Taxing Healthcare: Income Distribution by Another Name?

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Taxing Healthcare: Income Distribution by Another Name?
Published: Friday, 17 Jul 2009 * 12:35 PM ET Text Size By: Mark Koba
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Democrats in the House have rolled out an ambitious $1 trillion plan to fund healthcare reform that forces businesses and wealthier Americans to pick up the costs with higher taxes.

But while the House bill proposes revenues for healthcare, some analysts say the real goal could be to re-distribute income for an ailing economy.

"The tax increase will put the tax code to pre-Reagan days," says Chris Dolan, a professor of political science at Lebanon Valley College in Pennsylvania.

"On the whole, what the bill is trying to do is move the tax code back some 33 years when it was higher," says Dolan. "It's tax increases under the guise of healthcare reform to help the economy."

According to Dolan, there's nothing in the House bill that would keep the government from using the tax increases to fund spending on other projects. "I’ve just looked at the House version and there’s nothing in there that says the money is only earmarked for healthcare," says Dolan.

The bill is working its way through Congress as the House Ways and Means Committe voted Friday in favor of the measure. Republicans and three Democrats on the committe failed in their efforts to remove any of the tax increases. The Senate is working on its own version of a healthcare reform bill.

"In fairness, to Obama, it's not his bill," says Al Waxman CEO and senior managing member, Psilos Group, a venture capital firm for the healthcare industry. "But it clearly puts people in a situation that looks like some are in favor of wealth re-distribution."

John Barrie, a tax expert at the law firm of Bryan Cave LLP, also sees the House proposal as a move to increase overall taxes on the wealthy.

"I think the administration wants to raise taxes on the rich," says Barrie. "Previous earmarks for a segmented tax increase have not been as blatant as this."

(Calls and e-mails to the House Ways and Means Committee, as well as to the office of Rep. Henry Waxman (D-Ca), a main sponsor of the bill, for comment on possible tax re-distribution were not returned.)

As for the bill itself, healthcare taxes would raise an estimated $544 billion over ten years with these increases among the proposals:

5.4 percent tax increase on individuals making more than $1 million
A gradual tax beginning at $280,000 for individuals, $350,000 for couples
Employers not providing coverage face penalty of up to 8 percent of all their worker's wages
Individuals who decline affordable coverage would pay 2.5 percent of incomes as penalty, up to average cost of a health insurance plan
Whether the taxes are used for healthcare or not, analysts say the proposals as they stand would do nothing for a struggling economy.

Financial Crisis: Then and Now
"The taxes will have an adverse affect that will hurt the bottom lines of small businesses," says Patrick Paule, an employee benefits consultant at Savage & Associates. "The taxes small businesses have to pay will limit wages and bonuses and force them to cut jobs. That will have a negative impact on the economy."

And wealthier Americans targeted to be taxed are sure to push back, says Paule.

"Knowing that most of these individuals making in excess of $280,000 a year are corporate executives and business owners, they will be fighting to stop the increases. They get hit both as individuals and business owners with the taxes."

Americans spent $2.4 trillion on healthcare in 2008, according to the Congressional Budget Office. That spending is projected to reach $4.3 trillion by 2016, far more than the $544 billion expected from the tax increases.

A Gallery of Medical Marijuana
Experts also say that along with hurting the economy, the tax increases won't do the job they're intended for.

"This wouldn’t even cover the amount of the cost of healthcare," says Gary Milkwick, director of operations for the Tax Club, a tax counsel for small businesses. "They are not going to have enough money. They are way short of what they want to achieve."

But if it comes to paying higher taxes for healthcare, the nation's middle class has no problem with wealthier Americans footing the bill, says Robert Blendon of the Harvard School of Public Health and the Kennedy School of Government who conducted a survey on funding healthcare.

"What people in the middle believe is that those who were well off while they suffer in the recession, should pay for healthcare," says Blendon.

Some 70 percent of those recently surveyed by Blendon favored increasing income taxes on people making more than $250,000 a year. "The only other approach that won such approval, 72 percent, was raising taxes on cigarettes," Blendon says.

For their part, Democrats say the tax increases will affect only 4.1 percent of tax filers who report small business income and apply to only the top 1.2 percent of households or those who earn one-quarter of all income.

However, raising taxes on anyone to pay for healthcare could have huge political costs for Obama, says Bridget Crawford, a professor of law and associate dean at Pace Law School.

"If he supports this, he's playing into Republican fears with the tax increases," says Crawford. "They accused him of being a tax and spend liberal during the presidential campaign and he's falling right into that."

As to what should be done to resolve the healthcare problem, most analysts say raising taxes is not the way to go. "The whole idea of health care reform is to have people do a better job of managing healthcare costs," says Al Waxman. "I don’t see how raising taxes does that."


