PBS高端访谈:美国税改会对医疗费用抵扣产生影响

Judy Woodruff: Republican leaders in the U.S. House and Senate are meeting this week to try to iron out their differences over a massive tax overhaul¹ plan in time to send the bill to the president by Christmas. We're continuing to look at important provisions that are the subject of concern. One starting to get more attention is the elimination² of a tax deduction⁴ for medical expenses. Lisa Desjardins zeros in on that.

Lisa Desjardins: The House version of the tax bill eliminates the medical deduction. Right now, individuals qualify if their medical costs exceed more than 10 percent of their income. The Senate version, it goes the other way- It would make it easier for Americans to qualify for at least two years. But consumer groups are worried that the deduction may be killed as part of the final bill. Cristina Martin Firvida is with AARP, which has taken a position here. They are lobbying lawmakers to keep the deduction. She's here tonight to help us walk through how this works and who could be impacted. Thank you for joining us.

Cristina Martin Firvida: Thank you.

Lisa Desjardins: Let's just start with a little bit of history and also bring it to current times. How did this deduction start, and what is the House trying to do?

Cristina Martin Firvida: Well, since the 1940s, individuals who had very high health care costs have been permitted to deduct³ those from their income when preparing their federal income taxes. So this is a deduction that's been in the tax code for decades. And, unfortunately, now we see, with the House bill, an attempt to repeal⁵ this medical expense deduction. And that is something that of course will affect many, many tax filers; 8.8 million tax filers take the deduction annually⁶.

Lisa Desjardins: You know, last week we sent out a call online to everyone reading our Web site. We wanted their questions on this tax bill. And, Cristina, we got a lot of questions on this particular issue. We're going to talk about other questions later this week. But I want to highlight two of these e-mails that we received, first from Elizabeth Gross in Bellingham, Washington. She wrote "My husband and I are both in our 70's and living on a fixed⁷ income. He has Alzheimer's disease and now needs skilled nursing care. If this deduction goes away," she wrote, "I will need to sell my house to pay for his medical expenses." We also got this from Laurence Bardoff in San Francisco. He wrote simply "How will the loss of medical deduction affect seniors on limited budgets with medical conditions?" And I think that's the question here. Do we know how this will affect people? Obviously, there are some people worried about losing everything because of this change.

Cristina Martin Firvida: Sure. So, this is a concern we're also hearing from many of our members. Something to bear in mind about the medical expense deduction is that it is available for anyone at any age, but, overwhelmingly, older Americans claim this deduction, because, unfortunately, as we age, our health care costs do go up. We have heard from many of our own members who have shared similar stories about what it will mean to lose this deduction. For most people we have heard from, they have said it will raise the cost of their health care because they will lose the tax benefit associated with the deduction, and it will make them go through their life savings⁸ much more quickly as they meet those high health care costs in older age.

Lisa Desjardins: Do you have a sense of what the average kind of deduction is for this right now?

Cristina Martin Firvida: It depends. It depends on the expenses that an individual has. And it depends on your income. So it's very hard to pin down an average. Of course, you're only permitted to take it if your expenses exceed currently 10 percent of your income. So it varies both by the amount that you make each year and the amount you spend.

Lisa Desjardins: You mentioned that many seniors and others are worried about running through what savings they have if they lose this deduction. Is there any indication that perhaps more people will have to turn to Medicaid because of this? Are there any kind of statistics on that?

Cristina Martin Firvida: We have heard that as well. Now, we have not had an analysis from any of the official score keepers, for example, from the Congressional Budget Office, to explain what the effect will be on Medicaid. But we have heard that from our own members, who have explained to us that currently they use their life savings and other assets that they may have to pay for expenses such as nursing home care. And, if they lose the deduction, they will run through their savings much more quickly, and they will end up having depleted⁹ their assets and having to turn to Medicaid to meet more of their health care expenses.

