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Small Companies Get Tax Breaks, Too!

How can this possibly be fair?

By Rick Kahler MS CFP®

An April 29th headline in The New York Times got my attention: “Profitable Giants Like Amazon pay $0 in Corporate Taxes. Some Voters Are Sick of It.” My immediate reaction was outrage. Amazon had a 0% tax rate. My company’s overall tax rate was 24%, and its net profit was less than 0.000025% of Amazon’s. How can this possibly be fair?

The Times article, by Stephanie Saul and Patricia Cohen, gave few specifics but left the impression that Amazon simply gets out of paying taxes on its profits because of a legal, but unfair, manipulation of the tax code afforded only to wealthy corporations, leaving the heavy lifting to the rest of us poor saps.

I wanted to know how Amazon did it, so I did some research

First, let’s put the $11.1 billion profit into perspective. The past 18 months are the first time Amazon has shown any meaningful profit since 2011. Many of those years saw them losing billions of dollars.

The total value (market capitalization) that shareholders have invested in Amazon is $954 billion as of April 29, 2019. That means the 2018 profit of $11.1 billion represents an earnings yield of 1.16% return on investors’ money. The average earnings yield on a large US company is 4.5%, significantly higher than Amazon’s. While $11.1 billion sounds like a lot of money in dollar terms, when viewed in the amount of money it takes to generate those profits, Amazon’s financials are significantly subpar.

Amazon reduced their taxes to zero by primarily doing four things:

  1. They reinvested their profits in equipment and buildings, and were able to deduct a portion of these expenses. They will have to repay the taxes they deferred on these purchases when they sell the equipment or property. And the money spent was not available for distribution to their shareholders.
  2. They received a tax credit for spending on research and development. This credit is an incentive for any company to help offset the high risk of the up-front costs of developing new ideas, not all of which pay off.
  3. They paid some employees in the form of stock, rather than cash. While still a real cost to the company, this is used to minimize cash outflows, while giving employees an opportunity to reap the rewards of their hard work in future profits.
  4. In their start-up years, Amazon lost billions of dollars. Out of fairness, the tax code allows any business to carry losses over into future years to offset profits, when and if they ever materialize. This type of “write off” is real money that was lost.

The article cited a carpet layer who had a profit of $18,000 and paid more in taxes than Amazon. He was so upset at this injustice that he joined the Socialist Party.

The article failed to mention that many of the same write-offs used by Amazon were available to him, too. If his business was incorporated, the tax bill on his profits was probably 21%, or $3,780. If he had reinvested his profit in a new carpet cleaning machine, had losses from previous years to carry forward, spent money on developing a new type of carpet cleaner, or paid his employees in stock, he would have paid nothing in taxes.

***

***

Assessment

Critics of big corporations might say such strategies would not be realistic for a one-person company. Yet I have seen many small business owners use them, particularly carrying forward losses that result from the essential start-up costs. The corporate tax code generally applies equally to all businesses and is meant to encourage small companies as well as large ones to take the risks necessary to create new jobs.

Conclusion

Your thoughts are appreciated.

***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

 

Consider Taxes Before Retiring Abroad

Physicians Considering Retirement in Another Country?

By Rick Kahler CFP®

One way for a retiring doctor to stretch a retirement nest egg is to relocate your retirement nest. Finding a place with a lower cost of living can include considering retirement in another country.

International Living

According to International Living, Panama is one of the best options for Americans looking for affordable living costs, good medical services, and an appealing climate. Costa Rica, Mexico, and Belize are also good possibilities.

Before you pack your sunhat and flip-flops and head for a low-cost retirement haven like Panama, however, take a look at all the factors affecting your retirement income and expenses. One of those is taxes.

Taxes

Moving out of the country does not mean your tax bill to the US government or your current state will decrease. Short of giving up your US passport, there is nothing you can do to escape paying US taxes on your income, even if you don’t live in the US. We are one of two countries worldwide—the other is Eritrea—that taxes our citizens based on both residence and citizenship.

You might assume, however, that moving out of the country would end your liability for state income taxes. That isn’t always the case. Some states still want to tax your income even though you don’t live there. According to Vincenzo Villamena in a December 2018 article for International Living magazine titled “How to Minimize Your State Tax Bill as an Expat,” it’s especially problematic if you end up returning to your old address in the state and start filing an income tax return. Eventually, he says, “the state will see the gap” and may require you to pay taxes on the missing years.

