A government impost that started out small in order to get it into law soon becomes much bigger -- surprise!

Penalties for Massachusetts residents who can afford health insurance but do not purchase it in 2008 could quadruple compared with the maximum penalty in 2007, according to draft regulations released by the Department of Revenue yesterday. The maximum penalty for those who flout the law and do not buy health insurance would be $912 a year, compared to $219 in 2007. The higher penalty is intended to get those who are on the fence to buy health insurance. For those wavering, it could make more sense to pay for insurance than to pay the penalty.

The proposed penalties also drive home the full impact of the health reform law's personal mandate principle. This approach makes buying health insurance a responsibility of all residents, similar to the way drivers are required to purchase auto insurance. The penalty was enacted to spur residents to purchase insurance rather than rely on the care hospitals are still required to provide to patients regardless of coverage or ability to pay. "We have worked hard to craft these penalties in a manner that is straightforward and easy to understand," said revenue commissioner Henry Dormitzer in a statement. "We hope they will encourage people who can afford health insurance to buy it."

In a statement explaining the penalties, the revenue department said, "These penalties apply only to adults who are deemed able to afford health insurance." Residents who cannot afford insurance, based on state standards, won't be penalized. Residents who face penalties can appeal.

Residents can comment on the proposed penalties until Jan. 15. The regulations will be finalized early this year. Residents won't face the proposed penalties until early 2009, when they file their tax returns for 2008.

The health reform law, signed by former governor Mitt Romney in April 2006, states that the penalty for 2007 would be the loss of an individual's personal income tax exemption. This will cost residents who didn't get coverage $219 when they file their 2007 state income tax return. Under the law, penalties for 2008 and beyond would be tied to the lowest-cost option of insurance coverage. But it was up to the revenue department to determine the precise formula. Under the formula issued yesterday, the amount an uninsured resident pays for 2008 varies by income and how long the resident goes without insurance. For instance, those 26 and younger who earn too much to qualify for low-cost insurance and who go the whole year without coverage would pay a $672 penalty. Those 27 and older would pay $912, the maximum. Those who have coverage for part of the year would pay a corresponding amount of the penalty. In addition, those who earn less than 150 percent of the federal poverty level, or $15,324 for an individual, won't face penalty.

The fees are based on half the cost of the least expensive insurance plan available to each resident but are capped to avoid excessive fees. Thus, a 60-year-old resident of Boston, who would pay more than $4,600 a year for health insurance provided by the state, could have been hit with a $2,300 penalty. But the maximum possible penalty is $912 for all residents. The draft regulations are available at the revenue department's website at mass.gov/dor.

It is still unknown how many residents will have to pay the $219 penalty for 2007, according to the Department of Revenue and the Massachusetts Health Insurance Connector Authority, which administers the new law. A spokesman for the Department of Revenue, said it would measure how many pay the penalty when 2007 tax returns are filed this spring.

The connector authority has said that about 290,000 residents have signed up for health insurance since the personal mandate went into effect July 1. That includes 160,000 residents who qualify for subsidized coverage, 70,000 who qualify for Medicaid, the government health plan for the poor, and 60,000 who purchased full-cost coverage through the state or their employers. The tally will be updated Jan. 10. Before the health law was implemented, the state estimated that about 400,000 residents lacked health insurance while the US census estimated the number of uninsured was 657,000.

John E. McDonough, executive director of Health Care for All, an advocacy group that helped craft the health insurance law, said he was pleased with the proposed penalties. The department "really listened, and we see a lot of our concerns reflected in this schedule," said McDonough. "It's fair, simple, and sensitive to the needs of residents."

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Some context for the above -- and a warning about where it is headed

Take the example of Social Security:

Franklin Roosevelt, a Democrat, introduced the Social Security (FICA) Program. He promised:

1.) That participation in the Program would be Completely voluntary,

2.) That the participants would only have to pay 1% of the first $1,400 of their annual incomes into the Program,

3.) That the money the participants elected to put into the Program would be deductible from their income for tax purposes each year,

4.) That the money the participants put into the independent "Trust Fund" rather than into the General Operating Fund, and therefore, would only be used to fund the Social Security Retirement Program, and no other government program, and,

5.) That the annuity payments to the retirees would never be taxed as income!

Since many of us have paid into FICA for years and are now receiving a Social Security check every month -- and then finding that we are getting taxed on 85% of the money we paid to the Federal Government to "put & lt away"

You may also be interested in the following:

Q: Which Political Party took Social Security from the independent "Trust Fund" and put it into the General Fund so that Congress could spend it?

A: It was Lyndon Johnson and the democrat Controlled House and Senate.

Q: Which Political Party eliminated the income tax deduction for Social Security (FICA) withholding?

A: The Democrat Party.

Q: Which Political Party started taxing Social Security annuities?

A: The Democrat Party, with Al Gore casting the "tie-breaking" deciding vote as President of the Senate, while he was Vice President of the U S

Q: Which Political Party decided to start giving annuity payments to immigrants?

A: MY FAVORITE: That's right! Jimmy Carter and the Democrat Party. Immigrants moved into this country, and at age 65, began to receive Social Security payments! The Democrat Party gave these payments to them, even though they never paid a dime into it!

Then, after violating the original contract (FICA), the Democrats turn around and tell you that the Republicans want to take your Social Security away! And the worst part about it is, uninformed citizens believe it! Actions speak louder than bumper stickers





In just one year in one Australian State 4200 nurses quit

What happens when you overwork nurses in order to employ more and more of those lovely bureaucrats

NURSES are leaving public hospitals faster than the Government can replace them despite a record 2368 graduates starting this year. The NSW health system is haemorrhaging nurses at a rate of 10 per cent - 4200 positions - a year, leaving existing staff overworked. Premier Morris Iemma yesterday admitted, while visiting Royal North Shore Hospital, that it was difficult to recruit and retain nurses.

However, embarrassingly for the Government, Mr Iemma also conceded in front of his embattled Health Minister Reba Meagher that Royal North Shore Hospital needed to return "to the forefront". Ms Meagher has been under siege over the hospital's performance, since staff and patients revealed a series of horror stories about the hospital's performance last year. Continually forced to defend the hospital, Ms Meagher yesterday looked on as Mr Iemma did the talking.

"I have taken a number of small steps to address the issue here at Royal North Shore Hospital," he said. ". . . to restore the reputation of the hospital as well as continue to improve the health services. "There are challenges, as there are in any hospital. "We are taking extra measures to address that." The hospital will be allocated 128 nurses at the end of this month, one of the largest intakes in the state. However, it still needs another 22 experienced nurses to fill the hospital's current shortfall. But difficulties remain as bullying and harassment of nurses has tainted RNSH. Long-serving staff have complained publicly of being intimidated by senior management.

Trying to soothe the hospital's bruised reputation, Mr Iemma assured new recruits: "I can promise the graduates that anyone who intimidates . . . will be dealt with, and dealt with very strongly. "I guarantee these graduates there is no place for bullying."

Despite the Government's recruitment push, a global shortage of nurses is placing strain on hospitals. NSW Nurses Association acting president Judith Kiejda said an ageing work force was having an impact on the health sector. "Some (nurses) do leave for overseas, career changes but a lot of the losses come down to retirement," she said. "There are a lot of nurses who are coming up to retirement far more than we are bring in the new ones."

New graduate, Emma Bowen, 20, said she was not put off by the negativity surrounding RNSH. "I did my practice here (at Royal North Shore) and really enjoyed it," she said. "I had excellent support."

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