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Background to U.S. Healthcare & National Debt Crisis

Mid-1400s Black Death (Bubonic Plague) came from Asia and killed 30% to 50% of Egypt’s and Europe’s population (100+ million deaths).  The 1500s were a period of exploration, colonization and advancement in civilization.  Printing presses were being manufactured, the Bible and books were being translated into common languages, the New World was being conquered and built, and universities were found in most of the great cities.  The 1600s were a time of mass immigration and establishment of governments, churches, schools and military presence.

In the 1700s writers and universities spoke of ‘enlightenment’ which would come through government and science, as opposed to strictly religious means.  Nevertheless, before the 18th century, war, persecution and hardships were a way of life in many countries.  Most people desired freedom, but few countries were prepared to seek it, find it and pay its cost.   During the Late Colonial Period in America, in 1763 the British ended a war with American Indians with a Treaty agreeing to prohibit colonists from settling west of the Appalachian Mountains.

It would be a moot point to the British, because after a progression of taxation without representation (Sugar Act tax 1764; Stamp Act tax 1765; Townshend Acts taxes on imported goods and tea in 1770) the colonists protested and then revolted – leading to the American Revolution and declared independence by the Continental Congress in July 1776.   It would be 1789, when after the U.S. Constitution was ratified (1788), that George Washington was elected the first president of the United States of America.

In 1700, America’s Colonial population was 250,000.  In 1800, America’s second Census revealed a population of about 5.3 million people, of which over 893,000 were slaves.  The U.S. had 15 states at that time.  In 1803, America negotiated the Louisiana Purchase with Napoleon and France – adding 530 million acres or 828,000 sq.’ miles (14 states lie in the area) – and doubled the size of the United States.

In 1751, Benjamin Franklin co-founded Pennsylvania Hospital.  Columbia University’s College of Physicians and Surgeons was founded in 1767 (King’s College); Harvard Medical School was established in 1782 (Harvard – 1636); the first U.S. Medical Journal was the Medical Repository (1797); and the New England Journal of Medicine began in 1812.  In 1867, Congress created the Commissioner of Education and “established at the City of Washington, a department of education, for the purpose of collecting …statistics… (NCES.ed.gov)”

According to the National Center for Education Statistics, 120 Years of American Education: A Statistical Portrait (1993), “From colonial times, America has recognized the value… of a basic education.  …In 1869-70, millions of young people were enrolled in public elementary schools… (and) the large enrollment in high schools is one of the many success stories of American education during the 20th century… In 1869-70, there were only about 2 persons receiving high school diplomas per 100 17-year-olds… In 1939-40, the ratio rose above 50 percent…  Immediately after (World War II) the graduation ratio resumed… reaching 70% in 1959.”

Continuing from NCES’ Statistical Portrait, “Development of American Institutions of higher education began early in the colonial period…  Harvard University was founded in 1636 to prepare ministers…  Public colleges expanded westward… as states made higher education available to their citizens… Another major development of the early 19th century was the creation of normal schools.  These institutions were designed to help prepare teachers for the expanding school systems…  In 1839, Horace Mann established the first public normal school in Massachusetts…   Some 37 of today’s colleges were founded prior to 1800…  During the first two decades of the 1800s, 31 more colleges were founded… the next two decades brought 102 more colleges that still exist today, and between 1840 and 1859, an additional 210 colleges were founded… Today, many of the 380 colleges founded prior to 1860 are independent or public, but most were originally controlled by religious groups…”

https://nces.ed.gov/pubs93/93442.pdf

As universities gained accreditation and graduated educated professionals, industries looked to these graduates and their professors to help develop and advance best practices in their fields.  Associations and Boards were formed by business and industry professionals and the government maintained a connection with those that were reputable.

During the 20th Century, Universities and Colleges worked with professional industries and Federal and State Governments to development guidelines and requirements for professional industries.  Courses and curriculums were established by schools, licenses and practices were development and requirements set by governments and trade associations or industries.  The medical industry was at the forefront.

According to the Federation of State Medical Boards (www.fsmb.org 2017), FSMB History: “Since its inception in 1912, the FSMB has grown in the range of its services to state medical and osteopathic boards charged with protecting the public health and interests in their respective states…”  Prior to the FSMB, the North Carolina Medical Board was established in 1859 and many states began licensing laws in the 1870s.   Nevertheless, in 1900 rural population still out measured urban.

