When you tax something, anything, you get less of it. When you punish the productive, you get less productivity.
Any questions? I think Obama should consider taxing high school drop outs at 80%. Talk about an incentive to finish high school. You'd get less high school drop outs.
She implies that by her making over $250,000.01 a year that after taxes she will take home less than someone who makes $249,999.99 which is obviously wrong and shows her ignorance.
ReplyDeleteShe needs a quick lesson on marginal taxes.
ReplyDeleteIf you make over 250K, then that amount over is the portion that will be taxed at the higher rate. Anything under, will be taxed at 35%
http://economix.blogs.nytimes.com/2009/03/03/tax-fallacies-explaining-marginal-tax-rates/
Lots of assumptions being thrown around already. Perhaps she's quite aware of marginal taxes and simply wishes to not work toward further diminishing returns on time/effort invested.
ReplyDeleteThe logics makes sense to those who have their eyes glued to money and anxious to leave their society behind.
ReplyDeleteIt's rather frightfully stupid to believe that one will take home MORE money by earning LESS than $250K per year, and to behave as though one will never see a cent of any money earned above that amount because the government is going to snatch it away. 35% is not 100%. I'm glad she's not my dentist; I like mine a little smarter than that.
ReplyDeleteShe makes 320k a year now. With a tax rate increase of 5% points on income over 250k, that would mean $3500 more in taxes. Why on earth would you want to decrease your income by 70k just so you don't have to pay a few grand more in taxes? Not to mention the tax decreases on the original 250k would offset some of that increased tax 'burden'.
ReplyDeleteAnon 10:38: It's called fear. Fear that has been spewing from the media about socialism. How is going back to the tax rates of the 1990's punishment for your success?
ReplyDeleteWhenever there is an initiative, for better or worse there will be skeptics.
ReplyDeleteWhether they are motivated by fear, greed or anger, it's time to let go of our old ways and give our society a better chance and our children a better future. No one is an island.
Any dentist earning more than $250,000 per year is not doing enough to see the poor that can't afford dental care. So if she wants to earn less than $250,000 per year then can simply see more people that can't afford dental care.
ReplyDeleteJust like doctors, dentists need to spend some of their time seeing people who can't afford them. If she wanted to be in a "for profit" business she should have gotten an MBA and worked on Wall Street. Or she should have become a lawyer that worked her way up as partner for one of those big law firms.
She sounds like one greedy, selfish gal to me.
Incidentally, I'm an MD that spends a lot of pro bono time helping others not because I feel obligated but because I like helping others. I help with infertility education and referrals, anti-smoking, and gifted children. A lot of highly gifted children get misdiagnosed with ADHD, Bipolar, Asperger's OCD and others. A lot of parents of these highly gifted kids don't know how to manage and I and others spend time ensuring that the know about the proper books.
See:
http://www.amazon.com/Parents-Guide-Gifted-Children/dp/0910707529/ref=pd_sim_b_2
http://www.amazon.com/Misdiagnosis-Diagnoses-Gifted-Children-Adults/dp/0910707677/ref=sr_1_1?ie=UTF8&s=books&qid=1236583246&sr=1-1
Our dentist friend and other should read:
http://www.amazon.com/Youngest-Science-Medicine-Watcher-Alfred-Foundation/dp/0140243275/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1236582923&sr=8-1
BTW $250,000 in Boulder, CO goes much further than $250,000 in Manhattan, NY where I live. The complaint should be that the marginal tax rate should be adjusted for cost of living differences between different places to live.
David MD
With respect, sir, we don't know the circumstances (e.g. a traumatic past or a family member who falls ill) that make people the way they are. It makes little moral sense to second-guess other people's motive behind their backs. Two wrongs don't make things right.
ReplyDelete"...lest we become bitter and judgmental, working against the ideals that we once stood for."
PROPOSING A CEASE-FIRE.
"Not doing enough to see the poor that can't afford health care"?
ReplyDeleteAre you kidding me? Since when do we presume to tell people how to live their lives or do their business based on our own morality? It's great that you do such work, but that in no way obligates her or anybody to do anything similarly.
