

Big pharma lobbying being one of the most detrimental influences on American healthcare (with the AMA American Medical Association probably next in line to that title behind Big P), lobbying (all kinds) should be part of the Mandate.

Can you get US some numbers on lobbying? Or correct me if the 10 billion already includes it.

14

The child’s HSA is used to pay for her/his birth expenses. An HSA can be established for a child as soon as conception is confirmed–there will have to be some mid-year, pro-rated rules yadda, yadda–you’ll be good at asking the right, “how are we going to do that” question$. That HSA gets re-confirmed at birth (so if a pregnancy is terminated, that unborn child’s HSA monies return to the NHSA). As soon as conception is confirmed, the parents (we’ll get into the "what if"s on dads at a later time) perhaps make a one-time payment from their HSA to the hospital where they intend to have the baby delivered, and the child starts making his/her monthly contributions to the hospital system (or “other”) where mom intends to deliver. This is just like all other cooperatives between potential patients and their medical providers. The child, and mom, get whatever care they require at that time of birth. There are no astronomical preemie bills or whatever. The patients’ payments are coming in all the time, the hospital exists (and uses that constant revenue stream) to take care of patients, whatever their needs are.

“…the idea the father will use his HSA benefits to pay for a mother’s pregnancy” I thought this one might get your attention. Good questions. As far as paying for the mother’s pregnancy goes, her own, and the child’s HSA pays for that. It would be good if the father’s cooperative agreement with the hospital of his choice (for himself) were the same one his partner in creation of another human being were using, I suppose, but I don’t have a gut feeling about this one way or the other. What’s a man’s point of view on this?

My mention of parents making an effort to be sure there was adequate money in their HSA for a planned-for child was thinking along the lines of we should make carve-outs in the HSA system for parental leave and eventual early-years child care (RIGHT TO MATERNAL/FETAL HEALTHCARE & EDUCATION to stabilize the abortion issue has some specific ideas on details of “what” is needed, for example). I am suggesting the lost work time be compensated out of the HSA, that that be an allowable deduction with specified limits, etc. (not by forcing the employer to pay for maternity, and sometimes paternity leave–as well as whomever fills in for the missing employee). Daycare could be paid by the child’s own HSA?

Do you plan on requiring paternity testing to ensure we’re taking from the right father’s HSA? short answer, No. But that’s because I’m talking about a wanted child who is being acknowledged by a father who wants to be one. And no one is “taking” anything from a father’s HSA. He is directing what medical providers are allowed to debit his HSA. OR in what we’re discussing here, he has notified the NHSA he is going to be a dad, and he will be filing paternity leave with appropriate timing when that becomes something he is going to do for his health and that of his child.

Mandated paternity testing is a legal matter. It may become an issue at some point in some court somewhere, but it isn’t a part of this proposal (this proposal, as I’m sure you recall from our earlier exchanges is all about getting the legal system OUT of healthcare as much as possible). Elective paternity testing would always be an option for a dad, or dad and mom, of course. That is a private matter between them that, yes, would become an allowable expense under an HSA, just as many other elective procedures are (presumably already covered under whatever their monthly payment is to their chosen medical system. I need to keep emphasizing this, we need to strike a balance in this country such that we are automatically putting enough into the NHSA system every year such that the hospital/lab that’s receiving a steady income from the system just does whatever needs to be done in an appropriately timely manner, as the work comes in. There is no billing at time of service anymore. No catastrophic medical bills for anyone, ever. No insurance denials, ever; no waste of anyone’s time deciding “if” about any of it…or making a massive profit on someone else’s tragedy…

“Can anyone just step in and say “put the bill for those healthcare services on my HSA for that other person”?” Again, short answer, No. Anyone, can make a contribution to someone else’s HSA, however (or an individual can add money to their own HSA if they want to–though I can only imagine doing that if the HSA interest rate were more than what could be gained elsewhere—will be interesting to see where that works out with the state banks–unless it’s just a self-discipline thing that a person wants to put something away toward a potential health thing (or toward retirement?–as this system slowly replaces Social Security???)

In the case of a very unusual situation–sudden mass unemployment because of a natural disaster (such as the storms in the southeast not long ago) there should certainly be an option for people, or groups (churches, relief agencies, the government?) to put non-HSA money they are choosing to donate into other people’s HSAs. And then victims so-affected would have a special dispensation to take specific deductions from their HSA–we’re talking a “health” emergency after all–at their time of need. The HSA accounts would be a very expedient way of getting appropriate help to people when they really need it (note, no HSA holder is identified as an R or D or any other party affiliate–politics needs to be booted out of HEALTHcare permanently, too)

Great questions! I don’t think they’re rhetorical, at all. I think we/WE are going to get this done…soon.

15

A lot of good questions in just this paragraph. Let’s start with the first two:

The “period” is once a year (the Wednesday before Thanksgiving seems extremely appropriate) for distributions to pass from the NHSA assets held in trust by state banks, to IHSAs (INDIVIDUAL Health Savings Account. that’s probably a better designation than AHSA–they’re ALL AHSAs, including the NHSA, right?). The banks have been accumulating money from political donations and excess revenue used for “advertising” (as newly defined under U.S. business tax code) all year long. They know this deposit shift is coming in late November. Perhaps the appropriate cut-off for the NHSA fiscal year should be election day? The distribution within the bank is largely a computerized re-distribution of held assets within the bank (while new PM-HfAA assets continue to come in and go into the NHSA national trust fund, verified ?quarterly by internal bank audit and ? annually by banking regulatory (federal?) auditors who have no conflict of interest of any kind (like don’t have a federal auditor audit the bank where his/her own IHSA is held).

