Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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Part 3: Guideposts To The Future

Outline: Summary of Two Beads on a String:

Health (and Retirement) Savings Accounts as a Political Entity: A Lobby for Balanced Budgets

No government should favor one class over another.

Health (and Retirement) Savings Accounts as a Political Entity: A Lobby For An Improved Share of the Private Economy

The present system cannot possibly support adequate pensions for all, at least for decades to come. Since this is more or less permanent, it should be put to use, balancing proposed subsidies. On a small scale, the German and Swiss systems follow this principle, but they have been unpopular without historical disasters to preserve them.

20% copayment absorbtion

Apparently, some regions are self-suporting, some are in constant deficit.

Accumulated debts of the past.

The system cannot possibly afford to carry these debts, and must fight to avoid adding new ones.

Outliers which do not fit the model

This varies by region, which could lead to politicall partisanship.

Adjusting the Existing Pearls to Scientific Advances

A legitimate portion should be established.

The Ultimate Tension: Subsidies vs. Balanced Budgets

Employer-based Gifts

The system of increasing corporate taxes, then expunging them with loopholes, must be stopped, but probably gradually. Since corporations must compete internationally, effective rules are crippling. Therefore, it is possible the only solution is to eliminate corporate taxes (and shift the revenue burden to individuals.)

Balancing Ownership(stockholder) control vs. Corporate Profits

Some way must be devised to keep price gouging under control with taxes for the absence of competition. The patent system is a useful model, but its weakness has been the time limits.

Conclusion: exploiting the curve of compound interest must be protected by 1) special safeguards against imperfect agency 2) special safeguards against rare catastrophes 3) limiting the rules to American residents 4) the substitution of competition for monopoly .


Originally published: Friday, August 26, 2016; most-recently modified: Saturday, August 27, 2016