"How is going back to the tax rates of the 1990's punishment for your success?"
ReplyDeleteThis is among the weaker replies that I hear constantly. What relevance does the tax rate of the 90's have to do with the point at hand? The answer is none, but don't let that stop from spouting the party line.
The only relevant fact is that the "rich" already pay more in taxes than the "non rich" both in absolute numbers as well as percentage-wise. You're now going to take more from a group who is already disproportionately taxed. All of the distracting talk about "what rates used to be" and how "they have more disposable income" doesn't detract from that simple fact.
If people would just admit that they're ok with "rich" people paying more because they're not one of them, we'd actually be having an honest discussion at that point.
Anon 7:43.
ReplyDeleteI agree, that argument is weak as it has no relevance to our current conditions...except the fact that these tax cuts will expire in 2 years. The reply is in response to posts decrying that this is socialism, the end of capitalism etc.
No doubt, the tax sysytem is not perfect. But I ask you, what do you propose? The fair tax? The flat tax? Or no tax? Criticism is quite easy if one offers no solutions to the problem.
I am quite open to an honest discussion, whether or not anyone is paying taxes at 0, 25%, 35% or 40%. But again, offer a solution, but don't decry that expiration of these tax cuts is 'Socialism' or the 'End of Capitalism.'
"Any dentist earning more than $250,000 per year is not doing enough to see the poor that can't afford dental care..."
ReplyDeleteWow! Just wow! What a specious, head-up-your-#$% statement!
You have no idea of her, or any other dentist's participation in commuity programs like Give Kids A Smile, etc. Support doesn't have to take the form of direct participation either, but includes monetary support, equipment donation, and so forth.
The dental community has been able to avoid getting sucked into the managed care morass and thus has enjoyed, on average, higher incomes than many primary care providers in the medical community.
It sounds like you would prefer to spread the misery around a little more evenly.
Anon 7:43 and DocV
ReplyDeleteIt is the duty of the profession of health care (doctors and I would guess dentists) to spend some time seeing some patients who otherwise cannot afford to see them and people going into medicine (and I would presume dentistry) know this before going into the profession and if they don't like that idea perhaps they should consider a different profession. Today is a bit different than in the past because thanks to epidemiology we know that a number of people are intentionally causing themselves to be ill (e.g. through smoking which they know is bad for them) and then they come to doctors to fix them up. The price of cigarettes should reflect the additional costs of health care incurred by smoking otherwise it is taking advantage of the health care system by asking others to pay for ones voluntary unhealthy habit. With obesity since people must eat it is a slightly different issue but still people that eat Big Macs daily and large sugar cokes daily should be paying their additional health are costs voluntarily incurred. But there are others that through lack of being born in the "right circumstances" or through bad luck or low IQ or otherwise are unable to afford health care and there is certainly some obligation of those in the profession to at least see some people in this situation.
Dentists (most of whom do not do a residency) earning over $250,000 a year (and not in expensive markets like Manhattan) if they are so worried about paying additional taxes can spend more time volunteering their services or doing more Medicaid dentristry, especially in this time of high unemployment.
I didn't mention it but in fact I am "in touch" and do many other things to help poor people get access to good medical care and do in fact work with referral networks which includes dentists that do help others.
I don't disagree. We are in a "helping" profession. But as I said, there are many ways to help.
ReplyDeleteI think the problem with income has been poorly articulated. It's the thought that if I work harder and earn more money, a greater percentage of it is going to be taken away in taxes. It doesn't matter how much.
By the way, you would be surprised at how many dentists have post graduate training. More and more states are requiring at least one year that is similar to your transitional internship before they will grant a license. NY started that program several years ago. I did a 2 year, hospital based residency(and since I am a "guvmint" employee I make a lot less than 250K!)
We have a saying in the Navy; "Pick your rate, choose your fate".
That is not a duty. That is a personal choice. If you choose to do so, good for you. Many of us do and don't feel the need to pressure others to do the same.
ReplyDeleteI would love to see those same standards applied to other professions and watch the reaction. Somehow our time and effort isn't always our own, and that's ok for some reason.
P.S.