Non-citizens? A person in the United States as a non-citizen gets their first distribution into their IHSA (which they are required to establish) in the year they get their green card?–or whatever documentation (e.g. here under circumstances of needing political asylum) identifies them as being here, as a non-citizen legally. No, they do not receive backed up distributions to their IHSA commensurate with their age (they chose to come here). But, they can sign up with their chosen doctor and hospital cooperative so they will receive needed medical help when required (and not have to deal drugs, commit other kinds of crime, or be forced into some kind of prostitution to get health help), or be allowed to tap the already tapped-out Medicaid systems.

Might go a VERY long way toward encouraging people from all over the world to apply to come here legally, as our immigration laws order, rather than risk life and limb and pay whatever money they do have to human traffickers just to crash a border any way they can, no? (and hope and pray the current Administration in Washington will extend human services to them–human services this $35+ trillion in debt country CANNOT AFFORD)

This is how to “encourage” non-citizens who want to live here to want to be “identified” non-citizens (not “illegals”), via their IHSA account number if nothing else–which also reveals very important information about their whereabouts by way of which state bank is holding it as an account. People who cross the border illegally, or come here illegally in any way are not eligible for an IHSA unless and until they leave, and apply to re-enter, legally. If they are apprehended more than once for entering the country illegally, they will NEVER be eligible for an IHSA. Even if they eventually establish residency legally, they will be expected to pay for any medical services received, out-of-pocket via personal assets according to how much the hospital/doctor deems specific services are worth–charging excess for this need to do itemization on a criminal’s bill–no charity, and hospitals can directly attach to assets of known criminals (–because we’ve stopped bankrupting bill-paying, hard-working, law-abiding American citizens by doing this)

Americans no longer pay point and time of service bills to hospitals according to the complexity and inherent costs of whatever medical help they needed. Americans now pay a fixed, monthly co-operative fee out of their IHSA to their doctor/hospital of choice. And that hospital gives them what they need when they need to go there, whether what they need is a bandage, or brain surgery.)

It needs to be kept in mind, non-citizens are not going to get a job with healthcare benefits once the PM-HfAA is in place, either–if their employer wants to fund the IHSA of a more-than-once violator of our national laws, I guess that’s between the employer and the State Department and Justice Department, but that funding is NOT tax-deductible for the employer business.

As to the unbanked: An IHSA is a pretty good reason to become “banked.” (and it doesn’t require having enough money to make an opening deposit because that’s been provided under the PM-HfAA) People get a driver’s license/government ID by way of visiting a government office/establishment at least once (they figure out how to get there, somehow). Someone obtains a social security card for them, or they got one by filling out the appropriate paperwork and mailing it somewhere. Banking can be done by mail or via cell phone these days. Once the IHSA account has been linked to a doctor and hospital system, the INDIVIDUAL holder of the account has granted the designated doctor/hospital authority to debit the account in payment of the monthly cooperative. There really isn’t anything the Individual has to do unless they want to change doctors, check they received their annual distribution from the NHSA trust, or would like to see what the account has gained in interest. And even these things can likely be done by phone or mail because the account holder was properly identified by the bank (under the Patriot Act among other federal laws which state banks routinely follow and federal banks routinely ignore–my real life experience, with evidence, NOT, conjecture from listening to alternate media–because our worthless mainstream media ignores this to the tune of one person in America having their Life, in the form of their identity, stolen from them every three seconds because of the out-of-control, “business as usual” by the federal loan sharks.

The state banks holding the NHSA will profit (be paid for their services) on the NHSA deposits the same way banks “profit” now (or are supposed to) on any other kind of “savings account,” by lending money they hold in deposit accounts to borrowers (who are usually working for a living) who want to buy a house, or a car, or some other expensive item they arguably need, but cannot afford out-of-pocket, all at once. Borrowers then make payments, with interest, on the money borrowed, for a secured and contracted period of time.

The bank, out of that interest income from borrowers, then pays all of their employees and operating expenses, as well as interest on their deposit accounts. (PS No one gets rich working for a local bank, even as its president, but they can earn a comfortable living–and remember, with this system in place, the bank no longer has to provide “health insurance” benefits to their employees–a huge amount of money the bank can now further distribute as wages/salaries or interest paid to depositors, including IHSA holders, as the bank deems appropriate.)–why and how the NHSA system becomes a “savings” system.

Well-run small banks have been operating this way pretty much since banking began. My little T-----ville National Bank about ten miles from where I live still does. And it currently is paying me 5.25% on a 15 month IRA deposit account. (They are the “Bailey Building and Loan” of central Pennsylvania in my opinion–and I’ve dealt with a lot of banks, Big and small, at this point in my life).

The beauty of this system is all these little banks are not engaging in speculative, unsecured lending (like credit cards) and are not peddling personal debt as a “bank product” thru advertising telling people they are “pre-approved” for credit they arguably (or clearly) cannot afford (thanks to federal mandates by financially clueless, reckless, and power-hungry politicians buying votes–can you say sub-prime mortgage?), and these small, respectable and fiscally responsible banks are legitimately checking the IDENTITY and other relevant things like income, and credit history of their borrowers, declining to loan money to people (OR businesses) who fail to pass credibility and authenticity tests and show no visible means to be able to pay the applied-for loan back. The state banks are not being asked to, or told, they

I hope I’ve cleared that up adequately. If not, please ask another question!

