真是奇怪的法案,                            
未來任何沒有工作或負擔不起
而不幸生病的人
都會受要相當的照顧;
反之最健康的小康之家
將要負擔最重的健保費。
(至於真正的有錢人,
大概都會移民海外吧。)
 
這根本就是在變相懲罰努力維護健康的人,
並且鼓勵人們一生病就離職,
或更可怕的:
「生任何病都不怕,所以不用刻意管理自己的健康」
歐巴馬簽署新健康醫療法案
擬縮小貧富差距
 Economic Scene

In Health Bill, Obama Attacks Wealth Inequality

By DAVID LEONHARDT  Published: March 23, 2010

For all the political and economic uncertainties about health reform, at least one thing seems clear: The bill that President Obama signed on Tuesday is the federal government’s biggest attack on economic inequality since inequality began rising more than three decades ago.

Over most of that period, government policy and market forces have been moving in the same direction, both increasing inequality. The pretax incomes of the wealthy have soared since the late 1970s, while their tax rates have fallen more than rates for the middle class and poor.

Nearly every major aspect of the health bill pushes in the other direction. This fact helps explain why Mr. Obama was willing to spend so much political capital on the issue, even though it did not appear to be his top priority as a presidential candidate. Beyond the health reform’s effect on the medical system, it is the centerpiece of his deliberate effort to end what historians have called the age of Reagan.

Speaking to an ebullient audience of Democratic legislators and White House aides at the bill-signing ceremony on Tuesday, Mr. Obama claimed that health reform would “mark a new season in America.” He added, “We have now just enshrined, as soon as I sign this bill, the core principle that everybody should have some basic security when it comes to their health care.”

The bill is the most sweeping piece of federal legislation since Medicare was passed in 1965. It aims to smooth out one of the roughest edges in American society — the inability of many people to afford medical care after they lose a job or get sick. And it would do so in large measure by taxing the rich.

A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.

原文(全)連結: 

http://www.nytimes.com/2010/03/24/business/24leonhardt.html?hp

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  • LKK
  • 健康的人不需要醫生 有病的人才需要醫生

    以有餘補不足 是全民健保的核心 是整體共同分散個體風險的社會安全網 也是經濟學教科書的經典範例

    二十年前要住院必需要先交高額保証金 沒錢就醫的人只有等死 
    義診或慈善性質的醫院因來者不拒且不收保証金 就流芳百世
    連續劇的情節是二十年前的真實事件

    私人保險公司會只承保健康的人 反而是最需要的老弱殘病者會被拒保 這叫作逆選擇問題 解答是一定要由國家出面強制全民納保 這是經濟學的好例子 

    英 法 德 日 義 荷 比 瑞典 丹麥 瑞士 奧 西 澳 紐 加 等工業化已開發國家都有全民健保 連非常弱肉強食且非常私有化的英國都有全民健保 美國是OECD國家唯一沒有全民健保的國家 
    USA花在醫療產業的錢是OECD前三名 健康指標(嬰兒死亡率與平均壽命)是OECD倒數三名  USA律師與會計師在私人保險體系中賺的比醫生還多 這是美國奇蹟




  • mike
  • 關鍵在於保費收取方式與支付項目的設計有問題:
    1.若要按照所得高低收錢,請先把稅制改善,例如證所稅復徵,土地交易按市價課征,包租公包租婆的收入...
    2.支付項目請重新規劃,例如平常看感冒跟牙齒會讓你破產,影響生計嗎?然後酒醉駕車造成事故的醫療費用請自己出....
    3.詐騙健保醫療者,加倍罰款
    健保局有太多事情可做,年終獎金要拿不是從收入面來看(強制纳保是法律規定的,不是健保局人員像業務代表辛辛苦苦取得的),有效節流才是績效(可不是簡單刪除給付,而是追討地方政府欠款,代位求償,抓詐騙...)
    年輕一輩很辛苦,交了一輩子健勞保,屆時卻可能破產,這不就是國家版的馬多夫詐欺?

  • LKK
  • 自由意志 自己決定

    人可以自己決定 投保或不投保
    不保 就是賭自己很健康 或者錢多多  若生病就自費
    投保 就是承認現狀 雖不滿意但尚可勉強接受

    英 法 德 日 的全民健保也有一些... ...的事情
    人間天堂瑞士和瑞典也有...
    世外桃源澳洲與紐西蘭也有...