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"Costs of care are the culprit," says Patrick Paule. "If I increase your taxes or force you to buy insurance does that lower the cost of an MRI or cancer treatment? Absolutely not."

"Raising taxes might help fund the deficit, but it won't help out on healthcare costs," says John Barrie. "But I don’t think it will go through. The Senate side will not accept what the House is proposing."

Where The 200K+ Crowd Lives
Convincing taxpayers to lend a hand to others in a sick economy is probably the biggest hurdle of all to the House plan, says Pace Law's Bridget Crawford.

"It's the wrong time to be asking people to foot this bill," says Crawford. "Even if people have homes and make good money these days, they still might not feel like they can help pay for other people's health insurance."
 
The problem is no one is suggesting a complete overhaul of the system. Not only does the insurance need to be overhauled but so does the malpractice system in this country as well as the medical school system.

First, medical school. In lots of countries with nationalized health care you have nationally subsidized medical school. Doctors in Germany are not going into massive debt to become doctor. My ex Girlfriend went directly from secondary school ( Called Gymnasium in Germany) to medical school and she didn't amass huge debt to do it.

Second, malpractice insurance. There are far less lawsuits in Canada, England, most of Europe and other nations where the loser pays the winner’s legal costs. I have for years been opposed to loser pays because most of the time it used to do nothing but keep truly injured people from suing because the damage done to them is hard to prove. I actually think that other states should look at New Mexico as their paradigm of medical malpractice. TO get to court you have to present you case to the med mal board made up of Doctors, lawyers and lay people. If they do not certify your case for court, no lawyer is going to take it there because the chances are very high that they are going to no recover. I think you could go one better by saying that if you take your med mal claim to court after it has be non certified, and you lose, then hell yes you pay costs for the other side.

The premiums that Doctors pay for med mal insurance is outrageous. It is absolutely part of what drives our prices up.

I know that a lot of what is broken in the system stems from insurance companies who have a duty to stock holders to show a profit. If you are paying for peoples medical care that is hard to do. But it what is supposed to be done. Instead we have high school educated phone answers looking in books to determine if what you got is covered. Exactly the same thing we were told we would get with Hilary care.

We have to tear down the entire system from Soup to nuts, and then build it back up. WHich is why doctors, and insurers and lots of citizens don't support health care reform.
 
spintop is right....but it is also called "progressive taxation" and both parties have used the term and the power to tax that way
 
The problem is no one is suggesting a complete overhaul of the system. Not only does the insurance need to be overhauled but so does the malpractice system in this country as well as the medical school system.

First, medical school. In lots of countries with nationalized health care you have nationally subsidized medical school. Doctors in Germany are not going into massive debt to become doctor. My ex Girlfriend went directly from secondary school ( Called Gymnasium in Germany) to medical school and she didn't amass huge debt to do it.

Second, malpractice insurance. There are far less lawsuits in Canada, England, most of Europe and other nations where the loser pays the winner’s legal costs. I have for years been opposed to loser pays because most of the time it used to do nothing but keep truly injured people from suing because the damage done to them is hard to prove. I actually think that other states should look at New Mexico as their paradigm of medical malpractice. TO get to court you have to present you case to the med mal board made up of Doctors, lawyers and lay people. If they do not certify your case for court, no lawyer is going to take it there because the chances are very high that they are going to no recover. I think you could go one better by saying that if you take your med mal claim to court after it has be non certified, and you lose, then hell yes you pay costs for the other side.

The premiums that Doctors pay for med mal insurance is outrageous. It is absolutely part of what drives our prices up.

I know that a lot of what is broken in the system stems from insurance companies who have a duty to stock holders to show a profit. If you are paying for peoples medical care that is hard to do. But it what is supposed to be done. Instead we have high school educated phone answers looking in books to determine if what you got is covered. Exactly the same thing we were told we would get with Hilary care.

We have to tear down the entire system from Soup to nuts, and then build it back up. WHich is why doctors, and insurers and lots of citizens don't support health care reform.


I disagree with the premise that malpractice insurance drives up costs all that much. To the extent that they do, based on a Harvard study from a few years ago, the medical review tribunal system is unlikely to eliminate much of the cost because most of the costs involved with medical malpractice claims do not involve the easy cases where there was no doctor error. Instead, the cost from claims where errors were actually made by a doctor or physician.

There just aren't all that many truly frivolous lawsuits filed and, to the extent that frivolous claims are filed, they are usually disposed of quickly and at little cost. The tribunal system, while a good idea, doesn't do all that much on the cost front.

http://www.hsph.harvard.edu/news/press-releases/2006-releases/press05102006.html
 
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