ReplyDeleteI have spent the last two decades providing health care to the poorest of the poor in some of the worst hell holes on this planet from Haiti to the Persian Gulf and Africa. I can't wait until I retire so I can make as much money as possible so that I can return to some of these places and do more. I don't need guidence from the government or anyone else on how to be charitable. The less the government takes from me, the more I will be able to do good works with!
Annon 1:14
ReplyDeleteWhy does one individual (a poor person) have the right to another individual's labor (a provider of services)? Why does one profession (health care workers) have an obligation to give their labor freely to the marketplace and another profession (lawyers, Wall street bankers)does not? Do not mention the Hppocratic oath - this oath also states that one should not charge to teach medicine and yet my student loan bill surely reflect that I was charged for my education. The answer is no one human being can force another to give them their labor - that is slavery. If one wants to give out of their own sense of morality - so be it. However, to claim that it is one's obligation to give one's labor for free is nonsense.
not one to each other, but to an abstract concept of a "society," perhaps? it's also known as a social contract.
ReplyDeletePlease explain how that social contract applies to other professions. I'll be waiting with baited breath for the answer.
ReplyDeleteSimple, and it doesn't just apply to YOUR profession: Everything we share from state park to social security to national defense (however inefficiently they are run) need money. That's what tax is for. Is it so irrational to tax in proportion to one's income? I think not. $500 simply doesn't mean the same thing to people with different levels of income.
ReplyDeleteThanks for waiting with your baited breath. What on Earth is "baited" breath anyway?
Hope that you haven't passed out from your bated breath. Starting CPR - GO, GO, GO!
ReplyDeleteCheer.
We are speaking as if we have the whole world all to ourselves. Who do you think pay for the EMS if, say, you are to get hurt and need to be airlifted to the nearest ED, stat? Would it be a drag if the agency no longer had budget to keep helos on flight line? "Sorry, buddy; we know that your situation is critical but have to bring you there on wheel instead." (Each flight costs about 1K, each, not counting the cost of staffing.) We are speaking as if state or federal agencies should have their budgets magically balanced or that their employees should all be volunteers. "It's MY money," you declare.
ReplyDeleteFor those of you speaking of a social contract and taxes you missed the point of my post. It had been stated that this individual dentest, because she was prosperous, had an obligation to to give her labor to individual poor people. There was no mention of society. I would argue that she has an obligation to pay taxes to fufill her social contract, and if she doesn't like those taxes she has the right to redress her grievences to the government (a right which is protected by the US constitution). However, she has no moral obligation to give her labor freely to another because she is in health care and someone tells her that this free gift of her labor is an obligation. Why is health care different in terms of morality? Should grocery stores be obligated to give free food to the poor? This issue is not paying taxes and a social contract - it is that this individual can do with her time and labor what she wants and she has no moral or other obligation to give these valuable items freely to the poor.
ReplyDeleteHear hear, Ohio Oncologist!
ReplyDeletei wasn't aiming at your post.
"Dentists (most of whom do not do a residency) earning over $250,000 a year...
ReplyDeleteWhy don't you spell out what you're saying here, Anon. It sounds like you think that doing postgraduate work is what qualifies you to make the big bucks, eh? Maybe in medicine, but dentistry is a different animal.
I prefer to do pro bono work on folks I choose. I usually do my pro bono work for drug addicts with proven recovery. If I were to see Medicaid patients the reimbursement is so bad that I would have to pay to see them.
I much prefer giving to who I would like to give to.
Baited/bated are both acceptable ways of spelling that particular figure of speech.
ReplyDeleteA very nice try at distraction though.
I don't think there's a soul here who doesn't think that some level of taxation is necessary. The issue is with the discrepancy of taxes being paid. Does the guy making $500k a year use 10X more EMS services than a person making $50k? Does he use 10X more roads? Obviously 10 is a number pulled out of a hat as it is more than that when considering the "progessive" taxation system we live in.
ReplyDeleteI wish people would just admit the truth. You want to tax the "rich" because that's where the money is, and those folks are the minority. It's not about fairness or social contracts. It's about sticking it to the other guy because you can get away with it.
