$100K a year, and still in serious trouble from health care problems

[eridani]

http://seattletimes.nwsource.com/html/health/2009393598_insuredandbroke28m.html

"It's not just the uninsured. It's people who have insurance that doesn't protect them" who are fueling the hunger for reform, said Sara Collins, an economist and a vice president at The Commonwealth Fund, a private health-care foundation in New York.

Until about a year ago, Moody and Krull lived comfortably on her earnings as an associate broker for Windermere Real Estate. But despite their income and his seemingly gold-plated coverage, he can't get either a second organ transplant or an expensive drug that might eradicate his hepatitis C without risking financial peril.

A ruminative, youthful-looking man, Moody is a retired real-estate developer who now volunteers with Northwest Awakening, a nonprofit Christian outreach group he founded. He readily acknowledges the clashing self-interests — his included — that are attempting to sway the debate over reforms.

Yet he also believes that when insurance slips beyond the grasp of people like him and Krull, it's a sign that the country's health-care system has gone seriously awry.

"People say, 'You make a $100,000 a year. What's your problem?' " Moody said. "They in their wildest imagination don't think that we can be devastated by the same things."

[The_Casual_Observer]

1. If you make 1ook you bought a house, so that's it., that's where all the money goes.

This bullshit where 100k is somehow a lot of money is proffered by the journalists & so on. If you are making 100k you are actually being taxed as aggressively as can be & struggle like hell.

[Hannah Bell]

2. then the 50% making under 50K/yr must *really* have it rough.

Cause evidentally being in the top 20% of households is still poor.

[The_Casual_Observer]

3. I would guess that it unless you are into big money you are

struggling.

[Hannah Bell]

11. $100K ain't struggling unless there are special circumstances.

[MajorChode]

12. Hep C kinda sounds like "special circumstances" to me

Most private health insurance plans have catastrophic maximums. Once you exceed certain limits they cut you off and you effectively have no insurance for that condition. A liver transplant typically costs over a quarter of a million dollars and the interferon drugs for Hep C are astronomically expensive.

[Hannah Bell]

14. did you read the post i was responding to? it's about *everyone* making $100K, not just people with

hep c.

"This bullshit where 100k is somehow a lot of money is proffered by the journalists & so on. If you are making 100k you are actually being taxed as aggressively as can be & struggle like hell."


Sorry, if you're healthy & "struggling" on $100k, it's your own fault.

that's what we tell people making $25K.

[MajorChode]

19. Sure I read it, and I'm also used to your sour grapes posts

and this one isn't much different. Someone doesn't have to live in absolute squalor to be "struggling". You don't even need "special" circumstances. Many people make 6 figures simply because they live in areas where the cost of living demands it for those types of jobs. Throw in several kids and maybe an elderly parent to support, and you can easily find yourself in conditions that aren't so high on the hog as you suggest. Furthermore he was exactly correct. Someone making $100K is taxed at a higher rate than almost everyone else, and if they are self employed (as people who are in real estate quite often are), they are paying the highest rate, even compared to those who make millions (actually especially compared to those who make millions, but that's another story). A self employed person making $100K is going to pay about $22,000 more just in federal taxes compared to someone who isn't self employed and makes $50K. Throw in state and local taxes and the number climbs higher. Throw in an insurance policy that he's paying completely out of pocket (with no group rate), and other business expenses which can be significant, and suddenly he doesn't wind up with nearly as much in his bank account as you think.

So there are people who make $100K who have it pretty good, but there are also those who pay significant expenses in order to make that much, and the end result is not as cut and dried as you would pretend.

[Hannah Bell]

20. i'm quite used to your ad hom, too.

22K in taxes from $100K leaves $78 clear.

if you're struggling on $78 clear, it's your own fault.

because that's what we tell the people clearing $25K.

[MajorChode]

23. Too bad you spent too much time imagining ad hominem rather than comprehending

That's $22K MORE in federal taxes. Not $22K TOTAL in federal taxes. Big difference.

