Single Payer
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Kucinich Tries to Kill Vote on Medicare For All
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Many Roads to Divide and Conquer Healthcare
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Why Do We Need a Public Option Anyway?
Can't Make Your Policy Federal? Empower the States.
Published October 01, 2009 @ 05:54PM PT
It’s been a dominant theme in how Congress has handled health care since the creation of Medicaid. Can’t find a way to federalize your policy? Then downscale it to empower states to take it on themselves. That strategy was on full display today as members of the Senate Finance Committee, unable to overcome stiff resistance from a more-or-less unified Republican nay-saying, and the strangely conservative votes of one Sen. Blanche Lincoln, opted to kick it to the states. It’s like sending a baseball player to the minors -- flourish there, and you may actually make it back to the Big Show to become federal law.
Two amendments and one proposal yet to be drafted as an amendment made this “Empower the States” day in the Senate Finance Committee.
Sen. Ron Wyden (D-OR), a creative and progressive force on the issue of health care, got an amendment pass that might well be called the “You show us how it’s done” amendment. In the Baucus bill, states are given a certain amount of federal money to create the Exchanges. Rather than one big Exchange, each state has its own -- granting it greater autonomy in terms of design, making sure all plans abide by state-level regulations, etc. Wyden’s amendment takes it a step further. So long as the states create coverage for all of its citizens that’s as affordable, comprehensive and high-quality as an Exchange would have been, and has all the protections in terms of insurance reform and caps on out-of-pocket expenses that the plans in the Exchange would have had, and the legislature and the governor agree to apply for a waiver to the Secretary of HHS... you can do whatever you want.
So your state could create an Exchange, like Massachusetts. It could add the uninsured into the existing program for state workers and retirees, like Sustinet in Connecticut. It could create a state-level public option. Hell, it could create a statewide single-payer plan like many states (including New York) are already contemplating. Those with long memories will remember this was a scarcely-noticed but important provision of the Wyden-Bennett health care bill as well. It’s not just punting the tough decisions to the states. It’s giving them the ball and giving them the money to make it happen.
Not quite as comprehensive is the amendment by Sen. Maria Cantwell (D-WA), which passed with the support of all Democrats except -- you guessed it -- Lincoln. Washington State doesn’t have a public option or anything remotely like it. What they have instead is something called Washington Basic Health, where the most likely to be uninsured are eligible to purchase private insurance. Essentially, the State of Washington acts like a mega-employer, with the uninsured below 200% of the poverty line (about $44,000 for a family of four) as its “employees.” The state uses the size of its pool to negotiate great rates on premiums from four insurance companies -- much cheaper than this population could afford on the open market, with better coverage and smaller deductibles and out-of-pocket expenses. The individual or family gets to choose which plan they want.
Cantwell’s amendment allows states to set up their own version of Washington Basic Health. The rest of the Baucus bill already provides Medicaid for up to 133% of the federal poverty line, so this Basic Health plan would cover those between 133-200% where, as Sen. Cantwell notes, “75 percent of the uninsured population lives.” There would be extra protection for individuals -- participating plans would have to spend 85% of the cost of premium on health care, more stringent than plans in the Exchange. The state would get the subsidies that would normally go to individuals of that income range in the Exchange and use them to subsidize the cost of the Basic Health plans. On the plus side, this has dramatically saved money in Washington State, as they’ve negotiated for fantastic discounts. On the minus, if a state set up a Basic Health system of their own, people in that income window couldn’t opt-out and get a plan on the Exchange. The state gets the subsidies, not them. Plus Washington Basic Health itself is demonstrating the problem with relying on a state solution during a time of economic crisis. Go to its Web site and you’ll see a waiting list to get into Washington Basic Health and a warning of jacked up rates – both the results of the state’s fiscal crisis.
