By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    healthcare organization
    5 Actionable Strategies For Healthcare Organizations
    August 15, 2022
    7 Truths and Myths about Being a Full-time Emergency Doctor in a Big Hospital
    7 Truths and Myths about Being a Full-time Emergency Doctor in a Big Hospital
    October 6, 2022
    health issues
    How To Overcome The Financial Impacts Of Health Issues With Home Equity
    January 1, 2023
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Health Affairs Briefing Addresses Costly Consequences of Diabetes Treatment in America
    January 12, 2012
    HSAs vs. HRAs: Which is Better?
    May 19, 2011
    Unintended Pregnancy: A Biomarker for Disease and Poverty
    February 13, 2012
    Latest News
    Let Your Lawyer Handle the Work Before You Pay Medical Costs
    July 6, 2025
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Are Republicans Plotting a 100% Death Tax on the Middle Class?
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Health Reform > Are Republicans Plotting a 100% Death Tax on the Middle Class?
Health Reform

Are Republicans Plotting a 100% Death Tax on the Middle Class?

DavidEWilliams
DavidEWilliams
Share
4 Min Read
SHARE

Merrill Goozner of GoozNews has a provocative take on the Ryan plan for Medicare. He contends that it is the equivalent of a 100 percent estate tax  (or “death tax” in GOP parlance).

Merrill Goozner of GoozNews has a provocative take on the Ryan plan for Medicare. He contends that it is the equivalent of a 100 percent estate tax  (or “death tax” in GOP parlance).

He has a point. Ryan would shift most of the cost of Medicare to patients and give them more “skin in the game,” aka incentives to keep costs down. That’s fine when we’re talking about moderate expenses for middle class people, such as encouraging patients to take a generic statin instead of a branded one. But it won’t work for the big expenses, like hospitalization, that characterize end of life care and which account for much of the cost of Medicare. As Goozner argues:

Seniors and the poor account for over half of health care spending. Within those groups, 5 percent of the population accounts for 50 percent of health care costs; and 20 percent of the population accounts for about 80 percent. These costs come for the most part at times when economic incentives have no influence at all on medical decision-making: in medical crises; in treating chronic conditions; and, for most Medicare patients, in the last six months of life.

More Read

Health Care Costs and retirees
Corporations Shifting Retirees to Health Exchanges: Is That Bad?
Where the US Lags Italy in Healthcare
Walmart, Lowe’s Offer Employees No-Cost Joint Replacements at 4 Hospitals
Medication Non-Adherence: A $290 Billion Unnecessary Expenditure
Physician Payments: The Not-So-Secret Secret

Therefore, Goozner expects the result to be that many people will loose their life savings to the medical profession and have nothing to pass on to their kids. Instead of the “death tax” going to the government it will go to the medical profession.

I agree that giving individual consumers more “skin in the game” is unlikely to affect medical practice much, especially for costly procedures and hospitalizations. The free market approach that works so well in other areas of the economy to promote efficiency, value and competition doesn’t work well in the health care environment.

But Ryan has done us a favor by getting people to start to face up to the reality that the country can’t afford it’s current approach to Medicare in particular, and that if today’s working age population wants to receive some form of Medicare at retirement we’ll have to make some changes.

The solution isn’t to put Medicare cost control in the hands of private insurance companies. Take one look at Medicare Advantage with its high costs and you’ll see why. But we also won’t be able to keep costs down just by bashing insurance companies either and focusing on their profits and executive salaries.

What we’ll really have to do as a country is figure out a way to reduce the cost of care delivery. Accountable Care Organizations (ACOs) or something like them are a reasonable first step in that direction. It’s a baby step that could still end up backfiring as ACOs lead to consolidation of local market power. But the sooner we come to understand the need to focus on the delivery system as a cure for high costs the better.

And as long as Ryan has opened the door to radical ideas, maybe we’ll also start losing our fear of looking at best practices, i.e., how other rich countries manage to spend at half or less of the US level. When I hear politicians talk seriously about what lessons we can adopt from countries like the UK, Switzerland, France and Singapore I’ll know we’re getting real.

 


TAGGED:health care reform
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

9 Lifestyle Tweaks That Can Add Years to Your Life
9 Healthcare Lifestyle Tweaks That can Add Years to Your Life
lifestyle
July 11, 2025
car accident lawsuit
Let Your Lawyer Handle the Work Before You Pay Medical Costs
Policy & Law
July 6, 2025
women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025

You Might also Like

Image
BusinessGlobal HealthcareHealth Reform

Paying Bills: A Novel Idea in Southern Europe

June 28, 2013

How Healthcare Reform Will Change Healthcare Communication Forever

November 6, 2011

Steady as She Goes or Down With the Ship, a Parable for Healthcare

June 17, 2013

Much Ado about Nothing

April 17, 2011
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?