If you need help with the math or locating a tax table, don't be afraid to ask.

[hfojvt]

27. I came up with $17,225

the average tax rate of the $40,000-50,000 group is 7.9% and that of the $75,000-100,000 group is 9.7%. So that's 9700 - 3950. Plus the extra 7.65% a self-employed person pays on the first $50,000. Then the 15.3% paid on the next $50,000 (but I think that may be deductible too.) On line 27 of the 2008 form 1040 they have a $7,650 deduction.

So even after the extra $17,000 in taxes, they still have $33,000 more in income and $58,000 or so more in income than a family making $25,000.

I don't see why they necessarily are struggling, unless by special circumstances. That house payments will make them struggle is kinda silly. Many times house payments are lower than rent. They certainly were for me, about $300 a month for a house, and much less once it is paid for. Depends on how affordable housing is. In two of five markets where I have searched, I found a lack of affordable housing, but that is also from the perspective of $20,000 a year.

[MajorChode]

29. The tax tables are pretty easy to follow

So I don't know where you get your average rate, but it's pretty much meaningless, especially without any context or source, and most likely it's based on gross income and not taxable income. You can't even begin to compare gross income between someone who is self employed and someone who isn't as the apples and oranges get ridiculous.

Here's someone with an average household income of $50K straight from the tax tables for married filing jointly:

Federal income tax:
$6,665

FICA:
$3,825
(actually FICA is taxed on total earnings and not taxable income, so it's actually going to be a bit higher, but that means the difference between the two is actually going to be greater. However this is close enough to get the idea).

Total:
$10,490

Here's someone with an average household income of $100K straight from the tax tables for married filing jointly:

Federal income tax:
$17,375

FICA:
$7,650

Total:
$25,025

Now add in the self-employment share of FICA, $7,650 and you get:
$32,675

The difference is:
$22,185

That's just federal taxes. State taxes average 6.47%. So a person with $50K more taxable income is going to pay $3200 more in state taxes on average (actually they will probably pay even more as many states have progressive income tax rates). Local taxes would narrow the difference even more. Now throw in a few variables such as business expenses and health care premiums. Home and car insurance can vary widely between locations as well as many other things. In some areas the median home price is $500K or more. Compare that to the rest of the US at $170K. Are those special circumstances?

It's easy to say that someone making $100K is rich, especially if you're trying to make some type of emotional argument, but it's just not that simple.

[hfojvt]

31. they are not at all easy to follow

you don't know, for example, what a self-employed person is deducting on schedule C or schedule A. As I mentioned, they have a deduction of 1/2 of self-employment tax which you did not include. Then there are home mortgage interest deductions, IRA deductions, etc. My figures were from actual taxpayments to the IRS, from IRS statistics. What people making $40-50,000 and $75-100,000 actually paid as a percentage in 2005.

It is easy to say that the person making $100,000 is rich compared to the person making $25,000, or even $50,000. Even with $20,000 more in taxes, that still leaves him with $30,000 more in income.

On DU it always seems to be easy to find somebody willing to goto the mat for that poor, poor $100,000 person. Imaging all the ways they MIGHT be just scraping by, almost in the same boat as me. I make about $15,000 and I am not just scraping by. Ceteris paribus, if I made $100,000 I would be rich beyond my wildest imagination. Of course, in the real world, the ceterises are never paribus.

[MajorChode]

37. Match the income with the tax. How is that hard?

Whether you realize it or not, you're simply engaging in obfuscation. Ceteris paribus is exactly why I chose to use the example of taxable income, and not gross income. You're trying to pretend that I'm using the example of taxable income in order to skew the numbers favorably towards my argument, and actually the reverse is true.

If you want to approach this from the perspective of gross income, fine. I can go there too, but I don't think you're going to like it.

