The Senate Finance health care bill (available here in its plain English summary form), would tax the gross revenue (not net profits) of clinical laboratories and manufacturers of drugs and medical devices. Why would a bill that purports to help slow the increase in health care costs impose taxes that raise those costs? Especially when the users of devices and drugs are most often those who need it most, indeed may require the device or drug to survive? More curiously, why would you go along with such a tax if you are a drug or medical manufacturer?
Answer: The drug and device manufacturers are confident that their drugs and devices will be included in the federally defined minimum insurance benefit. Their increased costs will be passed through in the form of increased insurance premiums. In other words, this is an indirect tax on all purchasers of health insurance.
For the record, I'm don't think the bill taxes revenue per se -- it applies a tax based on market share of the company. All other excise taxes are charged without concern of profit or loss. If my company is losing money, it still has to pay the payroll tax for social security.
The argument that all taxes get passed on to consumers is tired. Particularly when you ignore that the money in this bill gets passed on to drug companies, insurance companies, and the medical industry in general.
Posted by: John Jensen on September 28, 2009 11:23 AMLevy a tax on gross receipts but that is ok because the government is paying the bill? Sounds like a make work plan for bureaucrats. Somebody has to handle the claims and somebody has to collect the tax.
Just like I could never understand the military paying income tax. The government pays you but you have to give part of it back? How is that right?
I will never understand the thought process of government officials.
Posted by: Vince on September 28, 2009 12:33 PMI would think the first argument would be the important one (i.e., tax gross or net). Yet, you seem to focus your point on the second. To me, it is appropriate to tax these companies for products they produce. It is no different than taxing automobile makers. I believe it is already done. So, are you arguing for a tax cut, instead (i.e., give drug and equipment manufacturers a tax break in order to lower medical costs)?
Posted by: tc on September 28, 2009 02:39 PMI agree with John on this that these companies will see alot more revenue (and profits) than the additional tax burden.
One item this does bring up that I think is a worthwhile point is whether equipment manufacturer's should be covered as minimum insurance benefit. This is where I agree/disagree with you. My feeling is basic equipment, yes should be covered, but not super-duper, go anywhere electric wheelchairs. This is what irks me about the electric wheelchair commercials. Why should insurance pay for all the bells and whistles when a base model will do just as effective job? We have that problem today.
Posted by: tc on September 28, 2009 03:48 PMBut the market is going to vastly expand. The government is largely subsidizing that expansion to make it affordable for individuals. That expansion leads to more revenues for health care providers and suppliers -- and because of competition can lower prices and effectively "eat" the tax through the additional revenues. Given the unique situation here -- the government vastly expanding a particular market -- I feel as though a unique solution of taxing that market is warranted.
It would be like an income tax applying to only me -- how unfair! -- but in the law the government subsidizing a much larger infusion of money to me. I'll come out ahead. And this is why not a single of these interest groups are seriously concerned about the fee, as far as I know.
Posted by: John Jensen on September 28, 2009 04:05 PMYeah, I mean the gall of that pampered disabled person to want to get around without an inordinate amount of physical exertion, right John? Wow.I guess that's a dose of modern day liberal compassion.
Posted by: Rick D. on September 28, 2009 04:07 PMPutting these incompetents in charge of your medical care is one big, huge mistake. They haven't proven themselves to be capable of saving $$ anywhere else.
Posted by: Michele on September 28, 2009 05:21 PMYou're right, it was tc. My apologies.
As for the rest of the two sentences, I'm confused how you can take a leap of assumptions from my post that were neither implied or suggested therein.
I agree with John on this that these companies will see alot more revenue (and profits) than the additional tax burden.
Completely depends upon the tax rate; the insurance companies could very well see LESS profit. Gross receipts are a bad way to tax.
Consider that the average health insurance company makes about 3% net on receipts. A gross receipts tax of 2.8% pretty much wipes out ALL profit; a gross receipts tax above that will result in a loss.
In terms of "standard" before-tax rates, a 1% gross rate on a 3% margin industry is equivalent to a 33% income/corporate profits tax. It doesn't take much at all to completely eliminate all profit. And that is regardless of the number of new consumers because it's on gross, not net.
Posted by: Shanghai Dan on September 28, 2009 06:10 PMNo one is proposing a tax like that, and the original post basically misspoke.
It would be something like $8bn across a given industry, spread by market share. So if the market grows but the individual companies maintain their market share year over year, their tax burden decreases.
Posted by: John Jensen on September 28, 2009 06:38 PMYou are still assuming that the young and healthy will opt to pay the health insurance premium. You are also assuming that this "40 Million new customers" will drive profits.
Last time, it's not 40 million. Even Obama has back away from that.
But lets suppose that the more likely number of 15 million uninsured suddenly sign up. Without an ability to manage risk, the insurance companies will have to increase the premiums to become more flush with cash to pay claims. Which will prompt more to pay the penalty for deciding to exclude themselves. And if you think those fees will go to the insurance companies, you are naive. No way DC will give that up.
Add to that the bureaucracy that must be paid for, I just don't see how they come out ahead. Sub 1% profit margins is a given.
Posted by: Chris on September 28, 2009 08:25 PMBecause the tax will likely be small and those that get in on this reform deal are getting a captive market in return. The feds will probably put in many of these "graft hooks" to generate revenue. I'd also look for some kind of document creation tax on top of the royalty payment Microsoft or somebody will get for its patented file formats. Rackets and corporate welfare middlemen, it's the American way.
Posted by: donbless on September 28, 2009 10:32 PMI do have compassion for the individuals that do need it, like ones with paralysis, but it shouldn't be the general case for those who don't need the bells and whistles. My grandfather lost both legs to diabetes (back in the late 60's, early 70's). He got around fine with a manual wheelchair. He drove a car. He worked in his woodshop. Don't tell me that all the bells and whistles are mandatory.
Posted by: tc on September 29, 2009 07:13 AMIt would be something like $8bn across a given industry, spread by market share. So if the market grows but the individual companies maintain their market share year over year, their tax burden decreases.
Unfortunately, the numbers don't support your conclusion. How much is "spread" per person? Well, $8 billion divided by 40 million is $200 per person in additional costs.
The average health insurance company turns a 3% return on gross revenue. Do the math, you'll find out that $200 is 3% of $6600.
SO, to break even (not even add profit margin) you would need to sell an average $6600 annual insurance policy for each of those 40 million people. Is that the plan, to spend $550 per month, per person? That comes up to $264 BILLION annually, which is about 2.5 times HIGHER than the President talks about.
So the numbers say otherwise, John. There won't be additional profit; in fact, if the costs of health insurance reform are $100 billion annual (as the President likes to proclaim), and 80% of that is for premiums, then we are talking about $80 billion annually spent on insurance. That's $2000 per person, annually.
Now, for that $2000 annual policy, a typical 3% profit margin would be $60 per person. And with the $200 per "new" person taxation, not only is the entire profit from that new person but $140 additional lost dollars for existing clients. Meaning not only do you NOT see additional profits from these additional clients, but you see a LOSS in profit from existing clients.
So, you're wrong John. The numbers don't back you up. Unless the President and his backers in Congress are lying about the actual costs per additional person covered?
Yes, you miss a lot. President Obama has now stated there are 30 million uninsured citizens, and a breakdown of those people shows that there are about 18 million who really need assistance.
Posted by: Shanghai Dan on September 29, 2009 10:43 AM