5 Goals for the Obama Health Summit by Peter Yellowlees
President Obama is holding an important Health Summit at the White House to workshop his plans and ideas for health reform with a wide range of influential stakeholders. Hopefully he will keep his blackberry switched on because this is now one of the emerging new tools commonly used to deliver healthcare. President Obama, with his promotion of information technology, broadband networks and electronic health records, is poised to accelerate many positive changes in healthcare, so what goals should be identified for this Summit?
Let's look first at some of the current forces for change.
The business of eHealth on the Internet is expanding rapidly. Two recent reports from the Pew Foundation and Harris Interactive have confirmed that 75-80 per cent of United States Internet users utilize the Internet for health information and healthcare - that is around 140 million people per year. This is over 65% of the entire adult population of the USA - an average of 8 million people every day. Not surprisingly those individuals who are carers, who have chronic illnesses, who have recently been diagnosed with a medical condition or who have broadband Internet connections use the Internet for healthcare more commonly than other Internet users, and their searches for health information are becoming a regular habit, often several times per month.
Business sees the healthcare sector as a particularly attractive industry that will benefit from web-based technologies because of its enormous size, inefficiency and information intensity, and companies like Google, Microsoft, Intel and Cisco, as well as the telecommunications giants like ATT and Verizon, all have major health plans. Moreover, the healthcare industry is particularly fragmented with a large number of participants, including general practitioners and primary care clinicians, specialists, institutions (public and private hospitals and diagnostic companies), health funds, pharmaceutical companies, retail pharmacies and, of course, patients.
Our population is ageing with "baby-boomers" demanding better quality healthcare. They are also determined to have home-based health care, and will pay to avoid going into nursing homes. At the same time employers are trying to reduce the escalating cost of health care. Everyone recognizes that the use of electronic medical records is a way of improving the quality of care and making patient information more available where it counts, at the time of the doctor-patient consultation. There is a widespread understanding that we need to shift the center of gravity of care away from expensive hospitals and clinics, and back to the home. It is not only cheaper to treat people at home and online, with less hospital bills at thousands of dollars per day, but patients can also become more involved in their own care. With a single keystroke patient, primary physician, specialist and home health nurse can be brought together.
Many homes in the US have broadband Internet, or cable TV, both of which can be used to deliver electronic home care in future. The core infrastructure for healthcare is shifting from bricks and mortar to bits and bytes. Companies such as Intel are already developing technologies to be used in the home for the elderly in particular - for the baby boomers. These involve multiple health monitoring options - not only to collect obvious health data such as blood pressure, weight or pulse rates for patients with heart conditions, but to monitor patients with Alzheimer's as they move throughout their home, undertake survey responses from family members via television, and as alarm systems for any medical emergency. Telecommunications and cable television companies are the likely future infrastructure providers of tomorrow's health environment as they replace hospital beds with homecare accessibility.
So what goals should the summit consider?
1. All patients should have access to their electronic records and their health information in a secure and privacy protected manner, most likely involving a unique healthcare identifier
2. High quality Internet based healthcare systems and networks should be further developed, with the Internet being recognized as core health infrastructure
3. All health providers must move into the Information Age, and be supported and trained to use electronic systems for clinical work
4. Electronically mediated homecare, as well as healthcare prevention and monitoring must receive more focus
5. Healthcare must become a more collaborative information based industry, with major players from the Information Technology world being recognized as core partners and infrastructure providers
This is an exciting time for the health industry, and a time when the right decisions can create very positive health reform to help current and future generations of Americans.
This article is based on excerpts from the recently published book "Your Health in the Information Age - how you and your doctor can use the Internet to work together" by Peter Yellowlees MD. Available at http://www.InformationAgeHealth.com and most online bookstores.