The differential becomes much smaller if you use gross income. An average person doesn't have that many deductions. Deductions aren't free. A self employed person making $100K can easily have $30K in business related expenses and maybe far more. In fact, it's not all that unusual to have expenses exceed income in some years. GM ran in the red for many years, and it happens to small business also. So I'm not talking about the average person who makes $100K and never so much as suggested as much, so your IRS statistics for the average $100K income earner's tax payments are about as useful as a fart in a whirlwind.

And no, it's not "easy" to say that someone who makes $100K is rich regardless of taxes because you have absolutely no idea how much they put out to make that $100K, or where they have to live in order to make that $100K. Taxes are only part of the equation.

And don't even pretend that I'm trying to say that EVERYONE who makes $100K is struggling. I'm simply saying that the blanket statement that someone needs "special circumstances" to be struggling if they are making $100K is pure unadulterated bullshit. The only thing that matters is how much you have left after mandatory expenses like taxes and cost of living are taken into account. Everything else is simply an appeal to emotion (aka bullshit). Do you still think you'd be rich beyond your wildest imagination if it cost you $90K to make that $100K? The reality is you'd be $5,000 worse off than you already are, and if you don't think that happens all the time in this country, you have no concept of small business.

[Greyhound]

35. "even compared to those who make millions (actually especially

compared to those who make millions, but that's another story)"

That's what you are failing to comprehend, it's not another story, it is the story. This is the very issue, the distraction and division, that causes and promulgates our problem. The mythical dividing line between the gatekeepers and the masses.

The people below see that income and say, "Fuck! I'm earning a fraction of that and you're whining!" and those that make that and more say, "Fuck! you low-lifes just don't understand how hard it is up here!", meanwhile the people that really matter, those that steal 100 - 1000 times that much just keep us all fighting each other over the scraps they leave.

I see it here every day, the haves defending and justifying their lifestyle to the have-nots and neither of you can see that your real enemy is the have-everythings that you both feed.

It is a class war, FFS, and it has been declared and waged for a century. Wake up and look at who the real enemy is.

[MajorChode]

38. You failed to comprehend much of what I said

So how can you even begin to claim what I comprehended or didn't?

Class warfare is a completely different subject and has next to nil to do with this thread. I've written volumes about class warfare and unfair taxes and privileges. So you'll have to forgive me for saying so, but I find the notion that I just because I chose to write a few messages about a different subject, that I could give not one shit about class warfare more than just a bit asinine. YMMV.

[digidigido]

24. I don't know where you live, but in L.A. NYC and SF $100K is not a lot of money

[hfojvt]

28. fortunately most Americans don't have to live there

but it's probably not much better, real estate cost-wise in Chicago, Baltimore, Boston, Hartford, St, Louis, Denver, etc., etc., etc.

But there are still plenty of people in all those places making less than $30,000 and they probably think that $100,000 would be quite a bit, even in NY and LA.

[MajorChode]

30. And those people may also be living in wretched conditions

So you can't really compare someone who makes $30K in Manhattan with someone who makes $30K in Jerkwater, MS either. It's all relative.

The vast majority of those in the US don't live in extremely high cost of living areas. $100K jobs are relatively common in Manhattan and rare in Jerkwater. There's a good reason for that. You don't need to pay a plumber $100K in Jerkwater to find one that knows hot is on the left and shit runs downhill.

[hfojvt]

32. it's not ALL relative

and I was comparing somebody who makes $30,000 in NYC to somebody who makes $100,000 in NYC. I am pretty sure that the former would think he was kicking some serious tail if his income more than tripled. Yet to read it on DU, NOBODY can live in NYC on less than $100,000 a year.

Of course, as a guy from Jerkwater, Midwest, I think anybody living anywhere in NYC is living in wretched conditions. I would probably need more than $100,000 to consider moving there, even if it meant I could sometimes have coffee with Eric Alterman.