Finally, we’re hearing more and more of a proposal by Sen. Tom Carper to empower states to produce state-level public options -- a much less effective version that has popped up from time to time from the likes of Secretary Sebelius, Tom Daschle, and Bob Dole, among others. Carper’s exact plan is as yet vague, but it reinforces the trend of the day.
Relying on state governments for what you can’t push through at a federal level may have some downside, but its biggest upside is it allows the more progressive states the opportunity to lead. We could look to Canada, where their single-payer system spread province-by-province. But better examples are right here in the U.S. After all, Medicaid is set to federalize coverage to 133% of the poverty line -- a threshold that some states have already reached. The concept of the Health Exchange is liberally borrowed from Massachusetts (Utah has its own Exchange, and California tried to get one in its health care reform attempt in 2007-2008). Today’s minor league players may be tomorrow’s rookie of the year.
(Photo credit: http://www.flickr.com/photos/aurenh/ / CC BY 2.0)
Single-Payer Health Care in Cartoons
Published September 05, 2009 @ 07:49AM PT
About once a year, someone makes the universal health care argument in the form of a cartoon and puts it on YouTube. This is a worthy entry into that genre. Clearly part of the appeal of single-payer health care, a system where all health insurance is paid for by the government out of a central fund to private hospitals and physicians, is its simplicity – you have the whole thing explained in about 4.5 minutes, maybe 10 if you want to get into “What If?” scenarios. But also exposed well in the cartoon format is the Looney Tunes-style contortions we put ourselves through now in order to keep up with the perverse incentives of for-profit insurance.
The comparison of firefighters as a government paid and provided service vs. a for-profit “fire insurance” industry was also taken up in an op-ed by NY Times columnist Nicholas Kristof. New York City, in fact, used to have a disastrous private industry fire-fighting system. Instead of efficiencies through competition, it bred corruption and the threat of future financial pain for those who had just lost their possessions, usually because of a stroke of fortune. We wouldn’t stand for someone privatizing our police or our army or our fire-fighters or even our water treatment centers. But somehow, despite no other industrialized country standing for a system that makes a profit on basic health (some of them allow insurance companies to make a profit on add-ons and non-essentials, but the essentials are non-profit), we are convinced there’s value to a profit motive with incentives to deny care and avoid customers that are likely to need it that actually enhances our health. Although, when pressed, we’re not sure what that value is.
Sometimes it takes a cartoon to realize how much of our argument is about inertia.
The Indispensable Henry Waxman -- Energy and Commerce Votes Out Bill
Published July 31, 2009 @ 11:15PM PT
We began with five committees – two in the Senate and three in the House. The early money was on Max Baucus’ Senate Finance Committee to mark-up their bill first. Instead, they’re the only committee without so much as a draft of their proposal. Everyone else is done. Although the House did not have a full floor vote before breaking for the August recess, the fact that all committees with jurisdiction have passed a comprehensive health reform bill out of committee to the House floor is a historical accomplishment – all the more so because of the rollercoaster of the past few days.
Form where I’m sitting, this simply wouldn’t have been possible without two critical events in November. The first was the election of Barack Obama, obviously enough (we wouldn’t be reforming health care right now under John McCain.) But the second was Rep. Henry Waxman emerging the victor in his committee chairmanship fight with Rep. John Dingell. For the past two days, Waxman has been the indispensable man.
First, kudos to the staffs of Ways and Means, Energy and Commerce, and Education and Labor for the leap forward in transparency. Every single one of the committee Web sites allows you to review all materials on HR 3200, including what happened in mark-up. I know it will become incredibly popular to say no legislator knows what’s in these bills as one of those "everybody knows" talking points. But folks, I, Random Blogger Dude, know what’s in these bills. That means it can't be that frakkin' hard. And now so can you:
- Ways and Means Mark-up and Amendments
- Education and Labor Amendments
- Energy and Commerce Mark-Up and Amendments
The path to get us to a vote in Energy and Commerce was, in a word, treacherous.