Another beauty of all of this is these banks will have a very large amount of deposit assets securing their conscientious lending and are assured of a continuous deposit stream and holdings, as well as a largely predictable pattern of deposit depletion (the monthly payments to the doctor/hospital cooperative). All of this serves to stabilize the state banking system, making it the most secure part of our national money system. Bail-outs and bank closings are largely a result of incompetent and/or corrupt lending that tries to profit on foreclosure, i.e. stealing, from borrowers, not from encouraging deposits with worthwhile and stable interest paid (that cannot be guaranteed on things like stock holdings and other hi-risk investment that is subject to economy fluctuation due to political disagreement}.

One thing I recognize you haven’t understood (and you are not the only one) is individuals largely DO NOT

Their cooperative payments to their doctor/hospital remain the same whether the individual is healthy or ill/injured.Some other complicated numbers that need to be gathered are actual, not profit-driven, hospital and clinic operating costs Hospitals are no longer profit-driven and having to “sell” the most expensive procedures/treatments (whether they are the most appropriate “help” or not–cancer medical care comes to mind again). Hospital income is stable to meet staff, supply, and infrastructure costs. There is no medically completely un-knowledgeable, corporate CEO somewhere saying, “We need to do more liver transplants (or joint replacements). Start having our doctors recommend those as the “best” treatment.” (<<those are real-life scenarios I have witnessed tangentially as a patient, not something I made up for this discussion). Ditto, doctors are at liberty to recommend no treatment, coupled with lifestyle and diet changes and have the patient come back for follow-up monitoring and not be fired for not “generating” enough revenue, or for being sued by a medically-clueless malpractice attorney for not recommending the “best” treatment or most most expensive drug, first. There is no insurance company, so there’s no one telling the hospital it will not be paid for some reason (or none at all) because the insurance company “declined” “the claim.”

The doctor/hospital was already paid, in advance, via IHSAs, before the patient made the appointment, whether that’s the (required) one appointment they need to make every year for an annual check-up, or the twentieth appointment they needed to make that year (which gets scheduled according to the criticalness of the problem as decided by hospital/doctors’ schedulers (who work cooperatively with other hospitals which may have a different current caseload)–not according to insurance company whims. So, the answer to

is no, because there is no need for that to happen.

Clearer now, how this truly works? I hope…

16

The estimate includes all state and federal campaign contributions plus all state
and federal lobbying already, plus dark money ad spends, plus multiple levels of PACs.

Really, you should poke around the opensecrets.org website. You keep claiming that all this data is public and should be retrievable… you’re right, and that website is a place that organizes it, summarizes it, and publishes it all the way down to the lowest individual contribution details to make it easy for us to get and do our own research.

Quick correction, I used only Federal lobbying in that 4.5 billion figure, State Lobbying adds another 1-1.5 billion, bringing the lobbying total to under 6 billion. That amount won’t change the rounded estimate of $20 billion for 2024.

I also only did the detailed work for this 2024 presidential year, mixed in with some 2023 numbers, which should give us a decently high-water mark year estimate.

We could call it $10 billion per year on average, or $20 billion, and it won’t make a difference in the analysis.

The order of magnitude is the concern here. Political spending is on the order of the low tens of billions annually, and therefore a 50% tax on that, will contribute a low tens of billions amount of revenue to the NHSA.

Frankly I think we should exclude all personal contributions to candidates because this tax ensures that campaigns have 50% the money they would normally get, but that’s a secondary “in the weeds” detail we can talk about later.

17

I did do some preliminary poking on opensecrets.org before you made this post. It is, indeed, a seemingly excellent site full of useful, detailed information (some of the specifics worthy of more posts). There’s a major problem for our purposes, here, however:

[quote=“Mike Fair, post:4, topic:1098, username:mjf75”]
The “Dark Money” spending seems to be around $500 million
[/quote] [my emphasis]

The Dark Money is the “black hole” where the better part of a fifth of GDP has been going for years now, claiming to be in some way connected to “healthcare” dollars often being collected by and for people who have no medical, or other health-related skills whatsoever under the fraudulent heading of a “non-profit,” the name of which always implies some type of “good work” is being accomplished. This money, in the tens? hundreds? of billions of dollars if not more (and, yes I have tried to do my internet searches in this direction–what is supposed to be “public information” is anything but) is being sucked away from hospitals, clinics, doctors’ offices, physical therapists, legitimate primary research, etc. etc. etc., even gymnasiums and veterinary offices, and the people who work for all those places along with small donors working everywhere else, and more, to further line the pockets of the uber-rich, who then “redistribute” that American wealth intended to be providing “help” to “those less fortunate” (which obviously includes a whole lot of the sick and injured) to the political party, local/state/or federal of their, the non-profit’s CEO and/or directors choosing. There are no limits on how much of Washington (or local/state) government these “wealth-ists” can buy and then demand what’s been purchased–Congresspeople on down–do the wealth-ists’ bidding.–And trust me, that bidding has NOTHING to do with your son having gotten the heart surgery he needed, when he needed it, nor my, after waiting in an agony no human being or animal should EVER be forced to suffer, for almost ten years, getting appropriate orthopedic surgery to restore me to a livable, at least minimally functional, quality of life.