Lisa Desjardins: We do know that the majority of people who take this deduction right now are earning under $75,000. And also, speaking to the House Ways and Means Committee, I know the chairman has said that he wants to bring this up, bring this, put this on the table during negotiations¹⁰, see if there's a way to find a middle ground here. But Republicans overall, Cristina, say that this is in the name of spreading out sort of tax benefits, so that take away these deductions¹¹ and more people get a tax cut. Do they have a point there?

Cristina Martin Firvida: Well, we have been telling policy-makers what you just noted¹². This is a middle-income deduction. Close to 70 percent of the individuals who claim it have income under $75,000. By comparison, only 35 percent of individuals who claim the mortgage interest deduction or the charitable deduction have incomes of under $75,000. So I think an important thing to bear in mind is, as we look for ways to simplify the tax code, we also want to be fair in the way that we do that. And it's unfair to tell people who are sick, through no choice of their own, that their taxes may go up.

Lisa Desjardins: OK. Cristina Martin Firvida of AARP, thank you for joining us.

Cristina Martin Firvida: Thank you.

1 overhaul   

v./n.大修，仔细检查

参考例句：

• Master Worker Wang is responsible for the overhaul of this grinder.王师傅主修这台磨床。
• It is generally appreciated that the rail network needs a complete overhaul.众所周知，铁路系统需要大检修。

2 elimination   

n.排除，消除，消灭

参考例句：

• Their elimination from the competition was a great surprise.他们在比赛中遭到淘汰是个很大的意外。
• I was eliminated from the 400 metres in the semi-finals.我在400米半决赛中被淘汰。

3 deduct   

vt.扣除，减去

参考例句：

• You can deduct the twenty - five cents out of my allowance.你可在我的零用钱里扣去二角五分钱。
• On condition of your signing this contract,I will deduct a percentage.如果你在这份合同上签字，我就会给你减免一个百分比。

4 deduction   

n.减除，扣除，减除额；推论，推理，演绎

参考例句：

• No deduction in pay is made for absence due to illness.因病请假不扣工资。
• His deduction led him to the correct conclusion.他的推断使他得出正确的结论。

5 repeal   

n.废止，撤消；v.废止，撤消

参考例句：

• He plans to repeal a number of current policies.他计划废除一些当前的政策。
• He has made out a strong case for the repeal of the law.他提出强有力的理由，赞成废除该法令。

6 annually   

adv.一年一次，每年

参考例句：

• Many migratory birds visit this lake annually.许多候鸟每年到这个湖上作短期逗留。
• They celebrate their wedding anniversary annually.他们每年庆祝一番结婚纪念日。

7 fixed   

adj.固定的，不变的，准备好的；(计算机)固定的

参考例句：

• Have you two fixed on a date for the wedding yet?你们俩选定婚期了吗？
• Once the aim is fixed,we should not change it arbitrarily.目标一旦确定，我们就不应该随意改变。

8 savings   

n.存款，储蓄

参考例句：

• I can't afford the vacation,for it would eat up my savings.我度不起假，那样会把我的积蓄用光的。
• By this time he had used up all his savings.到这时，他的存款已全部用完。

9 depleted   

adj. 枯竭的, 废弃的 动词deplete的过去式和过去分词

参考例句：

• Food supplies were severely depleted. 食物供应已严重不足。
• Both teams were severely depleted by injuries. 两个队都因队员受伤而实力大减。

10 negotiations   

协商( negotiation的名词复数 )； 谈判； 完成（难事）； 通过

参考例句：

• negotiations for a durable peace 为持久和平而进行的谈判
• Negotiations have failed to establish any middle ground. 谈判未能达成任何妥协。

11 deductions   

扣除( deduction的名词复数 )； 结论； 扣除的量； 推演

参考例句：

• Many of the older officers trusted agents sightings more than cryptanalysts'deductions. 许多年纪比较大的军官往往相信特务的发现，而不怎么相信密码分析员的推断。
• You know how you rush at things,jump to conclusions without proper deductions. 你知道你处理问题是多么仓促，毫无合适的演绎就仓促下结论。

12 noted   

adj.著名的，知名的

参考例句：

• The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
• Jim is noted for arriving late for work.吉姆上班迟到出了名。