[MajorChode]

36. Do you know what the per capita income in NYC is?

In just NY county alone which covers a much larger area than just Manhattan, the per capita income is $127K. Compare that with $39K for the rest of the US.
http://www.bea.gov/regional/

So yes, it is all relative, just as you admit in your own post.

And I perfectly understood the comparison you're trying to make, but I fail to see the relevancy. You can give a bum sleeping on the street $10 and they might think they are "kicking serious tail" because they can now afford to buy 3 bottles of Night Train instead of one. What does that prove? The bottom line is there are people who are struggling on $100K in this country by any reasonable definition, and you don't need "special circumstances".

[Kittycat]

9. It really depends on who is needing the care, and where they live.

If you have a special needs child, and live in the State of IL - making less than $65K/year - your child's medical needs are pretty well covered by the state's Division of Specialized Care for Children. They'll pick up the tab where your insurance doesn't, and also step in - with help from the state's AllKids program and become the insurer. Unfortunately, if you make a penny more (and they don't consider adjusted gross), you're SOL. Throw in living in the Chicago region - and you're fucked. Welcome to my world. Almost everyday, i see kids at my boy's therapy clinic that get far better care and coverage than we do, yet we pay upwards of $25K/year in our insurance expenses (including premiums). They pay nothing, or a minimal amount in comparison.

[Hannah Bell]

18. according to this, financial eligibility is a bit different:

TITLE 89: SOCIAL SERVICES

CHAPTER X: THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS
PART 1200

PROGRAM CONTENT AND GUIDELINES FOR DIVISION
OF SPECIALIZED CARE FOR CHILDREN

Section 1200.APPENDIX A Financial Eligibility Scale


Family Size     Financial Eligibility Maximum*
1               $ 23,798
2                 32,063
3                 40,328
4                 48,593
5                 56,858
6                 65,123
7                 73,388
8                 81,653


http://internet.dscc.uic.edu/forms/2000Rule.pdf

pg 44.  285% of 2000 federal poverty guidelines.

[Kittycat]

21. They have a working scale.

I've spoken with them on numerous occasions. Family of 4, $65K - and diagnosis does weigh in to that, to which our son's DX qualified, just not our income level. Like everything else. Denied.

Funny thing though - while he was in the NICU, we qualified for Social Security, though not really. Apparently there's some thing where the hospitals received almost $500/mo for him being there (6.5mo), we received $30. Once he was released, we no longer qualified. I don't understand how we did at all, just because he was in the hospital - but the hospital social worker insisted to the point of being rude, that we fill out the papers so they could get the money.

[Just Saying]

4. I'm certain it depends on where you live,

It varies, but in Ohio, $100K is a lot of money. You're not super-rich, but upper-middle to upper class for sure. Everyone is taxed with the same vigor, IMO. The difference is that those in the middle probably get vastly fewer deductions since they can't afford good accountants.

Besides, the point of the OP is that they lived well on $100k and had supposedly great coverage, but the system still fails him. It's a disgrace.

[SoCalDem]

5. It could be the "morality scolds" coming into play here too

HepC has a "sexually transmitted/dirty needles" connotation to it, and the SECOND transplant thing is another. There are many people who die waiting for the FIRST..and many of them are children.

[Just Saying]

7. You could be right.

It mentions at the link that he contracted Hep C in the 1960s probably from drug use. As far as the donor lists go, I don't know if they consider that or not, but it looks like his insurance simply won't cover a second operation period. Plus the drugs that might help are $5K a month.

It's all so unreasonable and unbelievable and horrible.

[SoCalDem]

10. I have a friend with polycystic kidney disease, and she was told at age 40

"no transplant for you". They determined that it would not "save" her life, and that the transplanted kidney would probably get the disease too, so they just basically told her she would die from it, and there was no hope for her:(

[Just Saying]

17. I'm sorry about your friend.

That is tragic.

Isn't it interesting that those who fight so hard to protect the unborn and those on life support aren't screaming about situations like this?