Addressing my previous comments (forgot to sign Anon 1:14 which is mine too). The role of physician (and by extension I would presume dentistry) is different than other professions (my BS is in Elect Engr/Comp Sci so I am in two different professions) (e.g. law, CPA, Engineer, Architect) because there is a special duty to take care of the health of the poor. This does not mean as I said before extensive amounts of time but yes, some time. As I stated earlier in this day and age when people are deliberately causing their illnesses such as smoking these people need to have cigarette taxes raised to go into health care. If you don't like that idea you shouldn't have gone into being a physician as it is part of the physicians obligation.
ReplyDeleteInstead of arguing, read Lewis Thomas, "The Youngest Science" that I mentioned in an earlier posting. Read it, then comment.
http://www.amazon.com/Youngest-Science-Medicine-Watcher-Alfred-Foundation/dp/0140243275/ref=sr_1_1?ie=UTF8&s=books&qid=1236705644&sr=1-1
You can read the first few pages on Amazon.com.
Spring for the book and read it. Every physician should.
David MD
http://www.arkchicago.org/health.html
ReplyDeleteMedical Clinic
With the help of volunteer physicians, our medical clinic operates five days a week. Medical specialists are available in our clinic to treat those with specific health problems. Procedures that cannot be done in our facility are performed free of charge at area hospitals that have agreed to provide this assistance to The ARK's indigent patients. Clinic volunteer doctors are supplemented by a referral network of volunteer medical specialists outside our clinic.
Dental Clinic
Unfortunately, when poverty overwhelms a person’s life, regular dental care becomes an unaffordable luxury. However, even a small problem, if ignored, can have serious consequences. Our patients suffer from severe pain, malnutrition and dangerous infections. In The ARK’s Minnie & Peter H. Okner, D.D.S., Dental Clinic, volunteer dentists treat their conditions, ease pain and save lives.
David MD
Continually stating that there is a duty or obligation to give your time and effort for free to anybody doesn't make it anymore true. Again, WHY is medicine any different than other professions in that regard? Stop projecting your values on others.
ReplyDeleteDavid MD,
ReplyDeleteDo I think there need to be taxes? Yes! (It pays my salary! :-) )
Do I volunteer my time and skills? Yes.
Do I encourage others to do so? Absolutely! It's good for your soul and it is good for the community as a whole.
But as I said before, I don't need the government overseeing my charitable work and I still think your statement about "Any dentist earning more than $250,000 per year is not doing enough to see the poor that can't afford dental care." was ill-informed and patronizing.
Why is it that liberals can legislate their morality against certain demographics but when a church tries to do the same its decried as bigotry?
ReplyDeleteThis is America, and if we continually try to use the government to sacrifice the freedom of some for the entitlements/ideals of many, you'll see us become an undeveloped nation, potentially in our lifetime.
Freedom means being free to give as much to charity or as little as you like. Freedom means being free to be the next Mother Theresa or a selfish ass. We might have a moral obligation to others, but its certainly not a legal one.
As a medical student and soon to be part of the 2% minority that will be exploited again and again, I can tell you right now that I'll be taking my charity to a place that really needs it. I will continue to vote and defend the United States, but I promise you this: I'll watch this place eat itself alive on the news and then take my services to a country whose citizens aren't a bunch of whiny, entitled, self-centered, self-destructive, government dependent infants.
Physicians work their asses off and make more sacrifices in their 12+ years of post high school education alone than you ever will in your lifetime, Anonymous. They don't owe you or anyone else anything. Finally, Anonymous, don't use STAT in a medical blog discussion. They only use that on TV, and it makes you sound like an idiot.
Re: bated vice baited
ReplyDeleteBATED BREATH
The correct spelling is actually bated breath but it’s so common these days to see it written as baited breath that there’s every chance that it will soon become the usual form, to the disgust of conservative speakers and the confusion of dictionary writers. Examples in newspapers and magazines are legion; this one appeared in the Daily Mirror on 12 April 2003: “She hasn’t responded yet but Michael is waiting with baited breath”.