First, Chairman Henry Waxman made a deal with 4 of the Blue Dogs on Energy and Commerce who had put the breaks on mark-up. As you’ll recall, my bottom line on that deal was, “I just don’t see that the bill has lost anything.” The Congressional Progressive Caucus massively disagreed – with a rally and with a letter signed by 57 Democrats – 7 more than the Blue Dogs have in their whole caucus. What originally seemed like posturing for future fights – Rep. Lynn Woolsey’s pronouncement, “Many of us were for single-payer system standing up here today, but we have compromised. We have rallied because we want a plan with a meaningful public option, and we can compromise no more” seems like a refrain that you'll start to hear again and again during the full House debate in September – turned out to have real matter to it.
For one thing, there was no actual back and forth compromise to the Blue Dog "compromise." It was purely giveaways for the sake of advancing the bill. When the Progressives stood up, they made it clear that those concessions would come at a price. Despite Rep. Woolsey’s pronouncement, the liberal members of the Democratic Party were very much ready to compromise, leading to an amazing thing – this time, the bill actually got better. The deal that liberals struck with conservative Democrats doesn’t roll back the Blue Dog provisions, but does gets two big improvements into the bill. First, a legislative fiat for the public health insurance option to negotiate for the best rates on prescription drugs and hold prescription benefit managers – the middlemen who arrange the deals between the government and Big Pharma – to a much higher standard than the loosey-goosey Medicare Part D program. Secondly, and far more importantly, a restriction on how much private insurance companies can jack up the rates each year.
This is probably the biggest improvement in the bill since it first dropped weeks ago, and represents a big step forward in consumer protection. Currently, private insurance can raise premiums as high as they want whenever they want on individuals, leading to a preposterous 30% jump in premiums for Anthem Blue customers in the Bay Area. They also don’t need to justify such a jump other than by "what the market will bear" – similar to how the number of medical malpractice lawsuits has plummeted in Texas yet malpractice insurance premiums continue to rise. Now, private insurance plans in the Exchange will be restricted to 150% of the rate of medical inflation for that year. So if costs go up 4% from 2014-2015, the Humana plan in the Exchange can raise its premiums 6% in 2015. It cannot raise its premiums 9-15% for the heck of it. Of course, the insurance company can apply for an exception – there may be some strange reason why it’s necessary – but such an exception has to be approved. You have to actually make the case.
The last important gain for the Progressive Caucus is less substantive. It’s mostly symbolic. But it’s an important symbol given the years of passionate advocacy for an American single-payer, Medicare for All solution to our health care crisis. A full House floor vote will allow, for the first time in history, an up or down vote on replacing HR 3200 entirely with a single-payer system.
With no disrespect to the long and storied career of Rep. Dingell, it is almost impossible to imagine him navigating the minefield like Waxman has for the past week. As a sharp contrast to the “let’s all get along now” negotiations of Max Baucus, which have only resulted in endless delays on Senate Finance, Waxman’s negotiating sessions with Mike Ross of the Blue Dogs have been contentious and, at times, explosive. It is likely part of the reason the Blue Dogs’ demands were so meager is because Waxman lived up to his reputation as a relentless negotiator. He was reportedly even willing to have the bill bypass his committee and go to the House floor if the Blue Dogs didn’t step down from their most radical demands. Similarly, Waxman was able to quickly get the Progressive Caucus what they needed to move forward, in no small party because, as Ezra Klein wrote of Ted Kennedy, “[he] has, over the years, given people on both sides of the aisle a pretty clear sense of his core values…. when [he] cuts a deal that seems to diverge from his principles, there's an underlying sense of trust that that was the best deal he could get.” (Ezra explicitly puts Waxman and Sen. Orrin Hatch in the same category). Finally, Waxman had by far the roughest mark-up. The public health insurance option is the most contentious issue in health care right now. Abortion is the most controversial issue in American politics. Waxman navigated his way through both, and got votes to pass the bill out of committee.
There was not a single easy step in that process.