“In the United States, some types of nonprofit organizations may spend money on campaigns without disclosing who their donors are. The most common type of dark money group is the 501(c)(4) (often called social welfare organizations).[[3]]”(Dark money - Wikipedia)[4] Such organizations can receive unlimited donations from corporations, individuals and unions. Proponents of dark money maintain it is protected under the First Amendment, while critics complain recipients of dark money (as with any contribution) are beholden to their funders, while voters are kept in the dark about connections between donor and politician when favors are paid back.[5]

Dark money entered the politics of the United States with Buckley v. Valeo (1976), when the United States Supreme Court laid out “Eight Magic Words” that define the difference between electioneering and issue advocacy – exempting the latter from election finance laws. Dark campaign spending increased from less than $5.2 million in 2006 to well over $300 million in the 2012 presidential cycle, more than $174 million in the 2014 midterms,[3] $216 million in the 2014 midterm elections,[5] and more than $1 billion in all 2020 federal elections.[6] The 2010 landmark case, Citizens United v. FEC , marked the turning point when dark money contributions surged, and some political groups began contending that they were not required to register with the FEC as any sort of PAC because their primary purpose was something other than electoral politics.[7] As of 2022, the non-profit OpenSecrets states that Dark money is “pouring” into U.S. elections, but not only are its donors not being disclosed, the total quantity of the dark money isn’t either. “The vast majority” of what is spent "is not being disclosed to the Federal Election Commission".[8] [again, my emphasis]

To get a good look a just one grotesque and disgraceful example of a billionaire’s misuse of the gaping “healthcare” loopholes in U.S. tax code to further enrich himself and amplify his delusions of being a demigod, try reading The Real Anthony Fauci by RFK, Jr. Bill Gates is a college drop-out, computer geek, whose biggest legitimate claim to fame happens to stem from his “marketing” ideas, i.e. what he accomplished in the “advertising” realm with his software products. He knows nothing more than the average Google U. graduate about medicine or immunology, having no experiential or academic qualifications in those realms, yet, he has gone about the world conducting medical experimentation with drugs and vaccines which he then intends to profit on back here in America (sadly, with the governments of the affected countries having been on board with his ‘medical’ intervention because of his Money PS, India recently kicked him out, permanently, after he’d spent several years permanently crippling and killing children with improper polio vaccination protocols–harming more people with the vaccine than would have been expected to suffer harm from the naturally-occurring disease) on whole populations. Mr. Gates, using his Google U. diploma, apparently, had decided DNA was merely a variation on binary code (the mathematical underpinning of computer programming “language”), and his being an “expert” in that binary code realm meant he could “program” the human genome. There are reports he’s spoken to closed-door meetings at the Pentagon about how to use injected, laboratory-modified, mRNA (yes, the same synthetic biomolecules contained in the COVID shots–maybe…yet another post for another day, perhaps several posts for several days-- to effect mind control over enemy combatants. Thus, American “healthcare” is yet another extension of the American war machine, i.e. the “Defense” budget. NOT “healthcare.”

And I can give you a smaller example with which I’m intimately familiar, unfortunately, which involves prescription drug addicts in charge (the CEO and at least the President of the Board–another member being an attorney who was complicit in the coverup if not also an actual user) of an animal shelter with over a million dollar endowment using the shelter as cover for what I have evidence has become part of the NE corridor distribution for prescription street drugs, including controlled substances like ketamine (used, inhumanely in my professional opinion, as part of a pre-sedation drug mixture for the slaughter of cats in the facility–thousands per year–the cat killing being a means to obtain the drug through legal channels–they thought my DEA registration was going to become their main one–for diver$ion purposes, so when my animal welfare work there helped to reduce cat euthanasia by 75% in under two years, me and my work started to threaten the cartel–PS DEA the Drug Enforcement Administration of the federal government took my report and some of the evidence–some of the rest being held in an attorney’s safe–and did NOTHING about it, including my eventual whistleblower firing at the height of the national opioid crisis because I upheld the drug laws I’m obligated to uphold under my medical license. PPS the 30something yo, heroin addict daughter of the female CEO of the shelter was found dead on the CEO’s lawn one morning, presumably dumped there by a drug dealer she had not paid. It is still an open murder investigation in the jurisdiction, but since the local DA’s office and the nexus Commonwealth Court are involved in both the drug ring and the political benefits therefrom, it likely never will become a closed case.

I appreciate, enormously, your efforts and your hanging in, here, on behalf of our country, BUT (you knew that was coming) your math does not math, Mike, because you are working with the wrong equations, using a whole lot of incorrect variables, trying to prove the PM-HfAA is the wrong “solution.” The number you are starting with as the “must be achieved” fund-raising (for lack of a better word) goal is idiotically and unconscionably inflated to make sure, first and foremost, the already-wealthy and powerful, who are not sick or injured, continue to have their wealth and power expanded still further (because their end-goal is world domination, not a baby boy being able to live because some dedicated-to-human-life medical experts developed a surgical procedure to help him, and others with a similar condition, to survive, and grow.)

The equations we need are what are our base costs, with research removed (NIH used to fund primary research with tax dollars because the public realm didn’t have that kind of money–what they’re doing now doesn’t even qualify for the heading of “healthcare” three quarters of the time), of providing needed and necessary medical care (not whatever a patient “wants”) from among the medically-appropriate differential options (which includes doing nothing and continuing to monitor a condition for which there are limited, and questionably effective treatments, only–without threat of malpractice lawsuit–lawyers and the legal system directing medical care, after-the-fact and with money as a main motivation MUST cease–and in case you haven’t thought about it, that means all the money currently being poured into insurance premiums for personal liability becomes available to direct toward the NHSA–think about how much–or better yet, find out–money that is in just car insurance cost reduction and homeowner/businessowner cost reduction because if someone gets hurt, they go to the hospital where they are already assured of receiving care that is already paid for under their IHSA).