[truedelphi]

33. That's often my reaction too. One Terri Schiavo dies and theRW neo cons

Are all bonkers, but in the time she was on life support, how many kids died because the treatment they needed was deemed "experimental" or whatever, and the treatment is thus denied.Just so the insurance company can save some bucks.

Crazy world we live in.

[The_Casual_Observer]

8. You know, it's relative & regional. , it's worked out

by the employers. 100k in LA is 50k or whatever in Ohio. It's all a struggle.

[mwooldri]

26. Especially if you have $60k of student debt as well.

[dkf]

6. Unfortunately, you don't know you are screwed until you are screwed.

Medical Insurance is BS, and taxing people more to get the less fortunate medical insurance is also BS. If someone could explain to me exactly how much single payer would cost me and every other taxpayer, maybe I could support it, but if it bankrupts the country, then I don't think that is a good idea either. I don't want pie in the sky promises, I want just the facts.

[KillCapitalism]

13. $100K isn't that much anymore.

Yeah, it's more than 80-85& of all Americans make, but you're not rich by any means. Some medical bills that equal your $100K salary can wipe you out.

$100K/yr. hasn't been A LOT since the 1980's.

[Just Saying]

16. Well, I would guess that folks living on $25K/year think it's a lot of money.

And again, the point was that they were doing great on that income UNTIL the illness and DESPITE great coverage. If people like that are getting wiped out because of our healthcare system, then the system is an epic fail. We need to point out stories like this to show that only the very, very rich can afford to really be ill. How sad is that?

[BlooInBloo]

15. The basic plot of SiCKO.

[HughBeaumont]

22. Elizabeth Warren Re: Health Care . . ..

"Unless you're a multi-millionaire, you're not safe."

Speaks volumes, I think.

[mwooldri]

25. If your insurance doesn't cover it, you're screwed basically...

even at $100k a year. If it weren't for insurance we'd be totally BK'd at the birth of my son: $250,000 worth of medical bills in his first two months alone, $150,000 in his first 2 days. I was on $30k a year at that time, my wife was on $0. My payment was $500.

I'm one of the lucky ones I guess, I have good insurance, even if it's an HSA type plan. I'm extra lucky in that my son and I both have British passports and if the worst came to the worst we could go live with my sister and get the healthcare needed there... a few extra hoops might get healthcare for my wife if needs be too.

[DFW]

34. Here's the part I hate:

From the article:

"In 2007, nearly two-thirds of all personal bankruptcies filed across the country were linked to illnesses, loss of income or high medical bills, according to a survey published in June by researchers at Harvard University and Ohio University. Of those cases, 78 percent of the debtors had health insurance when they first got sick."

Instead of bashing people whose incomes are higher than mine, I'd rather turn attention to the fact that in
our country, even with a health insurance policy, a six figure salary and a home worth a third of a million,
the fact is that you can get completely wiped out financially if you develop a serious health problem. To
me, this transcends the question of who is well-off where. The fact is that practically none of us are safe
if we come down with a medical problem that requires us to sell our residences, deplete our savings and go
into deep debt just to save our lives. This doesn't happen in most Western European countries. My wife is
a German citizen, and our children, though now living in the USA, are quite aware of this situation, and have
retained their German citizenship for just this reason (plus the fact that there was no really compelling
reason to give it up).

When my wife had cancer, she had to pay zero for the year of operations, chemo, radiation, and follow-up.
When I had my heart emergency, I was treated at a German hospital, and when I submitted the bill to my
American insurer, they tried not to pay it, even though it cost about one third of what the same procedure
would have cost in the States (they even admitted it!). But the German clinic wasn't on their "approved"
list (DUH!!). Something is obviously in need of drastic revision.

My wife and I are not financially ruined or dead because we are lucky. That shouldn't have to depend on luck.
In Malawi, I could understand it. Not in The USA.