The Health of Our Health System

For this rant, let me qualify that in a prior career I was a Hospital Administrator and Health Care Consultant… for 15 years. I worked for the New York State Hospital Association as a Hospital Management Consultant. I was the Director for Planning and Management System at Mercy Hospital, a 500 bed hospital in Miami, FL. I was the Vice President of the South Florida Hospital Association, a consortium of 43 hospital located in Date, Broward, Palm Beach and Monroe Counties, serving 50% of Florida’s population.

So with the above pedigree I open this blog thread with the intention of encouraging all casual readers and fervent followers (do you exist?) to comment and voice your opinions. Obvious from the heading of this posting … we are participating in a dialogue about what we see is the state of our current health system. If it’s sick, then how do we treat it? Moreover, can we cure it? Lastly, and extremely important, who does the curing and how will the patient, our health system, pay for its treatments?

I’ll start the discussion on a topic that will provide a foundation for all points of discussion, opinions and pompous prognostications. So here goes…

Is the consumption of health care an “unalienable right” or is it a “welfare right?” The former being described in our Declaration of Independence as endowed by our Creator. The latter form of “rights” is merely a claim for legal entitlement attached to individual interests and preferences. In other words “rights” that requires someone else to provide for what an individual may want.

These welfare rights are imposed obligations, contrary to the intent of our Constitution, where people assume risks and obligation via contracts. This sets a dangerous precedence, where the notion of rights as entitlement combined with public property and money leads to political and social conflicts.

Ask yourself this question… should my property, in the form of taxes or otherwise, be taken from me involuntarily to deliver health care to others that choose to behave badly, say smoking cigarettes or taking controlled substances? We can take this quandary one step further. Am I responsible for the genetic misfortunes of others? What about a personal preference to be in harms way? A federally funded health system would have you and me pay for Evil Knievel’s hospital bills.

… your turn.

The Not So Rich… Obama’s Fallacy

So here is the deal. In 2008 I was getting taxed at the rate of 26%... that is all my taxes withheld divided by my gross salary. OK… fair enough. I figure that giving ¼ of what I earn to Uncle Sam is acceptable.

I am a Technology Architect and Consultant. My company sends me all over the world to work with their clients wherever they are located. I am considered a Mobility Asset and for that reason, I have no permanent office, other than a dedicated room in my home. I do the road warrior 3-4-5 shuffle every work week – three nights away, four days at the client site and the fifth day at my home-office. I am always home during the weekend. My weekly travel expenses range between $1,500 and $2,500 each week, and contractually, these expenses are paid by the client as part of the fee for my services.

Enter IRS tax hell. Did you know that if you work for more that a year away from where you live and the location were you do your work is the same city or with a 50 mile radius, then all of your travel expenses are considered by the IRS taxable income? That’s right, my airfare, hotel, auto rental, meals, parking, etc. are TAXABLE INCOME. If you don’t believe me go to http://www.irs.gov/publications/p463/ch01.html and see for yourself.

So why am I complaining? Well because since January 2008 I have been traveling to clients located in the New York City and Jersey City (50 mile) vicinity and in January 2009 that makes it a year. So that the $2,000 a week average travel expenses paid to Hertz, Hilton, American Airlines and the local restaurants are considered in 2009 by the IRS to be taxable income. To make this worst, New York and New Jersey take their cut for their state income and unemployment taxes, even though I live and vote in Florida.

Remember 26%... well now it’s 71% and I am not getting any more money than before! Where is the justice in this? My company does give me tax assistance by providing an additional 50% of my travel expenses as additional reimbursement. But the IRS also considers that additional taxable income. Bottom line, I am giving Uncle Sam 53% of my real income, doubling that 2008 26% rate, just because I happen to travel for my profession!

And you want to hear something funny. The added taxable income that I am NOT getting will put me over the $250,000 Obama limit! Yippee, I am one of the rich... give me a break! It’s like triple taxation with nothing to show for it, except for the US economy in the dumps and the feds spending our money like scorned housewives using their husband’s no-limit credit cards!

We need a tea party!