These costs will vary from region to region throughout the country, but so will the number of people who potentially will use a given hospital, and those people’s needs. We need to look at the numbers equations of what happens when, instead of hospital A selling more still-on-patent drugs and doing more expensive surgical procedures to reap more revenue so they can build more buildings, they instead find out whether hospital B already has staff and infrastructure in place to accommodate patients hospital A cannot, at the present time, serve appropriately.

We need to calculate many more of these type equations, AND, take an intense look at medical education in this country, from Google U./TV advertising tech school to Harvard Medical School, and demand the “curriculum” in all of it shift from profit-driven to patient-driven, permanently.

This is the ONLY way to determine “feasibility.” What we have now is not only proven to not be feasible, it is absolutely UN-sustainable. You don’t start a “math” equation by stating what the result is supposed to be, and then finding a way to force the numbers to “prove” it.

18

The number we are discussing is what does “50% of political activity” look like, as a dollar amount. It would be nice if you actually started using numbers, like I’ve requested several times now, to discuss numeric estimates for revenues and costs (1/5 of GDP is not a number, $6 trillion dollars is that number).

The number for political activity spending so far is in the low tens of billions on an annualized basis per year. Nothing in your post changes this. You said a lot, but none of it was particularly relevant to how we legally currently calculate political activity. Unless you are now requiring we change the electioneering rules to say that issue advocacy (like a non-partisan registration or get out the vote drive) is political activity.

It looks like you are claiming the “dark money” spend is closer to $6 Trillion and not $0.5 billion.

I have no idea where you get this idea that 20% of our GDP is spent on dark money political activity because you have chosen against sharing how you get any of your numbers, but let’s follow your logic train anyway.

To make sure I have this straight, you seem to be basing it on “healthcare donations” as the main part of your estimate of “dark money political activity”, and not on current election reporting laws that are actually in place now?

You then give an election law history lesson that is irrelevant because, like it or not, the existing rules are the world we actually live in to calculate these things at the moment.

Then you use your hypothetical world where the political activity laws are what you believe should be the laws as the basis for including this $6 trillion conclusion.

If there is $6 trillion in unreported political activity spending, I agree, that would definitely be significant but I sincerely doubt the “dark money” number is actually this high. Since we aren’t requiring any actual basis for the numbers we throw out here, I am claiming that this extra “dark money” you are claiming is less than the total combined spends of all existing known spending activity.

Which means, at best, it adds another $10 billion to our existing annual political activity spend.

Knowing who the donors are is irrelevant to the amount. 501c3 orgs are required to file open tax returns with the IRS which we could download. They are required to file electioneering ad buys with the FEC.

Or are you claiming that these “dark money” donors/organizations are violating existing electioneering laws to the tune of $6 Trillion dollars in illegal political activity contributions already and we are currently not prosecuting these criminals who are messing around with 20% of the nation’s GDP in our elections? Because that’s a different claim that would make the $6 trillion more relevant to our calculation but also mean a serious dereliction of duty on the part of the FEC and many others. I don’t think you’re making this claim, I think you’re making the claim that the current rules are wrong, and if they were corrected to your point of view, that would make this money relevant for taxation purposes under the proposed plan.

Otherwise, I don’t care what the “healthcare non-profit ecosystem” nor “Defense Spending” looks like because they aren’t captured by the funding description unless they are participating in recognizable and significant political activity that isn’t already captured by the existing list.

If you want to add a funding source to say “50% of donations to healthcare non-profits” then this becomes relevant as it’s own discussion. If you want to say “healthcare donations” are political activity too, then we will disagree, but at least it makes this $6 trillion number more relevant.

Donations to a 501c3 which then spends money on issue advocacy is not a “political activity donation” which is the taxable source you described. If you want to claim “all political donations and spending including issue advocacy by 501c3s, individuals, and other entities” is what you really meant to say, then fine, correct the description and make that claim.

Our best estimate for NHSA inflows through recognizable political donation activity, of which non-partisan issue advocacy spending is excluded, remains around $10 billion per annum.

If you want to say we’re missing something in the estimate, use a number, or at the very least provide a method for calculating it that you’ll accept, say why you believe this number should be included (how is it currently uncaptured political donation activity according to the now existing relevant laws), and leave out most of the irrelevant editorializing.

I don’t need you to prove how bad or unfair you think the existing system is. You’ve made it quite clear how much you think it sucks and is unfair. I’m looking to nail down a numeric range for the three numbers as described in the proposal. Whether or not the existing system is fair or unfair is irrelevant.

Not that you seemed to directly complain about this case, but I really wish people would read the actual case before complaining about its decision.

  • A guy made a documentary movie about the actions of a sitting president during a significant event in America.
  • The documentary was critical of that president’s handling of that event.
  • The guy spent money to advertise his documentary while that president was running for reelection.
  • The FEC tried to claim that spending on advertising for the documentary was political electioneering.

If that case had been decided the other way, then all advertising for books, TV shows, podcasts, T-shirts, coffee mugs, movies and anything else you can think of involving anyone currently running for office would be considered “political campaign activity”.

That case is good law. We can find other ways of dealing with its consequences.

