Tuesday, December 08, 2009

Health care reform shorts:
Deficits matter more than people?

It has been hard to understand why, having set the health care reform train in motion, the President and administration generally have seemed unwilling to dig in and push to get a reform that people will appreciate. After all, if you take actions that presumably will change how people get their doctoring -- something folks get exercised about since for individuals this can be life or death -- you'd think you'd want to make darn sure most people liked the result. That seems an elementary political calculation. But the administration has been acting as if anything that passes that is labeled "Health Care Reform" will do the trick with the voters.

On Monday, Ezra Klein shared what seems to be the explanation for the White House's passivity.

Generally, Democrats want to reform the health-care system because they want to cut the number of uninsured. The Obama administration's commitment to health-care reform stems from their belief that it's the first step towards cutting long-term deficits.

That is, their eye is on the ball, but it isn't the ball that will provide affordable care to most people. They want reform in order to cut the federal deficit.

Washingtonians are always getting fixated on the deficit, the accumulated amount the government spends that exceeds what it takes in from taxes. And the deficit is huge -- $1.4 trillion dollars, whatever that means. I'm not going to pretend that a number that big actually means anything to me. The government gets the money that it spends but doesn't have on hand by borrowing it through issuing bonds; this costs money in the form of interest paid to the people/countries that buy the bonds.

All this sounds scary, but it shouldn't. Compared to the overall size of the U.S. economy, those numbers aren't so large. And their scale is not unprecedented as this chart shows.

But the real reason that deficit concerns shouldn't be constraining what sort of health care reform we're allowed to have is that the deficit would be easy to fix if the country stopped operating on one or both of two nonsensical premises we are trapping ourselves in. There are obvious solutions that break through false constraints we pretend limit our options.
  • We could raise more taxes from people who have more than they need. We used to. In the Eisenhower era, all these Wall Street rip-off artists who've been robbing us blind would have been taxed at a 91 percent rate. In 1986, they would have paid 50 percent of income. But thanks to the best Congresses and Presidents that their money could buy, nowadays they pay only 35 percent of their income for the common good. They could pay more -- really, does anyone need more than $250,000 a year? I doubt it.
  • We could cut our bloated military budget. In 2009, what with two wars of dubious use to us, some 900 bases around the world, nearly 1.5 million troops, dozens of weapons systems in use or development, and the management structure to keep track of all this, the military sucked up somewhere between $900 billion and $1.1 trillion. Or at least that's more or less what they tell us -- since a lot of secrecy prevails, actual costs may be more, much more. Expenditures on our war apparatus are something like six or seven times those of the country with the next largest military (China). If we really wanted to pay down the federal deficit, we could probably cut half of this without noticeable loss of security. After all, the last set of folks who actually injured a large number of people in this country did the deed with box cutters and scheduled airline flights. This war budget is "patriotic" waste that lines the pockets of "defense" industries and the politicians they buy -- but keeps us from attending to the actual needs of the people.
But no, the federal deficit constrains action on health care for all. This is kind of sickening to contemplate, actually. Everything for greed and war; pennies for sick people. That's not an attractive picture, but it is the country and apparently the administration we have today.

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