So in Waxman’s short tenure as chair of Energy and Commerce, he’s managed to get cap-and-trade to a successful vote in the House, and he’s been able to get a comprehensive health care bill out of the committee for the first time in history. It’s fitting that the best commentary of all came from the man he replaced – Rep. John Dingell:
“Mr. Chairman, you’ve done a superb job. You have every right to be proud.”
Bill Moyers, Ezra Klein and the NY Times: The Best of This Weekend
Published July 26, 2009 @ 07:54PM PT
The best part of being semi-obsessed with health care policy and politics is we’re truly living in a flood of information. Every Sunday morning talk show, every newspaper, every political blog is talking about health care to one extent or another. The bad part is that a lot of the stories are “the same old stuff” – political theater and horserace stuff that doesn’t actually contribute to a greater understanding. Do we really need to know that President Obama is saying the same things in private to Chuck Grassley that he said back publicly back in March? Did anyone learn anything new from David Axelrod? Do we really need another, “Gosh, Obama has a lot to lose if he doesn’t get health care” article?
So every Sunday, I want to post the best of the best – the three must-reads or must-watches that will really help you parse what’s going on.
1.) Bill Moyers Journal – “Debating Healthcare Reform”
Bill Moyers has consistently showcased the voices in our national debate that we should listen to more. Two weeks ago, he hosted a riveting interview with former Cigna executive Wendell Potter, who’s made it his mission to make transparent the workings of a private insurance that’s focused more on Wall Street than its customers.
This week, he held a but no less important discussion with Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and one of the best-spoken proponents of single-payer reform in health care, and Trudy Lieberman of Consumer Union and the Columbia Journalism Review. Since so much of the debate this week has focused on whether Obama is looking to change too much about health care, Moyers turns the tables to talk about whether the reform plans being offered will actually change too little. As Moyers reports:
Meanwhile, supporters who want to scrap the present system for fundamental change are staring glumly through the fog of war at a battlefield in total disarray. They fear that in the White House's desire to get a bill -- any bill -- passed by Congress, it will have been so compromised, so bent to favor the big interests, that it will be less Waterloo than water down, a steady diluting of what they'd hoped for, or America needs.
PBS does not allow for embedding videos (come on, folks! It’s 2009!), but you can view the whole episode on their site.
2.) Ezra Klein, “The Ghosts of Clintoncare”
Folks like William Kristol are openly hoping for a repeat of the defeat of Bill Clinton’s health care plan, which helped spike a Republican resurgence and the Gingrich Revolution. Democrats in Congress are openly worried that pushing too hard on health care reform and losing will lead to a backlash like what they went through in 1994. Everyone wants to analyze the current health care fight in the light of Bill Clinton’s political wake.
But until Ezra Klein wrote his piece in the Washington Post this week, few paid attention to the other fallout of health care reform’s failure in 1994 – how we as patients and consumers actually got all of the demerits of Clinton’s plan anyway, but with none of the benefits.
But then a funny thing happened: Managed care came anyway. By last year, only 7 percent of American workers were in "traditional" indemnity health plans, while the rest of us -- or at least those of us fortunate enough to have insurance -- were swimming in the alphabet soup of HMOs and PPOs and HDHPs. We're all in networks now. We don't get our choice of doctor. There's no appeals process. No out-of-pocket caps. Nothing to stop insurers from rejecting our coverage applications based on preexisting conditions. And if we don't like our insurer? Tough.
"We got managed care," says Chris Jennings, who was one of Clinton's top health-care staffers. "But we didn't get the things that would protect us from managed care. We got the Wild West version of it."
Read all of Ezra’s aricle here.
