Friday, July 10, 2009

The Rich Must Pay More Taxes if Everyone is to Have a Right to Health Care

It's absurd to argue whether the US should have a public option health insurance or not. The real question is whether the for-profit insurance companies should have a captive audience or not.

The US already has public options for many people, but on a smaller scale than is necessary through the Community Health Service and the Veterans Administration Hospitals. I think the Government should rename the VA "The Veterans and Patriots Hospitals", make the hospitals available to all Americans - not just veterans.

To meet the increased need for services, the Government should purchase underfunded hospitals that have been closing in inner cities and rural areas, reopening them to serve anyone and everyone who presents with a health need.

Is this "big Government". No, it's "sufficient public health care" for a nation with a population of three hundred million people and growing. Anything and everything designed to meet the needs of a third of a billion people will inherently be big and to pretend otherwise is quaintly foolish and silly. New York City has 39,000 police officers and 11,000 firefighters, but I don't hear anyone complaining about "big government police and fire services," except those who would prefer that their houses burn down.

The deparments are big because they serve a city with over eight million residents. I would certainly hope that if Republicans ranted against the big police and fire departments of New York then residents would ask these politicians if THEY would like to put ouf the fires and make the arrests themselves.

If we want extra around-the-clock security, then we each can buy that. But, we all have a right to police and fire protection without paying a separate premium for each of these services, and now what we need is a right to health care as well. Lord help us if the first person we talk to when we call the police or fire department is an insurance adjuster who wants to know if we're covered or not.

So much money and bureaucracy would be saved by making health care a right and making its provision a collective national duty, as it is in Brazil. It would be less expensive if only because the Government wouldn't need hordes of bureaucrats for means testing and other hordes to collect individual premiums.

I'm frankly disgusted to hear politicians wanting to "mandate" that individuals buy insurance, as if individuals don't want to be insured. That's like mandating that people individually purchase access to police and fire deparments. Is there anyone who doesn't want the police and firefighters to come when their called? What individuals don't want is to have to go out and each pay bribe to police officers and firefighters in order to access these services. They don't want to pay individual premiums that they know they can't afford.

Meanwhile, police and firefighters don't want or need the responsibility for "point of service" fee collection. A system like that would prevent these public employees from doing the jobs that they're paid to do.

Individual mandates are absurd. If individuals refuse to assume five hundred dollar per month payments, what is the Government going to do? Send the insurance police out to get them? Oh, that will be VERY popular! If they don't have insurance, one very reasonable explanation is that they simply cannot afford it. Ridiculous discussions of tax breaks for individuals are like tax breaks so that people can pay for fire and police protection. Just the collection of such taxes would double the cost of the service provided.

Insurance companies would LOVE such a mandate, particularly without a public option, because then insurance companies could jack up their rates even more, with all of America unable to leave the used car lot without buying one of the crummy used cars.

We already have a way to get money from people for health insurance based on their ability to pay. It's called the IRS. Because we already have the IRS to collect taxes based on ability to pay, we have no need to create an entirely new bureaucracy for determining and collecting individual health premiums. And our society does not need the transaction costs involved in each of three hundred million Americans selecting insurance from among dozens of incoherent and incomprehensible "options". What people need is the assurance that their health needs will be met regardless of what they are, with no deductibles, co-pays, or yearly limits.

I'm so glad to hear Charles Rangel, Chairman of the House Ways and Means Committee finally coming to his senses and discovering that we mut pay for health insurance for all by taxing the rich as we did before the series of Reagan/Bush tax cuts. That was always the obvious solution.

We may all remember when, shortly after the election last year, Obamacrats announced they would not increase taxes on the rich now and would wait for absurdly generous tax breaks to expire in 2011. With this pronouncement, Obama put himself unneccessarily in a box early on - a box wherein the money for national health care could only be found by new taxes on the working poor and the middle class.

Health insurance became unworkable on that day and only now is being revived with the realization that people who have gotten rich in America must help to pay for the health care of those who have not. That's the way it works in Brazil. If that were not the case, then Brazilians would not all have the assurance that they can go to a doctor, hospital and pharmacy as the need arises.

1 comment:

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