According to The American College text Group Benefits: Basic Concept and Alternatives (1991), “…During the 19th century the United States made the transition from an agrarian economy to one characterized by increasing industrialization and urbanization.  The economic consequences of death, sickness, accidents, and old age became more significant as individuals began to depend more on monetary wages than on self-reliance and family ties to meet their basic needs…”  In 1900, life expectancy was much lower then – 46 years for a male and 48 for a female (UC Berkeley’s Population Research Centers).

Although in 1900 there were 76 million people and 45 states, with America controlling all the land within the Continental United States, there was no INCOME TAX, the NATIONAL DEBT was $2.1 Billion, and cities were growing.   Still, as most of the population and jobs were rural, many Americans helped each other build their houses and exercised humble contentment; they also traditionally dealt with HEALTH CARE through families and country doctors.

In 1790, the United States had four National or Commercial Banks; by 1800 the number reached 29 with about $27 million in capital and $50 million in assets.  After the defeated renewal and closure of the Bank of the United States in 1811; Rothschild and others Central Bankers backed the British against America in the War of 1812.  According to historians, the War led to chaos in shipping and banking and an increase in government debt.  In 1816, Congress approved a second Bank of the United States and owned a fifth of its stock.   The Bank issued currency, purchased government debt and served as a central depository.

In 1835, under President Andrew Jackson, the U.S. National Debt was paid off.  In 1850, immigrates were flowing into North America and the population increased over 35% from a decade earlier to reach 23.2 million – of which 3.2 million were slaves.  That year California became the 31st state.  To keep and expand territory since 1803, Americans had fought and made treaties with Indians, Mexicans (Mexican-America War), the British (War of 1812) and Russia.

In 1865, after the Civil War and the enforcement of President Lincoln’s 1863 Emancipation Proclamation ending slavery, America entered a slow period of healing and reconstruction.   Though steel, cotton and tobacco were big industries, there was little infrastructure and technology to advance ‘civilization’ as in the 1900s.

In 1861, the National Debt was $90 million, and by the end of the war it reached $2.6 billion – more than a 2,780% increase in less than five years.   To help pay this July 1, 1862 Congress passed the INTERNAL REVENUE ACT and first income tax – primarily on the wealthy.  Yet even during three decades of reconstruction after the war, and during the expansion of railroads into the west, Congress adhered to a reasonable budget – actually decreasing the National Debt to $2.1 billion in 1876 and removing Income Taxes in 1873.   And Congress held debt in check reducing it to $1.5 billion in 1893 and just under $2 billion in 1899.

By the 1880s petroleum or oil was an important part of American’s economy.  Also banks and railroads were chief industries pushing forward the growth of the nation.  By the 1890s, the names of Vanderbilt (Railroads), Carnegie (Steel), Morgan (GE, US Steel, Railroads, Chase Bank) and Rockefeller (Oil, Chase Bank) were well known and their enterprises well established.

According to the ‘Historical Timeline’ at Federal Deposit Insurance Corporation: “1901: First National City Bank (Citibank), …Stillman and …Rockefeller, with Standard Oil money, buys $115 million of Northern Pacific Railroad’s stock and triggers a stock market panic.  Thousands of small investors are wiped out.  Theodore Roosevelt… continues …McKinley’s trust-busting efforts.   John P. Morgan creates U.S. Steel, the first billion-dollar corporation… U.S. Steel elevates both Wall Street and U.S. Industry… 1904: the Bank of Italy is chartered in California… renamed Bank of America (1927) …1905: there are 9,018 state banks and 5,664 national banks… 1907: …the New York Stock Exchange goes into drastic decline… President T. Roosevelt provides Morgan with $25 million …to use to control the panic.  Morgan, acting as a one-man CENTRAL BANK, decides which firms will fail and which firms will survive…   1909: Taft establishes the National Monetary Commission… to propose a banking reform plan… 1911: The Supreme Court rules that Standard Oil… is a monopoly… House Committee on Banking and Currency… hearings reveal …J. P. Morgan and First National City Bank (Citibank) with 341 directorships on 112 companies …controlling $22 billion in resources.  1913: The FEDERAL RESERVE ACT …establishes the Federal Reserve System… the Fed, as the CENTRAL BANK – the nation’s third… with a 20-year charter (permanent 1927).  World War I: 1914-1918… The economy booms… The financial havoc reigning in Europe presents U.S. banks with new demands for services.  The U.S. economy is the largest in the world in terms of GNP.  The FINANCIAL CENTER of the World shifts from London to Wall Street.”

https://www.fdic.gov/about/history/timeline/1900-1919.html

In 1903, automobile production surpassed 12,800 units; and in 1908 it was more than 43,000; about 318,000 in 1913; and by the end of World War I (1918), over 800,000 vehicles had been produced that year and in 1919 over a million vehicles were being produced.   The second decade of the 20th century also saw significant expansion, industrialization, advancements in communication, power plants and changes in American homes.