It’s easy to mock, but there’s a real problem here. Bated and baited sound the same and we no longer use bated (let alone the verb to bate), outside this one set phrase, which has become an idiom. Confusion is almost inevitable. Bated here is a contraction of abated through loss of the unstressed first vowel (a process called aphesis); it means “reduced, lessened, lowered in force”. So bated breath refers to a state in which you almost stop breathing as a result of some strong emotion, such as terror or awe.
Shakespeare is the first writer known to use it, in The Merchant of Venice, in which Shylock says to Antonio: “Shall I bend low and, in a bondman’s key, / With bated breath and whisp’ring humbleness, / Say this ...”. Nearly three centuries later, Mark Twain employed it in Tom Sawyer: “Every eye fixed itself upon him; with parted lips and bated breath the audience hung upon his words, taking no note of time, rapt in the ghastly fascinations of the tale”.
For those who know the older spelling or who stop to consider the matter, baited breath evokes an incongruous image; Geoffrey Taylor humorously (and consciously) captured it in verse in his poem Cruel Clever Cat:
Sally, having swallowed cheese,
Directs down holes the scented breeze,
Enticing thus with baited breath
Nice mice to an untimely death.
http://www.worldwidewords.org/qa/qa-bai1.htm
Re: RTM
ReplyDelete"...soon to be part of the 2% minority that will be exploited again and again...." By that you mean part of "the 2% rich that has rarely been exploited," perhaps?
Freedom, American freedom; very constitutional and patriotic. Perhaps in the process you forgot the sacrifice and values that made such ideal ever possible in the first place. Perhaps you haven't realize the sorry shape your gov is in today and how much it needs your contribution, voluntarily (caring for your fellow humankinds) and non-voluntarily (tax). Compared to other developed countries, we ARE already underdeveloped, by the way.
Finally, name calling rarely make yourself less idiotic that you realize. "Self-centered, self-destructive, government dependent infants." Very patriotic and very American indeed.
HAPPY 4TH OF JULY later this year.
Very nice exposition on "baited breath" Doc V. As someone who gratuated from undergrad with a BA in English with honors, but then realized they couldn't get a job , I very much appreciate a nice summary of a word's origins.
ReplyDeleteDoes anyone know where the phrase "freeze the balls off a brass monkey" comes from? how about Jury Rigged?
Thanks for the info, DocV :)
ReplyDeleteAt first i thought "baited-breath" had something to do with aquatic life or long-line fishing or something, hence the remark. LOL
ReplyDeleteAnon 5:34:
ReplyDeleteYou forgot to mention that I also called them entitled and whiny. :)
Re: RTM
ReplyDeleteWe are entitled to our opinions after all.
No harm, no foul.
Re: Jury-rigged
ReplyDeleteBeing a salty old sea dog, I can answer that off the top of my head.
"Jury" a nautical term meaning “temporary.” If a ship’s mast broke, the crew put up a “jury-mast” and “jury-rigged” it.
Anon 3/10 1:14 said:
ReplyDelete"Continually stating that there is a duty or obligation to give your time and effort for free to anybody doesn't make it anymore true. Again, WHY is medicine any different than other professions in that regard? Stop projecting your values on others."
I stated that there should be ** some *** free care on the part of every physician....
They are not my values but those of the profession of medicine....Please read what I am writing. Read the book by Lewis Thomas that I keep suggesting that you read.
Medicine is different than any other profession. It should not be a profession that you go into because your love and passion and chosen field of wasn't remunerative enough.
People that become physicians (and by extension dentists) should be more carefully screened by medical schools when applying (unlike law, MBA, engineering, accounting, architecture, etc. medical schools do day long personal interviews and there is a reason for this). If your passion is some other area besides medicine but is not remunerative enough then you shouldn't become a physician but a different profession such as a CPA, lawyer, or MBA.
Instead of commenting on my comments just read Lewis Thomas's book "The Youngest Science." Spend the $11 and read it.
http://www.amazon.com/Youngest-Science-Medicine-Watcher-Alfred-Foundation/dp/0140243275/ref=sr_1_1?ie=UTF8&s=books&qid=1236764845&sr=1-1
David MD
My grandfather graduated from medical school in 1926. He worked, went to school, worked, and went to school until he graduated. As a graduation present, the soap company he worked for outfitted his office with a desk, bookshelves, cabinets, and an exam table. He made house calls, even going by rowboat during the '36 Ohio River flood. You payed what you could, and believe me, he knew what you could pay! He went after a bank president once for non-payment of a bill. He practiced for over 50 years. Too bad those days are gone.