I gave reasonable estimates and you shot them down. I then asked you what the number should be and you continue to refuse to answer. We are attempting to lock down these numbers one at a time; that number is last on the list because I believe it is going to be the hardest for you as it seems you refuse to accept any answer that has an actual dollar amount attached to it.

You keep saying I’m wrong, then you accuse me of “unconscionable acts” (ad hominin attack), and then you don’t supply any numerical corrected information. You then cite published estimates, then accuse those estimates of being inaccurate to keep the issue confused and muddled. This is the kind of behavior people who don’t know what they are talking about because they didn’t actually do their homework use.

Tell me what number you believe should be the average annual healthcare spend for 350 million Americans and why you believe that is the correct number.

Otherwise, just wait on this, we’ll get there; we’re not there yet. We have to finish political activity revenue first. Then we’ll do US advertising revenue. Then we’ll get there.

I haven’t said crap about the concept being the wrong solution, merely that, as described, it’s underfunded. The description promises a lot of things that I don’t see the described funding sources being able to deliver on.

What I’m pointing out is that the revenue sources, as described, and under the currently legally recognized context, are, at best, in the low hundreds of billions of dollars.

I see no way the total annual HSA spend for 350 million Americans per year is going to get under where your funding sources, as provided for by current election law and advertising industry estimates, need them to be.

We are currently in the process of proving me wrong.

Again, you think I’m wrong, great, you should be able to prove it quite easily with actual numerical answers.

You have written pages upon pages of everything you see wrong about the existing systems which I really just don’t give a crap about at the moment because they don’t become numbers under the current legal standards.

Translate them to hard numbers, show me the math. I’ve shown you mine.

Umm, yes you do, that’s exactly what you do; you put in the numbers you can know (as best you can) and then figure out what the others need to be in order to make the equation work…

[Political Activity Tax] + [Business Advertising Tax] >= [Annual HSA spend by Americans]

That’s the equation.

19

The discussion covers costs and physicians. Simply, more physicians, lower cost, fewer physicians higher costs.

HYPERLINK “http://clicks.onlineamplifier.com/trkr/?c=42606&g=2818&p=5b1385ad625a24ac1df87eb79d1cb9ab&u=ccd4f8c29c5058db8ba2f150026eab78&q=&t=1” Interstate Medical Licensure Could Ease Physician Shortages
from HealthLeaders Media by Christopher Cheney 8aug 2014
With anxiety rising over the potential for a physician shortage in the years to come, a push is on for interstate medical licensure. Physicians seeking to practice in more than one state and hospitals seeking to alleviate staffing shortages may find their paths eased if a proposal for an interstate licensure compact is approved and adopted.

Physician Turnover Rate High As Retirements Rise.
HYPERLINK “http://mailview.bulletinhealthcare.com/mailview.aspx?m=2014082701ahla&r=5739032-0c1d&l=044-d46&t=c” Modern Healthcare (8/26/2014, Robeznieks, Subscription Publication) reports a survey by the American Medical Group Association and the St. Louis-based Cejka Search recruitment firm has found high rates of retirement for physicians, physician assistants and nurse practitioners has led to abnormally high turnover rates. The study also suggested the recovering economy has played a part in the turnover rates as the previously depressed economy was cited as keeping doctors from either moving or retiring.

Number Of Accredited Residency Positions Stagnant Since 1997.
The HYPERLINK “Doctors With Borders: How the U.S. Shuts Out Foreign Physicians - The Atlantic” Atlantic (11/18/2014, Sopher) reported that garnering “a coveted residency post is a significant hurdle for foreign-trained” physicians. Currently, “all U.S. states require at least one year of residency in an accredited American or Canadian program to qualify for a medical license.” Unfortunately, “the number of accredited residency positions has remained relatively stagnant since 1997.” Robert Wah, MD, president of the American Medical Association, said in an email, “US residency program positions have not increased at an adequate rate to accommodate the expanding number of US medical graduates and the current IMG [International Medical Group] applicant pool.”

Analysis Finds Number Of Latino Physicians Not Maintaining Pace With Population.
The HYPERLINK “Number of Latino doctors isn't keeping pace with population, study says” Los Angeles Times (2/20/2015, Brown) reports that a recent analysis published by the journal Academic Medicine “found that the number of Latino physicians was not keeping pace with population growth and suggested that correcting the imbalance could be key to addressing Latino health disparities.” The Latino community suffers “disproportionately from poverty-related conditions such as diabetes and heart disease.” Additionally, Dr. Faustina Nevarez, an obstetrician at Kaiser Permanente Los Angeles Medical Center, “said that internal studies by Kaiser had shown that Spanish-speaking patients were more successful controlling their diabetes, depression and blood pressure when they were able to consult with Spanish-speaking doctors.”

May 9, 2006
Infants Dying for Lack of Basics, Report Says
By HYPERLINK “Celia W. Dugger - The New York Times” \o “More Articles by Celia W. Dugger” CELIA W. DUGGER
More than four million newborns worldwide die each year in their first month of life, comparable to the number of babies born in the United States annually, Save the Children reported Monday.
Many of those infants could be saved with simple, inexpensive items, like sterile blades to cut the umbilical cord, antibiotics for pneumonia and knit caps to keep them warm, the group said in “State of the World’s Mothers 2006,” a new report. Ninety-nine percent of newborn deaths are in developing countries, where such items are often not widely available.