In 1911, Nelson Aldrich (whose son was President of Chase and daughter married John D. Rockefeller, Jr.) chaired the Senate Finance Committee and worked to create the Fed Central Banking system.  In 1912, there was NO INCOME TAX, but there were signs of a coming Great War.  Years before World War I began the main Allied Powers and Central Powers had their alliances.  The United States would build up its military, and it would support the British Empire and French Republic.  However, where would the money come from to build a massive war machine, how would Congress pay for it and what about its Veterans?

The answer was the FEDERAL RESERVE ACT.  It passed 43 to 25 with only 68 of the 100 senators voting just before Christmas 1913.   The Reserve Bank issued shares to Banks such as National City Bank (Rockefeller major shareholder), Chase National, First National Bank (Morgan), Rothschild’s Banks of London and Germany, Warburg’s German Banks, and Goldman Sachs.   In 1911, Paul Warburg became a naturalized US citizen and in 1914 the German Banker was on the first Federal Reserve Board (and 1921, he was a founding member of Council on Foreign Relations with Wilson’s advisor, Colonel House).   William McAdoo, the Sec. of Treasury, became the first Chairman of the Federal Reserve Board.  He owed J. P. Morgan for bailing out his Railroad Company; he was also President Wilson’s (who signed the 1913 Federal Reserve Act) campaign manager.

In 1913, to pay back Central Bank loans for the coming World War, Congress enacted INCOME TAXES starting at 1% and up to 7% on $500,000 and above.  The NATIONAL DEBT in 1913 was about $2.9 billion.  By 1919 it reached $27 billion; knowing their future debt crisis, Congress in 1917 raised Income Taxes significantly – less than 7% on middle class families, but 65% on incomes over $1 million – raised in 1918 to 77%; and 15% to 20% on incomes from $10,000 to $20,000 (over 50 brackets that year).  The rate on the top Income bracket continued at 73% several years until 1922 being reduced to 58%; then 46% on amounts over $500,000 in 1924 and 25% on amounts over $100,000 in 1925 to 1931 as the National Debt was reduced to $17 billion.

https://files.taxfoundation.org/legacy/docs/fed_individual_rate_history_nominal.pdf

Thus, the National Debt from 1789 to 1931, after about 142 years, was $17 billion.  And in order to maintain it, Congress used taxes – primarily on the very wealthy.  Nevertheless, at that time families bore the burden of their healthcare and life expectancy in 1931 was about 60 for males and 63 for females.

In 1915, about 1 in 12 (8%) homes had electricity.   By 1920, the U.S. Census revealed that over half of the population was urban.  Additionally, by that year about 35% of U.S. households had electricity; though less than 3% of America’s 6 million farms had electricity. Between 1840 and 1850 over 1.7 million Europeans came to America; and from 1880 and 1930 about 27 million European immigrates came to the United States.   In 1930, the U.S. population was 123 million; at that time only about 10% of farms had electricity.

In 1929, the stock market crashed and by 1933 nearly half of the banks failed and two million Americas were homeless.  In 1936, Congress passed the Rural Electrification and Telephone Act to help fund electrical distribution to rural areas.   The Act also helped to deal with high unemployment during the Great Depression; but building infrastructure comes at a cost – DEBT.  President F. D. Roosevelt’s took office saying in his inauguration address, “…rulers of the Exchange of mankind’s goods have failed through their own stubbornness and their own incompetence… unscrupulous money changers…”

The Federal Emergency Relief Administration began to aid many unemployed workers, the Federal Trade Commission increased its powers and in 1934, the Securities and Exchange Commission was created to regulate Wall Street.  In 1935, the SOCIAL SECURITY ACT was passed, giving federal ‘grants to states for old-age assistance,’ and ‘grants to states for aid to dependent children;’ as well as ‘assisting the States in the administration of their unemployment compensation laws.’