ReplyDeleterich people in my town go to the public ER on midgnight and not in daylight, why? because public service is free, since its FREE its too crowded in the day, people with money doesnt go to private health service at night they go at day when the public one is crowded, people want no delay, with this im gonna say people can afford health care but as long as they can save money in order to drink their beers on weekends they will do it.
ReplyDeleteshould health care be free? NO
do people have to paid an ammount for it? YES
i have seen many people that wants a free shot, no to pay medication on pharmacy, if you have money for your beer you shuld have money for your doctor.
we live in an era where people is too concerned about paying for THEIR HEALTH, but not concerned at all for paying for THEIR BEER or THEIRS CIGARRETES.
and dont call me CAPITALIST doctor, sometimes i work for free, but im noticing people just dont care, you gave them a free consult you see them drinking on a bar.
Is it possible to create an universal healthcare system that has safeguarding features that can prevent exploitation such as that mentioned above by Alexy? YES.
ReplyDeleteInternational examples: from among the richest (Germany) to among the poorest (Cuba) states that have universal healthcare systems.
Would it be worth a try: YES. (In double? Let's ask our kids when we get home, shall we?)
"It was once said that the moral test of Government is how that Government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped" ~ Hubert H. Humphrey
Hi DocV, i read it somewhere* that there are still PCPs in Southern states that run their clinics very much like the way you described your grandfather did. For them, their aim is to help rather than shear financial gain. Their patients pay them back if they can; some folks even end up paying their bill in form of shrimps and clams.
ReplyDeleteIt's unfortunately that the management care system we have today is driving many of such courtesy calls to brink of extinction....
* i'll try to find the article clip.
Re: Happy Hospitalist:
ReplyDeleteWith respect, will you trust drug reps or insurance companies instead?
Doc V,
ReplyDeleteA Breass monkey refers to the device which held cannon balls on a ship of the line. When it got cold and the metal contracted, the cannon balls would be pushed off - hence "freezing the balls off a brass monkey." It is thought that "jury" was short for "injry," but this is by no means clear.
Ohio Onc,
ReplyDeleteInteresting origins. The jury rig definition I got from an old text on seamanship, but without word derivation. I have never heard that definition of a brass monkey. I did hear a Brit Sailor in the Gulf say it was "hot enough to singe the hair off a brass monkey!"
Anonymous:
I would be willing to engage in a barter system if I could find the right small town.
A not-so-related update:
ReplyDeleteIt's impressive how EU could swiftly (practically over a weekend) agreed to authorize massive dosages stimulus packages at the onset of the current financial storm. It's equally impressive how they can put a brake on unnecessary rescue packages (and in a sense, using creative means of "collateral circulation" to keep the economy perfused) before an definite end is in sight.
We have an economy that can pull an equally impressive feat. The political structure is in the process of being redefined and is catching up.
There are means to keep companies afloat and economy perfused without resorting to massive lay-off or excessive spending. The European ways (one, two): social democracy ("social safety nets"), free market disciples & technology.
ReplyDelete"U.S. Still Struggling With Infant Mortality," according to today's NYTimes article. Hungry and Cuba had lower infant mortality rate than we did in 2004.
ReplyDeleteObama family reports an income of $2,656,902 this year and pays $855,323 in tax; that's 32.19%. NYTimes article.
ReplyDeleteBrace for impact: budget cuts to affect regional MEDEVAC.
ReplyDeleteCHINA, a country that's poorer than the US, has a population 4 times larger than ours and a health care system baseline worse than our own is taking the first initiative (Forbes) toward universal health care.
ReplyDeleteMeanwhile, the notion of universal health care in USA still gets the cynical stigma of "sharing wealth and scarce resources with bums and 'self-centered, self-destructive, government dependent infants.'"