3.) The New York Times editorial, “Health Care Reform and You”
If my inbox and some of the comments sections are any indication, people are hungry for details on the proposals coming out of the House and Senate. But they don’t want spin and they don’t want legislative language. They want to know what’s in it for them. The New York Times offers the longest editorial you’re every likely to read – and they break it down in as simple language as I’ve seen done anywhere:
The health care reform bills moving through Congress look as though they would do a good job of providing coverage for millions of uninsured Americans. But what would they do for the far greater number of people who already have insurance? As President Obama noted in his news conference last week, many of them are wondering: “What’s in this for me? How does my family stand to benefit from health insurance reform?”
Many crucial decisions on coverage and financing have yet to be made, but the general direction of the legislation is clear enough to make some educated guesses about the likely winners and losers.
Read the whole editorial here.
(Photo credit: World Economic Forum on Flickr.)
"Outlawing Private Insurance" Is the New "Obama Birth Certificate"
Published July 21, 2009 @ 08:52PM PT
Did you hear about how the constant mantra of "If you like what you have, you can keep it?" isn't true? That President Obama, or the House Democrats, or the Romulans somehow snuck a clause onto page 16 of HR 3200 (America's Affordable Health Choices Act) which would effectively outlaw private insurance? That private insurance would be forced not only to compete with the private plan but become no different than the public plan? It's insidious - how did they think we wouldn't notice?
Well, for starters, because it ain't there.
This is not a new strategy for killing reform. Betsy McCaughey in the 1990s performed a hideously inaccurate "close reading" of Bill Clinton's reform bill, complete with section number citations, that seemed to suggest that everything you could possibly fear about Clinton care really was true. Of course, it still wasn't, and the idea that a politician who had popped out of nowhere (but soon would be running for Lt. Gov. of New York on the Republican ticket) had found hidden passages that every policy wonk had missed was always a little fairy tale-ish. But once her article hit The New Republic, it couldn't be retracted, and the forces of a status quo were able to effectively scare the bejeesus out of the general populace.
In 2009, however, we have the blogosphere, including yours truly. Two stylistic points before we hit the heart of the matter:
1.) Much like the president's birth certificate, which suddenly is in the news again (in addition to being right here), this is a manufactured controversy. Not only that, it strains the bonds of credulity. First Read asks of the birthers: "Let's get something straight: If Obama weren't a United States citizen, don't you think the Clinton campaign (first) or the McCain camp (second) would have said something during the two-year-long presidential campaign?" Ditto with HR 3200. If it actually outlawed private insurance, don't you think the Eric Cantors and Paul Ryans of the Right would be bringing it up every chance they got - and don't you think the John Conyers and the Dennis Kuchinichs of the Left would be doing an end zone dance?
2.) Honestly, if the Romulans were going to hide something that explosive in a 1,018 page bill, don't you think they would have made sure to hide it outside the first 20 pages? (Personally, I'd hide it in page 898, which is the section on the Public Health Workforce. Just seeing that page number makes me sleepy.
So what is on this page 16? This describes what happens to the completely unregulated individual insurance market which, not for nothing, is where the abusive parts of private insurance are on most frequent display, including exclusions on the basis of pre-existing conditions. If you already have a health insurance plan - nothing happens for the first five years. And by nothing, I mean nothing - they can't accept new customers but they also can't jack up your rates (individual market plan customers for Anthem Blue saw their premiums jump 30-40% this year). After year 5, the ground rules change. If the plan you're enrolled in as an individual meets the minimum standards offered in the Health Insurance Exchange, that's fine. If not, the private insurance company is required to offer you a plan that does meet the minimum standard benefits.
What determines what goes into this minimum standard benefits? You might want to keep on reading to page 27. The qualified benefits package includes coverage for hospitalization, doctors visits, prescription drugs, mental health, maternity, etc. that is defined to be "equivalent to the average prevailing employer-sponsored coverage." So right from the start, the definition is what private employer-sponsored plans are already providing. The Health Insurance Exchange is itself populated with private insurance options and, according to page 81, anyone buying from this transparent marketplace, whether because their employer doesn't offer them insurance or because they work for a small business "may choose coverage under any such plan" both for themselves and for their dependents. And, of course, those who cannot afford a plan are subsidized so they only pay a fraction of their income, and Uncle Sam picks up the rest.