After centuries of colonialization, border disputes and wars in Europe, Asia and Africa; Italy invaded Ethiopia (1935), Japan invaded China (1937) and Germany invaded Poland (1939) and then Denmark, Norway and France (1940).   The British entered World War II in 1940.  In 1941, Germany invaded the Soviet Union (Russia) and Japan attacked the Philippines and Pearl Harbor, Hawaii.   Japan did not surrender until America dropped 2 atomic bombs.  Just before the war ended, FDR had finished 12 years as president (1933-1944) and the NATIONAL DEBT increased from $22.5 billion to $201 billion.

During the next 8 years, President Truman and Congress would hold the National Debt steady at about $255 billion.  This was done in large part by increased taxes on the wealthy.  Seeing the oncoming war the income tax on the top bracket was 63% on income over $1 million in 1935; then raised to 77% in 1936 and 79% in 1941 (81% portion over $5 million).  During 1942, all American taxpayers carried the War burden with the lowest bracket at 19%, 38% at $10,000,  55% at $20,000 and 88% over $200,000.   In 1944, as the Allies were advancing, Americans paid 23% in the lowest bracket, 50% at $14,000 and 92% at $100,000 (94% – $200,000+).   The lowest bracket remained at 20% and the top at 91% (with slight variations and increases) until J. F. Kennedy took office and Congress made changes for 1964.

From 1945 to 1963, the National Debt increased from about $250 billion to $305 billion – that is from 1789 to 1963 (174 years) it was $311 billion.  Or from 1913 (Federal Reserve and Income Tax) to 1963, after two World Wars and 50 years it increased from $2.9 billion to $305 billion.  In order to maintain it, Congress used budget constraints and taxes on high incomes. At that time (1963) the average medical and legal professional made nice but reasonable incomes, average life expectancy was about 67 for males and 73 for females, and HEALTHCARE was affordable.

In 1960 the U.S. population was about 180 million and the average family size was 3.1.  The Average Annual Costs per person for Healthcare was $146 and the Average Family Income was $6,691.  There was 1 person in 16.8% of households.  Male workforce participation was 83.3% and female at 37.7%.   Median family income was $5,620; 36.1% of families had incomes below $5,000 and 18.9% had incomes under $3,000.   Housing was the largest expense at 29.5%; and food was second at 24.3%, followed by clothing at 10.4% and average family’s charitable giving increased from $165 in 1950 to $303 in 1960.  (Source: bls.gov ‘100 Years of U.S. Consumer Spending’ using data from the U.S. Bureau of Labor Statistics, Consumer Expenditure Survey).  If healthcare cost $450 a year in 1960, than it was < 7% of the average family incomes.

November 1963, the Federal Reserve’s ASSETS for ‘all member banks’ was $251 billion (source: FRASER, St. Louis Fed).   That was up from about $25 billion before WWII in 1940 when Gold Reserves back nearly all of the funds; whereas Gold represented less than $20 billion in 1963.  Thus, over the last two generations, our currency has been backed by increased Debt Ceilings.

As education and technology increased in the 20th century, professionals were restricted with governmental regulations, subjected to litigation, required to hold licenses and keep up continuing ethics and education.  However, Congress and the Fed has no such requirements.

From 1964 (L. B. Johnson) to 1980 (J. Carter) the NATIONAL DEBT rose from just over $310 billion to just over $900 billion (3x in 17 years).   Moreover, the $600 billion increase in 17 years was TWICE as much as all the accumulation from 1789 to 1964 (175 years); thus each of those years with created INFLATION and MONETARY POLICIES were equal to 10 years during a time that Americans sacrificed and lived much more humbly.   According to the Social Security Administration the National Average wage index for 1964 was $4,576 and was $12,513 in 1980 (less than 2.75 times that of 1964).   Federal Reserve Assets of all commercial banks surpassed $1.5 trillion in 1980 up 6 times that of 1964.   The Income tax rates at tax brackets $20,000 and $200,000 were 34% and 76.5% (MFJ) in 1964; and 28% and 70% in 1980 (MFJ).