Article Source: http://www.articlesnatch.com
jeudi 12 mars 2009
Whether you voted blue or red, if you're a small business owner, you probably want to plan now to reduce business taxes you pay under an Obama preside
Business Tax Planning under President Obama by Stephen Nelson
Whether or not you agree with Barack Obama, if you're a successful business owner, you need to plan now to minimize the tax increases an Obama administration seems sure to implement. Why? A bit of upfront planning could easily save you tens of thousands a dollars a year--in some cases, for decades.
Recognize Capital Gains Now
Here's the first and easiest idea to consider: Book any long-term capital gains right now, before 2008 ends.
Here's why: While the IRS taxes long-term capital gains at a relatively low 15% rate, Obama proposes raising this rate to 20% for individual taxpayers making more than $200,000 a year and for families making more than $250,000.
While a 5% rate increase may seem modest, long-term capital gains are often substantial. Long-term capital gains regularly break into seven figures if the gains stem from decades of appreciation in a real estate investment or from decades spent building up a successful business.
Note: The fifteen-percent preferential capital gain rates were originally set to expire in 2010, so capital gains rates were always at risk of sneaking back up.
Delay Capital Losses Until Later
A quick related point: Because capital gains and losses offset each other, you might decide to delay recognizing any capital losses until the point capital gains tax rates rise.
The savings calculations related to this technique are tricky. But delaying a capital loss a few weeks could in many cases save you several thousand dollars because the loss will be applied, or netted against, either capital gains or ordinary income that would otherwise be taxed on a higher rate.
Extract Earnings and Profits Now
If you own a C corporation or former C corporation, you should be aware of a potential tax time bomb that may exist inside your corporation: previously taxed profits retained inside the corporation.
Here's the problem: Right now, if the corporation pays out these earnings and profits to shareholders as dividends, the shareholders pay a modest 15% qualified dividends tax on the dividends. And that's pretty good.
However, this qualified dividends tax rate expires at the end of 2010. And after that, dividends paid from C corporation earnings and profits will get taxed at the shareholder's top marginal rate. That top rate may be close to or even exceed 40%.
You see the savings, right? Paying, say, a 40% tax rate instead of a 15% tax rate will have a huge effect.
Accordingly, to the extent possible, extract previously taxed C corporation profits now, before the qualified dividend tax rate expires or before tax law changes eliminate this legislative loophole.
And a special note for any S corporations that used to operate as C corporations. If you retained some of your C corporation profits during the years you operated as a C corporation, talk with your CPA about this issue, too. The same time bond ticks inside your tax accounting records and books.
Reconsider the Roth Option
One powerful long-term tax planning technique is worth mentioning for high net worth business owners. If you're someone with more than adequate retirement savings, you may want to setup and use a 401(k) plan to make Roth contributions.
Here's the logic. Typically, high income tax payers can't contribute money to a Roth-IRA account because the Roth-IRA cutoff point is $160,000. Rise above that income level and you lose your Roth eligibility.
However, no income cutoff exists for Roth-401(k) plans. And this opportunity creates a long-term tax saving opportunity for business people who've accumulated substantial assets.
Say you've a fifty-year-old who's got a sizable taxable investment account. In this case, almost without effort, you could transfer $40,000 a year from your taxable investment account to a couple of Roth-401(k) nontaxable accounts for you and your spouse.
In this case, you end up with a million dollars in your Roth-401(k) at the point you retire. You won't have saved any tax (yet) with the 401(k). But the money you've accumulated and the investment earnings on the money won't be taxed. Not ever.
This is big. During your retirement years, having this $1,000,000 of Roth wealth could save you $30,000 to $40,000 a year in income taxes.
And if you've got kids or grandchildren, this tax planning trick gets even better: Your kids can (with a little bit of clever upfront planning) continue to save the $30,000 to $40,000 a year over their lifetimes.
Stephen L. Nelson is a Seattle-area CPA, the author of Quicken for Dummies, and the publisher of the Write a Business Plan and Starting Your Own Business web sites.