Read that again. Not only is private insurance not being outlawed, it's receiving subsidies from the federal government.
Some of the folks who have emailed me presume that the House is trying to rig the game in favor of the public health insurance option, which is already widely expected to give the private insurance market real competition particularly on cost and quality. But they've got it backwards. If the measure of the benefits is that they're equivalent to prevailing employer-sponsored private coverage, it's private insurance that's driving the conversation. (And believe me, this drives progressives who were hoping for a stronger public option up the wall! That frustration and outrage can't be feined.)
So I suppose it may be somewhat misleading to say, "If you like your coverage you can keep it." It would be more fair to say, "If you like your coverage, and it isn't so insufficient and abusive that even most private insurers would have qualms screwing you over that badly, you can keep it."
Update: (7/23/09 at 9:05 am PT)
Ezra Klein's says the same thing shorter and funnier.
(Photo credit: alvy on Flickr.)
Bipartisan Support for Removing Barriers to State Single-Payer Experiments
Published July 18, 2009 @ 03:00PM PT
The mark-ups in the House may seem to have gone by in a twink, but they crammed much matter into the days they had, with an all-night session to 6 am for at least one of the committees. But one amendment stands out from the rest. Dennis Kucinich (D-OH) who was the only presidential candidate in 2007 to embrace single-payer Medicare for All, introduced an amendment to finally make it possible for states to experiment with creating single-payer without fear of litigation from businesses.
Whether the country as a whole is ready for an equitable system whereby the government pays for everyone’s health care costs out of tax revenue is clearly a debatable question. But many states and localities may already be. A consistent roadblock has been legal interpretations of ERISA, the Employee Retirement Security Act of 1974. ERISA governs the laws surrounding benefits offered by an employer, including health care benefits. ERISA, of course, does not require employers to provide health insurance. The fact that it does not always comes up when as the basis of legal challenges for employer mandates, like the one that Golden Gate Restaurant Association launched against Healthy San Francisco, the City’s “public option” for the uninsured, paid for in part by a modest employer mandate. It’s ironic for a bill that was originally developed to guarantee transparency and a minimum set of pension and benefits has been used so often to prevent more progressive benefits from being developed at the state level. Since a state-based single-payer system would doubtlessly either involve more money from employers in the form of a higher tax rate to compensate for the benefit costs they no longer have to provide, or either forbidding or discouraging them from purchasing benefits plans, you can bet someone would squawk. The possibility of a drawn-out legal process was always part of the calculus.
If the House bill passes and Kucinich’s amendment is still attached, that’s not in the calculus anymore. That’s good news for those of us in New York, where Assemblymember Dick Gottfried has begun aggressively pushing a New York Health Plus plan which would enroll all New Yorkers into a state-financed health insurance system built on the already-successful Family Health Plus and Children Health Plus (employers would be able to “opt-out” and provide their own benefits if they insisted). It’s good news for the efforts at Sustinet in Connecticut and the single-payer proposal in California, as well as half a dozen other states. They’ll have other challenges to be sure, from funding to ideology. But this was an unnecessary barrier, and one removed with bipartisan support, 25-19.
States are supposed to be the laboratories of democracy. In every state, health care costs are either the biggest or second biggest item in the budget. Every state is already spending exorbitant amounts of money on a fragmented system that leaves far too many behind. Washington may not be ready for single-payer, but it shouldn’t get in the way of Albany, Sacramento or St. Paul giving it a try.
(Photo credit: Cheshire County Democrats on Flickr.)