You have nothing to worry about if you live in one of the seven states with no income tax: South Dakota, Wyoming, Nevada, Washington, Texas, Florida, and Alaska. Tennessee and New Hampshire aren’t bad, either, as they don’t tax your earnings but they do tax your investment income. Most other states will let you off the hook if you submit evidence that your residence is in another country and you haven’t lived in the state for a while.

Then there are the states that won’t let go of their former residents easily. Those are California, Virginia, New Mexico, South Carolina, North Carolina, Massachusetts, and Maryland. Assuming that when you leave you will be coming back, they require that you continue to pay state tax on your income.

***

Solutions?

The solution to this issue takes a little financial planning and some extra time. The best way to escape paying taxes to a state you no longer live in is to move to a state with no income tax first before relocating abroad. You must prove to your old state that you have left and have no intention of ever coming back.

***

***

This means moving for real—cutting as many ties to your old state as possible and establishing as many as possible in your new state. You will want to sell your home, close bank accounts, cancel any mailing addresses, change healthcare providers and health insurance companies (including Medicare), be sure no dependents remain in the state, and register to vote and get a driver’s license in the new state. As a final good-bye you will want to notify the tax authorities that you are filing a final tax return for your last year that you lived in the state.

Assessment

In case you need a good state from which to launch your leap into expat status, consider South Dakota. Not only would my income tax-free home state let you go easily, it would welcome you back if you should decide to return to the US.

Your thoughts are appreciatedBook of Month

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Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

***

Keeping Up with the Clauses

Feeling the Pressure to “Give”

By Rick Kahler MS CFP®

Are you feeling any pressure this Christmas season to give, give, give? Keeping up with the Joneses all year is hard enough. It gets even worse during the holidays, when we feel pressured to keep up, not just with the Joneses, but also with the expectations others, and ourselves, put on Santa Claus.

Some Christmas shoppers overspend on gifts and end up paying off credit card bills for months. Others drive themselves crazy trying to find exactly the right gifts for the right people. Others hate the whole idea of shopping so much that they find it hard to enjoy the season.

If you fit into any of these categories, the cause may be your money scripts. The unconscious beliefs about money that we all hold are especially likely to kick in this time of year. We are surrounded by expectations and pressures about “ideal” holiday celebrations with the perfect gifts, the perfect decorations, and the perfect foods. As a result, we are especially vulnerable to making money decisions blindly in response to beliefs we don’t even realize we hold.

You may be one of those who regularly end up spending significantly more on gifts than you intended to. You may impulsively buy additional, unbudgeted gifts for people you’ve already bought presents for. You may not even try to set holiday spending limits. You may overspend on things for yourself while you’re Christmas shopping.

  • If any of these are true for you, you may have some unconscious beliefs about money that drive you to overspend. See whether any of the following money scripts might fit for you:
  • “The more you spend, the more love you show.”
  • “It takes the joy out of giving if you pinch pennies.”
  • “It’s the season for giving lavishly, not for being a Scrooge.”
  • “If I don’t buy just the right gifts, people won’t like or respect me.”
  • “I need to give my kids more than I got when I was a child.”
  • “More gifts and more spending will make the holidays okay (and make my guilt go away).”
  • “It’s tradition. Everyone expects (whatever) from me.”
  • “I do so much for everyone else; I deserve something for myself, too.”

It’s also possible you may go to the opposite extreme and be a Grinch when it comes to the holidays. If you hate Christmas shopping, grumble about the holiday being so commercialized, and look forward to January, it’s possible you may hold some money scripts that drive you to underspend. Your beliefs may be similar to the following:

  • “It’s wrong to spend money except on necessities.”
  • “You aren’t a spiritual or religious person if you spend too much money.”
  • “Christmas shouldn’t be about money.”
  • “It’s wrong to spend money on luxuries when poor people are suffering.”
  • “It isn’t good for kids to get too much.”
  • “My kids shouldn’t have more than I had when I was a child.”

Christmas Wreath

If you’d like to change some aspects of what you do and how you feel about holiday spending, you may find it useful to take a closer look at your own beliefs about the season. One way to begin this is to quickly write answers (short statements are best) to the following questions: What do I believe about money and each of the following? Christmas? Family celebrations? Presents? Giving? Spending? Receiving?

