There is a bit of a problem here. The members in this forum come from every country in the world. The topic under the discussion involves a local matter of one particular country. So how can it be discussed by anyone who is not an American? And if it is discussed by anyone else, how can they not help but reflect from he perspective of their own countries?
I, for one, was interested in the fact that John mentioned this reporting requirement, and the health care reforms, in one and the same thread. He never made a link between the two things which seem quite separate. For the latter, those of us who are assured health care and don't have to worry about a rapid plunge into poverty should we become seriously ill, are probably hoping that whatever is going on will help alleviate the situation down there.
You are inviting an international forum to look at your local situation. How can we not look at it from the perspective of our own countries? Is this extra reporting going to help with the health situation? Is it related to the health situation? (I'm still on page one, wondering why it was mentioned).
Exactly. And, some of us have the added perspective of having more than one nationality and/or having lived and worked in many countries around the world, including the US.
It is hard to explain how music sounds to someone who is deaf. It is hard to compare situation A with situation B if someone is only familiar with situation A, or only believes that their situation A or their status quo is the only one possible. Or who believes that comparisons to situations in other countries are attacks. Or is shocked and insulted to hear that despite what they were told ad nauseum in seventh grade civics class or what is implicitly told during hours of television advertising each evening, that their situation isn't the best in the world, and on many issues, including the tax system and the health care system is actually one of the worst in the developed, Western world.
In much of Western Europe small businesses including piano teachers already have to account for every single business related purchase and are motivated to do so, since they receive up to 19% of the purchase price back on their taxes. Likewise they are responsible for accounting for every invoice such as an hour lesson and charging and collecting the appropriate VAT tax rate on these invoices. It is ubiquitous, easy, universal and not seen or experienced as a burden. The VAT taxes collected are netted against those paid and only the difference is submitted.
At the same time, using the Netherlands as an example, everyone is on mandatory, no qualification criteria, high quality, competitive private health insurance that covers everything, including 100% of drug costs, no co pays for visits or procedures, only a $150/year deductible and a maximum basic policy cost of around $1500/year with supplemental policies available that cover more such as alternative medicine (and free for all children up to 18 years including dental and eyeglasses). Those whose income is too low, have their insurance policy costs subsidized on their tax return. Never worries about costs, no trouble finding a physician (general practitioners are spread evenly throughout neighborhoods all over the country have a walk in hour every day and make house calls), no HMO saying no, no 'in-network, out-of-network' games, no surprise bills, no medical bankruptcies, no choosing whether to eat, pay the rent or have one's medicine, no staying with a bad job instead of becoming an entrepreneur just to keep a company insurance plan. Just freedom and high quality, accessible, no wait health care at an affordable cost. And, all this is done at about half the cost per capita as what is spent in the US, with comparable and often better health outcomes including longer life expectancy.
So, if a small country without the buying power and riches as the US can make things so high quality, inexpensive, fair, easy and efficient, the question is why is that not possible in the US?
Part of the answer is to be found in the fact that those who benefit the most from the status quo (such as monopolistic health insurance companies with little to no local competition and pharma companies with carte blanche to overcharge on drugs) have much more leverage on the political process than an average citizen (who on average also does not vote).
To make matters worse, as we have seen on this thread, those who would most benefit from a change from the status quo are often the most vocal opponents, finding themselves hoodwinked by deceptive propaganda paid for by big business they fight against their own interest, that of their profession and their local community.
This ultimately leads to an unfair situation with gross inequalities and with wild discontinuities such as the recent Great Recession.http://www.thenation.com/article/36893/unjust-spoils?