Ain't Nothin' New on Rangel's Proposed Surtax
Published July 14, 2009 @ 12:23AM PT
The House bill’s timeline was slowed down—we were expecting a bill to drop Friday and, as of this writing, it still hasn’t dropped. So perhaps Rep. Charles Rangel, chair of Ways and Means and one of the Tri-Committee with jurisdiction for health care reform, was trying to get things started. Or perhaps he was just stating the obvious. Rangel’s proposal to add a dedicated surtax to individuals making $280,000 and families making $350,000 may seem familiar. That’s because it’s been cited as the obvious source of income for health care reform. Repeatedly.
Indeed, if you go back to the presidential campaign, every Democratic candidate pledged rolling back the Bush tax cuts for the wealthiest 2-3%, or letting them expire. That threshold is the oft-mentioned quarter-million dollar figure. Indeed, rolling Bush’s tax cuts and ending the Iraq War seemed to be the “go to” answers for every spending project from candidates like Bill Richardson. Since Obama survived the primary, that made him the keeper of the torch for the idea of financing health care reform by letting the tax cut for the wealthiest Americans expire, while not raising taxes on those making less than $250,000. He’s been consistent to that thus far in his proposals, even in the face of an economy that would seem to discourage raising taxes – politically, at least. His plan to limit charitable deductions for the top tax bracket and use that money to pay for health care is a downsized derivative of the original.
So Rangel’s proposal would seem to be the obvious choice. He’d create three tax brackets -- $350,000, $500,000 and $1 million for couples, and $280,000, $400,000 and $800,000 for individuals – and increase them 1%, 1.5% and 3%. Incidentally, that means people making $1 million would be paying the same rate as during the Clinton years – you know, the longest sustained period of economic growth that didn’t involve a war. Do that, and you raise $550 billion for health care, which would get you 1/3 to 1/2 of the way there, with the rest to be filled in with finding savings in Medicare and Medicaid. It’s a natural fit for the Obama Administration.
So why hasn’t it been mentioned ‘til now?
In part, Baucus and Grassley over at Senate Finance latched onto the idea of removing or capping the tax exclusion for benefits, and that seemed like an obvious big pot of money that you could take from one part of the health care financing system and move to another part. Obvious, that is, until some pollster actually asked Americans what they thought, and we hated it. Ezra Klein reported on all of the revenue options that Senate Finance is considering in its place: up Medicare payroll tax slightly; apply new taxes to investments; add a regressive Value Added Tax or national sales tax like they have in many European countries; or add a whole sheaf of consumption taxes. That’s a pretty far way to go just to get around the financing scheme that every Democratic presidential candidate ran on in the first place.
There’s no question the richest 2-3% benefited well under a tax cut system that we simply couldn’t pay for and has been rendered unsustainable. They’re traditionally more likely to take advantage of deductions and giveaways in our tax code, making fewer of them likely to pay the full percentage. It’s a demographic that has benefited disproportionately to the billions of dollars spent bailing out the economy. And, not to put too fine a point on it, they’re paying for the uninsured and the high costs of preventable chronic diseases already in taxes and premiums – they’re just not getting value. It’s easy to demagogue in patently false ways. Republicans will say it will hurt most small business owners. It won’t. They’ll say it’s socialism. It’s not. It’s the same progressive tax structure used by Eisenhower, Nixon, Ford, Reagan, Bush I and Bush II.
Looks like the first choice was the best one we’ve seen so far.
Bonus post!:
By the way – to go the Ecclesiastes route of “Ain’t nothing new under the sun,” check out this answer from John Conyers’ Web site on what we would need to do to finance HR 676, the Medicare for All bill: “Sources of funding will include: Maintain current federal and state funding for existing health care programs; Closing corporate tax loopholes; Repealing the Bush tax cuts for the highest income earners; Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax); Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners; One quarter of one percent stock transaction tax.”
Yup, it’s all of the options being considered by the House and the Senate. Why has Congress been so quick to compromise away from single-payer? Well, if taking a vote for one funding source is throwing the House and the Senate into such paroxysms of fear, imagine them screwing their courage to the sticking point to vote for all of them at the same time!
(Photo credit: studio08denver on Flickr.)