Assessment

You may uncover some money scripts similar to the ones listed above. Learning why you tend to overspend or underspend this time of year won’t instantly change what you do. Yet understanding what is behind your pattern of holiday spending is an important way to start becoming a more conscious Christmas shopper.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Why is it SO DARN difficult to talk about money?

The SCREAM?

[By Rick Kahler MSFS CFP®]

Do you have difficulty talking to people about money? Specifically, about their money or yours?

Here’s a quick test that will give you an amazingly accurate answer to that question:

Ask the next five people you see how much they make and what they are worth, then share with them the same information about yourself. If you can do that with ease, you probably don’t have difficulty talking to people about money.

Of all those to whom I have suggested this test, hardly anyone has reported back that it was easy. Actually, most people encounter intense emotions just imagining doing the test. Very few complete or even attempt it.

That includes financial professionals. Many people will admit they find it difficult to talk about money, but few financial professionals will. After all, their profession is all about money, so how could they have trouble talking about it? Yet they do, when the money is theirs.

Research

Research finds that most people have such difficulty talking about their money that they will pay to keep their salary a secret. According to an October 16, 2018, article by Jacob Passy in Market Watch, researchers at Harvard Business School and UCLA found that 80% of those surveyed would be willing to pay money to stop coworkers from receiving an email containing their salary information.

“Employees may be afraid to ask coworkers about their salaries because that may force them to reveal their own salaries, which they dislike,” the researchers said.

Why, regardless of our profession, do we dislike telling people what we make or how much we are worth?

Net worth

To find out, try this quick exercise. Imagine asking the next five people you see to reveal their earnings and net worth and sharing your earnings and net worth with them. Then write down all the one-word feelings you can identify that this brings up. Next, write down the thoughts, beliefs, or reasons that come to mind that would keep you from asking or answering these financial questions. Don’t censor your responses, and keep writing until you have nothing else popping up.

You should now have a really good list of why you dislike talking about what you or other people earn and are worth financially.

***

***

Some of the common feelings are terror, panic, embarrassment, shame, guilt, shock, surprise, and anxiety.

Some of the thoughts are: 

  1. If I ask that, people will reject me and think I am a nutcase.
  2. If people find out what I am worth, they will shame and reject me.
  3. It’s too vulnerable to share financial information, I would rather talk about my sex life.
  4. I am afraid of being hurt, rejected, and shamed if I ask someone about their finances
  5. If people find out I don’t have much money, they’ll lose respect for me and take advantage of me.
  6. If people find out I have a lot of money, they’ll lose respect for me and take advantage of me.
  7. If they make more or are worth more than me, I will feel small and insignificant.
  8. If they make less or are worth less than me, I will feel guilty and unworthy of having more.
  9. People don’t like people who make more money or are worth more money than them.
  10. A person’s net worth is equal to their self-worth.

Assessment

Given the emotional weight of money as a topic, at your company Christmas party you may want to stick to talking about politics or religion. If you do want to spice things up and ask “The Money Question,” I would be interested to know about your experience.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Tis the HealthCare Insurance Renewal Season

A Story on Health Savings Accounts

[By Rick Kahler MS CFP®]

Tis the season to select our health care plans for the coming year. It brought me a little bit of holiday joy to see that my high-deductible bronze plan only went up 6%, to just over $2,000 a month. This is my lowest increase since Obamacare was enacted.

I wasn’t as pleased when I found out my family $4,500 deductible increased to $6,600, with a maximum out-of-pocket cap of $13,200. After analyzing all the options, I decided to stick with this plan. The way I figure it, the minimum I will pay for health care for my family of four is $3,100 a month. The year before Obamacare my family premium was $660 a month for much better coverage.

HSA

Since I have a high-deductible plan, I take advantage of having a health savings account (HSA). An HSA allows me to set aside funds for health costs and receive a tax deduction for the full amount. The limit is $7900 for 2018 and $8000 for 2019 (including an extra $1000 for those over 55). This means that if I chose to use the funds for current health care expenses, I could deduct about half of my annual out-of-pocket expenses.

The HSA rules require that you use the funds for health care expenses, but they set no time limit on when you must use the funds. Many people with HSAs need immediate access to the funds to pay medical insurance. Others, like myself, can afford to cover the deductible out of pocket, allowing the HSA funds to accumulate tax free for future use.

