I have now heard and read all over the media that Congress is having difficulty passing a health care reform measure because Republicans and Democrats have become more ideologically cohesive internally, and therefore in greater conflict with each other, making bi-partisan cooperation more difficult. I do not believe for a moment this is true. Ideologies are points of view about what would be best, or fairest, for everyone. The political parties are not cohesive advancers of such ideologies, they are servants of powerful interests. And it is powerful interests that benefit from things as they are, even as inequity grows, the economy is wrecked, and the future borrowed against, that are blocking health care reform – unless the “reform” would be a system that rewards the powerful and diminishes the future even more. Want proof? How about Democrats in opposition to progressive taxation (and in favor of regressive taxation), and Republicans against curbing government spending? Well, that’s what we have.
As I wrote in my series on equity and eligibility two years ago, when the government seeks to fund a public service or benefit through non-reversible tax breaks, the big winners are upper middle class yuppies, because the breaks are worth more to you the more you make. So it is with the exclusion from taxable income of health insurance paid for by employers. And yet the Democrats are against making that off the books income taxable, above a certain reasonable amount, so those with more income pay more in tax. On this one Max Baucus is absolutely right and President Obama is wrong.
But it isn’t about right and wrong – some of the biggest beneficiaries of that massive off the books public health care funding via tax break are unionized public employees and upper middle class professionals in government, law and the non-profits – a big part of the Democratic machine. The marker was a compromise floated to allow this income to be tax free, no matter how high it was, for those in unions, but not for other workers, no matter how little they earn. It appears that progressive taxation is bad if affluent members of the Democratic machines would have to pay the same taxes on the same income as less well off people who are not in those machines. It isn’t progressive ideology, it’s Tammany Hall.
Not only that, but it appears that regressive taxation is OK, as long as younger people are paying. What is a mandate for insurance but a tax that hits you harder the less you earn? Recall that I had argued for a tax that one could take a reversible credit against if they purchased insurance, with the tax relative to income and amount of the reversible credit based on age and the presence of certain agreed chronic conditions. Younger people would get less of a credit, but would pay less for insurance, and if they earned less as they tend to (and for younger generations will throughout their lives), they would also pay less tax. From what I have heard, however, only the fine for those who are uninsured will vary by income.
And Republicans? The Wall Street Journal editorial page has become an unreadable attempt to rally those who are feeding at the public trough under the existing system against cost reductions under the proposal. While providing more and more people with nothing, presumably something the WSJ agrees with, the current system provides unlimited taxpayer funded benefits for others, no matter how well off, paid for in many cases by those worse off. You would think that “fiscal conservatives” wouldn’t like that, and would agree to question some of that spending, perhaps deny some of that spending. You would think that saying to some beneficiaries that there are some things they are welcome to pay for themselves, but cannot expect taxpayers to pay for them, among other reasons because they don’t work, would make Republicans and conservatives pleased.
But no. The discredited Republican strategy, the one that made them popular with Generation Greed for 25 years until the bills came due, has been be against “spending” in theory, but only against spending on the poor, minorities, and those in older central cities in practice. And to be against taxes on the affluent today, but in favor of far greater taxes on everyone tomorrow, as a result of massive debts. That’s their story, and despite a near universal political wipeout and a younger generation that has been completely and permanently lost to Republicans, the WSJ is sticking to it, ideology be damned.
Perhaps the most nauseating WSJ piece was penned by Betsy McCaughey, a woman who (because she became famous based on her opposition to the prior attempt at health care reform on in the 1990s) may be considered one of the mothers of the mess we have now. According to her, any attempt to restrain the unlimited health care (whether it works or not) at unlimited cost now due to those age 65 or over would “reduce access to care, pressure the elderly to end their lives prematurely, and” (this is the kicker) “doom baby boomers to painful later years.” Ah yes, Mc. McCaughey was born in 1948, is now age 61, and is heading for senior citizen hood with the rest of her generation. And while they are there can be no public scrutiny of the public money spent on them. They must have it, all if it, unlimited, unvetted, undebated, unanalyzed, unprioritized, to or beyond their last dying breaths. Universal cryonics for Boomers clinging to life because they don’t believe in a non-material existence? That should be between a patient, their doctor, and the contractors providing the equipment – even if taxes are extracted from other to pay, the WSJ suddenly seems to believe now that it is seeking to scare baby boomers into opposing “Obamacare.”
Age 65 is not, however, a magic number. The chances of falling victim to a costly medical condition rises gradually with age. Right now there are people in their 50s and early 60s, not her apparently, who are facing painful earlier years as a result of losing their job and thus their health insurance. People who are having difficulty finding new jobs, because employers with health insurance are worried about what having older employees will do to their insurance premiums. But will find it easier once they reach age 65, and Uncle Sam picks up the tab. But for how much longer?
Unlike many at the WSJ, Ms. McCaughey does admit that “Medicare is running out of money” which might be a problem for those of her generation. So how to solve it? Not by limiting what all generations are entitled to have funded by taxpayers (and, let me say again, this has nothing to do with what the are free to pay for themselves). By providing future generations with nothing! That’s right, she says it would be a “reasonable solution” to gradually (after her generation is in) raise the Medicare eligibility to age 70 by 2043. Somehow, whereas for her generation any limits on taxpayer-funded health care expenditures at age 65 will lead to suicide and pain, younger generations will have no problem getting by with nothing until age 70. Perfect. If they aren’t getting health care, they’ll have more money to pay the Reagan, George W. Bush and (ahem) George Pataki debts.
So don’t kid yourself. This isn’t about Republicans who want lower taxes with fewer government services and benefits for everyone, and Democrats who want more services and benefits for everyone funded by more taxes on everyone. This is people who have deals that allows them to get more and pay less at other people’s expense, manipulating and draining our institutions to the point of institutional collapse.
There is a reasonable reform that could satisfy everyone’s ideology as it should be – I wrote about what the real problems were, what the incorrect solutions would be, and what the best solution would be in series of Room Eight posts back in early 2008. For those who missed them, and is interested in evaluating if the issues as I identified them are being addressed, can read the 33-page MS Word document attached to this post, so I won’t repeat myself. I will say that what I’m hearing about the sausage is not making me optimistic.