(Cross-posted)
I wish that I could write a paragraph that start “the problem with the health care bill is…” but there are so many problems with the health care bill that to single out just one is ridiculous. The bill is a monstrosity in the truest sense of the word – it is an excessively bad object of frightening size and complexity.
The size alone is enough to give pause. 1,990 pages of law that no representative (or representative’s staff) will read or understand in its entirety before (or after) it is voted on. I’m not going to argue that every bill should be read by every legislator before it is voted on. That seems unrealistic. But I’d like to know that it can be done and that the provisions of the bill can be understood both separately and when placed in their context. I think that some lawmakers will attempt to read and understand the bill with their staff, but undoubtedly they will come up with completely contradictory ideas of what is actually meant by the bill. The actual debate will be rushed (as it has been all year long) and a vote far to premature for the subject matter will be held. The only question mark over it passing the House is just how many Blue Dogs will actually stick to their positions.
Note to Blue Dogs: If you are going to claim to be fiscally conservative and socially liberal, then at some point you have to actually vote in a fiscally conservative manner. We (those of us citizens who actually are fiscally conservative and socially liberal) are getting sick of the charade.
The bill doesn’t (and can’t possibly) accomplish so many of the goals that it supporters claim that it does. Key example: Many supporters of this form of health care reform claim that a lot of the waste in the system is because insurance companies spend a lot of money lobbying the government that could be spent on health care (or reducing cost or whatever). Do they really think that by making the profits of those insurance companies more tied to government decisions that there will be less lobbying? That seems ridiculous on its face. If I ran an insurance company, then the more that my profits depended on government decisions the more money and effort I am going to spend on lobbying to make sure that I get the right contract or that lawmakers/bureaucrats make the decision in my favor. This isn’t that difficult of a concept: Big government leads to big lobbying. No matter what some people might argue big government doesn’t fight against big business – big government begets big business. Just ask the financial industry.
Another thing that I worry is the tax implications. Whether you “pay” for this (I put it in quotes because we should all recognize that, like social security and welfare, debt is what will really “pay” for the bill) with taxes on good health insurance plans or taxes on income, you are having some pretty bad outcomes. Tax good health insurance plans and companies have a disincentive to offer them – not only will the company have to pay (part of) the cost of the good health insurance plan, but they will have to pay the employee more to cover the cost of the extra tax the employee will have to pay (or the employee just functionally makes less money). Set a maximum level of health insurance that won’t get taxed and that is just where everyone is going to end up. There would be a disincentive to have better health care for everyone except for those at the very top who can afford it. And that won’t be enough to cover the costs of everyone else. Or just raise taxes on the highest earners and we are moving farther down a path that has, to this point, led to 57% of Americans paying 100% of the taxes. Seriously. A little over 43% of Americans pay zero federal income tax. Now, I don’t think that everyone should pay taxes. Some people can’t afford it plain and simple. They are impoverished and should be helped. But it is not true that 43% of Americans cannot afford to pay in to the system. Of course, if you don’t pay taxes, you don’t worry when taxes get raised. Especially if the raising of the taxes give you something. I know that our Country was founded on No Taxation Without Representation, but how long can we ignore the counter of that statement – that with representation comes the responsibility to put in to the system?
Am I arguing that nothing needs to be done with our heath care system? No. There clearly are problems with it that need to be solved. The employer based system needs to be replaced. Not with a public system, but with an individual based system.
Is it frightening where this particular bill leads us? Yes. Very much so.