I’ve decided to let my HSA funds accumulate with the intention of creating a financial cushion for future use when Medicare won’t cover a medical need.

Letting an HSA accumulate combines the best features of a traditional IRA and a Roth. Like a traditional IRA, you get to deduct 100% the contribution from your income taxes. Like a Roth, the funds are tax free when you take them out. Another advantage is that the annual $8000 limit is greater than either the IRA or a Roth.

You will need to open a specific account for your HSA. Where you open that account depends on whether you plan to use your account for current health expenses or allow it to accumulate for future use.

Most banks and credit unions offer HSA accounts. These accounts usually carry low costs and work well if you plan to use the funds immediately. However, they are not so good if your intention is to let the funds accumulate.

***

***

Long term accumulation 

For long-term accumulation (with over a 10-year time horizon), you need an HSA account that allows you to invest the funds in low-cost equity funds. Like any investment account, you need to pay attention to the fees. A great site, The HSA Report Card, compares the features of various HSAs. It lists the top 10 HSA providers in each of three categories depending on your needs: current spending, interest bearing, and investing.

For long-term accumulation, I went to the invest category. I was pleased to see my current provider, Health Savings Administrators, was listed among the top 10, but not so happy that they only rated a “C” for fees. The top plan is Fidelity, which carries no fees and offers four mutual funds with zero (yes, 0.00%) expense ratios. Opening a Fidelity account online and transferring the funds from my existing HSA account was easy and efficient.

Assessment

You and I can’t control the rising costs of health care. But by opening and investing with an HSA, we can be smart about how we pay for that care today or in the future.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

Book Marcinko: https://medicalexecutivepost.com/dr-david-marcinkos-bookings/

Subscribe: MEDICAL EXECUTIVE POST for curated news, essays, opinions and analysis from the public health, economics, finance, marketing, IT, business and policy management ecosystem.

DOCTORS:

“Insurance & Risk Management Strategies for Doctors” https://tinyurl.com/ydx9kd93

“Fiduciary Financial Planning for Physicians” https://tinyurl.com/y7f5pnox

“Business of Medical Practice 2.0” https://tinyurl.com/yb3x6wr8

HOSPITALS:

“Financial Management Strategies for Hospitals” https://tinyurl.com/yagu567d

“Operational Strategies for Clinics and Hospitals” https://tinyurl.com/y9avbrq5

***

Risk Management, Liability Insurance, and Asset Protection Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™8Comprehensive Financial Planning Strategies for Doctors and Advisors: Best Practices from Leading Consultants and Certified Medical Planners™

Money Beliefs and Luxury Lifestyle TV

Money Beliefs and Luxury Lifestyle TV

By Rick Kahler CFP

***

If you watch TV shows that flash luxury products and feature rags-to-riches stories or the lives of the rich and famous, will you become more materialistic and cold-hearted toward the poor? You might, according to an August 1 story by Sarah Knapton in The Telegraph, “Keeping Up With the Kardashians may make viewers cold-hearted towards poor, study suggests.” It cites research done by the London School of Economics showing that “just 60 seconds of exposure to materialistic media is enough to significantly increase anti-welfare sentiment.”

The article mentions two studies. In the first, participants were divided into two groups. One group was shown clips of luxury products, rich and famous people, and rags-to-riches stories. The other group saw neutral images of London sights, natural scenery, and headlines about dinosaurs. Both groups were then asked questions that evaluated their attitudes toward wealth and success, government benefits, and impoverished people. The group shown the materialistic media scored more negative attitudes toward welfare and welfare policies.

In the second study, participants were asked if they regularly viewed shows like The Apprentice and X-Factor. Those who did were found more likely to hold materialistic and anti-welfare attitudes.

I have some doubts about these studies. For one thing, they mix data on two very different issues—an acute reaction to a stimulus and a chronic behavior.

In the first study, both groups were exposed to stimuli and their reactions were immediately measured. What the research apparently did not do was follow up in one day, one week, or one year to see if the negative anti-welfare impact persisted. My hunch is that, had they tested the two groups one week later, there would have been no significant difference between them in their materialistic or anti-welfare sentiment.