Longer Lives Mean Headaches for Health Care Industry
The Elderly-Care Industry Battles Personnel Shortages While Bracing for Influx of Aging Boomers By ERIC NOE Oct. 24, 2005 — - The elderly-care industry is facing a human resources problem. As the number of aging Americans grows, the ranks of elderly-care professionals – from registered nurses to paraprofessionals who make home visits – remains stagnant, and is even shrinking in many areas.

Lure of Great Wealth Affects Career Choices November 27, 2006 GILDED PAYCHECKS By HYPERLINK “Louis Uchitelle - The New York Times” \o “More Articles by Louis Uchitelle” LOUIS UCHITELLE A decade into the practice of medicine, still striving to become “a well regarded physician-scientist,” Robert H. Glassman concluded that he was not making enough money. So he answered an ad in the HYPERLINK “New England Journal of Medicine - The New York Times” \o “More articles about New England Journal of Medicine” New England Journal of Medicine from a business consulting firm hiring doctors. And today, after moving on to Wall Street as an adviser on medical investments, he is a multimillionaire.
5,000 Hospitals receive $125 billion a year for MEDICARE alone, how about adding some medical student seats?
Medicare pays more than $125 billion a year to nearly 5,000 hospitals. The new plan is not expected to save money, but will shift around billions of dollars, creating clear winners and losers. The effects will ripple through the health care system because many private insurers and state Medicaid programs follow Medicare’s example.

July 24, 2007 New Orleans Recovery Is Slowed by Closed Hospitals By LESLIE EATON NEW ORLEANS ó At the tip of Bayou St. John in the Mid-City neighborhood here, the brown and white bulk of Lindy Boggs Medical Center looms behind a chain-link fence. Nineteen people died at the medical center after Hurricane Katrina, and now the hospital itself is dead, sold to developers who plan to replace it with a shopping mall.

HYPERLINK “Doctor shortage: Who should fill it? - Jaimee Givens (1) - CNNMoney.com” \t “_blank” Doctor shortage: Who should fill it? [ HYPERLINK “mailto:kfaenza@fedbar.org” kfaenza@fedbar.org
The U.S. health care system is struggling with a shortage of primary care physicians. CNNMoney.com asked readers – especially those who are medical professionals – to weigh in on who can help solve the problem. Here are some responses from a dozen people, nurse practitioner,

A Prescription for Our Nursing Shortage - Congressman Jim Sensenbrenner Contact: Raj Bharwani (202) 225-5101 A Prescription for Our Nursing Shortage Washington, DC, Aug 11, 2008 - Nurses have always been the friendly faces providing comfort and rehabilitation while we and our loved ones recover in the hospital or healthcare facility. However, over the past decade, the numbers of nurses in the US have been dwindling. According to the American Hospital Association, there are presently over 116,000 vacancies for registered nurses. By 2014, that number is estimated to be 1.2 million. This shortage not only creates a crunch on hospitals and other facilities trying to administer care, but has also contributed to nearly 24% of hospital deaths and injuries. Dubbed the nursing shortage crisis, this phenomenon has drawn the attention of Congress, where I cosponsored a bill with Florida Representative Robert Wexler. Known as the Emergency Nursing Supply Relief Act, HR 5924 will help us solve our nursing crisis in two major ways. Number one, it will provide immediate relief for hospitals facing shortages by increasing the number of temporary work visas available for foreign-trained nurses. Currently, there are very few visas available for these nurses. The second, an long-term goal of this bill, is to help universities educate more American nurses to fill the vacancies in our workforce. This assistance would come in the form of a grant program that would increase the quality and quantity of our nursing schools, and in turn, increase our number of domestically trained nurses. The money for this grant would be raised by charging employers $1500 for every visa they acquire to sponsor an immigrant nurse. There are a number of factors that contribute to our shortage of American registered nurses. Universities are not able to accommodate the large demand of students wanting to enter the nursing profession, and there is a shortage of nursing instructors. Additional challenges include non-competitive salaries for nursing educators, the length of time required for a nursing education, and the rapid retirement rate of current nurses. By addressing these factors, the Nurse Supply Relief Act will especially help Wisconsin’s 5th district by providing nurses for shortages in our major hospitals such as Community Memorial, Elmbrook Memorial, and Oconomowoc Memorial.
NIH Standard of care 83 patients per physician. Another standard of care is that set by the NIH for itself. A ratio of eighty-three patients to one physician exists in 2009 at the National Institute of Health Clinical Center in Bethesda Maryland. The NIH Clinical Center has 1,200 credentialed physicians and 600 plus nurses, for “100,000 outpatients and volunteers seen there each year,” according to the Washingtonian Magazine (October 2009 pg. 36.) The NIH Clinical Center conducts 1,500 NIH funded studies and 700 clinical trials. The Clinical Center budget is $352 million for 2009, or $3,520 per patient. This Center also has 27 MRI machines. If this is the quality standard of care proposed for the United States, this quality of care requires 3.7 million physicians now for a population of 307 million (2009) and 5.06 million physicians for a population of 420 million (year 2050 according to the US Census projected population HYPERLINK “http://www.census.gov/population/www/projections/usinterimproj/natprojtab02a.pdf” http://www.census.gov/population/www/projections/usinterimproj/natprojtab02a.pdf) This standard of care would also include half as many nurses as physicians, or 1.8 million nurses now, and two and a half million nurses by 2050. As of 2009, a JAMA data base includes 940,000 medical and osteopathic physicians, including both active and inactive, alien or native, AMA and non AMA, physicians.
I am unsure how many registered nurses are licensed in the US. One table listed 120, 000. The World Health Organization lists 2.6 million nursing, midwives, auxiliary, enrolled, and “other personnel” (US for 2000). Another WHO table lists physicians at 730,000, dentists at 134,000, Pharmacists at 250,000. Thus the WHO standard provides for nearly 4 nursing personnel for each physician, yet the NIH provides for 2 physicians for each nurse, which is an eight fold difference. The probable explanation is the WHO includes many personnel under the label of “nursing personnel” who are not registered nurses, or using the same definition of the NIH. HYPERLINK “World Health Organization (WHO)” World Health Organization (WHO)