In 1980, health care cost increased from $146 per person in 1960 to $1,110 per person or 9% of GDP according to Kaiser Family Foundation using the OECD Health Statistics database.   Note that since the 1970s the United States has spent more on health insurance as a share of GDP than any other OECD Country.   The M2 Money Stock increased from less than $300 billion in 1964 to $1.6 trillion by the end of 1980.  The Dow Jones Industrial Average high in 1964 was 874 and in 1980 it was 964.  The Federal Spending for 1964 included: Defense $65.4 billion – 35%; Education $27.2 B – 14%; Pensions $16 B – 8%; Welfare $12.9 B – 6.8%; Health Care $6.7 B – 3.5%).  In 1980 the Government collected $1.2 trillion in tax revenues and spent $1.36 trillion.   Government Spending for 1980 (based on $940 billion) included: Defense $167 B – 18%; Education $152 B – 16%; Pensions $148 B – 16%; Welfare $95 B – 10%; and Health Care $87 B – 9%.

During the 12 years of the Ronald Reagan and George H. W. Bush period from 1981 to 1992 the NATIONAL DEBT increased from $1 Trillion to just over $4 Trillion.  In 12 years, the National Debt increased FOUR TIMES (4x) as much as all the accumulation from 1789 to 1980 (190 years); each 1 of those (12) years equaled an average of 15.8 years from America’s preceding history.  In 1982, the Individual Income Tax rate on $36,000 MFJ was 39% and 50% on amounts above $85,600.   By 1992, the SIMPLIFIED three brackets for Married Filing Jointly were 15% to $35,800; 31% on amounts over $86,500 and 28% for in between.  Single Filers paid 31% on amounts over $51,900.  Reducing taxes during this ‘trickle down’ philosophy directly affected increases in the National Debt.

And how did the government pay 14% on 10-year T-bills in 1980 and how did banks pay out over 10% rates on savings accounts and CDs?   In great part due to the fact that the Federal Reserve freely increasing M2 and dumping billions of extra dollars into their 2000 banks which were in turn charging an average of 21.5% on 5-year Mortgages, 14% on auto loans and 36% on Credit Cards (should be illegal; don’t give the loan if they don’t qualify – but charging high risk customers 10 times more than low risk citizens is one of the worst forms of discrimination).

In 1916, John Rockefeller was said to be the world’s first billionaire (over 2,000 in 2017).  In 1982, Forbes began publishing its Forbes 400; in 1992 there were 73 U.S. billionaires.  These billionaires could not have been so without government contracts, increased M2 Money Supply, massive bank loans, the Federal Reserve, and dramatically reduced income taxes that were supposed to create more jobs through ‘trickled down economics.’

During ‘Bill’ Clinton’s eight (8) years the National Debt increased from over $4.3 trillion in 1994 to $5.6 trillion in 2000.   Congress increased the top income bracket from 1992 to 2000, to 39.6% on incomes over $250,000 to approach their budgets and monitor debt.  In 2000, following ‘mandatory outlays,’ Congress spent $408 billion on “Social Security… to provide a comprehensive package of protection against the loss of earnings due to retirement, disability or death… The Government will collect $473 billion in Social Security taxes in 2000…  In 2000, the Federal Government will spend about $152 billion and allocate about $92 billion in tax incentives to provide direct health care services, promote disease prevention, further consumer and occupational safety, conduct and support research… Estimated life expectancy reached a record-high of 76.5 for those born in 1997… (Source: Budget… Fiscal Year 2000).”

According to data from the Tax Policy Center (Urban-Brookings Institutes) only 5 years since 1960 saw Congressional Budget Surpluses – 1969 and 1998 through 2001.  Clinton increased the CHIP program and Medicaid spending; and the average health insurance premiums saw double digits increases 1998-2001 from their previous years.

Reports by RAND Corporation and the Bureau of Labor revealed that health insurance costs relative to payroll increased 34% between 1996 and 2005; and RAND cited studies that revealed over a 90% increase in total health spending during the same period; and that during the same 1996 to 2005 GDP rose 51%.   They more importantly said that “most economists believe that health insurance premium costs are ultimately passed back to employees in the form of reduced wages… (Monthly Labor Review, June 2008)”

Actual revenue for 2000 was just over $2 trillion and total expenditures $1.8 trillion or 17.6% of GDP.   The National Debt ($5.6T) was about half of GDP ($10.2 T).   Half of the revenue came from Individual Income Tax, 32% from Social Security and payroll taxes; 10% from Corporate; 3.4% Excise taxes; 1.4% Estate/Gift taxes; 1% Customs and 2% misc.   Outlays included: Social Security ($409 – 23%); National Defense ($294B – 16.5%); Income Security ($253 B – 14%: Unemployment, Food Asst., Housing Asst., Disability); Medicare ($197 – 11%); Health ($154B – 8.6%); Veterans Benefits ($47B – 2.6%) and Net Interest on Debt ($223B – 12.5%).