My belief that this is a short-term phenomenon is supported by similar research in neuropsychology made popular by the field of behavioral finance. For example, if two groups are asked to guess the price of something and one group is given a random number before guessing and the other isn’t, the guesses of the first group will be closer to that number than those of the second group. This is called Anchoring, which lasts but moments. A person’s ability to price the object into the future is not permanently impacted.

This is a separate issue altogether from the second study. Here we are talking about a long-term, chronic behavior. People who regularly watch these shows are drawn to them, in part, by their beliefs about money, known in financial therapy as money scripts. I would make the case that many regular viewers held money scripts of valuing wealth and materialism before they watched the shows. While it is unlikely viewing the show created these beliefs, it probably reinforced them.

Can media affect our attitudes toward money? This is a chicken-and-egg question. What comes first? Does the money script attract the viewer to the show, or does the show form the money script? My experience suggests it’s mostly the former.

Perhaps a more accurate headline summing up these studies might have been, “Keeping Up With the Kardashians may give viewers a momentary cold heart toward poor, study suggests,” or “The Apprentice attracts viewers more given to materialism and a cold heart toward poor, study suggests.”

The media play to what their consumers find attractive. I am guessing in an anti-materialistic and pro-welfare culture these shows would attract fewer regular viewers. While the media certainly can influence our attitudes toward money, it’s more probable that our collective attitudes toward money affect the media more than the media affects us.

Drs. Home

Assessment

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Conclusion

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More on US Health Care Costs

Highest in the World?

By Rick Kahler MS CFP®

The soaring cost of health care in the United States is painfully obvious to anyone who looks at a medical bill. This aspect of our system has been out of control for decades.

For example, a recent study by the Kaiser Foundation compared health care prices in the U.S. with those in other developed nations, virtually all of which have some form of universal health care. It found ours to be the highest in the world. The average American spends more than $10,348 a year on health care, amounting to a total of 18% of GDP. The average for citizens in other developed countries was about $5,198 per year, or 9% of total GDP.

Despite paying more, Americans average fewer physician consultations. Our rate of about 3.9 per person per year is well below the 7.6 average in the other countries studied. The researchers also found American hospital stays to be shorter, averaging 6.1 days while the average in other countries was 10.2 days.

The Kaiser study also compared costs for several expensive drugs and various medical procedures, including angioplasty and coronary bypass surgery, MRI exams, colonoscopies, appendectomies, and knee replacements. Costs in the U.S. were significantly higher. In fact, the average cost of replacing one knee here ($28,184) would almost pay for two new ones in Australia, where the average cost per knee is $15,941.

The study doesn’t attempt to assess the impact of the Affordable Care Act on U.S. medical costs or to offer any suggested solutions. Nor does it address the respective tax burdens of the various countries. This last is a shortcoming of the study that is important to consider.

Many of the European countries that feature significant “cradle to grave” universal health systems also have considerably higher taxes than does the U.S. According to data from the Tax Policy Center, the taxes at all levels of government in many European countries exceed 40 percent of GDP. Taxes in the U.S. are low in comparison. In 2015, U.S. taxes represented 26 percent of GDP. Of the 34 member countries of the Organisation for Economic Co-operation and Development (OECD), only four (Korea, Chile, Mexico, and Ireland) collected less than the United States as a percentage of GDP. It may not be surprising that these countries generally provide more extensive government services than the U.S. does.

Let’s put this into perspective. If Americans pay 18% of GDP in health care costs but spend 14% of GDP less in taxes than many European countries, that would leave the US paying a net of 4% of GDP for health care. This is almost half of what Europeans pay. Perhaps the lower amount we actually spend on health care is explained by the fewer physician visits and shorter hospital stays.

Certainly, not all of the 14% higher GDP in taxes collected by European nations goes to health care. Still, it is reasonable to assume that a significant portion of it does.

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Another fact that is often omitted by studies critical of the US for not having universal health care is that the US does have government funded health care that (as of April 2018) covers over 130 million people through Medicare, Medicaid, and CHIP. This compares with some 179 million people (2016 numbers) with private insurance. In addition, many U.S. citizens currently qualify for health insurance premium subsidies. A family of four with an income under $72,000 a year would qualify.

Assessment

The high cost of U.S. health care is certainly a serious problem that needs to be addressed. However, a valid comparison of costs here to those in other countries needs to include the differences in tax burdens.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements.

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