Republican Health Care Reform
Recent responses by Republican leaders to Democratic proposals on health care reform remind me of the scene in the movie Goldfinger in which Goldfinger has James Bond strapped to a table and sets a powerful laser moving up the table to cut Bond in half. Bond becomes agitated (to say the least) and asks what Goldfinger wants. Does he want him to talk? Goldfinger seems slightly puzzled or amused by the question. "No, Mr. Bond, I want you to die," he replies.
Republicans can't repeal Medicare (although it is clear that at some of them would like to, as former House majority leader Dick Armey showed on Meet the Press on Sunday), but they clearly want health care reform to die.
But if you held the Republican party's collective feet to the fire (metaphorically, of course), what kind of plan would they come up with? I would imagine it would look something like this:
1. Lower costs would be achieved through greater competition, by allowing any health insurance company licensed in any state to sell insurance in all 50 states.
2. Incentives for employers to provide health insurance would be provided through tax credits that would be in addition to the tax deductions already allowed.
3. Incentives for individuals to purchase health insurance would be provided through income tax deductions for premiums paid.
4. Revenue to pay for the tax credits and deductions could be provided by classifying employer-provided health care premiums as "wages" to employees subject to both FICA (Social Security and Medicare taxes) and federal income tax. (The employee would be entitled to an income tax deduction, consistent with #3, if the employee itemizes).
And this is not a complete strawman, because Republicans have actually proposed all of these things, or something like them, at one time or another.
The first proposal is insidious in a subtle way, because it seems like such a simple, open-market solution, but it would have the effect of destroying any meaningful state regulation of health care. All health care insurers would flock to the state with the weakest regulations, and every state would have an incentive to weaken their regulations in order to either attract or keep insurers in their state (and so increase tax revenues).
The effect of the second and fourth proposals would be to shift much of the cost of health insurance from the employer to the employees. And the deduction allowed by the third proposal would be valuable to high-income taxpayers but do no good whatsoever for those who don't have enough income to pay federal income tax, or don't have enough other deductions to itemize (usually those who don't own their own homes and so don't have mortgage interest or real estate tax deductions).
The fact that these proposals would benefit insurance companies, employers, and the wealthy, while imposing additional taxes on average working Americans, is, of course, completely inadvertant and unintentional.
And anyone who suggested otherwise would be un-American in trying to incite class warfare.
Republicans can't repeal Medicare (although it is clear that at some of them would like to, as former House majority leader Dick Armey showed on Meet the Press on Sunday), but they clearly want health care reform to die.
But if you held the Republican party's collective feet to the fire (metaphorically, of course), what kind of plan would they come up with? I would imagine it would look something like this:
1. Lower costs would be achieved through greater competition, by allowing any health insurance company licensed in any state to sell insurance in all 50 states.
2. Incentives for employers to provide health insurance would be provided through tax credits that would be in addition to the tax deductions already allowed.
3. Incentives for individuals to purchase health insurance would be provided through income tax deductions for premiums paid.
4. Revenue to pay for the tax credits and deductions could be provided by classifying employer-provided health care premiums as "wages" to employees subject to both FICA (Social Security and Medicare taxes) and federal income tax. (The employee would be entitled to an income tax deduction, consistent with #3, if the employee itemizes).
And this is not a complete strawman, because Republicans have actually proposed all of these things, or something like them, at one time or another.
The first proposal is insidious in a subtle way, because it seems like such a simple, open-market solution, but it would have the effect of destroying any meaningful state regulation of health care. All health care insurers would flock to the state with the weakest regulations, and every state would have an incentive to weaken their regulations in order to either attract or keep insurers in their state (and so increase tax revenues).
The effect of the second and fourth proposals would be to shift much of the cost of health insurance from the employer to the employees. And the deduction allowed by the third proposal would be valuable to high-income taxpayers but do no good whatsoever for those who don't have enough income to pay federal income tax, or don't have enough other deductions to itemize (usually those who don't own their own homes and so don't have mortgage interest or real estate tax deductions).
The fact that these proposals would benefit insurance companies, employers, and the wealthy, while imposing additional taxes on average working Americans, is, of course, completely inadvertant and unintentional.
And anyone who suggested otherwise would be un-American in trying to incite class warfare.
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