M2 Money Supply in 2000 surpassed $4.8 trillion – doubling in 16 years from 1984, and ten (10x) the amount from 1967.  Additionally, Federal Reserve assets December 2000 reached $619 billion with only $11 billion in Gold certificates, but $515 in U.S. Government Securities or Debt instruments (source: Board of Governors of the Federal Reserve System).  Moreover, the Federal Reserve was paid to increase M2 (and thus inflation).  The Federal Reserve Act of 1913 and laws that followed up guaranteed a 6% DIVIDEND paid out to the banks that held stock in the Federal Reserve Center Banks (this was about a 1% rake over the 10-year US Treasury).

In January 2001, George W. Bush became the 43rd President of the United States.  September 11, 2001 (9-11) al-Qaeda terrorists killed 2,996 people in America – in the worst attack on the U.S. since Pearl Harbor in 1941. This Islamic terrorist attack would significantly change government regulations, operations, expenditures and of course the National Debt.

The National Debt in 2001 was $5.8 trillion and by the end of Bush’s 8 years in 2008 it surpassed $10 trillion – thus, it was obvious that the U.S. Government could through the Federal Reserve electronically create M2 money and funds to cover our chosen Debt Ceilings – the Fed is the best Government Credit Card ever schemed – it surpasses all the EU and Vatican Euro printing presses combined.  Nevertheless, after 2001 would come: America’s longest war, outrageous corporate profits to international corporations, increased inflation, the creation of billionaires, millions of dead civilians in the Middle East and the creation of ISIS in a US prison camp.

UNLIKE after all the previous 20th century wars, INCOME TAXES were not raised to pay for the Middle East Wars.  In fact the top bracket DECREASED from 38.6% in 2001 to 35% in 2008.   By choice or coercion, Congress placed agendas of corporate lobbyists, the UN, Bilderberg, Trilateral Commission, the CFR, and the like above the future and cares of average citizens.

As to Healthcare, there was little risk of losing mandatory Medicare and Medicaid spending for Hospitals, the vastly growing LTC Facilities, Medical Professionals, and Pharmaceutical corporations (sued for their anti-depression industry which came from failed weight loss drugs converted to being anti-depressants which had serious side effects to many users).

In 2008, the federal government received $2.5 trillion and spent $3 trillion.  Total outlays for discretionary programs increased from $117 billion in 1968, to $464 billion in 1988 and $1.1 trillion in 2008.  In 40 years, U.S. population had increased from 200 million (1968) to 304 million (2008) or 52%, but the government’s discretionary spending increased 849%.

In 2008, MANDATORY Spending was almost $1.8 trillion and DISCRETIONARY the $1.1 trillion.  Spending included: Social Security $608B – 20%; Medicare $386B – 13%; Medicaid/CHIP $209 B – 7%; Interest on the National Debt $261B – 9%; Defense $481B + Global War on Terror $145B + Veterans Affairs $40B + Off-budget Discretionary Spending for Iraq and Afghanistan Wars $20+B? – 23%; and Homeland Security $34B – 1%.   In 2002, White House advisers estimated that cost of invading Iraq between $50 billion and $200 billion; and by October 2007 the CBO reported that $600 billion had already been spent in Iraq and Afghanistan, including related cost such as Veterans care.  At that time, before Obama would take office, the CBO estimated the wars in Iraq and Afghanistan could top $1 trillion.

The Watson Institute of Brown University estimated in September 2016 that “as of August 2016, the US has already appropriated, spent or taken on obligations to spend more than $3.6 trillion in current dollars on the wars in Iraq, Afghanistan, Pakistan and Syria and on Homeland Security (2001 – 2016).  To this total (add)… fiscal year 2017… the total …reaches $4.79 trillion.”  The U.S. paid $4 million per foreign casualty ($4.8T ÷ 1.17 million deaths).