Doctor Shortage May Worsen As More People Become Insured.
The HYPERLINK “Doctor shortage to get worse | Ellington” \o “Doctor shortage to get worse | Ellington” Chattanooga Times Free Press (10/27/2010) reports that “in many parts of the nation, there is a doctor shortage” which is “going to get worse” because the healthcare reform “adds 30 million or more uninsured people to government-run medical care” but “does little to add new physicians to provide care to those tens of millions of people.” The Times Free Press adds that many “who cannot find a family doctor are likely to wind up in emergency” departments. Notably, in Hamilton County Tennessee “there is one primary-care doctor per 1,057 residents,” and "just across the state line, in Walker County, Ga., there is only one primary-care physician per 3,420 residents

Years to Equilibrium for training Healthcare doctors Page PAGE 2 of NUMPAGES 60

Definition: a state of balance or equality between opposing forces. The number of arriving is sufficient only to replace the number leaving. “the condition in a reversilbe chemical reaction in which the products of thereaction are consumed by the reverse reaction at the smae rate as they are formed, and there is no net change in the concentrations of the products or the reactants. Websten’s New World Dictionary, 3rd college edition.

HYPERLINK “Medical College Admission Test - Wikipedia” Medical College Admission Test - Wikipedia
The Physical Sciences section assesses problem-solving ability in general chemistry and physics and the Biological Sciences section evaluates these abilities in the areas of biology and organic chemistry

HYPERLINK “http://www.mommd.com/premedplanning.shtml” http://www.mommd.com/premedplanning.shtml
US Medical Schools (Allopathic)
125 schools
37,304 applicants
17,004 entrants
42.4%* acceptance
48.5% women
11.3%* US under-represented minorities
11.7 applications/applicant*
59% Public/41% Private*
Average Matriculant Scores MCAT VR 9.7 PS 10.1 BS 10.1 WS P
GPA Sciences 3.56 Total 3.63 * Adapted from: Pfizer Medical Manual, 1999 and HYPERLINK “http://www.aamc.org/data/facts/2005/2005summary.htm” AAMC FACTS

HYPERLINK “Harvard Law School - Wikipedia” Harvard Law School - Wikipedia
The size of each cohort in the HYPERLINK “Juris Doctor - Wikipedia” \o “Juris Doctor” J.D. program numbers approximately 550 students and the first-year (1L) class is broken into seven small sections of approximately 80 students, who take all first-year classes (with the exception of one distribution requirement and one elective) together. Harvard Law has 246 faculty members. HYPERLINK “Harvard Law School - Wikipedia” \l “cite_note-1#cite_note-1” \o “” [2]

HYPERLINK “Harvard Medical School - Wikipedia” Harvard Medical School - Wikipedia.
As of Fall 2006, HMS is home to 616 students in the HYPERLINK “Doctor of Medicine - Wikipedia” \o “Doctor of Medicine” M.D. program, 435 in the HYPERLINK “Doctor of Philosophy - Wikipedia” \o “Doctor of Philosophy” Ph.D. program, and 155 in the M.D.-Ph.D program. HYPERLINK “Harvard Medical School - Wikipedia” \l “cite_note-HMSinfo-0#cite_note-HMSinfo-0” \o “” [1] HMS M.D.-Ph.D program allows a student to receive an M.D. from HMS and a Ph.D from either Harvard or the HYPERLINK “Massachusetts Institute of Technology - Wikipedia” \o “Massachusetts Institute of Technology” Massachusetts Institute of Technology (see HYPERLINK “Medical Scientist Training Program - Wikipedia” \o “Medical Scientist Training Program” Medical Scientist Training Program
Prominent alumni listed in Wikipedia total about 94, fictional alumni total 11, or 1 in 9. This does not count fictional alumni. See the web site.

HYPERLINK “Yale Law School - Wikipedia” Yale Law School - Wikipedia
Table lists 700 postgraduates.
HYPERLINK “List of Yale Law School alumni - Wikipedia” List of Yale Law School alumni - Wikipedia

HYPERLINK “Yale School of Medicine - Wikipedia” Yale School of Medicine - Wikipedia
Table lists 413 MD students, plus 74 MD/PhD.

HYPERLINK “http://www.law2.byu.edu/admissions/faq.php” http://www.law2.byu.edu/admissions/faq.php
“about 150 students expected to matriculate”

“You can Get There from Here A Roadmap of Solution to improve the Well being, Image and Service of the Bench and Bar” by Sharisse O’Carroll, The Oklahoma Bar Journal vol 79 – No. 33 – 12/13/208 pg 2783. At this rate there will be one lawyer for every 100 Americans by 2050. Citing Jason M. Dolin “Opportunity Lost: How law school disappoints law Students, the public an dthe legal profession,” 44 Cal. W. L. Rev 219 (2007).

HYPERLINK “http://www.aamc.org/data/facts/2007/schoolgrads0207.htm” http://www.aamc.org/data/facts/2007/schoolgrads0207.htm