Article Source: http://www.articlesnatch.com
Whether or not you agree with Barack Obama, if you're a successful business owner, you need to plan now to minimize the tax increases an Obama administration seems sure to implement. Why? A bit of upfront planning could easily save you tens of thousands a dollars a year--in some cases, for decades.
Recognize Capital Gains Now
Here's the first and easiest idea to consider: Book any long-term capital gains right now, before 2008 ends.
Here's why: While the IRS taxes long-term capital gains at a relatively low 15% rate, Obama proposes raising this rate to 20% for individual taxpayers making more than $200,000 a year and for families making more than $250,000.
While a 5% rate increase may seem modest, long-term capital gains are often substantial. Long-term capital gains regularly break into seven figures if the gains stem from decades of appreciation in a real estate investment or from decades spent building up a successful business.
Note: The fifteen-percent preferential capital gain rates were originally set to expire in 2010, so capital gains rates were always at risk of sneaking back up.
Delay Capital Losses Until Later
A quick related point: Because capital gains and losses offset each other, you might decide to delay recognizing any capital losses until the point capital gains tax rates rise.
The savings calculations related to this technique are tricky. But delaying a capital loss a few weeks could in many cases save you several thousand dollars because the loss will be applied, or netted against, either capital gains or ordinary income that would otherwise be taxed on a higher rate.
Extract Earnings and Profits Now
If you own a C corporation or former C corporation, you should be aware of a potential tax time bomb that may exist inside your corporation: previously taxed profits retained inside the corporation.
Here's the problem: Right now, if the corporation pays out these earnings and profits to shareholders as dividends, the shareholders pay a modest 15% qualified dividends tax on the dividends. And that's pretty good.
However, this qualified dividends tax rate expires at the end of 2010. And after that, dividends paid from C corporation earnings and profits will get taxed at the shareholder's top marginal rate. That top rate may be close to or even exceed 40%.
You see the savings, right? Paying, say, a 40% tax rate instead of a 15% tax rate will have a huge effect.
Accordingly, to the extent possible, extract previously taxed C corporation profits now, before the qualified dividend tax rate expires or before tax law changes eliminate this legislative loophole.
And a special note for any S corporations that used to operate as C corporations. If you retained some of your C corporation profits during the years you operated as a C corporation, talk with your CPA about this issue, too. The same time bond ticks inside your tax accounting records and books.
Reconsider the Roth Option
One powerful long-term tax planning technique is worth mentioning for high net worth business owners. If you're someone with more than adequate retirement savings, you may want to setup and use a 401(k) plan to make Roth contributions.
Here's the logic. Typically, high income tax payers can't contribute money to a Roth-IRA account because the Roth-IRA cutoff point is $160,000. Rise above that income level and you lose your Roth eligibility.
However, no income cutoff exists for Roth-401(k) plans. And this opportunity creates a long-term tax saving opportunity for business people who've accumulated substantial assets.
Say you've a fifty-year-old who's got a sizable taxable investment account. In this case, almost without effort, you could transfer $40,000 a year from your taxable investment account to a couple of Roth-401(k) nontaxable accounts for you and your spouse.
In this case, you end up with a million dollars in your Roth-401(k) at the point you retire. You won't have saved any tax (yet) with the 401(k). But the money you've accumulated and the investment earnings on the money won't be taxed. Not ever.
This is big. During your retirement years, having this $1,000,000 of Roth wealth could save you $30,000 to $40,000 a year in income taxes.
And if you've got kids or grandchildren, this tax planning trick gets even better: Your kids can (with a little bit of clever upfront planning) continue to save the $30,000 to $40,000 a year over their lifetimes.
Stephen L. Nelson is a Seattle-area CPA, the author of Quicken for Dummies, and the publisher of the Write a Business Plan and Starting Your Own Business web sites.
Article Source: http://www.articlesnatch.com
Inscription à :
Articles (Atom)