January 2009, Barack Obama took office as the president of the United States.  One year later, March 2010, he signed into law the Patient Protection and Affordable Care ActObamacare.  For many years the majority of the public wanted pre-existing conditions to be covered; yet, the 1996 Health Insurance Portability and Accountability Act (HIPPA, signed by Clinton) did not meet the needs of a great percentage of Americans.  HIPPA did significantly increase health insurance cost – primarily due to its new Group Health Plans laws.

According to eHealth (‘first-ever health insurance application online 1999’) the Average Individual Health Insurance Premium (PER MONTH) in 2008 was $159 with an average $2,084 deductible; Family coverage was $369 in 2008; and by open enrollment 2017 the average individual premium was $393 with a $4,328 average deductible and Family premiums averaged $1,021 with an average deductible increasing from $2,760 in 2008 to $8,352 in 2017.

The average family premium had increased about 177% in 7 years or an average of 25% per year – more than 20% a year beyond average wage increases and nearly 20% of GDP.   Family premiums in 2017 are about 25% of median household income ($59,000) and equaled to the median 30-year mortgage ($1,050).  Thus, housing and healthcare cost equaled about 50% of the average middle class budget; and with 15% in fed (income & S.S.), state and sales taxes; 10% for utilities; 13% for transportation costs and 10% for food – that often left nothing for clothing, education, charity, entertainment and occasional vacations.

Sad that in a land so free and full of resources, so few can easily enjoy life.  And thus, overall U.S. household debt has increased 12% in the past decade and credit card balances average more than $17,000 or nearly $800 billion owed by Americans; plus about $9 trillion in mortgages, $1.2 trillion in auto loans, $1.4 trillion in student loans and $13 trillion in other loans.

As America was entering wars in the Middle East region, Rupurt Murdoch and many of his News Corp 170+ media outlets and millions of weekly papers were supporting a full war effort by claiming as Murdoch said in 2003, “the greatest thing to come out of this for the world economy… would be $20 a barrel for oil.  That’s bigger than any tax cut…”  Yet, the opposite occurred as the price of oil per barrel would soon skyrocket and America would find a newly organized global terrorist group – IS/ISIL/ISIS.

After World War II, by 1947 oil price per barrel passed $2.15 but remained stable from $2.77 in 1948 to $3.60 in 1972.  Then since the 1973 oil crisis and politics with OPEC nations, prices spiked from $4.75 to $29 in 1983; and settled down to less than $20 from 1986 to 1999 (except for 1990).   Then from 1999 oil prices increased from $16.50 to about $27.50 when Murdoch and many government advisors made their claim that oil prices would fall because of the war(s).  Yet, the increase was from $27 at the beginning of the Second Gulf War (2003) to $91 in 2008 with a high of $147.30 in July 2008.  During Bush’s 2 terms the top five Oil Corporations made more than $650 billion in profits.

Medicare and Medicaid Services’ NHE Fact Sheet (June 2017) reported, “NHE (National Health Expenditures) grew 5.8% to $3.2 trillion in 2015, or $9,990 per person, and accounted from 17.8% of Gross Domestic Product (GDP)… Hospital expenditures grew 5.6% to (over $1 trillion)… Physician and Clinical Services Expenditures grew 6.3% to $634.9 billion… Prescription drug spending increased 9.0% to $324.6 billion in 2015… (after) 12.4% growth in 2014… The largest shares of total health spending were sponsored by the FEDERAL GOVERNMENT (28.7%) and the Households (27.7%)… private business share …accounted for 19.9%… state and local governments accounted for 17.1%…”

The U.S. Money Supply (M2) increased from $286 billion in 1959 to about $8.2 trillion in 2009 when Obama took office to over $13.2 trillion in 2017 when he left office.  Uncontrolled mandatory and entitlement programs, war spending, foreign aid, debt interest, monetary policies, rates of interest on loans, low taxes on the wealthy would all contribute to the historical high health premiums on Americans accompanied by historically high Debt Ceilings and National Debt.    And the Office of Management and Budget shows estimated deficits are more than a half trillion dollars per year from 2017 to 2021.

