On the radio, Mr. Bush suggested that we should â€œtreat health insurance more like home ownership.â€ He went on to say that â€œthe current tax code encourages home ownership by allowing you to deduct the interest on your mortgage from your taxes. We can reform the tax code, so that it provides a similar incentive for you to buy health insurance.â€
Wow. Those are the words of someone with no sense of what itâ€™s like to be uninsured.
Going without health insurance isnâ€™t like deciding to rent an apartment instead of buying a house. Itâ€™s a terrifying experience, which most people endure only if they have no alternative. The uninsured donâ€™t need an â€œincentiveâ€ to buy insurance; they need something that makes getting insurance possible.
Most people without health insurance have low incomes, and just canâ€™t afford the premiums. And making premiums tax-deductible is almost worthless to workers whose income puts them in a low tax bracket.
Whenever some wingnut proposes to solve X problem by offering tax deductions to make something more “affordable” I want to tear my hair and scream. For people in low tax brackets this really is the same thing as “Let them eat cake.”
Even if we took Bush’s comparisons to mortgage interest deductions seriously — the mortgage interest deduction doesn’t exactly make it possible for everyone to own his own home, does it? It’s a great benefit for people with average and above incomes, but owning a home is still way out of reach for people with lower incomes.
Of those uninsured who arenâ€™t low-income, many canâ€™t get coverage because of pre-existing conditions â€” everything from diabetes to a long-ago case of jock itch. Again, tax deductions wonâ€™t solve their problem.
Indeed. Bush’s plan “is tied to the average cost of family health coverage, which is currently $11,500 a year,” according to this article. I don’t have data handy, but I strongly suspect that if the insurance companies were not allowed to reject “undesirable” (i.e., sick) customers, that cost would be even higher.
While proposing this high-end tax break, Mr. Bush is also proposing a tax increase â€” not on the wealthy, but on workers who, he thinks, have too much health insurance. The tax code, he said, â€œunwisely encourages workers to choose overly expensive, gold-plated plans. The result is that insurance premiums rise, and many Americans cannot afford the coverage they need.â€
Again, wow. No economic analysis Iâ€™m aware of says that when Peter chooses a good health plan, he raises Paulâ€™s premiums. And look at the condescension. Will all those who think they have â€œgold platedâ€ health coverage please raise their hands?
Krugman writes that what’s behind this nonsense is a theory currently popular in wingnut think tank circles — that too many people have been spoiled by their health insurance, and if they had to pay for more of their health care costs out of their own pockets they’d be more frugal and do without luxury items. (Such as … ?)
In the real world I ‘spect not a whole lot of people demand medical procedures unless doctors tell them they should have them, and insurance companies can always refuse to pay for procedures they deem unnecessary, anyway. In my experience if you press a wingnut to explain what these luxury procedures are, usually the first item they list is “unnecessary tests.” Doctors are supposed to do a better job of guessing what’s wrong with you and not rely so much on the “luxury” of medical technology, in other words.
I realize there are people who demand tests for ailments that doctors know they don’t have. These people are called “hypochondriacs,” and most of ’em would benefit from seeing a shrink. But the wingnuts don’t want to pay for that, either.
Whatâ€™s really striking about Mr. Bushâ€™s remarks, however, is the tone. The stuff about providing â€œincentivesâ€ to buy insurance, the sneering description of good coverage as â€œgold plated,â€ is right-wing think-tank jargon. In the past Mr. Bushâ€™s speechwriters might have found less offensive language; now, theyâ€™re not even trying to hide his fundamental indifference to the plight of less-fortunate Americans.
As I wrote here — once upon a time the British government chose not to provide food aid during the Irish potato famine because (they believed) the Irish were lazy and backward and too accustomed to being impoverished farm laborers, and a little hunger might make them more ambitious. Beside, importing cheap food undercut food prices (bad for business), and if the Irish were given food without working for it they’d become dependent on government handouts.
So, more than a million Irish starved to death. If only they’d had more of those gold-plated potatoes.