You can see from this article just how skewed the debate on health care is going to be. I don't know whether the reporter is transcribing FUD from an insurance industry source, or has just internalized it, but let's unpack the notion that there will be terrific opposition to taxing "excessive" insurance benefits paid by employers to people earning more than $100K a year.

Where to start? Well, $100K a year is twice the median household income in the US, so talking about the impact on the "middle class" is just a touch deceptive. (Except that you have to havethree or four times the median income these days to feel "middle class".)

Then there's the amount of the impact, which maxes out at half a percent of income for people getting the "average" benefits package. What a terrible price to pay for universal coverage and removing the deadweight of paying for coverage for the uninsured and for all our excess morbidity and mortality. People getting more-than-average benefits packages would pay more, but then they're getting more from their employers, so what's the complaint, other than that they're well-off and entitled and don't want to pay?

Oh, and about that average: the cut-off points for taxing benefits are from a study published in 2004. The average cost of plans cited is current. Anyone think that the price of insurance has gone up by only 20% total over the past 4 years?  In other words, the cutoff was well above the average in 2004 when it was published, and there's no question that any legislation passed next year would put its cutoff well above the average too. Heck, it might even -- gasp -- set cutoffs according to the average family and individual plans in each state, so that people in high-cost states would bear an extra burden. Unless, y'know, there's no one in the entire federal government who can do simple arithmetic.

Why is it so important for insurance companies to skew the debate on this? Because what they would like is universal coverage along the lines of Medicare Part D: everybody ponies up to pay whatever they set as the going price, and the federal government picks up the extra tab. Taxation of excess benefits, community rating, anything that puts pressure on to reduce costs, is anathema for private companies under the current multiple-payer system because the most obvious target is that big fat 20% in administrative costs. (Yeah, there are lots of other ways to reduce spending, but they typically can't be made profitable when you customers can jump to another carrier every year.)

If this is what the discussion looks like when things have barely gotten started, I can't wait for the real thing. My only hope is that the anti-reform people are going to overplay their hand early, but I'm not holding my breath.