According to Kaplan’s, Long-Term Care and Partnership Programs (Initial 8-Hour Course, Online 2017), ‘The Challenge of Long-Term Care: The Graying of America:’ “Rapid advances in medical care and health care technology have eliminated many major causes of premature death and terminal illness.  As a result, the older population in the United States is growing rapidly.  Since 1900, the percentage of Americans 65 and over has more than tripled for 4.1% in 1900 to over 13% in 2010, and the number increased from 3.1 million to 40.3 million…”  Continuing in the Course section: Increased Longevity: “…Thanks to medical technology and better health care, people are living longer after retiring.  A child born in 2010 can expect to live 78.3 years, about 30 years longer than a child born in 1900…“

The National Conference of State Legislatures (NCSL) 9/20/17 issued a ‘Health Insurance: Premiums and Increases’ report that stated, “…Annual premiums reached $18,764 for 2017, up 3% from 2015 for an average family coverage with workers on average paying $5,714 towards the cost of their coverage.  For those Americans who are fully-covered, these cost realities affect employers… plus the ‘pocket-book impact’ on ordinary families.  Yet for those buying insurance on an exchange or private market plan for 2017, the average increase before SUBSIDIES was a shocking 25 percent…”

According to the Bureau of Labor Statistics (September 2017), “Employer costs for employee compensation averaged $35.28 per hour worked in June 2017… Wages and salaries averaged $25.10 per hour worked and accounted for 68.3% of these costs, while benefits averaged $11.18 and accounted for the remaining 31.7%…”  BLS June 2017 release stated, “Employer costs per hour worked for employee… (for) health care… INSURANCE (was) $2.95.”

[40 hr.w. x 4.3 weeks = 172 hr.] x $2.95 Employer Cost = $507.40 per month

According to the Heritage Foundation (‘Federal Spending by the Numbers 2012), “In the past 20 years, federal outlays have grown 71% faster than inflation.  The average American household’s share of spending is $29,691…”about $5,000 per household more than 2008.  Heritage adds, “federal entitlements are driving this spending growth, having increased from less than half of the total federal outlays just 20 years ago to nearly 62 percent in 2012.”  In their 2014 report, the Foundation stated, “Obamacare …alone will add $1.8 trillion in federal spending by 2024.”

By July 2017, many major Insurers had pulled out of the Marketplace in at least one state.  They included United Healthcare, Humana, Aetna, and Anthem and Cigna (which are still considering a merger as of October 2017).  According to the Kaiser Foundation in 2018 – 1,433 counties will have ‘one or no insurer’ for Obamacare’s Marketplace.  This noted that that equaled about 45% of all (3007) U.S. Counties.  They have reported that half of the counties in Texas only have Blue Cross – who asked for a 56% increase in marketplace premiums for 2017.

Cornell University published for the Congressional Research Service (‘CRS Report for Congress’ 9-17-2007) U.S. Health Care Spending: Comparison with Other OECD Countries.  It revealed that “the United States spent $6,102 per capita on health care in 2004 – more than double the OECD average ($2,552).”  They showed that ‘Health care spending as a percentage of GDP’ was 15.3%.

In the 182 page Budget of the U.S. Government Fiscal Year 2017, the Office of Management and Budget revealed that by 2018 the Debt held by the public would be $15.3 trillion.  They projected an increase of $6 trillion in deficits from 2017 to 2026, thus projecting at least a National Debt of $26 trillion in 2026 – all other things constant (and they rarely are).

OMB revealed the following Outlays for 2017: Defense $601B, Social Security $967B, Medicare $602B, Medicaid $377B, Net interest $304B.   They projected for 2021 the following Outlays: Defense $695B, Social Security $1.2T, Medicare $781B, Medicaid $469B, Net interest $609B.  Thus, an increase in Total outlays from $4.1T in 2017 (Receipts 3.5T) to $5.1T in 2021 (Receipts $4.2T).  Note a $1 trillion increase in spending in 4 years with only a $100 billion increase in receipts – and this will be effected by the change in reduced taxes.

Now the America middle class taxpaying family lies in dire straits, we their children caught in the flow of massive and increasing National Debt and interest, with increasing household cost – namely healthcare; with the mountains of war and defense spending on one side and the Social programs on the other side.  And many will run their course into an average of hundreds of thousands in Long Term Care cost including $200,000 in nursing home costs.

Perhaps for most, the Federal Government will subsidize most or all of the cost.  But how can this be if there are not receipts to cover it – and at some point – countries will stop purchasing our Debt instruments? How will we endure and maintain our standard of living? If the National Debt and Debt Ceilings are meaningless and if the Federal Reserve can continue to Fund/Loan trillions of dollars at no consequence than let them pay for all Healthcare costs; but if America can’t continue this way – a balanced budget must be reached and healthcare cost controlled.

 

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